You and Your Microbiome, Are You Talking?

While we may feel stressed in the world, most of us would like to think of our own bodies as a calm place where we are in charge. But that may not be the case.

In the past ten years, we've discovered a vast unexplored region in the body, hidden in the gut. Research is showing that your gut bugs are not just for breakdown. They can affect everything from how your belly feels to how your brain functions.

So how well are you communicating? If you clear a room or have to leave your home spraying deodorant behind you with every number 2, then maybe your gut is trying to tell you something you don't want to hear.

There's so much about this subject, I wrote a short book for my patients. Have a look at your inner rainforest (and it is a rainforest). 

A World Without Cancer By Margaret Cuomo, M.D.

A World Without Cancer by Margaret Cuomo (yes, Mario Cuomo’s daughter)

I’m a sucker for M.D.’s coming up with a complete cure for cancer.  I just love the idea of addressing the global issues of cancer and coming clean about the fact we need to have a different paradigm.

Dr. Cuomo spends the first half of her book talking about the ills of the current cancer system, and the second half listing basic things that we can do to reverse the tide.  Midway along, we get a call for a new institute based on the idea of preventing cancer.  So that’s how we’ll get a World Without Cancer: start a new institute.

In looking at the information, the discussion of the ills of the current system was far more informative than the cursory overview of what we can do about it. 

Dr. Cuomo makes general claims about cancer care, but most of them apply to breast cancer.  In discussing breast cancer, mammograms reduce breast cancer deaths from 3.5 to 3 per 1000 patients (p.47).  We have an interesting take on the need to get informed consent from patients:  “some will become informed consumers…Many will not, and that’s reasonable too” (p.55).  In a disturbing insight about what constitutes a clear margin in cancer surgery:  “no strict agreement on how large it should be, leaving surgeons to make decisions” (p.61)  We get another support of the lumpectomy over complete mastectomy, and the fact that the choice is not given to many women (p.62).

On p. 72 we learn that Gleevec cures CML, the rare exception to chemotherapy drugs.  (In a follow up, Gleevec is no longer first line therapy as of 2011 as CML is too often resistant (http://jnci.oxfordjournals.org/content/103/4/E1.long)

When we move into the money matters, things get really ugly.

The pharmaceutical industry is the most profitable industry in America, holding monopolies on its products for twenty years (p.86).  Oncology drugs provide the highest source of growth for the industry (p.84).  Medicare and Medicaid are barred from negotiating prices for drugs, unlike the Veteran’s Affairs Department which pays 48% less on the most frequently prescribed drugs (p.87).  In 1991 Medicare paid 7,100 on average for lung cancer chemotherapy.  In 2002, the same treatment cost $40,000, an increase of 500% without any increase in survival rates (p.88). 

Despite discussions of market economics, the disconnect between insurance payer and covered patient shows that consumption of the drugs is not significantly altered by costs (p.92).  New drugs on the market may be called “new standards” (1.2 months more life at $80,000 cost) or “game changer” (2 months more at $120,000 cost).  In comparison, placing patients in end-of-life hospice care provides an average of 3 months more life (p.99).  We pretend we can afford to pay for everything (p.109) and institutes looking at patient outcomes are barred from considering cost as part of their evaluations (p.110). 

Despite being insured, we are currently seeing rationing with cancer drugs.  “Prescribing different medicines to different patients based on their health care plans.” (p.111).  Of households affected with cancer, 25% used up all savings, and 11% were unable to meet basic necessities despite having insurance (p.120).  Adults with Medicare can pay as much as $6,000 out of pocket for cancer therapies of marginal benefit (p.121). 

Doctors get paid to prescribe and administer treatment (p.159).  One third of oncologists felt uncomfortable discussing the costs of chemotherapy with their patients (p.123).  Dr. Cuomo ends her discussion of the current state of cancer care by asking us to change our whole gestalt (complete picture) and not to demonize any one player (drug companies, doctors, FDA) while we look for other solutions.

Dr. Cuomo’s solutions are not a prescription for a world without cancer.  They are a step in the right direction.   As a radiologist, she takes issue with the ordering of so many CT scans, each one equaling 100 to 800 chest X-rays (p.172).  The CT machines themselves have a 13 fold variation between highest and lowest exposure to radiation depending on how the machine is calibrated.  So most people are getting more radiation than they need to during a CT scan (p.173). 

