Hard News by Russell Brown

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Hard News: Miracles just rate better, okay?

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  • Kyle Matthews,

    I'm closing the site down.

    I think in order to do that you require some sort of 'perfect storm'.

    Maybe an Osteopath logging on to talk about copyright over a book he wrote about (the evils of) vaccination.

    Since Nov 2006 • 6243 posts Report

  • dyan campbell,

    The NIH in the US have burned through USD1 billion in assessing alternative medicine really hard to try and extract useful, working, safe therapies from it. They have found nothing, nada, not a bean.

    Er, not so Peter. From the NIH:

    NIH Consensus Conference

    "According to a panel of experts at a National Institutes of Health (NIH) Consensus Conference in November 1997, acupuncture has been found to be effective in the management of chemotherapy-associated nausea and vomiting and in controlling pain associated with surgery."

    And from Johns Hopkins:

    Massage and Acupuncture Relieve Pain After Cancer Surgery

    "If you or loved one face surgery for colon cancer, you may want to consider adding massage and acupuncture to the usual care provided."

    Acupuncture is not really "alternative" therapy where I come from - Canada is has a very Chinese heritage, and acupuncture has long been accepted as mainstream medicine. My Mum, pregnant with my sister, opted for acupuncture and moxibustion waaay back in 1946 to control "morning sickness" (*all day all night sickness) after refusing to believe the conventional western doctor who told her that if she took up smoking cigarettes it would calm her nerves and that in turn would quell her nausea. As cigarette smoke was one of the things making her sick, she decided that taking up smoking was probably not going to make her nausea go away. And she always thought cigarettes were bad for a person - gave them bad teeth, bad complexions - long before anyone in the medical profession believed it.

    I don't know anything about chiropractors or osteopaths, so I can't comment. My husband Paul is a physiotherapist (one of the best, if I do say so, in my own biased way) and he is horrified at the thought of "cracking" a neck. You can do a lot of damage that way. Pain can be alleviated by an anti-inflammatory in the short term, and the underlying cause should be treated very carefully and gently in the long term.

    A lot of people don't like physiotherapy treatment because it is not passive - you are required to do quite a bit of the exercise in many cases - and often the pain gets worse before it gets better. In cases where there pain is referred out to a different part of the body from where the problem originates (neck joint referring pain to the shoulder, or sciatic pain referring pain down the leg etc) the treatment will make the pain more intense as it moves closer to its source. When the pain finally moves up to where the injury actually is the pain disappears.

    Not all physiotherapy is painful, but some of it is. It's very effective if you genuinely want to relieve the underlying problem.

    A caution about anti-inflammatory medication: they relieve the pain, but by doing that they can trick your body into thinking an injury is gone - and because of that absence of pain you can injure yourself a lot more. Which is not to say don't take them, but don't be fooled into thinking you can thrash whatever injury you had - the healing process still needs to take place. Keeping moving is usually a good idea yes, but skiing/running/pitching with that injury, not so good.

    Peter, you say a lot of alternative therapies are no more effective than placebos - but the same is true for a lot of allopathic drugs.

    Ben - I think it was Ben - your thinning skin from steroids might be helped by an anti-inflammatory diet

    Anti-inflammatory diet

    and also by avoiding sugar (including alcohol) and possibly a topically applied vitamin C cream. This approach may very well help any underlying rash that the steriod was used for in the first place.

    The role of "alternative medicine" and "mindfulness" as well as a nutritional approach or "ortho-molecular" medicine became very interesting to me when I was a student (biochem/medical ethics etc) and met Linus Pauling. Very interesting guy. I always liked Nobel laureates.

    Jon Kabat-Zinns is also an interesting guy with nearly as impressive credentials (no Nobel prize though),

    UMass Behavioural Med Faculty

    If you have ever sat with someone who has been vomiting so hard and so long they haemmorage a blood vessel in their throat and start gushing blood, you would be grateful to any nutball who can make that stop. I have seen AIDS patients in that state respond brilliantly to aromatherapy. To see someone who has been vomiting/soiling themselves for 12 - 14 hours straight, puking up fluids faster than they can be IVd in - to see that stop and have them sleep soundly for several hours, and wake up asking for soup - well, I'm prepared to endorse the crazy lady with the lavender/mandarin/bergamot potion who used to volunteer for us. They weren't cured, obviously, but a 36 hour reprieve from that kind of misery is pretty valuable in the last days of a patient's life.

    auckland • Since Dec 2006 • 595 posts Report

  • Sacha,

    I'll see whatever it is chiropractors and osteopaths can for a sore back, and raise you polio, smallpox, scarlet fever, and tetanus. Oh, and modern public health.

    Tell it to an engineer. Good sanitation and water supply have saved more lives than doctors ever have.

