Monday, December 30, 2013

Kaizen Curmudgeon 2013 Archive


“Hey, Curmudge, we’re at the end of another calendar year.  Do you think that the information we presented in our blog this year did some good?”

“Not for the 7.2 billion people on this earth who didn’t read it, Julie.  Of course, each person saved about five minutes per posting by not reading each of the 40 postings.  Assuming each person‘s time is worth $0.10 per minute, on a world-wide scale, we saved $144 billion by writing a blog that few people read.”

“I think your numbers are right, Curmudge, but your logic is goofy.  Maybe there’s a job waiting for you in Washington.  But what about those people who did read our blog?”

“There is a high probability that they gained from each posting something that they might not have otherwise learned.  It was free from the Internet and cost a few pennies of their time.  Such a deal!  So here’s what we wrote about in 2013.”


2013 Archive—Table of Contents

Title (Subject)
Date Posted
Risks and Fears—Introduction
1/03/13
Risks and Fears—Examples
1/13/13
Risks and Fears 3 (The Old Risks and Benefits File)
1/20/13
Bloggers—Affiliated or Independent
1/27/13
The Ordeal 1 (Chemotherapy)
2/04/13
The Ordeal 2
2/10/13
The Ordeal 3—Summary
2/16/13
Unconventional Wisdom 1 (Heath Effects of Low Doses of Ionizing Radiation)
2/28/13
Unconventional Wisdom 2—Mice in the Laboratory
3/07/13
Unconventional Wisdom 3—Epidemiology
3/20/13
Unconventional Wisdom 4—Radiation Background
4/01/13
Unconventional Wisdom 5—How much?  How does it work?
4/15/13
Unconventional Wisdom 6—Policy Issues
4/24/13
Happy Sixth Birthday
5/13/13
Kaizen Curmudgeon for Seniors (Introduction and Contents of Interest From Earlier Postings)
5/27/13
A Look Ahead on Kaizen Curmudgeon (An Introduction to Global Warming)
6/04/13
Curmudgeon and Jaded Julie Read the Newspaper
6/17/13
Curmudge and Jaded Julie Talk About Cause and Effect
6/26/13
Curmudge and Jaded Julie Talk About Models and Vested Interest
7/02/13
Peer-Reviewed Publications
7/11/13
600 Years Ago (An Allegory on Global Warming)
7/15/13
Climate Science 1 (Anthropogenic Global Warming)
7/23/13
Climate Science 2
7/30/13
Climate Science 3
8/06/13
Climate Science 4
8/14/13
Climate Science 5
8/21/13
The Almost-Invisible Emotion (Mourning Seven Months Later, written August 11, 2011)
9/03/13
Mourning—Almost Three Years Later: Absence
9/11/13
Companion Qualities
9/20/13
Alternative Medicine 1—Introduction
9/27/13
Alternative Medicine 2—Words of Wisdom and Caution
10/04/13
Alternative Medicine 3—Nutrition
10/14/13
Alternative Medicine 4—Illness and Risk
10/21/13
Alternative Medicine 5—It’s Cancer!  Now What?
10/31/13
Alternative Medicine 6—Alt. Med. 101
11/08/13
Alternative Medicine 7—Mind-Body Medicine
11/20/13
Alternative Medicine 8—Energy and Hands-on Therapies
12/04/13
Your Plastic Brain—The Basics
12/11/13
Holiday Greeting--2013
12/18/13

“Do you suppose, Curmudge, that some of our readers might never have used the Blog Index to access an earlier posting?” 

“If that’s the case, Julie, we’d better provide some help, as follows:  Links to all postings are available via the Blog Index in the right margin of each posting.  But to use it one has to know when the subject of interest was in a posting.  In the Blog Index one clicks on the year and then the month of posting.  Titles of each of that month’s postings appear, and they are links to the posting with that title.  The problem is that one must know the year and month.  What is needed is a table of contents in which one can browse.  That’s what we have created (above) in our current end-of-the-year posting—a table of contents for the 2013 postings.  After one finds a subject of interest, he/she goes to the Blog Archive in the right margin of any posting and clicks on year, month, and title (link).”

“That ought to do it, Old Guy.  Happy New Year.”

Frohe neues Jahr, Young Lady.”

