The Cow Has No Legs

November 27, 2009 at 8:25 am (Cancer, Critical Thinking, Current Events, Nutrition, Vegan & Vegetarianism)
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Many people, of course, prefer food in what the vegetarians call ’the secondhand form’, i.e. after it has been digested and converted into meat for us by domestic animals kept for this purpose. In all these processes, however, ninety-nine parts of the solar energy are wasted for every part used. We shall escape the absurdity of growing a whole chicken in order to eat the breast or wing, by growing these parts separately under a suitable medium.”

Winston Churchill, 1931

“Fifty Years Hence“

Strand Magazine

Know what you call a cow with no legs?  Ground beef.  Know what you call beef with no cow?  Me neither.  But Winston Churchill once opined that it would be possible to grow meat without needing to tend to an actual animal.  This sci-fi concept of Jurassic Park meets Transmetropolitan meets Soylent Green is showing the vat cloning of livestock becoming a reality.   Scientists are growing nuggets of meat in laboratories without the ongoing use of animals.  In vitro meat production is a specialized form of tissue engineering, a biomedical practice in which scientists try to grow animal tissues like bone, skin, kidneys and hearts. Proponents say it will ultimately be a more efficient way to make animal meat, which would reduce the carbon footprint of meat products.  Much of the newest technology was presented at the Norwegian In Vitro Meat Symposium (motto: “Tastes Like Chicken!”).

This process seemingly solves many of the problems with a meat-eating world.  Contamination issues could be nearly eliminated.  Environmental issues such as the wasting of land, greenhouse gasses and water concerns raised by factory farming would be a thing of the past. And the problems of animal cruelty and barbaric slaughter processes would be non-existant in the laboratory kitchens.  Once the animal has been cloned, there really is no further suffering at the cost of producing the meat.  It’s like the joke about the lady in the supermarket’s meat section who couldn’t find the larger turkeys.  She asks the young clerk: 

“Sonny, do these turkeys get any bigger?”

“No, Ma’am.  They’re dead.”

Dead is dead and the damage has been done.  For PETA, not killing animals is good enough.  They have offered $1 million to the first people who produce an in vitro chicken-meat product that has a taste and texture indistinguishable from real chicken flesh to non-meat-eaters and meat-eaters alike.   And to the animals, not killing them is the good part.   But therein lies the (dry?) rub.  The reduction of our planet’s suffering and that of her animals are not really the only problems at hand.  The damage to humans from cloned, lab produced meat probably doesn’t occur until the meat is eaten.  In case you’ve forgotten, the evidence is very strong that eating animal protein causes cancer.  Like an on/off switch.  Eat enough of it…you are many times more likely to develop cancer.  Eat very little or none of it, you markedly reduce your likelihood of developing many cancers and heart disease.

Whether the animal product is from a test tube or gnawed off the animal itself, I do not think this fact will change. Cloned meat will probably prove to be just as unhealthy, just as dangerous and just as carcinogenic as farmed meat albeit a bit nicer to the donor.  Which makes it a slightly better idea than picking up packages of dead animal flesh from your friendly neighborhood grocer as long as you don’t plan to eat it.

Dr. Brett Kinsler writes for RochesterChiro.wordpress.com and doesn’t think lab meat sounds tasty at all.

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Don’t Confuse Me With the Facts

November 21, 2009 at 2:31 pm (Nutrition, Patient Information, Vegan & Vegetarianism)
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Food labeling cartoonAs chiropractors, we often get asked about diet and lifestyle in addition to the usual neck and back pain complaints.  In the current word-of-mouse era we live in, patients have access to an unprecedented amount of information only a click away.  Most have done their own research before they bring the subject up in our office.  Sometimes this is helpful.  Other times, it has only served to confuse them.  Some patients choose to follow each and every bit of nutritional news which only serves to drive them crazy.  Today, eggs are bad but coffee is good for you.   Yesterday it sounded like coffee was the Devil’s drink but eggs were the perfect nutritional powerhouse.

