The Scan by 2 Minute Medicine®: Tongue-Tied, Understanding Morning Sickness, Ketamine Causes, and Generic Drug Shortages

The Scan by 2 Minute Medicine® is a pop-culture medical newsletter and exclusive benefit for 2 Minute Medicine Plus subscribers.

Tongue-Tied

The Story: A procedure called frenotomy—where the frenulum (the tissue connecting the gums and underside of the tongue) is cut to allow for unrestricted movement of the tongue—is making headlines for its use in infants who are having difficulties with breastfeeding. However, a recent New York Times investigation has the public questioning whether the procedure, better known as a “tongue-tie release,” is actually beneficial in improving breastfeeding.

Tongue-Tie Release

When an infant has an abnormally short or taut frenulum, breastfeeding can be impaired due to restricted movement of the tongue. Frenotomy is a quick and simple procedure that a dentist or doctor can conduct with a dental laser or scalpel. Tongue-tie releases have become increasingly popular over the years with new mothers who are struggling with breastfeeding. Celebrities such as Chrissy Teigen and model Heather Rae El Moussa have recently shared their experiences with the procedure in their infants. However, while the procedure is aimed at improving feeding, there have been accounts of pain, dehydration, and refusal to eat in infants who undergo frenotomy. In fact, research into the area has not been able to point to a consistent benefit of the procedure on feeding in infants. Major complications of the procedure are rare but do happen—bleeding, infection, and extreme sensitivity in the mouth are just some of the potential drawbacks. While frenotomy is necessary in some infants, many physicians suggest that tongue-ties are being overdiagnosed. As a result, some medical practices have warned patients about the procedure. The debate around tongue-tie releases will likely continue as they grow in popularity.

Breastfeeding Blues

While the jury is still out on tongue-tie releases, breastfeeding troubles remain prominent—approximately 70% of mothers experience difficulties when trying to breastfeed. Although the infant formula shortage of 2022 resulted in over a 10% increase in breastfeeding, many women experience significant difficulties with lactation: for anywhere to 5-10% of mothers, breastfeeding is extremely difficult or physiologically impossible. Furthermore, new mothers experience several barriers to breastfeeding, including lactation problems, returning to work, limited social support, and more. Formula feeding remains a viable option for mothers who are unable to breastfeed, but unfortunately, ongoing shortages, stigma, and surging costs remain significant barriers for new parents. Although breastfeeding comes with several health benefits, there is an increasing awareness that “fed is best,” countering the notion that breastmilk is necessary for the healthy growth of the baby and reducing the stigma around mothers who do not breastfeed.  Amanda Seyfried and Khloe Kardashian are just two of the many celebrities who have opened up about their breastfeeding struggles and brought awareness to the issue.

Understanding Morning Sickness

A recent study in Nature may have uncovered the cause of morning sickness in pregnancy. A hormone called GDF15 was identified as the link between maternal risk of morning sickness. The study found that the hormone levels were directly correlated with the severity of symptoms in pregnancy. This comes as great news for the approximately two-thirds of women who experience morning sickness during their pregnancy.

While morning sickness is not uncommon during pregnancy, a small percentage of patients experience extreme nausea and vomiting called hyperemesis gravidarum. In this condition, pregnant patients experience excessive and uncontrollable vomiting, which can lead to dehydration and weight loss and pose several risks to both the mother and fetus. Fortunately, a new medication that blocks the culprit hormone, GDF15, is currently being tested in cancer patients who are also affected by nausea and vomiting. Morning sickness is largely understudied and misunderstood by researchers and patients alike, despite public attention around the condition from celebrities like Kate Middleton and Amy Schumer. The latest findings about GDF15 provide hope that one day, expecting mothers will have a treatment for their morning sickness woes.

Ketamine Causes

The world was shocked and saddened by the sudden passing of “Friends” star Matthew Perry months ago. A recent report revealed that the cause of death was linked to the acute effects of ketamine, which the actor was receiving for the treatment of depression and anxiety. Ketamine is classified as a dissociative anesthetic drug, which can temporarily alter a person’s perceptions. The medication is better known for its recreational use but is also used for treatment-resistant depression. Perry was vocal about the mental health and substance use struggles he faced throughout the years.

Although medications like ketamine and other psychedelic drugs can be ground-breaking for those with difficult-to-treat mental health conditions, they do not come without their risks: the triggering of manic episodes or seizures are just some of the concerns associated with the medications. Autopsy reports found that the amount of ketamine in Perry’s blood was approximately ten times higher than the normal therapeutic dose, and there were other medications, including buprenorphine, in his system at the time. Many are concerned that the tragic passing of Matthew Perry will result in public fear of using ketamine, resulting in stigma that may prevent people from accessing the benefits of the drug.

Generic Drug Shortages

We have recently witnessed shortages of commonly used antibiotics across the country. However, not only antimicrobials are in short supply: over 300 medications have been missing from the shelves this year. Generic drugs, a cheaper alternative to other brand-name drugs, which account for around 90% of prescriptions in the United States, are particularly affected by the ongoing drug shortage crisis. Causes of these shortages can be linked to increased demand, especially for new drugs efficacious in weight loss, such as Ozempic and Wegovy, manufacturing delays, and more.

Unfortunately, the drug shortages are reaching a frightening new level: common chemotherapies are no longer accessible to patients. Two common anti-cancer drugs, carboplatin and cisplatin, are running low, leaving some patients without the necessary treatments to curb their cancer. While nobody needs a reminder of the severity of cancer, the recent news of Brooklyn Nine-Nine star Andre Braugher tragically passing at the age of 61 from lung cancer further highlights the risk of cancer and the need for adequate treatments to improve the lifespan and quality of life for cancer patients. Ensuring chemotherapies remain accessible will be a top priority for healthcare institutions and governments heading into the new year.

©2023 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc