RAG RADIO / Thorne Dreyer : Mark Blumenthal on Herbal and Alternative Medicine

American Botanical Council director Mark Blumenthal in the studios of KOOP-FM in Austin, Texas, Friday, June 15, 2012. Photo by Thorne Dreyer / The Rag Blog. Inset photo below by Tracey Schulz / Rag Radio.
Rag Radio:
Botanical Council's Mark Blumenthal
discusses herbal and alternative medicine

By Rag Radio / The Rag Blog / June 21, 2012

Mark Blumenthal, the founder and executive director of the American Botanical Council (ABC), an "independent herbal think tank," discussed herbal and alternative medicine with Thorne Dreyer on Rag Radio, Friday, June 15, 2012, on KOOP-FM, Austin's cooperatively-run all-volunteer community radio station.

You can listen to the show here:


Rag Radio is also streamed live to a worldwide Internet audience and is rebroadcast Sunday mornings on WFTE-FM in Scranton and Mt. Cobb, PA.

On the show, Dreyer and Blumenthal discuss issues involving research, regulation, marketing, and responsible use of medicinal plants and other alternatives to conventional Western medicine.

Mark Blumenthal heads the American Botanical Council, an independent, nonprofit organization "dedicated to disseminating accurate, reliable, and responsible information on herbs and medicinal plants," and is the editor and publisher of HerbalGram, an international, peer-reviewed quarterly journal.

Mark has played a major role in "opening the doors" between alternative and conventional medicine in this country and his group has worked to create an interface between the interests of consumers, the herbal industry, and the scientific and research communities.

Mark Blumenthal has been a leader in efforts for more rational regulations of herbal and natural product manufacturing, and education on alternative and traditional medicines. He has written that "herbs represent the collective heritage of our planet. The use of plants and plant parts for medicine and food is part of what we've inherited from our ancesters."

Blumenthal was an Adjunct Associate Professor of Medicinal Chemistry at the University of Texas at Austin, co-founded the Herb Research Foundation (HRF), was president of the Herb Trade Association, and was a founding board member of the American Herbal Products Association (AHPA). He has appeared on numerous radio and television shows and has written reviews and book chapters for many major publications.


Rag Radio, which has aired since September 2009 on KOOP 91.7-FM in Austin, features hour-long in-depth interviews and discussion about issues of progressive politics, culture, and history.

Hosted and produced by Rag Blog editor and long-time alternative journalist Thorne Dreyer, a pioneer of the Sixties underground press movement, Rag Radio is broadcast every Friday from 2-3 p.m. (CST) on KOOP, 91.7-fM in Austin, and is rebroadcast on Sundays at 10 a.m. (EST) on WFTE, 90.3-FM in Mt. Cobb, PA, and 105.7-FM in Scranton, PA. The show is streamed live on the web by both stations and, after broadcast, all Rag Radio shows are posted as podcasts at the Internet Archive.

Rag Radio is produced in the KOOP studios, in association with The Rag Blog, a progressive internet newsmagazine, and the New Journalism Project, a Texas 501(c)(3) nonprofit corporation. Tracey Schulz is the show's engineer and co-producer.

Rag Radio can be contacted at ragradio@koop.org.


Coming up on Rag Radio:

June 22, 2012: Gay marriage and social change in America with Gail Leondar-Wright and Betsy Leondar-Wright.
June 29, 2012: Peruvian Sociologist Cristina Herencia on issues confronting indigenous peoples in global times.

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Marc Estrin : Acromegaly

Art from the ACLU.
ACROMEGALY

By Marc Estrin / The Rag Blog / February 15, 2011

Acronyms, I think, bring out the worst in people. For example, the USAPATRIOT act is not an act for American Patriots as it would appear, but rather the U.S.A.P.A.T.R.I.O.T. Act -- Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and
Obstruct Terrorists Act.

Imagine the wordsmithing over that one. Imagine how many taxpayer dollars went into the choice of those acronymic wonders. And the marvellous mendacities therein -- “uniting," “strengthening," “appropriate," “required” -- all hidden behind the mask. Truly a work of the devil. There are masks that hide, like that one, and masks that reveal. It’s important to distinguish them.

Acromegaly is a disease resulting from a pituitary tumor overproducing growth hormone. In children it produces giants, and in adults, overgrown jaws, thick skulls, and thick skin. You can see an acromegalic giant in action in Kurosawa's great film, Yojimbo. He wields a mean sledge hammer against his enemies.

Big jaw, thick skull, thick skin. Could this syndrome describe the US approach to the world?

Our president is about to pull a Joshua (10:8-14), to try to stop the sun from setting. During one campaign in an early Operation Cast Lead, while the children of Israel were smiting the Amorites, man, woman, and child, Joshua, in a fit of chutzpah, bade the sun stand still so smiting time might be longer and smiting more complete.

And behold,
the sun stood still,
and the moon stayed,
until the people had avenged themselves upon their enemies.
The sun stood still in the midst of heaven,
and hasted not to go down about a whole day.
And there was no day that like that before it or after it,
that the LORD hearkened unto the voice of a man:
for the LORD fought for Israel.

The 342-page USA PATRIOT ACT -- clearly already prepared and lying in wait -- was passed by Congress (357-66 in the House, and 98-1 in the Senate), and signed by George W. Bush on October 26, 2001. Many legislators admitted to not having read it through before voting. Most of the bill's provisions were due to sunset after December 31, 2005, four years after passage, and safely after the 2004 election. But by March 2006 Congress had voted to reauthorize the bill so as not to tie the president's hands in his Global War on Terror.

Sunset now six years late.

Though having campaigned for greater oversight, the White House is now out-republicaning the Republicans by asking to further delay its sunset until December 2013, giving the new Republican majority, and perhaps a new Republican president plenty of time to authorize permanent status.

The Children of Israel no doubt approve.

And it's not as if the abuses of the bill have disappeared as GWOT has aged and mellowed.

Rather, the jawbone and skin continue to thicken, and the skull grows ever more dense as we resist and punish those on the side of freedom.

[Marc Estrin is a writer, activist, and cellist, living in Burlington, Vermont. His novels, Insect Dreams, The Half Life of Gregor Samsa, The Education of Arnold Hitler, Golem Song, and The Lamentations of Julius Marantz have won critical acclaim. His memoir, Rehearsing With Gods: Photographs and Essays on the Bread & Puppet Theater (with Ron Simon, photographer) won a 2004 theater book of the year award. He is currently working on a novel about the dead Tchaikovsky.]

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David P. Hamilton : My Remission and the Business of American Medicine

Graphic from The Patient's Doctor.
Rheumatoid arthritis, my remission,
and the business of American medicine

Their deficiencies, spawned by the system’s economic organization, might be more tolerable if doctors didn’t so often act like they had been anointed by God with special powers to save your life provided you have a deferential attitude and the right insurance.

By David P. Hamilton / The Rag Blog / December 15, 2010

Over two years ago I was diagnosed with rheumatoid arthritis (RA). According to all rheumatologists, it is an incurable and progressively degenerative disease. These alleged specialists earn an average of $224,000 a year “treating” it. They confidently assert that once you have RA, it’s permanent and dealing with it becomes the dominating feature of your remaining life.

With RA, your immune system inexplicably short-circuits and attacks your own body, particularly in the joints of the arms and legs. The onset of the disease requires a genetic predisposition and a triggering incident. Three months previous to the RA diagnosis, I had hip replacement surgery. In conformity with the apparent professional secret code to cover for colleagues, no doctor I’ve asked has been willing to speculate on the possibility of that being the trigger.

The RA diagnosis was based on several assumptions. Since I had it, it was assumed I had some triggering incident and the required gene, although I’m aware of no genetic test being done or speculation on what may have been the trigger. The hip replacement surgeon, whose specialty averages over $600,000 a year, performed his task with great technical skill, but failed to mention RA as a possible side effect.

The diagnosis of RA is not made in a casual manner. It is quite scientific and quantifiable on the basis of a blood test to determine your “rheumatoid factor”. For men, above the score of 30 is positive. At one point, I was 176. Once you’re positive, it is “standard medical practice” to never test for that factor again, based on the assumption that the disease is always chronic, so further tests would be superfluous.

When I asked for a new test after months without symptoms or medications, my rheumatologist at first resisted, but acceded to my request since she had a blood lab on site at the VA. The new “rheumatoid factor” reading was down to 27. She declined to speculate on the cause of the score dropping. A few months later, it was back to 94, but I still had no symptoms.