    Still, in the event of a traumatic injury, I know whose hands I'll be putting myself in. It is not me who is all black and white about this - hence the analogy with religious fervour.

    Ak • Since May 2008 • 19745 posts Report

  • Rich Lock,

    I think in order to do that you require some sort of 'perfect storm'.

    And I heard the voice of The Angel saying 'come and see'. And I looked.

    And The Angel broke the first of the four seals, and before me was an Osteopath, and he rode upon a white horse.

    And The Angel broke the second seal, and behold! A red horse. And upon him was seated a lawyer, specialising in copyright issues.

    And then did The Angel break the third seal, and I beheld Andrew Wakefield, riding upon a black horse.

    And The Angel broke the the fourth seal, and I beheld a plae horse, and upon him was seated a chiropractor.

    And the aPAScolypse followed with them.

    back in the mother countr… • Since Feb 2007 • 2728 posts Report

  • BenWilson,

    Ben - I think it was Ben - your thinning skin from steroids might be helped by an anti-inflammatory diet

    Anti-inflammatory diet

    and also by avoiding sugar (including alcohol) and possibly a topically applied vitamin C cream. This approach may very well help any underlying rash that the steriod was used for in the first place.

    Thanks dyan. The word from 100% of the doctors I have seen regarding my skin condition (eczema) is that there is no proven relationship between dietary factors and eczema. But they are also careful to say that it has not been proven that there is no relationship either, and many people think there is one. This I think is one of the many fallacies of over trusting-medical science - the absence of proof is not the same as the proof of absence.

    For reasons given upthread, I'm willing to try some alternatives - but part of being scientific is not to change too many variables at once, hence my giving the 'trusted scientific methods' a very long run.

    Auckland • Since Nov 2006 • 10657 posts Report

  • dyan campbell,

    __I'll see whatever it is chiropractors and osteopaths can for a sore back, and raise you polio, smallpox, scarlet fever, and tetanus. Oh, and modern public health__.

    Tell it to an engineer. Good sanitation and water supply have saved more lives than doctors ever have.

    Yes, clean water has saved more lives than any other single human advancement, it's true. But let's not forget the contributions made by virologists Jonas Salk (polio vaccine) Edward Jenner (smallpox vaccine) Emil von Behring (tetanus vaccine) - I don't know who came up with the scarlet fever vaccine. Oh, and doctors can be pretty useful...

    Would Alanis Morrisette find this ironic? My Dad (a retired civil engineer) caught typhoid in Nepal (when he was 83) working as for Engineers Without Borders.

    He is now 86 and very grateful for modern medicine, especially antibiotics and IV fluids...

    auckland • Since Dec 2006 • 595 posts Report

  • Lucy Stewart,

    Tell it to an engineer. Good sanitation and water supply have saved more lives than doctors ever have.

    Oh, like the doctors who established the germ theory of disease and the water-borne nature of many epidemic diseases? Those doctors? The engineers didn't just wake up one morning and decide to sanitise drinking water on a whim.

    Wellington • Since Nov 2006 • 2105 posts Report

  • Hilary Stace,

    Ben - I hesitate to inflame the discussion but from my personal experience of eczema I have found the Chinese herbal/acupuncture medical tradition (which is after all older than modern western medicine) to have been effective. The theory behind this is that the body needs to be kept in some kind of equilibrium like a well tuned engine. However, it can get overheated and eczema is one manifestation. It certainly feels hot and itchy. According to this theoretical approach there are ways to cool the body and reduce inflamation by using various herbs/acupuncture points and particularly foods known for their cooling properties.

    Wgtn • Since Jun 2008 • 3229 posts Report

  • Russell Brown,

    I don't know anything about chiropractors or osteopaths, so I can't comment. My husband Paul is a physiotherapist (one of the best, if I do say so, in my own biased way) and he is horrified at the thought of "cracking" a neck. You can do a lot of damage that way.

    I don't know anything about chiropractic, but I should note that it's perfectly possible, common, even, to have an osteo treatment without adjustments (cracking) of the back, let alone the neck. A good practitioner will always ask new patients if it's okay, and should happily treat without it.

    Although my old osteo did say that some part of her work was fixing up the results of patients trying osteopathic techniques on themselves. Duh.

    Auckland • Since Nov 2006 • 22850 posts Report

  • Sacha,

    The engineers didn't just wake up one morning and decide to sanitise drinking water on a whim.

    Fair enough.

    Ak • Since May 2008 • 19745 posts Report

  • Lucy Stewart,

    (which is after all older than modern western medicine)

    I just really fail to grasp why this is supposed to make it any more useful. Or accurate. Or...anything, except old.

