A good friend of mine once told me to “lead with the body” when you are struggling with anxiety or depression.  Talking things out has it’s limits, he said, as do drugs.  It was my friend’s belief that exercising the body will often allow the mind to clear itself up.  It appears that my friend’s instincts were correct:

In a Duke University research study, published in the October 25, 1999 issue of The Archives of Internal Medicine, exercise was found to be almost as effective as medication in reducing symptoms of depression.

Though medication can be a life saver for some and no one wants to suggest otherwise, these studies open the door for other or additional strategies. “One of the conclusions we can draw from this,” according to psychologist and study leader Dr. James Blumenthal, “is that exercise may be just as effective as medication and may be a better alternative for certain patients. While we don’t know why exercise confers such a benefit, this study shows that exercise should be considered as a credible form of treatment for these patients. Almost one-third of depressed patients in general do not respond to medications, and for others, the medications can cause unwanted side effects. Exercise should be considered a viable option.”

This is good news in these days of skyrocketing health care costs.   Walking around the block is a lot cheaper than most drugs, with fewer side-effects (unless you live in a dangerous neighborhood).

This article at MSNBC explains the history of the term “nervous breakdown.” It’s rarely used now, except in pop culture.

The term — a vague catch-all phrase that could mean anything from a psychotic episode to having a bad day — is not a medical term, doctors say, but it was a popular one that was gentle, non-specific and therefore non-threatening, and could serve as a cover.

In previous decades, those with “nervous breakdowns” would simply disappear, because we had little understanding of what was causing the problem and few treatments for bringing the person “back.”

“The world has changed dramatically in the last 50 years or so, in terms of our understanding of mental disorders,” said Dr. Darrel A. Regier, director of the American Psychiatric Association’s division of research. “When I was a kid, there were references to relatives or neighbors, who had a ‘nervous breakdown’ and had to go to a hospital, and dropped out for a period of time, and nobody would really be very specific about what the nature of the illness was.”

Treatments varied from the “rest cure,” isolation and preventing all stimulation in the 19th century (described by Charlotte Perkins Gilman in her 1891 short story “The Yellow Wallpaper”) to hydrotherapy, electric shock treatments, insulin treatment and lobotomy in the 20th century. Patients who were hospitalized often faced long-term commitments.

“People are no longer just disappearing from the community in the same way that they did when that term was coined and was in use,” Regier said. “The major emphasis now with the mentally ill is on recovery.”

Reading this article made me wonder whether we should bring back this non-specific term to enable over-stretched people to take a break from their routines, without the stigma of “mental illness,” in order to recharge.   This article also reminded me of a friend who recently went on a Catholic Jesuit retreat:  a 3-day stay at a 90-acre wooded compound where those attending bring no electronic devices and are discouraged from talking the entire time. The purpose is to meditate and pray intensely.   My friend said that he finds this to be a valuable experience (he attends once per year).

The “American Life League” is putting out this silly garbage. They are trying to make it illegal for anyone to purchase birth control pills. This would put us back to the 1965 case of Griswold v Connecticut.

Consider some of the this wacko group’s talking points:

Q: Is it OK to take the pill for my acne or other health reasons?
A: Although the pill may have some minor benefits, the fact that it can kill preborn babies and cause harmful side effects for the woman outweighs its minor benefits. Because the pill weakens the immune system, it can cause bacterial infections and can make a woman more susceptible to the AIDS virus. It can also cause the following side effects: pelvic inflammatory disease, infertility, cervical cancer, ectopic pregnancy, shrinking of the womb, breast cancer, blood clots, birth defects in children conceived while their mothers are on the pill, stroke, weight gain and much more. 2,3,4

Q: Isn’t it better to be on the pill when you
are sexually active?
A: Better for whom? The pill does not prevent you from getting a sexually transmitted disease, it is not 100 percent effective in preventing pregnancy and you could conceive a child who gets chemically aborted before the baby’s presence is even known to you. Moreover, sexual activity outside of marriage is seriously wrong.

These are not new tactics (these arguments have been used by “pregnancy resource centers” for years), but it’s as stupid as it’s ever been. These “conservatives” want to government to have the power to dictate private sexual behavior between consenting adults (including married consenting adults). Unbelievable.

The media needs to hit McCain in the head with this blunt question: “Do you support the right of American adults to freely choose from all available birth control pills and devices, without any interference from the government?” Make McCain decide if he wants to publicly assume the looney side of this issue too.

I was in a bad mood after I wrote a post summarizing a recent Harpers Magazine article demonstrating that the United States government is working hard to keep its citizens from knowing whether numerous commonly used chemicals are dangerous.

After all, our government is supposed to be there to protect us yet it appears that our government is, instead, kissing up to the chemical manufacturers, allowing them to dump highly questionable substances into the products American consumers purchase and use.

And now, I’m in a worse mood. I just finished reading an extraordinary article called “You Are What You Drink Out Of,” by Nadia Pflaum. This article appeared in a local alternative St. Louis newspaper called the Riverfront Times. Pflaum’s story is available online, and thank goodness, because this is extraordinary piece of writing and it serves as an illustration of just how corrupt the system has become. I’ll give just the basic outline here. You’ll want to go read the entire article, however, if you want to be prepared to pull out Exhibit A the next time you get into an argument with one of the many remaining Bush-loving purported free-marketers.

