Articles

Neck Adjustment for Newborn Supraventricular Tachycardia: More Chiropractic Manipulation of Reality…..

[Editor’s note: Not enough Clay for one day? Check out this post on homeopathy over at The Scientific Parent!]

SVT

It was recently brought to my attention that a chiropractor was promoting his profession on Facebook by claiming to have treated and cured a potentially life-threatening cardiac arrhythmia. The condition in question, supraventricular tachycardia (SVT), can be very serious and even deadly in patients of all ages. Needless to say, the thought of anyone but a well-trained medical professional with access to appropriate medication and equipment to control the heart rate if necessary was unsettling to say the least.

After a deep breath, I followed the link and was sadly not surprised to find that it was true. In fact, after taking a minute for the rage to subside, and a few more to delve deeper into the case, I found that it was in reality much worse that I had initially imagined. The intervention, a stealthy adjustment of the child’s first cervical vertebrae, was performed by her father while she was being treated in a neonatal intensive care unit just hours after being born.

The events in question were posted by the chiropractor on a public account for his practice. Still, I feel hesitant to link to them directly as they reveal not only the name of the child but the identity of the cardiologist and intensive care doctor involved in her care (who naturally cannot respond because of privacy laws). If readers want to go to the trouble of locating the source of my outrage, they certainly can.

I will provide details of the child’s care as described by her father, but first a brief primer on SVT to set the stage a bit.

What is supraventricular tachycardia?

SVT is the fancy medical name for an excessively fast heart beat that has an origin above the heart’s lower chambers, also known as the ventricles, which pump blood out of the heart into either the lungs or the rest of the body. SVT, which is the most common abnormal cardiac rhythm diagnosed in children, typically occurs in patients with a normally-formed heart and no other medical problems, but is more likely to occur in the presence of congenital heart defects. Regardless of whether the heart is structurally normal or not, the problem stems from an abnormality in the conduction pathway that defines the electrical communication between the upper and lower chambers.

In a neonate, the most common form of SVT is known as atrioventricular reentrant tachycardia (AVRT). The electrical activity within the muscle of the heart under normal circumstances is initiated in the upper chambers and passes into the lower via the AV node, a specialized collection of cells between the chambers that slows conduction just a bit in order for the ventricles to fill with blood prior to their contraction. AVRT becomes possible only when an accessory pathway for electrical activation of ventricular contraction exists that bypasses the normal route.

Electrical signals can pass through the accessory pathway from the atria to the ventricle or vice versa. Anterograde conduction results in a signal that bypasses the AV node and avoids that important slight delay. This “preexcitation” can be seen on an EKG as the infamous “delta wave” that medical students and residents learn about several hundred times during their training, despite it being relatively uncommon. Patients who develop SVT in the setting of preexcitation are diagnosed with Wolff-Parkinson White syndrome (WPW). Retrograde conduction absent SVT, where the accessory pathway allows electrical activity to pass from the ventricles back into the atria, cannot be seen on ECG.

The process that results in abnormally increased heart rate in SVT, which can be as fast as 300 beats per minute in young infants (normal is less than half of that) and 220 to 240 in older children, is when a reentrant circuit forms. The most common form of this, seen in roughly 95% of cases, is when electrical conduction goes through the AV node and then quickly moves retrograde through the accessory pathway where it can go right back through the AV node. This results in the impressively fast heart beat associated with SVT and can lead to a variety of clinical presentations.

How does SVT affect children?

Despite heart rates that seem too fast to believe, most episodes of SVT occur suddenly, stop without any intervention within 10-15 minutes, and are clinically silent. Some episodes resolve spontaneously within a couple of minutes while others, less commonly, last much longer. When they do cause symptoms, older patients will often describe heart palpitations (the sensation of their heart beating in an abnormal way), chest pain, and feeling tired or lightheaded. Infants and toddlers, who obviously can’t express what they are feeling, may just act fussy or funny.

Some patients will actually lose consciousness because of associated dips in blood pressure and poor perfusion of the brain with oxygenated blood. In general, the longer that an episode lasts, the more likely it is to result in more serious complications, and Wolff-Parkinson White syndrome in particular is associated with sudden death. Neonates and older infants, because persistent or frequent episodes are less likely to be recognized in a timely fashion, are much more likely to present in heart failure with excessive fussiness, poor sleep, feeding difficulty, bluish skin because of low oxygen levels, and abnormally fast and difficult breathing.

