Jay H Goldstein DDS

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Army Doctors

In our final post on modern medicine we will discuss the medicine and the new technologies used in plastic surgery. Plastic surgery is not just for aesthetics. Oftentimes plastic surgery is necessary after an accident such as a car crash or when someone experiences burns from a fire, but it is important to differentiate these two types of plastic surgery as one is elective and one is arguably extremely necessary. There are many plastic surgeons who only work in reconstructive and therapeutic surgery in order to help people restore the book of their former face or even to have them restore the book of their body or any service at all in the case of an extreme accident. This sort of emergency plastic surgery is different from elective surgery in that it is very necessary for the patient to have it done possibly so the injuries heal correctly where is if it is left untreated then they will have an open area and perhaps look very grotesque.

Patients who do not have plastic surgery after major accidents or after major burns often suffer severe depression because of the change and how they look. This sort of plastic surgery is different from elective plastic surgery and it is important that we differentiate the two before moving forward. The doctors who do this sort of therapeutic plastic surgery are heroes in my mind and are responsible for restoring some semblance of normalcy to someone’s life after a catastrophe has occurred to them. These doctors will often work in war zones where people are experiencing catastrophes from war like Burns and shrapnel and explosions that they are surviving.

There is an operation that goes to war zones with the Red Cross to work with civilians to help restore their faces after they have experienced a bombing or are burned from shelling or bullets. This is often part of the Red Cross and these doctors work for little or no pay simply for the greater good to help those who are in need. There also plastic surgeons who work strictly for the US Army and their whole responsibility is to help return the soldiers again back to some level of normalcy with how they look and their face so they can return to their families and their home life without horrible disfigurement.

These doctors often work for much less and earn a lot less than aesthetic plastic surgeons working in major cities. In my mind this makes them heroes just as much as the doctors who are creating prosthetics for veterans returning from war or the doctors that seal up the bullet holes when they return from battle. This sort of plastic surgery is not frivolous and deserves a place of honor for those that choose this path.

The past for those who want to get into the plastic surgery field requires the same set of pre qualifications that any doctor requires. First you need to major in a science as an undergraduate and get a Bachelor of Science with adequate grades to qualify for medical school. Then you must apply and get accepted to a medical school and graduate hopefully with this as your idea of major. Then you need to do your residency as well just like any other family doctor. However being a plastic surgeon is not the same as simply being a heart surgeon or a gastrointestinal surgeon. All surgeons need a lot of experience and a steady hand and a working knowledge of anatomy and what they are doing. But a plastic surgeon also need something more. Thank you for following along on our adventure through modern medicine.



MDMA

Another exciting form of modern medicine is using often considered recreational or illicit drugs for new therapies for serious medicine. In the next blog post we will discuss some of these therapies and the way that they are we categorize and certain drugs from party drugs you serious medication. The first things we will discover is also a therapy that is being tested in bipolar patients especially those who are experiencing their depressive symptoms. Often times with traditional drug therapy it takes a long time for the medication to build up in your system and this can we be patient with a two month window where they are not sure if medication is go to work and there’s no admission from it sometimes. It says required a lot of patience for the doctors and it is not a stable situation when potentially you have a depressed client who made you want itself cannot hold a job and is possibly going to try and commit suicide.

The anesthesia club drug known as ketamine is now being used intravenously and has shown to have incredible results to alleviate depression symptoms instantaneously. This is a fascinating development as ketamine has been used as a rave drug for decades now and acting in concert with such depression causing drugs as ecstasy. Or MDMA. Click here to read more. I need to go over this way and have results for up to 3 weeks. Of course is not enough they’re still needs to be a concerted effort to actually use other methods like exercise and diet and lifestyle in order to alleviate the depression symptoms however it is very important to note that is one of the few drugs that has an instantaneous lasting effect of the depression. This is a very exciting life and works otherwise the rest of the drugs that have been scheduled by the federal government as having no medical use are being your classified and shown to have serious effects for those who are suffering seriously. Another exciting area of a club drug that is now being used at the new medication are silicide mushrooms that are now being used for new uses. He sort of magic mushrooms are traditionally used recreationally to generate hallucinogenic and spiritual quick trips in the US. However be so excited and has now been shown to have therapeutic properties for those suffering from post-traumatic stress disorder and those who are going through certain kinds of psychosis and other mental disorders.

The active ingredient in magic mushrooms has been shown to grow new neural Pathways and establishing new connections between the synapses and generating new connections. This has been shown to be extremely important for those suffering from mental illness as this is the reason they think why these problems are not affected at all. Silicide mushrooms are distilled down to their essential chemicals and then administered to a patient in a slow day so that they don’t experience the hallucinations but are able to experience the lifting effect that also affects the serotonin. The other way that this is being used is not with suicidal but with LSD. Micro dosing LSD is the latest trend among technology CEOs and start-ups in San Francisco. In this way you take the LSD very small those were just rumors and opening of your brain and it’s supposed to say my creativity. Well this is not a medical use per se it is still an exciting and new trend along the lines of declassifying certain substances as only for drugs and trying to find a reviews for these powerful chemicals. Modern medicine is littered with all kinds of stories.



