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Dry Needling

Pictured: The difference between the acupunctures and dry needling.

Pictured: The difference between the acupunctures and dry needling.

War, huh, yeah
What is it good for
Absolutely nothing
Uh-huh huh
War, huh, yeah
What is it good for
Absolutely nothing
Say it again, y’all
War, huh,
What is it good for
Absolutely nothing
Listen to me
Ohhh, war, I despise
Cause it means destruction
Of innocent lives
War means tears
To thousands of mothers eyes
When their sons go to fight
And lose their lives
Ooh, war, huh
Good God, y’all
What is it good for
Absolutely nothing
Say it again
War, whoa,
What is it good for
Absolutely nothing
Listen to me
War, it ain’t nothing
But a heartbreaker
Friends only to the undertaker
Ooooh, war
It’s an enemy to all mankind
The point of war blows my mind
War has caused unrest
Within the younger generation
Induction then destruction
Who wants to die
Aaaaah, war-huh
Good God y’all
What is it good for
Absolutely nothing
Say it again
War, huh
What is it good for
Absolutely nothing
Listen to me
War, huh, yeah
What is it good for
Absolutely nothing
Come on, let me hear ya
War, it ain’t nothing but a heartbreaker
It’s got one friend
That’s the undertaker
War has shattered
Many a young man’s dreams
Made him disabled, bitter and mean
Life is much to short and precious
To spend fighting wars these days
War can’t give life
It can only take it away
Ooooh, war, huh
Ooh yeah
What is it good for
Absolutely nothing
Say it again, y’all
War, whoa,
What is it good for
Absolutely nothing
Come on, sing it
War, whoa,
Come on and shout it, y’all
What is it good for
Absolutely nothing
Come on, come on now
It ain’t nothing but a heartbreaker
Friends only to the undertaker
Peace, love and understanding
Is there no place for them today
They say we must fight to keep our freedom
But Lord knows there’s got to be a better way
Ooooooh, war, huh
Good God y’all
What is it good for
absolutely nothing
Say it again, y’all
War, huh
What is it good for
Absolutely nothing
Say it again, y’all
What is it good for
Absolutely nothing

Edwin Starr

I’m convinced. War is bad. But I have a solution. To the 54 current armed conflicts in the world: forget about it. Then no shots will be fired and no one will be injured or killed. It’s that easy. Problem identified, problem sol-ved. Go Science and Big ‘S’ Skepticism. Any complaints about my solution aren’t worth responding to.

Now that the problem of war is settled, let’s move on to dry needling. (more…)

Posted in: Acupuncture

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Vaginal Seeding. Ew. That’s nuts. Hmmm, interesting.

A breakdown of bacterial species from your skin's microbiome. As a favor to

A breakdown of bacterial species from your skin’s microbiome. As a favor to pregnant women expectant fathers teenage boys on the internet everyone, this is the image I went with. Click to macrolaarggen (Ikean for embiggen).

Sometimes a headline will cause me to run through a series of reactions in rapid sequence. For example “Mothers facing C-sections look to vaginal ‘seeding’ to boost their babies’ health”:

Early studies show that swabbing a mother’s vagina and transferring it to her baby’s mouth, eyes and skin may stimulate microbiome development similarly to babies born naturally – and protect it from health issues later in life

I mean ick.

But take a step back. Not really. I tend to think of people like “Pig Pen” in Charlie Brown, shedding skin and bacteria into the environment. If we were to really think about each other’s microbiome, we might not have intimate contact with our significant other. Or any other animal. I always point out, when someone lets their dog lick them, that they (the dog) had probably just licked its rear, AKA dog-ass seeding. And no, a dog’s mouth is not cleaner than a human’s, unless your dog brushes and flosses with greater frequency than you. (more…)

Posted in: Basic Science, Evolution, Faith Healing & Spirituality, Humor, Nutrition

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Join Us at NECSS 2016. One Week To Go

A day of Science-Based Medicine, a weekend of science and skepticism

NECSS, the NorthEast Conference on Science and Skepticism, is this spring.

Included in the program will be a full day of Science-Based Medicine.

The NECSS will be held May 12th–15th, 2015, in New York City at the Fashion Institute of Technology.

Full Conference schedule here.

Description: NECSS welcomes over 400 attendees to New York City for a celebration of science and critical thinking. Through individual presentations, panel discussions, and performances, attendees are informed and inspired by leading scientists, educators, activists, and performers – each bringing their own perspective and passion to the goal of fostering a more rational world.