The story centers around Frederick vom Saal, a biology professor at the University of Missouri. He is one of the leading experts on bisphenol A, a chemical that is ubiquitous in the United States-more than six billion pounds are produced every year. The trouble is that bisphenol A contains a substance that acts as a synthetic hormone that has been suspected of being dangerous for human beings. Vom Saal’s research found that the synthetic estrogen that leeches out of bisphenol A can pass it right into human cells at doses 25,000 times lower than any toxicologist ever before studied, and it wreaks havoc with developing reproductive organs.”

Vom Saal and his colleague, Susan Nagel (a professor of obstetrics, gynecology and women’s health), found that bisphenol A is so potent that exposing a developing fetus to it could permanently alter crucial phases of development. Their experiments showed that tiny doses of bisphenol A could trigger breast cancer. Their experiments also showed that tiny doses enlarged the prostates of laboratory mice.

The problem is that humans are exposed to bisphenol A everyday. We are exposed to it in the form of food packaging, almost every water bottle, eyeglass lenses and the linings of aluminum food cans. Bisphenol A is a synthetic material that is commonly used to make plastic.

But this is where the story only begins to get interesting. Vom Saal and Nagel published their findings regarding the dangers of bisphenol A and they were about to publish a second article (announcing that exposure to bisphenol A lowered sperm counts in mice) when they received a visit from a scientist from Dow Chemical who offered to pay the University a huge amount of money to conduct a new bisphenol A “study” at the University. Here’s the kicker: the Dow Chemical scientist (who told the university scientists that he represented the Chemical Manufacturers Association) asked “Can we arrive at a mutually beneficial outcome where you withhold publishing this paper until authorized to do so by the Chemical Manufacturers Association?”

University scientists knew that they were being offered a bribe. (more…)

This Chris Kelly headline says it all:

America: #1 in Bibles. #37 in Infant Mortality.

Here’s an excerpt from Kelly’s Huffpo article:

Europeans are feeling pretty smug lately, with their sturdy currency, “health care,” and rising rates of life expectancy, but there’s one area where we kick their ass: American Christians read the bible a lot more often than European Christians do.

Here are a few interesting tidbits about the Bible (these are some of my previous Bible-relevant posts from Dangerous Intersection):

Reading violent Bible stories can make you more violent.

If you’re a Bible literalist who’s going to read the Bible, don’t cherry-pick. Make sure you read these parts too.

The Bible is not really inerrant.

Adam might have had a belly button.

You can love going to church, even if you’re an atheist.

The New Testament says some bizarre things about morality (in addition to saying some very good things).

And finally (as Kelly suggests), most Americans who claim to read the Bible are liars.

–

I’ll end on a bleak note, because I’ve made the mistake of paying too much attention to the “news” today: The intellectual deterioration of the United States is about to his critical mass (or has it already?).

I’m not a big fan of big Pharma. There’s a good reason for my attitude. Many drug companies are selling hype rather than bona fide drugs. And some of those big drug companies have been caught outright lying.

Merck has already been shown to have killed tens of thousands of people as a result of its lies regarding the alleged safety of Vioxx. The well known lies of Merck involved the withholding of important data that suggested that Vioxx was more dangerous than Merck wanted to allow the public to know. “FDA analysts estimated that Vioxx caused between 88,000 and 139,000 heart attacks, 30 to 40 percent of which were probably fatal, in the five years the drug was on the market.”

The April 17, 2008 edition of Nature (available online only to subscribers) indicates that Merck’s deception was more prevalent than previously suspected. These new accusations have come to light as a result of the extensive litigation regarding Vioxx. The discovery responses produced by Merck made thousands of documents available for analysis. This analysis, paid for by the litigants in a Vioxx case, “seem to show Merck’s extensive involvement in ‘ghost writing’ and ‘guest authorship’ of research and review papers.”

This new evidence seems to show that Merck had its own employees designing the drug trials, analyzing the data, writing the papers and then simply recruiting academic authors to give these papers supposed authenticity. This ruse was discovered by analyzing first drafts of the manuscripts compared to the final articles. The first drafts were written by Merck employees, whereas the final drafts indicated that allegedly independent academics had done the studies and authored those articles. Worse yet, the articles failed “to disclose relevant financial relations” regarding the participants.

The bottom line is that Merck apparently manipulated the authorship of dozens of “independent” articles in order to promote Vioxx.

But that’s not all.  This same article in Nature reports on a second recent article based on documents obtained in a separate court case.   This second article “reports ’striking’ disparities between the mortality results for the drug in published papers and those contained in Merck’s internal analyses.”

It makes you wonder what other drug companies are manufacturing lies along with their drugs. It’s also further evidence that the FDA is largely a rubber stamp for the drug industry rather than a public watchdog.  It’s also evidence that motivated trial lawyers can sometimes do an impressive job of puncturing corporate obstructionism and exposing disturbing wrongdoing that others fail to find.

Summer of 2004. I have considered myself an atheist at least since the summer of 2004. For the sake of feeling smart and consistent, I believe I’ve considered myself an atheist for much longer. But I only have documented evidence of such a stance dating back to the summer of 2004.

Did I have some great logical awakening that roused me to critical thinking and clear-headedness? No. I know I did not. I know I didn’t become a perfect bastion of scientific thinking because, in the summer of 2004, I believed in handwriting analysis.

A knowledge-thirsty little 10th grader, I still believed then that if someone with a PhD wrote a book, that book had to contain gospel truth. I didn’t know the difference between bad science and good science. I didn’t even realize such a rift existed. So handwriting analysis, with all of its certain language and its sheer lack of cited empirical evidence, seemed as valid as medicine or geology.