The Zika Virus

Let’s continue our discussion of new diseases. For example of these zika virus that is now spreading its way through South America and moving through the world has been around for a very long time however the mosquito that carries it has only flourished in recent decades due to climate change and other environmental factors. The mosquito that carry this virus is a seat of that only feeds on human beings and no other animals. Therefor part of the treatment for this disease is to attempt to eradicate the mosquitoes so that there is no means of transmission. Diseases are very important to consider in the quest for modern medicine but it is not just communicable diseases that are being addressed with modern medicine but also diseases of the mind. Bipolar disorder is a disorder that affects millions of people and it’s still very misunderstood.

Manic depression as this is sometimes called is a state where patients first are feeling very up and excited and little bit out of their minds and that is followed by a period of severe depression or they have no energy and just the opposite but they feel disconnected from all. Not being able to control your emotions and your energy is very frustrating for these people and it is something that is still be understood by scientists today. I’m just going to describe to you what is like to have a bipolar episode. I was out with some friends and I had too much coffee and I think I may have done some drugs as well. When I was out I thought myself very connected to the people around me and wanted to strike up conversations at the touch of a button. I also was making connections and feeling like my head was spinning but I kind of enjoyed it as I was feeling very connected and have a lot of energy. However my friends told me that I was being very erratic and very temperamental and that it was not pleasant to be around . later on I was followed by a period of catastrophic depression. And is characterized by ignoring all over as well as a complete lack of energy or desire to get up and do anything.

This lack of desire it was complemented by a lack of self-worth and also a constant interior monologue telling me that I was worthless. This is what a manic depressive episode feels like period now passing the various ways that modern scientists are using to address this problem. First there are many drugs are used to it including letting them however they are very broad drugs that affect all parts of the brain and therefore have tons of side effects. Even though the lithium is only 33% effective it is often used but is not always successful. There are no scientists who are mapping the brain to see where electrical impulses light up when someone is having either a depressive episode or a manic episode. Using scanning technology including that scans and MRIs the doctors are able to access these parts of the brain and noticed when they’re letting up and when they’re not. In doing so they’re able to now develop therapies where they can Target the part of the brain that are not working appropriately and if you like them. They’re able to simulate them either directly with electrodes that are then implanted into the cranial cavity or by general electric shock.  This sort of modern medicine address and yourself to a mental disorder by taking it apart as opposed to just using the traditional method. There was also talk therapy which it can be used in concert with his methods but often times there was a combination of treatment that need to be used in order to address all of the problem.

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The Testing Phase

Modern medicine is not just about technology but also about the new uses for current and perhaps old Technologies for new purposes as well. But let us discuss the new technologies that are changing the way that doctors heal and treat disease. Another disease which has taken the lives of so many and continues to ravage the human population without a cure is that of cancer. Currently the treatment for cancer involves the removal of the infected area and also targeted radiation and general chemotherapy that eventually poisons the body and cuts off the blood supply to the cancer and the tumor. These are highly destructive and broad treatments that the patients survive hopefully and the cancer does not. These treatments are extremely toxic and bad for the human body and their success rate is also very low.

But there are no are new technologies that are much more specific and targeted that are able to address themselves to cancer in a way that does not destroy the surrounding tissue and is not as toxic and destructive to the health of the patient. This new technology addresses the main fatal aspect of cancer which is metastasis . Metastasis is when the cancer cells move from whatever part of the body where they originated such as the skin or the breast or the prostate and they move to a more vital organ like the liver. The cancer itself on the skin or the breast is not fatal but once the cancer moves to a vital organ and begins to grow their it interferes with the function of that vital organ and this is what leads to death. This new technology however is able to attack the site of the cancer or tumor and is able to reprogram its DNA in order to make it a self-destruct. This sort of gene therapy is able to address itself to the cancer directly and only affects the cancer cells and the genetic markers that cause it to reproduce. Cancer is essentially just a over reproduction of cells and as such this is the mechanism which needs to be turned off in order for the kids words that begin with that way.

This sort of specific gene splicing is a very new development and one which has exciting consequences for not only the field of cancer research and study but also for the millions of people who died of various cancers per year. Currently this technology is only in the testing phase but conservatively doctors believe it could be used in treatment in as little as five years. Modern medicine truly is a marvel but the diseases are also adapting very quickly. A good example of this is the race to eliminate certain bacterial infections through antibiotics. Bacteria mutate very quickly and then mutate very quickly in the presence of antibiotics. Ever since the invention of penicillin this arms race to develop a new and more successful antibiotic has continued but fails every time. Now the window between developing a new antibiotic and having it made useless buy a new bacteria is almost instantaneous. To the point where pharmaceutical companies do not even spend the money now to develop new antique bacterial medications because it’s a waste of money knowing that a new bacteria will evolve to replace and make it obsolete. Modern medicine is not perfect at eliminating disease. Pathogens are always mutating and evolving and new pathogens are being developed every day in mother nature just as human beings are rapidly rapidly searching for cures to these diseases. We are locked into an arms race between the pathogens and Medicine. Every year new diseases pop up and viruses evolve and music and the scientific Community is tasked with treating these diseases as well as searching for a cure and also a means of stemming the tide of infection .