The diet piece of cancer prevention reads like every cancer prevention diet:  fruits and vegetables, berries, cruciferous vegetables (broccoli), tomatoes, dark leafy greens.  We should buy organic, eat more fiber and fish, drink green tea, limit alcohol, and avoid processed foods.  Add turmeric to your diet and avoid red meat.  Limit alcohol and avoid processed foods. 

Dr. Cuomo is not a fan of supplements except to gush over vitamin D, recommending fairly high doses of that and calcium. 

When I picked up the book, I was looking for a paradigm change.  What I got was a reality check that a trillion dollar cancer-war industry needs to change (ie. lose an enormous amount of money).  That industry has, since the war on cancer started, gone in one direction (more drugs, more expensive drugs) and has every incentive to keep doing more of the same.   In the meantime, I’m supposed to eat well.    

Gold, Frankincense, and Myrrh: Which of These Was Most Useful?

We've all heard the story. Matthew 2:11 talks about Gold, Frankincense and Myrrh. So which of these was the most useful? From a strictly monetary point of view, it was the gold. That would allow mom to buy some things for the baby. But what of the other two? Myrrh is a powerful natural antibiotic. It is part of a formula I use successfully to treat sinusitis. In his early years, the baby would have benefitted from having this around for the illnesses of youth. Frankincense is a powerful pain reliever for arthritis. Now we have multiple randomized studies showing that it benefits arthritis sufferers. So all three were equally valuable for the child. 

I just finished listening to the short book Many Lives, Many Masters by Brian Weiss. It's always hard when someone goes from being a nonbeliever to being someone who says: "this is exactly what the afterlife looks like, and here is the meaning of life for everyone." Clearly the rendition of what was said by his patient in hypnotic state was in line with what would translate for him. The Masters said as much, and even his patient didn't want to listen to the recordings. But it was interesting to hear about his search of the literature and the extensive research that has been done on these issues. I simply don't see any of this literature making its way into the hospital wards and nursing homes, which is unfortunately where most of us go to die. I've also talked to several hospital pastors who are more and more non-denominational these days. Hospice seems to do the best in terms of dealing with spiritual issues, but if someone is dying of an acute illness (and therefore needs the most help quickly) we don't have the resources in place to address their spiritual needs. I know it will never be a hospital priority, but it doesn't even seem to be on the radar in most locations. Muchas vidas, muchos maestros / Many Lives, Many Masters By Weiss, Brian (Google Affiliate Ad)

Strange Things For The Sake of Science: Ben Franklin Fries a Turkey

Most of us know that Ben Franklin did things with electricity.  But few of us realize we almost lost him on Dec. 23, 1750.  Ben and his buddies were fixing to fry themselves a turkey, using a built up charge of this magical new electricity.  Franklin got distracted and sent the charge through himself instead.  Fortunately for him and for all of us, his charge was only enough to daze him for a few minutes.  Later on he got together a bigger charge and fried a turkey with it. 

Read this anecdote and many more in the aptly named Electrified Sheep by Alex Boese.  Bed time stories for the geek in all of us. 

Good Calories, Bad Calories: Ignoring the Paradox And Trashing Carbs.

In reading Good Calories, Bad Calories, there is a hope that the author will give a balanced viewpoint of the situation.  He disproves the idea that fat causes weight gain, then takes issue with the idea that carbs cause weight gain. 

In a chapter entitle the Paradox, he points out that when you starve people they lose various amounts of weight.  He also shows that when you stuff people they gain various amounts of weight.  So any blanket statement about weight gain and weight loss is moot.  It doesn't exist.

Then, because everyone needs an ending, he goes back to carbs and makes them the villain.  It isn't just the carbs, it's the insulin imbalance caused by the carbs.  But wait, didn't we just show that it wasn't straight carbs and that any weight gain or loss is a highly individualized process?   Under those circumstances, wouldn't it be possible that some individuals might even gain weight by eating fat? 

What starts off extremely well becomes one more carb trash fest while glorying the joys of meat and fat.  What's missing from all this is some allowance for the fact that we all cannot eat meat and survive as a planet.  It isn't a sustainable eating pattern, and it isn't terribly healthy.  We've got other books that make that clear.  They are focused on lifespan, rather than weight loss. 

The End Of Illness. David Agus' Inability to See His Own Prejudices.

One day I too hope to write the definitive book on the cure for Cancer.  But I think I will base my treatment protocols on more than one reference book.   

