The Neutropenic Life ... And Reliable Research

Vanderbilt is checking my blood counts every Monday and Thursday. Yesterday was Thursday, so we were up bright and early beating the traffic into Nashville.

A plug for Nashville drivers: Monday we drove in at 7:15, and the freeway was busy. There was already a slowdown at our exit some 7 miles outside the I-440 loop. Nonetheless, I don't think I've ever seen a freeway that full move that fast. I complain about drivers who don't know what they're doing all the time—I'm certain that will haunt me at the judgment—so I thought I'd say something good finally.

Anyway, I was surprised to find my white blood cell count at 1700 and my neutrophils at 850. They were at 25,400 and 24,000 on Monday because of a Neulasta shot. Under 1,000 is a seriously compromised immune system, and under 500 is called neutropenic and requires extreme measures to prevent infection.

I don't know whether to expect those numbers to go up or down, and they won't be checked again until Monday, so we went back to following all the neutropenic precautions.

Some of them are not what you'd expect:

• No living plants in the house and no fresh flowers!
• No raw fruits or vegetables unless they have to be peeled to be eaten.
• All food boiled, thoroughly-cooked, pasteurized, or processed and packaged.
• Washing hands and cleaning counters as though we all have an Art Monk version of Obsessive Compulsive disorder.
• I get my own bathroom for just me to use.
• Mandatory daily showers.
• Wear a mask in public over my mouth and nose.

Platelets, which are the cells that form blood clots and stop bleeding when it occurs, drop with chemotherapy as well. So, no shaving with a razor, no jogging (to prevent bleeding in the joints), and they don't want me to clip my nails, either!

Fun.

I canceled my trip back to the village this weekend as well. Handshaking and hugs and hanging around people are really not a good idea when your body can't kill bacteria.

I realized last weekend that I haven't been to a gathering (a "church service") in weeks ... probably since early July.

I'm convinced modern Christians overemphasize the "church service" to a pathological degree, but even when the gathering of the saints is in it's proper place—as one small but important part of daily life as God's family—it's very nice to be part of one.

Last weekend I sat with Jim, a friend from Rose Creek Village, and talked about the Gospel and the relative emphasis that should be put on God's lovingkindness towards us and our responsibility towards him. It was great, and that sort of thing happens so often that it's possible for me not to notice that I haven't "been to church" in weeks. (Are you noticing that I don't like the use of "church," when it primarily means a meeting?)

Anyway, that won't happen this weekend, either.

Taking Pills ... And Paying for Them

Because my neutrophil count dropped under 1,000, the nurse practitioner assigned to my case prescribed me three medications: an antibiotic, an antiviral, and an antifungal. When I got to the pharmacy to get them, though, I was only able to pick up two. The insurance refused to pay for the antibiotic.

"That's odd," I thought.

I've been without health insurance most of my adult life. I have bought antibiotics several times, usually for dental issues. They're usually about $25 for a 10-day course.

"How much do they cost?" I asked the clerk. "I'd hate to skip antibiotics while I'm neutropenic over twenty or thirty bucks!"

She went off to check.

$337 for 28 pills.

Wow.

Good for the insurance. I wouldn't have paid for that, either.

Drug Costs and the Pharmaceutical Industry

I waited, and the NP prescribed me a different antibiotic that the insurance did pay for.

In my mind, the problem with drug costs is the incredible, unwieldy American system for testing and approving drugs. Because so many of the companies, people, and government agencies are corrupt, the whole system has to be regulated to a ridiculous degree, driving research and development costs through the roof.

I wrote a note to that effect on Facebook, and my cousin Janelle in Indian informed me that I was mistaken. Advertising, she told me, is the real culprit

The numbers she cited me don't appear to be accurate, but her point was.

From Science Daily:

The researchers’ estimate is based on the systematic collection of data directly from the industry and doctors during 2004, which shows the U.S. pharmaceutical industry spent 24.4% of the sales dollar on promotion, versus 13.4% for research and development.

So $45 of those $337 can be blamed on R&D. $82 was support their advertising.

And to whom are they advertising?

The industry spent approximately US$61,000 in promotion per physician during 2004.

WHAAAT???

$61,000 IN ADVERTISING PER PHYSICIAN IN THE UNITED STATES???

So what does that tell us? Doctors and pharmacists just don't care about what works best, so the pharmaceutical industry has to market their really good, life-saving products because physicians won't bother checking to see what works?

I don't think that's true.

I think major pharmaceuticals are blowing 25% of our prescription dollars on getting their pill to sell better than the next company's pill, and how well it works only matters if it affects the bottom line.

We can do better than that.

From Brad Weeks, MD, citing the same study:

As well, note the authors, the number of meetings for promotional purposes has dramatically increased in the U.S. pharmaceutical industry, jumping from 120,000 in 1998 to 371,000 in 2004, further supporting their findings that the U.S. pharmaceutical industry is marketing-driven.

Thus, he concludes:

Thus, the study’s findings supports the position that the U.S. pharmaceutical industry is marketing-driven and challenges the perception of a research-driven, life-saving, pharmaceutical industry.

Yeah, that was my conclusion, too.

How to Find Reliable Research

So who did this study? Is the study accurate?

