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Nahum Kovalski

Run Run, The Future Will Be Here Any Moment

How will medical technology change our perspectives on health?
Doctors perform a liver transplant, April 7, 2003 (file photo: Flash90)
Doctors perform a liver transplant, April 7, 2003 (file photo: Flash90)

Like it or not, the future is coming. I am not talking solely about technology but about everything. Whether we want to think about it or not, in 10 years from now, we will be 10 years older. The alternative is unpleasant. There are many people who are concerned and even frightened by what the future will bring. Some would even prefer knowing what’s coming rather than have to face it at the moment it happens.

This is becoming an issue in the world of medical testing. With advances in genetic testing coming almost on a daily basis, and other technologies becoming available that can assess future risk for disease, people are faced with a new dilemma. If a test can tell you that you will most likely have a major stroke by the time you are 70, do you want to know that? Some people would definitely say yes, and begin a whole new lifestyle with a new diet and exercise regimen. Others would not do the test because firstly, they have no intention of changing their lifestyle, and secondly the test is still not hundred percent accurate.

A recent technology has the ability to spot the first signs of Alzheimer’s disease years before it manifests. What this means is that very early Alzheimer’s is already doing damage to our brains years before it starts to affect our memory and ability to do regular daily activities.

At the moment, there is no cure for Alzheimer’s. There are some treatments that can help minimize some of the symptoms. But unfortunately, medicine has little to offer for this devastating disease. From a medical research point of view, being able to identify patients with the earliest signs of the disease would be an excellent foundation for doing human trials on various treatments and medications intended to halt or at least slow the progression of Alzheimer’s.

So imagine you have identified 100 people with very early signs of the disease. For 50 of them, you could try a new treatment. For the other 50, you would follow them over time without any manipulation. At the end of, say 10 to 15 years, you could compare the group that was treated with the group that was not. This is how medical research is done. It is slow, expensive and can be nerve-racking for those who participate in the study.

Also, specifically in this case, the people who are found to have early signs, would really have to be altruistic to join the study. I say this because at the moment, even for those who are in the treatment group, the likelihood of a major success is small. I think it is also clear why many people would not want to have this test. For the simple reason that there is nothing at the moment to do for Alzheimer’s, people would rather not know that they are effectively living on borrowed time.

There have already been companies that have offered genetic analysis to assess the future risk of a whole range of diseases. This is still a very new field and there is still a great deal we do not know. As such, one should be very careful before submitting themselves to be tested in this way. Various genetic testings may actually contradict each other. Therefore, the present recommendation is to avoid this kind of testing unless there is a very specific reason for needing to do it [such as potential parents with a family history of a severe disease, wanting to know what the risk is to their future children].

At the moment, regardless of whatever testing is available, the best advice that any physician can give a patient is to eat healthfully, exercise frequently, avoid smoking and have yearly checkups with their doctor [who will do age-appropriate screening as needed]. I thought of writing a book about the “best advice” from doctors, but as you see, the book would only be three lines long. It would be hard to sell this to the public.

Thanks for listening

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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