So what are they looking for from us?  Google “diabetes”  or “heart disease” and you will get well over ten million hits.  Most likely, after the cereal, shake and snack bar Googlemercials, the next few links will be to popular sources like WebMD.  These have their place but they are supported largely by pharmaceutical ad revenue.  Even if patients found their way to Medline (a source for medical journals) the average person is not used to reading technical and often seemingly contradictory research studies.

What patients are looking for is a way to look out at the endless sea of information and fish out from it the most relevant facts to their own situation.  This should be the role of their health care provider — to assist in this process.  Yet, in many cases, the information from the health care provider does not help in a positive way.

 The cycle goes something like this:

  • patient gets diagnosis (or is told to “lose a few”)
  • patient finds the latest “diet” and follows it
  • patient loses a couple pounds then hits a plateau
  • patient gets frustrated and goes back to old habits
  • this becomes another “diet” that they tried that didn’t work. 

Any diet can work, especially in the short term.  The problem is most are unhealthy and are being used as a temporary fix.  Even diets like the South Beach Diet, which is very effective at weight loss in the beginning, is not an effective long term plan for health when taking into account factors like cancer and heart disease due to too much reliance upon animal protein and complicated “what you can eat when” charts.

Nutritional science can be very technical and complex.  Even if you make it a full time endeavor, keeping up on all the latest research is nearly impossible.  What is a person to do?  First, forget about the current politics of food.  Using only common sense, imagine what a healthy, nutritional meal might look like.  Chances are you imagined a plateful of vegetables.  Maybe there was some meat or fish on the side but the bulk of the plate was filled with plant foods.  Well, let’s start there.  Make your meals (and snacks) look like that imagined ideal meal.  Dramatically reduce (or eliminate if you can) the size of the animal protein (meat, fish, dairy) you have on the plate.  Push it off to the side and fill the rest of the space with several different plant foods.  Add a heap of brown rice or a plain baked or sweet potato.  Then add sauteed spinach, roast carrots, steamed broccoli and/or peas.  See what you did there?  Without even going to night school to get your Masters in Clinical Nutrition, you just put together a perfectly healthy meal.  Just make sure the vast majority of stuff on your plate is unprocessed and plant based.  Still hungry?  Try some whole grain bread with your meal and some fruit for dessert.  Getting started really is that simple.

Dr. Michalene Elliott is a chiropractor in Rochester, NY who has gotten started.

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Rethinking Cancer Screening

November 17, 2009 at 4:46 pm (Cancer, Critical Thinking, Current Events, Screening)
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Mark Twain sent a note to the New York Journal in 1897 responding to a story error in which the illness of Mark Twain’s cousin was incorrectly reported as Twain’s death. Twain told the Journal: “The reports of my death are greatly exaggerated.”

Dr. Otis Brawley, chief medical officer of the American Cancer Society told the New York Times on October 21, 2009, “We don’t want people to panic, but I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”  In other words, the reports of the benefits of screening have been greatly exaggerated.

The recommendations for mammograms and prostate cancer screening have been off target and set against what the evidence suggested for decades.   An article in the October 21, 2009 issue of Journal of the American Medical Association, titled “Rethinking Screening for Breast Cancer and Prostate Cancer”, says so.  Millions of patients have been damaged by the universal and overly enthusiastic recommendations of early detection programs and screenings.   Oops.  The American Cancer Society’s sorry.  Their bad.  Buy you a drink? 

Enough good scientific evidence to stop these screening programs has been readily available for more than 30 years.  In 1976 Pietro M. Gullino presented his findings on the natural history of cancer, showing early detection is really late detection.  Many other researchers have stated that mammography, breast self-examination, PSA and digital rectal exam are really late detection methods and cannot be expected to save lives by catching cancer before it spreads. By the time these methods “catch” a tumor, the likelihood is that it has already metastasized. 

Sadly, as in so many other fields, there is no money to be made in telling the truth and more than $20 billion is spent annually on screening for breast and prostate cancer.  And while the press may have you believing that there has been a massive breakthrough in the literature leading to the guideline changes, the truth is that the evidence has not changed — only now, more people are willing to tell the truth and give up their chunk of the $20 billion screening pie and hundreds of billions more for the tests and treatments that follow.