Link to posting from blog archives: Primary care in 1940 (Doc on call 24/7.)—8/20/09 http://kaizencurmudgeon.blogspot.com/2009/08/primary-care-in-1940.html

Wednesday, December 18, 2013

Holiday Greetings—2013


“Curmudge, you look as if you just took a dose of unflavored Metamucil®.  It doesn’t taste really bad but not very good either.  Is your morose expression just for the holidays, or is it for everyday use?”

“I try to be consistent, Julie; it’s now my default mien.  I used to be the happiest guy at St. E’s, but events of recent years have cured that.”

“Okay, Ebenezer.  So how can we conjure up any sort of holiday greeting?”

“I’ve been puzzling over that, Mrs. Claus.  It’s difficult to be cheery about big issues.  Our nation and the world certainly appear to be going to pot.  We’ll discuss that in 2014 under the title, Curmudgeonomics.  That leaves us with personal concerns for which to be thankful and possibly even cheerful.”

“Bravo, Old Guy.  I knew that you would come up with something.  Here’s an example: We are both grateful that last summer’s tornados—only a hundred yards away—didn’t blow in your windows and tear the roof off your apartment.”

“I agree, and here’s another: At my age, I rejoice that I can still see and hear—with assistance—and walk up the steps in the 222 Building.”

“These deserve our prayers of thanksgiving: People we love who have survived melanoma and Burkitt’s lymphoma.”

“And you know, Julie, we are thankful for the advances in neuroplasticity that we are writing about.  Application of that knowledge will give new hope for autistic kids and seniors with age-induced memory loss.”

“So there we have it, Curmudge.  If people take time to think about it, most everyone should be able to find something about which to rejoice this holiday season.”

“Happy Holidays, Julie.”

Link to posting from blog archives: Physicians and Lean—6/25/09

Wednesday, December 11, 2013

Your Plastic Brain 1—The Basics


“Curmudge, it seems that we have suddenly changed from discussing alternative medicine to brain plasticity.  Is there a connection?”

“Of course there is, Julie.  Techniques that we have already mentioned, like meditation and tai chi, are designed to relax and refocus the mind.  As we quoted a couple of weeks ago, the mind is the software for the brain.  So we are going to move inside and find out what is really going on inside the brain.”

“In your brain, Old Guy, nothing other than a big memory leak is going on.  Even the smallest parts were cemented in place by the time you learned that girls were different from boys.”

Au contraire, Madame.  That’s what was believed 50 years ago, about the time I finished graduate school (good thing I wasn’t studying physiology).  It was called localization.  Here’s how it is described in Doidge’s book (1): ‘The brain came to be seen as made of parts, each one in a preassigned location, each performing a single function, so that if one of those parts was damaged, nothing could be done to replace it.’  ‘Most scientists believed that the brain areas (devoted to sight, hearing, taste, touch, smell, balance) were so specialized that one area could never do the work of another.’ “

“I anticipate that you are going to tell me that great advances have been made in understanding the brain in recent years and that the localization concept is outmoded.  Please elucidate.”

“Here’s the story: ‘Brain plasticity, also known as neuroplasticity or cortical remapping, is a term that refers to the brain's ability to change as a result of experience. These changes can occur as a result of learning new things or because of damage to the brain.  Up until the 1960’s, experts believed that changes in the brain were only possible during infancy and childhood, but research has demonstrated that the brain is capable of altering existing pathways and even creating new ones.’ “

“Hey, Curmudge, this neuroplasticity stuff is mindboggling.  Don’t stop now.”

“There’s lots more, Julie, such as these two kinds of plasticity: ‘Functional Plasticity—refers to the brain's ability to move functions from a damaged area of the brain to other undamaged areas.  Structural Plasticity—refers to the brain's ability to actually change its physical structure as a result of learning.’  A two-page overview provides more detail.“

“Amazing!  And neuroscientists learned all of that while you were teaching analytical chemistry and helping to make soft toilet tissue.  One might say that from top to bottom, science was advancing.  So what kind of experiments did those brainy people perform to demonstrate neuroplasticity?”