RA won’t kill you in a few months or even years. However, it hastens one’s general physical deterioration leading to earlier death from something else. Along the way it cripples you and makes you wish you were dead because you can’t walk or use your hands. It is also quite painful and disfiguring. Not the Last Act one would choose.

Conventional American medical wisdom is that the pace of the inevitable degeneration caused by RA can be slowed only by the use of drugs so toxic as to require frequent tests of one’s liver function, if any. Rheumatologists offer no cure and no allopathic physician ever gave me the slightest reason to hope that I would ever be well again, let alone be playing tennis and strolling the boulevards of Paris without pain.

Yet, today I have had no symptoms in well over a year, remain athletic, haven’t taken pharmaceuticals for RA for over a year and recently returned from two months in France, celebrating my remission, which included many such strolls. My last rheumatologist has dismissed me from her care “until further notice,” her way of warning me that it may return. My general practitioner calls my recovery “truly remarkable,” but has no explanation. Getting well, even if it is only temporary, while consistently rejecting medical advice was never considered a reasonable option.

Both the rheumatologists I saw recommended I take methotrexate. This drug was first developed in the late 1940’s to treat cancer. It was FDA-approved for the treatment of RA in 1988 and remains “the gold standard” of RA treatment. It was once a breakthrough in cancer treatment, but that was over a half century ago and cancer chemotherapy has come a very long way since then. According to Wikipedia, methotrexate “inhibits the synthesis of DNA, RNA, thymidylates, and proteins.” Not exactly the stuff one takes to return the body to a natural state of balance.

The first rheumatologist I saw was the local big wheel of the specialty with the big office on the central lobby of the first floor of the big private medical center of which he very likely owns a big part. First, he sent me to various of his colleagues in the facility for multiple expensive tests, sometimes of questionable necessity, thus helping enrich his co-owners who operate large and expensive pieces of medical diagnostic machinery and their collective corporate enterprise.

After this process, he prescribed the same stuff he prescribes to almost everyone, methotrexate. That’s what he does most days, over and over, for those big bucks. He looked justifiably bored. He had absolutely no advice for me besides taking that caustic pharmaceutical, only grudgingly conceding that fish oil might have some limited benefit.

When asked if walking would be a good form of exercise for me, he responded, “It won’t do much harm as long as you can tolerate the pain.” When I suggested employing a less invasive, more holistic regimen for starters, he dismissed such approaches as having “no scientific basis,” the sooner I started on the methotrexate the better, and I’d probably be on it for the rest of my life. Of course, I fired him, walking out after telling him I’d seek other opinions.

My second rheumatologist was at the local VA clinic. Since I’m a veteran and she’s a VA doctor on salary, she had to put up with me regardless of my routinely and overtly not following her advice either. Being able to talk back to your doctor without being thrown out into the street is a seldom recognized benefit of socialized medicine.

She wanted me to take methotrexate too. I again refused and requested her guidance in a more holistic approach. She willingly acknowledged having no special training in the use of “alternative therapies.” Apparently, in the official parlance, “alternative” is anything other than stuffing yourself with chemical combinations that are by definition toxic.

She did, however, loan me a book from her own library put out by the Arthritis Foundation that evaluated such alternatives. [Alternative Therapies for Arthritis by Dorothy Foltz-Gray, Arthritis Foundation.] She also gave me a stack of pamphlets describing each pharmaceutical commonly used to treat RA and asked me to decide which, if any, I would agree to take. Her attitude seemed a great leap forward, a willingness to enter into the aberrant state of patient directed medical care. Maybe she had no choice, but she was an empathetic woman, and that was progress.

I expected the book to be a smear on holistic therapies. Surprisingly, the author tried to strike a pose of tolerance, likely in deference to the widespread resort to alternative remedies by RA patients dissatisfied with conventional pharmaceutical approaches. Much of the evidence cited was inconclusive, but you could get the drift of what they thought was fraudulent and what they thought might help.

There are lots of natural anti-inflammatories, but nothing that anyone would claim cures RA. The book inspired me to buy a round of exotic supplements like borage oil and stinging nettle extract. The combination of several such concoctions did nothing noticeable about my RA but may be implicated in a subsequent attack of diarrhea. My cynicism in regards to American allopathic medicine began to spread to its alternatives.

More important, the book let slip a closely guarded secret that rheumatologists are loath to acknowledge -- that some RA patients go into complete spontaneous remission, at least for long periods of time, and the medical specialists don’t know why. This is not so surprising when you realize they don’t know what starts it either.

There are various definitions of “RA remission,” one of which has the patient asymptomatic, but on the heavy drugs. These variations cloud the issue somewhat, but there are indeed a small percentage of people diagnosed with RA, perhaps as much as 10%, that experience “spontaneous remission," meaning that they did it outside the guidelines of established medical practice. Medical journal articles on RA remission sometimes throw these cases out of their studies since they distract from their focus on what expensive new pharmaceutical might be effective.

It bothered me that until recently the most common drugs used to treat RA were originally developed to treat something else. Also troubling in my case was that RA strikes many more women than men and usually hits people before they are 50. I was a 64 year-old guy, way outside the standard pattern. My doctors offered no explanation for this anomaly. It all gave me the impression that rheumatology was less than a precise science and that its practitioners didn’t have a very solid grip on causes or effective treatments, regardless of their standard pose of all-knowingness.

The question to me was how to be among that small group that somehow got well without resort to the standard pharmaceutical regimen. There were many ideas floating about the internet, but no clear path. For example, there were numerous dietary suggestions. Many claimed their particular diet had beneficial effects on RA, but none claimed it cured it. Although some foods were suggested repeatedly (e.g., fish oil, avocados), the diets varied widely and in some cases were contradictory. There was no shortage of suggestions, often endorsed with great certitude by alternative true believers.

Over the course of a year, my body somehow healed itself despite continued positive blood tests for RA. I don’t know how. It was probably some genetic luck. I simply took good care of myself. My approach was eclectic; some of this, some of that, but not methotrexate or anything similar.

I improved what was already a very rich organic, whole grain, localavore diet, became more disciplined about my exercise routine, added some of the suggested supplements to my preexisting supplement regimen, tried to keep my stress level down and adopted a fighting spirit. Nothing revolutionary. Just enhancements to what I had already been doing, including the maintenance of our 400 square foot kitchen garden.

For almost a year I took what seemed to me to be the most benign of the recommended RA prescription drugs; an antibiotic (minocycline) and an old anti-malaria drug (hydroxychloriquine). They didn’t seem to do much except make me more susceptible to sun. I quit taking them more than a year ago, of course “against doctor’s advice.”

I also spent several hours being interviewed by a homeopathic physician (also an MD) who concocted a couple of crystals for me to ingest. His primary distinction was being the only medical professional that said he could cure me. Whether he did or not, who knows? I tossed the crystals down, added to the mix.

I have long felt that if there were such a thing as a fountain of youth, it was endorphins. I continue to firmly believe that you cannot be very healthy without a serious exercise routine, something that should take about an hour of your day, every day, and cause sweat.

With the RA diagnosis, I became a very disciplined walker, eventually evolving into a speed walker through hills, progressively adding weight to my daypack to make it harder. But like other features of my therapeutic approach, this was an augmentation of a preexisting practice, not some new feature of my lifestyle. I had been a runner and tennis player for decades.

My approach was anything but scientific. It has worked so far, but it’s impossible to know what factor was crucial or even important or that it was even anything I did at all. Perhaps I was predestined to get better regardless. But now that I have returned to an enviable state of wellness, even fitness, for someone 67, the question naturally arises: what happened? What, if anything, did I do to help cause remission? There is no way to answer that question with precision.

One factor, however, is very clear to me, and all my most trusted medical consultants agree. For me to have ever recovered not only my health, but also the ability to walk, even run, and the normal use my hands, it was essential that I rejected standard medical opinion and resisted the pharmaceutical path. That path leads to long term prescription drug dependency and a rotting liver, not back to true health.

I have come to see my wellness as exemplary of a conceptual failure of America’s allopathic medical practice. My body healing itself was simply not on their radar, because they don’t make money from healthy people who are independent of pharmaceuticals.

