tag:blogger.com,1999:blog-4519234397783312626.post7279310960021975521..comments2023-10-09T11:42:57.305-04:00Comments on Healthcare, etc.: Furthering the discussionMarya Zilberberghttp://www.blogger.com/profile/16080475886113209344noreply@blogger.comBlogger18125tag:blogger.com,1999:blog-4519234397783312626.post-3136701477775372102011-08-26T13:04:48.424-04:002011-08-26T13:04:48.424-04:00In many cases, scientists aren' t sure what sp...In many cases, scientists aren' t sure what specific ingredient in a particular herb works to treat a condition or illness.Parker Massagehttp://hatchchiropractic.com/parker-colorado-massage.htmlnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-69576332970688575132010-10-28T22:26:45.174-04:002010-10-28T22:26:45.174-04:00Anonymous, exactly! Just like parachutes, your cra...Anonymous, exactly! Just like parachutes, your craft does not lend itself to RCTs in all cases. That is exactly the point! Thanks.Marya Zilberberghttps://www.blogger.com/profile/16080475886113209344noreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-29995488950734389322010-10-28T21:04:09.211-04:002010-10-28T21:04:09.211-04:00Gunshot injuries to the aorta are rare, and deadly...Gunshot injuries to the aorta are rare, and deadly. There are no randomized controlled trials regarding the management of these injuries I am aware of. Just some case reports and expert opinion.<br /><br />So when that 20 year-old is in the trauma bay with a blood pressure of 75/40, what should I tell him? <br /><br />"There are no RCTs regarding your injury. I think you need emergent life saving surgery, but I have no absolute proof. It is theoretically possible other forms of treatment such as homeopathy or natural herbs may be superior to surgery. I do not wish to force my paternalistic views upon you. Please research the options and let me know how you would like the hole in your aorta treated."<br /><br />Trauma is a difficult area to study. Many treatment approaches have changed significantly in recent decades. The science is not perfect and is often debated within the field. Fortunately there are a lot of dedicated people doing the best they can with the data available, including lowley expert opinion. As a result, your chance of surviving a significant injury continues to improve.<br /><br />When I tell a trauma patient the need an operation, nobody argues. No anecdotes about relatives who got better with chiropractic therapy. No conspiracy theories about surgical equipment companies. It's easy to understand that you have a hole in the aorta and it must be fixed. I'm an expert in fixing certain injuries, they trust my expert opinion based on training, experience, and science.<br /><br />I feel bad for my pediatrician brother when he tells someone they should vaccinate their children. How could he know that? Obviously, big pharma got to him.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-3239697445849811332010-10-28T09:02:37.039-04:002010-10-28T09:02:37.039-04:00"Chickenpox is mild, but highly contagious, a..."Chickenpox is mild, but highly contagious, and results in a significant period out of school. Missing more than a few days in a row of school is associated (for obvious reasons) with reduced grades."<br />Then there is the shingles you get in older age, a nasty often very painful episode that at its worst can leave you visually impaired. Having a good chance of avoiding that alone is worth the vaccination. Ask anyone who has had it.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-75336107038746658002010-10-27T17:07:58.541-04:002010-10-27T17:07:58.541-04:00Thank you again Dr. Zilberberg!! I am a mom who ha...Thank you again Dr. Zilberberg!! I am a mom who has obsessively studied both sides of the vaccine argument and I find you voice both refreshing and reasonable.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-75401159869766578142010-10-27T10:52:11.035-04:002010-10-27T10:52:11.035-04:00I have another comment to make, this time regardin...I have another comment to make, this time regarding the varicella vaccine. You say:<br /><br />***What I have stated, however, is that I am of the opinion that we have gone a bit overboard with some of them, one being the chicken pox vaccine. Now, this does not make me an "anti-vaxer"; this just makes me a bit skeptical. The way I view the data is that the advantages for this vaccine are mostly economic, in that they prevent parents from missing days at work. Now, I am certainly not opposed to making such a vaccine available to parents who desire it, but I am not convinced that it should be a prerequisite for my kid to go to school.***<br /><br />You are mistaken that the advantages for the vaccine consist primarily of the parents not missing work. There is certainly a financial argument, but it is far from the primary one. The reason that schools, including private schools and daycare centers, tend to require it has nothing to do with the parent missing work. It's to do with the *child* missing *school*.