Sometimes a patient is desperate for a diagnosis: If she has been going from doctor to doctor, and has been told uncountable times that nothing is wrong, it's all in her head - she might be relieved if she finally gets told she has "chronic fatigue." At least, now she can deal with it.
Sometimes a diagnosis can save a life: If your belly hurts, and the diagnosis is “appendicitis”, a surgeon will operate on you, and your life is saved in all likelihood. When my son, a few years ago, had high fever, stiff neck and the worst headaches of his life, only the diagnosis of a physician turned the course of the disease around. The physician thought it likely was a tick-borne disease and probably tularemia: With the right antibiotic, my son recovered quickly.
Sometimes a diagnosis is just and word: Say, your doctor tells you that you have hypertension - high blood pressure. That doesn’t help you much. It helps the doctor to know what pill to prescribe you – for the rest of your days. Now you are a patient.
High blood pressure is a typical modern-day stress disease. Only about five percent of people who are diagnosed with high blood pressure, have an underlying medical condition. The rest – ninety-five percent! – have a wrong lifestyle. But interestingly, the diagnosis doesn’t tell you that there might be a difference – or that something else than a pill might help you.
If you have an especially astute doctor, he will tell you that you have “essential hypertension”, “essential” here meaning no real reason he knows of. With other words, the diagnosis is a medical throwing up his arms in the air, declaring nothing can be done. Except for a few pills, of course.
You have stress because your boss is unreasonable, or your spouse is the nagging kind, or your gambling debts are threatening to destroy your family life – again, you might not be able to do much. On the other hand, you might be starting thinking about what can be done. Getting more sleep every night? Eating more vegetables? Going into therapy? Returning to school, training for another line of work? Divorcing your spouse, or going to marriage counseling together? Enrolling in a course of ballroom dancing together? Changing jobs? Taking up tennis to get a handle on your stress and work some of the anger off physically?
No – you have a diagnosis, and now you get a pill. That’s all. Your doctor didn’t even tell you to drink more water, I bet.
You were probably told to go easy on salt. That is nice advice – if you were also told that most processed and restaurant foods contain too much salt, even your breakfast cereals and the “nutritional” bar. And that the salt problem is really big in black people but less of an issue in Caucasian people.
Chances are that your doctor also gives you a diagnosis of too high cholesterol – hypercholesterolemia. That’s another pill, right away.
Your doctor didn’t tell you that high blood pressure and high cholesterol aren’t two different diseases. They are one bad lifestyle. More often than not they go together.
And, oh, now you got diabetes! Your sugars are too high and this new diabetes really needs good management. Your doctor might even give you a new name for the three diseases above: Syndrome X. He will wiggle his head in concern, because having all three makes it really dangerous. One has to be treated extra-extra carefully – with many pills.
Some (or all) of those pills have side effects. Liver failure, depression, impotence, muscle inflammation, fatigue, upset stomach, and so on – which will require more pills and more monitoring.
None of the pills will buy you real health – glowing, sweaty, happy health as you might experience when you play a round of pick-up Frisbee or swim in the ocean.
I am not saying here you should throw away all the pills your doctor gave you. I am just saying you should strive for health, not for diagnoses and an assortment of pills, so that, one by one – and with the supervision of your physician – you might be able to drop the pills.
What is the difference between this diagnosis and that diagnosis? My son’s illness had nothing to do with lifestyle, and all to do with a nasty bug. Most diseases like high blood pressure, diabetes, high blood fats, and many cases of depression, arthritis and cancer have a whole lot to do with lifestyle. If you break a bone, only a good cast will help mending it – and good food will speed up the healing process.
Once you have a cancer, of course, a bit of lifestyle change is not enough to save your life – you need surgery, radiation, chemotherapy. Once the cancer is diagnosed, eating more fresh vegetables and going for a daily walk in sunlight might help you recover – but better would have been you would have started on a healthy path many years ago.
The uncomfortable truth is: Health does not come out of a pill bottle. And a diagnosis is just a name. What you do with your life counts for your health. Read More
Blog: On Health. On Writing. On Life. On Everything.
Quackery
July 30, 2010
On the British "Quackometer" site, I have been negatively reviewed: http://www.quackometer.net/.
This is what I answered:
Dear Mr. Andy Lewis,
Basically, I like the idea of a quackometer. On the other hand, I am not tickled that I received all those ducks. They are cute, though.
In my books and health blog, I use easy language while being informed about science. I use some new-agey terms so that people understand me – that explains “This web site is using lots of alternative medicine terms.”
At the same time, you accuse me of the opposite: “It is full of scientific jargon that is out of place and probably doesn't know the meaning of any of the terms.” You don’t want to argue with degrees - but here I have to: I was a teacher of mathematics and statistics, and have a master’s degree in philosophy, especially in epistemology (which is the science of what we can know, and where we better shut up – as Wittgenstein put it). That all before I studied medicine and finished with board-certification here in the U.S.A. in internal medicine. And I hold a degree in “Natural Medicine.” So, in all likelihood, I do understand the medical and scientific terms I use.