Doctors have no special training in the benign and natural means to promote the body’s capacity to heal itself. The intellectual monopoly of the pharmaceutical model blocks out such approaches. Conventional American medicine pays minimal attention to either prevention or enhancing natural recuperation. They’re not profitable. The focus of our medical system is instead on devising salable products that replace natural recuperative mechanisms with artificial ones, producing and distributing such products so that health care becomes a commodity and doctors are transformed into entrepreneurs.

It is an inherent and inescapable feature of the capitalist health care model that it profits from illness. The average U.S. doctor makes nearly a quarter million a year, most specialists a half a million and surgeons more. Scant few don’t become millionaires. On average, they’re the best-paid national professional group in the world. Yet, the U.S. wallows at 37th (behind Oman, Portugal, Morocco, Columbia, and Costa Rica) in the World Health Organization’s ranking of the quality of national health care systems, 74th according to the UN, and 49th in life expectancy.

Compared to the other G8 nations, the U.S. has the highest infant mortality, the most mothers who die during childbirth, the most lives lost that could have been saved, and the worst in treatment of cancer. In the American system, there are no poor doctors, but lots of sick people, bankrupt patients and 59 million miscreants without “coverage."

Like their plan for innumerable others, my doctors wanted me to take caustic chemicals for the rest of my life while pouring my meager savings into their bank accounts for my perpetual “treatment," a steady income source for them throughout my remaining years of worsening disability.

In the capitalist oriented American health care system, private doctors have a clear vested economic interest in patients not getting well. My chronic is their meal ticket. My wellness hurts their bottom line. How could I be so naïve as to expect them to cure me when my sickness is so much more lucrative?

The standard Western doctor operates almost exclusively on a very narrow procedural model. They order expensive diagnostic tests done by other specialists in order to determine which prescribed drug to give you. In most cases, that’s all. To a great degree, they are agents of the pharmaceutical industry in charge of customer service. Patients wait patiently to see doctors. Big Pharma reps walk right in.

It is nearly axiomatic that whenever you go to the doctor’s office, you leave with a prescription. Otherwise, most patients feel cheated. If you’re a favored patient, you’ll get some of the doctor’s stash of free samples the pharmaceutical reps have graciously left. Whatever your germ, doctors have exclusive access to the appropriate specialized germ killers. These medications, however, have high toxic potential or they wouldn’t have to be “prescribed."

The cornerstone of American doctor’s wealth is their monopoly on the right to prescribe drugs to which the government has restricted access. If your condition further deteriorates, they “operate," i.e., cut you open and remove or install things, a service that costs many thousands, requires the expenditure of many thousands more in ancillary products and is dangerous because the fourth leading cause of death in the U.S. is going to the hospital.

If you asked most U.S. doctors what s/he could do to improve your health besides pills, shots, and surgery, they’d be out of their element. Especially don’t ask about nutrition or exercise routines and expect an expert opinion.

Their deficiencies, spawned by the system’s economic organization, might be more tolerable if doctors didn’t so often act like they had been anointed by God with special powers to save your life provided you have a deferential attitude and the right insurance. Many an idealistic youth who set out to serve mankind by being a doctor, became seduced by the Big-Pharma orthodoxy of the training institutions. And after pre-med, med school, internships, residencies, and the related costs, developed a sense of material entitlement not matched by equally educated PhD’s.

There are, of course, legions of doctors operating in the capitalist medical system who have maintained at least some of the most humanist motives for practicing medicine. There are, without doubt, saints among them. I’m especially partial to general practitioners, pediatricians, trauma specialists, and women doctors. Many surgeons have great technical skill. Morally unimpeachable motives and competency, however, are largely irrelevant to the operating economic principals of the system.

The American medical model is systematically corrupted by its capitalist character, resulting in serious conceptual limitations. These corruptions derive from health care being a commodity instead of a right and from illness being a source of profit. A principal conceptual limitation is their failure to focus on methods to enhance the body’s natural recuperative potential, favoring instead doctor controlled pharmaceutical dependency.

The most effective and economical approaches to health care for most people involve prevention, health maintenance and recuperation. For this, important societal inputs would be nutrition education, subsides for genuinely healthy foods and lifestyles, community fitness programs, low job stress, social security, sufficient time off to pursue personally rewarding activities, and universal public health care so that people don’t neglect seeing a doctor for fear of the costs associated with getting medical care.

The problem is that in the unfettered market system, none of these components of optimal health care offer the pharmaceutical, hospital and health insurance industries opportunities for profit even close to equaling those offered by the existing model.

[David P. Hamilton has been a political activist in Austin since the late 1960s when he worked with SDS and wrote for The Rag, Austin's underground newspaper.]

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Stayin' Alive : Learning About our Bodies

Apples and oranges: Rats have substantially different physiological systems.
Stayin’Alive:
What do we know about our bodies,
And how do we know it?

By Mariann G. Wizard / The Rag Blog / February 16, 2009

[Stayin' Alive is a periodic column on Complementary and Alternative Medicine by Rag Blogger Mariann G. Wizard, a professional science writer with a wide-ranging knowledge of natural health therapies. Readers may suggest topics for future columns; use the Comments section below the article.]

In establishing a self-health care continuum that successfully incorporates both conventional Western medicine (CWM) and complementary and alternative medicine (CAM) elements, the best tool would be a solid understanding of how our own bodies work. Many people believe that they possess such knowledge; many more believe that even if they don't, their health care provider (HCP) does, or that Medical Science in general must have the facts.

"Nuts!" to all that.

To the contrary, I would venture to say, for example, that most folks' understanding of their digestive system resembles the indigestion remedy ads of the 1950s: a hole at each end, a long tube connecting them, and a holding tank, or "tummy," nestled cozily in the middle, where mysterious fluids ebb and flow.

As far as imagining that your HCP has a much better understanding, that is also a dubious assumption. HCPs are highly educated and well-informed about many things, but the how and why of healthy functioning aren't much stressed in their education; it's more about how to respond to the illnesses and dysfunctions we all-too-frequently sprout.

As for Medical Science, sometimes it must seem to the attentive reader that we are still living in the Middle Ages, if not Middle Earth! Many amazing things may be seen and "proven" in laboratory (in vitro) studies, where everything happens in a test tube or Petri dish.

In screening labs all over the world, substances are tested for antibiotic, anti-inflammatory, and/or anti-cancer effects, among other actions. Many hundreds of natural substances, most from plants, exert such effects in vitro. Among them, as one small example, rosmarinic acid, from the common herb rosemary, has very potent antibiotic effects in vitro.

However, this has not yet translated into an effective antibiotic medicine.

Similarly, animal tests (in vivo) may illuminate many biologically active substances; however, they are unreliable predictors of how a substance will act on humans. Rodents and rabbits, used in the great majority of in vivo studies, have substantially different physiological systems than humans. The only animals, really, that are close enough to human beings to make in vivo studies reliably predictive of a chemical's effects on us are other primates: chimpanzees, orangutans, monkeys, etc.

We have no compunction, as a species, about sacrificing hundreds of thousands of rats and rabbits annually in the name of Science, even breeding special research animals who are born with or develop specific disease conditions, e.g., cancer.

Primates, fortunately for them, do not reproduce quickly enough, or in sufficient numbers, to make similar research on them cost-effective, and we may stroke our "humanitarian" side as Masters of Nature, with strict controls on primate medical research, requirements for "humane" treatment, and laws limiting trafficking in their lives, although these latter seem, from preservationists' reports, to be rather loosely observed in some areas.

The essential irrelevance of animal research to advance Medical Science as applied to humans is probably the strongest argument against such research. A cancer drug that "works" in mice doesn't necessarily produce the same effects in human beings.

Human clinical research is much more strictly limited, with international protocols and standards of informed consent, exclusion of subjects with certain risk factors, and the option to drop out if a trial medication produces unacceptable adverse effects. Randomized, placebo-controlled human trials (RCTs), the "gold standard" of clinical research that can lead, in the U.S. and in many other countries, to official approval of a new medication, are thus extremely expensive and, as has been pointed out in previous columns, are generally only conducted by pharmaceutical companies seeking approval for a single, newly-synthesized chemical compound for use in a specific condition or conditions.

More and more, as our frontiers of knowledge expand, researchers are better able to see the great unknown in which they operate. Within the human body, thousands of compounds are created, used, activated and de-activated, altered, broken down and disposed of, all without our conscious volition. We are, each of us, amazing biochemical factories. Responses throughout our bodies occur in linked but mutable ways, often involving "cascades" of reactions, like a string of black-cats popping on the 4th of July.