    Wellington • Since Nov 2006 • 2105 posts Report

  • dyan campbell,

    For reasons given upthread, I'm willing to try some alternatives - but part of being scientific is not to change too many variables at once, hence my giving the 'trusted scientific methods' a very long run.

    Advocates of the anti-inflammatory diet are about as credential rich and western trained as sci/med types can get. Anderw Weill trained at Harvard med school and Jon Kabat-Zinn is Professor of Medicine Emeritus at the University of Massachusetts Medical School.

    Things change slowly in medicine, and things we know change all the time. When I went to school my biology prof was fond of saying "a sugar molecule is a sugar molecule is a sugar molecule" - riffing on the quote from old Gertrude Stein "a rose is a rose" etc. but it turns out the conventional wisdom was wrong and fructose is not metabolised the same way as sucrose, lactose, dextrose...

    In my Mum's day, doctors said smoking was something everyone should do to maintain good health.

    It's well known that when an injured person goes into shock, letting the shivering occur actually increases the chances of survival... but patients are still wrapped up in thermal foil blankets. A doctor friend of mine says there will probably be a 40 to 50 year lag between that established fact and the way emergency teams respond to a patient in shock.

    When I was hit by a car several years ago, 8 km into a run, on a hot day, lying on red hot ashphalt, shivering with shock, they wrapped me in the inevitable foil blanket. I asked them to take it off, begged them to take it off... they refused... so I screamed those B grade horror movie screams and they took it off... if I hadn't been conscious to do that they almost certainly would have cooked my already overheated liver and kidneys...

    auckland • Since Dec 2006 • 595 posts Report

  • Lucy Stewart,

    but it turns out the conventional wisdom was wrong and fructose is not metabolised the same way as sucrose, lactose, dextrose...

    And this is the awesome thing about science: it changes based on learning new things. Sometimes it takes a while. Sometimes people try to block it. But, ultimately, it changes. It is predicated upon change based upon new evidence. When have you ever seen any type of alternate medicine changed because something was shown to be wrong or not work? Ever?

    Think about it.

    Wellington • Since Nov 2006 • 2105 posts Report

  • Hilary Stace,

    Lucy - New Zealand Chinese herbalists no longer use remedies from endangered species. Now they use equivalents from plant or synthetic origins. That's a change. And the alternative therapists I know are always changing and updating their work. Just like all health practitioners, the best ones are those prepared to critically and constantly review their practice.

    Wgtn • Since Jun 2008 • 3229 posts Report

  • Lucy Stewart,

    Lucy - New Zealand Chinese herbalists no longer use remedies from endangered species. Now they use equivalents from plant or synthetic origins. That's a change.

    Forgive me for being a little sceptical that this is a change based on best practice rather than the illegality of killing endangered creatures.

    Just like all health practitioners, the best ones are those prepared to critically and constantly review their practice.

    But it's not a part of the idea of alternative medicine. You yourself were saying upthread that Chinese traditional medicine must have something because it had been around for a while. That kind of epitomises the ideas at play here.

    Wellington • Since Nov 2006 • 2105 posts Report

  • Hilary Stace,

    Lucy- Chinese medicine has been around many centuries longer than modern western. That means it has has had many centuries to evolve and to develop effectiveness. Just as western medicine is continually improving. And what about Maori medicine - rongoa I think its called. Where does that fit?

    Medical practitioners of all traditions should have forums to share and discuss ideas - they would probably find they have more to agree on than disagree. This thread has shown that it is not an either/or situation.

    Look at something like manuka honey and its antiseptic properties - where did that idea come from? Now been proven through randomised control trials. A remedy from one tradition tested and becomes part of another.

    Wgtn • Since Jun 2008 • 3229 posts Report

  • Lucy Stewart,

    Look at something like manuka honey and its antiseptic properties - where did that idea come from? Now been proven through randomised control trials. A remedy from one tradition tested and becomes part of another.

    Manuka honey? The antiseptic properties of honey have been known for a very, very long time. The mechanism is equally well-known. It's not hugely surprising someone spotted a more effective variety.

    Thing is, though: lots of proven remedies have come from traditional medicine (aspirin!). That's great, and there are whole branches of modern medicine devoted to testing out traditional remedies, as there should be. Nothing should be dismissed totally out of hand.

    But there are also whole swathes of traditional medicine that have not been proven to be effective (e.g. acupuncture.) You can't say on one hand that the bits that pass randomised tests are good, and then that the bits that haven't are equally as good. They're not, or the effect (and mechanism) would have shown up by now. How long do we have to keep trying?

    I say again: Chinese traditional medicine does not get a pass for being old. Bits of it do work. Bits are mystical bollocks. E.g.: acupuncture has been shown to be slightly more effective than a placebo. But so is the placebo acupuncture - sticking needles in the "wrong" places. The point is that someone's sticking needles into you, not that they're in some vital energy points. We aren't required to pay lip service to the mystical bollocks because some bits are useful.

