RACIAL BIAS IN MEDICINE PT. 1 – PULSE OXIMETRY MEASUREMENT

Hello world! I have returned! I will try to revert back to my weekly Wednesday posts, but I figured this one was long overdue already. This post will not be the last time you see this topic on my blog because I feel that it should be talked about more. I, myself, am not too educated about it, so I wanted to educate myself and you guys about it.

Upon going to the doctor recently, I noticed a new medical device used on me alongside the typical sphygmomanometer and stethoscope. It was a pulse oximeter (below is a picture of it).

Sammons Preston Finger Pulse Oximeter | Performance Health
pulse oximeter

A pulse oximeter is a device that is typically clipped onto your finger to measure your oxygen saturation level. It can rapidly detect small changes in how efficiently oxygen is being carried to the extremities furthest from the heart like the legs and the arms. It uses infrared light refraction to measure how well oxygen is binding to your red blood cells. The device shines two wavelengths of light through the skin of the finger to detect the color of blood.

One of the main diagnostic criteria for COVID-19 is shortness of breath and low oxygen levels. COVID-19 enters the body through the respiratory system which causes direct injury to a person’s lungs via inflammation and pneumonia which leads to a decrease in the person’s oxygen saturation levels. Pulse oximeters are also helpful for detecting people who have “happy hypoxia” which is when the person with COVID-19 appears well but has dangerously low oxygen levels.

Because of the nature of how pulse oximeters obtain readings, they can be faulty if a person has circulatory issues with poor blood flow to the extremities (cold hands, intrinsic vascular disease or Raynaud’s phenomenon). In addition, dark colored nail polish can distort the readings. Also, the color of your skin also distorts readings. Researchers found that the device was three times more likely to give black patients false readings. Melanin which is “a dark brown to black pigment occurring in the hair, skin, and iris of the eye in people” absorbs lights in those wavelengths which causes errors within the readings.

Inaccurate oxygen level readings can also be the difference between going on necessary supplemental oxygen or not. Medicare requires you to have maximum of 88% of oxygen saturation and the test saying so or they will not cover the supplemental oxygen. So, people of color who are not getting an accurate reading because of the error of the device may not be put on lifesaving oxygen and could suffer brain cell damage due to the lower oxygen levels in their blood.

While researching, I stumbled upon some stories told by others about how the pulse oximeters had given them drastically inaccurate results. On Instagram, user @/nadirahyas said that she “literally had liquid in my diaphragm and couldn’t take a full breath, but according to the machine mhy oxygen levels were at 98%.” A normal reading is between 95-100.

Though there have been improvements to the device, there is always still work ahead. The majority of study subjects that were used were typically light skinned and that caused a skew in the data. If you are wanting to test out a new device, medically or not, remember to take into account a wide variety of people.

Sources:

https://www.houstonmethodist.org/blog/articles/2020/aug/can-an-oximeter-help-detect-covid-19-at-home/

https://www.nejm.org/doi/full/10.1056/NEJMc2029240

https://www.ktvu.com/news/widely-used-medical-device-has-higher-error-rate-in-darker-skin-study-suggest

oxford language definition of melanin

Things That Native People Invented

Hello world! Sorry for the late post, but hopefully this longer post will make up for it.

There are tens of hundreds of inventions that we use everyday. These things are so fundamental to our daily routine that we never stop to think of their origins. Some of these useful everyday things were actually invented by Native American people.

  1. Cable Suspension Bridges
Q'eswachaka Inca Bridge: The 500-year-old tradition is still alive.
Q’eswachaka Inca Bridge; pic creds: Inkayni Peru Tours

Rope suspension bridges have a long history of use within the Americas, most notably with The Inca people. They had originally weaved mountain grasses and other vegetation into cables—which could be as thick as a human body—to build strong suspension bridges that spanned across gorges. One of these bridges is still standing in Peru’s Canas Province and is pictured above. Today’s modern steel suspension bridges draw on the Inca design as the model.

2. Aspirin

The salix nigra willow tree’s bark was used by many different native tribes for particular ailments. Native Americans recognized the many useful medicinal and technological qualities of the willow tree. The inner bark and leaves of many willows contains the medicinal extract, salicin, or salicylic acid which is an active ingredient in common aspirin (acetylsalicylic acid). The Native Americans would chew or boil a tea from the willow’s leaves or inner bark to relieve fever or minor pains like toothaches, headaches, etc. This is why the willow was given the nickname “toothache tree.”

