Ladies, how would you like a chiropractor to deliver your baby? How about perform your annual well-woman exams, such as breast exam, bi-manual pelvic exam, speculum exam, recto-vaginal exam and Pap smear?
Sound out of their league? I thought so too. Way out. But, in some parts of the U.S., the law allows chiropractors to do all of these things and a great deal more. Including “adjusting” your basset hound.
A 2011 survey asked chiropractic regulatory officials whether their jurisdictions (all states, plus D.C., Virgin Islands and Puerto Rico, but I’ll refer to them collectively as the “states”) allowed 97 different diagnostic, evaluation, and management procedures. The results were recently reported and interpreted in the Journal of Manipulative and Physiological Therapeutics, in an article authored by Mabel Chang, DC, MPH, who was primarily responsible for the survey. Missouri allows the most procedures (92) and Texas, the fewest (30). A handful of states did not respond or did not respond to all questions, but the overall response rate was 96%. Results from a survey of Canada, Australia and New Zealand will be reported in a separate article. (more…)
Years of analyzing popular but dubious claims leads to the impression that just about all knowledge that filters down to the popular consciousness is essentially wrong, at least as a first approximation. This may sound cynical, but think about any area in which you have specialized knowledge and compare that to what the average person believes about that area. Now extrapolate that to every other area of specialized knowledge.
I may be skeptical, but I am not a nihilist. I do think the situation can be and is being improved by popularizing science and other areas of knowledge. Experts need to be directly involved in teaching the public about their area, and when they are, popular beliefs can be corrected.
One example is the myth that we only use 10% of our brain. This is still fairly popular, and was recently a central plot element to the blockbuster movie, Lucy. However, Google “10% brain” and you will find nothing but links to sites debunking this myth, at least in the first few pages.
George Papanicolaou, who originated the cervical dysplasia test that bears his name (the Pap smear)
Naturopath Kate Whimster has written a case study of a patient with cervical dysplasia who was allegedly treated successfully with naturopathic treatment. She says:
In many cases conventional treatment can be invasive, ineffective, or can put patients at risk for future complications. Fortunately, there are wonderful naturopathic treatment options available both instead of or in conjunction with conventional medical treatments. This case study is a great example of naturopathic treatment for cervical dysplasia as part of my HPV Healing program.
The patient was a 32-year-old woman who first had an abnormal Pap smear at the age of 26. Here is Whimster’s report of the course of events:
- February 2012: Pap HSIL, Colposcopy CIN I, Biopsy HSIL
- April 2012: LEEP procedure
- July 2012: Pap HSIL, Colposcopy CIN I, Biopsy HSIL
- August 2012: Start of naturopathic treatment
- Nov 2012: Pap LSIL, Colposcopy normal
- May 2013: Pap LSIL, Colposcopy CIN I, Biopsy LSIL
- July 2013: Pap ASCUS, Colposcopy normal, Biopsy normal
- October 2013: Pap normal, Colposcopy “cannot rule out CIN I,” Biopsy normal
- May 2014: Pap, Colposcopy and Biopsy all normal.
She was also successfully treated for a bacterial vaginal infection. (more…)
Without a doubt the big medical story of the last week or so has been the ongoing outbreak of Ebola virus disease in West Africa, the most deadly in history thus far. Indeed, as of this writing, according to a table of known Ebola outbreaks since 1976 at Wikipedia, in Guinea, Sierra Leone, and Liberia, the three nations affected thus far, there have been 1,440 cases and 826 deaths. Worse, the World Health Organization (WHO) is reporting that it is spreading faster in Africa than efforts to control it. In particular, late last week it was announced that two Americans who had been infected with Ebola were going to be flown back to the US, specifically to Emory University, for treatment, a development that ramped up the fear and misinformation about Ebola virus to even greater heights than it had already attained, which, unfortunately, were already pretty high. Indeed, the ever-reliably-histrionic Mike Adams of NaturalNews.com wrote a typically hysterical article “Infected Ebola patient being flown to Atlanta: Are health authorities risking a U.S. outbreak?” On Saturday, we learned that Dr. Kent Brantly, an aide worker for Samaritan’s Purse, a Christian charity run by Franklin Graham, son of the well-known preacher, Billy Graham, who had been evacuated from Liberia aboard a private air ambulance, had arrived in Georgia.
This latest development inspired medical “experts,” such as Donald Trump, to stoke fear based on the arrival of two infected Americans in the US. For instance, last Friday, after it was first announced that the Ebola-infected Americans would be flown back to the US, Trump tweeted:
[Editor's Note: I'm pleased to announce that Grant Ritchey has agreed to join SBM as a regular. He'll be writing about dental science and pseudoscience every four weeks on Sunday. (I swear, we'll get up to seven day a week publishing if it kills me—or the other bloggers.) Grant will be starting with science, but I'm sure he'll soon be discussing all the sorts of claims about dentistry and dental disease that are—how shall I put it?—less than science-based soon enough.]
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder in which the airway is partially or completely blocked during sleep. Although little or no air is flowing, the person continues to attempt to breathe. Typically, cessations in breathing last longer than 10 seconds per episode, but can last over a minute and usually occur multiple times during sleep. This can lead to poor sleep quality and precipitous drops in blood oxygenation levels over an extended period of time. This potentially life-threatening condition is frighteningly prevalent, especially in adults over 40, and it is estimated that 80-90% of OSA goes undiagnosed, further compounding the problem.
When a person experiences multiple apneic episodes during the night, the brain responds by alerting the body, resulting in increased efforts to breathe, gasping, and arousal from sleep. These frequent waking events, combined with lowered oxygen levels, can lead to the signs, symptoms, and sequelae of obstructive sleep apnea. Typically, OSA sufferers snore loudly, then are silent for 10-30 seconds as the airway is blocked. This is followed by choking, snorting, or gasping sounds when their airway reopens.