Only half a year or so later, as I struggled to tell a friend that the dominating middle region in her script belied a permanently childish outlook, did I begin to realize exactly how idiotic this whole graphology thing sounded.

Ouch. It still stings to admit. Should I also admit that I used to take multivitamins? That I preferred bottled water over tap? Evidence supports none of these beliefs.

I hope I’ve made my point clearly: atheism did not protect me from having moronic faith in things not supported by evidence. The empiricism I had used to destroy God did not extend automatically to all other silly things settled in my head. I had to force out all of the cobwebs. (more…)

Sometimes, my body has a strong opinion with which I disagree.

Here’s a good recent example:  My body doesn’t like getting stuck with hypodermic syringes.  When I refuse to allow my body to leave the doctor’s office and when I allow my body to get jabbed with a hypodermic needle, it retaliates by fainting.  It’s one of those things that I completely forget about until I’m sitting in a doctor’s office overly aware that I’m about to be stuck again.  At such moments, my body reacts in a way that embarrasses and annoys me. 

Here’s a bit of context. For the past few months, I’ve had some nagging back and arm pain.  On a lark, I signed up for some acupuncture administered by a chiropractor.   Getting stuck with those little acupuncture needles didn’t give me big problems—not that I enjoyed the sensation of those tiny needles being pushed into my back.  After three treatments, I gave up on the acupuncture because it didn’t offer any long-term effect (although each treatment relieved my symptoms a bit, for a few hours).

My next step was to see my family physician, who arranged for x-rays.  He told me that I had “arthritis” and suggested some physical therapy.  [Before going any further, anyone reading this should probably email me a HIPPA form].

I was hoping for more of a pinpoint diagnosis, though, so I visited a doctor who specialized in Physical Medicine & Rehabilitation.  He arranged for an MRI, resulting in some fascinating pictures that suggested that I had noticeable deformities in several cervical vertebrae and in the discs that separate those vertebrae. It is not an unusual condition for someone in his 50s, but for me it has been quite painful because it’s pushing on a nerve root.  It’s distressing to see such clear pictures of my body’s insides deteriorating.

The physical medicine doctor suggested that I might eventually want to consider some surgical options. Therefore, I visited a surgeon who confidently assured me that the pain I am suffering is due to the spinal deformities evident on the x-rays and the MRI.  It was delightful and refreshing to hear this surgeon discourage surgery, at least for the time being. 

[As many of you might have experienced, many doctors are over-eager to provide you with what they offer.  For example, the chiropractor I visited, a pleasant fellow, appeared content to keep administering acupuncture, with no diagnostic images to inspire a more accurate diagnosis.  Because it is appearing that my problem is a pinched nerve caused by deteriorating bones, additional acupuncture would have been an essentially worthless investment.] 

This brings me to the topic of needles.  The surgeon suggested that I consider special injections by a pain management doctor (as well as continued physical therapy).  All I had to do was get a few “injections” of a cortisone-like slow-acting drug that would be placed near the nerve root that is currently being irritated by the deteriorating cervical disks. I set up an appointment with the pain management doctor.

The pain management doctor was an affable fellow who described the technique he would be using in great detail.    It turned out to be more than simply injecting me with steroids. The procedure was called a Cervical Epidural Steroid Injection. The procedure involved a preliminary injunction to numb part of my back, which allowed a blunt-ended catheter to be pushed several inches through the inside of my body toward the affected nerve root.  The procedure is done under a fluoroscope, which allows the doctor see where the catheter is going. Nonetheless, the insertion needs to be done while the patient is awake so that the doctors can learn if they get too close to a nerve root (I would feel unpleasant sensations in my arms if that were to occur). 

[Above is a fluoroscope image of my cervical epidural steroid injection.]

As my friendly pain management doctor described this procedure (in much more detail than I’m describing for you) I was sitting in a chair across from him, taking some notes.  I found it all interesting, in fact too interesting.  My visual field started to get cloudy as he spoke to me and I started to feel clammy.  I started falling forward out of my chair.  He jumped up to get my legs raised and he called for the nurse to bring in the monitoring equipment.  I was told that my blood pressure dropped from 110/60 down to something like 50/30 (I was at 80/40 for 15 minutes).  I recovered slowly over the next 30 minutes, quite embarrassed.  You see, the doctor was not administering any treatment at the time.  We were not yet even in the x-ray room where the treatment was going to occur.  He was merely talking with me.

Before we had even started talking, had warned him that I was sometimes not good about getting jabbed with needles, and this was proof that I wasn’t exaggerating.  As this fainting episode proved, I’m not even good at discussing syringes. (more…)

Not very difficult, according to Jeffrey Sachs. 

Hard as it is for us to imagine, Africa’s households simply can’t afford even $10 for a net, or a dollar for medicines when a child falls sick. Nor can African governments carry these costs on meager budgets or take extra vital steps to train local health workers and ensure that every village has reliable access to effective medicines.

Here is where you and I come in. Considering the costs of the nets, medicines and other components of malaria control, a comprehensive program would cost about $4.50 per African at risk, or about $3 billion a year for the whole continent. This is an amount that is too large for Africa but truly tiny for the rich world.

Let me put the $3 billion in perspective: there are a billion of us in the high-income world–that amounts to $3 a person, or one Starbucks coffee a year. It’s around 12.5% of the estimated $24 billion in Wall Street’s Christmas bonuses.

Jeffrey D. Sachs is the Director of The Earth Institute, Quetelet Professor of Sustainable Development, and Professor of Health Policy and Management at Columbia University.

