[Ed. Note: Dr. KSS writes about medicine and biotech stocks for the Irregulars. His words and opinions are his own. Enjoy!]
In the Saturday morning Looney Tunes many of us saw as children, one trope always stuck with me: that of the grand piano falling from way up high and crashing, splintering itself. There’s a disease that makes me always think of this notion: like the falling piano, it takes some time for the crash to occur, but once the piano starts falling, absolutely no one can do anything can do but wait for impact and then clean up the mess. If there were to be a way, once this disease begins, to stop it, arrest it, stay its progression, and prevent a catastrophic outcome, if there were a way to do something about it, that should be a way for investors to profit.
On a Friday morning, I was sipping a double espresso and glad the week was nearly over. Patients were just checking in. One of my nurses rounded the corner and dropped a chart in front of me. ”Heeeeee’s baaaack,” she said.
It was Roger R. I liked him a lot, and looked forward to his visits. He was a city official, charming, and quite bright. But he was becoming like a bad penny, a patient we could neither keep well nor out of hospital. He was led into a room, and clearly was in bad shape. He was agitated, and was wearing a blue T-shirt with flecks of blood on it, blood seeping through from his trunk.
”Can’t stand it anymore!,” he said. He was scraping his back against the wall and meanwhile using his nails to dig at his flesh. Tears were streaming down his face. ”I haven’t slept since Monday!” Roger was at wit’s end from itching. He was deeply jaundiced.
Roger had primary sclerosing cholangitis, and this had led to decompensated cirrhosis. PSC is the piano that falls, from 100 storeys up, on the unwary. He was listed for liver transplantation. Medically, he was a mess. He was 54, and before he had become my patient, he’d been diagnosed with ulcerative colitis. Ulcerative colitis (UC) is inflammatory bowel disease like Crohn’s, but with key differences. While Crohn’s disease causes pain, UC seldom does. Crohn’s tends to affect the ileum (distal small intestine) though it can ...
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