When evidence says no, but doctors say yes

If you might ever need to listen to medical advice, you’ll want to read this 2017 Probublica article: When Evidence Says No, But Doctors Say Yes. The site summarizes it:

Years after research contradicts common practices, patients continue to demand them and doctors continue to deliver. The result is an epidemic of unnecessary and unhelpful treatment.

Go read the whole article. If you ever needed a reason to question before accepting some treatement, surely you will find it here.

The gruesome history of eating corpses as medicine

This tidbit turned up in a blog post at Jason Fung’s site:

A physician’s job has always been to heal the sick and give advice on how to stay healthy. There were medical treatments, to be sure – leeching, purging, and my personal favorite – eating ground up powdered mummies. Yes. You read that correctly. For thousands of years, eating the ground up mummified remains of long-dead embalmed human beings was considered good medicine. That’s what they taught at them ancient medical schools. The demand for powdered mummies was so great that sometimes hucksters would simply grind up dead beggars and plague victims and sell them as mummies.

The history of medicine is the history of the placebo effect. This mummy-eating practice died out in the 16th century was was replaced by other equally useless procedures – such as the lobotomy to cure mental illness. Hey, let me shove this ice pick through your eyeball and mash up parts of your brain like I’m mashing a potato. The inventor of this procedure received the 1949 Nobel Prize for Medicine. This was the cutting edge of medicine circa 1949. Any criticism of this mashed-brain strategy could be legitimately met by “Did YOU win a Nobel Prize, buddy?”

Wow. A search for more information led me to The Gruesome History of Eating Corpses as Medicine at The Smithsonian. An excerpt:

“The question was not, ‘Should you eat human flesh?’ but, ‘What sort of flesh should you eat?’ ” says Sugg. The answer, at first, was Egyptian mummy, which was crumbled into tinctures to stanch internal bleeding. But other parts of the body soon followed. Skull was one common ingredient, taken in powdered form to cure head ailments. Thomas Willis, a 17th-century pioneer of brain science, brewed a drink for apoplexy, or bleeding, that mingled powdered human skull and chocolate. And King Charles II of England sipped “The King’s Drops,” his personal tincture, containing human skull in alcohol. Even the toupee of moss that grew over a buried skull, called Usnea, became a prized additive, its powder believed to cure nosebleeds and possibly epilepsy. Human fat was used to treat the outside of the body. German doctors, for instance, prescribed bandages soaked in it for wounds, and rubbing fat into the skin was considered a remedy for gout. [continue]

Oh my.

A public service announcement on how to get rid of leg cramps

Several years ago, I switched to a low-carb paleo diet. This did me fantastic amounts of good, but there was one problem: leg cramps at night. Sometimes I’d wake several times a night with really, really painful cramps in my calves. I’d have to get up right away, put weight on the affected leg, and even then – oh, the pain!

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Deadly spider venom could ward off stroke brain damage

This could be hugely helpful. From the Guardian: Deadly spider venom could ward off stroke brain damage, say doctors.

Doctors have stumbled on an unlikely source for a drug to ward off brain damage caused by strokes: the venom of one of the deadliest spiders in the world.

A bite from an Australian funnel web spider can kill a human in 15 minutes, but a harmless ingredient found in the venom can protect brain cells from being destroyed by a stroke, even when given hours after the event, scientists say.

If the compound fares well in human trials, it could become the first drug that doctors have to protect against the devastating loss of neurons that strokes can cause. [continue]

Thanks to Khurram Wadee for posting a link to this article on Diaspora. That’s how I found it.

An exaltation of links!

I’ve come across dozens of interesting things to share with you lately, but I’ve also been quite short of time. So here are a whole bunch of things I think you’ll like, all at once, for your weekend reading pleasure.

I’ve thought of doing this for a while now: occasional posts full of linky goodness. But a pleasing name for such postings failed to suggest itself to me, and so I was thwarted. This morning, though, the name arrived in my brain. This is An Exaltation of Links. Because why should the larks have all the fun?

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Do we need predators to prevent Lyme disease?

From the New York Times: A Natural Cure for Lyme Disease.

If humans have inadvertently increased the chances of contracting Lyme disease, the good news is that there’s a potential fix: allow large predators, particularly wolves and cougars, to return.

They would help keep down the number of deer, which, although they don’t carry the Lyme-causing bacterium, probably encourage its transmission. [continue]

If you missed it a couple of weeks ago, take a detour over to the how wolves change rivers thing I pointed out. The four-minute video is stunning.

(Link to the NTY article found here at Microfishing.)