In a tragic story from my own state of Wisconsin, an 11-year-old girl died last week because her parents trusted God to heal her. The parents apparently didn’t realize that their child had diabetes, so they never sought medical help. Instead, they prayed.

Though not reported in the StarTribune article, local radio reported that the parents did not blame God for letting their daughter die. Instead, they blamed themselves…not for failing to seek medical help, but for failing “to have enough faith” to heal their daughter with prayer. Sheesh.

Check out this current website from Tylenol.   You’ll see that McNeil (maker of Tylenol) has heroically and voluntarily removed all of these medicines from the market:

Concentrated TYLENOL® Infants’ Drops Plus Cold
Concentrated TYLENOL® Infants’ Drops Plus Cold & Cough
PediaCare® Infant Dropper Decongestant
PediaCare® Infant Dropper Long-Acting Cough
PediaCare® Infant Drops Decongestant (containing pseudoephedrine)
PediaCare® Infant Dropper Decongestant & Cough
PediaCare® Infant Drops Decongestant & Cough (containing pseudoephedrine)

Why remove all these children’s medicines?  According to Tylenol, it’s because:

[W]e have become aware of rare instances of misuse leading to accidental overdose, especially in children under the age of two. Therefore, we are voluntarily withdrawing [these] concentrated cough and cold medicines from the market.

Really? Does the manufacturer of Tylenol really believe that it is removing these drugs only because consumers are misusing Tylenol products?  Or could it be something else, perhaps this relatively recent and damning press release by a reputable group of pediatricians:

Cold and cough medicines given to infants and toddlers work no better than dummy pills and can be dangerous, pediatricians seeking to curb their use told government health advisers Thursday.

The doctors told the Food and Drug Administration advisers that the over-the-counter medicines shouldn’t be given to children younger than 6 because they don’t help them and aren’t safe. Such a prohibition would go beyond last week’s drug industry move to eliminate sales of the nonprescription drugs targeted at children under 2.

The group petitioned the FDA seeking in part a government statement saying the medications shouldn’t be used in older children as well. The expert advisers began a two-day meeting to consider the issue. The FDA has yet to act, in part pending a recommendation expected late Friday from the joint panel of outside experts in pediatrics and nonprescription drugs, said the agency’s Dr. Joel Schiffenbauer.

The medicines have been marketed for use in children for decades, with drug companies spending $50 million a year on heart-tugging ads in parenting magazines and elsewhere. Still, it has long been acknowledged there is little or no data from studies in the very young to show the medicines are safe and work. Worse, some studies suggest the medicines are no better than dummy pills in treating cold and cough symptoms in young children, the petitioners said.

“When a treatment is ineffective, its risks — if not zero — always will exceed its benefits,” said Dr. Michael Shannon, a Children’s Hospital Boston pediatrician and Harvard Medical School professor who was another of the petitioners.

It’s quite amazing that the drug companies might be selling chemicals that don’t really do what the drug manufacturers say they do.  It’s most amazing because it happens so incredibly often.  

What do I mean?  Consider the recent news regarding the scam regarding Prozac and other modern antidepressants.   And remember Vioxx, the “miracle” drug that created 100,000 widows and widowers?   Not only are some of these drugs dangerous; another aspect of the scam is that many of these medical “miracles” don’t function any better than placebos for many patients.  

But back to Tylenol.  This isn’t the first time Tylenol has been caught scamming the public.  If you Google “acetaminophen” and “liver,” you’ll see hundreds of sites that talk about the danger of taking a too much Tylenol (which might surprise you, given the common belief that there is considerable tolerance built into the product and given the existence of Extra-Strength Tylenol).  Follow this link to see that the makers of Tylenol have fought hard, at least since 1977, to keep the public from knowing that overdoses of Tylenol can cause liver failure.  

How else would you explain that the FDA and the pharmaceutical makers delayed giving liver failure warnings for decades?  Since 2003, Tylenol has carried a liver toxicity warning, but it makes you wonder how many lives it cost when it delayed giving that warning.  It cost more lives when consumers use the cup that comes with Children’s Tylenol (see above photo) with the concentrated formulas of cough and cold concoctions (now discontinued) that should be administered with a dropper. You see, the discontinued formulas had higher concentrations of acetaminopen.  A parent mistakenly using the little plastic cup (that comes with children’s Tylenol)  instead of the dropper (that came with the (now-discontinued infant formulas) could destroy childen’s livers.  According to the manufacturer, it’s the consumer’s faut, even though swapping the cup for the dropper was entirely foreseeable.  But now, the maker of Tylenol can blame the consumers for the need to take these products off the market rather than admit (because the pediatricians were correct) that these products didn’t really work.

Aside from the risk of liver toxicity (which exists only when the consumer more than the recommended dose of Tylenol), isn’t Tylenol an important and effective way to reduce your child’s fever?  Is fever always a bad thing?

Mass marketing has programmed parents to fear all fevers and to feel a deep need to prove their dedication to their children by pouring bright red chemicals into their children’s mouths at the first sign of fever. 

I have a different understanding of fever than most American consumers.   I believe that Tylenol’s multi-billion dollar budget (more money is spent per year on Tylenol than on Coca-Cola) is geared to making people needlessly anxious about fevers.   A low grade fever is not always dangerous.   In fact, it is rarely dangerous. Here are some guidelines as to when to treat a child’s fever.  

