Most fearsome medical treatments

I have a more than healthy interest in medical procedures. When I have something or hear from somebody having some sort of serious illness I read up on it. Most stuff is just interesting, but some treatments cause me to fear and respect medicine. Here are some of the treatments I will hopefully never need:

(please note, I am not a doctor, consult one for official opinions on these procedures)

Heart transplant

A heart transplantation is performed when a heart is no longer able to support the patients body. The new heart is harvested from someone who has recently deceased and is kept on artificial circulation to keep the heart in good condition. When the surgery is near, the heart is stopped and put on ice. The patient is put on cardiopulmonary bypass which means that circulation and oxygenation of the blood is done with a heart-lung machine. The old heart is removed, the new one put into its place and connected to the main veins and arteries. The heart is then restarted and from then on handles circulation in its new body.

After surgery it will take about 2 weeks to recover. Because the body will attempt to reject the foreign tissue, patients will have to take immunosupressant drugs for the rest of their lives, which compromise the patients immune system. So, while this procedure can be life saving, it introduces new medical challenges. Fortunately, a lot of research is being done on heart transplants which has brought more insight on complications, and as a result treatment options have increased, resulting in improved prognosis for patients.


Bone marrow transplant

Bone marrow transplants are performed on patients with leukemia or multiple myeloma, both cancer type diseases that affect the bone marrow and/or white blood cells that are generated by bone marrow tissue.Basically, bone marrow is replaced with non-diseased tissue from either the patient (tissue removed beforehand) or another person. Because of the risks involved in the treatment, it is usually reserved for life-threatening situations.

When a patient receives bone marrow from another person, usually the old tissue is completely destroyed by chemotherapy or total body irradiation. This leaves the patient temporarily with no immune system at all, and probably requires them to stay in one of those nice “cleanrooms” for patients. The patient is dependent on the success of the treatment to get his or hers immune system back online. Not something I would like to experience.

One of the major complications with this treatment is graft vs. host disease, in which the donor tissue attacks the patients tissue because it sees the whole body as foreign tissue. Compared to this, my corneal transplant rejection was nothing…

Severance of the corpus callosum

The corpus callosum connects the two halves of the brain. Without this connection, communication between both sides of the brain is severely disrupted. For example, people with this condition usually can’t vocally describe something seen with their left eye. This is because the optical information is sent to the right side of the brain and the vocal center usually resides in the left part.

Would we intentionally sever this connection? Yes, in certain patients with epilepsy the corpus callosum is partially or completely severed to prevent epileptic seizures from affecting the whole brain. However, living with a split brain doesn’t look like fun to me…

Neutron capture therapy

To treat cancers of the head, brain and neck, very local irradiation is needed to prevent damage to healty brain tissue and nerves. A way to do this is to inject a chemical containing the element Boron or Gadolinium in a tumor and activate the element with a high intensity neutron beam.The element then becomes radioactive and causes local, very precise irradiation of the tumor.

The required amount of neutrons means that the patient has to be treated inside a nuclear reactor. Thats right, a friggin’ nuclear reactor. Neutrons exit the reactor core through a long straight tube which ends up next to a table in the treatment room on wich the patient lies down. I once visited the High Flux Reactor in Petten here in the Netherlands which has a treatment room dedicated to this treatment. You can wake me up in the middle of the night to visit a nuclear reactor, but I hope that will never happen because I need this treatment.

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