Allergies: The Time to Start Treating Is Now

From Allergies Update, at Maloney Medical (all abstracts available there):

Deep winter is the perfect time to start treating for allergies in the spring.  We have a range of different plans that will down regulate the histamine response, but don't wait to start sneezing.  That's like waiting for a flat tire before you go out and get a spare. 

Currently the standard program to desensitize patients involves injections. But the state of the art is now drops under the tongue. “Sublingual immunotherapy (SLIT) has been proved to be effective in allergic rhinitis and asthma…New sensitizations appeared in 34.8% of controls and in 3.1% of SLIT patients.  ” But, you ask, is it as effective as the injections? “The mean peak expiratory flow result (how much air you can exhale) was significantly higher in the active group than in the control group after 10 years.

But can I go off my inhaler? Unfortunately, we don’t know, because: “when mild-moderate asthmatic children are optimally controlled by pharmacologic treatment and HDM (human dust mite) avoidance, SLIT does not provide additional benefit, despite a significant reduction in allergic response to HDM. Under such conditions, only a complete, but ethically unfeasible, discontinuation of inhaled corticosteroid would have demonstrated a possible benefit of SLIT.”  It could be dangerous to remove the inhalers, so we’ll keep people on them for life. Of course, the long term effects of steroids…

Gandhi: One of the Few Untouchables.

I mean untouchable in terms of personal integrity, not a reference to the caste system.

It is truly an extraordinary story, how a man went from being an English lawyer to the de facto leader of a non-violent revolution.  It was his mother who would fast if things displeased her, and his English law degree helped him understand what would push the English out.  But it is the moment when Gandhi was shoved off the train and fought back that I think is his most courageous moment.  He was no one.  To start a mad group willing to burn their registration papers, and to allow himself to be beaten senseless in trying to do so, without fighting back.

All the rest is history, but it is his time as a nobody fighting an impossible fight and winning that really inspires me.

Today, Don't Focus on the Bottom Line. Look Where That's Gotten Us.

One of the most disturbing things about the current economic problems is that no one is questioning the basic premises upon which the whole thing is founded.  The CEOs are still responsive to the stockholders, and the stockholders want the highest return.  So we all get to go down the tubes together with the responsibility spread among millions of small stock holders who individually don't feel like they can do anything.  But we can.  Direct your miniscule savings into things you really care about.  You may not be guaranteed the high returns of the past, but nothing can do that right now anyway. 

William Shakespeare: Would He Be Writing Now?

It is unfortunate to think, that were Shakespeare alive today, he probably be a speechwriter or an advertising executive.  He might even be in one of those high priced think tanks where they come up with catchy names for new pharmaceutical drugs.  But he most definitely would not be writing for some theater in England.  And he probably would have given up on iambic pentameter, because his editor would have given him heck for "making up words." 

Sometimes a man is perfect for his time. 

Have You Been Chatting With God Recently?

I haven't read this book, but I really like the idea of silence as a spiritual practice. 

I'm also constantly amazed that God says very different things to different people.  In any major sporting event, is God really on both sides?

So here's an Evangelical look at when God doesn't talk to you.  Spread the word, sometimes silence is golden.

In Buddhist traditions, the whole point is not to fill your head with chatter.  Nobody knows better than a Buddhist that the chatter in your head is mostly that, chatter.  The still, small voice is not the clarion call to closemindedness that some seem to believe is God.

My Christmas Present: A Kindle.

My father, bless his stars and garters, bought me a kindle for Christmas.  Evidently a wide variety of books are free through Amazon, although I am prevented from checking out e-books from my library because my kindle is not compatible. 

So far, I like the non-glaring screen, and it is certainly light, but it's not a book.  I can't flip around like I'd like, check the back for a glossary, etc.  I got Da Vinci's Notebooks without pictures, which is a little like smelling a nice dinner from across the street while you're boarding a bus.  It's not the same as eating, or in this case reading. 

So I know I'm supposed to rave about my electronic gadget, and I do want to send my father heart felt thanks, but I'm waiting for my kindle to provide me with e-book checkout, which is something I can't get from a book (all the most recent titles for free, to be browsed and discarded after a week). 

Another Argument for Licensing Naturopathic Doctors.

One of the claims made by skeptics of Naturopathic Medicine is that licensing us will somehow endanger the public.  Au contraire.  Here's a case in Oregon where licensing N.D.s has resulted in at least one former N.D. being blocked from medical practice.  The case was pursued by the attorney general with the support and assistance of the Oregon Association of Naturopathic Physicians. 

The former N.D. in question is paying 50k as a fine and is permanently blocked from seeing patients.  I cannot remember many cases of an M.D. or a D.O. receiving a permanent injunction from his board.  Usually they are suspended, or take early retirement.  So we police our own strenuously.  Let's license all fifty states already.   

For those with a lot of reading time, the former N.D.'s complaint is online.  Compare this to an alcoholic surgeon's license removal six years after getting pulled over for a DUI while driving to the hospital to perform surgery.  While the former N.D. should have lost his license, the M.D. was literally operating under the influence for years.  There are numerous programs that protect addicted M.D.s from charges, getting them treatment while they continue practicing.  N.D.s just pull the license.  I guess we just have a different standard.

Da Vinci: Still Worth Reading.

While Leonardo Da Vinci wrote in mirror script, in Italian, lovely people have translated his notebooks for us.  I was reading one section from his discussions of perspectives.  Admittedly, I've never really thought about the color differences of distant perspectives in paintings, but I'm fascinated that we really haven't moved forward from the 15th century in terms of his discussion. 

Terry Pratchett: Get Your Political Commentary Through Fantasy Novels.

I admit I love Terry Pratchett, despite/because of his ability to continue to write about criminals as real people doing goofy things.  His novels are like doughnuts, you enjoy them, think they are fluff, and yet find yourself craving more.  All of his heroes are flawed, his women strong, his criminals good hearted (or at least fair), and generally corruption is the norm.  You don't actually need to start anywhere with his novels, because each one is a variation on the others.  It's like reading a series of plays where the same characters show up in different roles.   Is Pratchett like Shakespeare?  Well, in the same way that the creator of Beavis and Butthead or any current sitcom is like Shakespeare, which is not at all.  But he is enjoyable, and that is rare enough.  He also occasionally makes you think about just how foolish our traditions (paper money, stamp collecting, football) can be. 

