Success is an Iceberg: My Thoughts

By: S.C. Ali

Founder/Author

A few weeks ago, a friend posted the above picture on social media. Typically, when I see shared posts I bypass them relatively quickly. However, this particular picture caught my eye.

In physical science, an iceberg floats in water because ice is less dense than water. Water is most dense at 4ºC in its liquid state, an anomaly in the science world. Because of the density difference, approximately one tenth of the ice floats above the water, and the other nine-tenths is submerged below the water.

The basic analogy drawn in the picture is simple. The road to success is long and hard, and when you reach the top (the apex of the iceberg), society recognizes it. However, unfortunately, many people do not understand and appreciate the road it takes in order to be successful. As a result, feelings of jealousy and envy may arise. However, these harbored feelings are weak and immature. If people valued more the determination and persistence that it takes in order to reach the top, there wouldn’t be jealousy, only admiration.

One example I am most familiar with is the road to becoming a physician. I am fortunate to have over 100 colleagues who are undergraduate students interested in medicine, medical students, or medical residents. Some individuals who are not healthcare professionals tend to glorify doctors. One of the first things I have heard time and time again from people is, “Oh, doctors make a lot of money.” Although doctors tend to be in the higher income strata, in the United States, they need to go through at least 11 years of school/training after high school before they reach the tip of their iceberg. Medical students who would like to pursue a residency in a more specialized field have to go through even more years of residency training before they achieve their goal. Residency is a tough road, as physicians are frequently overworked and underpaid during these years of training.

Some examples of current successful and prominent figures outside the medical realm include: Bill and Melinda Gates, Warren Buffet, Angela Merkel, and Janet Yellen. Although all of these individuals are reaping the rewards from their many years of hard work and determination at present, they all had their own trials and tribulations to go through before reaching there.

In essence, the qualities shown in the picture above are essential to success. The higher and more ambitious your goal, the steeper the hill will be to climb. However, the steeper the hill, the more rewarding the accomplishment when you reach the top. I implore you to set the example for society. Strive only for the best in whatever you pursue. Know that if you sincerely want the best, the road will be difficult and full of obstacles. However, the reward will be great. If you are serious about succeeding, it is imperative to master the qualities in the picture carefully. In doing so, you will acquire the capability to pave your own road to success. If there is someone who is highly successful among your cohort of family or friends, use them as an example. Ask them what they did or what they had to go through in order to reach where they are. Don’t just focus on the finished product, acknowledge and appreciate the process that it takes in order to reach that result.

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Quick Update!

Hi everyone,

I hope everyone has been doing well, and you are enjoying the high quality content we strive to output.

In case you all haven’t already noticed, we are limiting our posts to once a week in order to ensure consistency and fluidity. In addition, it makes it easier for you, the readers, to keep up to date with everything.

All of the writers are going to be pursuing graduate education starting this Fall. As a result, we won’t be able to write as frequently as before. However, Bronze Lifestyle will stay active for you to spread the word to your family, friends, and followers. The site is always up 24/7 for your perusal. We hope you all enjoy the wide variety of topics we have to offer.

Thank you for your readership!

S.C. Ali

Editor-in-Chief

Macular Degeneration: An Overview and Treatment Options

By: S.C. Ali

Founder/Author

Age related macular degeneration (AMD) is one of the most common causes of vision loss in the elderly demographic. It is defined in basic terms as the degradation of the macula, which are multi-layered ganglia cells that are located approximately in the middle of the retina. For those who aren’t aware, the retina is one of the main portions in the eye. It is a, “light sensitive layer of tissue.” It has many important functions. However, for our purposes, one of the main functions of the retina is to absorb light, and then electrochemically excite the cells which then cause nerve impulses. These nerve impulses travel via the optic nerve through the brain. Thus, the retina can be viewed as somewhat of an important intermediary between what we see physically and our brain comprehending what we have seen.

When you go for a routine eye exam, your ophthalmologist/optometrist will look at the fundus (interior portion of your eye). It typically involves asking you to look straight ahead into an apparatus and stare at a point on an image. The macula shows up as a dark spot towards the middle (see picture 1 below).