The maker of Tylenol (and those who manufacture other fever-reducing products) have successfully convinced the public that something absolutely must be done to bring down all fevers in young children.  Is that good medical advice?  Usually not.  The pediatrician treating my children made it clear to my wife and me that even a fever that spikes up to 106 is not a problem in a young child as long as that child is hydrating (drinking fluids and peeing regularly).   At some point, of course a sustained fever should give a parent concern.  But a few days of 102 or 103 is usually nothing to be worried about—unless you watch a lot of television commercials that tell you that you MUST get that fever down by pouring those bright red chemicals into your child’s body (chemicals that are potentially harmful to your child’s liver). 

Here’s one other thing to consider.  (more…)

When I saw this article at MSNBC, I thought it was a joke.   But no, it was no joke.  Check out the photo.   Apparently, 30 men and one woman residing in the Philippines actually had themselves nailed to crosses.  They went through the Good Friday rites

in three villages in northern Pampanga province’s San Fernando city. Five other devotees, including a woman, were nailed to crosses in nearby Bulacan province.

The people going through this procedure were trying to cure loved ones of disease as well as purportedly trying to “atone for their sins” (whatever that often-uttered phrase might actually mean–it’s apparently an attempt to invoke the moral accounting metaphor elaborated by Lakoff and Johnson).

Here’s definitely a place where religion and science diverge.  Imagine Alexander Fleming in his lab trying to understand the properties of penicillin, all of a sudden inspired with an alternate method for curing sick people.  

“Quick!” he yells to his lab assistant (in a Scottish accent).   “Nail me to a cross to help heal sick people!”   

Don’t get me wrong.  I’m not knocking this crucifixion method of curing people.  Maybe it works.  Maybe hospitals should have corridors filled with crucifixes where patients and their relatives can all be nailed up in order to get cured.   Since it would be relatively cheap to administer this treatment (some of the sadistic contractors working for our government in Iraq and Guantanamo would be happy to do this work), insurers would probably be happy to waive the co-pay.

I recently went to the doctor because I have had pain in my back and left side.  The doctor sent me down to a diagnostic office for X-rays.   When those x-rays came back, my doctor thought he saw evidence of a pinched nerve.   But that’s not what I saw when I saw the X-ray results.    What I saw was that

There’s a big skeleton inside of my body!

It’s one of those big creepy skeletons much like you’d see on Halloween or in a horror movie.  I’m not speaking metaphorically.   I’m talking about a real skeleton.  Apparently, this skeleton inside of me moves about when I move about.  It imitates me.  When I walk, it walks.   It has a hideous grin.  The doctor tells me that it is white in color, just like the skeleton bones you hear about in graveyards.  

I don’t think life will ever be the same for me.  I don’t quite know what to do about this.   Should I admit to my friends that I have this condition?  Would they be able to handle that I have a skeleton in my body?  Will they start seeing me as some sort of animal?  Should I seek out a support group?  What else is inside of my body?  Bats? Ghosts? Living things that don’t even share my DNA?  This is creeping me out to have this bony alter ego.

I’m beside myself.

Are they gone?  Are all the millions of people who take Prozac, Effexor, Paxil and Serzone-who-are-not-severely-depressed gone?  Good.  Now we can talk. The rest of you have probably already read the news that:

Antidepressant medications appear to help only very severely depressed people and the drugs work no better than placebos in many patients, British researchers said Tuesday.

Why would the news media ever report the truth regarding these wildly-hyped antidepressants?   After all, scientists have long known that most of the power of these drugs is in the placebo effect.  Or, at least, scientists should have suspected this, because the FDA was refusing to release the full data sets regarding these drugs trial, at least until the good scientists who work on this new report (Prof Irving Kirsch and colleagues) requested “the full data under freedom of information rules from the Food and Drug Administration, which licenses medicines in the US and requires all data when it makes a decision.”  Gosh, it appears that some of the relevant data wasn’t available to the forty million people taking these drugs, until long after the release of these drugs through massive corporate guerilla marketing.

In its advertisements, the manufacturer of Prozac, Lilly, doesn’t say anything about the drug not working well for large numbers of the patients for whom it was being prescribed.  In fact, Lilly makes this claim:

The safety and effectiveness of PROZAC have been thoroughly studied in clinical trials with more than 11,000 patients. There have been more than 3,500 publications on PROZAC in medical/scientific journals.

It’s that three thousand five hundred and EIGHTEENTH publication (or whatever) that gets you every time, especially when the full data set is finally made available.   

But enough attacking of soul-less pharmaceutical companies.  Well, almost enough.  Forty million people paying good money to use this stuff?  Egads!  Kirsh and colleagues sum it up for me when they say:  “This study raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported.”  Ouch.  I could sum up this quote in my own way, using richly deserved expletives aimed at Big Pharma, but this is a family site, so I’ll refrain.  Instead, I’ll simply disclose a new creative spelling for Lilly:  L-A-W-S-U-I-T.

But now, the irresponsible news media has blown it too, and the news about these depressingly ineffective drugs is now available to the public at large.   Because the media has reported that the effect of Prozac, Effexor, Paxil and Serzone is mostly due to the placebo effect, there won’t be any more placebo effect, at least for those people who saw the news and who understand the placebo effect.

Therefore, please keep your non-severely depressed friends away from the news media for the next several days.  If they accidently see that the placebo effect is the main effect of Prozac, Effexor, Paxil and Serzone, they won’t be able to take those drugs any more to counter their mild depressions. (more…)

Michael Lewis recounts his harrowing personal medical journey in Slate.  It was difficult for me to read this account without cringing. 