The SBM schedule (subject to change) at NECSS

9:30-9:40 10 minutes Welcome
9:40-10:15 35 minutes Functional Medicine is Dysfunctional Harriet Hall
10:15-10:50 35 minutes Science-Based Dentistry: Where the Truth Meets the Tooth Grant Ritchey

10:50-11:00 10 minutes Break

11:00-12:10 70 minutes Natural Disaster: Dietary Supplements Scott Gavura & Jann Bellamy

12:10-1:40 90 minutes Lunch

1:40-2:15 35 minutes Kids & CAM: Playing Make-Believe with Children’s Health John Snyder
2:15-2:50 35 minutes Chronic Lyme: When Life Hands You Lemons Saul Hymes
2:50-3:25 35 minutes Your Baby’s Spine Will Be Just Fine Without Chiropractic Adjustment Clay Jones

3:25-3:40 15 minutes Break

3:40-4:45 65 minutes Debate: Should Physicians “Fire” Anti-Vaccination Patients? John Snyder, Saul Hymes, Clay Jones
4:45-5:20 35 minutes Bayesian Statistics Steve Novella
5:20-6:05 45 minutes Ask Us Anything: Audience & Twitter Q & A All Speakers
6:05-6:15 10 minutes Closing

Registration is open.

See you there.

Posted in: Announcements

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Chiropractors, Blind Pigs, and Acorns

Sometimes you need to help the blind pig.

Sometimes you need to help the blind pig.

When people are at the end of their life they like to pass on their life lessons. One thing I have never had a patient say is “Doc, I sure wish I had spent more time at work.”

I try and keep that in mind, but then there are those work commitments that are hard to avoid. I need to have a talk with Drs. Gorski and Novella. No one should have write a blog entry any week their team is in the play-offs. The Blazers were not meant to win more than 25 games, much less be the 5th seed in the West with a chance to make the conference finals. I know. Trailblazers fans are not always grounded in reality. But we are up on the Clippers 3–2 and heading home to close out the series tonight. For the record I wrote the preceding sentence during the game 5 tip-off. I really should not have to do any work this week. Basketball is simply more important.

Take this case report. Anywhere else.

Case reports are a tradition in medicine. Usually they are unique or unusual cases, diseases you are likely to see but once in a career, if that. There are all sorts of medical curiosities that need to be reported. I have a blog over at Medscape devoted to Infectious Disease case reports.

Some case reports, however, inspire eye rolls and sniggers. Why are these even reported? (more…)

Posted in: Chiropractic, Clinical Trials, Humor

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Chiropractic- Ignoring the Precautionary Principle Since 1895

My reaction to reading the paper discussed herein, were I a handsome Spaniard.

My reaction to reading the paper discussed herein, were I a handsome Spaniard.

Bleh. I turned from a short trip to the city of angles with a bad man cold that just isn’t going away. Those who do primary care all tell me that whatever is going around lasts 2-3 weeks. Great. I am not sick enough to get out of work but I am not well enough to have any enthusiasm to do anything. I look at the key board and sigh. I just want to binge watch something mindless.

I know Harriet covered “Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation” last week. But it is one thing to read the evaluation of a paper and quite another to evaluate a paper on your own. It is the latter process where you, and by you I mean me, actually learn something. I write mostly for my edification, not yours. Sorry. It is all about me. I will likely read Harriet’s post this weekend.

The issue at hand is whether chiropractic manipulation can cause a stroke. (more…)

Posted in: Chiropractic, Clinical Trials, Critical Thinking

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April Fool Cannot Surpass SCAM

Stick some coffee up the tailpipe and you've got yourself some complementary and alternative auto care!

Stick some coffee up the tailpipe and you’ve got yourself some complementary and alternative auto care!

It’s April Fools’ day in the US of A. One of the internet traditions is to come up with a story that is weird or unlikely, but not so weird or unlikely that it is not believable, in order to fool people that the story is real.

I gave it the old SBM try, I really did, but I couldn’t do it. I wanted to come up with a SCAM therapy so weird, so unlikely, that I could not find an example of it actually being practiced.

It can’t be done. Like a Trump utterance*, you can’t invent a SCAM (Supplements, Complementary and Alternative Medicine) that someone, somewhere, has already pulled out of, er, well, thin air and are using it on patients.

Of course, what would you expect given that many SCAMs were in fact, pulled out of, er, well thin air. Think chiropractic and DD Palmer, iridology by August von Peczely, and reiki by Mikao Usui. Making up fantastical stuff is what they do.

But even within the spectrum of pseudo-medicine there are those are practices and papers that are so bizarro they should be an April Fools’ joke. But are not. It may be a matter of taste, what one person considers wack-a-loon another would find imminently reasonable. There are certainly assigned delegates that prove that assertion. But even within the wack-a-loon world of SCAM, there are those practices and papers that are more wack-a-loon than others and should be April Fools’ jokes. Maybe it is like more unique. Unique is one of a kind, so something can’t be more one of a kind. More wack-a-loon? Such is the world of SCAM. (more…)

Posted in: Acupuncture, Energy Medicine, Homeopathy, Medical devices, Naturopathy, Politics and Regulation, Science and Medicine

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Oregon Health & Science University SCAM Day

From the Wikimedia Commons, originally posted by Flickr user Alex E. Proimos (link)

From the Wikimedia Commons, originally posted by Flickr user Alex E. Proimos (link).  Oy.