Can tilapia skin be used to bandage burns?

From statnews.com: Can tilapia skin be used to bandage burns?

FORTALEZA, Brazil — In this historic city by the sea in northeast Brazil, burn patients look as if they’ve emerged from the waves. They are covered in fish skin — specifically strips of sterilized tilapia.

Doctors here are testing the skin of the popular fish as a bandage for second- and third-degree burns. The innovation arose from an unmet need. Animal skin has long been used in the treatment of burns in developed countries. But Brazil lacks the human skin, pig skin, and artificial alternatives that are widely available in the US. (…)

Enter the humble tilapia, a fish that’s widely farmed in Brazil and whose skin, until now, was considered trash. Unlike the gauze bandages, the sterilized tilapia skin goes on and stays on. [continue]

Nature neuroscience

Every day I set out for the forest with my dog. I’ll admit that I am often vexed or grumpy when we enter the woods, having dealt with hours of computer frustration or human stupidity. But somehow, the forest fixes it all. If I walk long enough, my world is set right, and I wonder why I do anything but walk in the woods.

So this NYT article caught my attention: Get Out of Here: Scientists Examine the Benefits of Forests, Birdsong and Running Water.

Imagine a miracle drug that could ease many of the stresses of modern life — a combination mood enhancer and smart pill that might even encourage the remission of cancer. Now imagine that this cure-all was an old-fashioned folk remedy: Just take a hike in the woods or a walk in the park. No prescription necessary.

That’s the proposition of Florence Williams’s fascinating “The Nature Fix: Why Nature Makes Us Happier, Healthier, and More Creative.” We suffer from an “epidemic dislocation from the outdoors,” Williams writes, and it’s destructive to our mental and physical health. The therapy is straightforward. “The more nature, the better you feel.” (…)

It’s all very encouraging, but how exactly does nature have such an effect on people? To answer that question, Williams shadows researchers on three continents who are working on the frontiers of nature neuroscience. [continue]

When evidence says no, but doctors say yes

Here’s the article summary: “Years after research contradicts common practices, patients continue to demand them and doctors continue to deliver. The result is an epidemic of unnecessary and unhelpful treatment.”

And now an excerpt:

A cardiologist recommended that the man immediately have a coronary angiogram, in which a catheter is threaded into an artery to the heart and injects a dye that then shows up on special x-rays that look for blockages. If the test found a blockage, the cardiologist advised, the executive should get a stent, a metal tube that slips into the artery and forces it open.

While he was waiting in the emergency department, the executive took out his phone and searched “treatment of coronary artery disease.” He immediately found information from medical journals that said medications, like aspirin and blood-pressure-lowering drugs, should be the first line of treatment. The man was an unusually self-possessed patient, so he asked the cardiologist about what he had found. The cardiologist was dismissive and told the man to “do more research.” Unsatisfied, the man declined to have the angiogram and consulted his primary-care doctor. [continue]

That’s from When evidence says no, but doctors say yes at propublica.org.

If you weren’t already the sort of person to do your own research before consenting to a medical procedure, perhaps you are now.

Senator Larry Campbell vows push to legalize opioids

From The Tyee: Senator Larry Campbell Vows Push to Legalize Opioids.

The former Vancouver mayor who oversaw the installation of the city’s first open safe injection site says he intends to push for the legalization of opioids, even if it means introducing the legislation himself. (…)

Campbell is a proponent of the so-called “Four Pillars” initiative, which advocates balancing harm reduction, prevention, treatment, and enforcement to help ease Vancouver’s addiction troubles.

But although Metro Vancouver could use more safe injection sites, Campbell said Canada must go further to tackle its opioid problem as the fentanyl crisis spreads across the country.

“I’m beyond that now,” Campbell said of injection sites, which he said keep people alive but don’t address the underlying causes of addiction. “We should be actually supplying opioids to addicts within facilities.” [continue]

This makes so much sense.

Maybe moderate drinking isn’t so good for you after all

From The Conversation: Maybe moderate drinking isn’t so good for you after all.

We generally assume moderate drinking (two standard drinks per day) is good for our health.

This idea comes from studies over the past three decades showing moderate drinkers are healthier and less likely to die prematurely than those who drink more, less, or don’t drink at all.

I would be glad if this were true.

But our latest research challenges this view. We found while moderate drinkers are healthier than relatively heavy drinkers or non-drinkers, they are also wealthier. When we control for the influence of wealth, then alcohol’s apparent health benefit is much reduced in women aged 50 years or older, and disappears completely in men of similar age. [continue]

David’s Fajgenbaum’s medical mystery

I like medical mysteries, so this is exactly my kind of article. From the New York Times: His Doctors Were Stumped. Then He Took Over.