We all seek immortality in some way. Death has been one of the prime terrors haunting us since humans first started realizing that every living thing dies and death is permanent. After all, no one wants to face the end of everything that one has been, is, and will be. Indeed, a key feature of many religions is a belief that death is not the end, that there is an afterlife where we will all live forever. In some religions, in the afterlife evil is punished and good rewarded. Even if, as seems most likely, death is simply the end, and the time after death is just like the time before we were born (or, more properly, before our first memories), something that seems relatively benign just thinking about it, emotionally we still don’t want it. Being human, I get it, particularly now that I’m on the wrong side of 50 and, unless I’m far more long-lived than my genes are likely to permit, have considerably less life to look forward to than the lifetime I’ve already lived. I also realize that the number of people who are remembered long after they are gone by anyone outside of their family and friends is exceedingly small—and even that memory fades rapidly among family members. As the succeeding generation dies off, direct memory of the generation that spawned it disappears. I get it. Fifty years from now, it’s likely that all that will remain of my existence will be some scientific papers and a faint memory held by my nieces and nephews and maybe, if I’m lucky, a few of my youngest readers.
I don’t, however, get cryonics.
Detroit, like many large cities, has a free weekly “alternative” newspaper, The Metro Times. This week’s issue features this cover:
“Ummm, I probably shouldn’t be telling you this.”
The July issue of Pediatrics, the official journal of the American Academy of Pediatrics, contains an extremely thought provoking article discussing the risks and benefits of disclosing an incidental finding of nonparentage during pediatric genetic testing. Nonparentage occurs when one, or very rarely both, of the social parents did not serve as source code for a child’s genetic programming, so to speak. Naturally, we aren’t talking about known adoptions but rather when the nonbiological parent is unaware of the fact that they did not contribute an egg or sperm.
Authors Marissa Palmor and Autumn Fiester, both bioethicists at the University of Pennsylvania’s Perelman School of Medicine, take the position of universal nondisclosure when nonparentage is discovered. They acknowledge the pro-disclosure arguments and, in my opinion, successfully rebut them. They go on to make a compelling recommendation for the incorporation of a universal nondisclosure clause into consent forms which states clearly that parental status will not be discussed. (more…)
Chiropractors often deny that neck manipulation can be a primary cause of stroke by injuring vertebral arteries. But according to Jean-Yves Maigne, M.D., head of the Department of Physical Medicine at the Hôtel-Dieu Hospital in Paris, France:
It is now a well established fact that cervical thrust manipulation can harm the vertebral artery. This accident was formerly regarded as very rare, although severe, and related to atherosclerosis. Clinical tests were proposed to detect patients at risk. The problem is now better known. It is no longer attributed to atherosclerosis…but to a dissection of a vertebral artery, a clinical entity observed in younger patients (20-45 years). It remains very rare, but mild symptoms appear to be not so infrequent. Finally, the predicting tests seem to be deprived of any value.1
In 1997, the French Society of Orthopaedic and Osteopathic Manual Medicine (SOFMMOO), following presentations by anatomists, neurologists, radiologists, and practitioners in the field of French Manual Medicine, adopted the neck-manipulation proposals made by Dr. Maigne.1 “Acknowledging the fact that prevention is out of reach,” said Dr. Maigne, “the aim of these recommendations is to reduce the number of (not to say to suppress) rotational cervical thrust manipulations in a targeted population. This population consists mainly in females of less than 50 years old. Five recommendations were developed, in addition to classic contraindications of spinal manipulative therapy.”
The recommendations of the SOFMMOO, dealing with cervical manipulation in general and allowing the use of neck manipulation in special cases, are worth considering since they were reviewed by medical specialists in different disciplines and approved by licensed practitioners who use manual therapy, long before the stroke-neck-manipulation furor reached its peak in the United States.
In May, prompted by an uncritical article in the Daily Mail, the internet was buzzing about a company that was offering drinkable sunscreen. This is one of those game-changer health products that immediately garners a great deal of attention.
At first the claim seems extraordinary, but it is not impossible. It is theoretically possible to drink a substance that becomes deposited in the skin and absorbs or reflects UV radiation providing protection. However, upon reading the details it becomes immediately apparent that the product in question is pure snake oil.
The product is Harmonized Water by Osmosis Skin Care. In fact, UV protection is just one claim among many for the harmonized water line of products. The website claims:
- Remarkable technology that imprints frequencies (as standing waves) onto water molecules.
- Advances in the ability to “stack” thousands of frequencies onto one molecule.
- Revolutionary formula allows us to reverse engineer the frequencies of substances found in nature and/or the human body.
- Newly identified frequencies that have beneficial effects on the body.
A new book by Thomas Schneider, MD, offers A Physician’s Apology. The subtitle asks, “Are WE making you sick?” I was eager to read it, because I could think of many things doctors might be apologizing for: overdiagnosis, overtreatment, ordering unnecessary tests, pathologizing the vicissitudes of everyday life, offering misleading low-fat diet advice, misrepresenting inadequately tested treatments, not putting enough emphasis on prevention, prescribing medication before giving lifestyle changes a chance, etc. I was disappointed: his basic apology was “Truth is extremely hard to find in medicine and science, and I’m sorry,” which is true but is hardly his fault. Then he promises to “tell you a number of medical and scientific facts that are different from what many have always been told.” He blames commercials, creative marketing, and clueless doctors. Then he offers his own “truths” and his personal recipe for wellness. Some of these “truths” are questionable, and some are frankly wrong.