Using Sound Waves For Outpatient Neurosurgery 152
eldavojohn writes "Got a piece of malfunctioning brain tissue in your head? Want to avoid messy lobotomies and skull saws? Well, you're in luck; a study shows that acoustic waves can do the trick and will hopefully treat patients with disorders like Parkinson's disease. A specialist said, 'The groundbreaking finding here is that you can make lesions deep in the brain — through the intact skull and skin — with extreme precision and accuracy and safety.' They focus beams on the part of the brain needing treatment and it absorbs the energy, which turns to heat. The temperature hits about 130 F, and they can burn 10 cubic millimeters at a time. Using an MRI to see areas of heat, they can watch the whole time and target only what needs to be burned. The study consisted of nine subjects suffering from chronic pain that did not subside with medication (normally they need to go in and destroy a small part of the thalamus on these patients). After the outpatient procedure, all nine reported immediate pain relief and none experienced neurological problems or other side effects after surgery."
HI, FU! (Score:1)
this sounds like it could be a good video game!
How would you like your brain, sir? (Score:4, Funny)
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I'm sure it's more pleasant than having a metal probe supercoooled with liquid nitrogen held on my eyeball for five minutes, let alone needles stuck in my eyeball [slashdot.org]. "If I'd been strapped to a chair at Guantanimo when they did that I'd have confessed to anything."
If I had a brain cancer or a leaking blood vessel in my brain, I'd rather have this proceure done than have them saw my skull open, let alone die or become crippled.
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McGrew, that's the second time I read that journal entry
Thats the second time I have been freaked out of my friggin' mind
Please post a warning when you link to that story!
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Will do. You think you're freaked out reading it, how do you think I felt living it? I wouldn't wish a vitrectomy on my worst enemy, let alone the nitrogen probe.
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I mean, I got Lasik surgery done like 6 years ago (and I'm still wearing glasses, thanks for asking) and I was freaked out of my mind the whole time...
Reading about your experience makes me glad I didn't get anything more invasive
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"I do wish we could chat longer, but... I'm having an old friend for dinner. Bye. "
Hannibal would like this new tool.
Um (Score:1, Redundant)
The groundbreaking finding here is that you can make lesions deep in the brain—through the intact skull and skin—with extreme precision and accuracy and safety.
Ah, the miracle of modern medicine.
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Other parts of the body. (Score:4, Interesting)
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There's probably quite a bit of the body that has no pain receptors. You don't really need pain receptors on a lymph node, for example, so I would imagine there would be rather fewer of them.
I don't see why this couldn't be used elsewhere in the body, and I imagine as the technique improves, people will find all kinds of uses for it beyond killing cells. (For example, being able to selectively warm internal tissue might be quite valuable when treating hypothermia.)
RTFA (Score:3, Informative)
They already use it on some other tumors--I think some uterine tumors, for example. This version is for the brain and has some particular tricky problems associated with it, notably that the skull can absorb sound waves and its density varies--kind of like how when you build a nuke you need to focus the shock waves right, through solid materials of different densities.
(Only on Slashdot could you simplify something by comparing it to building a nuke)
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Possibly, but it might need to be made hotter. Neurons are one of the more sensitive cells in the body.
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There's also several clinical trials for using the technology on treating prostate cancer, breast cancer, liver cancer, and many other forms of soft tissue tumors. There's also studies being done to use focused ultrasound to break up clots within the brain that
How brain surgery is done these days. (Score:3, Insightful)
Actually I find the fact that we just go in there and destroy a relatively large part of the brain as the leading edge technology kind of amazing. The fact that it seems to work is even more amazing. But essentially this is a hammer, made to work on the opposite side of the wall. You still go in there and destroy whatever is there. Just weird to me that this is the cutting edge so far in brain surgery is all. Just goes to show how far we still have to go.
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You do realize, right, that ten cubic millimeters is not large? It's 2.15443469mm (yes, I used a calculator) on each side. Granted, most procedures will likely require more than one
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You do realize, right, that ten cubic millimeters is not large? It's 2.15443469mm (yes, I used a calculator) on each side. Granted, most procedures will likely require more than one ... shot? ... with the device, but such a small amount leaves a lot left untouched.
I don't understand how you arrived at that number.
when i did the math, my answer was that 10 cubic millimeters is 1 cubic centimeter.