How is SVT diagnosed?

There are additional causes of SVT other than AVRT, although it is the most common of the vast majority of cases in kids under 2 years, and even in older children. Other potential etiologies can be associated with worse prognoses so it is extremely important for the right diagnosis to be made. This requires the involvement of a pediatric cardiologist and appropriate testing modalities, most importantly an ECG, but also an echocardiogram to rule out any structural abnormalities. Ambulatory monitoring of the heart at home is often necessary because of the sporadic and brief nature of most SVT episodes.

How is SVT treated?

In many cases of acute SVT, no treatment is required at all because it stops spontaneously without any intervention. The parent or patient may even be completely unaware it happened. When a child with SVT does come to the attention of medical professionals, whether in the office, emergency department, or inpatient unit, the first step is always an assessment of their hemodynamic stability. An ECG with continuous monitoring of the child’s heart rhythm is of course important as well, but assessing for evidence of low blood pressure, heart failure, and shock is critical.

Stable patients, which make up the majority of cases, are typically managed conservatively at first, but still with urgency. The goal is always to convert the rhythm back to normal – we don’t wait to see if it will stop on its own. The initial approach is usually trying one of several vagal maneuvers, which can be done while appropriate resources and personnel are gathered for additional treatments if necessary. A vagal maneuver is one of several techniques employed in an effort to increase the activity of the vagus nerve, which can slow conduction through the AV node and convert SVT to a normal rhythm.

Vagal maneuvers can involve having an older and cooperative patient bear down as if trying to have a bowel movement or blow through an occluded straw. In younger patients and infants, a common vagal maneuver involves covering the face with a bag filled with ice water for up to 30 seconds in order to stimulate the “diving reflex” and slow AV nodal conduction. Massaging the carotid arteries or pressing down on the eyes have been tried historically but are currently not recommended in children because they are less effective and can cause harm.

Another key component of any vagal maneuver is close observation of the patient and their cardiac rhythm during the attempt. The particular pattern seen if successful can help diagnose the etiology of the SVT. And although rare, vagal maneuvers can potentially result in different and more concerning abnormal rhythms or even prolonged asystole, which is when the heart fails to contract at all. Sometimes parents of older patients are counseled to evaluate their child at home and perform or assist in vagal maneuvers. To perform an unsupervised vagal maneuver on a newborn having their first episode of SVT is, well, I’m getting a little ahead of myself. Let’s put a pin in that for the moment.

If vagal maneuvers were to fail, and the child remains stable, the next step in treatment is almost always big pharmaceutical. The drug of choice is adenosine, which acts on cardiac cell surface receptors leading to an increase in the normal AV node delay in conduction. This can interrupt the reentrant circuit that is usually causing all the fuss in the first place.

Adenosine is an IV medication that acts extremely rapidly, usually within seconds. Continuous ECG monitoring is a must in order to document what happens and help make the diagnosis. It has an extremely high rate of successful conversion to normal rhythm in most cases of pediatric SVT, but should be avoided in some circumstances. It can worsen the situation if used in a patient with WPW, for example. Adenosine should never be given without the team being ready to provide emergency resuscitation if needed.

Patients who are unstable at presentation are treated very differently. Time is never wasted on vagal maneuvers or even medications. Instead, the child is given appropriate sedation and electrode paddles are used to cardiovert (i.e. shock) the rhythm into a normal pattern.

What are the long term implications of SVT?

SVT can recur in many children. Depending on the etiology, the risk of recurrence can be higher or, as in the case of WPW, associated with more concerning acute events, even sudden death. I won’t get into too much detail on this because it is complex and there is much less of a clear evidence base to go on. Essentially, some children can be observed without any preventative medications, just counseling on recognition, use of vagal maneuvers, and when to seek medical attention. Some children may be placed on medications or even undergo procedures to remove the abnormal accessory pathway. Luckily, many young children who are diagnosed will stop having episodes as they age.

Chiropractic management of SVT in a newborn infant?

