April 27th, 2009 by DrRob in Better Health Network, Humor, Quackery Exposed
2 Comments »
Somehow the medical community has missed a very important news Item. In her website goop.com (dang, I was going to go for that domain), movie star Gwyneth Paltrow weighed in on a very frightening medical subject.
Shampoo.
“A couple of years ago, I was asked to give a quote for a book concerning environmental toxins and their effects on our children.
“While I was reading up on the subject, I was seized with fear about what the research said. Foetuses, infants and toddlers are basically unable to metabolise toxins the way that adults are and we are constantly filling our environments with chemicals that may or may not be safe.
“The research is troubling; the incidence of diseases in children such as asthma, cancer and autism have shot up exponentially and many children we all know and love have been diagnosed with developmental issues like ADHD [Attention Deficit Hyperactivity Disorder].”
Apparently, she went on to point the finger at shampoo as a potential major problem in our society and raised a possible link between shampoo and childhood cancers. Now, I am not sure how one can use shampoo on the head of a foetus (or a fetus, for that matter), but we have to tip our hat to celebrities for bringing such associations to the forefront.
So I did a bit of science myself to assess the voracity of her claims. I too was seized with fear when I noted the following:
- All of the kids in my practice who have ADHD have used shampoo.
- All of the kids with cancer have also used shampoo.
- I used shampoo as a kid (but not as a fetus), and I have ADHD.
- The projection is that 100% of the people now using shampoo will die.
Whoa.
This really backs up my misgivings about shampoo. I have always wondered at the claims these so-called hair-care products make so boldly. Here are some examples of lies spread by the shampoo industry:
Clarifying shampoo – What are they claiming with this? Is there such thing as unclear hair? Do some people look as though they have a giant blob of hair-like substance on their head instead of many separate hairs? Does clarifying shampoo make each individual hair once again visible on these people?
pH Balanced – What is pH imbalance? Is it when the pH sometimes is so acidic that it burns your hair off? That would be terrifying if true.
Volumizing shampoo – I was not aware volumizing was a word (nor was my spell-check). This means that the shampoo volumes things. How can you volume something? Does each hair get a separate volume, or does the hair suddenly get very loud. Personally, I am afraid to open the bottles of these shampoos for fear of going deaf.
Shampoo for stressed hair – I have never thought about the emotional state of my hair. I was not aware that it worries about things. Perhaps it worries about being volumized or burned by non-pH balanced shampoos. Perhaps it worries about being put on a foetus. Does this type of shampoo contain a hair version of valium?
Vitalizing shampoo – At least vitalizing is actually a word, but would you really want vitalized hair? My dictionary defines this as “giving life and energy to.” Hair is dead, as we all know. Does this “hair resurrection” cause your hair to scream every time it is brushed or cut? Does it move about on your head independently? What if it decides it wants to become a mullet?? Thank you, but I prefer my hair dead.
Self-adjusting shampoo – Instead of the hair having independent action, this type of shampoo seems to have an intelligence of its own. How would it self-adjust? Does it have a computer chip embedded in it or does it somehow have sentience? How do we know if it will adjust in a way we want? It could adjust to pH imbalance or de-volumization, couldn’t it? What if this self-adjusting shampoo, which clearly has some degree of autonomy, gets ideas and causes other shampoos to break the shackles we humans put on it and forms a shampoo revolution? An even scarier thought is if a self-adjusting shampoo comes in contact with vitalized hair! What will happen then? Will they fight, or will they conspire against the shampooee?
Baby shampoo – What is the life-cycle of a shampoo? How do they find these baby shampoos and why would they steal them from their parents? This is probably what is causing the shampoos to become self-adjusting. I will say, shampoos do seem to multiply in our bathroom. We probably have 16 bottles of different kinds of shampoo in our shower right now. I just recently noticed some baby shampoo, but I thought my wife had just bought it. I see now that we should not let the bottles touch each other if we want to have room in our shower to bathe.
So you see, while Miss Paltrow’s fears about shampoo are clearly far short of the whole story, at least they bring attention to this frightening situation. Shampoo manufacturers are clearly in cahoots and have eyes on world domination. The condemnation of this celebrity’s claims by “scientists” are clearly a smoke-screen to keep us from noticing the obvious plans for the destruction of humanity.
