don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

"The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease." ~Thomas Edison

Have you heard of regenerative medicine? This is an area of the medical system seeking wondrous breakthroughs via research on genetic advances and other whiz bang improvements to the human condition. Many dreamed-of therapies, cures and manipulations hold out hope for adding years while reducing significant amounts and types of morbidity. How much of what is dangled before a dazzled public is realistic? How long might patients and others now in their middle to late years have to hold on before they can avail themselves of the wonders to come, IF they ever come? Also, how many who need the improved devices, therapies, gizmos and such will be able to afford them? What are the most promising or likely near-term advances? Oh, and one more question: Does any of this relate to the wellness concept, to the traditional interests of those, like you, who pursue and even promote wellness lifestyles?

So many questions, so little space.

Since I posed the questions, I'll take the liberty of addressing the last question first, then go to the others.

Regenerative medicine is not a wellness matter by any means, however great and desirable the achievement of such gains would be. Wellness is not about healing or looking for changes in the human condition or ways to improve that condition beyond one's own efforts. It is a challenge for personal action, with the requisite attention to the larger environment, such as saving the planet and all that. Thus, this medical topic of regenerative medicine is not a proper focus of discussion to address here at the Wellness Center. I traffic in positive news that is within our individual reach, with information about the kinds of lifestyle advances possible by virtue of exercise, critical thinking, smart eating and at least a dozen other skill areas and lifestyle, quality of life initiatives. Wellness, unlike medicine, is about getting "weller," not overcoming genetic time-bombs, sickness or treating disease. The latter and much more associated-with-medical issues are important, but they are separate from wellness concerns.

What's more, a person's expertise in one area does not carry over to another. While many physicians know a great deal about wellness, the reverse is not the case. You would not want a wellness expert, such as myself, fixing a broken leg or delivering a baby, particularly yours. Separate, if overlapping "magisteria" set medicine, regenerative and otherwise, apart from wellness, as the late Stephen Jay Gould might have suggested.

Yet, regenerative medicine is an important topic. I don't hesitate to opine on politics, sex or religion, so why should regenerative medicine be out of bounds? Except for the reasons noted above, no reason!

So, let's look at the questions posed, starting with how much of what is dangled before a dazzled public is realistic? This is an easy question to answer: I have no idea. What's more, few others have a sense that the evidence is clear one way or the other. Obviously, we can hope for the best or, if so inclined, call upon imaginary supernatural powers to intervene. But, nobody really knows, regardless of the optimistic claims by some who sound as if they are writing science fiction in this arena.

The next question was, "How long might patients and others now in their middle to late years have to hold on before they can avail themselves of the wonders to come, IF they ever come?" According to an article in the Boston Globe by reporter Scott Kirsner (see "Hopes High for Artificial Organs, Despite Slow Going," Boston Globe, June 7, 2004), at least twenty years. As in the last case, nobody really knows. Personally, I would not advise getting one's hopes up even if you can last that long.

However, a short five-year time line is offered for a few advances, including:

• Multiple applications for skin, cartilage, bone, blood vessel and some urological products.
  
  
• Insurance-reimbursable regenerative therapies.
  
  
• Specialized cell banks for tissue storage, allowing storage of viable "off the shelf" products.
  
  
• Complex organ patches that can repair damaged pieces of the heart or other organs.

Next question: "How many who need the improved devices, therapies, gizmos and such will be able to afford them?" The answer: Only the richest amongst us. Later, prices will come down. By that time, the chances of success will have improved for those procedures that at first, like heart transplants in the early days, were not so successful.

The last question was, "What are the most promising or likely near-term advances?" Here is a partial list:

• Cellular therapies (in particular, stem cell therapies), tissue engineering and genetic engineering.
  
  
• Repair damaged heart muscles after heart attacks.
  
  
• Replace skin for burn victims.
  
  
• Restore movement after spinal cord injuries.
  
  
• Regenerate pancreatic tissues to produce insulin for diabetics.
  
  
• Produce artificial organs that can be easily implanted.
  
  
• Repair tissues in vivo (inside the body) and in vitro (in the laboratory).
  
  
• Produce complex skin, cartilage and bone substitutes.
  
  
• Harness regenerative medicine materials to produce in situ regeneration of diseased and damaged structures in many areas of the body.
  
  
• Produce in vitro sophisticated 3-D tissues and organs that cannot be regenerated through in vivo techniques, such as an entire heart or lung.

Pretty amazing possibilities -- "Aow, wouldn't it be loverly,?" as Eliza sang in "My Fair Lady." A good excuse to look on the bright side, in any event. However, skepticism is called for, especially when politicians get involved, such as former U.S. House Speaker Newt Gingrich.

Newt has a new gig these days, as head of something he created called "the Center for Health Transformation." He goes around the country, firing up doctors about regenerative medicine. He came to my town of St. Petersburg, FL recently (April 13, 2007) and said that, "in the not-so-distant future of health care, your doctor will implant in you a wireless pacemaker that continuously monitors your heart waves. The data will be uploaded into a supercomputer that compares your heart rhythm with millions of others. Based on that, the computer will be able to diagnose a heart attack hours before it happens."

Well, isn't that swell? Wouldn't it be better if your doctor just looked at you, and maybe measured your body fat, assessed your diet, exercise patterns and varied risk factors, checked basic medical indicators (blood pressure, cholesterol levels and so on) and said, "If you don't shape up and change your lifestyle, you're going to have a heart attack?"

Well, I guess doctors can't make money doing that and besides, the patient not given to wellness might prefer to have an implant go off instead, giving him plenty of time to get himself to a hospital emergency room.

Personally, I'm placing my bets on a wellness lifestyle. If I ever get an implant, it won't be to warn of an impending heart attack. It will be the other kind, the kind that stimulates nearly warn out body parts to respond TO desires of the heart (and brain) that have been and always will be a lot more fun than a rush to a hospital bed. A motel will do nicely.

(Note: This essay will be filed in the archives in the MENTAL DOMAIN under the skill area of adaptations and challenges. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

 Send e-mail to Don Ardell