Alternative Therapy for Wound Care

ok... talking points i want to hit:

1. physicians are scientists. there were a ton of med school-bound students in my class last spring, and they were all science majors. we expected as much scientific literacy and critical scientific analysis from them as we did from the future scientists in the crowd. additionally, we imparted to them that scientific knowledge is as much a part of the practice of medicine as bedside manner. medicine is based upon science. science carries over into medical practice. the two go hand in hand, and are not extricable from one another.

2. the atomic bomb n=1 and a safe, effective result with n=1 are not even in the same universe of scientific analysis. rob, you know better than to try this cheap trick. a single within-chemical breakdown reaction will follow the laws of physics, invariably. in america alone there are over 300 million people, all with differing genetic backgrounds, lifestyles, etc. you do NOT want one person to be representative of that entire population and base medical practice upon that. the reason we need sufficient sample sizes are to have proper controls (does the drug work better than placebo, if so, how effective is it, and does it work in most people?) also, the more people in a sample, the more likely we are to find negative side effects and catch them before something dangerous hits the market.

in pure statistical theory, if you require such a high n to achieve significance, you're right. this means the effect is small. but we're talking about an EXTREMELY variable population. increasing population variability also requires an increase in n to ensure the effect exists.

3. this claim of natural substances being safe, ok, less harmful than synthetics, whatever- has bothered me FOR EVER.

let me say that again. it has bothered me FOR EVER. more so now that my area of expertise heavily involves natural products pharmacology.

i'm in neuropsychopharmacology. most recreational drugs are natural, plant-based substances. you cannot in the least, EVER, convince me that natural products are somehow more safe, or that we always have a way to handle the undesired side effects. people die from this stuff. often. poppy seed tea keeps killing college students because they think it's safe. why? because it's natural. what did we do before naltrexone? people just died. end of story.

if i never hear another person equate natural to safe or less harmful or any other qualifier over synthetic drugs again, it will be too soon. biologically active chemicals are biologically active chemicals. period. you really hit a pseudoscience nerve on that one.

4. blood vessels, unlike other parts of the body, do not catch a break when injured. you hurt your leg, pain keeps you off it. you can't just quit using a blood vessel. because they never catch a break, healing is more difficult. blood supply is not the only factor, unfortunately.

5. on the vaccine pseudocontroversy:
putting all the information out there should not include distributing flat-out lies and calling them truth. claiming to inform the public based upon false information and labeling yourself a trusted source of information. period. there is no controversy that measles goes away until unvaccinated people start piling up, in which case it comes back. i could go on. how quickly we forget that coping with the death of a child was just a part of raising children not all that long ago, and the advent of vaccines (among other medical advances) curbed that.

 

Just the thought of Chi Square leaves me tingling with anticipation!

Whether naltrexone or Narcan, I say this: let them die. These are not productive members of our society. I really see no sense whatsoever to sending an expensive, fully equipped ambulance with EMS workers inside, to an OD victim, pumping them full of Narcan, and bringing them back to life

Yes

Try heavy drinking. Oh wait, that was rhetorical, wasn't it?

My parents generation, and certainly previous generations, that was all too true and common. Nobody raised an eyebrow back then if informed a neighbors child died of TB, MMR, smallpox, polio, dysentery, cholera, typhus, meningitis, a ruptured appendix, whatever

Personally, I feel we have to go back to those times. For a 5 year period, ban all vaccines. Shut down all sewage treatment plants and dump raw s*** into rivers and lakes. Stop all primary and secondary potable water treatment, especially chlorination.

After a few months, people would be BEGGING for all that pesky science-fictiony stuff to return!

 

i do understand. the last 2 months of my phd (and the occasional week here and there throughout) involved 90-110 hour weeks. it sucked.

specifically nutrition? probably 1-2 classes back in undergrad. in related fields, i am well versed in physiology, particularly neurophysiology, cell physiology and enough of the other organ systems to understand drug action.

regardless of my nutrition-specific education, i'm perfectly well qualified to shoot down every lame scientific "study" that people here have tried to feed me.

 

Science isnt an exact science.
There are errors due to human error.There are errors due to fraud where studies are intentionally fudged .
The Hormone Replacement Therapy studies are a good example of dumb error.The statistics were 180 degree misinterpreted for a decade.
There are plenty of fudged studies .
One recent example is the Gardasil vaccine.
They did a double blind study,but the placebo wasnt a placebo,it was the inert aluminum base used in Gardasil.
The side effects are alarming .

 

um, yes. you prefer wild speculation to systematic observation? i pointed out scientific fraud in the arginine literature, yet everyone was totally cool with it because they liked the result. so....

i think you mean that the results proved that the previous unproven speculation was wrong, and resulted in a major policy shift.

placebo is drug-delivery agent minus active ingredient. if i administer a drug dissolved in ethanol, the placebo (control) would be ethanol. the point is to demonstrate that the active ingredient is the source of the effect.