And Dr. Brawley (chief medical officer of the American Cancer Society) has “never had a PSA and I do not desire one.” He compares prostate screening to the Tuskegee Experiment—research on the natural progression of untreated syphilis performed on black male patients between 1932 and 1972. This study caused serious mistrust by the black community toward public health efforts in the United States, the ripples of which continue to be evident in some areas today.   Ironically, black males are heavily targeted for prostate cancer screening and treatments.  Brawley has further noted that he is aware of twenty-three different organizations of experts in screening around the world who have considered the question and all have chosen not to make the blanket statement that screening saves lives and men should be screened. Most actually recommend men not get the test because it is not proven effective.

So when the United States Preventive Services Task Force (USPSTF) announced changing its guidelines for mammography and no longer recommending routine screening for women between the ages of 40 and 49 Brawley seems to have changed his tune somewhat. “The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. When recommendations are based on judgments about the balance of risks and benefits, reasonable experts can look at the same data and reach different conclusions.” Okidokie, spin doctor.  Interesting how his views change once he is on the payroll for the ACS (his anti-screening opinions were published when he was at the NCI).

The benefits of screening and early detection are theoretically possible for prostate and breast cancer.  But as of yet, these benefits are unknown.  What is known are the risks and harms of screening and the resultant unnecessary treatment for millions that lead to morbidity, mortality, breast mutilation or loss of sexual function.

So the ACS is sorry they have mislead you.  I’m sure they promise never to do it again.  In fact, given the extremely strong evidence linking the consumption of animal protein to cancer, the ACS clearly states that people should, “limit intake of processed and red meats”.  Wow!  Strong words, there.  Limit intake?  Whoa.  Let me process that for a while.  Oh, and we are suggested to ”choose fish or poultry”.  Right, because they’re plants, right?  “When you eat meat, choose lean cuts.” 

This is a very interesting strategy on the part of the American Cancer Society.  They are already preparing us for the next big apology.  See, in another 15 or 20 years, they are going to report on the evidence which we already know today.  Animal protein increases cancer rates.  They’re so sorry.  Really. They should have told you that sooner, too.  Buy you a drink?

- BLK

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Could Your PCP Pick You Out Of A Line Up?

November 10, 2009 at 4:44 pm (Communication, Critical Thinking, Current Events, Managed Care, Medical Ethics, Patient Information, health insurance)
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DocBaker

I doubt mine could.  Which makes me think about Little House on the Prairie.  Anyone around in the 1970s remembers idyllic Walnut Grove, where Doc Baker took care of everyone and their pets.  He gave advice, dispensed medicines and sent the tough cases to Mancato (the big city).  People ran into him at the general store and he promised to stop on by the next time he was out their way.  To our modern ears, it sounds very quaint until you realize that this is the model of health care that we aspire to and were supposed to get with the onset of HMOs.  Under that model, we were each supposed to have a PCP who would monitor our health, give us lifestyle advice and send us to a specialist if any red flags showed up.  This would be the ‘gatekeeper’ (insurance term) that would be familiar enough with our health history that his or her decision would be one based on a long view of our individual health status.  Unfortunately, this model was managed to death by efficiency experts until it is neither efficient or effective.  The political choices we have before us continue this trend. Until we as patients demand better, the push will be for PCPs to do more with less.  In a recent poll (Investors Daily)  45 % of primary care physicians will consider quitting medicine if the government takes over the health care system.  That is approximately 360,000 doctors that will consider quitting practice.  Clearly, doctors are as frustrated as their patients.  Health care reform, to make any meaningful changes needs to redefine the role of doctor and patient.  The most efficient role the doctor can play is health coach in a proactive way.  That can’t be done in 5-10 minutes once a year. Or with a quick blood test.  Patients that are empowered by their relationship with their doctor will make the most beneficial (and coincidentally, the most cost-effective) changes to their own health.  In that climate, there will be less of a role for bean counters and government pencil pushers.  Let’s not give up the idea of Doc Baker too quickly. 

Dr. Michalene Elliott is a chiropractor in Rochester, NY who doesn’t want to be managed anymore.