<br /><br />You are an educated person; I'm sure you'll agree that it is not good for a child to miss two weeks of school. That's how much I missed when I had chickenpox, and I didn't even need to be hospitalized or anything. My mom was a stay-at-home mom; economically, it really wasn't any skin off our backs. But I missed a lot of school. Oh, they sent homework and stuff home for me, but I missed the lectures and such, and you can't really make that up. Time is one thing you just can't get back.<br /><br />Chickenpox is mild, but highly contagious, and results in a significant period out of school. Missing more than a few days in a row of school is associated (for obvious reasons) with reduced grades. If it's just one kid, well, that's too bad. But with a contagious illness, you could be talking half the student body out with it. The outbreak that got me wasn't that bad, because of good compliance with quarantine protocols. But of my close circle of friends, half were sick, one bad enough to be hospitalized. That's a lot of kids missing school, and that throws off the classroom dynamics.<br /><br />In short, schools have very good reasons to require vaccination, and it's nothing to do with parental convenience. It's to do with truancy.Calli Arcalenoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-83756284538383412822010-10-27T09:52:15.096-04:002010-10-27T09:52:15.096-04:00So be brief:
1) Those are your problems with SBM ...So be brief:<br /><br />1) Those are your problems with SBM - what, if anything, do you propose we use to get more reliable results?<br /><br />If you don't have an answer, do you agree that SBM is our best way of testing treatments?<br /><br />2) You quote a section on 'Proof' which correctly states the elementary idea that we cannot obtain 'absolute' proof of anything. That granted, do you recognise that SBM gives us the best evidence and closest thing to absolute proof, compared to all other 'ways of knowing'Endernoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-69081695119087724122010-10-27T08:54:55.816-04:002010-10-27T08:54:55.816-04:00You may not have meant the term "allopathic m...You may not have meant the term "allopathic medicine as derogatory, but that is indeed, what it is. It is a slight, a slur, a marginalization. Many people these days recognize what it refers to and do not (as you) intend it as a slur, but it remains a belittling term. The "all" in it specifically refers to "all" that other stuff which doctors & nurses do which is inferior to homeopathy. Look, we all know what someone means when they use the N-word; there's no lack of clarity there; hell, they may not even be intending it in a hateful way, but it is a slur, nonetheless.Timmhttps://www.blogger.com/profile/01801973181436909295noreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-20558395604322614812010-10-26T21:30:53.831-04:002010-10-26T21:30:53.831-04:00Dr. Zilberberg,
Between the testable and the unte...Dr. Zilberberg,<br /><br />Between the testable and the untestable; between science and woo; there can be no middle ground. You're going to have to pick a side.<br /><br />Are you a scientist or not?craigmontnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-3244538788084294642010-10-26T20:07:51.656-04:002010-10-26T20:07:51.656-04:00@liz ditz
I've now tried 3 times to register t...@liz ditz<br />I've now tried 3 times to register to comment on Dr Novella's blog without success, there is no email sent, there is no email in the spam box, perhaps Dr Novella needs to check his settings.<br /><br />So I wanted to post this comment on that blog but here it is instead.<br /><br />I'm not 100% sure but I think it's my comments Dr Novella refers to in the post. He has presented these comments which were directly relevant to the issue at hand as a personal insult, 'that his bedside manner is that of a paternalistic ass'. His reasons for doing that are his own but I encourage readers to go to Dr Zilberberg's first post to read what I actually wrote.<br /><br />The only other comment worth making at this time is that Dr Novella certainly uses 'post-modern' as an insult in the way he accuses Dr Zilbeberg of using 'allopathic'.