 

No .
They canceled the study midway because it was apparent that the testing proved that HRT caused heart disease ,stroke and perhaps more.
The medical world concurred and HRT was no longer used.
About a year ago someone realized that the statistics were all skewed because there was a preponderance of elderly women participating.
When analyzed by age they realized that in younger women HRT actually prevents heart disease and stroke.While older women are more prone.
So now the view is 180 degree from the original.

Aluminum as a placebo doesnt make a bit of sense to me.The control group gets as sick as the vaccine group so the vaccine is safe.
Last I heard Aluminum may be a cause of Alzheimers.
Anyway the vaccine is causing Lupus, Rheumatoid Arthritis,and more in kids who arent even sexually active .The vaccine will wear off by the time they are active.They guess it will last 5 years.Even if someone contracts HPV,it goes away by itself and there is a natural immunity after a few years.The vaccine only protects from a few strains anyway,its effective against %25 of the strains.
Something is very wrong when kids are getting sick from a vaccine that isnt even necessary.
The Pharma industry ,Merck in particular is making a fortune and they use bad science to push it.

 

people who can't handle adaptation in response to input and further evidence (ie, a patient saying a drug does not work due to intolerable side effects) aren't exactly scientific thinkers, are they?

cough... i never said that stupid people didn't sometimes get MD degrees.

however, medical knowledge is based upon science. a medical degree is the result of the study of the science of the human physiology. that is not particularly debatable. whether or not the resulting degree-holder can handle individual variation in patient response, was not what i intended to imply.

nope. n=1 demonstrates nothing, on its own, in a living system. p<0.05 is the demonstrator.

it's called the placebo effect, and it is a complex part of human psychology. it is required when using human subjects. i believe i have discussed the placebo effect in previous posts.

the placebo effect does not exist in cell lines, stained tissues on microscope slides, cloned cDNAs, interactions between molecules, electrons, or really anything else that isn't human. double blind does not apply outside the clinic.

for non-clinical sciences, positive and negative controls are king.

mechanistic explanations are one thing, but again, going from cell signaling studies to treatments in humans fails to account for a WHOLE LOT. the vast majority of compounds that sounded promising, based upon mechanistic research, fail before reaching early stage human studies. this is why "basic" and "preclinical" research are distinct from clinical research. (and it's a part of why drug development is so expensive.)

alright, we're clearly getting some confusion here as to the purpose of placebo/blinding to the treatment condition.

the placebo effect often leads to spontaneous improvement in condition, which cannot be attributed to the active compound under examination. the only difference between the way the two groups of subjects are treated is that one group is receiving the active compound and one is not. neither the subjects nor the investigators know which group is which, hence the "double" blind part. this is to ensure that investigator bias is not a factor in the result either.

this study design is implemented to properly control conditions, leaving the presence or absence of the active compound as the only variable. this is the only way the effect of the active compound can be tested. i've said it before, if we're talking about introducing a chemical to alter a living system, a highly stringent standard of evidence is absolutely required.

clearly, this design can't be applied to diet unless you want to feed people indistinguishable tasteless mush made from either hamburgers or vegetables. for this, a correlational study would be a better fit. measure ingestive behavior: food intake, total calories, calories from fat, etc. exercise: minutes per day, intensity, etc. then measure physiologic correlates as interest you. there is likely far more than one variable here, so as i mentioned above, a strict causative relationship can't be demonstrated this way. we could, however, do a causative study in an animal model where standards of practice necessarily differ.

sure, tell that to the first person who overdosed on cocaine!

thanks to years upon years of systematic study, which led to the development of those methods

oh- that reminds me- you might be interested to know your much-hated statins were originally discovered in plants

how many people die as a result of intentional misuse, how many die due to negligence on the part of the MD (cough, the recent death of a certain famous singer), how many die because they have several MDs prescribing different prescriptions and those MDs don't know of each other, or other failures to do due diligence?

how many recreational drug deaths count in those drug death totals? many of those are natural extracts.

who said dangerous? i only argue ineffective for the advertised claims. there can be some adverse effects to fat-soluble vitamin overdose, but rarely death.

though if someone who has asthma relies on vitamin d rather than a flu shot, contracts flu and dies... how do we attribute that otherwise preventable death?

yeah... because the opiates have already been extensively studied. a long time ago. the difference? TIME.
rewind many years, and the newly concentrated natural chemical called morphine is just as new and just as unstudied as the newly synthesized drugs of today. this has nothing to do with inherent safety and everything to do with relative newness.

yep- i don't know exactly how they do this, but some residues can be present on the seeds. the result is a tea with highly variable morphine concentration. you take too much, you're a goner. but you can't tell how much is too much due to the variability of the extract. cheap high turns into cheapened life.

you're right there. the FDA (my own gripes about the entire agency aside) is theoretically in place to review and approve/decline applications for permission to sell drugs as treatment for whatever condition. the FDA is intended to prevent drug companies from making false claims. hence the "permission" thing. but as i said, i've got lots of issues with that agency.

it may be used on the suggestion, but what does that get you? maybe it works, maybe you're wasting your time. maybe you're delaying getting actual effective treatment.