In the U.S., pharmaceutical companies seeking drug approval provide evidence of effectiveness and safety that meets Food and Drug Administration (FDA) standards. And, while there are hundreds of ways to design RCTs, hundreds of different "outcomes" that may be measured, and hundreds of ways to statistically analyze the results, there is no agency blueprint for constructing a study design that would or could apply in every case.

Nor is there any true national or international agenda for research, in terms of priority diseases to combat, or studies that should be conducted. It is all done on a somewhat laissez-faire basis, with scientists trying to research along their own interests, and funders defining those interests with dollars.

By the time Medical Science gets down to the level of a busy CWM practitioner, it is usually in the form of a pharmaceutical company salesman with new drug samples, or a Physicians' Desk Reference (PDR), with information on every approved drug available, its indications, dosage, and known adverse effects or contraindications.

By the time it gets down to us, the Patient, it's an advertisement for a new product that promises relief of what ails us; how it works is often the least of our concerns. We simply assume that somebody knows, and take our medicine.

Unfortunately, knowing how a compound behaves toward disease organisms, for example, doesn't necessarily convey how it behaves toward healthy tissue, or what other effects it may exert over time. The periodic recall of formerly-FDA-approved drugs that have been found, sometimes years later, to cause unacceptable "side effects" is a constant reminder of the huge void in which Medical Science is still but a flickering candle throwing shadows on the walls.


Women's health

Our slow climb from ignorance to knowledge has hardly been uninterrupted. In 1973, Our Bodies, Ourselves: A Book by and for Women (Boston Women's Health Book Collective) showed women of all ages with photographs and accurate diagrams of their own intimate body parts and instructions for self-examination that had previously been available, without the straightforward text, only in the rawest men's sex mags.

[Austin bookseller Susan Post (Book Woman, 5501 N. Lamar, Austin) recommends Our Bodies, Ourselves as a great high school graduation gift. Newer companion volumes cover girls' and teens' health issues, pregnancy and childbirth, and menopause.]

For many generations "Nice girls" were strongly discouraged from curiosity about what they looked like "down there," how the female organs functioned (other than to regularly "bleed"), and, certainly, from knowing how to self-identify and treat common conditions like yeast or urinary tract infections. Breast self-exams? We weren't supposed to play with the melons, either, especially not rubbing them firmly with soap-slippery fingers in rapid concentric circles!

Yet at one time, worldwide, women were primary keepers of much medical knowledge: herbalists, midwives, wetnurses, gardeners, cooks, preparers of the dead. Man, perhaps because of his interests in hunting and herding, seems historically to have gravitated more towards dentistry, surgery, and bonesetting. However, much herbal knowledge, and common remedies, are shared by both sexes in almost every "primitive" society.

"Witches," or traditional healers, both female and male, have been persecuted particularly since the rise of Christianity, and continue to be persecuted in Africa today, but what Friedrich Engels called the "world historical defeat of matriarchy" happened long before Jesus' birth. We won't go into all that now; it's too long and sad a tale.

As a result of "all that," however, health issues specific to women have often been relegated to second-class status in CWM. Even today, women are under-represented in clinical trials, and even in some population-based (epidemiological) studies that track broad health trends.

For example, there are epidemiological studies showing that Asian men who adopt a Western-style diet, both in Asia and in the West, tend to develop Western-style cardiovascular and other problems at a higher rate than those who eat a traditional Asian diet, but little research has asked if the same trend exists in women.

And, while heart disease is the number-one killer of men and women worldwide, it is much more studied in men than in women. Only recently has it been recognized that women's heart attack symptoms differ substantially from men's, and that many women's heart attacks are not recognized as such.

CAM research is a little better. Herbalists frankly acknowledge their debt to "wise women" of past eras. But ethnomedical researchers, seeking new therapeutic compounds and/or practices, tend to focus on interviews and field expeditions with traditional male healers. Unless a female healer is especially renowned, her knowledge is likely to be relegated to the dustbin of "folk or household remedy."

Some CAM clinical studies, as in CWM, focus on men alone. Of course, there are legitimate reasons for this in some cases -- for example, in studying benign prostate hyperplasia (BPH), women participants would have little to contribute -- but clinical knowledge tends to build up, over time, more knowledge of men's health.

However, modern pharmaceutical companies and medical specialists have taken to heart women's quest for health, and a growing number of products and services are targeted to women consumers. Dear Sisters, please keep in mind that, just because a product's ads imply that the entire company is founded on love and respect for women, features pink bows, and contributions to women's health research, that doesn't necessarily mean it does what it says, or only what it says. Don't be conned by a cute, savvy marketing campaign.

On a more positive note, a growing body of research shows that the health of any community's female members is a strong predictor of the health of all. Healthy women tend to produce healthy children and nurture healthy men, boys, and girls.


How others see it

By now, some of my readers are surely bubbling over with vexation at my debunking the infallibility of CWM. "At least," they may be thinking, "Western science has identified all of the human organs, unlike nonsensical psuedo-systems such as traditional Chinese medicine (TCM)!"

I have to admit, when I first began reading articles on TCM for Austin's American Botanical Council, I was quite flabbergasted by some of the concepts it involves. The most difficult to swallow was TCM's apparent ignorance of the stomach and other organs in favor of an "upper burner," "middle burner," "lower burner," etc. I mean, even if the study of anatomy never got around to dissection, any meat-eating society ought to be able to identify a mammal's "liver and lights," right?

My bafflement came from looking at TCM with CWM-educated eyes. TCM is, first and foremost, a philosophy of health, in which structure is less important than function, and "balance" between and among an infinite variety of biological events and processes is the essence of health.

In my own crude way, I've come to see TCM's upper burner "organ" as corresponding to the oxygen/carbon dioxide cycle of CWM's heart, lungs, and circulatory system; the "middle burner" as corresponding to digestion and extraction of nutrients in CWM's stomach and small intestine; and the "lower burner" as corresponding to the waste removal functions of CWM's large intestine, kidneys, bladder, etc. I'm probably wrong in the specifics of my grasp. But I'm convinced I'm on the right path!

It's somewhat analogous, I think, to being able to identify and/or trouble-shoot a carburetor, and being able to identify and/or trouble-shoot an internal-combustion engine. One may lead you to the other, but the other will never lead you to the One!

The tendency to focus on one aspect or effect -- to look at one tree instead of the forest -- may be the main weakness of CWM as a system of medicine. Laboratory research and RCTs tend to illuminate only a few of what may be many variable effects of a medication. Single-molecule medicines are the standard, with the thousands of molecules present in any herbal remedy, for example, being perceived as potentially problematic rather than potentially synergistic or balancing.

Literally thousands of standard multi-herb formulas are recognized in TCM and in other CAM systems such as India's traditional Ayurveda (one of several recognized systems of medicine on the subcontinent). These routinely contain at least three different herbs; many boast a dozen or more. Analyzing their effects scientifically presents major challenges, although both China and India are strongly committed to such research, in the hope that some traditional formulas may reward those who can obtain approval for their use on a prescription basis.

Frankly, I can't help but think that the profusion of multi-herb formulas must challenge TCM practitioners as well. Success demands that they be able to see both the forest of possibilities and the individual "tree" presenting with pain or other symptoms; then to select, and in many cases personalize, the formula that will be most helpful in restoring systemic balance. Tell you what, we'll see if any practitioners of this fine art can explain it for a future column, OK?



Whoooooo are we? Who, who, who, whooo??

As human beings, most particularly in the West, we learn to see ourselves as unique individuals; each of us a perfect snowflake in the blizzard of life. When we get sick, we become even more determinedly individualistic, each of us asking, "Why me?" Yet there is more and more evidence that our question should be, "Why us?"

For every cell in what you think of as your body, you contain, or carry, ten (10) single-celled organisms: bacteria, fungi, and whatever else is out there in the unicellular universe. And the majority of these are not invaders, parasites, or attackers, but symbiotic organisms without which you could not live, or would experience a far inferior quality of life. (I'll admit to wondering if that 1:10 ratio is somehow related to the reported "fact" that we use only 10% of our brains. Are our symbiotes using the other 90%??? Goddess, I hope so!)

Really, everybody should know by now about the symbiotic organisms that live in our digestive tracts, performing functions that our bodies cannot perform without their presence. Yet we abuse these little critters unmercifully, eating foods that don't nourish them, and periodically dosing them with killer chemicals – ANTI-BIOTICS, get it??

