Modern Medicine

Technological developments affect every part of our lives, from how we get to work to how we entertain ourselves.

Health-care professionals in Galveston County say that future breakthroughs could help millions live longer, and in many cases the future is now.

Of the nearly 20,000 emergency calls Galveston’s EMS teams received last year, nearly one-sixth were reported chest pains or other signs related to heart problems.

Historically, hospitals receiving those patients have had to wait until their arrival — via ambulance or helicopter — to see the exact problem and how to respond to it.

However, EMS officials say crews were training in late 2007 and early 2008 to operate a device they called one of the biggest breakthroughs in years.

The device is a machine that can transmit images and information about a heart patient from the scene of an emergency to the hospital itself.

“We can plug it into any phone jack, even one that’s not operational, as long as 911 works, which it does from any line,” said Aaron Pounds, a shift supervisor with Galveston EMS. “An EKG is very complex, and there are a lot of ways to interpret them, but this allows hospitals to base treatment choices on visual information, not just what’s being relayed by the crews.”

With a better idea of exactly what was wrong with a patient, a medical staff could more quickly and effectively begin treatment, Pounds said, noting that life-and-death margins measure in seconds for many heart patients.

“When we’re bringing a patient in, the hospital can have the exact team it needs to handle the exact problem,” Pounds said. “The faster you can take care of a blockage, the more likely you are to save a person from dying and to help them achieve a full recovery.”

Pounds said he and others in his field anticipated the heart monitors working even faster in the months and years to come.

“They’re supposed to be Bluetooth-compatible,” Pounds said, referring to a wireless network for information exchange. “What that could mean is that we wouldn’t even need a phone jack or connection. Anywhere we have a patient, we’d have the ability to send images and information at the push of a button.”

Pounds said chest pains were not the only signs of cardiac problems.

“Sometimes, it’s just someone saying they’re not feeling right,” he said.

Conversely, not every chest pain is a cardiac arrest. Chest pains can be one of many signs of an asthma attack, an increasingly common crisis, as the respiratory disorder becomes more prevalent.

“The rate of asthmna is about double in children what it was 15 years ago,” said Dr. Edward Brooks, director of children’s asthma programs and associate professor of pediatrics at the University of Texas Medical Branch. “There are a lot of theories as to why that is, but no one knows which of them is correct.”

One of the most widespread theories is that modern children are simply too clean.

“The theory is that children in the old days had a lot of bacterial infections that modified their immune systems, to where they balanced their immune systems’ responses. With the antibiotics and things like antibacterial soaps that are in use today, children don’t get exposed to those as readily.”

About 12 percent of the United States’ population has asthma, and treating the disorder has traditionally been limited to stemming its more severe effects. However, Brooks said that studies of correlations between asthma and RSV, a form of bronchiolitis that causes wheezing, have led to the discovery of a possible, injectible treatment.

Brooks said the availability of the treatment — current and future — had nothing to do with medical advances, but with the other entity that most affects people’s access to health care — the insurance industry.

“The antibody really protects young infants, who are the ones most susceptible to RSV, which in turn is one of the biggest triggers of asthma,” Brooks said. “However, it’s very expensive to produce, and the insurance companies have not been willing to pay for anything but the most high-risk kids. The RSV antibody costs about $12,000 a year, for a patient to receive 12 monthly shots. It doesn’t take a rocket scientist to see they’re going to be very particular about the distribution of it.”

Similarly, Brooks said the biggest changes for asthma treatment over the next decade would need to come not from the laboratory, but from classrooms and boardrooms.

“With the market in this country, little attention is given to preventative care,” he said. “I guess the thinking is, ‘If we prevent it, people switch plans so often that we won’t reap benefits,’ but that’s a short-term mentality. When it’s been implemented, asthma education has been very effective, but it’s always been a struggle. Getting the whole medical system to focus on prevention, as well as treatment after the fact, is a very difficult task. No one gets rewarded for preventing massive hospital stays. The very idea of ‘pay for performance’ in preventitive medicine is in its early stage.”

However, doctors nationwide continue looking for better treatments to continuing health problems.

Dr. Kathryn Cunningham, the medical branch’s interim chair of pharmacology, said other medicines in development could make for giant steps in the treatment of everything from genetic disorders to cocaine addiction.

She said modern medicine was on the cusp of tailoring medicines to an individual patient’s unique genetics.

“There are enzymes that will affect different substances in the body, and those can vary,” she said. “Many Asians, for example, lack the enzyme that destroys alcohol in the system. Instead of looking at these tendencies strictly as a problem, we can turn it on its head and look at it as an opportunity to gain perspective. If we can identify and then cover for those interactions in an individual, then we can make a therapeutic treatment that is customized to the individual.”

Cunningham cited depression as a problem that genetic tailoring of medicines could help alleviate.

“If you see a doctor for treatment of depression, they’ll give you a drug, but there’s no tailoring involved,” she said. “You’ll take it three to four weeks, and if it works, great. If not, they’ll try another, and that’s true of a lot of conditions. Because of specific genetic(s), I might simply respond to a particular treatment better than you. If we can identify those genetics, we can target better therapies. That’s what we’re trying to do and applying it to addiction.”