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-79971534632623842102010-10-26T13:47:49.426-04:002010-10-26T13:47:49.426-04:00I would like to address two of the issues you disc...I would like to address two of the issues you discussed. First, as to the regulation of herbal medicines I think this story from The PBS News Hour last Thursday, 10/26 does a better job of explaining why herbal medicines should be regulated than I ever could:<br /><br />http://www.pbs.org/newshour/bb/health/july-dec10/herbal_10-21.html<br /><br />As to the varicella vaccine, I think you have fallen victim to "I have not seen it, so it must not exist" syndrome that is so prevalent today when it comes to vaccine prevenable diseases such as: pertussis, HIB, polio, diptheria, measles, mumps and rubella. The list of possible complications due to varicella include, but are not limited to: pneumonia, cerebellar ataxia, meningitis post herpetic neuralgia and as MRSA has become more common, resistant secondary bacterial infections. As a resident in training I saw examples of each of those devasting complications and now when I speak to new graduates they have almost never seen them. Additionally, as the rate of vaccination has risen, those who choose to remain unvaccinated are at increased risk of reaching adulthood without immunity and subsequently contracting the disease. These are all benefits in addition to the financial benefit to society you described.moderationnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-75276768846961696352010-10-26T10:49:52.516-04:002010-10-26T10:49:52.516-04:00Sorry. You've lost. While I did find the '...Sorry. You've lost. While I did find the 'tone' of your piece on Paternalism overstated, there is no fairness in confrontational representation. The best one can hope for in a situation is to refuse to be be bullied and quietly stand your ground. Since you have already lost patience with being passive while misrepresented you must accept the necessity of 'treating' these disruptions with the contempt they deserve.opithttps://www.blogger.com/profile/01621946866211400380noreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-8618914353554655692010-10-26T10:04:23.512-04:002010-10-26T10:04:23.512-04:00***I will try to tackle my CAM argument next. If I...***I will try to tackle my CAM argument next. If I in any way implied in my remarks that I encourage allopathic physicians (by the way, I am not using it in a derogatory way, but merely as it is defined here; in fact, until today I was blissfully unaware of its negative connotation) to be purveyors of CAM, I sincerely apologize.***<br /><br />I strongly recommend you stop using the word "allopathic" if you want to be taken seriously by the critics of quackery. The term doesn't just have a negative connotation; as your linked definition shows, it means "that which is not homeopathy" and was coined by Hahnemann. Today, it is used more broadly to mean "medicine which is limited in its outlook" or as a synonym for "reductionist" or "materialist" and is typically used by alternative medicine practitioners. If you don't want to give the mistaken impressoin that you are yourself a homeopath, don't use the term. It's not even reflective of actual conventional medical practice.<br /><br />***I think we both agree, since there is really no reason to think that something like homeopathy has anything that can help, by the same token we do not believe that it have anything that can hurt.***<br /><br />Homeopathy, in the traditional sense, should be harmless except insofar as it causes people to delay effective treatment. However, what is sold today is not strictly homeopathy in the traditional sense. Zicam is 2X zinc -- that means the original zinc preparation is only diluted twice, leaving it still far stronger than is considered safe. The FDA is powerless, now that Zicam's manufacturers persuaded the keepers of the Homeopathic Pharmacopeia to add 2X Zinc to their list. (Seriously, that's all it takes to invoke the homeopathic loophole.) Or consider this, over at Todd W's blog: the FDA is recalling Hyland's Homeopathic Teething Tablets because they contain measurable amounts of deadly nightshade.<br />http://silencedbyageofautism.blogspot.com/2010/10/recall-of-hylands-teething-tablets.html<br /><br />(Note: as your blog does not permit the blockquote tags, I have enclosed quoted text in asterisks.)Calli Arcalenoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-6751660687696031452010-10-26T09:23:11.038-04:002010-10-26T09:23:11.038-04:00I totally love the link to the definition of allop...I totally love the link to the definition of allopathic medicine! Never saw that before, we'll be sure to pass that around.<br /><br />Anyway, you provide a very nice post here and the many people who are watching all love the fact that you're standing up to these psuedo- intellectual bullies. <br /><br />I too am growing concerned about the piling on of vaccines. Great, let's eliminate polio but ear infections and chicken pox? C'mon, that's not just for massive profit? Please. People are not dumb just because they go to a naturopath or prefer natural health care and think critically about science, medicine, pharma and what gets forced into in their bodies.