“The researchers and their work are described by Doidge in engaging detail. (1) Merzenich, Taub, and their coworkers, who did basic studies with animals, followed it up with applications to human patients.  Much of this was made possible by the invention of microelectrodes ‘so small and sensitive that they could be inserted inside or beside a single neuron and detect when an individual neuron fires off its electrical signal to other neurons.’  (Unless otherwise indicated, quoted material is from Doidge’s book.)  A portion of a monkey’s skull was cut away over an area of the brain’s sensory cortex believed to respond to the monkey’s hand. Microelectrodes were inserted, tested by touching, e.g., a fingertip, and a micromap of the part of the brain responding to each area of the monkey’s hand was created.”

“I’m certain to feel sorry for the monkeys, Curmudge, but can you tell me what was learned?”

“When two of a monkey’s fingers were sewn together, over time the separate bran maps for the fingers became joined.  Another experiment:  In a monkey’s hand, sensation is conveyed by three nerves, the radial, median, and ulnar.  Merzenich cut the median nerve; when he touched the middle of the monkey’s hand two months later, the area of the brain map that serves the median nerve showed no activity, as expected.  But when he touched the outside of the monkey’s hand, the median brain map lit up.  ‘The brain map for the radian and ulnar nerves had almost doubled in size and invaded what used to be the median nerve map.’ “

Voilà, Old Guy, plasticity!  That furry fellow was a hero.  He proved that, ‘When it came to allocating brain-processing power, brain maps are governed by competition for precious resources and the principle of use it or lose it.’ “

“Here’s a little more ‘monkey business,’ Julie; the researcher is Edward Taub.  He cut the sensory nerves in one of a monkey’s arms, but not the motor nerves.  Because the monkey had no feeling in his bad arm and couldn’t determine its location in space, he used his good arm and hand for eating.  During its period of nonuse, the brain’s motor map for the bad arm began to atrophy (i.e., use it or lose it).  Taub called this ‘learned nonuse.’   Then he immobilized the monkey’s good arm by putting it in a sling.  In order to survive, the monkey had to use his ‘bad’ arm for eating.  Taub’s finding supported Merzenich’s conclusion that when an animal is motivated to learn, the brain responds plastically.”

“I have the feeling, Professor, that these and other findings have become the basis for alleviating a lot of human beings’ miseries and weaknesses.”

“And, Julie, we’ll say more about them in a week or so.  See you then.”

Kaizen Curmudgeon

(1)  Doidge, Norman, MD The Brain That Changes Itself (2007).

Link to posting from blog archives: Communicate—Think—Diagnose—Communicate  6/18/09 http://kaizencurmudgeon.blogspot.com/2009/06/communicate-think-diagnose-communicate.html

Wednesday, December 4, 2013

Alternative Medicine 8—Energy and Hands-on Therapies


“Listen up, Julie.  Here’s how Mayo’s describes acupuncture.  It’s pretty typical of the energy therapies: ‘Traditional Chinese medicine is based on the belief that the body contains a vital life energy called qi (chee), which runs along pathways within the body.  Imbalances in the flow of qi are thought to cause illness.  These life-energy pathways are called meridians and are accessible at approximately 400 different locations, or points, on the body.  Practitioners of acupuncture attempt to rebalance your energy flow by inserting extremely fine needles into these points in various combinations.  This allows your body’s natural healing mechanisms to take over.’ (1)”

“Curmudge, I can almost hear your mind squeak as you struggle to understand and fully believe these energy therapies.”

“And all along I thought it was just high-frequency interference in my hearing aids.  But I’m willing to consider anything that might soothe the aches and pains of old age.  Here’s a study performed at McMaster University that actually yielded scientific data: Cell cultures were exposed to acupuncture-like and reiki-like treatments.  The cultures were exposed to x-rays before or after the treatments and were monitored for damage by the radiation.  From their findings, the authors concluded that ‘alternative medicine techniques involving electromagnetic perturbations may modify the response of cells to ionizing radiation.’ (2)”

“Wow!  Now I understand…I think.  But I believe we’d both feel more comfortable with these techniques if we could learn about some real, human examples.  One example is Doc Mack’s use of acupuncture for allergies and stress relief.  Come to think of it Old Guy, I have used the traditional Chinese medicine called acupressure.  It uses pressure at specific points on the body instead of acupuncture needles.  Putting pressure at a point three finger-widths up the inside of the wrist from the base of the hand controls motion sickness.  At the drugstore one can buy elastic wristbands with a rubber button at the right spot for this purpose.  They really work.”