No more shampoo for me!
Gotta go now. It’s time for my colon cleanse.
April 27th, 2009 by Harriet Hall, M.D. in Better Health Network
6 Comments »
We criticize alternative medicine for not being evidence-based, and they criticize conventional medicine in turn, saying that much of what conventional medicine does is not based on evidence either. Sometimes that criticism is justified. I have run across a conventional practice that I suspect began because it sounded like a good idea, but that never was adequately tested and is not carefully thought out for individual patients.
I recently had a bone marrow aspiration. The written instructions said not to eat or drink for 6 hours before the procedure, to bring someone to drive me home, and to expect an IV. I suspected from these instructions that they were planning to use IV sedation, and I was right.
I questioned the need for sedation. I am prejudiced about bone marrow aspirations. I observed several and did one myself during my internship. When I had finished, the patient asked me when I was going to start. We did the procedure at the patient’s bedside in a multi-bed ward with no sedation, only local anesthesia. So my prejudice was that the procedure was no big deal and was not terribly painful.
I can imagine that some patients may be terrified by the idea of a needle going into their bone and may want to be sedated and not remember the experience. But I was not anxious about it, and I saw no need for the fentanyl and Versed they wanted to give me. I figured it would only prolong my time in the hospital, produce amnesia, expose me to a small risk of adverse effects, and leave me groggy; so I asked to opt out. They readily agreed – although they did keep asking me if I was really sure I didn’t want it. They would not have offered the option of no sedation if I had not known to ask.
The pathologist doing the procedure told me the injection of local anesthetic into the skin was the most painful part of the procedure. He was wrong. It was the ONLY painful part of the procedure. The penetration of bone and the aspiration of marrow produced only a pressure sensation.
This study reported that 85% of non-sedated patients had intense pain. I find that hard to believe, based on my personal experience and the experience of the pathologist that the local anesthetic was the worst part of the procedure. I wonder if those patients were anxious and were expecting intense pain. At any rate, I think giving me IV sedation would have been the wrong thing to do.
I had a similar experience with an excisional breast biopsy. They offered me general or local anesthesia and I chose local as presumably the safer option. Then they said they would use IV sedation along with the local. I asked why. They said to relieve anxiety. I told them I wasn’t anxious so if that was the only reason for sedation, I didn’t want it. I finally prevailed. I was comfortable, alert, had a good time chatting with the anesthesiologist, and was able to leave the recovery room much sooner than sedated patients.
I’m not saying that IV sedation is not indicated for some patients, but I am convinced it was not indicated for me. Has it become a knee-jerk reflex to sedate everyone as a general principle? Why? To avoid complaints and keep patients more cooperative during procedures? Are we paternalistically deciding that it is better if the patients don’t remember the procedure? I wonder: if minor procedures are not remembered, might the mystery increase anxiety and fear of the unknown for future procedures? We must ask seriously whether IV sedation is done more for the patient’s benefit or the doctor’s. The answer will vary with the procedure and the patient.
Rather than sedating every patient, why not use some judgment? Even if the patient is anxious, perhaps a non-drug option could relieve that anxiety without risking the side effects of drugs. Surely some anxiety is due to fear of the unknown. Would it help to show patients a video of someone comfortably undergoing the procedure without sedation, with an explanation of exactly what was happening? Would simple reassurance or personal attention from a patient advocate be helpful? Worth looking into? I think so.
Doctors are frequently accused of prescribing unnecessary drugs out of habit or reflex. I suggest that IV sedation for minor procedures is an example of over-prescription that is based more on custom than on good evidence.
*This blog post was originally published at Science Based Medicine.*
April 26th, 2009 by EvanFalchukJD in Better Health Network, Health Policy
3 Comments »
Our survey of employer attitudes about health benefits told us a lot about what employers are doing, and what they want to stop doing. Here are 5 things employers want to stop doing:
1. Stop paying for bad employee lifestyles. Bad lifestyle choices are big drivers of expense. Our study shows that employers want to stop being solely responsible for those costs. More than half (54%) are adopting programs that use incentives — and penalties — to encourage employees to take responsibility for their health. A study released last week by Watson Wyatt showed similar results.
