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324 thoughts on “Chiropractic and Stroke

  1. quackdoctor says:

    “quackdoctor – The Tu Quoque “but they’re dicks too” doesn’t answer my question as to why you’re here making excuses for non-evidence based chiropratice rather than out getting to know what’s really going on and believed in your profession and advocating for the necessary changes. Are you even a member of the group of EB chiropractors that Harriet has written about?”

    Well no I have not ever been a member of that group. I simply do not agree with everything they are saying. I agree with much of it but not all. And guess what? Neither do they in practice. They say one thing and do another. And I will not be a whore. And I clearly know what is going on in the profession very very well.

    But my point about DOs is VERY valid. You do not see them being asked to change. And they are in the medical main stream.

    No as far as me changing the profession. Well it is a very very complicted thing. Not as simple as you think. If you come out and attack evry thing that you find incorrect you willcarry no credibility. You have to be political and realize that things change slowly. Or else you will be totally ineffective relative to changing the profession. I mean there are a couple of reformist chiros. One in particular that has written some decent stuff for the average person. But that DC has no credibility in the profession. So you cannot go offending people. And when you tell people that everything they are doing is essentially incorrect then that is offensive and they will shut down.

    The other thing that you are not considering is that a lot of the profession is based on a philosophical/religious doctrine. And you will never ever change that. That is tearing down someones faith and primary interpretation of how the universe functions. I mean that is like going into a christian rebival and proclaiming that Jesus never existed and had no power.

    So if you have a christian family and the family will not take a sick diabetic child to the hospital for care you will make no headway if you tell them thier religion is a bunch of crap. Your best bet is to tell them that you love Jesus too but in this case the kid needs to see the doctor. So you have to work within the system.

    You know I remember early in chiropractic college. I went to a couple of colleges but National was where I consider myself an alumni from. Well at National was a man I respect very much. He is an eminent researcher ant neuroanatomy professor at Dartmouth. He is a DC, MD and PhD. What I will be. No this man is extremely respected in chiropractic.

    Well I rember how a student asked him in class if spinal nerves could be compressed by vertabrae to cause disease. Well this man did not knock anyone. He simply explained in a rational manner based on anatomy and neurology why it could not be. Well the guy had all the credibility in my mind and the sheepskin. So I believed him. It made sense. So someone of his credibility saying something in the right manner can go far.

    As fare as negating the entire concept of subluxation. No I will not do that. Because I see things a little differently. In the way I define it. Vertabrae can become fixated, can have inflammation in the joint capsule or disc derangements and all of these things can impact motion. And if a vertebra is not moving properly and is inflammed in the joint capsule it is not where it should be. So it’s motion dynamic is altered. It is functionally out of place. Not misaligned however. The facetes and sost tissues prevent actual misalignment.

    Additionally with all of my eduction I still have a very superficial knowledge of how the spine works. But I think I would be thout of as knowing quite a bit. The spine is one tough cookie to understand and there are mechanisms that we do not understand. So I am not ready to discount soinal manipulation and adjustments having an effect on the nervous system by mechanisms other than spinal nerve root compression. Like I say the spine and nervous system is extremely complex. And I have seen things that while anecdotal require me to look deeper for explainations. Are these things cause and effect…Are they coincidence? I do not have the answers to that. But I have seen to much to shut down investigation.

    So I submit myself to people with more sheepskin than me. And those to me are the DC, MD, PhD researchers holding all three degrees that have no interest in being bias but are open minded. People that will not lie either way.

    So when someone like Rand Swenson DC, MD, PhD or maybe Scott Hadleman DC, MD, PhD says something I listen pretty damn hard whether it is pro or con relative to manipulative mechanism. Whe some MD in practice with no manipulative experience says somethin I will take it with a grain of saly. But by the sam token when some DC teaching chiropractic technique says something I take that with a grain of salt to.

    Now as far as the profession as a whole there is a big difference between the Dcs that believe that subluxation exists and can impact health and those that believe that and are dangerously anti medical. A lot of the Dcs that subscribe to subluxation and neurological consequences are not anti maeical and referr all the time. So they while possibly wrong in premise are not as “dangerous” to people as the skeptics think. But the delusional chiropractors that do not belive in medicine are very dangerous.

    So you cannot just dismantle the profession. And it is not going to happen. But you can make changes slowly to make things safer for people. But as I stated before. But people do not understand (and I do not expect you to because you are not on the inside) that the sheer numbers of chiropractors make turning chiropractic inot an evidence based dicipline for the treatment of joint and muscle pain a non possibility. Threre are not enough patients and medicine even if chiropractic confined it’self to that would not be supported by medicine. The hate runs too deep. So you better get use to the fact that chiropractic is not going to give up her philosophy period. Things can only be made safer.

    Now I have no high power answers to anything. And let me tell you. That when I have been sick with the flu for example and have sore joints and musles I feel much better getting manipulated. When I feel out of sorts and depressed or cranky a manipulation makes me feel a lot better. And I have found nothing to replace it and a lot of patients feel the same way.

    So no I am not interested in dismantling chiropractic. I am interested in keeping people safe. And I am also interested in seeking truth what ever the truth is. I am actually a very analytical person. More so than most here I think. As you guys have not even thought up how to challnge chiropractic methodology. Like how would you disabuse the chiropractic analysis of the cervival spine with e x ray. Because the chiros claim that they can demonstrate correction of the atlas subluxation on x ray but no one has a clue how to challange that. I do however. It is very easy.

    So there is verifiable truth, there is truth that we vcannot prove or disprove yet, there is quackery and there is dangerous quackery. I an interested in the quackery with my highest priority being that which is dangerous. I am not interested in fighting with someone who has methods not scientifically proven but is relatively safe. That is the least of the problem.

    And lastly you mention the association of evidence based chiros. Well with all I said I still would not be a member because they are not in line with my thinking in terms of what I should and should not do. Like saying that I must PROMOTE things like vaccines and flouride. Well to that I say “go to Hell”. And I am not against vaccines or flouride. But you are not going to tell me I have to promote them. It is not my job. It is not my area. I simply would not get involved. I would not speak against them. I would simply say “Ask to your MD”. But I am not going to be a salesman for medicine. It just is not my job. To speak in behalf of or against and medical method if I do not want to. Now when I hold an MD degree I will have something to say.

    And this is not connected but let me put it this way. Everyone thinks chiro has little to offer. Well to that I say maybe a smart chiorpractor should start offering classed on the seekend at the Holiday Inn for PTs and MDs that want to learn chiropractic analysis and manipulation. Why don’t you see how fast those seminars will be sold out?. Yeah..$495.00 for the weekend and 30 students. I can deal with that. That is almost as good as testifying in court.

    But seriously and rationally chiropractic will never be what you guys want. Nor in my opinion should it. What needs to be done is that dangerous things need to be delt with first and then out right quackery and thgere are levles of these things. And I think that preventing people from gettin strokes and loked in syndrime is a very good place to start because I sure would not want anyone to get paralyzed or badly hurt or kept from critical medical care.

    And as far as Harriet’s comment above. She knowa I am 100% right. I know it. But you see I see no articles being written about the quackery taught in osteopathic colleges. The bottom line is that if there was a modern Flexnor report and enforcement in medicine osteopathic medicine would be dead. But that is all I will say.

  2. Joe says:

    nwtk2007on 31 Jul 2008 at 12:55 pm wrote “Joe, I have presented evidence, you just didn’t read it as usual.”

    I want reliable evidence, not stuff in quack magazines. Or did you submit a “data dump” that would have required me to sort through it and analyze it for you? Surely, if you know that the chiro neck-snap has a good safety/efficacy ratio, you can cite a review or a recent paper with ‘leading’ references in a reliable source.

  3. Joe says:

    quackdoctor on 31 Jul 2008 at 2:36 pm wrote “[more argument, no data]”

    I must assume that you cannot support chiro neck-manipulation with anything factual.

  4. Fifi says:

    Quackdoctor – “The other thing that you are not considering is that a lot of the profession is based on a philosophical/religious doctrine. And you will never ever change that.”

    So, you seem to be saying that a lot of the profession is actually a religion or cult, and that’s the foundation of chiropractic and you can’t speak out against it to your peers because you’ll get excommunicated and will no longer be able to practice. Previously you’d been declaring this wasn’t true.

    Seriously, I can understand the personal bind you’re in vis a vis making a living and the time and energy you’ve invested into it but that does little to change the fact that rather than doing something constructive about the dangers and cult-like/religious behavior you’re here trying to make light of the dangers of your profession and your peers who practice according to make believe biology. That seems a bit odd and ironic next to claims that you have too much integrity to be associated with the group of evidence-based chiropractors. Sorry, you may personally feel okay with profiting from quackery (or not speaking out about it when it may cut into your profit margin and professional standing) but it really doesn’t say much about your integrity as a health professional or that you have your patients best interests at heart or in mind. Like I said, I’m sorry that you’re facing that kind of conundrum but the choice between personal and professional integrity and cash is one most people face at some time. The difference is that in your case if you choose the cash over integrity it’s the patient that pays the ultimate price.

  5. quackdoctor says:

    “Since this is a thread about the danger of the chiro neck-snap you seem to be defending a dangerous method. Try to keep in mind, it is not just the danger, it is the inutility of that procedure compared to safer methods (as Harriet has cited). Rather than writing “tis not” can you cite some reliable data?”

    When have I supported high velocity upper cervical manipulation or the “neck snap”? I think you are reaching for things to debate me on that I have not said. And back to the point you did not address relative to osteopaths. You said..

    “I would say the license is bogus, conferred by ignorant legislators, and (in health-care terms) not worth the powder to blow it to oblivion. Their institutions and organizations are equally worthless. ”

    How do you respond to the above statement?

    Now this statement..

    “There are people with many, many hours of (accredited) instruction in astrology. That does not improve their results. The hours you wasted learning to adjust subluxations were not educational. ”

    Well the thing is that most class time is not spent “adjusting” subluxations. But it is spent on learning how to position the spine to move it. How to mobilize. And techniques that proclaim to reduce subluxations happen to be very good and mobilizing the spind even if subluxation in the anatomical sense does not exist. It is extremely important for a student to know a number of mays to manipulate from a clinical perspective. And really Joe you have no idea what a class in manipulation is like. And of course as I said there is the vast amount of experience a DC has over anyone else in terms of numbers of procedures performed.

    And additionally let me tell you something. Despite what anyone wants to think. The public will not be so fast to trust a PT to manipulate their spine. They will trust a chiropractor or an osteopath. I have experienced this.

    You clearly have an agenda against chiropractic in any form. Be it manipulative medicine and therapy or it be traditional chiropractic. It would not matter what the DC did you would attack. Well you see that is fine. But you will have little impact in achieving anything in that manner. People are way to smart than that. You see they have gone to chiropractors and found may to be good clinicians and not doing the stuff said. And experience means the most.

  6. Fifi says:

    quackdoctor – “But I am not going to be a salesman for medicine. It just is not my job. To speak in behalf of or against and medical method if I do not want to. Now when I hold an MD degree I will have something to say.”

    But you call yourself a doctor and people come to you under the impression that you’re a medical professional (a doctor in fact). What ARE you selling if you’re not selling medicine? What are you practicing if you’re not part of medicine? And since chiropractors are one of the leading sources of the anti-vaccine hysteria and disinformation, why wouldn’t you speak up to dispel some of the misinformation being spread by your colleagues? Are you afraid of being attacked by your fellow chiropractors for telling a patient the truth in the privacy of your own office?

  7. nwtk2007 says:

    You know FiFi, if people are so ignorant about health care that they don’t know the diff between a DC, DO, MD or PT; throw on top of that a lack of knowledge of the diff between Advil, Motrin and ibuprofen, then who’s fault is it?

    Once again, I have never been told ahead of time that the medication I was being given has such harmful effects on so many people every day of the year.

    I doubt if the following is highly advertised or discussed with patients in medical offices:

    “One study (16) found a 4/10,000 annual mortality rate for NSAID induced ulcers among patients treated for non-rheumatic conditions such as musculoskeletal pain and osteoarthritis; that extrapolates to 3,200 deaths in the US annually.”” – this from above in a previous post.

    I know you will tu quo me, but really, who is spreading misinformation and who is not educating the public, misrepresenting the safety of medications and down playing risks?

  8. nwtk2007 says:

    One thing is for sure, in all those classes where we learned the different ways to do manipulation, we were never talking about subluxations. We were looking for fixations or abnormalities in motion. I don’t think the word subluxation ever came up except in philosophy classes. We were all pretty clear that the “subluxation” was a philosophical term.