“And this is my own example, Julie.  It’s a hands-on therapy: Several years ago I had constant pain down my right leg all the way to my ankle.  It was even hard to stand up in the church choir.  I went to an orthopedic doc who, after an x-ray, determined that I was in the wrong shop.  He didn’t try to solve my problem; he just established that it wasn’t his.  I subsequently saw a chiropractor who prescribed some stretches that resolved my pain and that I now do every day.  And, by the way, chiropractic is covered by Medicare.”

“And here is another technique that appears to have been successful.  It’s called reiki (RAY-kee), as in the study at McMaster University.  ‘The practitioner delivers reiki therapy through his or her hands with the goal of raising the amount of ki (or qi) in and around the recipient.’ (3)  A member of our editorial board experienced reduced pain in an injured knee after a reiki treatment.  I’ve also heard of reiki treatments reducing the intense pain of terminal cancer patients in a hospice.”

“Of course, Julie, you know how it bothers me not to have a better understanding of how these techniques function.”

“The problem is that you are a hide-bound old relic burdened by a mid-twentieth century education.  You don’t know all that goes on inside my smart phone (neither do I), but you accept it.  Perhaps we could tentatively accept at least some of these obscure mind-and-body aspects of alternative medicine if we used them on a regular basis.  You might try qigong; we mentioned it last week.  It’s like tai chi only less vigorous, and it is reported to relieve depression in old people.”

“Loneliness, but probably not clinical depression, may be endemic among widows and widowers.  But if I go bouncing around in my apartment doing tai chi or qigong, it might disturb the people in the apartment below mine.”

“Then do it in the basement where the cars are parked.”

“If my neighbors see me, they’ll think I’m a nut.”

“Not to worry, Curmudge.  They already know that.”

“Putting aside your levity and attempts at humor, Young Lady, you might have noticed my reading a borrowed copy of Norman Doidge’s book, The Brain That Changes Itself.  We mentioned it in last week’s posting.  Doidge’s discussions of neuroplasticity should be of interest to parents of young children, senior citizens, and people with brain injuries and mental illnesses.  We should share some of his insights in our next postings.”  

“Sounds interesting to me, Old Guy.  I’ll be here.”

Kaizen Curmudgeon

(1) Mayo Clinic Book of Alternative Medicine, Second Edition.  p. 121 (2010, Mayo Foundation for Medical Education and Research).

(2) Mothersill, C. et al. Alternative Medicine Techniques Have Non-Linear Effects on Radiation Response. Dose-Response 11 (1) p. 82-98 (2013).

(3) Mayo Clinic Book of Alternative Medicine, p. 127.


Link to posting from blog archives: Patient-Centered Communications  6/11/09

Wednesday, November 20, 2013

Alternative Medicine 7--Mind-Body Medicine


“Julie, Do you recall our January 3, 2013 posting on the Introduction to Risks and Fears?”

“I do, Curmudge, but what does that have to do with Part 2 of the Mayo Clinic Book of Alternative Medicine? (1)  Hey, you promised that we would discuss that this week.”

“We will.  Just stick with me.”

“I’ve been with you for 6-1/2 years, Old Guy, so I’m not leaving now.  Let’s return to Risks and Fears.  As I recall, at least hypothetically, I came face-to-face with a grizzly bear when we were hiking in the Rockies.  I jumped, and my heart ‘leaped into my mouth.’  It was a virtually instantaneous reaction; no thinking was required.  You described it as my ‘flight or fight’ response, starting in my brain’s thalamus and moving in milliseconds to my amygdala.”

“You’ve got it Julie, as usual.  Now let’s put me in a similar fictitious but illustrative situation.  At one time earlier in my life I believed that I almost died from eating a contaminated strawberry.  As a result of that extremely unlikely experience, I ‘flip out’ whenever I see a strawberry.  I become fearful and have a ‘blue funk’ for the rest of the day.  Dr. Sood at Mayo’s would characterize my ‘blue funk’ as a state of mindlessness in which the threat existing in my mind far exceeds that in the real world.”

“Your experience with the strawberry, Curmudge, resembles mine with the grizzly bear.  The strawberry triggered the ‘flight or fight’ reaction in your brain.  So once again, after over 100 words, what does this have to do with alternative medicine?”