Picture 1

As people age, this dark spot starts to fade and become less concentrated (see picture 2 below).

Picture 2

If a general ophthalmologist/optometrist sees this fading, they will make a note of it. Upon recommendation, the patient who has a degrading macula (hence the term “macular degeneration”) will be referred to a retina specialist for further treatment. A retina specialist is a board certified ophthalmologist who has completed additional fellowship training in retina care. In terms of vision, the patient’s vision becomes slightly blurred. Most importantly, if the patient is looking straight, the center part of the image is distorted. From the patient’s perspective, “straight lines appear wavy and parts of the grid may appear blank.” Although this does not lead to total blindness, it significantly impairs vision and thus quality of life.

Although age is the primary cause of macular degeneration, there are certain diseases that are potential risk factors, and associated with it. These include but are not limited to: high blood pressure (hypertension), obesity, Vitamin D deficiency, and smoking. There are a few other factors like high cholesterol and prolonged exposure to sunlight, but the data is more inconclusive for these two and thus further research is necessary. In addition, there are some genetic predispositions to developing macular degeneration. See this article for more details regarding the specific genetics involved. As a result of this polygenic factor, people who have a first degree relative with AMD have an increased risk and are advised to stay up to date with eye exams.

There are two main types of age-related macular degeneration: dry and wet. In dry macular degeneration, tiny extracellular material, called drusen, builds up “on the retina and beneath the macula”. It is typical for a small amount of drusen to build up over time. However, if too much drusen aggregates, it could be an early sign of AMD. Drusen is firm in nature hence the term, “dry.” According to Dr. Mogk, an international expert on age-related macular degeneration, dry AMD accounts for approximately 85% of all cases. This form of AMD tends to be a slow degradation. The other form of AMD, wet, is vascular in nature and accounts for about 15% of all AMD. This form is such more severe because according to Dr. Mogk, “abnormal blood vessels grow from the retina to the macula. This causes a bleeding or leakage of fluid, damaging the macula.” Because the wet version involves rupturing, the majority of severe vision loss cases in AMD are wet.

Unfortunately, there is no “cure” for age related macular degeneration. However, the goal of the ophthalmic team is to try and delay the deterioration of the macula as much as possible. There are a few options that look very promising. There is an FDA approved telescope implant that assists in gaining back the central vision that is lost with AMD. Again, this doesn’t regrow a macula by any means, but rather attempts to treat the effects caused by AMD. At the moment, the tiny implant is only for the most severe cases. The next type of treatment is pharmaceutical in nature, and tends to be used for wet macular degeneration. The two FDA approved treatments are ranibizumab/lucentis and bevacizumab/avastin. These medications are injected into the eye directly and work to inhibit growth of new blood vessels. Thus, it attempts to reverse the mechanism of wet AMD to a certain extent. These two medications are still undergoing clinical trials in order to determine the efficacy of each. Another type of treatment is laser photo-coagulation, where a laser is used to, “destroy or seal off new blood vessels to prevent leakage.” However, this can cause scar tissue. Thus, the laser isn’t as common as it once was.

In conclusion, with the large elderly population of baby boomers and the increasing life expectancy/rising senior population, being aware of AMD is of the utmost importance. Because there is no cure yet, it is difficult to treat AMD. However, there are some gold standards that can be implemented to slow the process. First of all, if you have a genetic predisposition to AMD, then you should see your local ophthalmologist for routine eye exams. The earlier it is detected, the quicker measures can be taken to reduce the deterioration. If diagnosed with AMD, there is a certain dietary regiment recommended by the National Eye Institute called the AREDS diet. It involves incorporating certain vitamins and minerals in your diet which includes but are not limited to: zinc, lutein, and omega-3 fatty acids. Please note that the literature shows that the AREDS diet doesn’t prevent AMD. Rather, it is recommended for if you have already been diagnosed with AMD. In addition, your retina specialist may implement a pharmaceutical regiment depending on if it is wet or dry AMD. In order to determine which treatment regimen is best for you or a loved one who has AMD, please consult your local ophthalmologist/retina specialist. For the future, we hope that researchers are able to devise a short term and long term cure for both wet and dry age-related macular degeneration.

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