After any course of antibiotics, it is both wise and kind to restore one's natural microflora balance with a course of probiotics. Why aren't these routinely recommended or even prescribed at the same time antibiotics prescriptions are written? Why doesn't the pharmacist counsel us to ingest probiotics after the antibiotics are done? The simplest way to support your gut symbiotes is to eat yogurt, and/or other fermented foods with active cultures.

Besides our gut, the skin, our largest organ, is next-most-populated with micro-critters. This was brought home to me forcefully and embarrassingly last summer, when a persistent butt-oriented rash defied a round dozen over-the counter and CAM products, prescribed antibiotics and antifungals, the services of five HCPs, recommended soaps and cleansers, sitz baths, antihistamines, and a recommended herbal tea, and led your humble health writer to the brink of despair; yea, to the brink of triggering her high-deductible health insurance!

Robert W. Cline, M.D., of Central Texas Colon and Rectal Surgeons, in the nicest way imaginable, finally clued me that cleanliness is not next to godliness where the sun don't shine. I had, you see, been using flushable moist wipes -- I told you it was embarrassing! -- and was killing off beneficial microflora that are vital to keeping the skin of rectum, anus, and adjoining areas proof against harmful organisms, to which they are routinely exposed in doing their duty.

The wipes I used contained vitamin E and aloe vera – two natural skin protectors – and I'd been using them for quite some time before problems developed, so it didn't occur to me that I was causing the rash. By depleting my skin's natural oils, I was depriving my microflora of their habitat. Three days after I stopped using the moist wipes, I could sit down again!

According to Dr. Cline's "butt lecture," the cure for 95% of pruritis ani (itchy anus) -- is to stop overzealous cleaning. Wash with warm water and pat dry; that's all ya need.

One problem with this sort of experience is that any number of the remedies I tried may have been sufficient to treat the various infections and what-not I may or may not have had, but I kept on ignorantly repeating the underlying, undiagnosed cause, so none of them had a chance to work.

So, whattaya gonna do?

So, given that human health, disease prevention, and treatment, regardless of which system of medicine one chooses, are full of unanswered questions and unsolved mysteries, how is an average, non-medically educated person supposed to take care of him-or-herself?

First and foremost, know what it feels like to feel your best, and be aware of your own health practices. If you are accustomed to eating whatever you like, and begin to notice frequent indigestion or an unwanted change in your weight, start keeping a detailed food diary, writing down every single thing you eat and any symptoms you experience.

Stay away from foods you suspect may be disagreeing with you and see if symptoms clear up. Allergies to wheat, gluten, milk products, eggs, and other foods may emerge at any age. The very act of keeping a food diary has been found to improve weight control.

On the other hand -- and there is always an "other hand" -- be aware of what nutrients you may be giving up if you delete a certain food from your diet, and take care to replace it with other foods or supplements. I have what is these days called a lactose intolerance -- in my opinion, adult mammals are not meant to drink milk as a beverage! -- so I'm careful to get calcium and vitamin D from other sources.

Do you feel less energy than you think you should? Have more insomnia? Unless symptoms arise suddenly or involve pain, I would try to observe and be conscious of possible causes for a couple of weeks, anyway, before visiting a HCP.

Stress -- unrelieved activation of a biological response -- depletes energy, yet can also cause sleeplessness. Stress contributes to many common illnesses, including heart disease, irritable bowel syndrome, depression, and, probably, cancer. Increasing pleasurable physical activity, getting a therapeutic massage, or giving yourself a long, pampered week-end of rest and wellness can make a strong positive contribution to restoring overall health.

Be aware when stress, changeable weather, air-borne allergens, or other conditions may tax your immune system. I've found in recent years that a few cups of tasty echinacea tea, sweetened with honey or agave nectar, really bolster my immune system in cold and flu season.

If a couple of weeks of solid rest, healthy eating, and adequate exercise don't make a difference in your feelings of well-being, consider having a complete physical exam. Whether by a general practitioner (GP), TCM doctor, naturopath, or other qualified HCP, a complete exam should measure baseline parameters and health status, and identify areas of concern. And we'll talk more about getting one in yet another future column!

For now, take good care of yourselves!

Image from aussie claus.

Self-health tip:
Miracle cures and fads don't work

Human beings are funny. We have rational minds, but often ignore what our minds know in favor of what our emotions (or our symbiotes???) desire.

In health care, if it sounds too good to be true, it probably is.

Americans spend millions every year on diet fads, in a vain attempt to shed pounds. Currently, there is only one FDA-approved product for weight loss. It is quite costly, and not reimbursed by insurance plans.

The only proven way to lose weight, and to keep off excess weight, is to consume fewer calories than are expended in activity. Even the new over-the-counter pharmaceutical operates on this principle, preventing digestive absorption of some fat calories.

"Miracle cures" are touted for diabetes, arthritis, cardiovascular complaints, and about every ailment known to mankind, and have been for thousands of years. In general, it's best to keep in mind that someone who is trying to sell you a product is not the most objective source of information on that product's efficacy. (To me, a real "miracle cure" would be one without a price tag!)

This same philosophy can be applied to the hoped-for miracle of "health care reform" in the U.S.! There is no quick cure for what ails us. The only way to reduce health care costs, and to keep them down, is to consume fewer acute health care services, preventing serious problems through positive practices.

As the population ages -- over 22,000 Americans are now over 100 years of age, with the number increasing every year -- preventive health care will become more and more vital to prevent a break-down of the health care system. If we're going to live to see 100, don't we want to be healthy as long as possible?

The biggest thing fueling the popularity of "miracle cures," as well as of proven CAM treatments, is CWM's lack of success in treating chronic illnesses and disorders. Fact-based research into what works and why could begin to show a way out of the maze of competing claims, but when almost all medical research is funded by pharmaceutical manufacturers, is it any wonder that our most popular medical fads all seem to involve a novel synthetic pill?

As for dietary supplements, there is not any one vitamin, mineral, or herb that can cure the hundreds of conditions for which claims are implied by unscrupulous internet marketers. As we can and really should learn from TCM, Ayurveda, and other non-Western health system, true health rests on balance, and over-reliance on any one substance simply isn't healthy.

-- mgw

The Rag Blog

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Stayin' Alive : Managing Osteoarthritis with Complementary and Alternative Medicine

"Skeleton Woman." Prisma color pencil, watercolor, applique by Lucy Madeline
Stayin' Alive:
Hanging out in the joints with osteoarthritis

By Mariann G. Wizard / The Rag Blog / January 19, 2010

[Stayin' Alive is a new periodic column on Complementary and Alternative Medicine by Rag Blogger Mariann G. Wizard, a professional science writer with a wide-ranging knowledge of natural health therapies. Readers may suggest topics for future columns, within the restrictions suggested below, in the Comments section of The Rag Blog.]

Osteoarthritis (OA) is a collective name for several degenerative processes in the body’s moveable joints, most often the hips, knees, feet, shoulders, or hands/wrists/fingers. OA incidence rises with age, and after about 50, affects more women than men. It causes chronic, often intense pain, reduces flexibility and strength in affected joints, and can discourage healthy exercise.

OA has several causes, including some that are hereditary, and it takes a multi-faceted approach to prevent or slow its progress. As usual, “use it or lose it”; healthy weight-bearing exercise is the best weapon against OA! Other sensible health practices are also beneficial, e.g., lower weight helps knee, foot, and hip OA; take a load off!

Rheumatoid arthritis (RA) is a different condition, and I'm not taking it on today -- maybe in a future column!

Conventional Western or modern medicine isn’t very successful with chronic illnesses, and dissatisfaction with this lack of success helps fuel use of complementary and alternative medicine (CAM). Conventional OA care includes over-the-counter (OTC) and prescription (Rx) pain relievers, e.g., non-steroidal anti-inflammatory drugs (NSAIDs). OTC NSAIDs (e.g., aspirin, ibuprofen, naproxen sodium) relieve pain but can have serious side effects. Rx NSAIDs, such as Celebrex®, can have even worse effects; similar drugs have been withdrawn due to their dangers.

There is also a vast array of Rx pain relievers about which I know very little, except what friends with severe OA and/or RA tell me. Please do not make any changes in your Rx medications, or begin using any herbal medicines (HMs), without discussing fully with your treating physician! I'll have more to say about this later, and what, maybe, some natural therapies can offer even those who really struggle with OA.

One formerly-CAM treatment, injection of hyaluronic acid into affected joints to improve lubrication, is now widely used by mainstream physicians, though with scant evidence it helps.