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i think you confuse 10 cubic millimeters (10 mm) with a "cubic 10 millimeters" (1cm = 1000 mm)
ok, that makes sense. i was visualizing it wrong.
"10 cubic millimeters" is 10mm X 10mm X 10mm, while "10 cubic millimeters" is just over 2mm X 2mm X 2mm...
hmmm... ...there really should be some better terminology to express the difference more clearly.
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"10 cubic millimeters" is 10mm X 10mm X 10mm
lol what? That's 1,000 cubic millimetres no matter how you cut it. Surely you meant "10 millimetres cubed", which no one says, but makes a bit of sense.
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But that's not quite right.
This is not the cutting edge of brain surgery. This is better than the cutting edge, it's the burning acoustic probe of brain surgery.
I think it's pretty damn cool that we can operate on a brain without having to open up the skull or damage surrounding tissue to get at the target tissue.
And FWIW, there are plenty of other areas where brain surgery is a
Mama always told me... (Score:2, Funny)
ow, my aching hot spot... (Score:3, Interesting)
Any ideas, Dr. Slashdot?
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Yeah, I was thinking along these lines -- and a cubic centimeter isn't really what I'd call a "precision operation".
On the other hand, TFA says that it's more precise than radiation, so...
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10 cubic millimeters is only 1/100th of a cubic centimeter.
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AFAICS the best you can do is make the pulse as short as possible ... with lasers and surface tissue you can use ablation to avoid heating the rest of the tissue, but that's not going to work internally.
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Pierce the skin with a fork a few times before you apply the heat.
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See this comment [slashdot.org], be careful following the link to the journal about lasers to the retina, supercooled metal probes to the white of the eye, and needles stuck in the eye, it's graphic and may cause nightmares (I promised someone I'd freaked out with that journal that I'd post a warning).
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there used to be a similar procedure called a gama knife which was used on cancers in certain locations as non-evasive treatment. The bursts and focus is so small that there really isn't any heat dissipation to be concerned with.
This apparatus should work in a similar method in which they direct the energy in non-damaging doses from several angles and where the point of intersection happens, they can slightly increase the strength giving the desired action without threatening any other part of the body. I i
Shades of Star Trek! (Score:2)
McCoy and Crusher and Bashir never cut anybody open, they use... er, it looks like the technique from TFA. Communicators, flat screen computers, self-opening doors, etc. Now this.
Amazing. When do I get my matter replicator?
Tin foil doesn't work! (Score:2)
Darn, the tin foil in my hat won't work against this! I'm going to have to add some sound-absorbing cotton wool too in order to keep the CIA out of my head!
Killing the appetite??? (Score:2)
Could this technique be used for people who are super morbidly obese to kill of the section of their brain than gives them an appetite? I mean they would still have to eat, but they would have to make eating a routine like brushing your teeth, etc...
Or would there be issues getting them to FIT into a MRI to do the procedure in the first place. I see a future where fatties are put into the MRI for 30 minutes until parts of their brains reach 130 degrees and they loose their appetites.
Of course me being a
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I think this would mean that you would have to carefully plan your meals -- times, portions, specific foods -- for the rest of your life. Or die of starvation and never even be aware of it.
It would work, sure, but it really strikes me as a case of the cure being worse than the disease. And if you are capable of putting that kind of care into your diet, you can probably lose weight without burning out a part of your brain.
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Just make them monitor blood sugar levels after the procedure like the diabetics do. You only need to plan you meals with an accuracy of +- 30 days to not die anyway. Also, if you faint or are very weak, then it is probably wise to eat something. There is plenty of other signals to inform you of not eating enough well before death.
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I believe there are drugs that do the same thing chemically and non-destructively. I've met a few people who've used them to great effect. Granted, they have side effects, but wouldn't overwriting part of your brain with NOPs also have some side effects?
I went in for this treatment (Score:5, Funny)
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They used you as a scratch monkey!
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and now my ice cream thinks trees are precisely why shoe laces bark the 1812 overture spatula rice mommy.
Now you'll be able to write "The Family Guy" episodes with the best of them.
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and now my ice cream thinks trees are precisely why shoe laces bark the 1812 overture spatula rice mommy.
Now you'll be able to write "The Family Guy" episodes with the best of them.