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What’d Ya Say? Divided By a Common Language.

October 27, 2009 at 4:13 pm (Chiropractors & Chiropractic, Communication, Critical Thinking, Evidence Based Medicine, Patient Information)
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applesoranges

The importance of using common language when communicating about back pain has been well documented in the medical literature. There are three main areas that lead to difficulties in communication about back pain:

  • patients seeking information from health care professionals can experience difficulties understanding them and the medical literature
  • misunderstandings among health professionals concerning terminology can arise
  • lack of standardized definitions for back pain terms can make comparison of research studies problematic

A study just published in the BMC Musculoskeletal Disorders aimed to explore the meanings and issues surrounding the use of existing medical terms for back pain from the perspective of health care professionals and lay people. Focus groups were used to explore participants’ understanding and samples included general practitioners, chiropractors, osteopaths, physiotherapists, and lay people.

Lay participants understood the majority of the terms explored in the group differently than the health professionals. Some terms were not understood, some misconstrued and some had inadvertent negative connotations or implications. (For example “wear and tear” instead of the harsher term “degeneration” gave implications of wearing away or rotting).   The commonness of misunderstandings, unintended meanings and negative emotional responses to terms used in this study have a number of implications.

Firstly, it must encourage providers to ensure their patients understand what has been explained to them including the contextual and emotional implications. Secondly, patients and providers should have an ongoing dialogue to promote understanding of terms and comminality of language.  Third, this study should be used as a lesson to chiropractors who cling to old, antiquated terminology that we know has differing meanings both intra- and interprofessionally. If other chiropractors cannot agree on a term’s meaning, and other professions cannot agree on that term’s meaning, you can sure as heck bet that your patients have no idea what you are taking about either.

I was recently told that we should take antiquated terms and reframe them so we can continue using them in a different context. To me, this study implies that is not a wise course of action.

 

Brett L. Kinsler, DC is a chiropractor in Rochester, NY who avoids using antiquated terms when he blogs at www.RochesterChiro.wordpress.com

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The Autism Panic!

October 15, 2009 at 8:46 pm (Autism, Evidence Based Medicine, Vaccination)
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panicThe sky is falling!  The sky is falling!

Wait, what?

Oh, sorry. 

The sky is rising! The sky is rising!

Wait, sorry.  What now?

Oh, okay. 

The autism rates are rising!  The autism rates are rising!

Alright kids, let’s go over this again.  Autism rates, really the autism spectrum disorder (ASD) rates, are on the increase.  You’ve heard the new 1 in 100 number quoted, right?  I’m not saying that’s inaccurate.  It’s just that there is no real increase represented.  How can that be? Clearly something (or someone) must be to blame for this terrible condition.  Who can we hang?  Quick, after them!

There were two recent studies concerning the prevalence of autism in the US that have attracted a lot of attention.  One study conducted by the CDC (not yet published) reports that the new prevalence of autism spectrum disorder (ASD) is now estimated at 1% or 100 in 10,000 children. This is an increase over the last few years. In 2002 the prevalence was estimated to be 66 per 10,000 (0.66%).

The second study published in the journal Pediatrics was a telephone survey of parents where they asked if they had any children who had ever been diagnosed with an ASD.  This non-clinician scored study estimated ASD point-prevalence at 110 per 10,000.  These are slightly higher numbers than the CDC data but that is to be expected, since diagnoses from the phone survey were not confirmed by a doctor.

There is no argument that the number of ASD diagnoses has been steadily increasing for the last 20 years. The real question is whether or not the increase is  a true increase in the disorder or an artifact of increased surveillance and an expanded diagnosis.  Without a doubt, the evidence strongly supports the conclusion that the increasing autism prevalence is due to increased efforts to make the diagnosis and a broadening of the definition of autism. The evidence is not sufficient to conclude that there is not also a real increase in ASD incidence, but nor is there data to support this conclusion.

Recently, more data have come out of the National Health Service (UK) that looked at a very interesting statistic.  They looked a the prevalence of ASD in adults.  See, if there is a true rise in autism, the adult population should have a lower number of cases than the current children.  Guess what?  1% across the board.  Kids and grown-ups.  Oops.  Sorry conspiracy theorists, move it along…nothing to see here. 

