I am impressed

[Charlie Reals]

I am thoroughly impressed with modern medicine. I had cataract surgery yesterday and am sitting here today with very clear vision in that eye. I get the other one done in two weeks and if all goes well I might be able to toss the glasses I have worn for over forty years. They even repaired astigmatism.
It means no wood work for a short while but oh well.
The wife watched them do it on camera and said it was amazing.
Charlie

[Robert Parrish]

Good for you Charlie, I had it done last year and now have 20/20 vision. I had to use the post-op drops for several weeks so I couldn't do any woodworking. I take extra precaution and wear eye protection more often. My Father had his done at 96!

[Stephen Tashiro]

I agree that the efficiency of modern cataract surgery is impressive. On the other hand, when it comes to evaluating drugs, we are still in the dark ages. Most of the time, what a drug actually does in the complex biological system of the body is not known. They merely give it to populations of animals and people, observer the statistical outcome and approve it if it seems beneficial. It's trial and error. At least it's organized trial and error.

[Mick David]

On the other hand, when it comes to evaluating drugs, we are still in the dark ages. Most of the time, what a drug actually does in the complex biological system of the body is not known. They merely give it to populations of animals and people, observer the statistical outcome and approve it if it seems beneficial. It's trial and error. At least it's organized trial and error.


Probably an oversimplification -- we understand a few things about targets and pathways, but the body is an extraordinarily complex set of systems that we are not able to model / simulate very well, as there is so much we don't understand.

I find it funny that, even in light of the above, people still expect drugs to work perfectly for everyone, be as safe as water, and cost little or nothing to buy.

[Pat Germain]

I agree it's amazing. However, it's interesting to note there was a Greek doctor named Galen who was performing successful cataract surgery in 160 AD. Good to know things are still improving. :)

[Stephen Tashiro]

Being able to write a reliable computer simulation is a good "acid test" of whether the mechanics of a process are actually understood. Since diabetes has been mentioned in another thread, it interesting to note that one of the major tests for diabetes is the measurement of hemaglobin a1c in the blood. The general idea is that this indicates some sort of average level of sugar in the blood from 30 to 90 days, so it is a better test that the current sugar level, which a patient could manipulate by being "good" only on the day of the test. But what is known about why blood sugar levels should have an effect on a1c? A friend (who is diabetic) and myself contemplated writing a computer simulation of the process. But after reading papers on the subject, he concluded that the a1c test was simply an empirical finding and that the mechanics of the process are unknown.

[Jim Rimmer]

I agree that the efficiency of modern cataract surgery is impressive. On the other hand, when it comes to evaluating drugs, we are still in the dark ages. Most of the time, what a drug actually does in the complex biological system of the body is not known. They merely give it to populations of animals and people, observer the statistical outcome and approve it if it seems beneficial. It's trial and error. At least it's organized trial and error.
I particiapted in a drug study a few years ago at MD Anderson for a stop smoking drug. The issues that still rattle around in my head about the study are:
1. They only checked to see if I was not smoking at the end of the study. No follow up months or years later.
2. They were not interested in any side effects comments that I had to make. Only wanted to know if I smoked since the last visit.
3. They didn't want any subjective comments from me and no post-test debrief. I would have told them that the only reason it seemed to work was that I had a large medical team really interested in my success and that I would probably not smoked with or without the drug just due to the fact that several people actively cared whether I did or not. (BTW, I started smokng again after the study but that's for another thread someday).
So, they only wanted objective, measurable data. Nothing else and that doesn't really tell you much about a drug's impact on a human.

[David G Baker]

I had cataract surgery two years ago. My right eye went great. During the surgery on my left eye I felt something different going on but was not able to find out what it was. The doctor implanted the wrong focal length lens in the left eye so I have to have corrective glasses for that eye and need glasses for reading. Several months after the surgery I got a V shape tear in my left eye retina that required laser surgery. The first or this year I had another tear in my left eye that required laser surgery. My eyes are dry all of the time and I have to use eye drops frequently.
Other than the above, I can drive without glasses, wear cool Sunglasses and I can now read road signs. I have trouble driving at night due to the glare of oncoming traffic lights.
If you need cataract surgery, with the exception of the above problems, I recommend it, I can see things that I haven't seen in years. I am very unhappy with my eye doctor and if I have a choice I will not use him again. My retinal specialist is great but could trim his finger nails before trying to hold my eyeball still during laser surgery.

[Stephen Tashiro]

A story from one of my friends: After a cataract operation, he went to see a retinal specialist for a different problem. The retinal specialist examined his eye and said "Your doctor did a good job on that lens. It's right in the center." My friend said "Don't they always put them in the center?". The retinal specialist said "There are some that don't have the skill".

I paid attention to the list of recommended cataract surgeons that came from the retinal specialist. I went to one and got a good result.

[David G Baker]

Stephen,
Wish I had gone to a retinal specialist prior to my surgery but I had never heard of a retinal specialist prior to my surgery. I have several friends that used my eye doctor for cataract surgery and were happy with his work so I took a chance.

[Brian Ashton]

I particiapted in a drug study a few years ago at MD Anderson for a stop smoking drug. The issues that still rattle around in my head about the study are:
1. They only checked to see if I was not smoking at the end of the study. No follow up months or years later.
2. They were not interested in any side effects comments that I had to make. Only wanted to know if I smoked since the last visit.
3. They didn't want any subjective comments from me and no post-test debrief. I would have told them that the only reason it seemed to work was that I had a large medical team really interested in my success and that I would probably not smoked with or without the drug just due to the fact that several people actively cared whether I did or not. (BTW, I started smokng again after the study but that's for another thread someday).
So, they only wanted objective, measurable data. Nothing else and that doesn't really tell you much about a drug's impact on a human.

Sounds like a very ill conceived and poorly executed study. You described perfectly the Hawthorne effect - too many propeller heads sticking there nose in and affecting the study outcome.