Now back to the case in question, which to refresh your memory involved the patient’s father, a chiropractor, claiming to have successfully treated his child’s SVT while in the NICU (emphasis added by me for future reference):

…Within an hour (of being born), things became very serious as her heart rate went to 300+ BPM and was taken to the special care nursery. Nobody knew what was going on and they had called care flight to take her to another hospital. As the nurses stepped out of the room to make arrangements to move my daughter to another hospital, I decided to step in and check her out while all the nurses were out of the room. As I walked closer I began to pray and cry, I thought my girl was dying. With one adjustment to her atlas (C1), her heart rate fell to zero and then quickly back to up to 140. The nurses all rushed in to see what was going on. To their astonishment, Gemma’s heart rate was normal. They had no clue what had just happened and so I told them I adjusted her…By removing the interference, her parasympathetic nervous system took back over and did what it was suppose to [sic] do.

From another post in which he throws the obstetrician under the bus (emphasis added by me for future reference):

…Our bodies are self-healing and self-regulating and our nervous system is the master system and master controller of our body. Without interference it functions correctly. So what happened to Gemma? Her ability to self heal and self regulate was taken away. She was healthy before birth, her delivery was quick and the doctor pulled too hard on her neck. Her atlas was subluxated causing interference of her parasympathetic nervous system, specifically the Vagus nerve, which slows heart rate. Without the inhibition of the parasympathetic nervous system, the stress of being born caused her sympathetic nervous system to speed up her heart rate. The adjustment allowed her brain to function correctly and self regulate her heart rate. Without an adjustment, Gemma could have possibly died, been injured, or have been on harmful medications the rest of her life. How many kids are medicated because their nervous system isn’t functioning properly? EVERY kid needs to get checked by a ChiropracTOR. [sic] Their health and well-being depends on it. You may just be saving their lives! Feel free to share.

There is a lot to unpack here but I’ll do my best. From the information provided, if accurate, it is very likely that this child did in fact have an episode of SVT. It’s possible, but very unlikely, that something else such as pain or illness caused the heart rate to increase to that degree. Usually that can be differentiated fairly easily. Fast but normal rhythm is usually variable with swings up and down, while with SVT it appears to be stuck at one rate. Also this child, from what I can tell, was otherwise perfectly healthy.

Twice he mentions that nobody knew what was going on. This seems odd as SVT is a pretty well recognized phenomenon in both pediatric and adult medicine. This child was born at around 11PM and the increased heart rate wasn’t noticed until an hour after birth. In most nurseries, this means that the pediatrician would not see the baby until the morning. Even if the facility, like my own, has an in-house pediatrician 24 hours a day, healthy babies aren’t typically seen right away unless there are problems.

This facility apparently has a special care nursery, which is usually considered the equivalent of a level 2 NICU. Babies of moderate prematurity (32 weeks gestational age and up) and/or illness can be managed in a special care nursery without needing to be transferred to a higher level of care. I would have thought that routine SVT would not require transfer.

There is no mention of a neonatologist or pediatrician being involved with the initial care of the baby, which leads me to think that this hospital doesn’t have one in-house. The father did provide a photo of a rather unhelpful consultation note from a pediatric cardiologist the following day, which also names a neonatologist, however. Any neonatologist or pediatric hospitalist would have recognized SVT and treated appropriately. Of course the provided narrative might be missing important details for dramatic effect or because of simple frailty of human memory.

Sneaking into a child’s room, even your own, in order to avoid awareness of the hospital staff is shady to say the least. I have no idea what kind of neck adjustment this father performed, but I imagine that it involved some kind of high velocity technique that would have been concerning to nursing. If he was simply going to break out his Activator, why hide it?

The father’s understanding of the pathophysiology of SVT is completely wrong. SVT isn’t caused by a malfunction in the nervous system or brain, it is almost always caused by an accessory pathway for electrical conduction in the heart. The problem isn’t an overactive sympathetic nervous system (think fight or flight), or even suboptimal parasympathetic activity (think rest and digest). Vagal maneuvers are an attempt to hyperstimulate the nerve and increase parasympathetic action above normal in order to convert the rhythm.

The father also demonstrates a lack of understanding of basic neuroanatomy despite all of that focus on it in chiropractic colleges. Manipulating the spine in any way is not going to have an effect on the origin of the vagus nerve, also known as the tenth cranial nerve, which lies in the brain stem’s medulla oblongata within the base of the skull. Even a complete injury to the spine at the level of the first cervical vertebra, which is where the father claims his child had a subluxation, would not result in changes in the heart rate let alone SVT because the vagus nerve doesn’t live there.

