Digital Amnesia

Technology is a brilliant entity. It creeps up on you and before you know it, you are a slave to the forces of something that is man made. While all of it isn't necessarily bad, there is enough dependence on it to have already caused turmoil in the medical community. Most of us are now parents and have children who we regularly reprimand for the excess use of technology, all the while, using it ourselves to help out in every little thing they do. Not only us, but even the schools they attend, subconsciously push technology into everything, while trying to play the reasoned head that says it's bad for you and don't do too much.

Needless to say, it's here to stay and if we need to get ahead in life we have to adapt and accept it. To what extent is the question at hand?

Kaspersky Labs brought out a wonderful paper a few years ago on Digital Amnesia and digital dependance. For those who want more in depth reading please head here.

For those like me who like simple explanations, here it is - We're losing our minds! Well, not really but quite literally, we are getting into Harry and Llyod territory. The few of you who didn't get this, you're probably more effected that the rest.

The basic premise of this post is this - Our dependence on the internet and technology for answers to questions we may already know is leading our brains to lose the information we could have easily stored for decades. A simple example is remembering a phone number. Now, I know that we've heard this multiple times and we've argued that telephone numbers have gone from 5 digits to 10 digits, but that's just an excuse and a defense for our denial.

Ask someone to try and remember something and the first thing they tell you is to please message them the details. I recently had a patient who was on antacids for her chronic acidity. She ran out of her medication and asked for the name on the phone to refill her prescription. A simple name with 3 letters and she wouldn't accept it on the phone line. Please whatsapp me was the quick answer. I refused and said if you can't remember it, perhaps you should get a pen and paper and write it down. Keep in mind, this is the same tablet she was using for a week prior to this phone call. It really got me thinking about her memory. Before you assume things like Alzheimer's, she's only 42!

To do task lists, calenders for birthdays, appointment lists, shopping lists, reminders for every day events, your best friends phone number, anniversaries and now even faces! We're forgetting things at an alarming rate and all because we know there is a digital space where we can find all these answers without using our brains!

Another important fact is that since we no longer need to tax our brains into working, we can no longer concentrate. The lack of concentration has already led to diagnoses like ADHD multiplying in incidence (albeit true or false is subjective). We no longer feel the need to even try and remember! Why should you waste those precious 30 secs to force memory when you can type/ask alexa or google!

Lastly, our kids! They're taking to phones faster than ever before. We see the risk in the damage to the eyes, damage to the social life but are we seeing what is going to happen to their developing brain. Grades are falling, anger is quick, patience is thin and tasks are backhanded because everything can be done online! I wonder where this will lead for the future.

What is the solution you ask? It's really quite simple. Work your brains. Try and remember stuff to do, numbers you call often, dates you need, appointments to keep, directions to travel (remember the time we could travel cities without GPS) and names and faces!

Ask yourself this. The person you call most often from your phone (most likely your driver or staff) - do you even remember their number? Try memorizing it and see how difficult it is. At first, it would seem impossible. Keep at it and once it's there, you won't forget it if you use it every time you need to dial them. Move further from this for other simpler tasks! 

A lot of you would pooh pooh this post and say this isn't affecting you that much. This is denial and the process has started already! Work against it and it won't affect you, ignore it and eventually you won't even remember reading this post!

As a parting shot, how many of you can remember the name of this blog without looking up.....and how many of you just did!

Expiry Dates and Logic

Just the other day, my friends and I got into a discussion on the expiry date on medicines and the safety aspect of the same. It soon ballooned into all health products including face cream and bread!

I promised I would do some research and write about it, so, here it is.

Are your medicines safe to take post the expiry date stamped on the packaging? Probably yes. Should you consume said medicines knowingly. probably not! Allow me to explain.

There is a thought that Big Pharma uses expiry dates as a means to push out newer medicines thereby earning more money for drugs that would have otherwise also worked. Let's get into some details.

The process of finding out an expiry date. (I'm no expert here so bear with me)

Expiration dates are set on a particular drug by using the accelerated storage test. Since the rate of disintegration of most drugs are very small at room temperature, the rate of disintegration is determined at higher temperature and extrapolated back to room temperature. Knowing the rate helps to calculate how long it can stay on the shelf. The expiry date is that point in time when a pharmaceutical product is no longer within acceptable specifications for potency and stability

The stability of each drug varies across medicines and each product needs to be tested to see how it is impacted over time. However, this testing is expensive so it isn't done by the pharma companies to add to their costs!

Once the expiry date is set, it's function is to let you know that the drug is probably not going to be effective post that date. Now, since it's an extrapolated date, it isn't very accurate but has been put as a safeguard to the efficacy of the active component of the medication. This works in the favour of the drug companies as well since they are only required to periodically test their products upto the shelf life which is printed on. This means that they are not obligated to test beyond that date. A Propublica study done by the head of the department of poisons in the US showed the following result:

In a study, Dr. Cantrell and coauthor Ray Gerona, MS, PhD, a chemist at the University of California–San Francisco, tested 8 medications in their original packaging that were discovered in a retail pharmacy and that had expired 28 to 40 years before.3 Twelve of the 14 drug compounds were present in concentrations of at least 90% of the labeled amounts.

Perhaps it's time for a rethink. There was a time when Pfizer was in acute shortage of a few products. They did a retest and were able to extend the expiry date on many of their products by up to a year and this was approved by the FDA. Convenient. 

Just a small note on the flipside before you all think I'm pro using expired medication. A study in pediatric antibiotic usage for expired medication showed the following result:

Administration of expired antibiotics can lead to increased antibiotic resistance and clinical treatment failure, as well as adverse drug reactions.

Just one study, but significant nevertheless.

Logic! Use it and you should be fine. If the medicines you think are expired control simple things like pain, a runny nose, some mild cough, it mostly will be safe to take well beyod expiry if you have it on hand. Antibiotics, chemical formulations for kids and serious conditions like Parkinsons and Multiple Sclerosis should probably be best avoided post expiry date simply because they won't work.

An interesting observation: All expiry date publications only talk about the efficacy of drugs. Not one study discusses danger or safety of the drug with respect to it becoming toxic or poisonous to the user (these are regular drugs I'm talking about). So, even if you do take a medication which is expired, in error, do not panic. It may not work as desired but it certainly won't do any harm!