David Fajgenbaum was the fittest of his friends at the University of Pennsylvania’s medical school, a 6-foot-3 gym addict and former quarterback at Georgetown. His mammoth hands seemed more suited to spiraling footballs than the fine fingerwork a doctor-in-training might need. He had endurance to match, taking multiple hits and returning to the field to play on.

“This guy was a physical specimen,” said his former roommate, Grant Mitchell, who used to walk to work with him. When they would arrive at the hospital for his obstetrics rotation, his friend recalled, “he would basically coerce me into doing pull-ups on the tree outside.”

In July 2010, that all changed. The 25-year-old woke up at night drenched in sweat. His lymph nodes were swollen. He felt stabs of abdominal pain, and odd red bumps began sprouting across his chest. Most bizarre of all, he felt very tired — so tired that he began slipping into empty exam rooms between patients, stealing five-minute naps to get through the day.

“Guys, I think I’m dying,” he recalled telling his friends.

A visit to the emergency room confirmed his fears. A doctor told him that his liver, kidneys and bone marrow were not working properly. Even more troubling, the doctor had no idea why his body was failing. “What do you think is going on?” he remembers the doctor asking him. [continue]

Is sugar the world’s most popular drug?

Have you come across any of Gary Taubes’ writing? If you’ve got the slightest interest in nutrition, history, and health, he is worth your attention. Here’s a recent article of his from the Guardian: Is sugar the world’s most popular drug?

Imagine a drug that can intoxicate us, can infuse us with energy and can be taken by mouth. It doesn’t have to be injected, smoked, or snorted for us to experience its sublime and soothing effects. Imagine that it mixes well with virtually every food and particularly liquids, and that when given to infants it provokes a feeling of pleasure so profound and intense that its pursuit becomes a driving force throughout their lives.

Could the taste of sugar on the tongue be a kind of intoxication? What about the possibility that sugar itself is an intoxicant, a drug? Overconsumption of this drug may have long-term side-effects, but there are none in the short term – no staggering or dizziness, no slurring of speech, no passing out or drifting away, no heart palpitations or respiratory distress. When it is given to children, its effects may be only more extreme variations on the apparently natural emotional rollercoaster of childhood, from the initial intoxication to the tantrums and whining of what may or may not be withdrawal a few hours later. More than anything, it makes children happy, at least for the period during which they’re consuming it. It calms their distress, eases their pain, focuses their attention and leaves them excited and full of joy until the dose wears off. The only downside is that children will come to expect another dose, perhaps to demand it, on a regular basis. [continue]

For more of Taubes’ writing, see the links he provides to his works.

Do endurance sports cause heart damage?

I read a lot about cardiac problems, and keep coming across articles like this one from velonews.com: Cycling to extremes: Heart health and endurance sports. It asks “Are endurance athletes hurting their hearts by repeatedly pushing beyond what is normal?”

And yeah, it kind of looks as though they are.

Stories abound that undermine the notion that elite athletes are healthy. From the running world, marathoner Alberto Salazar, at the age of 48, suffered a heart attack and lay dead for 14 minutes before a cardiologist placed a stent in a blocked artery, saving his life. Micah True, the ultra-marathoner and protagonist of the bestselling book Born to Run, went for a 12-mile run in the New Mexico wilderness and was later found dead.

Of course, these tragic tales are preceded by the origin story of an endurance athlete running himself, literally, to death. An enlarged, thickened heart with patchy scar tissue is common in long-term endurance athletes and is dubbed “Pheidippides cardiomyopathy” after the 40-year-old running messenger (and prototypical masters endurance athlete) who died after bringing the news of Greek victory at the battle of Marathon to Athens. Pheidippides was a hemerodrome, (an all-day running courier in Ancient Greece), and he had run 240km over two days to request help from Sparta against the Persians at Marathon, before expiring after running the additional 42km (26.2 miles) back from the battlefield. We celebrate his death by running marathons.

These deaths are even more alarming when you consider the subjects — highly trained athletes in what many would consider peak physical condition. Isn’t exercise supposed to prevent us from falling to a heart attack? [read the whole article]

If you’re an endurance athlete, does this give you pause for thought?

A one-minute workout?

From Science Daily: No time to get fit? Think again.

Researchers at McMaster University have found that a single minute of very intense exercise produces health benefits similar to longer, traditional endurance training.