Let me begin by saying I like much of The End of Illness.  Dr. Agus and I agree on many things, including that Michael Pollan does a wonderful job of talking about food.  But my admiration for Pollan does not distract me from the simple reality that Pollan is one of hundreds of opinions about food and what we should eat. 



So, I do not base my recommendations about food while referencing a single author, no matter how authoritative. 

Given that Dr. Agus' focus is on food, and that he spends a great deal of time trashing supplements of all kinds, I would expect a little more emphasis on what will be the most curative diet.  For it is diet alone, and nothing else, that will impact our genetic inheritance and help us live. 

I disagree with the concept that we'll be getting personalized medication any time soon.  Perhaps the very wealthy will be able to afford the sort of technological testing Dr. Agus describes, but the reality is that for almost everyone modern medicine is too expensive already. 

And here is the the fundamental flaw I see in the End of Illness.  Dr. Agus dedicates a huge section of the book to really making readers second-guess taking even a multivitamin because of the possible health consequences.  But he waxes rhapsodic about the benefits of the Statin medications and baby aspirin, taking both himself for "preventative purposes."  Hello?  We're not talking about inert medications.  A statistic percent of those following Dr. Agus' recommendations of daily statins and baby aspirins will suffer debilitating muscle pains and/or hemorrhagic stroke as a result of his "preventative" pharmaceutical supplements.  While we have large studies that show possible risks from overuse of multivitamins, we have no large scale studies that confirm the benefits of statins or aspirin for the general population without the real risk of side effects for a minority of those individuals. 

To place preventative supplementation off limits as a clear negative while recommending pharmaceutical medications as healthy and safe clearly shows a prejudice and double-standard for conventional medical "solutions."  Given the cost and safety profile of the statins, they are at least as dangerous for the general population as the Vitamin E supplements that Dr. Agus so effectively vilifies.  And aspirin is as dangerous to elderly populations as their multivitamin.  So we are left with food as the only panacea, and that needs a bit more book time that simply gushing over Pollan's ideas. 

On the Joys of Dieting.

People who diet are facing themselves in a battle of desperation against an implacable foe.  The survival instinct, honed by God or thousands of years of evolution, is pitted against fear of death and the need to look pretty.  They wrestle over and over in the mind, as the gluttonous smorgasbord that is modern society trundles by around them.  At a given moment, the fear of death wins, pinning its slathering foe beneath the boot of rational denial.  But just as victory seems apparent, the irrational mind throws up a dust screen of distraction and when it clears the bewildered fellow finds his face smeared with Boston creme donuts and wallowing in a tub of frosting with two giant Twinkies outfitted in scanty swimwear.  Such is the reality of the modern dieter, a creature so pitiful even Tantalus in his agony reaches out and plucks the forbidden fruit to offer sustenance to the sufferer.

But look!  There on the horizon is another toned body, chiseled with rippling muscles.  This genetic freak, this Darwinian throwback that would not have lasted a single hungry season, has news for the the desperate dieter.  Eat this way, in this proportion, and you too can look like me!  Honest, look at this science.  Ignore all those other diets that don't work, mine will work because I have more pretty pictures of airbrushed bodies joyfully starving per square inch.

And at what altar does the dieter pray?  No God affixes their altar.  It is a humble object placed on the bathroom floor, worshiped and venerated beyond all else.  Quietly the dieter approaches the object, stripped of all, cleaned inside and out, ready for the sacrifice.  Trembling feet adjust themselves to cold metal, and the object speaks.  It is a cruel God, dispensing grief and joy seemingly without justice. One day a slight down tick of its face sends the body into rapture.  The sun is out and the birds are singing the Hallelujah chorus!  The next day without cause it dispenses an uptick that destroys moods, egos, and sanity.

Such is the life of a dieter.    

Should You Become A Naturopathic Doctor?

A huge number of medical students have written to me personally over the years to ask me questions about Naturopathic Medicine versus becoming a D.O. or an M.D. or a N.P. What they don't realize is that the other professions are overwhelmingly variations on a theme, and being an N.D. in today's world is another direction entirely. So I wrote a book that really spells out the differences. Send it to anyone you love who is confused. They shouldn't be by the end. Available at Amazon (with free preview.) http://www.amazon.com/M-D-N-D-What-Should-Be/dp/1467940429

Should You Become A Naturopathic Doctor? It Takes A Book.

