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Alan Cassels

By Alan Cassels, September 2016

The war on blood glucose is stupid, costly and bloody.

blood glucose meter graphicAT 66, Sandra B. in Vancouver was feeling great. She lived a healthy lifestyle and was exercising. After the death of her mother a few years ago, however, she found herself inexplicably losing weight. The weight loss became noticeable and her partner suggested she go to the doctor and “get that checked out.”

She went to a walk-in clinic where the doctor sent her for a battery of tests. She wasn’t, however, prepared to hear the results. 

“I got a call three days later and the doctor told me to come in and see her,” said Sandra. “So I went to the doctor and she looked at me and said: “You’re a diabetic.’”

By Alan Cassels, July 2016

New studies provide further evidence that cholesterol-lowering statins and other new drugs may be a costly dead end.

Lipitor pillsTHREE NEW STUDIES in the past few months are like nails in the coffin of the Cholesterol Hypothesis, which has only seemed to become more questionable as our knowledge advances.

This hypothesis, simply put, posits that by measuring your blood cholesterol levels, and then altering those levels by taking cholesterol-lowering drugs, people can avoid heart attacks, strokes and an early death.

By Alan Cassels, February 2016

The likely cost of the unjustified firing of eight Ministry of Health researchers is staggering, yet no one has been held accountable.

Mike de JongNEXT MONTH WILL MARK four years since  whistleblower Alana James raised concerns to BC’s Office of the Auditor General about contracting and drug research irregularities in the BC Ministry of Health. Her complaint ignited a tiny fuse that led to a powder keg within the Ministry of Health. Thus began a truly unprecedented and bizarre chain of events that included the botched firing of eight employees and researchers, numerous investigations, a suicide, apologies, settlements and reinstatements.

By Alan Cassels, November 2015

Are flu shots 60 percent effective? Or are they 3 percent effective in a good year and 1 percent in a bad year?

It’s the season when the flu sound bites are flying around like sneezes in a windstorm, threatening to infect anything in contact. Despite all the media discussion of mutating viruses, hand hygiene and anti-flu drugs, there is a common punchline to all the chatter: “The best thing you can do to protect yourself is get the flu shot.”

According to the US Centre for Disease Control the flu vaccine this year will be “50 to 60 percent effective in preventing flu in those who get their shots,” a level of effectiveness that often gets repeated by Canadian public health officials.

By Alan Cassels, February 2015

A Victoria resident spearheads a national vaccine compensation movement.

Bob Martin is the kind of guy who inspires people to action. Fit, energetic, with a wry smile, a spiky crewcut and sparkling eyes, Martin exudes so much energy you’d think this 77-year-old has never had a health problem in his life. You might have met him in the Oak Bay Rec Centre where he works as a personal trainer, easily passing for someone 20 years his junior. One thing you learn very quickly about Bob is that he’s a man with a mission. 

In October 2010, two weeks after getting his routine annual flu shot, Martin lapsed into a severe case of Guillain-Barré Syndrome, a disorder where the body’s immune system attacks part of the peripheral nervous system. It left him paralyzed for eight months, four of which were spent in intensive care, so weak and disabled he needed a machine to do his breathing for him. 

By Alan Cassels, December 2015

The Ministry of Health’s attempt to privatize the voice of patients does not have a promising prognosis.

Private corporations vying to position themselves to suck as much as possible from healthcare budgets occasionally deliver some shocking truths. Greg Reh, the US and Global Life Sciences Leader at Deloitte Consulting LLP, wrote an online commentary last month, “Capitalizing on the latest breakthrough drug: the patient.” He writes that “life science” (i.e. pharmaceutical) companies “should consider revisiting the strategies and services they provide around patient access, support, education, and adherence. If they don’t, they could lose out on one of the best breakthrough drugs of the century—patient engagement.”

Which is to say, Deloitte’s the kind of big league multinational consulting firm capable of packaging up a nice little pill for governments and drug companies to swallow: the voice of the patient.

By Alan Cassels, September 2015

Vancouver Island’s aging baby boomers, coupled with stretched budgets and operating rooms, have created a perfect storm for timely access to needed joint surgery.

Sixty-eight year old Nancy Tienhaara, who works in marketing for a Victoria software company, felt she needed a new knee but couldn’t get it. The pain, she recalls, was unbearable and X-rays showed there was very little cartilage in her knees. Walking was difficult and painful. After seven weeks of waiting, she finally got in to see an orthopaedic surgeon. But she didn’t hear what she wanted to hear: She wasn’t a good candidate for surgery—her pain and immobility were not yet severe enough.

By Alan Cassels, February 2015

A Victoria resident spearheads a national vaccine compensation movement.

