Tuesday, April 29, 2014

Too Much of a "Good" Thing - DON'T take too much acetaminophen

In reflection on my latest Attrell Update video, I wanted to bring up another thing which I haven't really understood about modern society. This ties in nicely with one of the things I neglected to mention in my top 10, incomprehension of statistics (I intend to publish that video this week).

I have always been curious about humans and their dependence on medications, salves, balms, creams and elixirs. The placebo effect has been shown to play STRONGLY into all kinds of pains and aches, even showing results on systemic diseases that shouldn't possibly be cured by the powers of the human body. Statistics on the placebo effect have shown that most drug therapies probably aren't necessary and would be almost as effective as treatment with sugar pills (or other placebos).

I don't mean to imply that humans shouldn't take any medications. The discovery of vaccines, penicillin, antiseptics, pain-killers, cancer therapies, etc. have lengthened life-spans and improved quality of life in later years for humanity as a whole, and that is excellent. However, dependence on these medications can be just as bad as for addicting substances like narcotics.

Seemingly benign drugs like Tylenol are just as likely to lead to the placebo effect's nasty little sibling, the nocebo effect. If you have been taking acetaminophen (Tylenol) since childhood and find that you can correlate its use with a relief of headache or pain symptoms, it's possible that as you get older (and bigger) that you deem it necessary to start taking 2 Tylenol when you are feeling unwell, or that you move on to extra strength Tylenol, or even take 2 extra strength Tylenol (the maximum dosage recommended on the package is 1 cap every 4-6 hours depending on pain, or 8 per 24 hours).

The "safe" dose of Tylenol is getting
smaller and smaller.
It is a fairly well known phenomenon for drug companies to overstate potential benefits of increasing medicinal doses of drugs, and we were taught in my medicinal chemistry classes that there has in fact been little/no clinical benefit in even taking more than one regular strength Tylenol. Drug companies will benefit from the fact that a) people think they need MORE for stronger pain, and b) if you "harmlessly" swallow more of their product, you will run out quickly and you will buy more, especially if your treatment benefits from the medication as well as from the placebo effect. It is more than likely that if you have a headache (caused by something as benign as dehydration) that taking a nap and a big drink of water will make you feel better. So drug companies really have nothing to lose by trying to upsell you on these kinds of treatments.

**Don't even get me started on homeopathic/"natural" remedies and the lack of regulation on that multi-billion dollar industry.

The issue is, as we learn more and more about drugs like these, we can start to see that they have side effects that can start to become MUCH more serious than a simple headache. As I read today, it turns out the FDA (in the US) has actually stopped recommending the prescription of extra strength Tylenol (or any generic acetaminophen) and has tried to stop the sale of dosages of the drug higher than 325 mg (extra strength is 500 mg). The reason they did this (4 MONTHS AGO, mind you) is that they found that the incidence of liver damage and even liver failure to be much higher than acceptable ranges given the efficacy of the drug (and comparisons to other drugs with similar benefits, like Advil (ibuprofen)).

Livers can heal, but it is something that takes a long time, and taking any acetaminophen is being shown to cause more damage than initially thought.

Tuesday, April 1, 2014

Don't Tell Me

It is in the nature of humanity to want to experience something for ourselves.


We have all done it at one point or another, but requesting "no spoilers" is a really weird concept if you think about it. *Note, there are no spoilers contained within the text of this post. But stay away from Twitter...

First of all, in reality, there is no such thing as a spoiler. You wouldn't ask somebody not to tell you about something they heard on the news, or not to describe an event, simply because you wanted to have the story told to you by somebody else, or in another medium. In a world where something as simple as a TV show ending can merit people who are weeks or even years behind asking to please not get any details about the show until they have had a chance to digest it. I know people who are still wishing to not know what happens on the last episode of Breaking Bad, a show that ended 6 months ago.

The real spoiler is in the show's title.
Does hearing a single outcome that is revealed in 10 seconds over the course of a 30-60 minute piece really merit that kind of blissful incertitude for such a long time? If knowing a plot point in a TV show before you have seen it could ever render your own viewing of that show unnecessary, did you really enjoy watching the show?

I can and do spend time watching sporting events that I know have already ended and whose scores I already know. The fun of being entertained is entirely in the narrative that the story weaves and how the entire thing plays out, not a synopsis or boxscore.

I couldn't help myself but to read this morning about the major points of the finale of How I Met Your Mother, and out of courtesy, I will not share them here. But I feel a lot better now knowing what happened, even though I won't be able to watch the episode until tonight. It has been 9 years in the making, and I have been following the show since midway through the fourth season. I thought about trying to spend all day being extremely careful not to hear anything about the show, but since I found out what happened, I have only wanted to watch the episode itself more.

Knowing what is going to happen in sports, or in TV or movies is a very comforting thing, especially when other aspects of your life might make you uncomfortable or uneasy or you tend to stress a lot about things you don't know. I have watched episodes of Community, Big Bang Theory, Parks and Recreation, The Office, Arrested Development, Happy Endings, and others MANY, MANY times. I see new things each time I watch, and I think I actually enjoy the episodes more when I know what's coming. And we all have movies we love to watch over and over again, even when we can quote every line.

What makes life itself so difficult is its unpredictability, with twists and turns rivalling even the most well-written scripts. You will never be completely satisfied with a storyline, and I'm sure you can ask any writer if they feel comfortable with the way they wrapped up a story and they will be uncertain that they did things the "right" way. 

The fact is, in life as in entertainment, there is no "right" way for a story to play out. All stories are told in the same way, as they have for all of human history. There is little gained from knowing specific details of a story, and the "how" is a lot more satisfying than the "what". I cannot wait to watch the How I Met Your Mother finale, and I will take solace in the comfort of knowing that at least some things in life, I can know for certain.