In the last decade I have had enough conversations with confused students to want to make it a little clearer that we are talking about fundamentally different professions. Naturopathic doctors and medical doctors treat the same patients. They collaborate on care. So to patients the professions seem similar. But the framework of how the professions work, and how the people in those professions function, is like comparing the earth to the moon. Do you need this book? What are twenty-six hindsight clues that should have told me I absolutely had to become an N.D.? What percentage of medical students have been physically attacked? The rate of drug dependence of physicians is what percentage of the general population? Is it three times lower, three times higher? More? Less? What are the three assumptions about you that any skeptic will have if you are an N.D.? What percentage of his or her income does the average N.D. make on supplements? Learn these facts and the ten fundamental differences between being an M.D. and an N.D. https://www.createspace.com/3640348

No Child Left Waiting For Superman

As the states opt out of The No Child Left Behind Act, it is clear that we aren't getting where we need to go using a national model. Looking at a documentary like Waiting for Superman shows a very clear need for a ground-up model. We need to make changes at a local level to help our children learn. Our children are literally the only real health insurance. It doesn't matter how good your policy is if your nurse's aide can't read and can't do the math for your injections.

Mu: Do We Really Need Complexity to Be Happy?

I was reading Zen Flesh, Zen Bones, which rarely references itself, and came across an anecdote referencing the Gateless Gate's first koan. It goes something like this: Does a dog have Buddha nature? The answer given is Mu (no-thing). In the anecdote a man is given this one paradox and thinks about it for two years. In this way, he becomes enlightened. Really? He didn't need a doctoral thesis? He didn't need five hundred retreats with Tolle or whatever puckish German fellow replaces him? Just one single paradox, and a great deal of thought. Here in Maine we momentarily pause for rest. They are called snow days, or ice days, or "the weathermen panicked and we cancelled even though there isn't any snow" days. But the rest of the country just keeps building speed. We're hamsters on a wheel that's accelerating down a hill to nowhere.

Two Pennies at Amazon: Lithgow History Comes Alive!

Amazon now has Two Pennies!  Start your new year out right with a children's story that teaches you some very cool history and the money goes to a good cause!

My Two Cents: Two Pennies For Lithgow Library

It often seems in this crazy world we cannot make a dent in things.  But all you can do is throw in your two cents.  I just did in the local library debate by writing a book based on the history of our library (don't worry, it's full of Masonic intrigue-really).  Buy the book to support the library, because they get any profits.  Just my two cents.  I gave my granpa authorship credit for reaching his 100th birthday.

Go to the booksite here.

Is Organic Better? Yes, Mostly.

I've addressed the various issues with judging whether organic foods are better than conventional produce on my website.  http://www.maloneymedical.com/id156.html

The short answer continues to be that organic produce does, in fact, have more of some nutrients than its conventional cousin.  It varies from season to season and crop to crop.  Let's acknowledge that, and move on.  Unfortunately, places like the Mayo Clinic like to sound like authorities, and so cite one review (covering the last fifty years?  Don't get me started on soil depletion, changing farming methods, etc.) and say probably there's no difference.  I'd say some researcher needs to take the Twinkie out of his mouth and realize he's just set the debate back to the dark ages of the 1960's. 

Our current discussion needs to focus on the process of becoming locavores.  This term needs to enter the mainstream in the same way that vegetarian is now part of common knowledge.  If you are unfamiliar with this concept, here's a starting point.  Many people here in Maine have been locavores for decades, but have subsidized an otherwise exemplary diet full of fresh and flash frozen vegetables from their giant gardens with deep fried food.  All they need to do to get healthier is stop eating out.

For the crunchies among us, put down that Ecuadorian arugula.  It isn't in season, and you've just consumed a full tank of gasoline along with your "spring veggies."  Oh, I'm guilty as well, and everything in moderation.  But let's all keep humble and have a look at what our neighbors are doing right.  If we focus, necessity and intention meld together to make it more and more obvious that our only possible way out of our issues is to work together on every issue.     

EU Stops the Regular Use of Antibiotics For Animals, Time for Homeopathy To Shine?

I first read about the transition from the homeopaths at NCH, but  I doublechecked and confirmed at the Union of Concerned Scientists, which gives a different, supportive take on the banning of antibiotics in animal feed.

From a homeopaths' viewpoint, the banning of antibiotics is an opportunity to test whether homeopathy can be helpful.  In the never-ending, howling skepticism of homeopathy its critics have failed to notice reports of better outcomes for animals placed on homeopathics.  The data is good enough to inspire the EU to invest "1.8m in a pilot research project to examine the effectiveness of homeopathic treatments on farm animals." 