  9. quackdoctor says:

    ” Like I said, I’m sorry that you’re facing that kind of conundrum but the choice between personal and professional integrity and cash is one most people face at some time. The difference is that in your case if you choose the cash over integrity it’s the patient that pays the ultimate price”

    Now wait a second. I am not in practice. And any money I make is made from depositions and consultation in malpractice and occasional personal injury. I testify against DCs all the time. And I really do not think you understood my point. That one needs credibility to make change. You do not keep credibility by slapping a person in the face. You work slowly. And what you call evidence based chiropractors I do not see as evidence based. To a degree they are. But I simply do not agree with all of what they say they believe. And neither do they by the way.

    And as I have said I will be going to medical school and am out of clinical practice. So I will not dance to the tune of the close minded chiropractors or the close minded anti chiropractic camp. I am interested in truth. And I know that you are wrong to a degree and the chiropractors are wrong to a degree and there is also truth in what you both say.

    And like I said even if I agreed totally with you guys you have to understand there is no way you are ever going to get entirely what you want. You have to comprimise. You have to allow change slowly. But chiropractors are never ever going to be what you think they should be. It is just reality. So you need to focus on the most important issues.

    Let me put it this way. Let’s say you make the practice of subluxation based chiropractic illegal. OK. Well that is the equivlent of making christianity illegal. Or faith in God and prayer illegal. Chiropractors are just going to make lateral moves on the chessboard to practice. If tomorrow you took away every chiropractic license the subluxation based chiropractors would just practice as something else and skirt the law.

    And when you attack the profession too hard you are going to cause more unity in it. And the attacks on chiropractic have unified it more than ever. And unity has been the professions major problem. So one must move slowly. And it needs tyo be people with credibility. And an atheist has no credibility in a christian church.

    Look I am not just some chiropractor. I have spent years in the archives of chiropractic studying the formation and progression of the profession. I have taught. I have an advanced degree other than a DC. I practiced a number of different ways. I know what is going on.

    Now as far as your indication that if one went against chiropractic they could not practice. That is not true at all. It is done all the time. But anyway the following quote applies to both many chiropractors and their knowledge of medicine and many MDs and anti chiropractic people and their knowledge of chiropractic.

    “A paranoid is someone who knows a little of what’s going on.” — William S. Burroughs

    And to paraphrase another quote..

    “When someone constantly makes weak arguments for something future stronger arguments for the same thing are not taken seriously”

  10. Fifi says:

    quackdoctor – I got the impression you were still practicing – what led you to stop?

    You still haven’t explained why you’re here making Tu Quoque arguments, advocating for chiropractice (and you have been, despite your innately biased opinion about your own bias! ;-) ) and making excuses for why you can’t/won’t instead address the issues and potentially dangerous practices within chiropractic….

  11. quackdoctor says:

    “But you call yourself a doctor and people come to you under the impression that you’re a medical professional (a doctor in fact). What ARE you selling if you’re not selling medicine? What are you practicing if you’re not part of medicine? And since chiropractors are one of the leading sources of the anti-vaccine hysteria and disinformation, why wouldn’t you speak up to dispel some of the misinformation being spread by your colleagues? Are you afraid of being attacked by your fellow chiropractors for telling a patient the truth in the privacy of your own office?”

    Look. I would simply refer the patient to a medical physician if I felt that I could not help them. I would not decide what that doctor would do. It is their area. I would not say…I am sending you for antibiotics. or I am sending you to the neurosurgeon for a specific surgery. I would just send them. That’s all..

    Now as far as the vaccines go. No I would not get involved in that issue. It is none of my business, I simply would not address the issue. OI would tell them to ask their MD or pediatrician. I would not take on that responsibility. IOt is non of my damn business what they do about vaccines. It is between them and their medical doctor. What right do I have to speak for or against vaccines?

    I mean maybe their MD would feel their child should not have a vaccine for a medical reason. So who am I to say? I mean I had a good eduation in immunology but I am not up on all the current literature like an MD. I do not read all the product inserts and journals. I have never given anybody a vaccination. So what dio I kow about them and their child and if a vaccine is appropriate in their case. I just do not know. So I say go to an MD you trust and talk to them. That’s all.

  12. nwtk2007 says:

    Joe – “I want reliable evidence, not stuff in quack magazines. Or did you submit a “data dump” that would have required me to sort through it .. ”

    Joe you are exactly as I have said and did exactly what I said you would.

    For example, a part of what you said, “did you submit” and then “that would have required” indicates that you have no idea what I submitted because you did not bother to read it, or even glance at it or anything. You just made an assumption, based upon your own preconceived notions.

    Here you are on an evidence based forum, and you won’t even bother looking at the evidence to even make an attempt at a rational evaluation of it.

    And FiFi calls me a troll.

    Right!

    Well don’t worry Joe, it’s still up there. It ain’t going nowhere.

    What was it again you wanted evidence for? You seem to be asking for it a lot but won’t bother to look at it.

  13. quackdoctor says:

    “quackdoctor – I got the impression you were still practicing – what led you to stop?”

    Well my wife left me and she was always with me in practice and I just did not have the heart to go on without her. And I am getting into medicine now. Nothing wrong with chiropractic. Just new horizons that is all. I have nothing to live for so I might as well spend the rest of my days helping people. And I thionk I can help more people who need it with medicine and use my manipulative slills as well. That;s all.

    “You still haven’t explained why you’re here making Tu Quoque arguments, advocating for chiropractice (and you have been, despite your innately biased opinion about your own bias! ) and making excuses for why you can’t/won’t instead address the issues and potentially dangerous practices within chiropractic….”

    I have clearly addressed that. Because it will not work. I think you have an idea how things should be done. And I am saying that they will not work. I have explained that. There are many ways to make change. You can teach and I have. You can set an example. I mean I am really not sure what you want me to do or say. I have spoken against upper cervical high velocity manipulation in the extended and roteted position. I have spoken against keeping patients from medical care. I really do not see what you want.

  14. nwtk2007 says:

    Quackdoctor – “I have spoken against upper cervical high velocity manipulation in the extended and roteted position. I have spoken against keeping patients from medical care.”

    I have too but it just goes in one ear and out the next.

    Quackdoctor – “I really do not see what you want.”

    Some of them want you to join their religion. But you know, the Tu Quoque response was one Jesus used wasn’t it? Something about stones and big things in the eye of the accuser? Probably more than that.

  15. Harriet Hall says:

    This discussion is going nowhere. Isn’t it about time to stop?

  16. Graham Maynard says:

    Hi

    I don’t have time to follow everything written here, because # nwtk2007 and # quackdoctor are doing what always happens when chiro is challenged – rendering a good thread useless by bullying, dominating and drowning out everything other than what they want to be ‘heard’.

    Thank you for your comments Fifi and Joe.

    # nwtk2007 said >>I would remind you that his “films” have apparently been read by American Radiologists who, from what I can gather, said they were negative.<<

    THIS STATEMENT IS GROSSLY UNTRUTHFUL. SHAME ON YOU # nwtk2007.

    On spec I went to America for 1 week to try to get scans. I managed to get only my neck CT and MRI scanned. I did not manage to get investigation for my head, was very unwell and could not stay longer.

    Here at home I was not *granted* a CT scan of my head until after I could no longer claim !

    Hi Harriet,

    Friends of chiro would have us believe that chiro manipulation is ?gentle?
    My head was always pulled sharply and strongly – enough to move my entire body on the couch !!!!!.

    Also please not that I am not trying to get chiro banned !

    My website is a WARNING to authorities, also to the public so that they can make up their own minds.
    The public are not stupid – just they don’t KNOW what is happening or what their ‘treatment’ might be.

    Today I spoke to someone who gave up on chiro because it did not help. He did find help elsewhere though.
    He said he was not aware of the risks of chiro, and he became concerned that ‘his’ chiro had never told him either.

    Cheers ……. Graham.

  17. quackdoctor says:

    “Some of them want you to join their religion.”

    Yes that is it to a large degree. Then I can be a poster boy for anti the chiropractic camp. No matter how you try you cannot get over the chiropractic stigma with some people. And those same people have never attended a chiropractic college or seen patients with a rational DC in their office. To get a first hand look.

    I can remember when my father was dying in the hospital. He was a very well kown MD PhD. My brothers are all internists. My mother was a research pharmacologist with Dr Best in the study of insulin. Well anyway so the nurses are all in love with my family because they are all MDs. But then one finds out I am a DC. She begins to be abusive and treat me poorly as did a couple of others. It was funny. I have learned that if I ever see an MD for a health issue to tell them I am simply an anatomist.
    Now not all are bad by a long shot. But I just do not take that chance.

    I remember when my kid was sick in the hospital. The neonatologist was very abusive. The nurses were pretty cool. I remember that this one resident was kind of nice. She starts going off on how she really liked some holistic medicine. She starts saying how she is very impressed with homeopathy. And I am thinking “What a quack”.

    I remember when I was in chiropractic college. I rented this basement apartment in this lady’s house near National. Well she told me never to bring any black people into her house. She goes on this tangent about how she does not care how smart they are or how well educated or how much money they have. She does not want them in her house. Of course I moved shortly there after. So I have experienced the same thing as a DC. It does not matter what you know at all. Unless you can get into the right situation. Like Terry Yochum lecturing in Radiology at University of Colorado. Now his students will respect chiropractors. And know that many are highly educated.

    Now I have been around the block and provide accurate information. I can tell people exactly what goes on . I am happy to discuss the streangths and weakness of Palmer College for example. Or National for that manner. I am always honest totally. But you will notice that nobody ever asks any questions about chiropractic education or practice. I would be happy to reveal the dark side of any aspect. Any shool I have been at. But people do not want to know. They never ask questions at all. I am happy to reveal the weakneses. And the funny thing is that the people making critique really do not know what the true problems are.

    But anyway that is all.

  18. quackdoctor says:

    “This discussion is going nowhere. Isn’t it about time to stop?”

    Well yes harriet it is I suppose. Now getting back to stroke. I agree that upper cervical manipulation may cause stroke and that stroke may result in a number of syndromes. It is fact.

    Now one of the interesting thigs that chiropractors are guilty of is this. You see if the cervical spine is being manipulated and the patient exibits symptoms. Such as dizziness, a sensation of falling, visual changes ect. The chiropractor should immediately stop the proceedure. But classically what has happened is the chiropractor does not recognize these as signs of stroke or neurologic event and the DC thinks he adjusted the spine in the wrong manner. So the DC procedes to try and readjust the spine. Causing further damage.

    Now we know this because it has been reported that the patient got much worse after the attempt to re adjust the spine after the initial symptoms.

    So all of this is because some chiropractors have a monocausal view on symptoms. And because they are thinking subluxation only. So when they adjust and the result is neurological symptoms they believe they dispalaced the bone and it needs to be replaced. That they adjusted the bone too far one diredtion

    So this is the type of thinking that goes on sometimes. But what I have stated illutrates the thinking of a bad chiropractor. or at east one that is not thinking properly.

  19. nwtk2007 says:

    There is no question as to whether manipulation can cause a stroke, hemoragic or otherwise. But in the Nette case, even with bilateral tearing of the vertebral arteries, there is really no way to know for certain that the manipulation caused it. It is the same in many of the cases that have come to light.

    The proponents of this EBM web site are very quick to point out when thinking like this exists in any other arena. Take my previous case, with all of the evidence to back antibiotic benefit for sinus infection, not to mention the number of times that I have had to resort to them to be “cured” or at least recover sufficiently to return to normal (for me that is), they still suggested a potential placebo effect as what I perceived as definite releif from the antibiotics effects on the staph that inhabits my sinuses from time to time (verified by culture while under the care of a MD/respiratory specialist).

    Applying that same level of skeptical doubt about the efficacy of antibiotics to Ms Nette’s condition and what we have heard of the story thus far, I would have to say that there is little, if anything, by way of evidence that the manipulation caused the stroke.

    I personally have to think that there is a very strong chance that the manipulation did, indeed cause the stroke, but what I have learned on this web site about EBM and correlation-causation leads me to say that there is almost no evidence to support her story.

    We are left with the bare fact that something could have occurred prior to going to her chiropractor, as she had for seven years apparently, that actually started the process of dissection.

    They call the bilateral dissection a smoking gun. How so? Is it possible that she might not actually remember the incident factually and might, in truth to her, not remember the actual event that might have happened prior to her arrival to the chiro’s office?

    There are a lot of unanswered questions about chiropractic and stroke. My non-EBM self tends to think there is a link, but the EBM specialist cannot possibly state that based upon the evidence, that the doctor’s manipulation is the cause.

    FiFi will say that I am without compassion, heartless and cruel to say such things, but a bit of what I said, I learned from her.

    Who are we to say that the chiro’s defense attorneys are looking at web sites such as this one, everyday, using the information the can get here, and formulating their defense around the EBM model of “science”.

  20. nwtk2007 says:

    “There is no question as to whether manipulation can cause a stroke”

    I should change that. There is a huge question about manipulation causing stroke.