Then again (without getting too revealing), I know someone very close to me who had a vasectomy and it wasn’t as unnerving as the one Lewis describes.  Perhaps it was because, in the case I’m describing, the patient chose general anesthesia . . .

I have long been suspicious of chiropractors.  Why?  One reason is that the practice has a wobbly foundation.  In 1895, D.D.  Palmer declared that “95% of all diseases are caused by displaced vertebrate, the remainder by luck stations of other joints.”  His conclusion is that most diseases could be cured by adjusting vertebrae that interfere with nerve vibrations flowing from the brain through the vertebrae.  Recent studies have shown that while spinal manipulation can be helpful to treating some back pain, “there appears to be little evidence to support the value of spinal manipulation for non-musculoskeletal conditions.”  (Shekelle, P.G. “What role for chiropractic and healthcare?” New England Journal of Medicine 339:1074-1075.) 

Another reason for my skepticism regarding chiropractors is that I’ve heard too many tales of highly suspicious sounding chiropractors.  I’ve heard, for instance, about the “need” to be treated two to three times per week for years on end for nebulous sounding conditions.

I’ve never before been to a chiropractor. Five weeks ago I would’ve assure you that I would not likely ever go to a chiropractor.  That was before my pain got bad, however.  For the past five weeks, I’ve been suffering from a pain on the left side of my upper back.  It comes and goes during the day, ranging from a dull ache to a severe stabbing pain that makes it hard for me to concentrate anything else.  The pain sometimes borders on disabling.  Sometimes, lying down is the only thing that settles down the intense stabbing pain.  I’ve tried working out more, resting more and stretching more.  I’ve tried ibuprofen and, later, Naprosyn in various doses. 

I arranged for a massage last week, from a woman who has given me massages a few times over the past few years.  She exclaimed that I was holding my left shoulder much higher than my right and that she had never before seen such an extreme case. After working on my back for almost 2 hours, she gave me the business card of a chiropractor who did acupuncture.  The massage gave me some relief, but most of the pain returned a day later.  My medical doctor gave me a prescription to a double dose of Naprosyn (he diagnosed me over the phone).  I considered that if I pursued my problem with a medical doctor, he or she would probably refer me to physical therapy.  It occurred to me, however, that I’ve had two rounds of treatment from physical therapists in the past and that both of them were unimpressive due to the nonchalance of the therapists. 

It was time to do something about my problem, because I was losing valuable hours of productive time because of the pain in my back.  To make things worse, ibuprofen has been hard on the stomach, causing something bordering on nausea.  Therefore, I picked up the phone and I called the chiropractor/acupuncturist to set up a visit.

Two days ago (Monday), I visited the chiropractor/acupuncturist.  I felt it was worth a try given several discussions I’ve had with people who claimed that acupuncture brought substantial relief to them.  Further, this particular chiropractor is well known for treating quite a few professional athletes, including Olympic athletes and members of the St. Louis Rams and St. Louis Blues.

I was impressed with this chiropractor during my first visit.  He took a lot of time trying to determine what was causing the condition.  This is in direct contrast to my own experience (and the experiences of others) regarding medical doctors, who typically try to treat symptoms with drugs or cortisone, without taking a detailed history to determine the root cause.

Not that the root cause was hard to determine in my case. My chiropractor quickly determined that I was locked over a computer keyboard many hours every day.  And after I’m finished hovering over a keyboard at the office, locked like a statue, 10 or 12 hours per day at work, I do more of this hunching over a keyboard at home while writing for this blog.  He explained that this unvarying posture is hard on the body and that the sort of pain that I was experiencing was common among people who spend many hours sitting in front of a computer.  It was his theory that my pain emanated from my pelvis (even though my pelvis doesn’t hurt) which is fixed in a locked position on a chair hour after hour without relief.

He recommended two or three sessions of acupuncture a series of simple exercises that I could do at home or at the office.  Then he would be done with me.  His simple exercises don’t require any equipment and can be done in a couple of minutes every hour or so.  He also urged me to take periodic breaks from sitting in front of the computer.  I have been directed to stand up and do some simple stretches while at the computer (these one-minute breaks are to be taken every 15 minutes or so).  I have carefully complied with the chiropractor’s instructions ever since I received them two days ago.

What is modern acupuncture?  It’s quite different than traditional acupuncture in that it involves not only needles, but slight pulsing electrical current that is run through the affected tissue through the needles. The purpose of acupuncture is to relax the overwrought muscles and thereby reduce the pain.  My chiropractor readily admitted that the mechanism for pain relief is not well understood, though it often works. He made it clear that others have lots of detailed ancient hocus-pocus theories for why acupuncture works, but he doesn’t rely on those teachings (many acupuncturists still do, however). 

A modern acupuncture treatment lasts 15 to 20 minutes.  The acupuncture was not painful, although it was a just a bit uncomfortable.  It is done without any anesthesia.  After receiving the acupuncture treatment on Monday, I thought that I felt some good relief from the sharp pains I have been experiencing in my back.  At the same time, however, I was well aware of the placebo effect and I wanted to make sure that I was not simply psyching myself out.

I went back for a second acupuncture treatment today.  My wife (Anne) attended with me because she is interested in knowing more about acupuncture.  She brought a camera and took a couple of pictures so that I could show what acupuncture looks like.  This first picture shows the chiropractor inserting a needle into my back. 