A Wider Scope

Modern medicine is a wide and varied field which is driven at the moment by Cutting Edge technology. Just like throughout time when technology was the driving force for all innovation now are the advancements such as advanced data imaging, 3D printing, and advanced genetic techniques are driving not only our understanding of the human body and what can go wrong and how it works, but also new and innovative ways to address certain illnesses. For the purpose of these blog post let us goes through certain elements and discuss the ways in which new technology as well as old technologies are being used in new ways to address in cells to specific illnesses. Let us discuss the HIV/AIDS epidemic and new ways that new technologies as well as old medications are being used in new ways in order to stem the tide and decrease the proliferation of this disease.

HIV is a virus which originally came from monkeys that depletes the immune system of those who have it leaving them susceptible to other infections that normally would not be serious but become life-threatening with the absence of a functioning immune system. What took a cocktail of sometimes 20 different drugs to address all of the multiple ways that the HIV affected the body now has been condensed into a regiment of two pills taken every day that not only reduce the viral load in the infected person’s bloodstream to almost zero but also makes it much less likely that they will pass on the virus to someone else.

The serious development recently to come back not the virus itself but it’s transmission has been the development of pre-exposure prophylaxis or prep as a means of stemming the flow of transmission from one person to another sexually or with needles. This is been developed by taking what was before developed and used as a post-exposure prophylaxis called Truvada which is a combination of two other drugs but when taken pre-exposure make the body immune to infection. Essentially this renders the person immunity against the HIV. This is a perfect example of a way in which a medicine which is not new in and of itself is being used in a new and radical way in order to treat and inoculate against disease.

To modern medicine is not just the advent of new technology it is also the use of current medication and technology in brand new ways. This sort of off label use of different medication for new purposes is something that is still going on and is helping to fight diseases in new ways. For instance did you know that Viagra which is the common and popular erectile dysfunction pill was actually first developed as a way of treating high blood pressure because it is a vasodilator that opens up the blood vessels. It was discovered that the side effects was also sexual and this became its primary use. Now this is a different sort of modern medicine technology that of the genetic splicing parking now be used to address diseases. Disease can happen from many different sources from a virus to environmental stresses but also genetics play ever expanding role in certain diseases. Certain diseases are predisposed from birth based on the activation of certain genes in the DNA of certain people. Now with the development of the CRISPR, gene splicing has become so specific and pinpoint accurate that very small sections of genetic code can be activated or deactivated in order to get a favorable outcome. This is a huge development and we will discuss its ramifications further in our next blog post.



Modern Medicine

Modern medicine is akin to  magic when you consider how far along it has come in the last thousand years let alone the last hundred years. Medicine today contains many such miracles as antibiotics, surgery with anesthesia, as well as the eradication of diseases that have plagued mankind for millennia. Modern medicine can be defined loosely as the sum total of all technologies that can be applied to the human body in the eradication of disease . It is very important when beginning a discussion of modern medicine to take a look back in history and look how far we have come first. Medicine as practiced today is a relatively new discipline. Medicine was at first the realm of the spiritual leader of a community. Whether this was a village witch or mother or a priest or shaman the person in charge of the physical health of the townspeople was also the person who is connected to the spirit world and to god.

Before such understandings of microorganisms and cells and other such breakthroughs, the medicinal world was at the mercy of the spirits and gods who controlled all things that men do not understand including the human body and the weather. The medicine of these ancient peoples often included herbs and folk remedies that would have some effect but lacked any sort of understanding of why it was effective and how it was working. Modern medicine is steeped in understanding and research as the basis of its practice. First you must learn everything there is to know about biochemistry and the cells and how they work down to an anatomic level. This level of understanding may not be necessary in order to practice medicine effectively. There are nurses and nurse practitioners who are able to prescribe medication and also do basic medical care and treatment and this does not require an  advanced degree or level of understanding of anatomy and physics and chemistry.

However for the highest level of medical professional which is a doctor we value this level of understanding because it is not enough to understand if something is effective at curing disease or alleviating pain or treating a condition, it is also important to understand why the treatment is working down to its most fundamental level. after this era of shamans and Priests there was an explosion of Medical Science that coincided with new developments in technology. The development of technology that really moved science including modern medicine forward was the development of magnifying glass. With magnifying glass human beings were able to see farther than they had ever seen before but also to see things in detail and magnification in a way that was totally knew.

This new level of magnification lead people and physicians to be able to break down living things into their components parts and to start understanding how our body was made up. This also coincided with a new science of cutting open cadavers of dead people and looking inside to see exactly how the body worked. Whereas before the philosophy was that it had to do with spirits and humors that would dictate how a person behaved. Now our understanding of cells and disease and bacteria and other pathogens enter the understanding. In these blog post we will break down further the history of the development of modern medicine and also discuss where we are today and what the future looks like in the field of medicine. Modern medicine is based upon technology and the future of this science is very exciting. From gene splicing to nanotechnology and bloodstream robots, the future of technology and modern medicine has never been more bright or more exciting.

 




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