Hip and knee OA, if they are too debilitating, are treated conventionally with joint replacement surgery -- much more sophisticated than it was in its early years! -- and everyone I know personally who’s had this surgery has been pleased with the results. My Mom had both knees replaced after being diagnosed with cancer; it greatly improved her remaining five years. However, all surgery has risks. Also, today's replacements have an expected lifetime of only 15-20 years, so it makes sense to postpone replacement as long as possible, and not have to do it again later!

I have OA, starting in a broken toe in 1970 ("my weather toe") and spreading to knees (too much rock'n'roll), wrists and hands (too much keyboard) over time. I used OTC pain relievers for years, but became concerned because of potential stomach and/or liver damage from sustained use.

I then used an Rx pain reliever, with near-disastrous results. Since then, I've been exploring CAM's OA options personally, as well as continuing to read and report on the science behind them. I want to use OA here to show the breadth of CAM treatments for one very common condition, and some of their strengths and weaknesses, as an overall introduction to CAM.

If you've read my column before, you may recall my definition of CAM, but here it is again:

CAM is all health practices developed over the course of human history, everywhere in the world, before the discovery of microbes, and many developed since then outside of “Western” medical practice.

Prevention and treatment: Dietary supplements

Dietary supplements (DSs) can help maintain healthy levels of vitamins, minerals, amino acids, and other compounds in the body. I'll write more about nutrition, the modern food supply, and DSs in the future. For right now, it's enough to know that I consider HMs as very specialized DSs, and will talk about them separately. Unless otherwise noted, DSs, taken as recommended, shouldn't interfere with Rx or OTC medications or other conventional therapies. Over time, they may reduce the need for pain relievers, or slow the progress of disease.

Glucosamine and chondroitin, together and separately, have the most evidence for preserving and perhaps increasing cartilage in joints, the “padding” that keeps bone from rubbing on bone. Cartilage is invisible in X-rays, but OA is diagnosed by the decrease in inter-joint (articular) space as cartilage is lost to wear and tear, and to aging.

Inter-joint space in my knees increased when, after arthroscopic surgery for a torn cartilage in one of them in 1997, I began using both glucosamine and chondroitin, and has held steady ever since. I have much less pain, less often, and more flexibility in my knees than I did before starting them, and no serious problems with other joints. Both compounds have good safety records.

Glucosamine is essential for joint lubrication. It is found in all living things. Chondroitin is a related compound. Neither occurs in the usual human diet. Supplements are made from shellfish exoskeletons, and should be avoided by anyone with shellfish allergies. It takes several months to begin to notice the benefit, and you have to keep taking the supplements; for me, it's worth it!

S-adenosylmethionine (SAM-e), a natural compound produced by all organisms, decreases with age. SAM-e helps maintain joint health. It's also used for mood support and healthy liver activity. Methylsulfonylmethane (MSM) works with SAM-e and glucosamine for healthy cartilage. MSM is found in meats, fruits, and vegetables, but we metabolize it less efficiently with age, making supplementation desirable.

Essential fatty acid (EFA) intake is vital for joint lubrication and much more. Omega-3 and omega-6 EFAs (found, e.g., in hempseed oil, flaxseed oil, algae, and fish oil) must be obtained from diet, the body can’t produce them. Chances are excellent you don't eat enough EFAs. Supplementation can be recommended for almost anyone, it has so many benefits. It may cause temporary bowel looseness, but overall, improves regularity.

Osteoporosis contributes to OA through bone loss in joints. While elderly women are especially at risk, men and young women are not exempt. Bone health is complex, but everyone needs calcium and vitamin D to maintain strong bones. Supplements for menopausal women often have other bone-nourishing components, such as plant estrogen isoflavones from soy, red clover, kudzu, or other legumes.

Phytoestrogen use by women with elevated risk of estrogen-sensitive cancer is controversial, and probably best avoided. Also, phytoestrogens may interact with Rx medicines; I simply don't know enough about all the synthetic drugs out there to feel comfortable saying phytoestrogen use is OK for everyone! I will say that bone-conserving pharmaceutical products marketed in recent years have some of the scariest potential side effects of any drugs advertised on teevee; far better to keep your bones strong; again with good basic nutrition, weight-bearing exercise, and, if needed, DSs.

BTW, the preferred form of calcium these days seems to be calcium citrate, absorbable in the human digestive tract. Apparently, the ground-up oyster shell tablets I sucked down for years don't do much good; that calcium isn't in a form our bodies can use!

Treatment: Pain relief

Many CAM treatments for pain have strong evidence of benefit. Massage; aromatherapy; warm-to-hot therapeutic compresses, baths or showers; yoga; and meditation all may be used to good effect. Pepper salves are effective “counter-irritants”; that is, they produce such an intense burning sensation that joint pain becomes irrelevant! (This isn’t as awful as it sounds; OA pain may worsen in cold weather, and is often felt as a cold ache and stiffness, with pain on movement. Heat can feel wonderful, relaxing muscles and boosting blood circulation.)

OTC “heat” products use the same principle, as does the traditional Chinese salve Tiger Balm®. However, effectiveness of counter-irritants is generally short-term. One friend who has severe arthritis used a "TENS" device successfully -- delivering rapid, minute electrical shocks to himself -- for a while. Acupuncture also helped him temporarily, but it, too, is more suited, in my opinion, to relief of acute pain rather than chronic.

For those who prefer HMs, cat’s claw has thousands of years of human use for OA in South America, but has been little studied. It is not an NSAID; its means of action is not understood. I have personally used cat’s claw -- with the DSs mentioned above! -- for my OA, and find it to be one of the faster-acting herbs. If I miss taking it for a few days, my right thumb reminds me; after a few days of resuming use, I no longer notice my OA. It seems to be very safe, with no side effects except, perhaps, some bowel looseness; it goes away.

Cat’s claw isn't very expensive; however, there are concerns about sustainability due to increasing demand. The root bark is used; not a very sustainable harvesting method. I wonder if it would grow in Texas? Cat's claw hasn't been studied in conjunction with Rx or OTC pain medications, and again, I would hesitate to recommend an HM to anyone using such products. I started using cat's claw after a severe allergic reaction to a prescribed NSAID left me unable to use any NSAID, even aspirin; this was about the same time the above-mentioned thumb first began flaring with OA pain.

In general, if an HM is effective, it has the possibility of interacting with other medicines. If you think herbs are "safe" because they are "natural"; please, get a clue! Many perfectly "natural" substances can kill you deader than a dodo! Over 90% of existing synthetic pharmaceutical drugs are based on individual, "active" plant molecules from HMs.

Another HM pain remedy now legal for residents of 14 states, but not yet under the Lone Star, is Cannabis sativa, sweet Mary Jane. In British and U.S. studies of intractable chronic nerve pain -- pain unrelieved except by massive doses of morphine -- and multiple sclerosis (MS), ganja allowed patients to separate themselves mentally from their pain for a while.

Senseless continued prohibition of this valuable HM will soon be challenged by the pharmaceutical companies' desire to cash in on the “pot of gold." Bayer Health, for example, has an investigational new drug (IND) permit in the U.S. for Sativex®, a whole-cannabis extract in a mucosal spray, from British GW Pharmaceuticals. Sativex is already approved in England and Canada for MS.

An IND is a first step in approval for U.S. Rx drugs. If a whole-herb extract is permitted nationally, patients outside medical marijuana states will have a powerful argument for their use of the actual whole herb. Marijuana hasn't been clinically studied in OA, but is widely used for symptomatic relief.

Now, to be perfectly clear, I'm talking about ingesting marijuana! I've heard of using cannabis topically, in hot water compresses, but hey, what a waste! Tetrahydrocannabinol (THC), the main active ingredient in marijuana, isn't soluble in water, but in fats and oils. So, there's no evident way a hot water weed compress would bring any more relief than that obtainable less expensively from a wet towel. I expect somebody will tell me they've used the spent vegetable matter from making "electric butter" as a pain compress with fabulous results; maybe so, but did they also eat the brownies?

If you have surgery -- for any reason, not only joint replacement -- stop using all HMs and DSs (except any you and your doctors agree on) two or three weeks in advance. Some can interfere with blood clotting, effects of anesthesia, and/or post-surgical pain meds.