“Here’s the connection, Dear Colleague, quoting Amit Sood, MD, from p. 95 in the Mayo book: ‘Impressive advances in neuroscience research have brought to our attention a startling and exciting discovery—the mind can change the brain.  Software can indeed transform the hardware.  Training our mind using mind-body approaches can soothe the limbic areas of the brain such as the amygdala…’  ‘This literal rewiring of the brain by our recurring thought patterns and experiences is now popularly recognized as neuroplasticity.’ “

Voila!  That’s the link we need, Professor, to soothe your amygdala and your ‘flight or fight’ reaction when you see a strawberry.  No more blue funk, and we’ll be able to put strawberry shortcake on the menu again.  Of course, I must be careful not to lose my primordial fear of grizzly bears.”

“As an aged-but-still-somewhat-functional scientist, I remain puzzled by how this ‘brain reprogramming’ occurs.  You’ve read the Mayo book too, Julie.  Can you quote or paraphrase more from pages 96 and 104 of the Mayo book that might improve my understanding?”

“Coming at you, Chief.  ‘The system responsible for the flight-or-fight response is the autonomic (involuntary) nervous system.  It regulates many body activities, including heartbeat, perspiration, breathing, and digestion.  The autonomic nervous system is divided into two parts, sympathetic that mobilizes the body into action (flight-or-fight) and parasympathetic that creates a “rest-and-digest” response.  Current research is focused on understanding how meditation and related techniques can reduce the activity of the sympathetic system and increase the activity of the parasympathetic system.’ “

“My interpretation of what you just said, Julie, is that we don’t know exactly how meditation makes that work.  However from other reading one can conclude that it does work.  ‘Positive emotion may be a skill which can be achieved with training similar to learning to ride a bike or play the piano.’  But I bet it’s not really as easy as learning to ride a bike.”

“We don’t have to rely on just the Mayo book and Wikipedia, Old Guy.  For one really interested in this topic, there are several books that go into it more deeply than we can.  Norman  Doidge (2) reviewed the experiments that established the validity of neuroplasticity.  Applying neuroplasticity and meditation to personal problems is described by Sharon Begley (3) and in several books by Jeffrey M. Schwartz (4-6).”

“One can discern the theme and contents of these publications just by reading their reviews on Amazon.com.  An outstanding example is the review of Sharon Begley’s book by Barbara Rose, Ph.D.  You know, Julie, these books look so inspiring that I might try some of that meditation stuff.”          

“Knowing you, Ancient One, you’d probably just fall asleep while meditating.  And then there are people who might just naturally reject meditation or allowing themselves to be hypnotized.  Then what?”

“These people might try tai chi (‘moving meditation’) or qigong and achieve comparable results.  There’s a technique for everyone in mind-body medicine.”   

“What about the other mind-body medicines in the Mayo book?  Although the most space is given to meditation, there are ten other techniques, from biofeedback (alphabetically) to yoga.”

“We can’t talk about all of them in a blog, Julie.  In my own case I wouldn’t be too selective about the technique; I‘d seek the best coach who had the most success with strawberry-phobia.”

“I’m sure you are aware, Old Guy, that Part 2 of the book also has sections on Energy Therapies, Hands-on Therapies, and Other Approaches.”

“We’ll mention some of those in our next posting, Julie.  Don’t go away.”

Kaizen Curmudgeon

(1) Mayo Clinic Book of Alternative Medicine, Second Edition.  (2010, Mayo Foundation for Medical Education and Research).

(2) Doidge, Norman The Brain That Changes Itself (2007).

(3) Begley, Sharon. Train Your Mind, Change Your Brain (2007).

(4) Schwartz, Jeffrey M. and Begley, Sharon  The Mind and the Brain: Neuroplasticity and the Power of Mental Force (2003).

(5) Schwartz, Jeffrey M. and Gladding, Rebecca You Are Not Your Brain (2012)

(6) Schwartz, Jeffrey M. and Beyette, Beverly  Brain Lock: Free Yourself from Obsessive-Compulsive Behavior (1997)  


Link to posting from blog archives: Patient Safety—Epilogue  3/12/09

Friday, November 8, 2013

Alternative Medicine 6—Alt. Med. 101


“Did you know, Julie, that learning and blogging are both non-linear processes?”