  21. quackdoctor says:

    Well I see your point about evidence based medicine and proof. But we both know that manipoulation of the upper cervical spine can cause a stroke. I mean there are many documented cases of the patient being totally fine and stroking out right after the manipulation. Right on the table. Now the only thing is that in the case of the bilateral tear I cannot fathom how someone put in that much force. I mean I think I could do it to someone but I would really have to go extremely deep and even then it would be hard from what I can tell. I mean to do it bilaterally.

    I mean the course of events in an immediate stroke after a manipulative procedure are actually sometimes almost classic. Dizziness, a feeling of falling, visual disturbance, motor loss. It progresses from there.

    So I really think we need to step up to the plate and take responsibility here and fix this situation. Otherwise what little crebibility we have will be further comprimised. And instead of ending up in situations like what we are contending with in Canada show some good faith by attending to our own problems. And providing rational solutions. That is what being a rational professional is. Because I tell you what. The big boys in the profession with the triple doctorates working at major institutions are not going to defend the ussue of whether or not manipulation may cause stroke. As much as they are advocates for the profession. They cannot. So it is better to have them on chiropractics side and let them help define which methods are safe and which have potentiol harm.

    Because if we do not define what procedures cause problems then people are going to say all procedures are harmful. And in fact that is what they are doing. And to beat these attacks we need the real experts with credibility. And they are not going to lie. So it comes down to being honest. The time has come for technique modification. Not only to protect chiropractic. That is a small issue compared to preventing anyone from being disabled. That is the issue.

    So based on what I know about anatomy, mechanics and adjusting I pretty much know how these things happen. I have had one neurologic UMN event with the upper cervical spine and I remember exactly how I did it. Fortunately everything worked out for the patient. But I know that if you are not careful things can happen even though they are rare. I am sure I know exactly how to eliminate these strokes. But the first part is to admit that they can and do happen. The second part is to figure out exactly why.

    Now no matter what we do there will be those, many of which are withing the medical profession and may that are not that will never accept anything chiropractic does. But the thing is that it is not our job to convince them. It is our job to convince judges and lawmakers who objectively review facts. And of course the public who we own cafe and effective care.

  22. nwtk2007 says:

    Like I have said, I tend to think manipulation can cause strokes and fully back using informed consent, and studying the issue and at least coming up with a concensus about types of manipulation to avoid just to be on the safe side.

    And either way this goes, chiro’s are going to be more chastised by the medical community.

    I am still thinking, however, that anatomically speaking as to how you might conceive it happens, I still wonder why it doesn’t show up more in sports like foot ball or rugby. And how about wrestling, both the crazy kind and the classic kind.

    Or how about the cage fighters? Or boxing?

    I don’t think it as clear as it might seem. You might be right but I wouldn’t capitulate to the concept so very quickly. A knee jerk reaction by chiropractic would be telling, in and of it’s self.

  23. quackdoctor says:

    Well you really cannot compare the forces of football and boxing to a manipulative thrust. They are entirely disserent forces. The forces of the sports are more global to the body. The forces from manipulation are shearing forces.

    No let me put it in more general terms. When a boxer gets hit his neck does not produce an audible release. And this does not happen in football on impact either. The forces from the sports do not put specific vectora along the lines of the facets. manipulation does.

    And then we come back to the undeniable fact that quite a few people have waliked into the chiropractor with no symptoms and stroed out immedietly on the table after the thrust into the c spine.

    And really what this is about is patient protection. Like I said chiropractic will be hated by those who hate it no matter what. So it is about keeping folks from getting hurt. Because being in a locked in syndrome is no fun for anyone. Especially if you were able bodied before.

    I mean we have known about this for like 40 years. It probably did not happen in the early days of chiropractic as extension and rotation techniques were not used and side lying techniques in the lumbars and pelvis were not used. All of this came from the bonesetters of the midwestern regions of the USA and the osteopaths who modified their techniques.

    DD and BJ Palmer would have never tolerated twisting the neck as in diverified technique. So actually historically the twisting techniques came not from the Palmers or their chiropractic. They came form osteopathy and osteopathy modified them from families of bonesetters and those families came from Europe and wh knows where they originated from there?

    And the bonesetters and AT Still of Osteopathy were not brilliant students of the spine as were the Palmers. So we see the root.

    But anyway this situation needs to be taken very seriously

  24. nwtk2007 says:

    This is why I like treating injuries. The patient’s have symptoms and exams are revealing and very non-esoterric. I don’t go looking for something in the dark, they come in with specific complaints and we examine, diagnose and treat them.

    I don’t have to search for no stinking subluxation. But I find plenty of altered biomechanics associated with the injuries. I also get to recommend and schedule a great many brain scans, MRI and CT, for head injuries. For patients with red flags for stroke, be it head injury or pre-existing, I don’t do any manipulation. Why some chiro’s think everyone needs a manipulation is beyond me.

    But, tu Quoque, most MD’s and DO’s think all patients need a prescription, many times for something they could get OTC and much cheaper.

  25. Harriet Hall says:

    nwtk2007 said,

    “most MD’s and DO’s think all patients need a prescription,”

    I don’t think that’s accurate. If anything, they may think most patients “want” or “expect” a prescription. Most good clinicians try to avoid prescriptions whenever possible. And if a doctor writes a prescription for something that can be bought over the counter, it might be because insurance pays for prescriptions only.

    I wrote about not prescribing: http://www.sciencebasedmedicine.org/?p=126

    Have you written about not manipulating? Do chiropractic patients want and expect manipulations? Is anyone trying to educate chiropractic patients that they may not always need a manipulation?

  26. Blue Wode says:

    @ any chiropractors reading this, I’d be interested in a response to the two questions posed in my 30th July, 3.05am post.

    Meanwhile, here’s the latest from Sandy Nette:

    Quote:
    “My simple message is clear… Don’t EVER let a Chiropractor touch you above your shoulders! This chiropractor has caused me more pain and heartbreak than I can express. Everything and I mean EVERYTHING has now changed. Life for me will never be the same. SO IT IS MY PRAYER THAT THIS TYPE OF NEEDLESS INJURY Never ever HAPPEN TO ANYBODY ELSE.

    Please help me get the word out there. So many lives are depending on this information. Neck manipulation MUST be stopped.”

    http://sandynette.com/

    Full details of the Nettes’ lawsuit here:
    http://www.chirobase.org/08Legal/nette.html

  27. nwtk2007 says:

    Harriett asks – “Have you written about not manipulating? Do chiropractic patients want and expect manipulations? Is anyone trying to educate chiropractic patients that they may not always need a manipulation?”

    1. I have written a bit about it as material used in seminars I prviously gave for re-licensure for chiropractors. I might do another soon.

    2. That is an interesting question. For one, most people are so poorly educated about health care that they don’t even know about manipulation. Virtually ALL they know is medication, particularly prescription medications, which they assume are supperior to OTC meds. They don’t know that they are actually dangerous or experimental.

    Of the few who do have a clue about chiropractic and anything related to health care, some want manipulation and some do not. By far most have never been manipulated and often ask why some are and some are not. Also, of the one’s who have been to a chiro clinic, some are disapointed when not manipulated and some are releived when not manipulated.

    3. Every single patient who treats in this clinic gets educated about manipulation;why they might benefit from it or why I will not manipulate them because it might be unsafe or not medically necessary.

    Anything else Harriett? Was that a Tu Quoque in extrema?

    Harriett said – “And if a doctor writes a prescription for something that can be bought over the counter, it might be because insurance pays for prescriptions only. ”

    Do you think it is OK to write a prescription for a drug that could be bought OTC at a much better price than would be paid by an incurance company? You are certainly not implying that medical providers write scripts based upon what insurance will pay for and not what is medically necessary, are you?

    I think it was FiFi who accused chiro’s of that in another thread, or was it Joe?

  28. nwtk2007 says:

    Bait and switch my a$$.

    Chiropractors are experts in musculoskeletal disorders. That is a fact and it ain’t no bait.

    Also, everything a chiropractor does is defined by the legal system, medicare, etc. as chiropractic care since it is performed by a chiro or within a chiro clinic. Some of what chiro’s do is also PT, but if they do it, this same system defines it as PT or medical. The fact is that chiro’s only perform services that are within their scope of practice. Call it what ever.

    But bait and switch? No.

    Now where are my magnets? Crap, I think I reversed a patients polarity and chi flow accidentally. The rest of my patients are just going to have to do therapeutic exercises because I left my lazer pointer in my other pocket. Rats!

  29. quackdoctor says:

    ““My simple message is clear… Don’t EVER let a Chiropractor touch you above your shoulders! This chiropractor has caused me more pain and heartbreak than I can express. Everything and I mean EVERYTHING has now changed. Life for me will never be the same. SO IT IS MY PRAYER THAT THIS TYPE OF NEEDLESS INJURY Never ever HAPPEN TO ANYBODY ELSE. ”

    Well I am sorry about the injury. However the key is not avoid the C soine entirely but to determine what methods put patients at risk and what methods do not. And based on anatomy and knowledge of techniques we are pretty clear on what is going on and how to avoid it. But to say not to touch the cervical spine at all is illogical. That is like saying not to drive a car because you will get in an accident. No you must avoid operating the car in a dangerous manner. Like do not drive on the opposing lane. Or do not go 100MPH on an icy road.

    “How helpful is that? In other words, what is being done to eliminate the *many* cultists – and, until they are gone, what widespread action is being taken to warn patients and the public about the chiropractic ‘bait and switch’?”

    Well “bait and switch” is illegal. All state boards are against fraud. The FTC is against fraud. They have laws. When you see a problem of a DC breaking the law. By all means report them. If the public does not report and follow through you cannot expect the state boards, FTC, DAs and investegators to act without specific complaints.

    “A more subtle form of the bait and switch among chiropractors is the treatment of musculoskeletal symptoms with standard physical therapy or sports medicine practices under the name of chiropractic manipulation. Ironically, the more honest and scientific practitioners among chiropractors are most likely to commit this subtle deception. The problem comes not from the treatment itself but the claim that such treatments are ‘chiropractic’…. But by doing so and calling it ‘chiropractic’ it legitimizes the pseudoscientific practices that are very common within the profession – like treating non-existent ‘subluxations’ in order to free up the flow of innate intelligence.””

    This is a very ignorant statement. A profession is entitled to advance and change. And that is what is going on with these chiropractors. The same thing happened in osteopathic medicine. You cannot blame the scientific chiropractors from using the name chiropractic. Because the profession is entitled to advance. And these scientific chiropractors are using chiropractic methods. Just not all of them or all of the philosophy. If we did not allow for advancement we would have the same techniques and philosophy as DD Palmer. And the philosophy has changed markedly. Even from DD Palmer to his son BJ. BJ was accused of not practicing chiropractic when he changed it. Like when he changed the philosophy and introduced x ray. So even BJ’s chiropractic was changed over the original.

    So this concept of accusing the scientific chiropractors of being wrong in using the term chiropractic is clearly an attempt to contain and absorb chiropractic as a distinct profession independent from medicine. The same thing happend with osteopathic medicine post Flexnor with the closing of DO schools and the remaning them medical schools and issuing MD degrees. And the halting of the DO degree all together and the issuing of MD degrees to DOs. We know this game well.

    And even if the “scientific” chiropractos did want to call what they did something different they could not by law.

    So the thing is that chiropractic has every right to change the same as osteopathy. And additionally scientific musculoskeletal only chiropractic has been around since DD Palmer was issuing diplomas. It is not a new thing.

    So I was not even going to address this as it is a clear attempt to isolte contain and eliminate chiropractic medicine as a distinct healing art. And we can easily see through that. And lastly the practice of the DCswho practice musculoskelatal only manipulative therapy with modalities is protected under statute. So they are doing nothing wrong. They simply choose to practice chiropractic in a more limited manner. Not subscribing to all of the doctrine. And the DOs that practice EBM are doing the same exact thing.

    No not to divert the discussion but. What about the patient who chooses a DO? The DOs claim to be different but most are no different than MDs. Yet they do the “bait and switch” all the time. I mean if I see a DO that is a cardiologist it is no different than an MD. But their degree implies that they are different. But that DO is perfecttly within the law to do it. One does not have to paractice all of the limits of their license.

    But again I, the profession and the courts can see exactly what is being attempted here. Ti isolate absorb and destroy chiropractic as a distinct profession. And that is not going to happen. Do you think I ate stupid for breakfast?

    So you see I am not on the side of irrational dogmatic chiropractors. I am not their friend. But you see I an not a friend to medicine either. Because no matter what I do or say medicine will stab me in the back every time as long as I say I am a DC. No matter how scientific I am I do not trust medicine on a political level. Because I know the game. It is to contain and eliminate. And I will not and others will not allow that to happen. So we can agree with medicine on a lot of issues. But we do not answer to medicine and let us get one thing damn straight. WE are NOT friends. We just have some things in common.

    We will not take the bait. It is as simple as that.

  30. nwtk2007 says:

    I just did a quick run through my active files. (being seen at least 1x/wk)

    60% receive manipulation – some with other modalities some without.

    40% do not receive manipulation for one reason or another.