“It shows little or no critical thought and so should be treated with caution!” You might have overlooked my blog that states that homeopathy has no scientific basis – therefore I don’t use it with patients. But I did two courses of homeopathy to make sure I did not throw out a valuable tool unexamined. Then again, barely anybody dies of sugar pills – and here in the U.S.A. (unfortunately, I don’t have British numbers) about 100,000 people die per year of allopathic drugs. Only on your website today I found the information of this anti-malaria homeopathic concoction; that indeed is murderous, and I strongly oppose it.
However, since many ailments heal with time and better lifestyle, homeopathy (which is often combined with compassionate care and good advice for exercise and healthy eating) might be less of a safety problem than conventional medicine. I have practiced medicine for thirty years and have become skeptical of profit-driven, procedure-oriented, drug-dispensing allopathic medicine. But I would never discard good conventional medicine where it is needed and useful: When my son came home from camp with high fever, stiff neck and the worst headache of his life, I did not think for a second that “alternatives” were the answer. I drove him straight to the Emergency Room of a famous Boston Teaching Hospital (where they promptly misdiagnosed his tularemia – but that is another story…). – Appendicitis needs a good surgeon. And one doesn’t treat a heart attack by holding hands. – Guess we agree here.
Also, I am very critical of indiscriminate use of vitamins and other supplements without proven value and without documented deficiencies. You might also have noticed that I don’t sell anything – only my books which is the way to disperse ideas and knowledge). Not even a mug or a t-shirt.
There are bad genes and unfortunate accidents. But apart from that, health is a simple proposition, in my opinion: Eat well, sleep well, move a bit, drink fresh water, get your relationships and priorities right – and automatically, you will be healthier. Common sense, not more. But it is so much easier to pop a pill (allopathic, homeopathic, naturopathic) than do something yourself - that’s probably why my books sell so poorly.
Alexa Fleckenstein M.D.
P.S. I forgot two arguments:
1. Using language as the sole indicator for quackery might not work because – as you somewhere noticed yourself – language is ambiguous.
2. Writing on a rather “quackery” website should not constitute quackery itself – I often just bring arguments which might be enlightening – and lure readers to my blog. Also, if writing on a “quackery” site makes me guilty of quackery – then writing on the “Quackometer” redeems me??
Last thought: Homeopathy fills a void that conventional medicine leaves: Homeopathic practitioners care and listen. If we want to persuade patients with our scientific arguments, we first have to return to caring and listening.
Update 1/2/2011:
They took me off the list, after all!! Read More
Tick Time
May 14, 2010
A few years ago, our son returned from camp with fever, stiff neck and the worst headache of his life. It took me a second to decide that this was NOT a case for natural medicine and to ship him of to the ER immediately.
Well, he was misdiagnosed, initially. I sat at his hospital bed and saw him slip away. But then a good doctor appeared and made the life-saving diagnosis (I would not have known, not even for the life of my son, I was so thinking-impaired): tularemia. A few days of antibiotics, and our son was fine. A scary experience, more for us than for him - because of his delirium, he has nearly all forgotten.
Tularemia is one of several tick-borne diseases - none of them nice – probably the least likely of them, about one hundred cases a year in the United States. Much more common are: Lyme, Ehrlichiosis, Rocky Mountain spotted fever, relapsing fever; babesiosis; meningo-encephalitis and Colorado tick fever.
What to do about ticks? All winter those little creatures have been waiting for us, starved for attention – and our blood.
If you go outdoors, you are exposed. Ticks sit on grasses and bushes, ready to drop on us any time. This is what you can do:
• Have a high suspicion: Check yourself for ticks every evening, on your scalp, in body folds, behind the ears.
• Wear long sleeved gear and tucking in pants into socks helps deter them. Light colors are recommended – not sure because ticks like dark colors or that you can better detect them on light colors.
• Wear natural repellents: Citronella, lemon grass, peppermint oil.
• Eat garlic – not sure it works … but then again, it repels vampires.
• For Lyme disease, a tick has to be lodged into your skin for about twenty-four hours before transmitting disease. For tularemia, alas, just a little nick and a trace of saliva suffices.
• Remove ticks immediately (a little tea tree oil or other essential oils will make them relinquish their feeding place voluntarily).
• Watch for symptoms like rashes, fever, joint pains, stiff neck, headaches, nerve palsies, and go to an ER straight away.
• If put on a antibiotic, take it all to the end - untreated, these diseases can lead to life-long debilitation. If it was me, I would also take some GSE (Grapefruit Seed Extract), just to be on the safe side. Also take a probiotic while on antibiotic to protect your gut.
And no, our son did not get bitten by a tick in camp - it happened before and closer to home, in Concord, MA. Read More