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-81013228894117288122010-10-26T09:11:07.838-04:002010-10-26T09:11:07.838-04:00Litz Ditz says "The social and economic costs...Litz Ditz says "The social and economic costs burden of vaccine-preventable diseases falls disproportionately on those least able to pay for them: the poor and the working poor."<br /><br />So if it's mainly an altruism issue then why do Science Bloggers fervently argue the benefits and risk of the middle class, when you've just stated that it is the poor and working poor who benefit the most from high vaccine uptake?<br /><br />In other words, the poor and working poor statistics are applied to all classes as a homogeneous group. You seem to recognize that the risks are not homogeneous but that everyone, including those who aren't at high risk should vaccinate any because of altruistic or social justice issues. This seems to be more of a philosophical issue than a scientific issue.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-50855311851893742942010-10-26T08:58:16.893-04:002010-10-26T08:58:16.893-04:00"That is exactly NOT what I am trying to do. ..."That is exactly NOT what I am trying to do. I am merely reflecting on many of the issues that threaten the validity of what we think we know.<"<br />Ah, yes, the "just asking questions" gambit.Orachttps://www.blogger.com/profile/01370846202152605202noreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-78547533372969994192010-10-26T02:08:51.713-04:002010-10-26T02:08:51.713-04:00Dear Dr. Zilberberg,
At Respectful Insolence, yo...Dear Dr. Zilberberg, <br /><br />At Respectful Insolence, you posted:<br /><br />http://scienceblogs.com/insolence/2010/10/a_fallacy-laden_attack_on_science-based_medicine.php#comment-2880069<br /><br /><i>As I cannot leave a comment on Dr. Novella's blog, please, could you let him know as well?<br /></i><br /><br />1. Dr. Novella's blog's URL is<br /> http://theness.com/neurologicablog/<br /><br />It is a WordPress blog. It is configured to require a log-in.<br /><br />2. Log-in registration is easy, but many email clients dump the registration confirmation email into a spam filter. So perhaps if you registered but did not receive a confirmation email it may be stuck in your spam filter.<br /><br />3. I encourage you to register for Dr. Novella's blog and engage in comments there, as well. <br /><br />4. To me, high uptake rates for all vaccine-preventable illnesses, including those you characterize as minor (varicella or chicken pox) are a social justice issue. The social and economic costs burden of vaccine-preventable diseases falls disproportionately on those least able to pay for them: the poor and the working poor.Liz Ditzhttps://www.blogger.com/profile/03455722013211350247noreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-65095231825542871832010-10-26T00:14:28.232-04:002010-10-26T00:14:28.232-04:00So the definition of herbal medicine is stuff that...So the definition of herbal medicine is stuff that grows in peoples backyards? Actually I would agree that an unregulated market in herbal medicine sold by the farmer would probably be fine, if only that regulating that would be impossible anyways. Kind of like what we do with unpasteurized apple juice in some states. And it would probably discourage industrial solvents and bleach being called natural herbs.<br /><br />...but overall that's a pretty silly reason to not regulate herbs on the whole! Setting aside 'regulation' which has all sorts of issues, wouldn't you agree that they should be evaluated by the same standard as all other medicine?<br /><br />I'm really glad I barely made it into the chicken pox vaccinated generation (either that or I got chicken pox earlier and didn't show symptoms; glad either way).I mean, facial scars aren't uncommon from chicken pox. Talking about how everyone should be able to make their own decision with vaccines is a good example of rugged American individualism, but its completely naive of herd immunity. Even setting aside the immunocompromised, why should a vaccinated classmate of your child have to share the chicken pox hazing you wish to impose on your own children?<br /><br />Anyways stuff like this paragraph:<br />"To me the fact that there are such heated debates about this stuff is a testament exactly to how NOT straightforward our science is. I do understand that as a researcher I can afford a certain amount of analysis paralysis that is unacceptable at the bedside. However, I think we (and the press) do a disservice to the patients, to ourselves and the science if we are not upfront about jut how uncertain much of what we think we know is."<br /><br />makes me wonder if you read SBM much at all. They are constantly talking about what a complicated process science is. And it is a process, not an answer. Of course the media is pretty much a four-letter word on their blog.Ian Monroehttps://www.blogger.com/profile/16953610792430204523noreply@blogger.com