Well, at least it's better than the time that...
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So YOU'RE the one responsible for all those spam emails!
noises in my head (Score:2)
Now they won't laugh anymore when I tell them I have noises in my head
130 Fahrenheit... (Score:1, Offtopic)
... is about 54 degrees Celsius, by the way.
C'mon, America. Catch up with the world's weights and measures. ;-D
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But in America, bigger is better, and 130 is clearly bigger than 54...
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It's not our fault that you have no respect for history! Why, every American learns the maximum temperature in Farenheit's lab by heart. Even the ones who can't spell know what 100 degrees are!
See, we have a secret plan to memorize all trivia by using weird units.
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C'mon, America. Catch up with the world's weights and measures. ;-D
Well, we may be behind in measures, but our fatasses have your weights beat by a mile!
Safety? (Score:2)
'The groundbreaking finding here is that you can make lesions deep in the brain â" through the intact skull and skin â" with extreme precision and accuracy and safety.'
Something about the word "lesions" doesn't quite make me think "safety". Reminds me of Eternal Sunshine of the Spotless Mind where Jim Carey's character asks if there is any risk of brain damage and the guy tells him that "technically, it is brain damage".
Re:Safety? (Score:5, Interesting)
Currently, all brain surgery consists of excising something, implanting something, or making a lesion in something. We do not have the ability to make a repair on anything in the brain. The best we can do is find the part that is malfunctioning and kill it off so it at least won't interfere with the rest.
What this does is avoid the whole drilling holes in the skull part and the infection risk that goes with it.
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Epilepsy (Score:4, Interesting)
Re:Epilepsy (Score:4, Insightful)
Neurosurgery (along with other kinds of brain damage) frightens me like few other phenomena. It's a little bit like saying: "okay, this piece of code in the kernel is crashing. Let's overwrite it with NOPs and see what happens." What if you need that part of your brain? Are you really the same person after the procedure?
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Neurosurgery (along with other kinds of brain damage) frightens me like few other phenomena. It's a little bit like saying: "okay, this piece of code in the kernel is crashing. Let's overwrite it with NOPs and see what happens." What if you need that part of your brain? Are you really the same person after the procedure?
In that sense, you're a different person every time your brain undergoes any change, including learning, forgetting, being short on sleep or having extra sleep, etc. I think the notion of "identity" can be disturbingly slippery.
Abuse (Score:2, Interesting)
What springs to mind first is the terrible potential to abuse this technology on political prisoners, criminals, etc.
Depending on how well you pinpoint certain areas of the brain, but I wonder if you can permanently destroy a person's effectiveness at whatever skills the government doesn't want them pursuing. It sounds like this procedure doesn't leave any external evidence, and the internal lesion may not be readily identifiable without biopsy.
"We will release you to your family immediately, but only if y
Sound wave lobotomies (Score:1, Interesting)
Wasn't this in an episode of The Prisoner? That show was way before its time.
Already in use (Score:3, Funny)
I'm pretty sure this technique is already in daily use. From what I can tell, it involves rap, subwoofers, and the patient driving by my house at 11:30 p.m.
I bet (Score:2, Funny)
they're using Britney Spears waves to create the lesions.
Also, we now know what makes the RIAA people brain dead.
Oh HEYALL No (Score:3, Informative)
"During traditional surgery for Parkinson's, for example, the neurosurgeon stimulates the target area with the electrode to make sure he or she has identified the piece of the brain responsible for the patient's motor problems, and then kills that piece of tissue."
I got my PhD in psychology, but the work was done in the Center for Parkinson's Research in the chemistry department. At NIH I worked for a guy that did lots of studies on Parky's, and he loaned me out to other labs doing Parky's work to help develop new data collection and analysis techniques. I did work for a review paper on Parky's research and treatment techniques when I was with the psychiatry department at Yale Medical School. I've worked in surgery doing intra-operative neural monitoring -- I don't hold a knife, but I do hold that probe, test the target areas, and tell the surgeon where he can and can't cut. I know my way around a brain and a good bit about Parky's. That's not to ring my own bell, but is a set up for my response to TFA.