The Last Lecture: Was There Anything Else He Could Have Done?

Professor Pausch gives a very inspiring lecture, both in book form and on youtube.  In his lecture he breaks boundary after boundary, achieving the impossible.  Yet when he discusses his illness, he tells people he's had the best expert advice and not to bother him with anything like that.  No offense, but if he'd listened to the best expert advice in almost any area of his life, he wouldn't have done the things he was able to do.

The assumption that because they are experts they've explored every possibility is a myth.  We don't treat pancreatic cancer well in the west.  It's a fact.  Which means that every other possibility has as good or better outcomes.  I'm not saying that Professor Pausch could have been cured (that would take a miracle like the ones documented by the Institute of Noetic Sciences about pancreatic cancer).  But in my brief discussions with pancreatic cancer patients (all of whom still decide to go the conventional, hopeless route) very few are following basic commonsense things like taking huge doses of pancreatic enzymes.  The idea is that a cancerous pancreas needs all the help it can get and that the enzymes both take the load off the pancreas and decrease the speed of cancerous growth.  I got the idea from that bastion of alternative medicine, the Merck Manual.  But although enzyme therapy is recommended by the experts of the experts, it is rarely practiced.

I recognize that this could be taken as a criticism of an amazing man, but it is much more a regret that he is gone. 

Anti-Oxidant Status: Purity Does Not Equal More.

One of the standard assumptions that I've had about the vegetarian and vegan diets is that they provide significantly more antioxidants than a Standard American Diet.  But we have a study that shows that omnivores (meat eaters) are comparable to vegetarians (eggs and dairy) in terms of anti-oxidant status.  I'd like to see the study repeated with just vegans.


Eur J Clin Nutr. 2007 Aug;61(8):1011-22. Epub 2007 Feb 14.
Influence of habitual diet on antioxidant status: a study in a population of vegetarians and omnivores.
Haldar S, Rowland IR, Barnett YA, Bradbury I, Robson PJ, Powell J, Fletcher J.
Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster, Coleraine, County Londonderry, UK. s.haldar@ulster.ac.uk
Abstract

BACKGROUND: Antioxidant status can be used as a biomarker to assess chronic disease risk and diet can modulate antioxidant defence.
OBJECTIVE: To examine effects of vegetarian diet and variations in the habitual intakes of foods and nutrients on blood antioxidants.
SUBJECTS AND SETTING: Thirty-one vegetarians (including six vegans) and 58 omnivores, non-smokers, in Northern Ireland.
DESIGN: A diet history method was used to assess habitual diet. Antioxidant vitamins, carotenoids, uric acid, zinc- and ferric-reducing ability of plasma (FRAP) were measured in fasting plasma and activities of glutathione peroxidase (GPX), superoxide dismutase (SOD) and glutathione S-transferase (GST) and level of reduced glutathione (GSH) were measured in erythrocytes
RESULTS: Vegetarians had approximately 15% higher levels of plasma carotenoids compared with omnivores, including lutein (P< or =0.05), alpha-cryptoxanthin P< or =0.05), lycopene (NS), alpha-carotene (NS) and beta-carotene (NS). The levels/activities of all other antioxidants measured were similar between vegetarians and omnivores. Total intake of fruits, vegetables and fruit juices was positively associated with plasma levels of several carotenoids and vitamin C. Intake of vegetables was positively associated with plasma lutein, alpha-cryptoxanthin, alpha-carotene and beta-carotene, whereas intake of fruits was positively associated with plasma beta-cryptoxanthin. Intake of tea and wine was positively associated with FRAP value, whereas intake of herbal tea associated positively with plasma vitamin C. Intakes of meat and fish were positively associated with plasma uric acid and FRAP value.
CONCLUSIONS: The overall antioxidant status was similar between vegetarians and omnivores. Good correlations were found between intakes of carotenoids and their respective status in blood.
PMID: 17299498

S.A.D., Covering the Basics

As the winter arrives, many people here in Maine experience Seasonal Affective Disorder (S.A.D.) not to be confused with the Standard American Diet (also S.A.D.) although SAD may affect SAD (both ways).  Here's a blog post by another N.D. that covers the basics.

Walnuts Don't Make You Gain Weight, and They Ease Stress?

I posted on my weight loss page some time ago a very interesting study that involved walnuts.  Individuals who ate walnuts in addition to their regular diet did not gain the expected amount of weight.

Now we have Andrew Weil weighing in (pun intended) that walnuts also ease stress.  Wonderful!  Nothing on candied walnuts though, so take your walnuts straight. 

Penelope Trunk: An Underused Superstar.

I'm one of the few people who can claim to have purchased both Timothy Ferriss' Book and Penelope Trunk's book.  Unfortunately Ms. Trunk's book I purchased at a dollar store.  I did so because I wondered specifically why her book was there and Ferriss' book was a best seller.  Here is someone who did everything right, but still her book is at the dollar store.  So when I came across her delightful discussion of Ferriss, I was really pleased.  Her book is not representative of her writing as a whole.  It is dense, doesn't flow, and makes you feel excluded from the cool people before you even start.  Ferriss' allure is that he claims his book is for everyone, which is complete nonsense (gramma isn't web savvy, and uncle Joe needs his dialysis).  But he also generated an enormous upswell for his book from blogs like Trunk's.

Check out Trunk's blog for really useful tips from someone who looks like they should be the life of the party while hiding in the broom closet. 

Probiotic Capsules: A New Pharmacy Section in the Supermarket.

I'm suddenly seeing a great number of probiotic products on the supermarket pharmacy section shelves.  Looking through the claims and labels, these products are overwhelmingly similar to health food store offerings with one exception.  They are not refrigerated. 

Consumer reports did an analysis of probiotics some years back and found that the die off from manufacture date to purchase time was pretty extraordinary.  An equivalent metaphor would be packaged fish.  It might be possible to package fish well enough that they wouldn't start to stink, but that would be a pretty gamey fish by the time you got it. 