I was looking over a recent class catalog from my alma mater, University of Oregon. I see the Astronomy Department is having a day devoted to astrology, inviting astrologers to talk about their profession. And the Chemistry department is having alchemists give an overview on how to change base metals into gold. And, to green our energy, the Physics Department, where I acquired my undergraduate degree, is having a symposium on perpetual motion machines. I am so proud.

I kid.

But not when it comes to SCAM (Supplements, Complementary and Alternative Medicine). Medicine is strange in that has no issues embracing pseudo-science. My medical school, OHSU, had an afternoon devoted to Integrative Medicine for the third year medical students, with lectures by a chiropractor, a traditional Chinese pseudomedicine practitioner, a naturopath and an integrative medicine practitioner. They also had a small group discussion of a case of irritable bowel syndrome where one of the discussion leaders was a……Qi……….Gong………..master. Really. I would be so pissed if I was going $166,000 in medical school debt and I was being taught about the approach to ANYTHING by a Qi Gong Master. It was a day to ignore that whole ‘science’ thing in the name of the school. (more…)

Posted in: Acupuncture, Chiropractic, Homeopathy, Medical Academia, Naturopathy, Science and Medicine

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Acupuncture for Coronary Artery Disease

Pictured: Really, really bad idea, on all levels.

Pictured: Really, really bad idea, on all levels; literal, metaphorical, pedagogical, tautological, hemodynamic, pathological, basically all the -ics, -cals, and -als.

I have spent the last 35 years mostly in acute care medicine. Spending my day in the hospital gives me the bias that we are fragile creatures who can die unexpectedly and easily. Much of the time we pull patients through, but I have a great respect for acute diseases. Over the years I have seen too many people wake up feeling good and dead by dinner time

There is a reason the phrase is “as serious as a heart attack”. Heart attacks and heart arrhythmias can kill. About 5% of patients admitted to the hospital with a heart attack die. And 250,000 have sudden death each year, never making it to the hospital, succumbing to their ventricular fibrillation precipitated by acute coronary ischemia. Ted Cruz notwithstanding, you need a functioning heart to live.

Scary stuff. So when I read Pubmed articles like “Effects of Acupuncture at the Yintang and the Chengjiang Acupoints on Cardiac Arrhythmias and Neurocardiogenic Syncope in Emergency First Aid“, I wonder what is going on in the minds of some people. (more…)

Posted in: Acupuncture, Clinical Trials

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Chiropractors, Naturopaths, Concussions and Senate Bill 1535

Concussion small
There is a bill before the Oregon Legislature, Senate Bill 1535, that:

Allows chiropractic physicians and naturopathic physicians to provide release for athlete who sustained concussion or is suspected of sustaining concussion.

Unfortunately, the Oregon legislature has already granted naturopaths primary care physician status, so I expect this may well pass, despite the fact neither chiropractors nor naturopaths have much reality-based education and training in medicine.

You may wonder, why you should care about what is going on in Oregon? Well, it is likely similar laws are being considered in your state. You might be surprised at the shenanigans going on in your legislature. I was when I looked. To keep informed, go to Legislative Update at the Society for Science-Based Medicine for weekly updates.

Let’s go through the issues: why is it a bad idea for the athletes of the state, most of whom will be children, to be cared for by NDs and DCs? (more…)

Posted in: Chiropractic, Naturopathy, Politics and Regulation

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Curse Removal from the Annals. More Acupuncture Nonsense.

Pictured: Joshua Tree. Not pictured: My bleached bones.

Pictured: Joshua Tree. Not pictured: My bleached bones.  I hope.

A short post this week. Last weekend was a busy call weekend and as I type this I am heading for Palm Springs for a long weekend of hiking in the desert. If there is no entry in 14 days, look for my bleached bones somewhere in Joshua Tree.

Some observations about a recent article in the once-respected Annals of Internal Medicine, whose recent articles on acupuncture suggest their motto should be “The Annals: we have one too many ns.”

First there was, “Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomized Trial,” and now “Acupuncture for Menopausal Hot Flashes: A Randomized Trial.”

Spinning yin deficiency

Why do the study? Why do any acupuncture study? Negative studies will not change practice. There are no reality-based reasons to think that acupuncture would be effective for any process. All the high quality studies show no efficacy. (more…)

Posted in: Acupuncture, Clinical Trials, Science and Medicine

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