The findings put to rest the common excuse for not getting in shape: there is not enough time.

“This is a very time-efficient workout strategy,” says Martin Gibala, a professor of kinesiology at McMaster and lead author on the study. “Brief bursts of intense exercise are remarkably effective.” [continue]

The sugar conspiracy

Today the BBC published an article that is awesome on so many levels. It is The sugar conspiracy. The summary:

In 1972, a British scientist sounded the alarm that sugar – and not fat – was the greatest danger to our health. But his findings were ridiculed and his reputation ruined. How did the world’s top nutrition scientists get it so wrong for so long?

And indeed, how did they?

If you care about health, science, and whether the nutrition advice you’ve tried to follow is nonsense or not, this is worth your time.

What happens to the carbs?

Health. Diabetes. Pre-diabetes. Diabetes and the link to heart disease. How the body processes carbs. What causes people to get fat, anyway? If any of this interests you, you’ll want to read blogs like the one Dr Malcolm Kendrick writes. His latest post is What happens to the carbs – part II. It begins:

My interest in nutrition began many years ago as part of my over-riding interest in cardiovascular disease. This means that, unlike many other people, I backed into this area with no great interest in the effect of food on health. For most doctors nutrition takes up about an hour of the medical degree course. We are pretty much given to understand that it is of little medical significance. Eat a balanced diet…end of. I also paid nutrition about that much heed.

However, because of the power and influence of the diet/heart hypothesis I felt the need to understand more about this whole area, and how the system of digestion and metabolism actually worked. At first my interest was purely to find out if there was any clear and consistent association between diet and cardiovascular disease (which I shall call heart disease from now on, as it is simplest to do so).

Like many others, before and since, I could not find any such association. Nor could I find any biochemical or physiological reason why saturated fat, in particular, could cause heart disease. That issue, of course, represents a long and winding road that I am not going down here.

However it did not take long before I became side tracked by the very powerful and consistent association between heart disease and diabetes. People with diabetes have far higher rates of heart disease than people who do not. In the case of women with diabetes, the increase in risk hovers around five times the rate of non-diabetics. So it became clear that I would need to understand diabetes, if I was going to fully understand heart disease. [continue]

The Victorian anti-vaccination movement

From The Atlantic: The Victorian Anti-Vaccination Movement.

The dewy chill over Leicester, England, in March 1885 did not deter thousands of protesters from gathering outside nearby York Castle to protest the imprisonment of seven activists. Organizers claimed as many as 100,000 people attended, although historians estimate it was closer to 20,000.

The cause they rallied against? Vaccination.

This movement has faded from popular memory, obscured by the controversy of more recent anti-vaccination efforts, which gained momentum in the 1990s. However, the effects of the Victorian anti-vaccination movement still echo in the debate over the personal belief exemption, which was banned in California in June.

On the day the Leicester protesters gathered, vaccination was mandatory in England. Nearly a century before, Edward Jenner, a Scottish physician, had invented a method of protecting people against the raging threat of smallpox. The treatment was called variolation, and it involved [continue]

Running on empty

There’s a good article on Over-Training Syndrome (OTS) at Outside Online: Running on Empty.

OTS is one of the scariest things I’ve ever seen in my 30 plus years of working with athletes,” says David Nieman, former vice president of the American College of Sports Medicine. “To watch someone go from that degree of proficiency to a shell of their former self is unbelievably painful and frustrating.”

Nieman, a professor of health and exercise science at Appalachian State University in North Carolina, has spent his career studying the effects of training on the immune system. In 1992, he received the first of a dozen distressingly similar letters from endurance athletes, each of them describing a sudden loss of ability as they struggled with everything from anemia to chronic dehydration to a basic inability to get out of bed. Nieman was both troubled and fascinated by these tales. Their symptoms all seemed to point to overtraining syndrome, and he’s been looking into the root causes of the condition ever since. [continue]

Lost posture: Why some indigenous cultures may not have back pain

From NPR: Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain.

Believe it or not, there are a few cultures in the world where back pain hardly exists. One indigenous tribe in central India reported essentially none. And the discs in their backs showed little signs of degeneration as people aged.

An acupuncturist in Palo Alto, Calif., thinks she has figured out why. She has traveled around the world studying cultures with low rates of back pain — how they stand, sit and walk. Now she’s sharing their secrets with back pain sufferers across the U.S.

About two decades ago, Esther Gokhale started to struggle with her own back after she had her first child. “I had excruciating pain. I couldn’t sleep at night,” she says. “I was walking around the block every two hours. I was just crippled.” [continue]

She’s sure not crippled anymore. Now Esther teaches other people what she learned. Go look her up on Youtube if you’d like to see what she teaches.

