Saturday, September 5, 2009

New York Times Blog comment submission-NOT published (part one)

Here it is, the comment the NYT health blog did not see fit to print. It is kind of lengthy and I am sure that may be one explanation as to why it was not fit to print. As one can see if you read the entire article and posts, my comment clearly takes on a slightly different opinion and perspective. Luckily, the blog comments before my comment are fair and balanced, and their is no hint of of any quashing of any implied views that might not be in keeping with the PHILOSOPHY of the health blog.


"The article does not really present data, but opinions. Unfortunately the one sided opinions are about as leading and one sided as the Aricept TV commercial. The commercial seems to create visceral reactions in some that may have more to do with ambivalence towards one’s own mother rather than the treatment of Alzheimer’s.

It is well established in the scientific community that Alzheimer’s was discovered 100 years ago, and it is a progressive neurodegenerative disease that destroys neurons in the CNS specifically at the level of the cerebral cortex. The disease process happens to target cholinergic neurons. Acetylcholine has many functions within the nervous system. Memory is one of the many important functions. This is basic physiology and should not be dismissed. What is not understood in the clinical and research world is how and why this happens. Since acetylcholine has various other functions, artificially providing an influence through medicine on this neurotransmitter, can cause positive effects as well as side effects. Just about every pharmacological agent used in allopathic medicine and for that matter naturopathic, has potential benefit and risks (side effects) there are not many physicians who are interested in hurting their patients or causing more suffering through side effects. That is a concept that is instilled in the 15 year indoctrination process of becoming a doctor. It starts well before medical school.

Aricept is one of four cholinesterase inhibitors available to treat AD, Three are commonly used and one is even available generically. They simply work by blocking the enzyme cholinesterase that naturally occurs and is used to breakdown acetylcholine in the normal physiological equilibrium process. AD is not a normal equilibrium so there is a net loss of acetylcholine producing neurons. Using these medications has a net effect of keeping more acetylcholine around for longer. Since it is used in memory it may help with cognitive decline as well as have other potential side effects at many levels outside of the brain. These are the limitations of most modern meds.

Namenda has a different mechanism of action working to regulate the neurotransmitter glutamate at the NDMA receptor, resulting in a slowing of cellular destruction, and hence some preservation of memory for a relatively and varying period of time.

The degenerative process of AD is highly variable from person to person, like many diseases. The medicines do not work for everyone, and it is dogma that they do not stop AD or reverse the progression. In many patients it may slow the dementia process to one degree or another. Patients and families devastated by this disease need and want hope. It is easy to develop false hope through these meds. I have had the discussion with many patients and families over the years presenting the realistic expectations to families and essentially bringing down those unrealistic expectations that families develop about the medicines. Any competent physician that treats AD has been involved in this dynamic of setting expectations realistically."


David Schantz said...


I don't know you may have hurt their feelings when you said, "The article does not really present data, but opinions. Unfortunately the one sided opinions are about as leading and one sided as the Aricept TV commercial." You told the truth. From what I've seen in the past the NYT feels it is always right. I see no real reason for them to reject your comment.

I'm looking forward to part two.

God Bless America, God Save The Republic.

Lisa said...

I'm convinced they rejected it because it is long and has lots of medical terminology that might confuse a reader. We now, unfortunately, live in a society where the attention span has dropped dramatically.

I'm heading over to part 2.

Talking about the book with the Lake Superior wind....... a calm day