Two seemingly unconnected recent incidents inspired me to write this column. First, I saw a pal recently and noted his right eyelid was a little red and swollen and I duly asked him if he had seen his doctor. “Don’t worry mate, it’s just a stye (an infection of an eyelid gland), I have taken my contacts out and it will be okay in a day or two.” The following day I commented that the redness had tracked down onto his cheek and things looked a bit more swollen. He attempted to brush aside my protestations but I demanded he get some therapy. The infection in his eyelid had tracked down into his face and if left to its own devices my friend could have been in serious trouble. Thankfully after suitable therapy he fully recovered.
The second event was announced in the news on October 25, 2011; Eli Lilly, a large pharmaceutical company, withdrew one of their drugs, Xigris (pronounced “Zy – gris”), from the market after studies failed to show its impact in treating severe infections. Until that time physicians and the people at Lilly thought this medication might avert life-threatening infections on the intensive care unit.
In the first event one has a very classic – and typically male – response to a medical problem that calls to mind Alfred E Neuman’s famous “What, me worry?” statement. Many people tend to use this approach, the subtext being if I ignore it, the problem will go away. It may do so on many occasions, until one day it does not and you end up in the emergency room. Most styes can be treated at home with frequent warm compresses to encourage the infection to drain as well as applying an antibiotic ointment. However, if there are any signs of deterioration such as expanding redness, skin flaking, more swelling or pain, do not defer a visit to your doctor.
The second event has been characterized in several ways in the media, some holding out the belief that it is symptomatic of corporate wrong-doing or greed. I have spoken to a number colleague’s expert in this area who have educated me about the progress of the story. Xigris was developed as a last chance drug for those patients who were very late in the stages of infectious illness, or sepsis as we call it. It was brought to market with fanfare and a genuine belief that it could save lives, but the data have not borne this out. As doctors we have learned some valuable lessons here and I suggest the lay public can also learn from this experience.
An old aphorism states that five years after graduating from medical school, 50% of what we learned will have been shown to be wrong. The problem is, we don’t know which 50%. If you or a loved one has a medical problem use every resource at your fingertips – and yes, that includes the computer keyboard – to research the issue, find supporting and refuting data for whatever treatment is being proposed and bring this to the attention of your doctor. We are just human beings, do our best to keep up but cannot know everything. You do not want to be on the end of the 50% that has been shown to be wrong after all.
So keep your eyes bright and focused on the data – the AOPA website has plenty of useful aeromedical information at your disposal and you can always contact our Medical Certification Specialists if you would like to see a specific topic covered.
November 17, 2011