    100% of those who have also seen a medical doctor were given a prescription.

  31. nwtk2007 says:

    One of my patients who was seen in the ER, was given a prescripition for hydrocodone and soma, with specific orders to take, while continuing to take the 60mg morphine x3/day which she has been taking at the order of her ortho for six years.

    Whoosh!

  32. quackdoctor says:

    “40% do not receive manipulation for one reason or another.”

    Good God man. At least do some little token thing to bill the code :)

  33. Blue Wode says:

    Thank you for your replies, nwtk2007 and quackdoctor. However, they don’t answer my questions.

    Nwtk2007, the fact that “everything a chiropractor does is defined by the legal system, medicare, etc” is irrelevant since it is evident that legislators, and others, have been duped by prolonged and intensive chiropractic lobbying.

    Here are three points to consider:

    1. Quackdoctor has already admitted that “many chiros are cultists” (29th July, 7.29pm).

    2. The well-respected veteran chiropractor, Samuel Homola, recently pointed out that the reasons for use of manipulation/mobilisation by an evidence-based manual therapist are not the same as the reasons for use of adjustments/manipulation by *most* chiropractors – see here:
    http://jmmtonline.com/documents/HomolaV14N2E.pdf

    3. Richard E. Vincent, DC, FICC, Past-President, FCLB and NBCE, said at a presentation to the Federation of Chiropractic Licensing Boards in 2005 that “diagnostic and treatment services that exceed clinical necessity are indicators of incompetence or intentional mistreatment – a violation of public trust that requires remediation.”
    http://www.fclb.org/Conference2005/VincentKeynote.pdf

    So, I ask, once again, what is being done to eliminate the *many* chiropractic cultists – and, until they are gone, what widespread action is being taken to warn patients and the public about the chiropractic ‘bait and switch’?

  34. nwtk2007 says:

    The bait and switch is what you think, not what occurs. There is no bait and switch.

    Once again, I would have to say “you too”. And thus I would ask, what is being done to warn patients about the medical “bait and switch”, so to speak.

    You know, medical offices that call to verify exactly which codes an insurance company will pay for prior to ordering tests and studies for a patient, instead of ordering based upon medical necessity. That’s just one example.

    Lets see if you can follow this, Blue Wode. Do you know the quickest way to get out of paying what your health insurance says you “might” be responsible for after they pay for what they are responsible for? Simple. You write your doctor or hospital a letter requesting copies of all medical records for evaluation of the documentation of medical necessity prior to remitting payment for services apparently not covered by the insurance company.

    It is as simple as that. Do you know why?

  35. nwtk2007 says:

    Quackdoctor – “Good God man. At least do some little token thing to bill the code ”

    You know I could, but do I look like an …. never mind. But hey, if I at least see them and even do some assesment, or even fill out a form, or in some way perform some service relevant to their treatment or what ever, I can bill a 97211.

  36. nwtk2007 says:

    Actually that would be a 99211

  37. quackdoctor says:

    “The well-respected veteran chiropractor, Samuel Homola, ”

    By who? I was not aware that he wrote any scientific texts on biomechanics or manipulation. I was not aware that he recieved any honars from any chiropractic organization or institution. Or medical institution. I see no contributions to diagnosis, radiology, technique, research. I mean he has writen some stuff for the public and is popular by anti-chiropractic people. But what has he contributed to the profession of chirpopractic. Like research, diagnostic texts, x ray texts, manipulative medicine texts? And when did he go to school and where? Did he go to a top school? What was education like in the school he went to when he went there? These are questions to be asked. How good was he in clinical practice? I mean you have no idea about these things. He is only well respected within a certain group. And he is not respected as a clincian or a scientist in the field or the field of medicine or chiropractic based on my research.

    “So, I ask, once again, what is being done to eliminate the *many* chiropractic cultists – and, until they are gone, what widespread action is being taken to warn patients and the public about the chiropractic ‘bait and switch’?”

    Just as much as is being done in the professions of medicine and osteopathic medicine. At least as much. You cannot warn the public about someone who is practicing within the perimeters of the law. Yoiu have to change the law. And that is happening and that takes time. You have to change what is taught and that takes time. It is all politics and very complex.

    But some reformist chiropractic organization cannoy go taking out TV adda and newspaper ads that legal chiropractic is bad. They will be sued. And especially if they say do not go to them. Then it is restraint of trade. So it is a complex issue. It takes time.

    Look 25 years ago for example at Palmer College they had the ohycical examination center thgat did medical bloodwork and medical exams down the street from the clinic. They had the physical therapy equiptment hidden in the basement. Why? We I will tell you. Because they did not want the old chiropractos that made donations to the college to see it all. They wanted them to believe that Palmer was the same old school as when BJ was there and they were there.

    But now times have changed. Palmer has PT integrated into the clinic as well as medical exams and testing as well as reheb. It is all under one roof. So things take time. There are politics involved and much to consider. These are the way things work in the real adult world.

    I mean why do we have anything to do with China with all it;’s human rights abuses. Things take time and comprimises must be made to move forward.

    And the thing is that you can stomp your feet and throw a temper tantrum like a 4 year old. But you have to understand that chiropractic is extremely powerful. Has major money and things that you do not like are woven deeply into the field. So change is slow but progress is being made.

    I mean you have to understand that the osteopathic colleges are still teaching cultism and pseudoscience in there own way. But they are accepted. It is all politics.

    And the bottom line is that you are NEVER EVER going to see chiropractic give up her philosophy of Innate Intelligence. That is a total impossibility. So you have to be realistic

    Now for example I am going to medical school. I would like to see some changes in medicine. However I know that if I am going to make change I need to be political and cannot upset people. So I have to be political and keep my mouth shut on certain issues. This is how things are done in the real world.

    So you are making things a lot more simple than they really are. As far as telling the public. You seem not to understand. Let me give and paralel. Look at the Church of Scientology. There is a mass effort to expose it’s cultism and fraud. And it has been a bit effective. But plenty of new people are joining and the church is doing very well. Despite the fact that the internet is crammed with warnings. In fact people stand in large numbers in front of the churches warning people about what goes on. But the people still get involved. So the real change would have to happen from the inside. From people inside the church who did not stir the pot so quickly. Did not challange all of the doctrine but lead people away from the worst of it gently.

    But lets get one thing completely straight. Subluxation based chiro is not going away. The philosophy is not going away. Manintanence care is not going away. And even if the laws change the people involved are dedicated to it and very very intelligent. They will simply make lateral moves and adjust to the law.

    So with this idea the ball game is to deal with the most dangerous things first. And then gradually make headway over many many decades. So that is how it is.

  38. Harriet Hall says:

    “You are certainly not implying that medical providers write scripts based upon what insurance will pay for and not what is medically necessary, are you?”

    NO! I’m saying that providers write scripts based on what is medically necessary AND what insurance will pay for. I am saying that if a patient needs meclizine for the treatment of vertigo, he can buy Antivert over the counter, but if he does his insurance doesn’t pay for it. If a doctor writes a prescription for meclizine, insurance picks up the bill.

    Sometimes treatment is medically necessary and two drugs are equally effective. In that case, a doctor can choose which to prescribe by which the insurance company will cover – usually the less expensive, so everyone benefits.

  39. Fifi says:

    Actually, speaking out and public attention focused on Scientology has had a very profound effect in many places (just not the US, but it has had an impact in Germany and the UK). This is DESPITE just how insane Scientologists are about hunting down any critics and trying to disrupt and stop anyone who speaks out against them, and how much money they have and how much they invest in window dressing like Cruise and try to insert themselves in local politics. Seriously, look how Tom Cruise’s association with Scientology has made him a laughing stock (who wasn’t entertained by his wooish video for “insiders” that made it online?). Who didn’t laugh at Cruise in the closet on The Simpsons? Ditto what’s his head making Battlefield Earth (which showed just how disinterested the public really is in Scientology, talk about tanking!)

    Nothing ever changes unless people speak up and make a fuss. That’s how women got the vote. It’s how African-Americans got rid of segregation and changed racist laws. It’s how Mandela got rid of apartheid. It’s how Ghandi achieved is aims in India. I mean, why are you here if you don’t think speaking up can have an impact?

    First you attempt to put science lipstick on your magic pig, now you’re trying to say that we should cast pearls before the swine and try to seduce the pig into not being such a pig.

    Personally I’m going to see if there’s any way I can lend support to Sandy Nette so we can get some laws changed in Canada regarding chiropractors. You’ve convinced me that your magic pig will never fly and needs to be put down so it stops hurting people.

  40. Blue Wode says:

    Quackdoctor wrote: “You cannot warn the public about someone who is practicing within the perimeters of the law. Yoiu have to change the law. And that is happening and that takes time. You have to change what is taught and that takes time. It is all politics and very complex.”

    …and all very convenient for chiropractors who are likely to have very little interest in changing the law when you consider what British scientists Simon Singh and Edzard Ernst concluded about chiropractic earlier this year:

    “WARNING: This treatment carries the risk of stroke or death if spinal manipulation is applied to the neck. Elsewhere on the spine, chiropractic therapy is relatively safe. It has shown some evidence of benefit in the treatment of back pain, but conventional treatments are usually equally effective and much cheaper. In the treatment of all other conditions, chiropractic therapy is ineffective except that it might act as a placebo.”

    [Ref. ‘Trick or Treatment? Alternative Medicine On Trial’, p.285]

  41. Joe says:

    quackdoctor on 01 Aug 2008 at 5:32 pm “I mean you have to understand that the osteopathic colleges are still teaching cultism and pseudoscience in there own way.”

    Another, irrelevant, tuo quoque. The subject is chiro-stroke. The fact that chiro “education” is irrational is pertinent. http://www.chirocolleges.org/paradigm_scope.html “Chiropractic is Concerned with the preservation and restoration of health, and focuses particular attention on the subluxation.” It should bother you that you spent money and time learning about a fairytale as if it were real. There is more nonsense in the article I linked.

    One is left to wonder if you have figured-out that you studied nonsense. If so, how do you distinguish (today) between the chaff and the wheat? Or, can you? Your history suggests you cannot.

  42. quackdoctor says:

    “One is left to wonder if you have figured-out that you studied nonsense. If so, how do you distinguish (today) between the chaff and the wheat? Or, can you? Your history suggests you cannot.”

    I posted the NUHS chiropractic college roster for your review. Exactly what is taught at NUHS is there. I think the word subluxation is mentioned one time in one classs. And there are different definitions for the term. As far as my education goes HA. Sp anyway the course roster is posted. You can determine exactlyhow much nonsense that there is.

    I have laid out for you guys the facts. That change must be slow. But you seem not to understand that. I have also clearly told you what needs to happen first. And that is making the technical applications safe. Then over time we can proceed from there. I am telling you that you cannot have things totally on your terms. And with a DC from NUHS and and an advanced degree in anatomy I have been exposed to much. And when I have an MD I will have the highedt level of credibility on the subject. Now I have studied the archives and been in the profession. I am not anti medical and carry some credentials and in a few years I will have more. So you might just consider not discounting twhat I say. But the deal is that you are not thinking clearly. You are moving in your reactive minds. And when people do that they do not make good decisions.

    I have given you more accurate information than you know. And hell you have not once even bothered to ask me what I believed and how I would manage chiropractic. Or how I would prove that a technique does not work. You just want to chatter. But you clearly do not what even it is that chirpopractors believe and why they believe it and how it evolved. You are not experts in chiropractic studies and history. You do not even know the history of the sucessful and unsucessful attacks on chiropratic since 1895. I mean you are not even in the ball park relative to how to debate a chiropractor.

    I think the whole thing is quite amusing. Maybe as far as saying this and that . You should ask questions like. How would you probe upper cervical analysis is a fraud? But you do not do that. You just want to dictate and not learn anything.

  43. nwtk2007 says:

    Harriett said- “I’m saying that providers write scripts based on what is medically necessary AND what insurance will pay for. ”
    and this – “Sometimes treatment is medically necessary and two drugs are equally effective. In that case, a doctor can choose which to prescribe by which the insurance company will cover – usually the less expensive, so everyone benefits.”

    Aren’t patients responsible for medical bills? It sure doesn’t sound like the insurance company benefits from this? I checked BCBS and Aetna. Both will reimburse if a receipt is provided for the OTC meds.

    As much as insurance angers me, there are rules that need to be followed. There really is no code of anything that allows a doctor to choose treatment based upon what the insurance will pay for. You can’t even give cash discounts, at least not in Texas.

    I called a neuro clinic in Dallas today and was told the cost of an eval is $480. I said wow, what is it if they pay cash? $150.

    It runs amuck. If you practice Harriett, I wouldn’t talk so loud that the AG’s office can hear.

    FiFi said – “First you attempt to put science lipstick on your magic pig”

    You said that already.