The gold standard for research in the scientific community is peer review. Every field of science has a journal or journals that are highly selective and that are read and reviewed by scientists in that field. These journals make sure that junk science and dishonesty do not slip by. If you want to be heard, you have to publish in those journals, and when you do, all the scientists trained in your field will decide whether you have a leg to stand on.

The process is not perfect, indeed no such process could be, but men walking on the moon and that fact that I'm alive today prove that it is effective.

I emphasized effective because I think that word represents the best way to judge most intellectual pursuits. Jesus advocated it, too, in order to protect the average person from the trained and often dangerous religious clergy: "Beware of false prophets. ... You shall know them by their fruits" (Matt. 7:15-16).

Dr. Weeks points out that the study on pharmaceutical companies' spending was peer-reviewed:

Their study, The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States, appears in the January 3, 2008 issue of PLoS Medicine, an online journal published by the Public Library of Science.

I like to make sure I'm quoting good information when I cite internet sources. You can read about PLoS Medicine , their board, the PLoS standard for their journals, what scientific societies they belong to, and even browse their articles at http://www.plos.org/journals/journals.php.

Shameless Plug for My Research

Having said that, I have two web sites (free, like most web sites) that are research based, one on church history and one on the evidence for evolution. (Yeah, I know. Those seem to contradict.) On those sites, I've devoted a lot of effort to being honest and to verifying my sources just as I did above. I don't just throw my opinion around lightly.

Oh, and if I've not talked you into buying my book on the Council of Nicea, maybe this is my chance to do so, especially if you've read the nonsense Dan Brown tried to pawn off on the public in The Da Vinci Code. He made it look like the Council of Nicea created Christianity as we know it, and he was so effective that Glenn Beck actually repeated the junk history on his show.

All of this history is wrong, but worse, it's the Nag Hammadi Scrolls he's describing, not the Dead Sea Scrolls

Dan Brown got off easier than Glenn Beck. Dan Brown is an entertainer and few people hate him. Glenn Beck, on the other hand, was roasted as an idiot for repeating the same claims made in The Da Vinci Code.

I know that all Dan Brown had to do was read a couple books from the 60's and 70's, Holy Blood, Holy Grail and The Passover Plot, both long since rejected by historians, to come up with the "research" for his story. I read both books as a young Christian in the 80's, so I immediately recognized the theories.

In Dan Brown's defense, he didn't try to hide his source. The "expert" in the book is named Leigh Teabing, who is named after two of the authors of Holy Blood, Holy Grail, Richard Leigh and Michael Baigent. (Teabing is an anagram of Baigent)

There are real sources from which to do history. There are a couple eyewitness accounts of the Council of Nicea, and dozens of letters passed between bishops before and after the council. We know what it was about.

My book tells the story, explains the issues, and not only cites the right sources, but puts them in your hand. There's something like 60 pages of appendices at the end which include things like the emperor Constantine's opening speech at the council, his letter explaining to the churches why he called the council, and a letter from the bishop Eusebius of Caesarea explaining to the church of Caesarea why the council made the decision it did and what the Nicene Creed really expresses.

If that's not interesting for a Christian, then he's not much interested in the faith he's a part of. The Nicene Creed, or a version of it called the Apostles' Creed, is recited in millions of churches every week, and it is still the official creed of both the Roman Catholic and Eastern Orthodox Churches.

Teaser: Worse, almost no one but the Eastern Orthodox churches even know the main point of the Nicene Creed and agree with what it says! Most western Christians recite it every week while confidently disagreeing with the main issue about which it was written!!!

Weird, huh?

It's all in the book; it's all written so anyone can understand it; and yet the book both thoroughly cites the proper historical sources and puts them in your hand so you can verify them. What ancient writings that I don't add to the book are available on the internet for free. Christians already collect these writings, disguising them under the large generic term of "early church fathers."

How boring. My book sorts though the large, boring stuff to give you the distilled, pertinent, interesting stuff.

But I like the scientific method. You know, the one that Jesus advocated when he said "you'll know them by their fruits." I tell you about what was working for the Christians, how the Council of Nicea affected that, and then how their new practices worked.

The story's awesome.

Okay, that's the best shameless sales pitch I could make for my own book.

I got it reviewed by some people who have some history experience. Here's a couple of my favorite responses:

You did it! This is one of the best Early Church History books I have read. I could not stop reading. I have read many books on the subject, and none are better or clearer to read. (Rev. Steven R. Eubanks)

I am so loving this book! Where on earth did you find all this information! I'm so hooked. This book is good!!! (Audrey Griffith, B.A. in Theology)

You can get it at Lulu.com, where I self-published it. Don't think, however, that I skipped important publishing steps to do so. It is thoroughly researched (the research was both exhausting and exhaustive) and reviewed by every knowledgeable person I could reach, which was several. I've compared it with what other historians have written, and there is nothing fanciful or with the feel of a "conspiracy theory" about it.

Finally, I wrote the whole first half in story form so you could enjoy and understand the story before wrestling with its issue. A lot of that story is in the words of the early Christians themselves and the fifth-century historians who wrote about the council and its decades-long controversy.

Oh, and it will be avaliable on Amazon in about 6 weeks, though it will always be cheaper at Lulu, where you can also get it as an ebook.