Bob Martin is the kind of guy who inspires people to action. Fit, energetic, with a wry smile, a spiky crewcut and sparkling eyes, Martin exudes so much energy you’d think this 77-year-old has never had a health problem in his life. You might have met him in the Oak Bay Rec Centre where he works as a personal trainer, easily passing for someone 20 years his junior. One thing you learn very quickly about Bob is that he’s a man with a mission. 

In October 2010, two weeks after getting his routine annual flu shot, Martin lapsed into a severe case of Guillain-Barré Syndrome, a disorder where the body’s immune system attacks part of the peripheral nervous system. It left him paralyzed for eight months, four of which were spent in intensive care, so weak and disabled he needed a machine to do his breathing for him. 

By Alan Cassels, June 2014

The large drop-out rate during clinical tests on statins has disguised the dangers inherent in their use.

In early April this year, 68-year-old Sooke resident Veronica Diment finally got an explanation of her health problems and an official diagnosis: polymyositis, a chronic inflammation of many muscles.

The former language teacher, who now runs a rural vacation retreat near Sooke, told me the diagnosis landed like a bomb in her life. What was so startling was not that she finally had a name for the disabling condition which has left her at times without the muscle strength to climb the stairs, it was how matter-of-factly a specialist described the source of this auto-immune disorder: “long-term statin use.”

Many pharmaceuticals can improve the quality and length of our lives, yet as Diment’s experience with statins demonstrates, they can also do the opposite. 

Alan Cassels, November 2013

Update on the Ministry of Health scandal

Over the next few months patients and caregivers in BC are being asked for their opinions on the three main drug treatments used to treat Alzheimer’s disease that are covered by BC Pharmacare. On its “Patient Voices” website, the Ministry of Health is requesting input on experience with donepezil (Aricept®), galantamine (Reminyl®) and rivastigamine (Exelon®). Those comments will form part of the deliberations as a government committee decides whether or how the drugs should be covered by the public purse.  

By Alan Cassels, October 2013

Are we ready for the consequences of a province-wide colon screening program?

The sign on the front of the podium said it all: “Screening Saves Lives.” It was April of this year and Health Minister Margaret MacDiarmid was speaking at a very important event. After a three-year pilot study in several communities around BC, she was announcing the official start of the new Provincial Colon Screening Program which was going to be unrolled on Vancouver Island this summer, before moving on to the rest of the province. 

As she was announcing that program, few might have predicted the controversies that lay ahead; a summer where front page headlines were saying people who needed colonoscopies were facing massive line-ups and long waits for referrals to gastroenterologists. The new Health Minister Terry Lake had to face reporters to explain how they would fix things. 

By Alan Cassels, May 2013

Another lawsuit against the Ministry of Health for firings of drug safety evaluation employees

A large question mark still hovers over 1515 Blanshard Street, headquarters of the BC Ministry of Health, as observers try to make sense of the tsunami that has, and continues to wreak havoc in that building and delay drug safety evaluations. Just last month another fired Ministry employee filed her lawsuit against the government, raising the tally to seven lawsuits or wrongful-dismissal grievances. Two other employees were let go (with severance) and one died, a co-op student who was three days away from finishing his work term.

By Alan Cassels, March 2013

Health researcher Alan Cassels explores the context—and theories—surrounding the unprecedented and unexplained destruction of independent drug evaluation in BC.

When I met Robert Brown for coffee a couple of years ago he had something to show me. It was a sample of a new drug called Pradax (dabigatran) that his doctor had given him. It was the first in a new class of drugs prescribed for people with atrial fibrillation (AF), a relatively common condition that can increase one’s risk of having a stroke. The standard script for AF is warfarin, a widely used blood-thinning drug. I didn’t want to worry him but in the course of our coffee I asked if he was aware of the drug safety controversies surrounding Pradax. It was an innocuous question but when the 64-year-old retired professor of statistics and actuarial science called me a few weeks later, he was outraged. 

By Alan Cassels, October 2012

The Cochrane Collaboration’s examination of flu vaccines in healthy adults, a body of literature spanning 25 studies and involving 59,566 people, finds an annual flu shot reduced overall clinical influenza by about six percent.

How many diseases are important enough to have their own season? Not many, but we do have one, and it strikes every year: the flu. 

Arriving in the fall and exiting in the spring, flu season strikes with the predictability of clockwork. For some the flu might be a mild inconvenience, perhaps embraced as a way to stay home and get a few days couchside wrapped in the unpleasantness of high fever, aches, sniffles, and daytime reality TV. Yet for others, usually the elderly or those with compromised immune systems, the flu can be deadly. It can lead to hospitalizations, pneumonia, and sometimes death.