    FiFi also said- “Personally I’m going to see if there’s any way I can lend support to Sandy Nette so we can get some laws changed in Canada regarding chiropractors. You’ve convinced me that your magic pig will never fly and needs to be put down so it stops hurting people.”

    So get on with it already. Maybe you could be one of their “expert” witnesses.

    Joe copied- “Another, irrelevant, tuo quoque. The subject is chiro-stroke. The fact that chiro “education” is irrational is pertinent. http://www.chirocolleges.org/paradigm_scope.html “Chiropractic is Concerned with the preservation and restoration of health, and focuses particular attention on the subluxation.” It should bother you that you spent money and time learning about a fairytale as if it were real. There is more nonsense in the article I linked.”

    Jeesus Joe, you’re like a broken record. We all know that but we aren’t bound by it now are we? I’ll bet I don’t get sued if I say subluxations are horse hockey and that I don’t even try to find’em, and couldn’t if I wanted because they are philosophical and are not real anatomical entities.

    Blue Wode made this up- ““WARNING: This treatment carries the risk of stroke or death if spinal manipulation is applied to the neck. Elsewhere on the spine, chiropractic therapy is relatively safe. It has shown some evidence of benefit in the treatment of back pain, but conventional treatments are usually equally effective and much cheaper. In the treatment of all other conditions, chiropractic therapy is ineffective except that it might act as a placebo.”

    I will put that up in my office if the medical community will put this up in theirs:

    “Attention, you are about to be seen by a member of a medical community who is responsible for nearly 500 deaths everyday of the year due to their incompetent mistakes. Add to that the dangers of drugs like ibuprofen that kills about 3000 per year, and you can bet it gets a little dangerous in here. Just keep that in mind when you see your doctor’s eyes wondering about, not paying attention to you and failing to perform an evaluation which he will later bill your insurance company for.”

    I think that about does it for this chiro bashing party.

  44. quackdoctor says:

    Yes…They are very immature..Almost childlike. I have attempted to interact in a reasonible manner suggesting logical solutions. But they are like kids. They want things exactly the way they want then even though having them is impossible. In fact yeasr ago there were country clubs where a DC couold not join. The bylaws said that negros, Jews and chiropractors were not welcome. This is a throwback to the attitude of the old south.

    Irrational hate runs deep. Paranoia runs deep. It is so stupid. They do not take the time to self evaluate and ask themselves if they really know what they are talking about. Never bothered to actuall watch a rational DC work in a clinical setting. Yet they say they are evidence based.

    Well I can see from this that there is no real threat to chiropractic from this group. You see when chiropractic gets into a courtroom we alwys ask the attackers to define terms and to state what their perceptions are. Then we simply go about how all of the perceptions are flawed. I mean these guys do not even know how to attack chiropractic. What her weak links are. But they are not attacking the true flaws

  45. nwtk2007 says:

    Hey Quackdoctor,

    I know you believe that Ms Nette’s stroke was caused by the manipulation and to a certain extent I do also. I also think that you believe she should be compensated for her condition at least to the extent that it doesn’t shut down chiropractic. (I might be wrong but that is my take on how you think this thing should go.)

    But when you talk to these ultra biased (claiming to be unbiased) attitudes, their defensive posturing, accusational language and inability to reason beyond their deeply ingrained beliefs, you just have to know that they will have little if anything to effect the outcome. In fact, I think Harriett might be a good choice for the defense to call as a witness to EBM and force her to admit that “evidence” as she has defined it here in this public forum, is supremely lacking in this case as well as the others.

    It would be tragic for Ms Nette but it would be ironic.

    For a group who claims to be unbiased and positions themselves
    on this forum as seeming experts on EBM and “science”, they sure can’t be very objective can they?

    Heck, Joe responds to posts that he hasn’t even read, and then criticises the content of what he hasn’t read. No geting any logic or reason out of that one.

    The “religiousness” of this group rivals that of other anti-chiro groups that we both know about, they just disguise it better.

    Impressive indeed. And scary.

    But hey, don’t get the notion that I agree with YOU on everything either, man!

  46. Harriet Hall says:

    For the record, I practiced in the Air Force. We could write prescriptions for OTC things like Tylenol. Patients paid nothing. If they bought their own OTCs it was out of pocket.

    We were limited to a formulary of drugs approved by our own Pharmacy and Therapeutics committee. We might not be able to pick the brand we preferred, but there was always an acceptable choice. I never felt that patient care was compromised by the limitations.

    All of this is irrelevant to the subject of chiropractic strokes.

    I’m going to politely ask that you stop the discussion at this point. It is generating more heat than light. :-)

  47. quackdoctor says:

    “But hey, don’t get the notion that I agree with YOU on everything either, man!”

    Well damn it if you do not agree with me you should be booted out of the profession :)

    But anyway now you opened the can of worms….So where do you think I am wrong? I can accept being wrong. I am just curious what you think? Please explain…

  48. nwtk2007 says:

    Ok, I agree with you on most things you have said. And I have learned a great deal, both from you and the others on this forum.

    It’s good to stretch our legs on a forum like this, articulating what we feel certain we know and reinforcing a good deal of it to boot.

    But Harriett says we have to go to bed and I have two girls of my own who need to do the same.

    I have patients to see in the morning, it’s late and it’s hotter’in you know what down here…***, * * * , ***, ***, * * * , ***, ***, * *

  49. quackdoctor says:

    Well yes Harriet. The topic is strokes caused by cervical manipulation. And what I am sauing is we need to get to the bottom of exactly what methods that are causing these atrokes. And from an anatomical standpoint it seems pretty clear to me. And from what Sam Homola says in hiws article in Quackwatch he has similar suspicians. Because he gives advice on how to avoid them with correct technique.

    So when people say “Don’t touch the neckl at all” that is illogical. Or not to let a DC touch you above the shoulders. And also from a logical and anatomical standpoint you do not put a 3 inch tear in a vertebral artery and tear both sides without a very violent force. So techniques need to be changed.

    Now I will tell you that if the chiropractic community will be forthright enough to admit the truth. They are more than able to make the changes. They know the spine very well and it’s mechanics. And it pissed me off to no end to listen to chiropractors in news interviews or in public situations deny that manipulation could possible cause these things. We have known this for at least 40 years.

    I mean hell. The first chapter in Ralph Lee Smith’s book the case against chiropractic is about a patient stroking out. And the chiropractic insurance company’s tell DCs about actual strokes and how they happened and what to avoid and how to procede. So I do not understand the immature denial.

    It would be a lot easier for the profession to announce that they recognize the problem and are eliminating the potentiol causes. That would be good marketing.

    And lastly I find it pretty pathetic that Palmer College who has excellent research facilities and staff if would up in bogus spinal research on cats and rats that will lead no where when we could be working hard spending those millions on solving the stroke issue through research. I mean some of the stupid stupid studies like wireing animals vertebrae together to see if that will cause visceral disease and other non sense. Or extrapolating human spinal mechanics from cats and rats for God sakes.

  50. Blue Wode says:

    nwtk2007 wrote on 01 Aug 2008 at 7:22 pm:

    “Blue Wode made this up- ““WARNING: This treatment carries the risk of stroke or death if spinal manipulation is applied to the neck. Elsewhere on the spine, chiropractic therapy is relatively safe. It has shown some evidence of benefit in the treatment of back pain, but conventional treatments are usually equally effective and much cheaper. In the treatment of all other conditions, chiropractic therapy is ineffective except that it might act as a placebo.””

    The quotation can be found on page 285 of ‘Trick or Treatment? Alternative Medicine On Trial’. The book was written by British scientists Simon Singh and Edzard Ernst, and it was published in the UK by Bantam Press on 21st April 2008:
    http://www.amazon.co.uk/Trick-Treatment-Alternative-Medicine-Trial/dp/0593061292

  51. nwtk2007 says:

    Ok fine. I wrote this yesterday: as you well know.

    “Attention, you are about to be seen by a member of a medical community who is responsible for nearly 500 deaths everyday of the year due to their incompetent mistakes. Add to that the dangers of drugs like ibuprofen that kills about 3000 per year, and you can bet it gets a little dangerous in here. Just keep that in mind when you see your doctor’s eyes wondering about, not paying attention to you and failing to perform an evaluation which he will later bill your insurance company for.”

    The difference is that mine is much more accurate. (And grossly incomplete.) AND will save more lives.

    Come on Blue Wode, do yo have anything else to offer besides snips from anti-Alt and Anti-chiro BoZo’s?

    Have you noticed that every time a topic is considered and discussed it always swings around to bashing chiropractic? You are so biased that you are blinded and that is too bad. I personally think guys like you are just a little too excited about cases like Ms Nette’s. You feed on it.

    You see, I am a chiropractor so I am into my profession and like Quackdoctor, am willing to help get the chiro community to make the necessary changes so this doesn’t happen again. But who knows who you are or what your “real” agenda is. Would we find out that you make money either directly or indirectly from cases like this? Would we see your true color isn’t Blue at all?

    What changes are you going to make to educate the public about the medical mistakes? What are you going to do in the medical community to foster changes that will reduce these mistakes and bring more benefit to the public in their health care system?

    You gonna tu Quoque me? Hit me with some goofy latin phrase in an attempt to de-sophisticate me?

    Heck, let me jest git my cowboy hat an’ move along to work now leetle dogie.

  52. nwtk2007 says:

    “I personally think guys like you are just a little too excited about cases like Ms Nette’s. You feed on it.”

    let me rephrase that, – “I personally think guys like you Blue Wode, are just a little too excited about cases like Ms Nette’s.”

    Hopefully that clears up this statement.

  53. quackdoctor says:

    Well I think that this comes down to individuals that want full control. Kind of reminds me of a girl I liked in high school. I would try and be nice to her but she would always find something bad to say about me. Like”I don’t like your haircut” So I would change it. Then she still was mean to me. She would then say “I don’t like your sweater” So I would change oit. But she STILL did not like me. So no matter what I said or did she still did not like me. It did not metter. Then I finally realized. She did not like ME.

    I have talked to the anti chiropractic group for years. And what I see is that there is this idea that if you are not an MD you cannot have knowledge. That somehow an MD bestows the person with some kind of “magical accuracy” to their knowledge. And they try and get the public to buy into this
    That the sciences when applied, taught or understood by a chiropractor suffer from a “taint”. And the knowledge of an MD is clean.

    And on the stroke issue we see the desire to control. Like people saying “Don’t ever let them youch the neck”. As opposed to understanding that we need to know how not to touch the neck. But for the chiropractors that means admitting that the strok issue does exist. Now as far as the chiropractors what I fail to understand is that even if they have doubts that manipulation can cause strokes and feel it is not proven—Why they are not moving under the premise that it does. We are dealing with peoples lives here.

    And then we come to this irrational arguement from the chiropractic community that manipulation cannt cause a stroke but those patientsalready had a dissection or were in the eaarly phases of a stroke. Well then why would one do something to finish the job. I mean these people do have this happen often right on the treatment table. Or within a few minutes after sometimes.

    But the thing is that the people that are attacking chiropractic have a fixed idea in their heads about what is and what is not relative to the spine and chiropractic. They have no idea what a good chiropractor does or what they sein patients. In fact they do not even accurately understand why a bad chiropractor is bad.

    Now as far as spinal “subluxation” and biomechanics. What people fail to understand is how complex the spine is and how hard it is to prove or disprove anything. So proving or disproving imbalances in the spine is not an easy thing to do. It is a very complex thing to do. We know vertabrae cannot move beyond their restrictions and be “subluxated” in the Palmerian sense for th most part. But we do not know that about the SI joints and the atlas. We do know that the “nerve pressure” premise is false and minor changes in the foramen magnum would not produce significant cord pressure. That we know.
    But other more plausible postulated mechanisms are very hard to confirm or dispute.

    So I think that if educated people are going to make it their business to critique chiropractic methodolgy. Then they need to spend some time in a chiropractic college and with a respected DC who claims to treat global spinal imbalances. To see things from their perspective. But this is not done. Investigations are always into the questionable DCs. Like investigators will take “Free Spinal Exams” and report on their experience. Well duh…What the heck do you expect to find going to some free exam? Why not investigate a DC who is a team chiropractor for a major sports team. Or an olympic team? I mean why not see what the best DCs say and do? But no this is not done.

    But anyway like I say no matter what one says if they are a DC certain people will attempt to invalidate it no matter if it is logical or not. And these people are hell bent on destroying the profession. They will get defensive and say they are not but when you really nail them down they feel there should not be a distinct heath profession of chiropractic. And the same thing went on with the osteopaths. And most of these people actually feel the same way about osteopathic medicine.

    So just remember that there is no point in arguing with someone that is not changeable. Because they are not changable. So all you can do is to focus on your own field and changing view of people like judges and politicians and obviously the general public. The only reason I engage in debate with the close minded is to improve my debating skills and make them squuirm a bit. But I know I am not going to actually change anything. But I could change somebody reading the debate who can be objective.