The roots of the vagus nerve exit the skull via bilateral jugular foramen and travel with the jugular and carotid vessels on each side of the neck. This is why carotid massage can sometimes stimulate it and convert SVT. In fact, all vagal maneuvers attempt to stimulate the nerve at the point where it runs though the neck. So it is entirely possible that a chiropractic adjustment might “work” in the sense that somebody is potentially pressing down on the side of the neck for several seconds. The more likely reason that this child’s SVT converted is because SVT tends to just stops on its own.

As a pediatrician who often cares for very ill children, and a parent myself, I can certainly relate to the feelings of panic and fear expressed by the child’s father. He may have actually thought his baby was going to die, suffer injury, or go on to require harmful medications for the rest of her life. Apparently the possibility of life flight was even on the table and there doesn’t seem to have been anyone there to talk the family through the situation. In reality, the child needed appropriate medical care but was actually at fairly low risk of any of those concerns.

Chiropractic fear-based marketing

I probably wouldn’t have written about this if the father hadn’t turned the events into a marketing gimmick on his chiropractic practice’s public social media page. It’s a practice building scheme I’ve written about before several times and it’s as cheap as it gets. What better way to sell a product, particularly if it provides no demonstrable benefit, than to make people afraid of life without it? Even more powerful is the fear that your child may suffer horrible illness, even death, if you don’t do what they recommend.

Chiropractors certainly aren’t alone in the use of this marketing tactic, but I think that they might be the best at it. Despite any evidence to support their claims, they want parents to think that hidden subluxations are a risk for a variety of problems, even SIDS and “shaken baby syndrome.” And these hidden subluxations can occur during routine delivery or even regular care and play. Here is a chiropractor demonstrating how to avoid injuring the spine while changing your baby’s diaper. If a diaper change can injure the spine, imagine what falling down while learning to walk must do!

 
 

Posted in: Chiropractic, Science and Medicine

Leave a Comment (0) →

Rehydrating with an appeal to nature

Ski faster with coconut water?

Ski faster with coconut water?

I don’t tend to worry too much about hydration, except when I exercise. I’ve been running regularly for over 15 years, and since I started I’ve usually carried water, or for longer runs, I drink old-school Gatorade. The formulation is basic: sugar, salt, and potassium. There are hundreds of electrolyte products marketed for athletics, but I’ve been faithful to the original: It’s cheap, I don’t mind the taste (even when it’s warm), you can buy it nearly anywhere, and it’s the usual liquid (besides water) offered at races. After exercise, I rehydrate with plain water, preferring to get my electrolytes and carbohydrates from food, rather than a specialty beverage, some of which are “designed” to support rehydration after exercise. The science of sports and hydration is constantly evolving, and so is the marketing. I’m apparently an outlier by still running with Gatorade. New hydration products criticize Gatorade for being artificial and inferior, arguing that natural sources of hydration are better. There’s been an explosion of rehydration beverages, marketed both for everyday hydration and sport purposes. Coconut water was the first natural product to find fairly wide popularity as a sports-oriented beverage. Now you can find maple water, cactus water, watermelon juice and even artichoke water. Is “natural” hydration better that substitutes, including plain old water? (more…)

Posted in: Nutrition, Science and Medicine

Leave a Comment (0) →

Placebo by Conditioning

power-of-placebo-effectTruly understanding placebo effects (note the plural) is critical to science-based medicine. Misconceptions about placebo effects are perhaps the common problem I encounter among otherwise-scientific professionals and science communicators.

The persistence of these misconceptions is due partly to the fact that false beliefs about placebos, namely that “the” placebo effect is mainly an expectation mind-over-matter effect, is deeply embedded in the culture. It is further exacerbated by recent attempts by CAM proponents to promote placebo-medicine, as their preferred treatments are increasingly being demonstrated to be nothing but placebos.