What can be concluded is that 1% is likely close to the true prevalence of ASD in the population.  And, the strong evidence points to the lack of an increase ASD rates.  Let’s continue to use good science to get to the bottom of ASD and not sheer panic and anti-vaccination finger pointing.

 

Dr. Brett L. Kinsler is a chiropractor in Rochester, NY who blogs at www.RochesterChiro.wordpress.com

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Quantum Light Weaving

October 7, 2009 at 7:39 am (Alternative Medicine, Evidence Based Medicine)
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quantumhealing

“Tell me, Doctor, what do you think of Quantum Light Weaving?” my patient recently asked me.

“What do I think of what now?”

“Quantum Light Weaving.”

“You’re putting me on, right?”  My patients know I will usually express my opinion on most things that are wacky and some of them try to get me to take their bait.

“No, it’s a real treatment.  I saw it when I was in California.”

“You’re setting me up for a blog post, right?”

“I have no idea what you’re talking about.  Have you heard of it?”

Well, to be honest, I hadn’t heard of it.  I was almost certain it was something made up and silly.  Light weaving?  Really, now?  I have a friend who was a pretty serious weaver for a while.  I was nearly certain she used wool and fabrics.  Very, very rarely would she weave pure energy or electrons.  Nope, something didn’t smell quite right.  I promised to investigate and get back to this sweet young patient with an opinion.

I performed my usual deep level of research which can be partly reproduced for you by clicking this link.  I learned some amazing facts — and by “amazing” I mean “silly” and by “facts” I also mean “silly.” Quantum Lightweaving is, according to the experts (“salespeople”) ”an evolving and ever-expanding body of work that is bringing forth new aspects of spiritual work that embodies The Christos energy from the heart of Creation itself. The vibration is brought forth to this earth and Galaxy through The Council of 14 and your personal healing and support team of masters and angels.”

Okidokie then.  We’re got ancient Christian and presumably Last Supper stuff mixed with galaxy energy and personal support teams of masters and angels.  Hell, I can’t even put together a team that includes a decent plumber, how am I going to get an angel on such short notice?

Have no fear!  Your personal guide is Kenji who teaches you “how to be a miracle man, miracle woman, miracle kid and miracle pet.”  Miracle pet, huh?  Whoa.  Deep, dude.  And for only $25 to $50 there is an assortment of attunements you can download right to your computer.  You can even use your mystical Paypal account!  Let the miracles begin!

Well it all makes sense when you learn that “when we align through the meditative state, or “hook-up,” miracles beyond time and space and distance can occur in the twinkling of an eye.”  Wait…hook-up?  Do they really use “hook-up” to describe a state of being?  How is your hook-upedness today?  I am attempting to achieve the 9th level of hookopcity. Can I hook up my angels to my masters?  Do I need a special adapter? Will that create a miracle pet?  Will my miracle pet still puke on the carpet?

“Lightweaving affects all 144,000 dimensions of your being, or the 12 major levels of your embodiment.”  Awesome.  Lately, I have only sensed like 120,000 dimensions but I thought it was just the weather.  I feel enlightened.  I feel empowered.  I have seen the quantum light show and now know the true answer.  Quantum Lightweaving is…just…another magical way to separate people from their money.

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Health Insurance Crisis? Solved.

September 24, 2009 at 12:40 pm (health insurance)
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cone

Don’t panic.  I may have done it.  Yes, your friendly chiroblogger may have accidently solved the national healthcare crisis.  I found an existing health insurance company that provides comprehensive health coverage for under $40 per month.  And this isn’t just some catastophic Roadrunner gets smushed by a falling safe and winds up in traction kind of coverage.  This is really good.  Really, really good.  Just look at these benefits:

Illness – Covered
Injuries & accidents – Covered
Hospitalization – Covered
Surgery – Covered
Hereditary conditions – Covered
Diagnostics – Covered
Prescription medications – Covered
Vaccinations – Covered
Annual Exams – Covered   
Dental Scaling/Polishing  – Covered
 
Wow!  Prescriptions?  Dental cleanings?  They even include some elective surgical procedures.  For forty bucks a month?  There aren’t even any copayments!  I’m awaiting the phone call from Obama any second now.
 
