There has been a lot of speculation about what happened to and what could have saved Tim Russert.
Some, like a Wall Street Journal piece, “A Visceral Fear: Unexpected Heart Attacks,” bordered on disease-mongering. That story discussed:
“…experts who think wider use of coronary calcium CT scans could help spot more people at risk of soft-plaque blockages. The noninvasive procedure takes about 15 minutes and costs a few hundred dollars. But few insurers cover it because there is scant evidence that treating people on that basis saves lives.
At a minimum, seeing a picture of the calcium lining their arteries can be a wake-up call for patients to take their coronary-artery disease seriously and to be diligent in taking medication, exercising and making other healthy lifestyle changes.”
I’m sure there are such experts. But there are many other experts who do not support wider use of such scans. It’s not just insurers who are reluctant. The story makes the procedure sound quick and inexpensive. But that is on the individual level. Who should be screened? Everyone over 40? The entire population?
Pictures – even those of the insides of our coronary arteries – don’t tell the whole story. And neither did this piece.
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observer
June 20, 2008 at 9:20 pmPart of that quote you put up shows the real motivation behind this stupid idea which is adding to the “bottom line” and using the media (the WSJ here) as “free” advertising.
I repeat that quote here:
“At a minimum, seeing a picture of the calcium lining their arteries can be a wake-up call for patients to take their coronary-artery disease seriously and to be diligent in taking medication, exercising and making other healthy lifestyle changes.”
All bull…Here’s some reasons why:
1.) I have seen no overwhelming support in actual, valid, research that the calcium deposits have anything to do with heart disease at all.
Such VALID evidence, I suspect, does not exist.
2.) Those so-called “lifestyle changes” are not the panacea they are claimed to be. Recent studies, in fact, are starting to show quite the opposite: “Lifestyle changes” have not been shown to prevent or cure ANY disease. All they do is temporarily mitigate distressing symptoms and/or improve basic fitness, both useful aims but hardly “cures for what ails ‘ya”.
3.) Most of the value for health in “lifestyle changes” may well come at the lowest levels of change. Exercise, for instance, has been shown to be most helpful in terms of improving health when someone goes from “couch potato” to “somewhat active”, a modest level of conditioning. Going to the “extremes”, which is nearly always what the proponents of “lifestyle change” really want, almost always does more harm than good over the long haul.
Ditto with the medication regimens, which really are more useful for increasing pharmaceutical sales and the patient rolls of doctors and other health professionals than “preventing” anything.
These drugs may also cause more disease than they could possibly forestall since they are pushed on too many people. Research has shown, in many cases, that the populations being treated (“primary prevention” and even, at times “secondary prevention”) won’t benefit in terms of all-cause mortality and/or such all-cause mortality change is too small to prove effectiveness (the risk-benefit ratio does not support the intervention).
4.) Tim Russert’s early demise, apparently, was because of an inherited weakness of the heart.
NOTHING that the doctors did could have prevented his death or perhaps even have delayed it even one day. Nor is it likely that Mr. Russert, no matter how “compliant” or not with treatment he really was, could have delayed or prevented his sudden, sad end.
Nothing.
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