2. Stop expecting health plans to deliver customized programs. Health plan offerings are popular — there is a nearly 90% adoption rate for core health plan services. But employers increasingly turn to outside vendors for customized programs to fix bad employee health habits. Health plans are looked to for value-based insurance designs, with 40% of employers looking to implement VBID or similar programs.
3. Stop paying for programs that don’t work. Fifty-five percent of employers said they were reducing the number of health benefits they offer or focusing on those with a proven ROI. With 59% saying cost savings are their top priority, it makes sense that they cut costs where they don’t see savings.
4. Stop confusing employees with too many benefit offerings. Employers have in place 10 or more distinct health benefits, with 60% identifying at least five major programs (EAPs, nurse help lines, health coaching, wellness, etc). Employers want to implement a single point of contact to navigate their programs, with adoption rates of these services expected to triple in the next 2 years.
5. Stop thinking bad medical outcomes are because of bad luck. Sixty-five percent of employers said their employees struggle with making the right treatment decisions when sick. Thirty-five percent said making sure their employees have better quality care was a high priority, with 38% saying they wanted to do more to empower employees to make good health care decisions.
*This blog post was originally published at the See First blog.*
April 26th, 2009 by Dr. Val Jones in Humor, Medblogger Shout Outs
2 Comments »
This post is republished from Paul Levy’s blog. Please feel free to repost and distribute to raise awareness of those who do not enjoy free speech:
Thanks to T at Notes of an Anesthesioboist for getting this going, a group of bloggers is holding a blog rally in support of Roxana Saberi, who is spending her birthday on a hunger strike in Tehran’s Evin Prison, where she has been incarcerated for espionage. According to NPR, “The Iranian Political Prisoners Association lists hundreds of people whose names you would be even less likely to recognize: students, bloggers, dissidents, and others who, in a society that lacks a free press, dare to practice free expression.”
Hearing reports like these has prompted us to do a ribbon campaign. Blue for blogging.
Please consider placing a blue ribbon on your blog or website this week in honor of the journalists, bloggers, students, and writers who are imprisoned in Evin Prison, nicknamed “Evin University,” and other prisons around the world, for speaking and writing down their thoughts. Also, please ask others to join our blog rally
April 26th, 2009 by Dr. Val Jones in True Stories
3 Comments »
A surgeon friend of mine recently told me a story about a little girl who wandered into the territory of some pit bulls. These dogs were tied up with leashes in the neighbor’s back yard – specifically because they couldn’t be trusted to run loose near children. Tragically, the two year old wandered within their grasp after slipping through a protective kiddie gate and out of the house.
The dogs attacked her viciously, dragging her deeper within their territory and attempted to eat her alive. They tore off both her ears and shredded her chest and limbs. By the time she was discovered she was near death. The girl was rushed to the nearest trauma center – where my friend took her to the OR immediately. He spent the entire night putting the pieces back together, as it were.
A couple of days later, my astute friend noticed her having problems turning her head towards her mothers’ spoon during meal times. That observation triggered him to test her vision – and low and behold the girl was completely blind. A brain CT confirmed the clinical team’s worst fears: at some point during her resuscitation, the girl had a massive stroke, and her entire occipital lobe (the back of the brain) was damaged.
Wondering if there was anything he could do to help the girl, and devastated by what he assumed was a grave prognosis (a lifetime of blindness), my friend called a neuro-ophthalmologist for advice. Much to his amazement, the neurologist told him that her visual deficits were likely to resolve completely, because her brain would simply adapt. Children at very young ages can recover from otherwise devastating strokes because of neuroplasticity – the ability of the brain to rewire itself, and recruit healthy neurons to take over for damaged tissue.
True to the neurologist’s predictions, the little girl regained her site within a year. Fortunately, her body healed extremely well too – and despite thousands of stitches, her scarring turned out to be quite minimal. Today it’s hard to tell that she’s had surgery at all.
This story holds special interest to me, as I too was mauled by a dog when I was a little girl. Although I was bitten in the face, and nearly lost my left eye, I can’t remember the last person who noticed my scars or asked about them. They simply faded with time.
The extraordinary healing powers of young tissue cannot be matched in adulthood. However, some degree of neuroplasticity lives on in each of us, offering hope for brain rehabilitation for everyone – from the forgetful to those with major impairments.
Whether you (or a loved one) have internal or external scars – healing is always possible.