  54. Harriet Hall says:

    Sorry, but I don’t accept the argument that watching how chiropractors work is a valid way of determining whether their methods “work.” I don’t need to watch an appendectomy to be convinced that appendectomy is an appropriate treatment for appendicitis. If chiropractic significantly improves outcome, there are objective ways to show that. Do some studies and publish them; don’t ask me to come watch you treat patients. The most that could ever generate is more testimonials.

    I’m going to ask once more that this discussion be stopped. It is going nowhere and the same points are being made over and over. Enough, already!

  55. quackdoctor says:

    This is my last response on this issue unless people get off the stroke subject.

    Well lastly. On the Scientific American special on Chiropractic they had an ex chiropractic who was anti chiropractic demonstrate on a patient how a certain technique did not worl. BUT they did not have a chiropractor who practiced the technoque show how in their mind on the patient the technique did work. And what is viewed as “outcome” may not be the same for the DC as it is for you. The DC may see spinal balance as outcome and you will see pain control as outcome. So they are apples and oranges.

    I man it is clearly a refusal to look for truth. It is simply building a case against any model of chiropractic that exists. And then you will say. “Well I am not against all chiropractic”. But even that is untrue because you will fall back on the fact that even chiropractic for pain reduction is no better than other forms of therapy. .

    I mean have you ever had a well respected DC have you in their office? Or show you what they do and see? No. Have you ever set foot in a respect chiropractic college and sat in on classes and heard what is actually taught? No.

    You had your daughter call around and ask DCs if they treated “subluxation”. From the fact that they all said they did you derived that they were all quacks. But you fail to reveal that there are different definitions. And not all subscribe to an irrational model.

    So from my perspective the failure to actually sit in on chiropractic classes and shadow a top DC in a clinical setting reflects being stuborn and being afraid to put down the ego. It will be said for example. A short leg may not be produced by the spine being out of balance. The chiro and the DO will say it can. And explain why. Then a retaliation will be made as to how examination can be misinterpreted by the observer and so on. But what you fail to consider is that the chiros are taught that and taught methods to limit that. It will be said that it depends how the patient is positioned. Do you not think that that has been considered? ,

    So the only way to get any kind of grip on what is accurate is to let people show you what they see and how they have checks and balances to avoid misinturpretation. Or to limit it. I know I know….Sam Homola says this. Or he says that. I was not aware that he was awarded anything for his studies into the spine by the French Academy of Science. Or by anyone else in the arena of spinal mechanics. Let me see…Who am I going to give more credibility to. Rand Swenson. DC, MD, PhD…Scott Hadelman DC MD PhD or Harriet, a retired surgeon and Steve Barrett a retired psychiatrist. Or for that matter a bunch of people who never really studied health care in any form.

    So finally when you have intelligently approached this I would listen. When you can discuss the mechanical models of Fred Illi and Joe Janse upon which rational mechanics are based. Hell when you can tell me the difference betwen where Gonstead says the rotational axis of the SI joints is in comparison to Illi. Then we can have a logical discussion. But you people have not even educated yourself enough to enter into a decent debate on any issues relative to chiropractic in any form.

    But we can agree that the stroke issue needs attention. To that much we can agree to. And we can agree to other things as well. But at least I have well thought out reasons for my opinions.

    So that is the last thing I will say on this issue. Now we can talk about stroke. But if people are going to start attacking chiropractic globally then it is not me that is diverting the discussion.

  56. Harriet Hall says:

    I am relieved that that was quackdoctor’s last response. I’d like to point out to other readers that he offered no evidence for chiropractic. If “spinal balance” is a desirable outcome, where are the studies showing its benefit?

  57. nwtk2007 says:

    Every forum I have been on where evidence for manipulation was presented it has been sluffed off as no good or summarily dismissed without consideration.

    There has, indeed, been some evidence presented here also with virtually the same results. One who criticizes it without so much as a glance at it.

    Barring any forth coming evidence for balancing the spine, why don’t we just develop treatments for unbalancing the spine and see the effects of that. Or we could just look at the overall health of society and see the results of imbalance, in everything.

  58. quackdoctor says:

    “If “spinal balance” is a desirable outcome, where are the studies showing its benefit”

    There are not any. We just assume it is better not to walk around with one leg drawn up and with the spine all twisted. And when we adjust the spine and the spine untwists we assume that that is a good thing.

    Rememer I said that I would not respong unless people got off of stroke.

    So hopefully I will not need to respond again.

  59. Harriet Hall says:

    ‘it is better not to walk around with one leg drawn up and with the spine all twisted’

    I can certainly agree with that, but I question whether the average chiropractic patient meets that description. If he does, why do we not have good studies showing markedly different before-and-after x-rays and showing improved clinical outcomes? If Quackdoctor is right, it should be trivial to find objective evidence and convince the world. We’ve been waiting for over 100 years for such evidence, and I’m not holding my breath.

    As usualy, Quackdoctor has given us an emotionally worded assertion with no evidence to back it up.

  60. quackdoctor says:

    Well the thing is Harriet that radiographs are inadequate to document subtle changes in functional mechanics> So this is because of projection distortion. For example if a person has a striff neck for example and cannot turn their head to the right a cervical film will not reveal it. It and a normal film will be exactly alike.

    Along the same linesif a patients low back is in spasm and the muscles are unilaterally contracted above the pelvis we may see the patients leg pulled up on that side when we have them in the prone position. But it will not show on the radiograph..

    Additionall when the spine is globally twisted the summation of all of the twisting will produce a functional short leg. However the radiograph will not detect it because no one single area is distorted enough to be revealed.

    So we have a situation where many chiropractors and osteopaths for decades have noted the same syndrome. I mean is it so hard to believe that the muscles that when contracted superior to the pelvis unilaterally may draw up the leg? And is it implausible that a stiff neck may cause more global spinal changes. Not a “subluxation” of one bone. But a global twisting of the entire spine?

    So for example we come back to the fact that both chiropractors and osteopaths who deal with the spine on a clinical level agree that short legs may functionally occour and reduce after a manipulation. It is a totall obvious phenomena. Very obvious. But if you do not look you do not see it. We know it happens..

    So the thing is you say that it is wasy to document. Well that is not so. Attempts have been made with radiographs but projection distortion is to great. Bilateral scales that were very sensitive were attempted but good studies were never done and the data does not prove a lot.

    As far as the x rays. Films are more difficult to caibrate than you understand. When dealing with such subtle changes.

    No in my mind IF x ray would be helpful one would have to build a special machine. That machine would need to have around 5 or six primary beams one on top of each other. Six collomnators. Then we could bring the patient back from 72 inches to maybe 10 or 12 feet. Then we could film the patient with extremely high detail from the occiptal condyles to the feet. But we are still dealing with difficuties of patient positioning. But a machine of this design might help. So x ray is problematic..

    And then there is surface electrode EMG. But I have heard it is nonsense. But I really do not know anything about it.

    So you see it is not a simple thing to document this. I know it seems to you that it would be. But it is not when you understand what we are trying to document

    You see..Understand something. And this is something that a lot of chiropractors fail to grasp. Let us say you take a patient and you take a full spine x ray in the AP position for example. Then you take the patient out of the machine and have them do nothing. Just stand there. Then you put them back in the machine and shoot the full soine again. Then you take the two films and apply mechanical measurements to them. Like cervical and pelvic measurements to evaluate osseous position through geometry abd projection distortion.

    Well guess what. No matter how hard you try and get the patient positioned the same way in the two shots the two films will have very different measurments. Now attempts to deal with this are fior example head clamps that the upper cervical DCs use. But I do not think they really work/

    No for example I will give you a little ammunition. The uppercervical chiropractor puts the patient in an elaborate x ray machine and takes a picture and makes a number of measurements. Then the DC does an adjustment. Then the DC puts the patient back in the machine and shoots a second film. He sees a change and says…Ah HA..You see I changed the spine. If the change is good on the second film the DC keeps the same acjustment. If the measurments are “worse” then the adjustment is changed. But no third film is generally taken…

    Som if you want to disabuse this method. Just ask a chiropractor to take an x ray of the patient. Then take the patient and do not tell the DC if they were adjusted or not. Then have the DC take a second film. Then ask the DC IF the patient was adjusted or not. Now the thing is that the two films are going to always be different so the chiro will not be able to tell you if the patient was adjusted…So you see x ray measurments ar flawed.

    When and only when an x ray system is developed that when a patient is x rayed and then taken out of the machine and re-x rayed will produdce the exact same measurments when nothing is done to the patient. But that is not likley as positioning is difficult along with projection distortions. . As I said it would only be possible with very extended distances. Distances current machines will not achieve.

    So we have a big problem objectively documenting the phenomena. At this point the only evidence I can produce is subjective. But I am convinced if I had the opportunity to guide you on say 100 patients you would quickly be considerate of the concept that what you were seeing was most likely not something you were just creating in your mind.

    I mean this is not some impossibility or something that is out of line with the plausible. We are not saying that your spine goes out at T5 and the spinal nerves are compressed and you get pathology in your heart. He are proposing a much more plausible occourance. Simple muscle imbalances causinf spinal imbalance. Thie imbalance can lead to the spine not bearing weithat correctly and the result may be capsular inflammation and fixation of joint motion.

    So anyway no we have no objective documetation. It is not that easy. But hey damn it if there is anybody bright enough to figure it out it is me ;)

  61. Harriet Hall says:

    Alas, Quackdoctor’s “last response” wasn’t. :-(

    When it is so difficult to document a phenomenon, one must question whether the phenomenon exists.

    Range of motion can be measured, function can be measured. Even if you can’t document the phenomenon itself, you should be able to document objective improvement in patient outcome after treatment. The evidence just isn’t there.

    The evidence shows that spinal manipulation is effective for certain types of musculoskeletal pain but is not superior to other treatment methods. The evidence does not show that chiropractors offer anything unique that could not be offered by other medical professionals.

    It’s time to stop the special pleading and stop making claims for chiropractic until you can support those claims with evidence. Until then, your assertions amount to nothing more than opinion.

    ENOUGH, ALREADY!

  62. quackdoctor says:

    No one has put forth a good effort AT documentation of this issue. That does not n=mean it does not exist. It is a very very obvious occourance that is easily recognized. If you were open minded enough to look for it under guidence you would be able to see it to. It is pretty easy to tell when a person is twisted up. There musles are tight, they are tender, pain at end of motion sometimes and reactive short leg many times. These are obvious clinical observations. You could easily be taught to appreciate them but you refuse to even look.

    I think Harriet you should let me take you under my wing. Let me be your mentor. Put you under my tutelage. You could be my apprentice. :)

    http://www.youtube.com/watch?v=aBbTcuYYcFc

  63. Harriet Hall says:

    Quackdoctor said, “It is a very very obvious occourance that is easily recognized”

    Then it ought to be easily documented.

  64. quackdoctor says:

    Well OK Harriet. Then you tell me how. If it is easily documented then how? By what method. X ray is not accurate enough for such changes for reasons as presented. So let me make the statement. That I say a functional short leg exiast and the spine can become tight and twisted. And I say that cervical tension can effect the spine globally. How pray tell would you objectively document it?

    OK let me put it another way. I say there is a situatin when the dynamics of the cervical spine produces a short leg. Meaning that when the patient is prone the leg is short. But when they rotate the head the leangth of the leg changes. If you turn the head one way the leg gets tighter and a little shorter and when you turn the head the other way the legs equalize many times.

    So no assume for a second that my observation is accurate. What method would you suggest to confirm or deny my observation? How would I prove or disprove the observation. By what methodology?

    How would you prove or disprove objectively the observation?

  65. quackdoctor says:

    How would you prove or disprove the observation? How would you construct the study? How would you design it. You have agreed that it is not good for a person to walk aroud twisted with their leg drawn up. And may many DCs and DOs recognize this occourance. So how would you prove in a given patient that this was not happening or was happening. Whet laboratory equiptment? What methods?

  66. Harriet Hall says:

    quackdoctor,

    It’s not my responsibility to tell you how to devise a scientific experiment. If it is such an “obvious occurrence” and so “easily recognized,” you ought to be able to figure out how to document it and measure it. And if it really makes a difference in patient outcome, it should be simple to demonstrate that with a controlled trial.

    Bottom line: you are making claims that you can’t support with evidence. This discussion is over.

  67. quackdoctor says:

    Oh no Harriet. I have made a claim that numerous other Dcs and DOs make over many many years. And it is not implausible. You say it does not happen. But you are unable to come up with a way to disprove it. I mean it must be easy to disprove. Yet you do not know how. I mean if you are so sure that something does not exist that thousands of people observe. They it would be simple for you to tell me how to disprove it. But you cannt. That is because it is not easily objectively proven and thus not easily disproven.

    And we are not talking about patient outcome. We are talking about proving or disproving the fact that the spine may get twisted up and the leg can go functionally short. That is the issue.