    And that's the thing: alternative medicine always reaches for some very special circumstance in which it has been shown to be very slightly effective. That isn't improvement. Or progress.

    Wellington • Since Nov 2006 • 2105 posts Report

  • Keir Leslie,

    Lucy- Chinese medicine has been around many centuries longer than modern western

    isn't actually true; modern western medicine can be considered a tradition back to Hippocrates and etc, which matches if not beats Chinese medicine.

    Also, there is a decent argument against ye olde randomised double blind clinical trial as a gold standard, but that's an internal squabble in scientific medicine, not an argument against it. (Or, yes, medicine is a rather totalising rigid non-dissent allowing system, and I rather like that.)

    Since Jul 2008 • 1452 posts Report

  • Peter Ashby,

    @Ben Wilson

    The problem with your situation is that you do not expect reality, you want a miracle. Despite media stories like the one that stimulated the this post originally as 'miracles' they are nothing of the sort.

    There is no such thing as a side effect free effective drug, biology and chemistry just don't work that way.

    I am sorry that you are in the situation you are in, you have no good choices, only ones where you have to balance risk vs benefit. Welcome to real life. Forget about the possibility of a miracle cure. But be glad that you live in a time where there is a viable therapy

    Dundee, Scotland • Since May 2007 • 425 posts Report

  • Peter Ashby,

    @Russell

    The point of the Cochrane findings is not that Chiro and Osteo were as effective as standard medical treatments. It was that even standard medical treatments are not significantly better than either placebo or doing nothing. You cannot get from the findings to 'Chiro and Osteo are effective' except by ignoring this point.

    I don't want to get into a citation war with you either, it would be nice if you would just stop cherry picking the data to support the point you want so desperately to hold.

    You have been wasting your money, suck it up.

    Dundee, Scotland • Since May 2007 • 425 posts Report

  • Hilary Stace,

    Good discussion on Media7 tonight about miracle stem cells and the media.

    Wgtn • Since Jun 2008 • 3229 posts Report

  • Ross Mason,

    Phew

    And all that from anywhere else but Upper Hutt! So we could change the subject........

    (Quietly)....Has anybody read 'The Grestest Show on Earth" yet?

    Upper Hutt • Since Jun 2007 • 1590 posts Report

  • Sofie Bribiesca,

    Man, I am so glad I only have a swollen ankle, only the right one mind you, is that good? :)

    here and there. • Since Nov 2007 • 6796 posts Report

  • Peter Ashby,

    @Sacha

    I love the faith Peter has that if something is 'scientific and clinical' then it must therefore be okay.

    Which is of course not what I am saying. Science is no overarching panacea as the Cochrane Review on back therapies show. It is however the best way of knowing that we possess. It is particularly good at testing effectiveness and when applied to 'Alternative therapies' it shows that they do not work better than placebo, your anecdotes notwithstanding.

    That's nothing more than cultural arrogance when it comes to long-established and managed practises like acupuncture that were going for thousands of years before our Euro ancestors moved on from on leeches, trepanning and spells.

    This is funny. You do know the origins of 'Traditional Chinese Medicine' (TCM) don't you? It did not exist prior to Chairman Mao except as a random bunch of local witch doctory. When Mao promised to deliver 'barefoot doctors' to every rural village he had a problem: he didn't have anything like enough doctors, equipment, training places, medicines or even bandages. So kitted out every alternative therapist they could lay their hands on with a party uniform (sans footwear) and sent them out with a list of approved 'therapies'.

    I also note that in defence of it all the most you can summon is a plea for cultural respect, no mention of effectiveness, safety, cost etc. Did you know for eg that TCM herbal preparations are turning up dosed up with powdered pharmaceuticals? It seems they are feeling the pressure from 'patients' who unreasonably expect their expensive cultural medicine to work, yet in standard Mao formulation it doesn't so it needs 'beefing up'. Still beware the heavy metals and the endangered animal parts won't you?

    As for acupuncture, by all means pay your money. It will only hurt if you roll over or you delay a proper therapy for a real condition. Just hope your need for a 'tonic' isn't that undiagnosed tumour weighing you down, eh? Which is why earlier I said that if you must get acupuncture go to one the GPs who offer it.

    Dundee, Scotland • Since May 2007 • 425 posts Report

  • Craig Ranapia,

    Changing the subject... I've just finished watching Media 7 and was there any particular reason, Russell, why you didn't suggest Matt McCarten might like to STFU and let David Cohen finish a sentence a LOT earlier than you did? Otherwise, it was just talkback radio with pictures.

    North Shore, Auckland • Since Nov 2006 • 12370 posts Report

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