Friday, August 29, 2014

Theranos (fertility testing for 35$?!)

I will always remember the day when my third missed miscarriage was discovered. My awesome friend M had come down from Philadelphia to NYC just to hold my hand through it. Soon after I started talking to her, I started crying while in the waiting room. I do not know if it was the memory of past trauma or intuition, but I was literally a blubbering mess while waiting for them to get me into ultrasound. When the loss was discovered, nothing really changed, because it felt like a part of me already knew I had lost that pregnancy even before I got confirmation. I was then completely numb.

That was probably a good thing, because after that was done, they hustled me into a chair to get blood for the recurrent pregnancy loss panel. Usually, phlebotomists can stick me on the first try. On that day, it took them many tries, and each try was one that would have caused me no amount of distress on a regular day. It was the worst blood draw of my life, and I was luckily (or unluckily) too tuned out to care. They took 21 vials of blood, all which were sent off to different laboratories.

Why am I recounting all this? Because blood draws can be painful. They take too much blood, mostly because all tests are not run by the same center. The response time is slow. There can be laboratory-to-laboratory variation. The amount charged is insane.

Had that RPL panel not been covered by insurance, it would have cost me thousands of dollars.

The key to changing the face of medicine is faster and more affordable diagnostic tests. People talk about this constantly, but nobody does anything about it.

A few weeks ago, somebody "liked" a post by A Mighty Girl. I aimlessly clicked on it, and was soon electrified.

Elizabeth Holmes dropped out of Stanford to start a blood diagnostics company that would literally change the face of how things were done.

Asked why she wanted to start this company when she had not even finished college, she replied:

"Because systems like this could completely revolutionize how effective health care is delivered. And this is what I want to do. I don’t want to make an incremental change in some technology in my life. I want to create a whole new technology, and one that is aimed at helping humanity at all levels regardless of geography or ethnicity or age or gender."

Theranos has grown in leaps and bounds in the past 10 years. 

If this very gritty woman keeps forging on, she could very well accomplish what she set out to accomplish. 

How does this system work? Basically, many blood tests can be performed off just a few drops of blood, taken via a fingerprick.

The analysis involves microfluidics, and this company is paranoid about guarding their technology, so nobody knows how it works. Nonetheless, it delivers results rapidly, and their integrated approach allows them to keep adding tests that can be run off their platform, and it is cheap.

The normal fertility panel costs maybe around 2000$. If you use Theranos, you could test FSH for $12.77, LH for $12.73, TSH for $11.55, Progesterone for $14.34, and so on. See here for a list of the Theranos tests. In an intereview in Wired magazine, she stated that her fertility panel would cost $35(!!!!!!!!!).

Where is this available? Theranos has partnered with Walgreens, apparently, and they have planned a nationwide rollout. Currently this may be available to you at Walgreens stores in California and Arizona.

I thought this was amazing. If it takes off, the amount of money that could be saved in the US is mindboggling, and people would be more willing to get tested for little things like iron or vitamin D or Vitamin B-12, which could go some way in optimizing their own health. So here is hoping that this woman keeps forging on, and doing my very small bit to help spread the word.

For more information, go to the writeups in Fortune or Wired, or visit Theranos's website.

Random information aside, I also know that a few of you only stop by to find out how Gauri and I are doing, so here goes: Gauri is such a happy child...she has a smile and laugh for everybody. She now turns over easily and wriggles forward. She babbles up a storm, observes everything, and gets seriously pissed off if you make her lie on your lap like a regular baby. She needs to be sitting up or standing, dammit, because she is a big girl now. She is a total drama queen too...major crocodile tears that abruptly dry up when you do what she wants you to do. She  has discovered the joys of hair pulling: she yanks my hair around, and I feel like a horse being guided around by the reins. Her favorite thing is grabbing people by the hair and yanking them forward so she can slobber and gnaw on their cheeks/necks.  