For any and all of you considering probiotics, either go to a refrigerated product or use the yogurts in the dairy aisle.  Ounce for ounce probiotic capsules are more concentrated, but we generally eat far more yogurt at a sitting.  So they work out to be equivalent.  Consumer reports found that all yogurt brands continued to have live bacteria. 

If you are determined to buy probiotics, consult someone like me.  I can at least tell you what brands are doing independent testing at the consumer end to make the little guys are still alive. 

The Value of Real Fats.

We've got a group of NDs who really like good fats and point out that fat doesn't necessarily mean disease or obesity.  It's hard to reconcile this viewpoint with the reality of obesity in our society.  On the other hand, all the low fat foods we've been stuffing ourselves with haven't made us any thinner. 

I'm not a convert to high fat, but I think it's worth thinking about real food vs. processed food. 

Here's the link to the AANP article. 

A Book I Should Have Written: Prostate Cancer Expose.

I haven't even read this book, but I already love it because of the title alone.  I've added some of my own data on alternative treatments at my website. 

Inositol and Bipolar Disorder: Do Not Supplement On Your Own.

It's rare to see a supplement so directly problematic for a drug, but inositol regulation may be how lithium works in the brain.  As such, patients wanting to supplement with inositol could be inactivating their lithium.  Definitely discuss and monitor with your physician. 

Here's a link to the August 2010 study and here's the abstract below.  Another study looks at the complexities of the interaction (inositol supplementation might even be helpful, but don't chance it.)

Prog Neuropsychopharmacol Biol Psychiatry. 2010 Aug 26. [Epub ahead of print]


Association analysis between polymorphisms in the myo-inositol monophosphatase 2 (IMPA2) gene and bipolar disorder.

Bloch PJ, Weller AE, Doyle GA, Ferraro TN, Berrettini WH, Hodge R, Lohoff FW.

Psychiatric Pharmacogenetics Laboratory, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.

Abstract

Linkage studies in bipolar disorder (BPD) suggest that a susceptibility locus exists on chromosome 18p11. The myo-inositol monophosphatase 2 gene (IMPA2) maps to this genomic region. Myo-inositol monophosphatase dephosphorylates inositol monophosphate, regenerating free inositol. Lithium, a common treatment for BPD, has been shown to inhibit IMPA2 activity and decrease levels of inositol. It is hypothesized that lithium conveys its therapeutic effect for BPD patients partially through inositol regulation. Hence, dysfunction of inositol caused by IMPA2 irregularity may contribute to the pathophysiology of BPD. In this study, we hypothesize that genetic variations in the IMPA2 gene contributes to increased susceptibility to BPD. We tested this hypothesis by genotyping 9 SNPs (rs1787984; rs585247; rs3974759; rs650727; rs589247; rs669838; rs636173; rs3786285; rs613993) in BPD patients (n=556) and controls (n=735). Genotype and allele frequencies were compared between groups using Chi square contingency analysis. Linkage disequilibrium (LD) between markers was calculated and estimated haplotype frequencies were compared between groups. Single marker analysis revealed several associations between IMPA2 variations and BPD, which were subsequently rendered non-significant after correction for multiple testing. Although our study did not show strong support for an association between the tested IMPA2 polymorphisms and susceptibility to BPD, additional larger studies are necessary to comprehensively investigate a role of the IMPA2 gene in the pathophysiology of BPD.

Copyright © 2010 Elsevier Inc. All rights reserved.

PMID: 20800640

Carpal Tunnel: Just a spot in a very dark tunnel.

What most young people don't understand (because we've lost most of our manufacturing jobs) is that repetitive motion leads to problems.  This is especially true for the fine bones of the hand.  Long before there were electronic devices to mess up your hands, musical performers knew of a thing called carpal tunnel, a small subsection of repetitive strain injury.  I've written about this and posted the research.  But the master wrote a book that really helped my family.  Here it is. 

Has Homeopathy Ever Been Given a Fair Shake?

It seems as if homeopathy is, in the minds of some, a recent phenomena that somehow can be squashed by constantly providing misinformation.  Despite numerous attempts through the centuries, homeopathy is thriving.  Even as critics "squat" on alternative medicine definitions on Wikipedia, the growth of alternative medicine continues.  And poor old beaten up homeopathy may finally have an answer as to why it works. 

The Graceling: A Surprising Good Young Adult Fiction

It is so rare to find something in young adult fiction that actually justifies reading it.  I've been pleasantly surprised by Graceling, and will be getting a copy for my eleven year old to read.  It doesn't have the depth of Tolkien (who does?) and some plot points needed thinking out more, but I found myself deeply caring about the main character without realizing it.  That's accomplishment enough. It's a little gory for the younger set (what am I saying?  They are all reading Twilight these days). 

Sherlock Holmes: The Original and Unfettered Scientist

You've got to love a character that has become an expert in tobacco and the soils of England.  Doyle couldn't even kill him off, we loved him so much.  I always wanted to be him when I grew up, and remember reading the complete Holmes at a local college library when I was only ten.  In some small way I have become Holmes for my family:  it is my duty to track down lost objects.  Holmes always beat out the other detectives because he wasn't afraid to get his hands dirty.  Of course, we have him recreated as more of a fighter and less of a detective in the recent movie. 

Rabelais: A Time For Folly.

If you can wrap your noggin around the thick prose, this book has it all.  We've got pranks and wits and urinating off towers.  We've got enough graphic love to make Chaucer's Miller blush.  And all this from the 15th century.  Who says the classics have to be stuffy?

Preventing Bed Bugs: Does Stinking It Up Help?

I have yet to see any studies on whether stinking it up with garlic, etc. would deter the little critters. 
http://www.drweilblog.com/home/2010/10/7/preventing-bed-bugs.html

Pandemic 2010: Will There Be a Sequel?

We've got the CDC gunning everyone up to a frenzy again, even as they declare a normal flu season.  Have a look at some of the offerings from 1918.  I somehow don't think we'll be seeing the 2009 equivalent, mostly because it was about average as a flu year.  For an update on vaccination, check out Alternative Health Answers (with funny video).  For way more information, check out Guerrilla Healthcare for the Flu. 