He used a short straw looking sleeve, which he taps along with the needle, which distributes the sensation of the insertion so that it is not sharp or painful.  (more…)

Back in the 1970s, when I was an undergrad student at the University of Missouri, I took a psychology course that required me to interview someone who worked in the mental health field.  A nurse working at the Missouri State Mental Hospital (on Arsenal Street in the City of St. Louis) graciously agreed to talk with me.

The woman (her name now escapes me) told me that she previously worked as a nurse at a mental hospital in Canada, back in the 1950s.  Many people don’t realize that in the 1950s there were very few drugs available for doctors to prescribe for people with serious mental illness.  Therefore, the hospitals often served as places where people with “mental illness” stayed for their own protection or to protect society from them.  Protecting these patients was often a big challenge for the mental hospital staffs.

The nurse I interviewed told me about two categories of patients that were especially challenging.  The “catatonics” were severely depressed, to such an extent that they literally stopped getting out of bed.  In fact, they lay in bed in the same position for such long periods that they were at risk for developing dangerous infectious bedsores.  Another category of challenging patients were the manics, people who “raced up and down the halls” knocking things over and running into other people.

The nurse told me about the imaginative “solution” to dealing with these two types of patients at her hospital.  The professional staff took one catatonic patient and one manic patient and paired them up, connecting them with handcuffs.  The nurse was dead serious as she told me this story.  She explained that the manic patient kept the catatonic patient on the move, thereby lessening the risk of bedsores.  On the other hand, the catatonic patient slowed down the manic patient, thereby lessening the risk of collisions in the hallways.  She told me that this handcuff technique was used on a regular basis at her hospital and that it was a “successful” technique.

I can’t imagine how frustrating this situation must have been for the patients.  I can only hope that none of the patients injured each other (or killed each other) out of frustration.  On the other hand, it must of been incredibly challenging for the hospital staff to deal with these serious types of mental illnesses without any of the psychoactive prescription drugs now available. 

I haven’t discussed in this interview with anyone else who worked in a mental hospital in the 1950s, but I would be interested in knowing whether the “handcuff technique” was a widespread practice, or whether it was simply a technique used by the Canadian hospital where the nurse I interviewed worked.

What’s the preferred treatment for Major Depressive Disorder?  According to this study by a large team of researchers, anti-depressant medication and exercise led to comparable results.  The exercise consisted of 10 minutes of warming up, then 30 minutes of jogging or brisk walking, enough to get to 70% of maximum heart rate reserve.

Richard Dawkins is famous for his criticisms of organized religion. 

In this new two-part video (see here and here), he moves on to examine spiritualists, faith healers, dowsers, homeopaths, astrologers and others who shun evidence in order to practice their unsubstantiated trades.

Much of this video is straightforward and succinctly edited. Dawkins restrains himself in his many conversations that appear in the video.  He lets the quacks speak their own words and he allows them to put their best foot forward.   Not that he doesn’t sometimes get in his digs, for instance with Deepak Chopra, who exhibits absolutely no understanding of quantum physics despite making millions on books in which he allegedly invokes principles of quantum physics.

The general themes are well stated in the video.  We are disparaging real science and medicine yet giving unsubstantiated alternative medicine a free ride.  Why?  Because we are a society that is, more than ever, willing to value private feelings over evidence.  Unfortunately, this makes us vulnerable to those who obscure the truth (e.g., charlatans like Chopra).

There’s this odd thing about alternative therapies:  the more we look at them, the weaker they look.  At least this is true for those who aren’t striving to believe in them.  Why do we do this?  Dawkins suggests that it is perhaps an evolutionary adaptation.  We have evolved to see patterns even when they don’t exist.  To be that other kind of animal, one that tends not to see patterns, would be too dangerous.  That might actually be a predator behind that bush!  For many of us, this over-tendency to see patterns has apparently generalized into a form of naiveté when it comes to alternative therapies. 

To see Dawkins’ encounter with Chopra, go to Part II, about 19:00.  To see the section on homeopathic medicine, see Part II at 23:00.  

In the meantime, spiritualist book titles outnumber real science books 3-to-1.   And one-fourth of the public believes in astrology, which serves as a sort of poster-boy for all of these shoddy disciplines:  What makes them “work” is that they allow us to keep thinking that humans are the true center of the universe.  All of the stars revolve around us.  Therapies work because we want them to work.  Ergo, no need for evidence.  Just keep believing . . . 

I know that numerous chiropractors swear by homeopathy. I even know of a couple MD’s who push homeopathic “remedies.”  It makes me shake my head because A) homeopathic theory (e.g., “the law of infinitesimals” and “the law of similars”) makes no sense and 2) homeopathic remedies and double-blind studies don’t mix.

Homeopathy is a painfully well-known placebo that millions of well-educated people just can’t bear to give up.  They know that it can’t really work according to the theory of its promoters, but they just can’t part from that juicy hit of placebo.

I recently ran across a science website with good energy, lots of engaging stories and commentors chomping at the bit.  It’s called Bad Science.   The post that most recently caught my interest is on homeopathy, more specifically a highly suspicious article in the “British Journal of Homeopathy” that claims that water “has a memory.”  Check out the comments for a rousing tour of the many failings of homeopathy.   One fellow apologizes for peeing in the ocean when he was young, because he didn’t realize the effect that it was going to have on everyone in the future.