    You see I have backed you into a corner and you know full well you have no answer. You do not know how to disprove or prove what I claim. And that is my point

    I mean if it was so easily disproven then you would rattle off how to do it very fast. But alas you cannot.

    You my dear have been checkmated.

  68. Joe says:

    I recall an amusing article about teaching pigs to sing.

  69. Harriet Hall says:

    I have not said it doesn’t happen. I have said you have no evidence that it does happen. You are the one making the claim and the burden of proof is on you.

    You haven’t checkmated me; you’ve tried to tip the chessboard over because you can’t compete by the rules of the science game.

    You’re only making yourself look foolish.

  70. quackdoctor says:

    Oh I can play by the rules. That is why I am asking for advice on how to prove or disprove it.

    Now Harriet: I am going to quote you..

    “I have not said it doesn’t happen.”

    So what we have here is a statment made by Harriet Hall concerning subluxation as defined by many DCs.

    Larry King: So Dr Hall. Does subluxation exist??

    Dr Hall: “I have not said it doesn’t happen.”

    Thank you Harriet. You made my day.

    National Enquire headlines at the supermarket checkout.

    “Popular medical skeptic Harriet Hall MD says subluxation may really happen”

  71. Harriet Hall says:

    Quackdoctor said, “Popular medical skeptic Harriet Hall MD says subluxation may really happen”

    That’s not at all what I said, but I don’t mind saying it. Science does not deny that subluxation may really happen. Science allows for the possibility that anything may really happen. Science says we would be foolish to believe that subluxation or anything else really happens unless we have evidence that it does.

    Science asks, “Where’s the evidence?”
    Quackdoctor has no evidence; he only wants to argue. He has exhausted my patience.

  72. quackdoctor says:

    Well harriet you have for the record stated that subluxation has not been disproven by science.

  73. Harriet Hall says:

    For the record: “subluxation has not been disproven by science.” For the record: Neither has the Tooth Fairy.

  74. quackdoctor says:

    Yes but there is no clinical evidence for the tooth fairy. There are not two seperate schools of healing arts that have as their core belief the tooth fairy. Large groups of educated clinicians have not claimed to see the tooth fairy…

    And of course I need to re state that by subluxation I mean global spinal imbalance with hallmarkd like the reactive short leg. I am not talking a about a bone out of place pressing on a sinal nerve and causing disease.

    This would be the subluxation I recognize. of course there is another one.

    “What ever feels better after you crack it” :)

    I mean your mid thoracic spine is stiff and sore. Sombedy cracks it and it feels better. What ever the crack fixed was a subluxation. That would be another concept.

  75. Harriet Hall says:

    Please don’t feed the troll.

  76. nwtk2007 says:

    I swear, you wouldn’t know a troll in a million years.

    Look, a troll, lurks in the shadows, occasionally dropping in a snip or two (bait) to see if he can get a hook on you and, yank your chain, so to speak.

    Quackdoctor has done and is doing none of those things.

    Having a different point of view does not a troll make.

    Gosh, as smart as you anti-chrio and EBM guys appear to think you are, I would have thought you would have known that.

    In fact, Joe is the closest thing to a troll on this thread. And on others as well. He just hovers around in the dark, looking for any opportunity to cast his anti-chiro bait out there and get a bite. One of his “pals” referred to it as “like a video game” and is used to “blow off steam”.

  77. quackdoctor says:

    Yeah Harriet. You know I have given you more insight into chiropractic than you understand. And you do not have to get mad. I simply carry a lot of knowledge about the subject and do to superior intellect and able to synthesize it :)

    But I will tell you that what I have learned is that make no mistake about it you are a clear and present danger to chiropractic. You want to destroy chiropractic. No matter what anyone does to improve it you will say it should not be a distint healing art. And that means you are trying to destroy it. An enemy. It is impossible to get anywhere with you as you are way to close minded. I mean even when you are presented with rational arguments you resist. You have not ever bothered to see chiropractic practiced in a rational manner for yourself. And you use the “I don’t have to” as the cop out.

    And then I kid with you for a second and you freak out. I hope you are not that much of a prude. I really do not think you are. Because I have seen you make what prudes would consider “off colour” jokes.

    So the thing is that if you are really seeking truth then look a little deeper. We are not the people claiming to cure liver cancer. We are not the people claiming that the “Pulse” of the cerebrospinal fluid can be felt at levles inconsistent with manometry. Or even at all. Or that cranial bones move and cause problems.

    Hopefully you are not fixed in your belief and someday will at least take a first hand look at the rational people in the field. And by them I do not mean those that do exactly what you want them to.

  78. Harriet Hall says:

    Notice how the supporters of chiropractic twist my words, accuse me of trying to abolish the chiropractic profession when I have clearly stated that I have no such intention, and offer rhetoric instead of evidence.

    Whether or not this is “trollish” it certainly does not make for a productive rational discussion.

  79. Harriet Hall says:

    I’ve been thinking about the discussion above. It fits into a general pattern of many, many discussions I’ve had with various chiropractors over the years:

    Chiro: X works.
    Me: How do you know X works?
    Chiro: Quotes supposed evidence.
    Me: I explain why that evidence isn’t scientifically acceptable.
    Chiro: I know X works on my patients.
    Me: You believe it works. You could be mistaken; that’s what science is for – to test our beliefs.
    Chiro: You’re prejudiced and ignorant.

    So predictable. So pitiful.
    If they had evidence, they wouldn’t need to resort to insults.

  80. quackdoctor says:

    No Harriet my eebate is not that way at all. I have provided ample explaination for my statements. And I never said anything about chiropractic working or not working. We are talking about a person who it globally tight and twisted. I mean we have all been that way. It is a very obvious situation. Imbalance of the spine is pretty plausible. But it is tiugher to accurately document. As I said I am sure that many skilled DCs would be very happy to have you shadow them and let you decide if what you are seeing is most likely error or something quite obvious.

    So like I say when you can come up with a suggestion to prove or disprobe the alleged patient presentation I describe I would be happy to consider it. . I mean there must be a way to disabuse this myth if it is a myth, I mean homeopathy is easily debunked. Cranial pulses are easily debunked and so on. I defy you to debunk in a scientific manner the spinal imbalance syndrome as I have presented it. It is just spinal mechanics. Tight muscles imbalance the spine. That is the thing. What the chiros are calling subluxations are stress points along and imbalances spine. They are wrong in their subluxation theroy. Actuall wjhat the chiros are calling a subluxation is a stress point where vectore of stress are less freely distributed throughout the colomn and more focalized. It is simple mechanics. And also what the chiros are calling subluxations are hypermobile regions of the spine. Why do yu think that the far majority of patients with thoraci pain from bad posture get it in the middle of the thoracic spine. Well it is because the dorsal spine is like a long pole. You stress it at the top and bottom and it bows on the middle.

    Why do you think that patients who look at a computer with their head in flesion get pain at c7-t1 and 2 region. It is because of the up pulling of the grazing ligament(if you get that) in man. Why do people when shoveling wet snow get burning pain in the lower cervical and upper thoracic spine amd in the extreme fracture the spinous of C7 or so?

    It is all mechanics that we understand. But it is hard to document with machines.

    Now I am sure that it will be. And I am not so sure it has not. But Dcs are notorious at not putting out decennt research. This is why I wish someone like Rand Swenson would take the problem on. But he seems more interested in other things

    But I wish someday you woud take the time tolook at some patients with a reationa DC. Because the claims being made are quite reasonible and in line with mechanics and medical neurology. Not some twisted chiropractic version of it. Things like streatch reflexes and musle tightness and joint fixation are not voodoo or fairytails. Other things often are but this is not. So just have an open mind a bit. Because we are no claiming the Moon is made of green cheese.

  81. Diane says:

    HH said: “I’ve been thinking about the discussion above. It fits into a general pattern of many, many discussions I’ve had with various chiropractors over the years”

    Another blogger (PZ Meyer) decided to handle boring repetitive bandwidth-burning conversations (with other kinds of true believers) this way:
    http://scienceblogs.com/pharyngula/plonk.php

    Perhaps this is not the way this blogsite would wish to handle its repetitive posters, or maybe not quite yet, but everyone has a limit…

  82. Harriet Hall says:

    Isn’t Quackdoctor just the cutest little ole Energizer Bunny?
    Bless his heart!

  83. Harriet Hall says:

    Diane,

    So far we have elected not to ban anyone from this blogsite, although several posters have severely tried our patience.

    There is another category of offense that doesn’t appear on PZ’s list: crimes against spelling, punctuation, and grammar. I counted 32 errors in Quackdoctor’s last comment.

    It shows a lack of respect for your interlocutor if you don’t bother to take the time to proof-read or spell-check. If you want someone to read your comments, you might at least make them easier to read by correcting your errors. I could excuse dyslexia, but even dyslexics can use a spell-checker.

  84. quackdoctor says:

    Well it is just common sense. People get tight and stff all up and down the spine and manipulation losens up the tight and stiff spine. And the spine can get tight and stiff befor the person gets pain or really feels it. And when bones are noy moving right and out of their functional movement dynamic they can get swelling in the joint cabsule. And in the extreme Wolf’s law and the Hunter -Volkman principle come into play possibly. And when fixations and tightness is mobilized the normal vertebral righting reflexes can function.

    So is a vertabra is fixated it cannot be righted by the reflexes of the spine. It is not displaced but is is not in the place it needs to be because it is fixed. So by mobilizing it the fixation is broken and the motion dynamic is restored.

    And then all the planets come back into proper alignment. The gravitational pull of the moon on the ocean is righted. The sea calms down…Well OK I got carried away with the last part. But do consider the first two paragraphs

  85. quackdoctor says:

    Yeah Harriet I am pretty illiterate in English. You see. I did not have the benefit of a good education. Like in English and grammer and all. I was a high school drop out. Then I wanted to be a chiropractor so I took the GED. Then I went to community college and did well in sciences but not so good in other things. Then I transferred to a 4 year school and got my BS degree in sciences. Then chiro school then PhD. So I am kind of illiterate in English and grammer, and punctuation and all that stuff. I was tested and they never saw such a test. I was extremely high in some areas and low in others. Like a very strange IQ test. I was like the Idiot Savant or Rainman. And I do not have a spell checker. It is funny because my father was a well known Pulmonologist with an MD PhD. But he too was a high school drop out. And was quite illiterate in English. So genetic? I do not know. But despite my deficincies I tested at 165. That was averaging all.

    It is quite funny because I read very very fast and comprhend at a high level. But I cannot do English in any way. And I struggled with math. But tangible things I process very well. Like anatomy, mechanics and things like that. Like pathology, diagnosis, x ray and all. But I am still illiterate.

    So I guess different people think differently. Also I tend to process things quickly and communicate concepts that way. So anyway. I will try and not make so many mistakes

  86. nwtk2007 says:

    Quackdoctor,

    If you are using internet expolorer, there is a spell checker you can use, it is on the Google toolbar. You could also do your responses on word pad or note pad, spell check there and then copy and paste onto the comment box here.

    But I will tell you, I think you are beating a dead horse here. Even if you had x-ray evidence of what you are suggesting and could show changes, they would not accept it.

    Harriett’s prevous example –

    “Chiro: X works.
    Me: How do you know X works?
    Chiro: Quotes supposed evidence.
    Me: I explain why that evidence isn’t scientifically acceptable.
    Chiro: I know X works on my patients.
    Me: You believe it works. You could be mistaken; that’s what science is for – to test our beliefs.
    Chiro: You’re prejudiced and ignorant.

    So predictable. So pitiful.
    If they had evidence, they wouldn’t need to resort to insults.”"”

    You should check out my previous input and their response to me on the thread about vitamin supplementation. See who first begins to insult. Very telling.

  87. quackdoctor says:

    Yes it is interesting that in a controlled debating envionment they nevr seen to do very well. I mean one where they cannot say “enough”. I mean all I have said if that the spine can get still and that the mechanics of the spine are connected. So one interlevel can cause change at another.

    I found it intersesting. I was watching the Scientic American special that was anti-chiropractic. And here tis MD is on there acting like this big authority on the spine. He was not even a specialtist. Well he actually makes the statementr that chiros are wrons and the truth is that most back pain is muscular. And where in the hell is the scientific proof of that? Any clinician worth their salt knows the differencce between muscular presentation and joint or ligament presentation. And most back pain does in no way fall into the muscular catagory. Most is infalammatory involving the joint capsule most likely. But not muscular for God’s sakes. But yet he makes this conclusion and everybody shakes their head yes…

    And of course then he goes into short legs. He says the bones of the leg cannot get longer and shorter and a manipulation is not going to change that. Well Duh! WE never said that happend. And the deception goes on and on.

    And I can see throug all this stuff. They are attempting to do what the AMA did before we sued them. They are not a formal organization so the have protection from the legal ramifications that the AMA did not. But make no mistake. Their goal is ti absorb and iliminate the chiropractic profession.