Civil War: A Reminder

I just got the issue of Newsweek talking about armed militias.  It reminded me that we desperately need a sense of history in this country.  Any type of armed conflict within the United States is unthinkable.  We did that, and it was terrible for everyone concerned.  Whatever our disagreements, our children deserve to hear us debate them rather than fight them out. 

Back pain: Nonsurgical Options.

I just did an update on long term outcomes for back pain surgery and we still aren't seeing large studies.  The patients are there, but no one is doing follow up over a couple years.  In the meantime, there are a great many home treatments that are available. 

The little guy on the left is a TENS unit, every person with chronic pain's best friend (unless you have an inflammatory condition, in which case stay away).  Clinicians can get these for about $45 and they run on a nine volt battery.  I just don't see them being used instead of pain drugs, which is sad, because they are a much better option for specific pain.    

Khalil Gibran

Just a very good poet.  Lots of other things too, but focus on that alone. 

Hayao Miyazaki: Japanese Spielberg

Although Miyazaki works with animation, don't let that fool you into thinking he isn't the best thing for the genre.  Unlike U.S. animation, the movies have a much more complex feel, with views and down moments.  The Incredibles was very much influenced by the complexity and you can often see Pixar's Lasseter talking about Miyazaki.

Kiki is the only full length animation movies I know of without a villain.  Yet it holds your interest and lives within Miyazaki's world of a futuristic Victorian era. 

Learn Japanese with Manga.

For anyone who does not have a tween son into Manga, the idea of learning basic Japanese with a comic book may seem a bit farfetched.  But trust me, this is one language book that will get read over and over. 

Eat, Pray, and Love, but not with a Dragon Tattoo

I watched both these movies recently.  EPL the book is better and more complex, but there are aspects of the movie that come to life more, and Julia Roberts is great.  The second movie is pretty graphic and disturbing, a good mystery, but seeing Lisabeth, well, if you read the book you know.  So I'd watch the first as part of a chick flick night, but I wouldn't recommend watching Girl with a Dragon Tattoo unless you've read the book and loved it (and don't mind subtitles). 

Nobody is Perfick.

A little book about being a child, but it makes you realize just how little we all grow as we get older.  Cartoons, and little vignettes, which makes it a quick read.  It's the only place I've seen the word "yilkes," as a term of disgust.

The Most In Depth Discussion of Energy Work.

Despite their age, these are still the two most comprehensive books on energy work.  Preparation, explanation of phenomena, basic patient interactions.  I found the second book much more interesting in terms of depth and concepts.  A great deal of what is said dovetails off of the Course in Miracles.  If you make it through all the text at the beginning of that book, then you've got me.  I just skipped to the lessons (spoiler:  we're all one.) 

The Lorax: Did We Get the Message?

I've always felt the weight of the Lorax's message, but I can't say that I'm doing a great deal about it.  Instead I read it to my children and pass on the message.  Isn't it time to stop making thneeds?

The Cat in the Hat: Cleaning Up Our Messes and Taking Responsibility

The Cat in the Hat could teach us all (not just BP) about personal responsibility.  If only we had a cat cleaning service.

Tim Hawkins: A Little Southern Humor

Tim has finally explained to me the fascination with Chick-fil-A.  When we were in State Farm land outside of Chicago, everyone asked us if we'd been to the only Chick-fil-A in Illinois.  We didn't make the pilgrimage, but here's Tim singing a tribute.  Where are our songs about healthy food?  Besides cookie monster's rap, that is. 

Insomnia: Sleep Thieves

How many of us are having symptoms from sleep deprivation?  Coren covers his own experiments, animal and human studies.  Anyone who wants to be truly terrified can read the chapters entitled:  "Asleep at the Operating Table,"  or "Asleep in the Sky."

The Organon: A Book Advanced For Its Time

Here's the most recent translation of the old master.  Pretty dense stuff, but with some very pertinent observations.  p.204 on Mental Health " The physician...must always appear as if they credit such patients with reason."   He then goes on to discuss the beatings and torture of mental health patients common in his time. 

Treating Bipolar and Schizophrenia: A Starting Guide

I've found this book very helpful in breaking down different body constitutions for mental illness.  The treatment protocols tend to be lengthy and based in the functional medical model rather than Naturopathic.  But is is a good reference to help those starting out with alternative medical doctors to get a sense of the ideas, the testing, and the likely treatments.

Feldenkrais: A Method Worth Knowing.

The Feldenkrais Method allows greater movement by increasing understanding of the subtler senses. 

Looking for Naturopathic Doctors?

Many people assume if they don't live in a licensed state (we're working on it) they can't see a licensed N.D.  Not so.  The best place to check is the AANP website, which lists all members (you can be licensed and not be a member, so also check your state licensing board).

If you are local and want a mostly complete list of licensed N.D.s go to the MAND website.  If you want a complete listing, go to the Maine State license search.  It's complicated, so I would use the MAND site first. 

The Alchemist

I went to the camp where I first saw this book for a cookout yesterday.  When I discovered it I read it through in an afternoon.  Coelho is good in translation and makes me want to learn Portugese to read him in the original. 

The Alchemist is still my favorite work, although I also like Veronika and The Road.  Truly a gifted writer, although I didn't like his more recent work as much. 

Carpal Tunnel and Repetitive Strain Injury: Maloney's Take.

I've posted the video at Alternative Health Answers.
I've got a page on carpal tunnel at http://www.maloneymedical.com/.
Now here's the book that we used as a basis for non-surgical treatment.

Blade Runner: Where We're Headed?

A future dystopia where Asian languages dominate and anyone who can has gotten off world?  A future where human life is replicated, but the replicants have no rights? 

Truthfully, I love this movie for a little speech by a dying man on a rooftop.  The line "attack ships catch fire off the arm of Orion" is spacially impossible, but a wonderful image, and one of the very few memories this man can call his own.  But lots of violence as well.  Make sure to get the director's cut, which changes the ending by adding a paper animal. 

Krishnamurti: Still Fresh?

I have always found Krishnamurti's push toward complete rebellion a bit terrifying.  But his absolute philosophical line that we must examine everything in our lives remains just as true today as it was when he was alive. 

Many people seek to discount his message because of shortcomings in his own life.  If that were a just reason for ignoring a man's message, none of us would know of Nietzsche or Foucoult.  Or Socrates, for that matter. 