This just may be the ticket the country is waiting for. 
 
Now, there are a couple of exclusions.  There’s always fine print, right?  Okay, the following are not covered: parvo, distemper, kennel cough, heartworms and feline leukemia.  And grooming, bathing and dipping are out too.  Other than that, PurinaCare seems to provide a pretty darn good health insurance for a really reasonable price. 
 
Crazy, right? Dogs and cats get high quality health insurance while their owners are left to be ill.  What’s in it for we, the people?  A lot, according to the North American Pet Health Insurance Association (NAPHIA). 
 
According to recent studies, the NAPHIA figure the health benefits of  pet ownership  include:
  • Reduced risk of cardiovascular disease
  • Higher survival rates from heart attacks
  • Significantly lower use of general practitioner services
  • Reduced risk of asthma and allergic rhinitis in children exposed to pet allergens during the first year of their life
  • Better physical and psychological well-being for seniors

    • Interesting.  These are pretty tangible preventative health benefits.  I may have solved the health insurance situation after all.  I mean, obviously the pet insurance companies won’t cover people.  But if the benefits of pet ownership are so great for health, I might just start instructing my uninsured patients to take two kittens and call me in the morning.  Problem solved.

    Next?

     

    Dr. Brett Kinsler is a chiropractor in Rochester, NY.  He is insured but his cat (favorite hobby = peeing in corners) has no coverage.

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    This is why you’re marginal

    September 7, 2009 at 9:40 pm (Chiropractors & Chiropractic)
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    chiroad2009

    We are fairly insulated in Rochester from sleazy, totally unprofessional chiropractor advertisements.  They occasionally pop up like freaky little mushrooms and usually get stomped on rapidly.   Here’s one that appeared in a local fishwrapper this week.  Let’s have a little contest – how many unprofessional, insulting or just plain factually incorrect items appear in this ad?  Keep in mind the total ad has less than 100 words!

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    Up the Nose With a Rubber Hose

    September 3, 2009 at 9:35 am (Evidence Based Medicine, Inventions, Patient Information)
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    balloon_nose

    Sinusitis is an inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection.  There can be pain and nasal congestion.  Acute sinusitis often follows a cold, but chronic sinusitis can last for extended periods and make people miserable.  More than 30 million Americans suffer from chronic sinusitis, meaning symptoms last longer than two months or regularly recur. Patients repeatedly try antibiotics, decongestants or steroid-containing nasal sprays, but about a quarter are thought to get inadequate relief.  Sometimes, surgery is the best option for chronic sufferers.  Standard surgery involves cutting away bone in the sinus cavity to open the passage way and allow drainage.

    This week, a patient asked me about a procedure where they stick a balloon up a patient’s nose and inflate it in order to ‘move the skull bones’ and help with sinus problems.  I thanked him for the idea for a blog article and began to do my research on what I was sure would turn out to be some wacko in a clinic in California (why is it always California?) sticking things up people’s noses and declaring them “Sinus Free!”

    Instead, I got educated on a new alternative to the standard sinus surgery.  Balloon Sinuplasty is compared to angioplasty — you know the procedure where a catheter is fed through an artery and plaques are squeezed to the sides with an inflatable balloon.  With the sinuplasty, the catheter is inserted into the sinus cavity and inflated to open the passageway and promote fluid drainage and pressure reduction.  Inflating the balloon aims to stretch the sinus opening back to its original size or little bigger, thus letting air (and antibiotics) into the sinus.

    The research looks promising for this technology and it is most certainly not a novel means of cranial adjusting as I initially suspected.  Whew.  Patients who have the balloon catheter procedure appear to have significant improvement in symptoms two years after surgery.

    The best part is that the research generally scores patient symptoms using my favorite clinical instrument:  the SNOT – 20 which I discussed in a previous post.

     

    Dr. Kinsler is a chiropractor in Rochester, NY.

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