“It never occurred to me, Curmudge, so I’m going to need some explanation.”

“When one learns a foreign language, he learns to say a few useful phrases, such as ‘hello’ and ‘goodbye,’ before he learns the basics, such as how to conjugate verbs.  When you and I study a new topic and write about it, we learn and discuss aspects of the topic of our current interest.  We don’t start with the basics at square one and blog about the topic as if we were writing a textbook.”

“I think I’ve got it, Old Guy.  When we began blogging on alternative medicine, we jumped right into herbal medicines without laying a foundation for the whole of alternative medicine.  So perhaps the sooner we do that, the better.  Let’s call it Alt. Med. 101.”

“And our text for Alt. Med. 101 will be the Mayo Clinic Book of Alternative Medicine. (1)  It is authoritative and comprehensive; its main sections are Part 1  (Today’s New Medicine), Part 2 (Guide to Alternative Therapies), and Part 3 (Your Action Plan).   Contrary to other publications we have read, Mayo’s authors don’t have major vested interests in their contributions.  They are promoting neither practices nor potions.  Their overall views tend to be conservative, and their conclusion for each dietary supplement and mind-body practice is indicated by a red, yellow, or green ‘traffic light.’ “

“Right from the start, I am impressed by two things: (a) an institution with Mayo‘s stature has a Comprehensive and Integrative Medicine Program, and (b) the book must be so good that a skinflint like you, Curmudge, actually purchased it (at $29.95).”

“Julie, because we’re not going to discuss all of the book, we’d better tell our readers a bit more about its contents.  Part 1 deals with lifestyle issues, from diet, to exercise, to stress.  Part 2 covers herbs and dietary supplements, mind-body medicine, and energy-related therapies.  Part 3 provides a two-page discussion on each of 20 common conditions ranging (alphabetically) from arthritis to vaginal yeast infections.”

Part 1
Compared with traditional ‘diet‘ books, this book has broader lifestyle coverage and fewer diet specifics.

Part 2
“Gosh, Old Man, we have already read a lot about natural products and dietary supplements.  Does the Mayo book tell us much that is new?”

“For each item the book presents a few paragraphs of general discussion, then a two-or-three sentence summary called Our take, and then a research note called What the research says.  And of course, the ‘traffic light.’  They do this for 39 herbs (I wish there were more), 7 vitamins, 5 minerals, and 11 hormones and other compounds.  A common conclusion is that ‘more research is needed.’  But my answer to your question is a qualified ‘yes’ as well as ‘no.’  We learned new stuff, but several natural products of interest weren’t mentioned, including turmeric (curcumin), quercitin, and resveratrol.”

Part 3
“Hey, Curmudge!  How can we move on to Part 3 without discussing Mind-Body Medicine and Energy and Other Therapies in Part 2?”

“We‘re not going to skip those topics, Julie.  They are so important that we are going to defer them and put them in several postings.  But before we leave Part 3 we must mention the Mayo book’s contribution to treatment of its list of 20 common conditions.  For each condition, Mayo mentions the alternative medicine treatments that are available.  I can’t comment on the treatments because I haven’t had hardly any of the conditions except the common cold.  The book says that the Scandinavians use andrographis; that sounds like an interesting recommendation.”

“I consider it your promise, Old Guy, that we’ll be back within the next couple of weeks to talk about the rest of Part 2.”

Kaizen Curmudgeon

(1)  Mayo Clinic Book of Alternative Medicine, Second Edition.  (2010, Mayo Foundation for Medical Education and Research)

Link to posting from blog archives: Patient Safety—Accidents, Trauma, and Luck 3/04/09

Thursday, October 31, 2013

Alternative Medicine 5—It’s Cancer! Now What?


“I presume, Curmudge, that we are just going to play copy-cat and pass along what we have learned in our reading.”

“Right as usual, Julie.  Despite having read good stuff, what might sound like advice is really our perceptions.  So let’s begin.  For most people, a diagnosis of cancer hits like a whack with a wet towel in a locker room.  Their immediate emotion is, ‘Do something!  I want it out!’ “

“Whoa-up there, Partner.  If our patient’s diagnosis is based on a biopsy, she’ll want a second opinion from another pathologist.  Cancer is serious business, and nobody wants an incorrect diagnosis.  She should also read our Evidence-Based Medicine postings back in September and October of 2010.”
 
