Open Thread Friday
Self-care is growing in importance once again as our healthcare system is becoming less accessible to many citizens. From the early 1900's to about 30 years ago access limits were often due to physical location of practitioners and medical facilities. Most of us are now within a few miles of some type of medical care availability and cost has become driving factor limiting medical care.
Continuing to look at the two systems from last week.
Underlying philosophy of Chinese medicine is based on energy. Observation of circular energy patterns, knowledge how to effect a patterns and how a change in one pattern of a body system effects other body systems show up in the earliest medical texts from sometime between 770-220 BC. The six functional organ systems identified are comprised of a 1) a solid yin organ (viscera) that store essential substances, 2) a hollow yang organ (bowel) that eliminate essential substances 3) corresponding Yin and Yang meridians, 3) access points to monitor, adjust and balance energy flow and 4) An assignment to one of the descriptive elements in the 5 Element System.
Self-care using diet and exercise to adjust and rebalance energy is highly important in preventing health problems and first level of treatment. The individual body is considered a mini universe and energy changes in one organ system effects the others systems can be part of ones spiritual path. The different professional specialties are primarily based on treatment methods including herbal, acupuncture, acupressure, massage and surgery to modify or rebalance energy patterns.
Western based medicine is a mechanical and chemical model. Symptoms and diagnosis are associated with specific physical organs, chemical pathways and genetic material. Many treatments are directed to correct or alter stargets of physical function such as blood pressure, cholesterol or blood sugars. Professional specialties are based on physical function such as cardiac, pulmonary, orthopedics, etc. As it becomes more fractured the patient has growing responsibility of coordination. Insurance company payment practices are further limiting coordination by in some case only paying for treatment of a practitioners specialty. If a cardiologist writes a script for an asthma med some insurance companies will not pay for the prescription or the extra time the physician took to evaluate, diagnose and treat the problem.
Interesting article this week. Unexpected results from a medical treatment was identified by the crime lab at the Washoe County Sheriff’s Office.
Three months after his bone marrow transplant, Chris Long of Reno, Nev., learned that the DNA in his blood had changed. It had all been replaced by the DNA of his donor, a German man he had exchanged just a handful of messages with.
He’d been encouraged to test his blood by a colleague at the Sheriff’s Office, where he worked. She had an inkling this might happen. It’s the goal of the procedure, after all: Weak blood is replaced by healthy blood, and with it, the DNA it contains.
But four years after his lifesaving procedure, it was not only Mr. Long’s blood that was affected. Swabs of his lips and cheeks contained his DNA — but also that of his donor. Even more surprising to Mr. Long and other colleagues at the crime lab, all of the DNA in his semen belonged to his donor. “I thought that it was pretty incredible that I can disappear and someone else can appear,” he said.
The average doctor does not need to know where a donor’s DNA will present itself within a patient. That’s because this type of chimerism is not likely to be harmful. Nor should it change a person. “Their brain and their personality should remain the same,” said Andrew Rezvani, the medical director of the inpatient Blood & Marrow Transplant Unit at Stanford University Medical Center.
He added that patients also sometimes ask him what it means for a man to have a woman’s chromosomes in their bloodstream or vice versa. “It doesn’t matter,” he said.
Enough questions were generated the New York Times posted a follow-up article to address concerns.
Semen and sperm are different. A man who has a vasectomy still produces semen. That spermless semen, which may also be referred to as seminal fluid, is still of interest to forensic scientists. That’s because it could be used to identify a suspect in a crime or contribute other information to an investigation.
So how did his donor’s DNA end up in his spermless semen?
To say definitively what happened in Mr. Long’s case would require more research. But several experts in bone marrow transplants said that the forensic scientists’ findings made sense from a medical standpoint and that the answer involved white blood cells.
The two most common types of cells in semen are sperm cells and white blood cells, said Dr. Mehrdad Abedi, a bone marrow transplant specialist at the Comprehensive Cancer Center at the University of California, Davis, who treated Mr. Long but was not involved in the experiment.
Could a man pass on the DNA of his bone marrow donor to future children?
No. Several experts said that it’s not possible. In this particular case the man had a vasectomy, so he’s not likely to have any more children. But beyond that, white blood cells do not create sperm cells; they create more white blood cells, said Dr. Jonathon Epstein, chief scientific officer at the Perelman School of Medicine at the University of Pennsylvania.
It’s the DNA in sperm cells that a man passes on to his children.
“We don’t know a cell that can make a sperm cell,” Dr. Epstein said. “Even embryonic stem cells can’t be made into sperm cells at this point, though there are people working on it.”