Lappe's Diet for A Small Planet

The forward of the first edition of this book influenced vegetarianism dramatically with its discussion of combining foods to create a whole protein at every meal.  What many vegetarians don't realize is that Lappe altered her forward with new nutritional information.  Her original assumption was that a complete protein was necessary at every meal based on the egg as the ideal human food.  But the body is capable of using different, incomplete proteins given to it throughout the day.  Some theorists claim it is possible to sustain human life with a constant diet as restrictive as just broccoli (Please don't try this.)  For most people, it gives freedom to not be concerned about protein malnutrition because they did not get their combinations right at every meal. 

J.R.R. Tolkien: A Man with a Mission

One of the things I now appreciate about the Hobbit and the following trilogy was that Tolkien was out to create an English mythology equating to the Greek pantheon or the Norse Gods.  He succeeded in that much of the fantasy literature is derivative and certainly things like Fantasy video games owe much to Tolkien.  Reading the wikipedia entry just now, I was thrilled to find Tolkien employed working on the letter W for a dictionary maker at one point. 

Tolkien wasn't writing about fantasy, he was writing about courage in the face of extraordinary adversity.  I think it is time to read the books to my own children.

For those who have not been keeping up, Tolkien's son has been publishing all of Tolkien's background work.  Truthfully, it is very dull stuff, though I imagine we already have a body of scholarly work and very likely we have Tolkien majors and PhDs.  Bravo, let the deconstruction begin.  I'm sure Sam and Frodo...

Weight Loss: So Many Options.

I just posted a new video discussing weight loss. You can also read two years of work online at www.maloneymedical.com under weight loss.







If you are still looking for an "easy" solution to weight loss, might I suggest the following book. The author lost his weight by simply being aware when he ate. That's right, no restrictions, just awareness of the food going in. It's a lot harder than it sounds.

New Lyme Books

My dear patients have loaned me two Lyme books.  The first, Healing Lyme Disease Naturally, can be broken down to one word:  Teasel.  If you haven't tried it, get the book.  (It might be worth it for the picture of Wolf in the back alone). 

The second book, The Top 10 Lyme Disease Treatments, is a laundry list of a number of different treatments.  I assume the top ten were selected based on popularity.  Teasel, from the book above, gets a paragraph mention as a possible antibiotic. 

In neither book did I see what I've begun to put together from the medical literature.  The concept is that the antigens from the spirochete interact with the immune system so that continuing Lyme symptoms have much more to do with autoimmune response than continuing spirochete counts. 

Hypothyroidism: new video.

For anyone who has wondered about hypothyroidism, I've posted a video talking about the standard treatment and alternatives:  Youtube hypothyroidism video

Blueberries: cardiovascular and now dementia benefits?

Study out in April showing preliminary data that blueberry juice has a significant benefit in memory function.  Also tracing the anti-cancer benefits of something called "blueberry punch," basically Sangria with lots of blueberries.  Where is it being marketed?  You guessed it, southeast Asia.  Meanwhile we're drinking noni and acai berries from very far away.  While don't we just focus on our own local high anti-oxidant foods? 

I was just featured in Eat Locally!  Yay! 

J Agric Food Chem. 2010 Apr 14;58(7):3996-4000.
Blueberry supplementation improves memory in older adults.

Krikorian R, Shidler MD, Nash TA, Kalt W, Vinqvist-Tymchuk MR, Shukitt-Hale B, Joseph JA.
Department of Psychiatry, University of Cincinnati Academic Health Center, Cincinnati, Ohio 45267-0559, USA. robert.krikorian@uc.edu
Abstract

The prevalence of dementia is increasing with expansion of the older adult population. In the absence of effective therapy, preventive approaches are essential to address this public health problem. Blueberries contain polyphenolic compounds, most prominently anthocyanins, which have antioxidant and anti-inflammatory effects. In addition, anthocyanins have been associated with increased neuronal signaling in brain centers, mediating memory function as well as improved glucose disposal, benefits that would be expected to mitigate neurodegeneration. This study investigated the effects of daily consumption of wild blueberry juice in a sample of nine older adults with early memory changes. At 12 weeks, improved paired associate learning (p = 0.009) and word list recall (p = 0.04) were observed. In addition, there were trends suggesting reduced depressive symptoms (p = 0.08) and lower glucose levels (p = 0.10). We also compared the memory performances of the blueberry subjects with a demographically matched sample who consumed a berry placebo beverage in a companion trial of identical design and observed comparable results for paired associate learning. The findings of this preliminary study suggest that moderate-term blueberry supplementation can confer neurocognitive benefit and establish a basis for more comprehensive human trials to study preventive potential and neuronal mechanisms.

PMID: 20047325 [PubMed - in process]

Homeopathy: Would you trust congress to dictate the validity of your healthcare?

Here in the U.S., we have a great debate about whether congress should control healthcare spending.  In the U.K. the parliment has decided it will dictate what constitutes valid medical practice and is specifically attacking homeopathy.

Apologists may argue that since homeopathy is placebo, it may actually have beneficial effects.  

Meanwhile, it is unlikely that the report was unbiased. 

But the issue remains, does homeopathy have any effect beyond placebo?  The basis of this belief is a faulty assumption that a consistent placebo effect exists.  It does not.  The largest Cochrane database study of drugs vs. placebo vs. no treatment found no effect of placebo pills beyond a variable effect on subjective pain.  So those using the placebo effect in reference to sugar pills giving any measurable clinical difference in outcomes are basing their opinion on some preliminary information from the 1950's.  In reference to the doctor/patient relationship, which does provide comfort and reduces many illnesses, homeopaths are at the forefront of working to differentiate that effect from the active benefit from homeopathic remedies. A good doctor/patient relationship should not be termed a "placebo" effect because all medical practices encourage a good bedside manner. 

So do homeopathic remedies clearly show significant benefit beyond a good doctor/patient relationship?  Not consistently.  Certainly not when given in the same way drugs are given out.  The best studies consistently show individualized treatments are more effective than a blanket prescription for something like arnica.  But homeopaths have never claimed otherwise.  The equivalent blanket style studies would be giving aspirin for everything and concluding it does not work because it did not provide significant relief for a broken leg or a brain tumor.  That's not how you practice homeopathy. 