Other measures

OA is one of the most widespread chronic diseases in the world, and I’ve only scratched the surface of CAMs available. Purely dietary measures, such as eating only anti-inflammatory foods, can be very useful. For example, if you're an adult, stop drinking animal milk! Cheese, yogurt, kefir, etc., are all better for you.

There are many anti-inflammatory HMs with laboratory evidence, CAM usage, and not enough human clinical trials. Trace elements? People with higher intake of dietary boron seldom have arthritis. Shark cartilage, as a DS, is being tested for its effects by the U.S. National Institutes of Health (NIH), one of only a small number of DSs the NIH found had enough preliminary clinical evidence to qualify for government-funded study. Hundreds of Chinese, Indian, and African traditional OA CAMs are used with apparent success, especially by patients from corresponding backgrounds.

Some widely-promoted OA "cures" have been pretty well discredited, among them dimethyl sulfoxide (DMSO), a commercial solvent that penetrates the skin readily and is used as a carrier vehicle for a few human and veterinary medicines. Unfortunately, claims of arthritis relief from DMSO may have been due to the undisclosed inclusion of other pain relievers; also, animal studies found that DMSO use damages the eye lens.

DMSO cannot, however, be described as either a conventional or CAM therapy; it was a scam, pure and simple, because arthritis is a pain, and conventional medicine offers only limited "management" options and no cure. DMSO had no record of thousands of years of human use; no documentation by any reliable source; was not a plant-derived molecule. But many thousands of people tried it because they felt they had nothing to lose.

If you’re too young and healthy to have OA, you’re not too young to prevent it! Healthy weight, basic dietary intake, weight-bearing exercise, and mindfulness are your first lines of defense. Mindfulness includes, for example, being careful about surfaces for running, dancing, and other high-impact activities (firm but resilient is best), making sure you have good arch and ankle support in your shoes, and generally giving your joints a little support so they can support you later in life. Abused joints are weak points OA is likely to attack.

Walking can help prevent hip and knee OA, and benefit OA sufferers as well. I use musical weighted Chinese exercise balls to keep my hands and fingers limber. Whatever you do, keep moving!

Next time: Choosing a health care provider.

Previously: Stayin' Alive: Towards a conscious self-health-care continuum.

The Rag Blog

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Stayin' Alive : Complementary and Alternative Medicine

"Tree of Life," working design for Stoclet Frieze, Gustav Klimt, 1905/09.
Stayin' Alive:
Towards a conscious self-health-care continuum

No system of medicine is static, and none has a monopoly on beneficial knowledge or tactics.

By Mariann G. Wizard / The Rag Blog / January 4, 2010

[Introducing a new periodic column by Rag Blogger Mariann G. Wizard, a professional science writer with a wide-ranging knowledge of natural health therapies. Readers may suggest topics for future columns, within the restrictions suggested below, in the Comments section of The Rag Blog.]

“Complementary and alternative medicine” (CAM), in the U.S. and several other nations, refers to health practices that are not currently part of “mainstream” or “conventional” medicine. This flexible definition allows for therapies that accumulate enough scientific evidence -- or generate enough patient demand! -- to become part of mainstream practices.

In the US, for example, chiropractic, once the domain of energetic and sometimes kooky "bone crackers,” has benefited from the experience of practitioners, the development of comprehensive theory and standards of care, and the establishment of accredited colleges, and is now paid for by most insurance plans -- the true test of a treatment’s acceptance! Acupuncture, as well, with demonstrable benefits in pain relief at minimum, has gained mainstream acceptability in the U.S. within very recent memory.

However, the current CAM definition is rather misleading, having been imposed by conventionally-trained and -biased authorities. It is more accurate to think of CAM as all health practices developed over the course of human history, everywhere in the world, before the discovery of microbes, and including many health practices developed since then outside of “Western” medical facilities.

CAM includes, for example, entire multi-modal systems of medicine, such as traditional Tibetan medicine, Ayurveda, naturopathy, and others, some with continuous documentation of use and development over thousands of years. It also includes more recent practices: e.g., aromatherapy, Reiki, and Essiac, each with its own ancient roots.

One difference between most CAM therapies and “conventional” medicine, often cited by CAM skeptics, is a frequent lack of scientific evidence for CAMs, or even “disproof” of their worth. These criticisms are worth a closer look. “Scientific evidence” is not always best acquired in a laboratory setting, and what works in rats doesn’t always have the same effects in people.

Studies are often designed, depending on funding sources, to demonstrate certain hypotheses; their design may not be fair to competitors. Media coverage tends to focus on negative results in science reporting, as it does in other news. For example, a number of studies have found the herb St. John’s wort as effective as prescription drugs in treating mild to moderate depression. However, the most media coverage occurred when the herb was found to be not-so-helpful for serious depression. No one had ever claimed it would be.

So-called “anecdotal evidence” of practitioners and patients provides support for many CAM modalities, and is often discounted by those who understand only randomized, double-blinded, placebo-controlled clinical trials. However, lack of clinical studies is another misleading negative. Such studies are most often funded by pharmaceutical companies, and are extremely costly. Unless a unique, patentable, reproducible compound has been isolated for testing, there is little incentive to fund research on common herbal remedies such as echinacea, ginger, and aloe vera, or even more novel dietary supplements like shark cartilage.

Acupuncture. Image from Phiya Kushi's Blog.
For some therapies, problems in adequate blinding or other study design factors present substantial obstacles to randomized testing. Acupuncture, for example, is difficult to administer in placebo form. Cannabis medications also present problems in blinding, since experienced cannabis users have no difficulty in distinguishing the real thing from placebo no matter how it is administered; the effects speak for themselves. Different study designs often make it difficult to compare “apples-to-apples” -- but this is as true with pharmaceutical drugs as well as with herbal compounds!

Nevertheless, credible research is being done around the world every day on CAMs. For over 10 years, I have reviewed peer-reviewed journal reports of such work for the American Botanical Council’s HerbClips®, and have reported occasionally for ABC’s peer reviewed journal, HerbalGram®, on regulatory and other matters.

During that time, I’ve also -- somehow -- gotten older, and have begun to experience some of the annoying pitfalls of that process, as well as of ordinary hard knocks and exposure to modern living. While I began my work with ABC without any particular prejudice for or against conventional medicine or CAMs, today, I believe that each has its uses, and its distinct limitations.

I haven't accepted medical or other advice to “get used to” chronic pain and increasing disability any more than I’ve accepted war, injustice, disharmony, or exploitation. These may all be losing battles in the long run, but what are we doing that’s any more important?

A year or so ago on a rainy day, a homeless guy at the downtown library asked me why so many -- pardon the expression, "older ladies in Austin" -- were sporting, as I was, a knee or elbow athletic brace. I stopped and thought about it for a minute. "Because," I finally said, "we are fighting death to the finish!"

No system of medicine is static, and none has a monopoly on beneficial knowledge or tactics. ABC’s knowledge base -- including my own work -- has been priceless in helping me assess CAM options for my use, and even for friends and family facing health concerns. Like a growing world majority, I now consciously combine CAM practices with conventional medical care in a personal health continuum, making the decisions that affect, literally, my life, for myself, like we used to say in Students for a Democratic Society. I consider myself a “health independent” in the same sense that some voters claim independence from major political parties!

The fact is that conventional medicine is very poor in its ability to treat chronic illnesses, and most CAMs are ineffective or unnecessarily slow in treating acute illnesses such as infections. The fact is that professional health care providers of any kind are becoming less accessible to many of us, and that the costs of health care seemed doomed to skyrocket. The smart thing to do, it seems to me, is to use whatever we can to stay healthy!

Meanwhile, there is a skill to assessing unfamiliar health practices, products, and practitioners that I believe can be applied whether these are “conventional” or CAM-related, and I propose to try to impart some of that skill to readers of The Rag Blog.

If you have questions or suggested topics related to natural health practices, please post them in the Comments section of this article! For the record, I will NOT attempt to diagnose any symptoms, diseases, or medical problems. I will NOT recommend specific products, practices, or practitioners, except as examples of alternatives to be considered. I will NOT answer any questions of an intimate nature, e.g., what to do if you have an erection lasting longer than four hours! If none of you slackers have any interesting questions, I will merely regale you with my own adventures in health care; Lord'a'mercy; we are getting old!

I WILL freely discuss health-protective measures such as diet, exercise, and stress relief. I WILL consult with and drag in health care practitioners, researchers, and patients of all kinds as needed, some of whom may let me quote them. I MAY prescribe familiarity with controversial theories, regulatory policies, and historical tirades; take as directed: always with a grain of salt. Your life and health are your most valuable possessions -- guard them well!