One idea that proponents of placebo medicine have tried to put forth is that you can have a placebo effect without deception. The study most often pointed to in order to support this claim is Ted Kaptchuk’s irritable bowel syndrome study. However, this study was flawed in that it told participants that placebos can heal, so it wasn’t exactly without deception. (more…)

Posted in: Medical Ethics, Science and Medicine

Leave a Comment (0) →

ASEA, ORMUS, and Alchemy

Ormus powder. Ormusmanna.com: “Ormus could be the source of all metals. Therefore, we identify the Ormes elements in relationship to the metal they can unfold into (e.g. Ormus copper, Ormus gold, Ormus rhodium, etc.)”

An example of Ormus powder. Ormusmanna.com: “Ormus could be the source of all metals. Therefore, we identify the Ormus elements in relationship to the metal they can unfold into (e.g. Ormus copper, Ormus gold, Ormus rhodium, etc.)”

I got an e-mail from a woman who had read my article on ASEA, a multilevel marketing diet supplement that I characterized as an expensive way to buy water.  She had not tried ASEA products but was applying for a position as an accountant with the company, and she chastised me for not doing my due diligence and researching the new science of ORMUS.

First she dismissed science, saying “science as we know it is no longer valid and quantum physics clearly shows this.” Then she claimed there was valid science that would support ASEA’s claims. She had personally done a sea salt cleanse with good results. If ASEA is only salt water, that doesn’t negate its validity, since ORMUS material is from sea salt and when minerals are rearranged they no longer register as the original element. Alchemy is not a myth, and the “quantum non-mainstream sciences” prove it is real. Quantum physics “explains that particles can interact without actually being on contact, this is a form or property of superconductivity.” She thinks ORMUS material is superconductive and constitutes a percentage of the human brain mass, allowing transmission of thoughts to others who tune in to these superconductive energy transmissions.

But wait, there’s more! She went on to tell me about an experiment where a dog’s entire blood volume was replaced by seawater. She shared her belief that the power of the mind can heal all disease, and she explained that she relies on a natural knowing within herself and only uses outside evidence to confirm her beliefs. She has been studying subjects like sacred geometry, Vedic mathematics, the golden ratio, quantum physics, and extraterrestrials.

Orbitally Rearranged Monoatomic Elements

This woman is obviously misguided and misinformed, but what is this ORMUS she’s talking about? I’d never heard of it, so I started with Rational Wiki:

ORMUS, also called ORMEs (Orbitally Rearranged Monoatomic Elements) and m-state materials, is a fictitious group of substances exhibiting many miraculous properties, such as healing powers and superconductivity at room temperature. They were supposedly discovered in 1975 by David Hudson, a cotton farmer from Arizona.

(more…)

Posted in: Basic Science, Energy Medicine, Herbs & Supplements

Leave a Comment (0) →

Bastions of quackademic medicine: Georgetown University

The cover of Georgetown Medicine Spring/Summer 2015 issue. This image will drive Mark Crislip crazy, as it features yet another acupuncturist not using gloves while sticking needles into people. Dr. Gorski loves watching Dr. Crislip's reactions to such photos.

The cover of Georgetown Medicine Spring/Summer 2015 issue. This image will drive Mark Crislip crazy, as it features yet another acupuncturist not using gloves while sticking needles into people. Dr. Gorski loves watching Dr. Crislip’s reactions to such photos.

We frequently discuss a disturbing phenomenon known as quackademic medicine. Basically, quackademic medicine is a phenomenon that has taken hold over the last two decades in medical academia in which once ostensibly science-based medical schools and academic medical centers embrace quackery. This embrace was once called “complementary and alternative medicine” (CAM) but among quackademics the preferred term is now “integrative medicine.” Of course, when looked at objectively, integrative medicine is far more a brand than a specialty. Specifically, it’s a combination of rebranding some science-based modalities, such as nutrition and exercise, as somehow being “alternative” or “integrative” with the integration of outright quackery, such as reiki and “energy healing,” acupuncture, and naturopathy, into conventional medicine. As my good bud and fellow Science-Based Medicine (SBM) blogger Mark Crislip put it, mixing cow pie with apple pie does not make the cow pie better, but we seem to be “integrating” the cow pie of quackery with the apple pie of science-based medicine thinking that somehow it will improve the smell, taste, and texture of the cow pie.