Saturday, August 2, 2014

Unpredictability (updated)

That seems to be the general theme now.  My grandpa is in very bad shape: multiple strokes, deafness, etc have left him as a mere shadow of the dynamic and independent person he used to be. He is unbelievably frail, and yet has chugged along in this state for years now. My grandmother, a fiercely independent woman used to insist on taking care of him by herself, generally enjoys excellent health. We eventually persuaded her to move to Mumbai (a city she understandably dislikes, as it is so much less comfortable than Bangalore) by dangling the carrot of a great grandaughter. It worked. They have this beautiful bond: Gauri adores her, and she in turn lights up when she sees Gauri. My mom has always said how reserved her mother is, and yet this woman turns to mush when she sees my baby. I think the time Gauri spends with her on a daily basis has really helped my child too.

Last week, my grandma had two heart attacks. It came out of nowhere as these things always do, and I shudder to think how everything would have gone down had she still insisted on living by herself far away in another city. She is only here because Gauri is here, and that is a rather thought-provoking thing. She is doing okay after an emergency angioplasty with two stents in, but the precariousness of the situation has hit home hard. In all this, it was always my grandpa's health that worried people, and this happens to my grandma.

There was such an air of unreality around the whole thing, and still is. Thankfully, my mother is a rock in such situations, which really helps calm the rest of us down.

My grandma should come home in a few days, and hopefully, all will be well. Gauri is also contributing to the general unpredictability. It seems like she has five different sleeping patterns, and she keeps switching them around to keep me guessing. I'm philosophically opposed to imposing a strict schedule for how she should be spending her days and nights, lack the discipline to do it even if I were so inclined (I think), and also have an incredibly stubborn child who sleeps when she wants to sleep, wakes up when she wants to wake up, and eats when she wants to eat. There were an entire roomful of people determinedly trying to wake her up during her naming ceremony: this child determinedly slept through their efforts and woke up with a bright smile once they all left.  So, imposing a strict schedule to generate predictability as is the popular trend seems to be pretty much a non-starter here.

The one thing I CAN and want to control via schedule is when to give her a massage (my mom's contribution mostly), followed by a bath. These two (especially the massage) really seem to help her sleep. On her best nights, she nods off within an hour of her nightime bath, and wakes up at 6-7 am (!!!!). On other nights, she takes 2-3 hours to sleep, but sleeps till 7 am. Then there are in between nights where she wakes up every 3-4 hours and goes quickly back to sleep.  Slightly worse are the nights where she sleeps quickly but she wakes up every 1-2 hours. The worst nights are when she seems to incorporate Nessum Dorma as her personal motto and keeps me up till 3 am. Sometimes even 5 am. I never know which pattern it will be. I do know if I skip the bath and she has not stayed up all day, I'm likely dead meat.

Another challenge with this baby is boredom. All of us talk to her, and we have long rollicking sing-song conversations. Then there is her gym (somebody gave me this one as a gift and she loves it; should I also buy this one to keep it mixed up? Is the kick and play piano gym better? She also loves to be borne around being shown the ceiling fan (her great friend) in different rooms (rolling eyes).  With all this, this kid still is bored occasionally and tries to screech the house down when we stop playing with her and set her down. It is raining cats and dogs continuously, so I can't take her out till this deluge ends. It is time to introduce touch-and-feel books. Anybody have any recommendations?

Any ideas on books and other ways to keep her entertained would be very welcome.

Updated based on comments: Thank you all for the recommendations! I researched exersaucers, and the one thing I found is that they have a shorter usage window if you have a tall baby.  Gauri has gone from the 25th percentile at birth for height to the 80th percentile by 3 months of age, and she is probably passed the 90th by now, so I think she would have only a short time with it. I hence decided to go with an activity table: I picked this can remove its legs and put it on the floor, so she could use it unsupervised as soon as she can sit up unaided, which should not be too far away. I also got the kick and play piano gym, and I'm trying to restrain myself so as to not also buy the rainforest deluxe one.