I'm attaching below the Cochrane Systemic Review of the Placebo effect and a nice study on homeopathic Crataegus, which was found to be equivalent (non-inferior) to standard drug treatment in every area except blood pressure reduction.  Think about a dilute, low-side-effect compound that can be manufactured for pennies and costs patients next to nothing.  It would be impossible to compete with and allow treatment of chronic conditions even in desperately poor countries with a problematic healthcare infastructure.  Of course the parlimentary witnesses were on the drug company payroll. 

Cochrane Database Syst Rev. 2010 Jan 20;(1):CD003974.
Placebo interventions for all clinical conditions.
Hróbjartsson A, Gøtzsche PC.
The Nordic Cochrane Centre, Rigshospitalet, Blegdamsvej 9, 3343, Copenhagen, Denmark, 2100.
Update of:
Cochrane Database Syst Rev. 2004;(3):CD003974.
BACKGROUND: Placebo interventions are often claimed to substantially improve patient-reported and observer-reported outcomes in many clinical conditions, but most reports on effects of placebos are based on studies that have not randomised patients to placebo or no treatment. Two previous versions of this review from 2001 and 2004 found that placebo interventions in general did not have clinically important effects, but that there were possible beneficial effects on patient-reported outcomes, especially pain. Since then several relevant trials have been published. OBJECTIVES: Our primary aims were to assess the effect of placebo interventions in general across all clinical conditions, and to investigate the effects of placebo interventions on specific clinical conditions. Our secondary aims were to assess whether the effect of placebo treatments differed for patient-reported and observer-reported outcomes, and to explore other reasons for variations in effect. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library Issue 4, 2007), MEDLINE (1966 to March 2008), EMBASE (1980 to March 2008), PsycINFO (1887 to March 2008) and Biological Abstracts (1986 to March 2008). We contacted experts on placebo research, and read references in the included trials. SELECTION CRITERIA: We included randomised placebo trials with a no-treatment control group investigating any health problem. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information. Trials with binary data were summarised using relative risk (a value of less than 1 indicates a beneficial effect of placebo), and trials with continuous outcomes were summarised using standardised mean difference (a negative value indicates a beneficial effect of placebo). MAIN RESULTS: Outcome data were available in 202 out of 234 included trials, investigating 60 clinical conditions. We regarded the risk of bias as low in only 16 trials (8%), five of which had binary outcomes.In 44 studies with binary outcomes (6041 patients), there was moderate heterogeneity (P < 0.001; I(2) 45%) but no clear difference in effects between small and large trials (symmetrical funnel plot). The overall pooled effect of placebo was a relative risk of 0.93 (95% confidence interval (CI) 0.88 to 0.99). The pooled relative risk for patient-reported outcomes was 0.93 (95% CI 0.86 to 1.00) and for observer-reported outcomes 0.93 (95% CI 0.85 to 1.02). We found no statistically significant effect of placebo interventions in four clinical conditions that had been investigated in three trials or more: pain, nausea, smoking, and depression, but confidence intervals were wide. The effect on pain varied considerably, even among trials with low risk of bias.In 158 trials with continuous outcomes (10,525 patients), there was moderate heterogeneity (P < 0.001; I(2) 42%), and considerable variation in effects between small and large trials (asymmetrical funnel plot). It is therefore a questionable procedure to pool all the trials, and we did so mainly as a basis for exploring causes for heterogeneity. We found an overall effect of placebo treatments, standardised mean difference (SMD) -0.23 (95% CI -0.28 to -0.17). The SMD for patient-reported outcomes was -0.26 (95% CI -0.32 to -0.19), and for observer-reported outcomes, SMD -0.13 (95% CI -0.24 to -0.02). We found an effect on pain, SMD -0.28 (95% CI -0.36 to -0.19)); nausea, SMD -0.25 (-0.46 to -0.04)), asthma (-0.35 (-0.70 to -0.01)), and phobia (SMD -0.63 (95% CI -1.17 to -0.08)). The effect on pain was very variable, also among trials with low risk of bias. Four similarly-designed acupuncture trials conducted by an overlapping group of authors reported large effects (SMD -0.68 (-0.85 to -0.50)) whereas three other pain trials reported low or no effect (SMD -0.13 (-0.28 to 0.03)). The pooled effect on nausea was small, but consistent. The effects on phobia and asthma were very uncertain due to high risk of bias. There was no statistically significant effect of placebo interventions in the seven other clinical conditions investigated in three trials or more: smoking, dementia, depression, obesity, hypertension, insomnia and anxiety, but confidence intervals were wide.Meta-regression analyses showed that larger effects of placebo interventions were associated with physical placebo interventions (e.g. sham acupuncture), patient-involved outcomes (patient-reported outcomes and observer-reported outcomes involving patient cooperation), small trials, and trials with the explicit purpose of studying placebo. Larger effects of placebo were also found in trials that did not inform patients about the possible placebo intervention. AUTHORS' CONCLUSIONS: We did not find that placebo interventions have important clinical effects in general. However, in certain settings placebo interventions can influence patient-reported outcomes, especially pain and nausea, though it is difficult to distinguish patient-reported effects of placebo from biased reporting. The effect on pain varied, even among trials with low risk of bias, from negligible to clinically important. Variations in the effect of placebo were partly explained by variations in how trials were conducted and how patients were informed.
PMID: 20091554