I remember how, when I first discovered how prevalent outright pseudoscience and quackery had become in medical academia (which was before I became one of the founding SBM bloggers), I was in denial. I couldn’t believe it. Then I tracked this phenomenon with something I called the Academic Woo Aggregator. It turned out to be a hopeless endeavor because, as I soon discovered, the phenomenon was so pervasive that it was really hard to keep the Aggregator up to date. Since then, I’ve generally only focused on particularly egregious examples, naming names when institutions like my alma mater embrace anthroposophic medicine; “respectable” journals publish “integrative medicine” guidelines for breast cancer patients; cancer organizations include “integrative oncology” in their professional meetings; NCI-designated comprehensive cancer centers promote reiki to pediatric cancer patients or offer high dose unproven vitamin C treatment to patients; or respected academic institutions embrace traditional Chinese medicine (TCM) and the quackery that is function medicine. You get the idea. It’s depressing just how far medical academia has fallen in terms of being “open-minded” to the point of brains falling out when it comes to medical pseudoscience.
(more…)

Posted in: Acupuncture, Basic Science, Energy Medicine, Homeopathy, Medical Academia

Leave a Comment (0) →

Naturopathic Medical Magic in the NW

Me and my lovely wife Phyllis Schlafly, amazed at what naturopaths will believe. From the Wikimedia Commons, because we're that famous.

Me and my lovely wife Phyllis Schlafly, amazed at what naturopaths will believe.
From the Wikimedia Commons, because we’re that famous.

As regular readers know, I live in the great Pacific Northwest, specifically Portland, Oregon. I am at home in the organic/hippy/environmental mind-set. It is what I grew up with. It is a relaxed, informal place to live. It is not much of an exaggeration to say that formal attire is tucking your tee shirt into your jeans. At least the metro area, and perhaps much of the state, is relatively tolerant of the actions of others. A real what’s the harm/shruggie approach to life, the universe and everything.

I will admit that the irrational/shruggie/emotional/Oregonian/goateed part of my brain is often at odds with my more rational brain, which wants me to give a rat’s ass about issues I think are just wrong. It showed up strongly with fluoridation in Portland, where my rational brain knew adding fluoride to the water was a great idea and my Oregonian nature said water should be pure, man, like nature intended. I keep my inner Oregonian under tight control as his approach often sounds good until you carefully examine how his ideas are implemented. Except at the pub of course. Bring on the hops, man, like nature intended beer to be.

Naturopathy is well tolerated in Oregon, with two schools in the NW producing NDs. We have a Board of Naturopathic Medicine, whose vision is to:

To protect the health, safety and welfare of the public in the matters of care provided by Naturopathic physicians in Oregon.

(more…)

Posted in: Legal, Naturopathy, Politics and Regulation

Leave a Comment (0) →

The evolving story of the harms of anti-inflammatory drugs

Advil (ibuprofen)

Owing to summer vacation, today’s post updates a 2011 post and a 2013 post with some new information.

Anti-inflammatory drugs are among the most well-loved products in the modern medicine cabinet. They can provide good pain control, reduce inflammation, and eliminate fever. We give non-steroidal anti-inflammatory drugs (NSAIDs) in infancy, continuing through childhood and then adulthood for the aches and pains of modern living. It’s the later stages of life where NSAIDs are used most frequently, usually in the treatment of joint disease like osteoarthritis, which eventually affects pretty much everyone. Over 17 million Americans use NSAIDs on a daily basis, and this number will grow as the population ages. While they’re widely used, they also have a long list of side effects. Not only can they cause stomach ulcers and bleeding by damaging the lining of the gastrointestinal tract, cardiovascular risks are also significant.

It was the arrival (and withdrawal) of the drugs Bextra (valdecoxib) and Vioxx (rofecoxib) that led to a much better understanding of the potential for these drugs to increase the risks of heart attacks and strokes. And it’s now well-documented that these effects are not limited to the “COX-2″ drugs – almost all NSAIDs, including the old standbys we have used for years, raise the risk of heart attacks and strokes. (more…)

Posted in: Clinical Trials, Politics and Regulation, Science and the Media

Leave a Comment (0) →

Galvanic Skin Response Pseudoscience

How_Zyto_works

Selling snake oil is all about marketing, which means that a good snake oil product needs to have a great angle or a hook. Popular snake oil hooks include being “natural,” the product of ancient wisdom, or “holistic.”

