Manual Its Enough to Make You Sick: The Failure of American Health Care and a Prescription for the Cure

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You might not notice any symptoms of AKI at first. If you do have symptoms, you may notice some or all of the following problems:.

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Acute kidney injury AKI usually happens when your kidneys are damaged suddenly. The damage that leads to AKI may be caused by:. Some examples of problems that can cause you to have too little blood flowing through your kidneys are:. The treatment for AKI depends on what caused it to happen. Most people need to stay in the hospital during treatment and until their kidneys recover.

While you are being treated for the problem that caused your AKI, you may also have treatments to prevent problems that can make it harder for your kidneys to heal. Some possible treatments include:.

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When you return home, your doctor may ask you to follow a kidney-friendly diet plan to help your kidneys continue to heal. Your doctor may be able to refer you to a dietitian, who can help you make a kidney-friendly diet plan that works for you. Thirty years ago, scientists thought that it would be impossible to crack our genetic code and sequence the 3. And then in , never was over.

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It took the Human Genome Project 13 years, roughly one billion dollars, and scientists from six countries to sequence one genome. Today sequencing costs about a thousand dollars. The latest machines can churn out the results in a day. The technology, combined with sophisticated molecular analysis, illuminates the astonishing biochemical variations that make every human body unique. Researchers are pioneering cancer treatments that go beyond creating new drugs. Art: Christopher DeLorenzo. The more scientists discover about those differences, the cruder conventional medicine seems. Consider one-pill-fits-all prescribing.

Most people who take a blockbuster drug, such as a statin or corticosteroid, benefit.

The Food and Drug Administration has identified about a hundred drugs that may not work as commonly prescribed in people with specific gene variants. The problem can be deadly. The drug clopidogrel, for instance, is routinely given to prevent blood clots in patients after a heart attack. But about a quarter of the population has a gene variant that produces a defective form of an enzyme needed to activate the drug.

Some major medical centers now screen heart attack patients for the variant, but the test is far from routine. Geisinger, a large health system in Pennsylvania and New Jersey, recently began offering genome sequencing as a routine part of preventive care, along with mammograms and colonoscopies. Like advances in computer chips, which liberated us from desks and then tethered us to smartphones, the shift to genomics and data-driven medicine will be disruptive in unpredictable—and perhaps distressing—ways. We soon will have at our fingertips extensive data about diseases we may develop over the course of our lifetimes.

To glimpse what that future might look like, meet geneticist Michael Snyder. The result is a high-definition depiction of his inner workings that registers fluctuations that may signal problems. Snyder and the team in his lab take his DNA sequence into account as they analyze a continuous data stream. It includes measurements from blood, urine, and stool specimens he routinely provides and readings from bio-sensors he wears on both wrists, his ring finger, and his right arm.

His team tracks his gene expression, proteins and metabolites, and physiological measures such as his exercise activity, heart rate, skin temperature, and blood oxygen. He undergoes MRIs, echocardiograms, and other scans to detect changes in his organs, muscles, and bone density.

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Snyder is not a hypochondriac. He has devised ways to perform genetic and molecular analyses, starting a dozen biotech companies. Four years ago, his sensors picked up an infection, through changes in his heart rate and blood oxygen level, before he felt sick.

When he developed a fever, he suspected Lyme disease. By the time the standard test confirmed his hunch, he had already finished a course of antibiotics. While precision medicine tailors treatment to one person, precision health uses detailed data to help people adapt their behavior and make healthy lifestyle choices. The goal: to avoid the need for treatment in the first place by passively collecting, transmitting, and storing health information as an individual goes about daily life. Advances in electrodes small and flexible enough to fit in textiles could lead to pillow- cases and sheets able to monitor brain waves and sleep patterns.

Toilets that check urine and stool for disease are being developed. In the future, smart mirrors could measure vital signs with radar, and toothbrushes might analyze saliva. Smart refrigerators might soon monitor the food stored and record its nutritional informa- tion. Food quality and freshness would be tracked, along with dietary habits.

Smartphones could analyze patterns that might indicate depression—such as a drop-off in social communication—and alert the user to address potential mental health issues. Sensors could warn a driver about dangerous pollution levels, high blood alcohol content detected on the breath, and driving that indicates stress and drowsiness. Implantable technologies already monitor cardiac activity, nitrogen, and oxygen levels.

Passive monitoring throughout the day is key to constantly improving outcomes. Smart refrigerators might soon monitor the food stored and record its nutri- tional information. Smartphones could ana- lyze patterns that might indicate depression—such as a drop-off in social. Implantable technologies already monitor cardiac activity, nitrogen, and. He also watched himself develop type 2 diabetes. After a nasty viral infection, his glucose level shot up and stayed high, so he thought he might have diabetes. His doctor initially brushed off the possibility, as he had, but tests confirmed the disease.

He gave up sweets, doubled his bicycling, and started running four miles four times a week. Over nine months his glucose returned to normal. Meanwhile he has recruited more than a hundred volunteers for similar profiling. I signed up and went to Stanford for a battery of tests, including genome sequencing.

Did I want to learn all findings, only actionable ones, or none and simply donate the data to research? I checked the boxes to tell me all. My stomach surprised me by knotting in protest. Nurses swabbed the inside of my nose and cheeks and drew 16 vials of blood. Was that my genetic legacy? At 94, she lives on her own in New York City, gets around by bus and subway, and dances and plays mah-jongg at senior centers. The promise of genome testing is to give people more control over their health.

But for the first time I came to think of mine as an inheritance—maybe a lucky one, or not, but disconcertingly beyond my command. The DNA test found nothing bad, Dagan-Rosenfeld said right off the bat when we went over the results by video. I was grateful. I did learn that I metabolize some drugs poorly, including clopidogrel, so I should ask for alternatives if a doctor recommends them. Snyder has turned up important genetic findings in about 17 percent of his volunteers.

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One had been on medication for type 2 diabetes for years—wrongly, it turns out, because he has a rare, inherited form of the illness. Another has a mutation for cardiomyopathy, a disease of the heart muscle that often goes undetected until it causes death. For five years Snyder managed to keep his diabetes in check.