I've never heard of surgery for Parky's. If someone said they were going to have it I'd convince them not to. If a surgeon said they were going to do it, I'd offer to smack his hands. There are so many other things that can be done that it's foolish to kill off perfectly functioning brain tissue (motor area or thalamic circuitry feeding it) just because the circuitry that suppresses all but the desired actions (dopamine carrying inhibitory innervation) is running low on power because its source (substantia nigra) is itself dying off. Quite often the problem resolves itself because the various uninhibited signals wear themselves out fighting against each other, and some motor control can be retained. But if you kill the circuitry, it can't possibly be recovered.
When motor activity must be brought down due to disinhibition allowing random activity to become harmful, you can always do cryo-ablation of the nerve trunk coming off the spinal cord, killing off a small portion of it temporarily. It lasts around 18 months. You can redo it then if the problem returns, or let it recover if not. This is done as outpatient treatment in clinics by anesthesiologists all over, for chronic pain and such. Doing it to motor nerves differs not one iota in principle.
There's plenty of other alternatives, some approved by cross over for treatment of other symptoms, such as hydergine + nootropil conjunct (approved to delay or prevent dementia; helps sensitize the cortex to a lower level of dopamine), and high dose gabapentin to make those neurons that receive the dopamine signal and control cortical pyramidal cell circuitry to make them more effective.
If I ever run across a surgeon that wants to ablate some cortex or otherwise kill off brain tissue to treat a chemically based control signal failure, I'm going to attempt to alter his consciousness on the subject with an experimental technique of my own: corrective phrenology.
For the unlearned, phrenology is the discredited technique of reading the bumps in the various regions on one's head to determine the greater or lesser contributions from those areas to one's collective make up. Corrective phrenology is applying kinetic energy in the form of a good whack in order to change the size of the bumps and so the relative contributions of the areas this is applied to. The technique is discredited because nobody ever proved what areas do what, although we know that applies to the brain. So my technique would be experimental in that I'd have to give a good many whacks in various places to see what accomplishes the job. I'm thinking a Craftsman five pound ball peen cranial impact probe would be an appropriate tool.
icepick lobotomies (Score:2)
I know this can be beneficial, but this is too close to ice pick lobotomies for comfort.
And this seems like it is ripe for abuse by totalitarian states.
Old News (Score:2)
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Unless, of course, you have the regions overlap.
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Re:Very cool, but... (Score:4, Insightful)
You'd think that an outpatient procedure like this would be considerably cheaper than the traditional alternative. For a while the technology will be expensive, but the cost will come down, whereas the cost of human labor (i.e., of surgeons and nurses) will not. So in the long run, perhaps this is cheaper.
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whereas the cost of human labor (i.e., of surgeons and nurses) will not.
Eventually though it might. Eventually automated machines can take care of a lot of stuff. While surgeries might have to have more human intervention, eventually all minor procedures and general care-taking could be done via machine. So while for the foreseeable future you would need a human surgeon, in the two weeks you are in the hospital you might not need hardly any other people to take care of you.
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speaking as some one in a coronary care unit, I had a heart attack on saturday, the monitor I'm hooked up to automatically takes my blood pressure every hour can be more or less. Obviously this saves the nurses time and reduces costs.
Surprisingly I'm feeling quite well having a tube called a stent put in my artery has made me feel better than in months. Thats another great procedure developed in 1977 a sheath was inserted in my femoral artery
and some dye pumped in to show my damaged heart. It only took a fe
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Re:Very cool, but... (Score:5, Funny)
I concur. Chances are that this new kind of acoustic brain surgery will sooner be cheaper than a ticket to a Metallica concert.
Which is appropiate, since both have the potential to damage your brain
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For a while the technology will be expensive, but the cost will come down, whereas the cost of human labor (i.e., of surgeons and nurses) will not. So in the long run, perhaps this is cheaper.
I suspect that sometime in the near future (10 to 25 years), that most surgeries will not involve a human being for the operation itself.
For all its worth, I suspect America will never political solve the problem with Universal Healthcare, but technology will eventually fill in the gap.
At the cost of how many lives in
Bull (Score:3, Informative)
I don`t get where this meme is coming from. Ive seen it mentioned lots of places...the kooky idea that robots and computer software will soon be doing SURGERY.