Next week: “Osteoarthritis: it takes a village.”

"Bee's Knees," by tyrone_31 / photobucket.

Prevention tip of the week:
Save your knees now!

Everybody should do this mild exercise several times a week if at all possible! Especially if you have weak knees, or “bad knees run in the family," if you’ve had any kind of knee surgery short of a replacement, or if you do any running or jumping, this is a great way to strengthen and protect the most complex joint in your body.

1. Lie flat on your back on the floor, with feet more or less in line with your shoulders.
2. Extend your arms comfortably from your shoulders, so that, seen from the ceiling, you make a sort of “t” shape.
3. Pull your knees up and your feet towards your buttocks as far as you comfortably can, keeping your feet slightly separated and your feet flat on the floor. Seen from the side, you look a little like this: _/\__o
4. Keeping your upper body flat on the floor, gently lower both bent knees as far as you comfortably can to the right side of your body. Your left hip will lift off the floor. Seen from the ceiling, your knees look like a double chevron: >>. Stretch a little tiny bit closer to the floor with both knees, and hold for 20 seconds.
5. Return to position 3 and reverse, lowering knees to the left side: <<. Stretch and hold.
6. Repeat twice, three times a week, for six months. If you feel the improvement, KEEP DOING IT AS LONG AS YOU CAN GET DOWN ON THE FLOOR AND GET UP AGAIN! Don't do it in bed or lying on the couch; you may throw your back out, and I don't want you blaming me for your sciatica!

Hint: If your low-side knee doesn’t go all the way flat to the floor, or the high-side knee doesn't go parallel to the floor when you stretch to left or right, well, that is a goal you can set. Gently stretch as far as you can without discomfort; and next time go a millimeter further!

This stretch, unlike the bicycling motion often used in post-surgical knee rehab, strengthens muscles and ligaments along both sides of the kneecap that help keep the joint stable -- if you’ve ever felt the sickening sideways lurch of thigh-bone or leg-bone pulling away from knee-bone, you know the importance of these supportive structures!

Thanks for this tip to Wendee Whitehead, Doctor of Chiropractic, Austin, Texas, whose exact words to me were, “Knees are totally fixable!” Keep yours strong and flexible with this simple, zero-impact move.

--mgw

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Real Life Education Through YouTube

Sarah Griffith with her husband, Brian Mclean, and sons Declan, 8, and Bastian, 18 months. Photo: Erik S. Lesser/New York Times.
Lights, Camera, Contraction!
By Malia Wollan / June 10, 2009

BY her eighth month of pregnancy, Rebecca Sloan, a 35-year-old biologist living in Mountain View, Calif., had read the what-to-expect books, taken the childbirth classes, joined the mommy chat rooms and still had no idea what she was in for. So, like countless expectant mothers before her, Ms. Sloan typed “childbirth” into YouTube’s search engine. Up popped thousands of videos, showing everything from women giving birth under hypnosis, to Caesarean sections, to births in bathtubs.

“I just wanted to see the whole thing,” Ms. Sloan said. And see it she did, compliments of women like Sarah Griffith, a 32-year-old from the Atlanta area who, when she gave birth to her son Bastian, invited her closest friends to join her. One operated the camera, capturing Ms. Griffith’s writhing contractions, the baby’s crowning head and his first cries. Afterward, Ms. Griffith posted an hour of footage on YouTube in nine installments, which have since been watched more than three million times. “Childbirth is beautiful, and I’m not a private person,” Ms. Griffith said.

Mom-and-pop directors like Ms. Griffith think of their home movies as a way to demystify childbirth by showing other women — and their weak-kneed husbands — candid images they might not otherwise see until their contractions begin. If YouTube can illustrate how to solve a Rubik’s Cube, pick a lock and poach an egg, maybe it can also demonstrate how to give birth. Recently, a British couple became tabloid fodder after the woman gave birth, assisted only by her husband using a YouTube birthing video as tutorial.

Inevitably most childbirth videos are graphic, challenging not just YouTube’s rules but also societal conventions on propriety.

“Nudity is generally prohibited on YouTube,” said Victoria Grand, the site’s head of policy. “But we make exceptions for videos that are educational, documentary or scientific.” YouTube employees regularly review graphic videos and, depending on the content, may decide to leave a video up, restrict access to those 18 and older or remove the video altogether. Explicit medical videos are among the exceptions, allowing cyberpatients and other viewers 18 and over to watch videos of colonoscopies, appendectomies and open-heart surgery. Most childbirth videos are age restricted.

At first Ms. Sloan says she felt timid watching. She remembers one video featuring a couple speaking Dutch or German in which the man embraced the woman gently from behind while she crouched and swayed. Soon, Ms. Sloan was in tears. “It was really moving,” she said. “The videos are so unsensational, they’re largely unedited and people aren’t making money off of their videos. And so the purpose seems very genuine.”

Women logging onto YouTube to watch birth is a natural inclination, said Eugene Declercq, a professor at the Boston University School of Public Health. “A hundred and fifty years ago women viewed birth on a pretty regular basis — they saw their sisters or neighbors giving birth,” he said, adding that it wasn’t until the late 19th century that birthing moved out of living rooms and bedrooms and into hospitals. “But now, with YouTube, we’ve come back around and women have this opportunity to view births again.”

Every day Ms. Griffith signs into YouTube to answer comments and questions that viewers post in response to her videos of Bastian’s birth. She says her comments section breaks down like this: excited and apprehensive moms-to-be; a few comments so obscene she refuses to post them; and lastly, comments from those Ms. Griffith calls “repetitive guys.” “They’re always like, ‘Whoa, I’m so glad I’m not a woman,’” she said.

Ms. Griffith’s footage is difficult to watch. Bastian weighed almost 11 pounds at birth, and she did not edit out the close-ups, the screaming, groaning and cussing. “My goal is not to scare anybody,” she said. “But if someone is pregnant and they haven’t wrapped their head around the fact that there is pain involved, then they might want to start.”

The graphic nature of public childbirth videos makes them controversial. In an online forum run by Parenting Magazine, a user recently posted the question, “Mom Debate: Birth Videos on YouTube? What do you think — great, or gross?” Responses split between the gross (“My question is why do these people feel the need to post it on the Internet?!”), and the great (“I think it’s great for moms to see all the different and real ways women give birth”).

Childbirth videos have been screened at birthing classes since the 1970s. But those videos tend to be highly edited, and they can be dated, says Jeanette Schwartz, president of the International Childbirth Education Association, which certifies childbirth class instructors. YouTube videos could change the way classes are taught, Ms. Schwartz said: “This creates a wonderful opportunity to show free, real life, candid videos in a classroom setting.”

The majority of childbirth videos on YouTube are home births, recorded inside living rooms, bedrooms or bathtubs. In the United States, many hospitals and doctors forbid patients to record births because of liability concerns, so few American hospital birth videos appear on YouTube.

The thousands of online childbirth videos, garrulous mommy chat rooms and endless pregnancy blogs are changing the dynamic between pregnant women and their attendant medical professionals.

“The more information you have, the more sources you have, the more informed you are, the better questions you ask,” said Eileen Ehudin Beard, an adviser for the 6,500-member American College of Nurse-Midwives. But videos of complicated or difficult births could be detrimental, Ms. Beard said, especially if they made women more fearful of delivering a baby.

Providence Hogan insists she is “not a YouTube person.” Still, Ms. Hogan, 42, who owns a day spa in Brooklyn, has been logging long hours watching birthing videos in preparation for the August arrival of her second child. If Ms. Hogan’s birth goes as planned (at home in a birthing tub), she intends to have her 7-year-old daughter, Sophia, present. After prescreening videos on YouTube and another site, birthvideos.tk, Ms. Hogan started showing Sophia the less graphic ones.

“At first she was like, ‘That’s weird, that’s ugly,’ ” said Ms. Hogan of her daughter’s response. “Now it’s ‘Oh, what a cute baby!’ ”

Eleven months ago in Mountain View, Ms. Sloan recorded the birth of her son, Urban. She says she feels a little squeamish about putting it on YouTube, and she’s not sure what her husband would say. Still, eventually she thinks her video will become one more public testament to the agony and beauty of birth.

“I found it so helpful to see those videos,” Ms. Sloan said, “and I am so grateful to the families that shared them I feel like I want to return the favor.”

Source / New York Times

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