Eur J Heart Fail. 2003 Jun;5(3):319-26.
Efficacy of a homeopathic Crataegus preparation compared with usual therapy for mild (NYHA II) cardiac insufficiency: results of an observational cohort study.
Schröder D, Weiser M, Klein P.
Börsenstrasse 17, Frankfurt/Main, Germany.
Comment in:
Eur J Heart Fail. 2004 Jun;6(4):511; discussion 517-8; author reply 519.
Eur J Heart Fail. 2004 Jun;6(4):509; discussion 517-8; author reply 519.
Eur J Heart Fail. 2004 Jun;6(4):513; discussion 517-8; author reply 519.
Eur J Heart Fail. 2004 Jun;6(4):515; discussion 517-8; author reply 519.
OBJECTIVES: To compare the efficacy of the homeopathic Crataegus preparation Cralonin for non-inferiority to standard treatment for mild cardiac insufficiency. METHODS: Multicentre non-randomised cohort study in patients aged 50-75 years in New York Heart Association class II. Patients received Cralonin (n=110) or ACE inhibitor/diuretics (n=102) for 8 weeks. To adjust for confounding by baseline factors, populations were stratified according to propensity score. After adjusting, there were no statistically significant differences between treatment groups. Treatment efficacy was assessed on 15 variables. A stringent non-inferiority criterion for the upper limit of the 97.5% one-sided confidence interval of the treatment difference was set to 0.2x the standard deviation (S.D.). RESULTS: Both treatment regimens improved scores on most variables studied, with the greatest effect on double product after exercise (average score reduction 15.4% with Cralonin vs. 16.0% for the control group). Stringent non-inferiority of Cralonin was demonstrated on 7 variables. Medium-stringent (0.5xS.D.) non-inferiority was indicated by 13 variables (exceptions: systolic blood pressure (BP) during exercise and diastolic BP at rest; for these, differences between treatments were not significant). Both treatments were well tolerated. CONCLUSION: The Crataegus-based preparation Cralonin is non-inferior to usual ACE inhibitor/diuretics treatment for mild cardiac insufficiency on all parameters except BP reduction.
PMID: 12798830

A Little Light Homeopathic Reading

Here's a link to a series of positive studies on homeopathy.  I get so tired of people saying no one is researching alternative medicine; it's so eighties (1880's that is). 

Two Suzukis that have changed my life.

Did you think I was talking about vehicles?  Sorry.  The first is one of the first men to actively teach Zen meditation in the U.S.  His book, compiled from short lectures he made to audiences, is a classic of clarity about the reality of a meditation practice. 

The second Suzuki is much less well known in Buddhist circles, but has his own fanatic followers in the world of music.  The Suzuki Method has fundamentally changed how we view early music teaching.  I've spent hundreds of hours reading and rereading the basic violin texts with my older son.  If I'd done the same with the first Suzuki, I'd probably be enlightened, but instead I'm a middle-aged beginning violinist.

What both men have in common is a focus on right-minded persevering effort without an obsession with "getting somewhere."  Too often in modern society we need to accomplish something, no matter how poor the results.  We need to return to the careful process of doing. 

IBS: more than a "just live with it" diagnosis.

One of the saddest things is to have a patient mention they have IBS at the end of a visit as if it were something like a curse.  IBS simply means that no organic (big ulcers) illness was found in the bowel, which is a good thing.  But many conventional doctors are still under the impression that IBS is a mental condition, when mental health treatments don't work and a variety of functional disorders (malabsorption and fermentation of various sugars, for one) are clearly involved in a percentage of cases.  I've posted a page on IBS at http://www.maloneymedical.com/ to give an overview of some of the research.  Anyone who has a strong stomach can watch the following video (mostly shots of colonoscopies before and after dietary change).  Colonoscopies with dietary change.   Dr. Shinya promotes a variety of enzymes and Kangen water (think alkaline water with minerals added.)

If I were to get a book from Dr. Shinya, it would be his older work on colonoscopies, not his newer stuff on microbes and enzymes.  Colonoscopy: Diagnosis and Treatment of Colonic Diseases.  He's done a lot more research in that area. 

Hypothyroidism

I wish there was a definitive book on this subject, but everything I've read misses the major point:  a great many people have this as a problem without getting treatment.  I've posted research I compiled seven years ago, and none of it has made it into conventional practice.  We need to be testing patients for a variety of markers, and looking for other beginning autoimmune conditions.  For anyone with a weight problem that does not respond to self-discipline, a complete thyroid work up would be a good idea. 

Eating locally.

It's very important to be aware of what you eat.  Every year we "vote" with our food dollars for the kind of food we want in the future.  Make sure you're not voting for high fructose cardboard.  Here are two books that may help. 

Here's a letter to the editor I wrote that gives one of the many reasons for eating locally.  http://www.kjonline.com/opinion/letters/Local-farmers-provide-alternatives-to-antibiotics.html

The Elements of Style

Such a short book, and yet so underread.  A classic that explains that messy sentence structure leads to messy thoughts. 

Listening to the Alvin Maker Series

Although Card is a great storyteller, the unfortunate reality is that he's got a very cool idea of an alternative America but he spends all his time in the courtroom.  Two books, Journeyman and Heartfire, have Alvin "volunteering" to sit in the courtroom while people argue weighty issues. 

I'm listening to the books for free from a wonderful service called Overdrive.com.  If you have a library card, then it is likely that you can download free audiobooks.  For those of you without a library card or with a penchant for older, scholarly texts, check out the Gutenberg Project.  The readers volunteer to read uncopyrighted older texts online for all of us. 

Born To Run

If you haven't read this book,  let me paraphrase.  Big guy learns to ultramarathon, finds that too much shoe is a bad thing.  Maybe we should all be barefoot?  Not an option here in Maine.  If they make a decent thick waterproof sock... oh wait, that's an LL Bean boot. 

Orson Scott Card, beyond Science Fiction

For those of you old enough to remember the combination of war and childhood, Ender's Game was a classic.  I just remember thinking of how cool it would be to be able to play around in the war rooms without gravity. 

Card didn't stop, and he combines deep character development with complex, well thought out plots.  My most recent favorite is this Seventh Son series, which covers an alternative American Revolution and follows an extraordinary child through adulthood while bringing a new version of what might have been in the American colonies.  I just got the fourth in the series and can't wait.

Think on These Things

A very old book, but with very pertinent questions.  Simply asking the questions, not taking anything for granted, is too rare a tactic.  At times he seems belligerent about modern life, but his questioning of the assumptions of modern society are sound. 

An old, new, possibly Austenish book.

Surprisingly good beginning, making the case for an Austen like modern life.  I found myself unable to put it down despite nothing really happening.  In the end, mostly nothing happens, but it's a great nothing. 

New article on liver fibrosis

New article out on liver fibrosis reversal.  Read it for free online at Liver Health Today (p.28).

Have you lived?

If you've seen the video, maybe it's time to buy the book?