Out of all the jobs on this planet, surgery is going to be one of the last ones replaced by automation. Nearly every other form of employment is easier to automate. Surgery is a series of delicate, deliberately chosen steps that requires an enormous pool of knowledge and experience to do successfully. Surgeons go through more years of training tha
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Well, it'll get cheaper until we finally hit that impending shortage of helium (http://www.wired.com/wired/archive/8.08/helium.html) - you know, that situation where virtually all of the helium in the world comes from one deposit in Texas, and the well's running dry. It's also, at the moment, completely unrecoverable, as when it gasifies and escapes, it simply floats to the farthest reaches of the atmosphere.
When that happens, the price of performing MRI will skyrocket. MRI needs superconducting electromagn
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Most procedures in US medicine are obscenely over-compensated. This is why we have the highest cost (and lowest quality) health care in the developed world.
One recent example... A friend had a ski accide
Re:Very cool, but... (Score:4, Insightful)
You are logically correct. However, you would never get real people to go along with such a system because people quickly go illogical when their own lives, or the lives of loved ones are on the line. We are much more likely to have a healthcare system paid for by a preset percentage of the economy, the size of which will be quite large.
Re:Very cool, but... (Score:5, Insightful)
Try taking ethics. If we followed your slippery slope logic we'd start killing people when they hit retirement age. After all, they'll never again go back to work and 'pay back' their value after they start collecting social security. Same for the mentally retarded, just drown them right?
"Realistically we need to start realizing that not every person DESERVES the best treatment". And who decides that?
New procedures are always expensive, do you think the first x-ray machines were worth the cost to say "yup, you got a broken leg son". Now they are standard practice.
"so costly that society can never regain that investment". Public education is costly, if a kid isn't learning and behaving by second grade should society perform a retroactive abortion? After all without an education they'll just be a burden on society, and its not worth paying for the education if they aren't being productive, why not save the money for the other years of school?
Did you have a 4.0 GPA in school? what about college? How much are you contributing to society now? I'm not so sure I am getting back my investment in you. Most of the education system in the world are funded by tax dollars.
What about no child left behind? Why don't we get real efficient and just let them starve? They'll never pay enough in taxes to 'regain investment'.
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if a kid isn't learning and behaving by second grade should society perform a retroactive abortion?
I would have been dead long before second grade were that the case.
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What about every child left behind?
FIFY
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You say that like we're supposed to think "oh no, that could never happen", but have you seen Denmark recently? They don't just go out and kill people explicitly, sure; you make it a social thing. Guilt them into it. [firstthings.com] Or, w
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It does happen, it has happened. It should not be condoned.
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Wow, I'm so glad we don't do this. I was a second grade dropout for awhile and would have been targeted. Seriously. My teacher (Mrs. Demperio) hated kids, especially hated boys, and plain despised me. She'd make fun of me in front of the class, give me extra work just to keep me busy, etc. I decided I wanted to drop out and my parents didn't force me back into school for a bit.
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That example only works if you have socialized health care - and it actually is employed to some extent in countries which have single-tier government controlled health care. Here in Canada we don't kill off old people, we
Re:Very cool, but... (Score:5, Informative)
Actually, as a researcher in the field, controlling cost is one of the motivations behind this method.
Do you have any idea how much open brain surgery costs? It's several days in the hospital, plus a team of surgeons, plus an operating room. All in all, from $50,000 to $200,000. High intensity focused ultrasound (HIFU) doesn't need any of that. There are hopes this could almost be an outpatient type of procedure.
One my childhood friends suffered from epilepsy for many years until as a teenager, he had exploratory brain surgery (in 1988) where they removed a cubic centimeter of diseased tissue. He was in the hospital for a week.
Not every new idea in medicine costs more money.
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That's how they initially price it. Then another manufacturer comes along and charges X - 10%, then the first lowers their price, then they eventually approach Y, the cost of making the machine. Then someone else discovers how to do it cheaper and lowers the price further than competitors can to gain an advantage, and the price drops some more...
At least, that's how it's supposed to work. Works pretty well in tech., not sure if it's the same in medicine.
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I didn't exactly find where they said the cost of this was but it is a Swiss study so they could be off a little compared to other countries.
However, you are coming to the wrong conclusions. You are only measuring income disparagement between having and not having the procedure and coming to an arbitrary conclusion. However, this is wrong on so many levels as I can show that a poor person making minimum wage according to your criteria would never be eligable for most major procedures where a high level exec
No No No! (Score:5, Interesting)
As someone who lives with chronic pain, let me say you are so far off the mark.