 

Re: So I'm about to lose my right foot.

Your Dr. Prendergast sounds like a quack and scares the hell out of me.

I am a doctor and sometimes hear about these other MDs who fell off the deep end. They prey on gullible people like you. Makes me sad.

- From a Doctor

 

what blinders are you talking about, Rob? evidence-based blinders? rejection of belief-based medicine out-of-hand? i for one am glad to have seen a post from a medical doctor who rejects non-evidence-based medicine.

really, the ones who should be thinking about this more are the proponents of "alternative" medicine. they fight to create a different, lower standard for their medical practices. they really should think about why they NEED a different standard. science doesn't validate our claims, they argue. we shouldn't be subjected to the gold standard of clinical trials and all this mumbo jumbo to get our important unproven discoveries out to the people who may garner no benefit from it whatsoever because it's unproven.

they have zero scientific credibility. they operate based upon false claims and conspiracy theories (ie: "Big Pharma doesn't want you to know about THIS 100% effective treatment that costs you pennies!") and they take advantage of those who are afraid or simply don't know better.

that does not sound like the kind of medicine i would ever want to participate in as a researcher or as a patient. i have far higher ethical standards for my own work.

 

that's an overstatement. here is the press release:
NHLBI - Press Release

the active compound is the variable here. in order to prove the active compound is safe and effective, they compare it to the same injection minus active compound. certainly a saline injection group would have been useful, but i didn't design the study.

we have yet to link intake directly to AD development. also, daily food intake leads to consumption of 5-10x the amount of aluminum found in the vaccine. it is also a common ingredient in deodorant. if you're worried about aluminum, there are far bigger things to tackle than 225 micrograms in a vaccine that may prevent cancer.

see the article i linked below.

it is effective against some but not all major strains associated with cancer. many people who have HPV don't know they have it, and a lot of people don't get regular physical exams to catch the HPV or the abnormal cervical cell growth. once you've got cancer, there's no going back.

many medical organizations agree that it should not be mandatory.

an analysis published last month of reported events through VAERS (a public vaccine adverse event reporting system anyone can use... someone managed to report that a vaccine turned him into the Hulk if that tells you how lax they are with determining causation) found that most reported events are not above background levels in the general population. exceptions: syncope (fainting) and VT events.

Postlicensure safety surveillance for quadrivalent...[JAMA. 2009] - PubMed Result

 

(Galaxee - I'm not writing this towards you, I'm just quoting you because I agree with everything you are saying.)

A really great read on alternative medicine is "Trick or Treatment." They try as hard as they can to be non biased and discuss the history of many different types of alternative medicine (homeopathy, chiropractics, and acupuncture.)

For anyone who is interested, the authors of that book have found after reviewing many quality studies that homeopathy does absolutely nothing, and chiropractics and acupuncture are basically no better than taking a single tylenol, and they are only almost equal to that 1 tylenol for very limited types of pain relief. They are way more expensive, take many visits to the "practitioner" (when you have to make so many visits, you must ask yourself is this treatment working or is my body healing naturally?), and run a risk of death. Yes, western medicine runs a risk of death too, but the difference is our evidence-based medicine actually works for patients. It's worth risking death if you can actually improve your situation. It's not worth risking death over something that is clinically proven to be ineffective.

This is how I think: It is called alternative for a reason. If it were clinically proven to work then it would be adopted by western medicine and it would be used. I will not offer something to my patients that I do not believe will help them. It costs them money (most insurance companies wont pay for alternative/worthless treatments), and it gives them false hope. It also wastes their time and could hurt them. If some alternative medicine treatment is scientifically shown to be effective then I will offer it to my patients.

Another thing to consider is that these alternative treatment practitioners do not have the training that an MD has. They do not have the knowledge or the experience we have. They do not learn things in any detail and are not trained to handle emergencies in case they happen. What are you going to do when the alternative medicine person causes you to have an anaphylactic reaction? Or if you get a staph infection from an acupuncture needle? Do you think they can prescribe you antibiotics? Will that chiropractor be able to save your life when he severs your vertebral artery? (It has happened!)

(By the way, I was asked to give a talk to some massage therapy students recently. On the wall I saw a Reflexology chart. SIGH! Talk about your completely moronic alternative medicines.)