The arguments against homeopathy pale when we are faced with a very real possibility that within our lifetimes we will not have antibiotics as an effective tool.  It is far preferable to deal with the realities of commercial farming without an antibiotic buffer now than to wait until complete resistance is the norm. 

Here's a recent study:

Homeopathy. 2010 Jan;99(1):57-62.

Homeopathy as replacement to antibiotics in the case of Escherichia coli diarrhoea in neonatal piglets.

Camerlink I, Ellinger L, Bakker EJ, Lantinga EA.

Source

Biological Farming Systems Group, Wageningen University, Droevendaalsesteeg 1, 6708 PB Wageningen, The Netherlands. Irene.Camarlink@wor.nl

Abstract

BACKGROUND:

The use of antibiotics in the livestock sector is increasing to such an extent that it threatens negative consequences for human health, animal health and the environment. Homeopathy might be an alternative to antibiotics. It has therefore been tested in a randomised placebo-controlled trial to prevent Escherichia coli diarrhoea in neonatal piglets.

METHOD:

On a commercial pig farm 52 sows of different parities, in their last month of gestation, were treated twice a week with either the homeopathic agent Coli 30K or placebo. The 525 piglets born from these sows were scored for occurrence and duration of diarrhoea.

RESULTS:

Piglets of the homeopathic treated group had significantly less E. coli diarrhoea than piglets in the placebo group (P<.0001). Especially piglets from first parity sows gave a good response to treatment with Coli 30K. The diarrhoea seemed to be less severe in the homeopathically treated litters, there was less transmission and duration appeared shorter.
Copyright 2009. Published by Elsevier Ltd.

PMID:  20129177

Kubler-Ross and the Autumn

The Stages of Fall:  Transition Into Winter

I've noticed the stages of dealing with the autumn mimic the stages of Transition here in Maine.

First, we work through our denial.  It isn't just the people, the plants are just as busy trying to outgrow each other.  Winter won't come our way if we don't look at it. 

With the first early winter snow this year before Halloween, we have moved into the anger stage.  Racks of shovels adorn every store.  The armamentary of snowblowers and snow melters and heaters line our sidewalks.  We will battle snow with every ounce of our will.

But already we've moved into the bargaining stage.  We're trying to limit the damage.  I've already said, "no more than twelve feet this year."  As if somehow I could bargain with the winter winds.  Will six inches really make a difference to my year?

And I've seen in my patients the depression beginning.  They talk about the cold winter months and getting out of Maine for the season.  Many will, but those that do will be gone by November.  The rest of us will hunker down for the season.  Days will shorten to mere slivers, and the long, windy nights will swallow up the sun. 

Even as I write, I feel the creeping of acceptance.  It is a relief to let go of having to be everywhere on time.  Whole days can just come crunching to a halt.  Plans will be remade, or cast aside.  And the sun will come again. 

Here's a link to Kubler-Ross' stages of grief. 

Live First, Work Second: Understand the Young

New book out with a lovely title: Live First, Work Second.  Thanks to Candyce Carden-Deal of Candidness for bringing it to my attention.  She has a great blog post that describes the book.

Is Andy Kaufman dead?

There is a documentary out about Andy Kaufman asking whether he really is dead.  I was intrigued because the director shares my name.  But really, if Andy was alive, he'd be doing something else besides laying low.  On the other hand, the weathermen taught us that you can hide in plain sight.

Walking Dead: Shocking? Really? Isn't Everyone Supposed To Die?

I had the misfortune to develop an interest in the Walking Dead recently.  Blame it on the recent Austen/zombie book.  I wanted to see what a drama would be like played out against a zombie backdrop. 

In the first episode, we begin with the hero blowing away a young blonde girl turned zombie.  So children getting shot is how the series begins.  Imagine my surprise when in the opener of the second season they...have a child getting shot. 

Evidently my memory is longer than the reviewers, who are all atwitter (pun intended) with what it means to the morals of television now that a child has been shot.  Really?  Did you miss the horse getting eaten?  How about the walkers getting beaten to second death with bats?  Did you close your eyes during the moment when a man has to shoot his walker wife in the head? 

My biggest issue with Walking Dead is that I do not believe our hero survived the initial slaughter lying comatose in his hospital bed.  First, the walkers can smell people, so a bed across the door isn't going to deter them.  Second, there is no way he didn't die of thirst while his beard grew to the length it did.  World full of zombies who never die, fine.  But don't fake dehydration. 

I also found that I don't really care about the characters, so I stopped watching.