Though the Native Americans technically were not the first ones to discover this, I would like to emphasize how important traditional medicine is and how it has impacts modern medicine. In ethnobotanist and explorer of the Amazon Mark Plotkin’s talk, he discussed the significance of indigenous medicine and how things like deforestation and the rubber trade put the uncontacted tribes and their knowledge in danger. Within the Amazon Rainforest is thousands of plants and animals that are used to treat people. The venom from the Brazilian pit viper is the source of one of the most commonly prescribed drugs for hypertension, captopril. And yet, this area is getting ripped apart and chopped down. The Brazilians did not get a nickel from this.

Take a moment to reflect on yourself: what do you think of when you think of indigenous tribes? Are they people who have their own culture and knowledge, like the Akuriyos who have 35 words for honey? Or are they seen as primitive because they “didn’t know how to make fire”? These tribes are dying out, and with them the cultures that once danced, prayed to the gods, hunted for food. All that is left is an imprint in stone, and sometimes nothing more. Plotkin emphasizes that isolated tribes should be left alone, left to flourish. There is no need for us to change the way in which they live. There is a business called human safaris in which they take you to the isolated groups to take their picture and give them goods and tools, and subsequently, diseases. There is no reason for this infringement on to these people.

3. Kayaks

http://intellectuelbouffon.lemultiblog.com/fichiers/intellectuelbouffon/images/ kayak-inuit-gd.jpg | Kayaking, Sea kayaking, Canoe and kayak

The first kayaks were made by the kayaks from natural materials such as wood, whalebone, and sealskin. They were the main method used to travel for many coastal tribes and benefited from their small size which contrasted the large European ships. Also because of their small size, they could navigate choppy rivers and narrow canals.

4. Snow Goggles

First Sunglasses Were Used 2,000 Years Ago By Iniuts
Snow goggles; pic cres: themindcircle

Carved from wood, bone, or seal ivory, the goggles were invented by the Inuit people and allowed a limited line of sight to come in through slits which minimized the harm done to the eyes by UV rays and prevented snow blindness (photokeratitis) when outdoors. These goggles were the precursor to today’s snow and sunglasses.

MINORITY HEALTH AND COLORECTAL CANCER

In light of the death of Chadwick Boseman, a black man most famously known for his role in Black Panther and other Marvel movies (may he rest in power), we must realize the racial disparities that occur in colon cancer. Colon cancer is the third-most common cancer in all adults in the USA. Colorectal cancer affects men and women and impacts people of all nationalities and ethnic groups. However, they are not impacted equally.

African Americans

  • 15 to 20% more likely to die from the disease than patients of any other race
  • higher chance of being diagnosed at a later stage and with a higher morality rate
  • recommended to be screened at 45 instead of 50 because of genetic factors (“African Americans with colorectal cancer are more likely to cope with an aggressive subtype fueled by a mutation in the KRAS gene, which drives cancer growth )
  • affected by socioeconomic barriers (low income, difficult to find transportation, lack of health insurance, lack of medical literacy, and access to care)

Asian Americans

  • 52% of Asian American adults between 50-75 have not been screening for colorectal cancer
  • colorectal cancer is the 2nd most common cancer in Asian Americans
  • risk of colorectal cancer increases greatly upon immigration to the United States
  • many Asian Americans are unfamiliar with colorectal cancer as disease rates in native countries are very low

Hispanics/Latinx

  • 47% of Hispanic adults between 50-75 have not been screening for colorectal cancer
  • also affected by socioeconomic barriers
  • cultural barriers (misconceptions about western medicine, language barrier in communicating with medical personnel)
  • talking about disease and death is culturally taboo

American Indians and Alaska Natives

  • fewer than half are current with colorectal cancer screening
  • colorectal cancer is the second most commonly diagnosed cancer and second deadliest cancer in American Indians and Alaska Natives
  • they live in rural and isolated communities so it is hard to find screening
  • higher burden of cancer risk factors
  • socioeconomic barriers (lack of funding for tribal health clinics, high rates of poverty, lack of health insurance, etc. )

SYMPTOMS OF COLON CANCER

  • changes in bowel habits and stomach pain (diarrhea/constipation)
  • unexplained or unintentional weight loss
  • unexplained fatigue
  • anemia
  • cramping pain in the lower stomach
  • rectal bleeding with bright red blood
  • blood in the stool
  • cramps/abdominal pain

Symptoms of colon cancer mimic other GI disorders, so doctors are less likely to screen patients under 50 with these symptoms. If you have access to healthcare and you are experiencing any of these conditions, please see a doctor!