A few years ago I stumbled upon Esther Gokhale’s book, 8 Steps to a Pain-Free Back. Worth every penny. Esther’s book taught me things I didn’t know about posture and lifting. I was captivated by her story.

I follow Esther’s advice. It’s not the only thing I do for my back, but it’s an important part of being supple and pain-free.

How a history of eating human brains protected this tribe from brain disease

From The Washington Post: How a history of eating human brains protected this tribe from brain disease.

The sickness spread at funerals.

The Fore people, a once-isolated tribe in eastern Papua New Guinea, had a long-standing tradition of mortuary feasts — eating the dead from their own community at funerals. Men consumed the flesh of their deceased relatives, while women and children ate the brain. It was an expression of respect for the lost loved ones, but the practice wreaked havoc on the communities they left behind. That’s because a deadly molecule that lives in brains was spreading to the women who ate them, causing a horrible degenerative illness called “kuru” that at one point killed 2 percent of the population each year.

The practice was outlawed in the 1950s, and the kuru epidemic began to recede. But in its wake it left a curious and irreversible mark on the Fore, one that has implications far beyond Papua New Guinea: After years of eating brains, some Fore have developed a genetic resistance to the molecule that causes several fatal brain diseases, including kuru, mad cow disease and some cases of dementia.

Ancient DNA reveals how Europeans developed light skin and lactose tolerance

From The Conversation: Ancient DNA reveals how Europeans developed light skin and lactose tolerance.

Food intolerance is often dismissed as a modern invention and a “first-world problem”. However, a study analysing the genomes of 101 Bronze-Age Eurasians reveals that around 90% were lactose intolerant.

The research also sheds light on how modern Europeans came to look the way they do – and that these various traits may originate in different ancient populations. Blue eyes, it suggests, could come from hunter gatherers in Mesolithic Europe (10,000 to 5,000 BC), while other characteristics arrived later with newcomers from the East. [continue]

Compensating for a missing chunk of brain

From The Atlantic: Compensating for the Missing Chunk of My Brain.

“Do me a favor and don’t wear any eye makeup when you come in,” I recall the receptionist having requested over the phone. “It messes with the goggles.”

Instead of saying, “Goggles?” as I was thinking, I said, “Eye makeup?”

“Mascara, eye shadow, eyeliner,” the receptionist said.

“Sure.”

I’d been to this functional neurology center in a suburb of Portland, Oregon, several times since 2007, when I was diagnosed with having a puddle of cerebral-spinal fluid—the water that your brain floats in—about the size of a lemon where my right parietal lobe would be. The parietal lobe is the part of the brain responsible for judging time, space, distance, and the location of the body, among other tasks. I was diagnosed only a couple of months before leaving for grad school in Southern California; I had been hoping to get to the bottom of why learning to drive had proven impossible for me. [continue]

Link found between brain and immune system

From Science Dailiy: Missing link found between brain, immune system; major disease implications.

In a stunning discovery that overturns decades of textbook teaching, researchers at the University of Virginia School of Medicine have determined that the brain is directly connected to the immune system by vessels previously thought not to exist. That such vessels could have escaped detection when the lymphatic system has been so thoroughly mapped throughout the body is surprising on its own, but the true significance of the discovery lies in the effects it could have on the study and treatment of neurological diseases ranging from autism to Alzheimer’s disease to multiple sclerosis. [continue]

WOW, just …. wow. Suddenly all my anatomy textbooks are out of date!

Why hardly anyone dies from a drug overdose in Portugal

From the Washington Post: Why hardly anyone dies from a drug overdose in Portugal.

Portugal decriminalized the use of all drugs in 2001. Weed, cocaine, heroin, you name it — Portugal decided to treat possession and use of small quantities of these drugs as a public health issue, not a criminal one. The drugs were still illegal, of course. But now getting caught with them meant a small fine and maybe a referral to a treatment program — not jail time and a criminal record. (…)

The prevalence of past-year and past-month drug use among young adults has fallen since 2001, according to statistics compiled by the Transform Drug Policy Foundation, which advocates on behalf of ending the war on drugs. Overall adult use is down slightly too. And new HIV cases among drug users are way down. [continue]

This is great news for Portugal, but it makes me feel so frustrated about our approach to drug use in Canada. I’d like to be in charge long enough to change a few laws, and to make narcan available to paramedics and members of the general public. I think that would save a lot of lives.