“Here are some of the things that I have learned that pertain to many cancers.  If they don’t require immediate action, there is time for the patient to learn about the various modes of treatment and to select among them.  When one consults oncologists, the surgeons will want to cut, the clinical oncologists will favor chemotherapy, and the radiation oncologists will propose radiation therapy.  By their very nature, specialists in many fields are parochial in their diagnosis and plan of care.  And irrespective of the initial approach, the cancer may return, its further growth need to be arrested, and it might become something the patient must learn to live with.”

“Hey, that’s more scary than I realized.  To most people, ‘removed’ or ‘in remission’ means ‘goodbye.’ “ 

“Lots of people don’t realize that, Julie, and they also aren’t aware that alternative medicine might play an important role in their plan of care.  So before plunging ahead with surgery, chemotherapy, or radiation, our patient should—if possible—consult with someone who practices integrative or alternate medicine.  Our readings have told us about complementary medicine techniques that can strengthen the patient prior to conventional procedures, mitigate the procedures’ side effects, and hasten the patient’s recovery.  Furthermore, there may be opportunities to skip the conventional procedures altogether.”

“Wow, Curmudge!  I’ll bet those ‘opportunities’ enliven the debate between the allopathic and alternative docs.  Fortunately, if the cancer is growing slowly enough, there might be time to test the alternative meds to see if they shrink the tumor or arrest its growth.”

“Nevertheless, Julie, an alternative med zealot should not bet all of her chips on some herbal concoction without carefully evaluating the oncologist’s proposed conventional plan of care.”

“That’s for sure, Old Guy, but from my search of the Web, it’s not going to be very easy for our cancer patient to find an alternative medicine doc with the training she needs for consultation.  A person with cancer or malfunctioning innards such as liver, lungs, intestines, or whatever needs an herbalist with experience with her particular ailment.”

“That seems to be the case.  Recall the two main categories of alternative medicine mentioned in our first posting on this topic, ‘Alternative medicine includes use of natural products (herbs, vitamins, minerals, and probiotics) as well as mind and body practices (acupuncture, meditation, relaxation techniques, and movement therapies).’  If one specializes in just one or a few of the mind and body practices, less training is needed than for treatment with natural products.”

“I’ve even seen some of the mind and body practice clinics advertising their ‘antiaging’ services, whatever that is.”

“I’m puzzled too, Julie.  To me, antiaging is opposition to growing old, i.e. dying young.  I think we’ll just skip that aspect of alternative medicine.”

“So, Curmudge, back to our patient’s search for a natural products practitioner who can provide the help that she needs.”

“That may require reading the publications of Yance and Blaylock that we mentioned in our posting on nutrition.  The Blaylock Report Archives is a collection of his monthly newsletters on a variety of illnesses.  Another book that discusses a host of conditions has the intimidating title, Miracles from the Vault: Anthology of Underground Cures by Jenny Thompson of the Institute of Health Sciences (see Quackwatch).  She is an excellent writer, but some of her ‘cures’ sound too good to be true (and they may be).”

“Hey, Professor, let’s not forget Suzanne Somers, an actress also cited in Quackwatch.  She has been criticized mostly for promoting bioidentical hormones.  However, she has also written Knockout (1), a book comprised of interviews with ‘doctors who are curing cancer,’ including one whose treatments include coffee enemas (!).    Our cancer patient might wish to follow up with some of her more conventional interviewees, which might require long-distance travel.  But as you and I have said many times, we don’t make recommendations.  Recall also our suggesting that cancer patients may be willing to take somewhat greater—but hopefully intelligent—risks.”

“And that, Curmudge, is about as risky as this posting is going to get.  In future postings, do you intend to discuss any of the so-called mind and body aspects of alternative medicine?”

“I’ll try, Julie, and if we’re lucky we may get some help from a guest author.”

Kaizen Curmudgeon

(1) Somers, Suzanne  Knockout (2009, Random House)

Link to posting from blog archives: Patient Safety—Your Lifestyle 2/26/09
http://kaizencurmudgeon.blogspot.com/2009/02/patient-safety-your-lifestyle.html