For more information on the bad science of homeopathy, including a stab at one of my favorite psuedo scientists, Deepak Chopra, consider this article from the Skeptical Inquirer.  Here’s an excerpt:

Quite apart from the matter of how the water/alcohol mixture remembers, there are obvious questions that cry out to be asked: 1) Why does the water/alcohol mixture remember the healing powers of an active substance, but forget the side effects? 2) What happens when the drop of solution evaporates, as it must, from the lactose tablet? Is the memory transferred to the lactose? 3) Does the water remember other substances as well? Depending on its history, the water might have been in contact with a staggering number of different substances.

Homeopathy is only one of many forms of medical quackery being hawked to a scientifically naive public by researchers and public spokespeople who refuse to allow facts get in the way of their favorite version of snake oil:

The public is spending billions of dollars annually on sugar pills to cure their sniffles, hand waving to speed recovery from operations, and good thoughts to ward off illness, all with assurances that it’s based on science. Society has been set up for this fleecing in part by the media’s sensationalized coverage of modern science. Popular discussions of relativity, quantum mechanics, and chaos often leave people with the impression that common sense cannot be relied on — anything is possible. Scientists themselves often feed the public’s appetite for the “weirdness” of modern science in an effort to stimulate interest — or simply because scientists, too, can be beguiled by the mysterious.

I wish there were more of a placebo effect associated with the reading of science done carefully.  Maybe then we wouldn’t waste so much money and energy on all of those other placebo-effect inducers, including homeopathy.

In an article from the Washington Post we learn that the United States has slipped in the ranking for life expectancy in the world to number 42. Douglas Adams aside, this is not a good thing.

The article lists a good many factors contributing to this fact, which seems paradoxical since, as stated, we spend more on health care than any other nation. I’m not surprised. Americas in general live as though built like Abrams tanks. We work hard, we party hard, and we loaf hard. We eat badly, pay no attention to our personal health, assuming that if anything really goes wrong “the doctor can fix it.” We believe, innately, that we’re indestructible and can do anything. This leads to careless habits. One factor cited is that 45 million of us lack health insurance. Which brings me to the peeve of this post.

There is a talk show mouth named Mark Christopher.  His show is out of Nashville, but you can hear him (in St. Louis) on KTRS 550. This guy is a Rush Limbaugh wannabe. And one of his horses to ride hobbyistically is an ongoing rant against national health care. He’s phobic about this. Every other day he has some little tidbit about how bad health care is in other countries that have a state health care system. He commented yesterday on this report in the Washington Post. Now, aside from the fact that he cherry picked the article, which cited factors he then went on to name as if the Washington Post had not, he displayed a profound case of Innumeracy.

He said (I paraphrase) that in a country of 300 million, 45 million people is a “drop in the bucket.” Meaning that we ought not overturn our wonderful private health care system (which is going to bankrupt us eventually) for so few who just fall out of the system. 45 million out of 300 million is 15%. That is hardly a drop in the bucket. To put that in perspective, that would be one and half out of ten, or three out of twenty. Fifteen of every hundred people. Which means that on an average city block (which I determined by standing on my street and counting) of roughly 35 houses with an average of four people per house, there are around 21 people with no reliable health care. On one block.

Let’s assume for the sake of argument that among those 21 we have 2 or 3 cases of tuberculosis (which is a rising problem in this country). Tuberculosis is highly infectious. How fast might that spread among the various blocks around us? Another way to look at it. The worst battlefield casualties the United States ever experienced were in the Civil War, which sometimes reached 30%. They averaged between 12 and 18%. A modern army–-ours—regards 5% heavy and anything approaching 10% unacceptable. And fighting a war is by far more expensive than average health care costs. The unbelievable inability—or, more likely, carelessness—of someone with a national talk show to understand the most basic arithmetic in this way verges on criminal.

If 15% of our population dropped dead tomorrow, I assure you we would notice. It would not be “a drop in the bucket.” We are nationally anxious about 6 coal miners in Utah who may be dead and if they are, we will demand an investigation. We can’t 6 people dying in a mining accident. But in the sphere of health care, 45 million people become a drop in the bucket. The phobia that has taken root over this issue has become one of those insurmountable arguments that has run headlong into panic.

We Americans—I think all of us, it just depends on what aspect of our lives is under discussion—our suspicious of government. If it’s not national health care, then it’s Big Brother. Liberals, conservatives, and combination thereof, Americans can find something we don’t want the government to run. We have always been like this, it’s nothing new. And we are often stupid about it. But the world is shrinking and in so doing making it less and less possible for us to escape the consequences of ill-considered, knee-jerk prejudice. I don’t care how this issue gets resolved. Even if we do end up with some kind of federalized health care system, we will abuse it, it will cost too much, and it will still be bent to the service of a nation of people who act like they can do anything they want—play, eat, party, work, or loaf—too much and think nothing bad will come of it.

Which means that the most cost-effective health care system—prophylaxis—will not be the one that gets the priority. Insurance companies must be made to offer things like well baby care and prenatal coverage now. Taking care of a problem before it becomes something that lands us in the emergency room costs far less, but we don’t, for the most part, do that now. And we have a absurd and irrational devotion to extending Life far past any possibility of meaningful living, which is still where the bulk of our expense here falls (though obesity related health issues are rapidly catching up).

Whatever we do, the basic tenets of good health care will probably still be ignored by a people who think they don’t have to pay attention personally to their own health care. Which is reflected in the Washington Post article as well. But I am profoundly tired of the misinformation spread by both sides of the debate, and the incredible lack of grasp people who ought to know better have on the most basic aspects of problem-solving.

End of rant. You may now return to your regularly scheduled panic.