Required reading for anyone who eats food.

It used to be that only biochemists needed to know what transfats are.  Now the expectation is that the averaage layman is familiar with biochemistry.  This wonderful book has a fold out map that gives you all the different food groups and the compounds within them (hint:  high fructose corn syrup is not an essential nutrient).

Adrenal support

One of the funnest things about Women to Women is that they don't really ask if you're a woman when you sign up for their newsletter.  So I periodically get emails telling me my estrogen is likely to be out of balance.  That may be, but I'm personally more interested in my testosterone.  This discussion of adrenal covers both sexes.  I don't find the 24 hour testing terribly accurate, and the conventional approach is either a snapshot blood test (almost always "normal") or a 24 urine collection.  I use a much quicker in the office test.

Here's W to W's rundown on adrenal fatigue.  http://www.womentowomen.com/adrenalfatigue/effectsofhighcortisol.aspx?id=1&campaignno=adrenalfatigue&adgroup=ag1adrenalfatigue&keywords=adrenal+fatigue

Council of Europe Sees Conflict of Interest in Swine Flu Pandemic Experts

What are we to think when the very people who were screaming about the swine flu pandemic were on the payrolls of the drugs manufactured to stop the pandemic?  The word "conspiracy" is one the WHO has been talking about. 
http://www.bmj.com/cgi/content/full/340/jun03_4/c2912

Internal Medicine: What's Really Happening

Among the things I love about Harrison's is the addressing of basic medical philosophy.  Here is a quote from the introduction to oncology (Cancer Treatment).  "The dictum primum non nocere is not the guiding principle of cancer therapy.  When cure of cancer is possible, cancer treatments may be undertaken despite the certainty of severe and perhaps life threatening toxicities.  Every cancer treatment has the potential to cause harm...the guiding principle of cancer treatment should be primum succerrere, "first hasten to help." (p.514)

Yes!  The conflict I see played out in patients is a confusion between harm and treatment.  Never have I heard an oncologist explain both the nature and the practical side effects of their treatments better.  It would be wonderful to have this philosophy clarified, not because it's wrong, but because it would make it easier for patients to make quick decisions about their care.  Yes, there will be side effects, but we need to
work fast.  For those of you who don't know Harrison's is a standard medical text, interesting only to medical geeks like myself.

If you think you can't, read this.

Let's see...mountain climber to world education expert without any schooling.  Pretty impossibly true.

Zen Flesh, Zen Bones

Just when you think you've "got" one of the stories or koans, there's another layer.
A book of nonsense that has been passed on from master to student because maybe we're all full of nonsense.

Pride and Prejudice and Zombies?

I think the next time someone does this sort of mockup, they should hire a doctor to go through the mechanics of zombiehood.  It just seems inconsistent.  Although the collaborator attempts to replicate Austen's prose, I found myself relishing her sparring of manners all the more.  An interesting idea, and it did get me to go back to my classic.  But even the new, improved version with lots of mayhem simply adds in more grating references to swords and threats.  I did become used to the zombies as I progressed, and there is some sweet justice meted out to those who cross Elizabeth. 

A Wiser Man Than I.

A theoretical physicist gone monk.  A funny man with a wise sense of humor.

1000 Awesome Things

If you want something non-denominational, non-religious and uplifting, here's some happy fluff.

Beyond Self Sabotage

Most of us improve in one area of our lives and then blow it in another area.  Among the amazing things in this book is the claim that he hasn't had a fight with his wife in twelve years.  His concept of "the upper limit" of comfort is extremely useful.

Life is fleeting, breathe.

In every breath, a molecule of the air breathed by every fallen hero enters your lungs.  Rather than speculation, this is the simple reality of the recycling of oxygen in our atmosphere.  We are literally connected. 

http://www.youtube.com/watch?v=16MjXSj-Kek

Allergies

The application of sublingual desensitization is a necessary part of any allergy therapy.  We aren't supposed to be allergic to everything.  Check out http://www.maloneymedical.com/ under the What Do I Treat? page.  I just added a page on allergies.

Christopher Maloney, Naturopathic Doctor

We're linked up on my alternative health page!  For those who want the complete set of links, go to:  http://www.maloneymedical.com/ under other websites. 

A Naturopath's friend. The old Merck.

Every time they call alternative medicine old fashioned, pull out a copy of the original Merck manual and read about M.D.s dosing patients with arsenic.  We've come so far? Today we use methotrexate to treat RA, a disease caused by a bacteria.

Stress release, escape to another world.

While implausible, Lost in Austen was tolerable and interesting in its explorations of modern and Victorian life.  For Austen fans only.

The Unbearable Lightness of Being

The Alchemist reminded me of this earlier work, which is better as a book than as a movie.  That is saying a lot, since the movie is very hot, but you can't translate the sense of the book's ethereal nature into a movie.  The movie is a tragedy, but the book somehow avoids that sense. 

The Alchemist

I picked this up at a friend's parent's camp house and read it cover to cover in four hours.  It isn't so much the ideas as the images that he manages to insert into your consciousness without you being fully aware of it.  I've read everything? he's written that has been translated.  Good, thoughtful material, but his most recent didn't resonate as much as his earlier books.

Four Hour Workweek

When you look at this book, it seems so shallow.  A twenty something has figured out how to outsource his supplement business.  Now he's selling a book.  But have a look at the last chapters (not the blog additions).  He has some good points and makes anyone taking the "safe" path to retirement think (if the financial crisis hadn't already done that for you).

Mercola's Journey

If you look at Mercola's journey, he has moved from conventional to unconventional medicine for the sake of his patients.  Mercola's discussion of his journey.  So many doctors haven't taken the time to examine not just how they practice, but the overall picture of how to truly get their patients well.

Overcoming Underearning

One of the hardest things about alternative health is the fact you need to pay out of pocket.  It does motivate patients to engage fully in their own healing.  In my experience, alternative health patients are often the martyrs in their social group, outperforming and underearning their coworkers. 

Barbara Stanny's book gives a wonderful look at the steps necessary to move from being blocked and underpaid to being assertive and paid what you are worth. 

Natural Treatment Therapies

As patients ask me, I will post various answers to their queries here to help everyone live healthier lives.