    No the funny thing is that many times these people for example Barrett I believe will say that IF you do see a chiropractor see one that does things like ultrasound and other PT modalities. But yet there is NO scientific evidence for any of those methods. In fact there is less evidence for ultrasound and electrostim than manipulation. Yet the hospital PT departments use them. Now I know they have effectiveness but it has not been proven. So we see the inconsistency. ..

    So they simply cannot be objective. They are human. Now do not get me wrong. If chiropractic wanted less friction with medicine things should have been handled differently. I am convinced that a lot of this comes out of the professional bad mouthing that some DCs are doing against medical methods. So really what do we expect? I think we should have basically kept our mouths shut and just gone about our business. Whether or not our feelings about medicine were accurate or not.

    And while I do see advances in chiropractic I also think that because of the numbers of chiropractors and a good number of people in the profession with their crazy techniques and practice management things have also gotton worse. In some ways chiropractic is more rational than ever and in other ways it is wackyer than ever. The number of certifiable lunatics in the profession is at an all time high. But so are the number of reasonible DCs. I put a lot of blame on Sid Williams and Life University. I also blame the chiropractic colleges who are graduating way too many DCs. I mean Palmer does not need 3 schools.

    And National College who was very rational and still is with respect to chiropractic completely ruined it’s opportunity to gain any respect from medicine when opened it’s ND program and chinese “medical school”. But they went for the money. And it is absolutely deplorable that National is teaching some classes in Homeopathy. Because that says to an observer that maybe their other classes are quackery as well.

    And where did this all come from. Well it came from the fact that chiropractic was beginning to get insurance reimbursment and in some way became more respectable as a career choice. This produced way too many DCs. And then we saw people going into the field as a career and not a passion to a higher degree. We saw people that wanted money and only money and were willing to sell anything to get it.

    And you go back and study the old history and you find that the old DCs that were sucessful by no means had as their primary target, money. They provided service and the money was a byproduct of that. Like Gonstead and BJ Palmer. It was not a game of seeing how many times you could see a person. It was about helping people and as a side effect getting referrals. But then along came insurance and the popularity of chiropractic geometrically multiplied. Then DCs began to do anything to “sell” patients.

    I mean the patient that wants to see a DC and say “Doc my back hurts” and get a couple of treatments and be on their way is in a precarious position now adays. They have a high chance in ending up in a dog and pony show of high pressure sales. And this damages the profession. And a lot of the time these are sleazy manipulative sales. I mean like patients coming in with acute low back pain and looking for relief and put through all these stupid tests and x rays and THEN told they canno be tretated until they come back in 3 days with their family for an orientation. This is not acceptable. I mean the DC will take some x rays and tell the patient that they cannot get the results immedictely as the DC needs to “carefully review” the films and spend considerable time formulating a treatment plan. This is very wrong.

    I mean some people just make the profession look bad. I mean like Sid Williams and his actions. I mean since when does a health care university president have his students and faculty chant about money? And present the profession like a cult. I mean it does look bad
    http://www.youtube.com/watch?v=tI_J3DZNC38

    But what people do not realize is that there is a totally different side to the profession. That while it does not live up to what the medics think it should be it is quite rational and not a cult in the least. And the oppisition will say that what they consider to be rational is like 10% of the profession what they fail to realize if the people that they consider quacks ar not all the same. A DC may for the most part be quite rational but use a few questionable methods. That is different than being a total quack.

    They will say that so many DCs are quacks because they “believe” in subluxation and have not renounced it. No many have changed the definition. So things can be deceptive.

    But make no mistakeI have delt with the anti chiropractic camp fior a while. No matter what they say. They are enemies of the profession and want it eliminated. No matter what any school teaches and no matter how any DC practices.

  88. Harriet Hall says:

    nwtk2007 said,

    “Even if you had x-ray evidence of what you are suggesting and could show changes, they would not accept it.”

    That is a gross calumny. Every author of this blog would readily accept anything that was supported by good evidence. We are not ideologically motivated; we are willing to follow the evidence wherever it goes.

    I wonder – if we had good quality evidence that people who get chiropractic care have worse outcomes than people who get medical care, would you accept it? Or are you like the guy who told me that if craniosacral methods were proven not to work he would use them anyway because his patients seemed to like them?

  89. nwtk2007 says:

    Quackdoctor – ” I was watching the Scientic American special that was anti-chiropractic. And here tis MD is on there acting like this big authority on the spine.”

    I don’t guess I have seen that one. I have seen the one where the former DC, now pharamcist, was demonstrating an “adjustment”. Utter horse hockey. But the point of this former, now anti-chiro dude, was to make it look like silliness, which he did rather nicely. And who is Alan Alda to know the diff?

    Quackdoctor – “Well he actually makes the statementr that chiros are wrons and the truth is that most back pain is muscular.”

    Well maybe that’s what they think and they really don’t know the difference between a strain and a sprain. Peer review doctors, most MD’s hired by the insurance companies, always say the diagnosis is a strain. 100% of the time. I asked my kids pediatritian and she, and he, didn’t know who to test for the difference or if you could, and another I asked who was filling in on a Saturday, did not know the diff.

    Quackdoctor – “No the funny thing is that many times these people for example Barrett I believe will say that IF you do see a chiropractor see one that does things like ultrasound and other PT modalities. But yet there is NO scientific evidence for any of those methods. In fact there is less evidence for ultrasound and electrostim than manipulation.”

    Essentially correct. The anti-chiro’s will say go to the PT for essentially the same type of care. But its OK if a PT does it, just not a chiro.

    Quackdoctor – “I mean the patient that wants to see a DC and say “Doc my back hurts” and get a couple of treatments and be on their way is in a precarious position now adays. They have a high chance in ending up in a dog and pony show of high pressure sales. And this damages the profession.”

    It most certainly does. I wish they would go sell amway or something. But I’ll be honest with you, I haven’t seen that many who do that type of work hang around for very long. Most long term DC’s build thier practice based upon referrals form patients who have benefited from the care.

    Quackdoctor – “I mean since when does a health care university president have his students and faculty chant about money? And present the profession like a cult. I mean it does look bad
    http://www.youtube.com/watch?v=tI_J3DZNC38

    Is that what he is doing in this video? What a weirdo. If I had seen anything like that at Parker, I would not have gone past the first semester.

  90. nwtk2007 says:

    Harriett – “Every author of this blog would readily accept anything that was supported by good evidence. We are not ideologically motivated; we are willing to follow the evidence wherever it goes.”

    -accept anything that was supported by good evidence -

    Like in the thread on multivitamins? vit C? Antibiotics? Noting that I was a chiropractor, you almost denied the evidence supporting antibiotics.

    -we are not ideological motivated-

    Same thread, like when you pointed out that I am a chiropractor and suggested that I just get rid of my subluxations instead of vit C. You did apologize for that one, but your “ideological motivation” was what brought it up in the first place.

    -we are willing to follow the evidence wherever it goes-

    Quackdoctor’s attempt to describe what he sees as potential importance of spinal balance is hyothetical sure, but all thought processes that lead to good evidence begin with a hypothesis. I think his point is that it is so obvious that it is important, that we don’t need to look for evidence of that.

    He also is trying to break through that “ideological motivation” and keep the discussion within the realm of chiropractic that is science based.

    Going back to the point of this thread, there is very little evidence that chiropractic causes stroke. Some but not a lot. Your own standards of EBM deny that it is supported by evidence. In your own story you site your own anecdotal story in support of what appears to be your view.

    Even the “evidence” you cited in your story is weak. If my evidence for benefit from manipulation were that weak, you would instantly dismiss it.

    A “gross calumny”? I don’t think so.

    I also think it’s time to talley up all the true, non-anecdotal, evidence for chiropractic causing stroke. Not opinion. Not heart felt story. EVIDENCE.

  91. quackdoctor says:

    Ok well then. based on all this I have decided to formally change my position. I now say Chiropractic manipulation has no proven relationship to strokes. There is insufficient evidence to prove it from a scientific perspective. Correlation does not imply causation. I have realized that I have jumped to conclusions. As of now there is no good evidence. What is good for the goose is good for….Well you know the saying.

  92. Harriet Hall says:

    I think most people who have been following this exchange will fully understand why I have decided not to respond to nwtk2007 and quackdoctor any more. Most of them will wonder why I didn’t quit a long time ago.

  93. quackdoctor says:

    Well I understand fully. You see when you are playing a board game with a child and the child is checkmated they will often throw a temper tamtrum and break the game. And the thing is Harriet that most people who read the internet do not post. And what I have said. Simply that the spine can get sore and twisted and tight is something that everyone knows to be true. And when that happens someone can untwist it with their hands. And chiropractors are best at that. And everyone knows that waling around with a twisted spine is not a good thing.

    And it is interesting and telling that I have said many things that you do agre with. Yet You never once chimed in to say you agree with me. You only speak up when I say something you do not agree with..

    WEll now wait a second. There was one time you argeed with me for a moment. You agreed on the psychosis forum. And this was right after I revealed I was going to medical school. You approved of me then for a moment. That was telling.

    You know Harriet I have said nothing irrational. But you are clearly unwilling to bend. You Hate chiropractic and want it eliminated. No form would be acceptable no matter how scientific. All I have promoted was common sense.

    It is so so telling that you will not give me a way to prove or debunk the ideas I have set forth. If it was homeopathy you would do it in a flash. But you cannot.

    Everyone knows that when a person gets tight and sore between the shoulders that if someone walks on their back the back can losen up and feel better. Well if this works in the mid back then what is so hard to believe that applying forces to the rest of the spine would not work as well? It is just common sense.

    All I have done is provide logic. I have made no outlandish claims. So lastly we come back to the fact that people reading our interaction can decide if I make more sense than you or not. Because that is what metter. Not you and a couple of your cronies. And I openly challange you and anyone with high level knowledge of biomechanics to come forth and show the public how the spine cannot twist and lock and create a functional short leg. And guess what Harriey. They won’t becaise they know damn well it is in line with science.

  94. nwtk2007 says:

    Harriett – “I think most people who have been following this exchange will fully understand why I have decided not to respond to nwtk2007 and quackdoctor any more. Most of them will wonder why I didn’t quit a long time ago.”

    Yes Harriett, most people who are “ideologically” anti-chriopractic based on the behavior or the non-scientific ones will understand.. Sure.

    And this thread, Chriopractic and Stroke, the amount of evidence you have shown is scant at best. You violate your own EBM standards and claim as you accused me once, that correlation in THIS case is causation. Mainly because of your ideology.

    Don’t respond, that’s fine. It certainly wouldn’t change the evidence presented thus far relating chiropractic manipulation and stroke.

    I would imagine attorneys in the Canadian stroke case are finding this out also. But they have one big advantage, a jury can be convinced of anything, assuming it ever gets into a court room.

  95. Diane says:

    Here’s an hypothesis: the volume of posts from two chiropractors in this comment section is directly proportional to the anxiety they feel (perhaps for themselves, perhaps as self-appointed spokesmen for their stock and trade) regarding the thread topic, where two words are juxtaposed: “Chiropractic” (more a high-velocity verb, really, than a noun) and “Stroke” (an undesirable noun), liaised by the conjunction, “and.”
    They hope they could talk/argue/obfuscate/deflect/deny this juxtaposition of ideas out of existence.

    Diane

  96. quackdoctor says:

    Diane…

    If you say that you must have not read one single thing that I said from the very beginning. I quite squarely addressed the reality of the stroke issue fom the beginning and taught you more about it than you knew before. Actually consider reading what I posted instead of making up nonsense.

  97. Joe says:

    Diane,

    Haven’t you been told that pointing-out the obvious is not polite?

    The resident chiros are only capable of bluster. Oops, was that impolite- pointing-out the obvious?

    We still await justification for any, purely chiropractic intervention.

  98. quackdoctor says:

    Well the thing is that my posts speak for themselves. Contained within them is the truth. So it matters noy what a few irrational people syas. It matters what the intelligenct reader is able to extract from what I say. You have just come across someone a little brighter and more knowgeble than you expected. And you just have no idea how to handle me. So you come up with nonsense that sounds profound to the ignorant.

  99. nwtk2007 says:

    This thread is about the possibility of chiropractic causing stroke.

    There has been a lot of discussion, now talley up your evidence and show us that it is consistent with evidence as required to be EBM.

    I say what you have shown thus far is scant at best and mostly, in the terms of EBM, anecdotal.

    Diane, you and Joe should do it together.

    Talley it up. Get it all together. Heck, you could then just forward it to Ms Nette’s attorneys and be a part of the big “hammer” on chiropractic.

    Good luck with that.

    It is your turn to show something besides bluster.

  100. Graham Maynard says:

    What amazes me is the amount of time #quack’ and #nwtk’ appear to so actively waste !

    Their almost obsessive ‘expert’ keyboard arguments here have not actually added any scientifically based reason for the existence of chiropractic, not even for the lower back !

    That is what physios are for anyway !

    Cheers ……. Graham.

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