I do respond to medication, but the only pain-killers that work are very heavy - Fentanyl.
I haven't had a full time job for many years. I never will without advances in the treatment of pain. If a procedure like this may mean I can work again, and pay taxes. Then I can afford expensive medical insurance.
More importantly, my kids then have a Dad who works full-time. They see that working leads to reward. They see that working hard at school can lead to a better life. At the moment my 16 y.o. sees no point in trying, as life can throw a curve ball and fuck you over. So if I could get something closer to a "normal" life, my kids will see me modelling better work-ethics and will be more likely to emulate my success. They see there's a point to trying to achieve their level of personal excellence, earn more money, pay more taxes and have more productive and potentially happier lives.
That's 6 people now pay more taxes.
Now I'm a maths teacher by vocation. If I was able to teach full-time I would be able to show several hundred kids a year that maths is easy, maths is fun, and that they can use it to solve real problems in everyday life. A few of these kids will go on to do amazing things, just because I can do what I am good at doing, and I can do it well. Over say 20 years there would be a significant number of people who have happier lives, earn more money and pay more taxes.
That's say 300 people now pay more taxes.
It's been shown in the literature that children of professionals are significantly more likely to undergo tertiary study and become professionals. So the children of the kids that were inspired to greatness by having a great teacher are more likely to have happier, more productive lives with higher paying jobs.
So there are potentially thousands of people who are paying more taxes, who are making great discoveries, and are generally happier, just because my pain is better managed without putting knives inside my head.
Look past the short-term benefits to the individual, and look at the potential returns to society and humanity as a whole, and the pay-off of a (admittedly) expensive procedure becomes enormous. And the return to the individual who suffers otherwise incurable chronic pain is not something measured in $$. To not wake up crying because I didn't die in my sleep would bloody marvellous. It's the possibility that there will be advances that help me that has kept me from suicide, and I'm not Robinson Crusoe.
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Kudos and thanks for your unusually circumspect and long-term thinking, and for bringing it to
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The person I responded to was making the point that the immediate return from this procedure was possibly more than they would earn. My point was that the economic return to society is greater because of a flow-on effect. I also made the point that in my case, the returns would be greater due to people being inspired to greatness if I could return to my profession full-time (and not be drug-affected). Furthermore I made the point that to a chronic pain sufferer, relief from pain is not measured in purely
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From what I've seen given my limited experience (as I don't think weed is a good answer when you've got teenaged kids):
1) Great weed is less effective for pain reduction than many other things, although you may not care if sufficiently stoned. Or it might make it WORSE - just depends if the senses are numbed or heightened. Not worth it in my experience.
2) Oral preparations can work, but it's really hard to get the right dose and not turn into a blob stuck to the couch.
3) Nasty old weed that's a bit moldy,
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Congratulations, in an effort to extol a virtue of socialized medicine you beautifully summarized why it is desperately wrong on a human level.
I hope you never have the experience of a bureaucrat telling you that your life is not worth saving.
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Which of those two is preferable? The outcome is presumably the same.
The difference is this: in a socialist medical system your hope ends there. In an open market there exist hospitals and doctors that do charitable work. In a socialized medical world doctors do what the big scary government tells them to do and nothing more.
If the government wants to help people get medical coverage, here's the solution:
1. Cap lawsuit damages on malpractice suits. These outrageous settlements continue to drive up the
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blood carries away heat, but not instantly.
if you can add the heat in 1/100 of a second, and it takes the blood a second to get rid of this heat...
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Indeed, there are thousands of tiny blood vessels in the retina, and lasers are used to weld torn retinas back together; I've undergone the procedure. I'd post another link to a journal entry about my vitrectomy (the retina finally detached) but a) I already did and it would be redundant and b) the link I posted freaked a guy out too much.
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Blondes are only dumb because bleach causes brain damage. So I think this technique may be applicable...
Q-BTW, how can you tell if a blond has been using your computer?
A-There's whiteout on the screen.
Q-How many blondes does it take to change a lightbulb?
A-None, some horney man will change it for her.
Q-How many blond feminists does it take to change a lightbulb?
A-THAT'S NOT FUNNY YOU FUCKING PIG!
Q- Why was the parent post modded "offtopic"?
A- The moderator was blonde!