In honor of Chadwick Boseman, please consider donating to organizations like the Colon Cancer Coalition that raises awareness for early colon cancer detection and effective treatment for colon cancer patients.

sources:

https://www.inovanewsroom.org/featured-posts/2020/02/colon-cancer-and-the-black-community/

BLACK WOMEN I WISH I LEARNED ABOUT IN SCIENCE CLASS

Let’s be real, students are continuously lectured on the groundbreaking experiments and discoveries that white men have made. Black women, particularly Black woman in STEM, aren’t given the recognition and honor that they deserve. This is why I have created this post to honor the Black women who have impacted and shaped medicine/science.

Dr. Gladys West

Image result for dr gladys west
Dr. Gladys West, an American mathematician. The hidden figure behind the GPS; 1930-?

Dr. Gladys West is an American mathematician known for her contributions in a device that is essential to everybody all over the world: the GPS. Prior to her mathematical model of the earth, the precise measurement of distances over the Earth’s surface was nearly impossible. The imperfect shape of the earth and the variation of sea levels make calculating these distances challenging. Dr. West used the information from satellites to refine an increasingly detailed and accurate mathematical model of the actual shape of the earth, a “geoid.” Her work wasn’t officially recognized until early 2018 when the United States Military recognized her in a press release issued by the Air Force Space Command. She was later commended by the Virginia State Senate and inducted into the Air Force Space and Missile Pioneers Hall of Fame.

Katherine Johnson

Katherine Johnson - Wikipedia
Katherine Johnson 1918-2020

Katherine Johnson was a person who pushed the limits. Despite being both African-American and a female, she excelled both academically (graduating with highest honors and one of three black students to be integrated into West Virginia’s graduate school) and in her workplace (NASA, referred to as NACA at the time). In 1962, the United States decided to send people to the moon; Johnson was one of the members on the team that figured out the calculations and math surrounding the trip. Johnson figured out the paths for the spacecraft to orbit Earth and to land on the moon. Her calculations of orbital mechanics were critical to the success of the first and subsequent U.S. crewed spaceflights.

Henrietta Lacks

Henrietta Lacks and Her Remarkable Cells Will Finally See Some ...
Henrietta Lacks circa 1945-1951; pic creds. The Wall Street Journal; 1920-1951

Henrietta Lacks visited The Johns Hopkins Hospital, one of only a few hospitals that treated poor African-Americans, in 1951 due to vaginal bleeding. Upon examination, the doctor discovered a large, malignant tumor on her cervix and immediately began radium treatment on her. As standard procedure, they got a sample of her cancer cells and sent it to another doctor, Dr. George Gey. Typically, each sample quickly dies in Gey’s lab. However, Lacks’ cells doubled every 20 to 24 hours. Today, these cells—nicknamed “HeLa cells”— are used in a variety of ways including studying the effects of toxins, drugs, hormones without experimenting on humans. Her cells were the first immortal human cells ever grown in culture. They were essential to developing the polio vaccine and went up in the first space missions to see what would happen to cells in zero gravity. Between the years 1953-2018, HeLa cells have been used by researchers from 142 countries and in 110,000 publications.

Dr. Angella Dorothea Ferguson

Dr. Angella Dorothea Ferguson; 1925-?

Dr. Angella Ferguson is an American pediatrician known for her groundbreaking research on sickle cell anemia, a hereditary disease that causes improper folding of red blood cells. The folding results in improper blood flow to organs and deprive the affected organs of blood and oxygen. Dr. Ferguson’s research focused on the development of the sickle cell disease among African American infants. She developed a blood test to detect sickle cell at birth which eventually became the standard for forty U.S. states by 2010. Her research set the guidelines on how to diagnose and treat sickle cell anemia.

Alice Ball

Alice Ball - Death, Facts & Leprosy - Biography
Alice Ball; 1892-1916

Alice Augusta Ball was an American chemist who developed the “Ball Method,” the most effective treatment for leprosy at the age of 23. In 1915, an infection with leprosy—a chronic disease causing skin lesions and nerve damage—was a death sentence. If infected, patients were commonly sent into mandatory quarantine in “leper colonies,” never to return. Prior to the Ball Method, a somewhat-effective treatment for leprosy was the use of an oil extracted from the chaulmoogra tree. However, that oil wasn’t readily water soluble, making it difficult for the human body to absorb. Ball was able to discover a method for extracting compounds from the oil and modifying them to become more soluble (ester ethyl form) which led to the development of an injectable treatment for leprosy.