Perhaps my favorite snake oil marketing ploy, however, is claiming the product represents the latest cutting-edge technology. This invariably leads to humorous sciencey technobabble. There are also recurrent themes to this technobabble, which often involve “energy,” vibrations and frequencies, or scientific concepts poorly understood by the public, such as magnetism and (of course) quantum effects. Historically, even radioactivity was marketed as a cure-all.

One category of technical pseudoscientific snake oil measures some physiological property of the body and then claims that this measurement can be used for diagnosis and determining optimal treatment. For example, machines might measure brain waves, heart rate variability, thermal energy or (the subject of today’s article) the galvanic skin response.

(more…)

Posted in: Medical devices

Leave a Comment (0) →

“Hands On Learning Solutions”: Untested Solutions for Problems That May Not Even Exist

Get started...for as little as $14,000!

Get started…for as little as $14,000!

Hands On Learning Solutions, a business in Gig Harbor, Washington, evaluates and treats children for learning disabilities and claims to identify the underlying causes and help eliminate the symptoms. Much of what they do is questionable, and at least one of their methods is clearly bogus. Their program is reminiscent of the Brain Balance program that I wrote about in 2010. I’ll describe one child’s encounter with Hands On Learning Solutions and let you decide for yourself whether it sounds like a legitimate, helpful service.

Billy (not his real name) is an 11-year-old boy who is in the fifth grade at a Catholic school. He didn’t learn to talk until age 3, but he got speech therapy and is currently doing well in school, with a GPA of 86%. On his last report card, the section on “Successful Learner” rated him above average on working cooperatively with others, and satisfactory in all other categories, such as organizational skills, using time well, listening attentively, following directions, and completing work on time. His mother took him to Hands On Learning Solutions on the recommendation of a friend. On the intake questionnaire she expressed concerns about his written/oral expression, organization, study skills, attention focus, and motivation/behavior. She did not check the boxes for concerns about reading, spelling, comprehension, letter reversals, graphomotor skills, math, memory, poor grades, or slow work. (more…)

Posted in: Diagnostic tests & procedures, Neuroscience/Mental Health

Leave a Comment (0) →

Should physicians and managed care organizations offer homeopathy?

Homeopathy is water

Anyone who reads Science-Based Medicine on even a semi-regular basis will know our collective opinion of homeopathy. Basically, at its core, homeopathy is pure quackery.

I don’t care if it’s repetitive to say this yet again because it can’t be emphasized enough times that homeopathy is The One Quackery To Rule Them All. OK, there are others that compete for that title, such as reiki and other magical “energy therapies” like therapeutic touch, both of which, unfortunately, can be found in many academic medical centers where the faculty really should know better. Any “medicine” whose very precepts break multiple laws of physics and chemistry, laws that would have to be proven not just wrong but spectacularly wrong for homeopathy to work, deserves only ridicule.

The “laws” of homeopathy

Think of it this way. There are two “laws” of homeopathy, neither of which has any basis in reality. First, there is the law that states “like cures like” and asserts that, to relieve a symptom, you need to use a substance that causes that same symptom in healthy adults. There is, of course, no evidence that this is a general principle of medicine. For instance, we don’t generally treat fever by administering something that causes fever or treat vomiting with something that causes vomiting. The second law, however, is the one that’s completely ridiculous. Basically, it’s the law of infinitesimals. This law states that a homeopathic remedy is made stronger with dilution, specifically serial dilutions with vigorous shaking between each dilution step to “potentize” the remedy. That’s ridiculous enough, but homeopaths, never satisfied with the merely ridiculous have to turn the ridiculous up to 11 and beyond by using this principle to assert that dilutions far beyond the point where there is likely even to be a single molecule of the original remedy left are effective and become more so with more dilution. For instance, a 30C dilution is 30 one hundred-fold dilutions (C=100, get it?), or a 1060 dilution. Avogadro’s number is only on the order of 6 x 1023, or more than 1036-fold less than the dilution. The simple mathematics of homeopathy just doesn’t work, although this doesn’t stop homeopaths from coming up with some truly spectacular flights of pseudoscience (like the “memory of water”) to try to “explain” how it can work.
(more…)

Posted in: Homeopathy

Leave a Comment (0) →
Page 1 of 236 12345...»