How the NHS failed me and mine.
What it did, to the most important person
in my life and how it could happen to you unless
we do something about it!

Thursday, 21 October 2010

The Things 'They' Do To Women.

As many who read this blog will know, I am a critic of the current and highly flawed practises perpetrated upon women by Medicine. It is my belief, that many interventions, alleged to be for their good, are in fact counterproductive, and include in these, breast cancer screening, with mammography and the use of HRT  (hormone replacement therapy). I'm also pretty convinced that most of the treatments persued in 'curing' cancer, especially breast (and prostrate cancer), are ineffectual to a large extent, but I'll save that last bit for another day.

Postmenopausal HRT, was hailed as a breakthrough in assisting women adapt to life after child bearing years were over, both in maintaining their femininity and easing, or eliminating the symptomatic 'hot flushes' (flashes for the yanks). This is obviously something many women prized as an outcome, because it seemed like an 'elixer for youth'. Well, it turned out to be something completely different, and for some it was a death sentence. In JAMA yesterday, the results of  an 11 year study of a very large cohort of women was published that concludes, that combined HRT increases breast cancer significantly; well, in the cohort study, it was nearly doubled. Worst still was the fact that the type of cancer was node-positive, not the 'benign' type that 'Big Pharma' had already acknowledged was more likely when on HRT. How any breast cancer can be viewed as such boggles my mind but hey-ho, drug companies often use such terms as their stock in trade. Highly regarded (by me anyway) Paul D. Maher also highlghts this study in his blog today, which may mean great minds think alike, (would that I was as credentialed or clever as he) but maybe not. 

Well, it was already known in 2002, that the Women's Health Initiative Trial (WHI) was halted due to evidence of harm, and that many advocates ('Big Pharma'), refuted this as being purely observational and as such inconclusive. Whilst I still hold to the view, that observation does not prove causation, at the same time, observed harm, is a serious problem.worthy of urgent and serious investigation. After all whilst the use of 'extract of pregnant horse piss' may have afforded women comfort in menopause, it was hardly something worthy of risking one's life to eliminate. Amongst the many charges leveled at HRT in both the 'combined' form and Oestrogen only types are;-
  • Heart Disease
  • Stroke
  • Lung Cancer
  • Blood Clots
Insulin Resistence is also attributed as being a highly possible side effect, which may throw some light on the high incidence of Type 2 Diabetes amongst post menopausal females. That's a hypothsesis only, but there does seem to be some anecdotal evidence for this. Once more the drugs industry stands charged with producing dangerous products that do much more harm than good. Well, no change there then!

Friday, 15 October 2010

Acedemic Arrogance in the Matter of CAM.

In the matter of Complimentary and Alternative Medicines (CAM), much has been said by both medical bloggers, Doctors and Clinicians. Such words as 'wibble', 'mumbo-jumbo' and other derogatories, have been usefully employed to deride CAM. And, sections of the protocols employed within CAM, have been highlighted to prove the point. Homeopathy and Acupuncture particularly, have been held up to the light of day, and pronounced as worthless, and without any scientific proof of efficacy. I heartily agree with this view, and would apply it to quite a few other aspects of CAM. But, I do think, that to classify everything outside of mainstream drug protocols and the medical 'mainstream' as useless, is nonsensical, counter productive and further, it is arrogant in the extreme.In many ways, it also flies in the face of a number of treatments already adopted by many Clinicians.

Physiotherapy has become an essential part of recovery protocols, or even primary interventions for many, both in Hospital and in the Community. Yet, it is, in strict terms 'complimentary', to Medicine and Surgery. So get your terms right Doc'. If the use of specific vitamin supplements by Medics is invoked, again you are venturing down this road again. Some will recommend or even prescribe fish oil concentrates, to certain patients (Amcor). This is of course despite the fact, that the NHS will be paying through the nose for an expensive version, of that which can be obtained, 'over the counter' from quality sources. But that's the problem we have with NICE; they often recommend (or don't) the use of particular products based upon flawed or skewed evidence, or simply price.

In the matter of evidence, a lot outside of the 'mainstream', is viewed as being without any evidence of efficacy or safety, when the truth is that there is wealth of well constructed trials, just as good, if not better than those conducted by, or paid for by 'Big Pharma'. It's just that Clinicians pronounce judgement without even bothering to look for them. It used to be a widely used protocol in coronary heart disease, to utilise magnesium both in IV form as well as orally. It is also viewed as a major deficiency, especially in the elderly, and with the concentration in the diet, of 'industrial foods', is also becoming a deficiency in the wider populace. Supplementation, is now the only way to ensure an adequate intake due to it's depletion in the soil and consequently the food grown, and animals who live on it. It is essential for human metabolism and a deficiency, is linked to many diseases as well as CHD. But prescribing it, and taking it is CAM. Yet it is embraced by many, both within and without Medicine. It is also the subject of much research as shown here and and here too.

Moving onto drugs; there are number currently in use that owe their existence to CAM, which of course embraces herbs, vitamins and supplements. Metformin, the drug almost of first use, for Diabetics, is the synthetic form of French Lilac. Statin's, for what use they are, are the result of a poison found in China called Red Yeast Rice, and of course many, if not most of the older drugs in use, especially analgesics, are all based on, or made from natural sources (Opiates). In fact in the early days of medicine there was nothing else, as anyone who has studied its history can attest. In many ways, some herbs can afford results to patients, that are better, or as good as drugs, and usually (but not always) with fewer or no side effects. The problem arises, that treatments, based on this type of medicine, yields little or no benefit to the Drugs Industry.' They' love to 'patent' everything, so as to make money; lots of money. It seems in fact that 'Big Pharma' and some Doctors view disease as an income stream, rather than something to cure, and patients as a means to a handsome livelihood.

Doctors also advocate diets. Diets are part of CAM. Most of that, which they tell the patient, is counterproductive, because they do not keep up to date with research, or slavishly follow the advice of vested interests of the Drugs Industry, which requires dietary input to legitimise its drug protocols. This often flies in the face of common sense (high carb diets for Diabetics) or legitimises heavily flawed, or unproven hypotheses such as 'fat causes heart disease' (see last post), but diets however, are part of CAM, so curb the hypocrisy, Doc' you recommend diet all the time! Just because it's the wrong one does not change this.

There is much within CAM that is wrong, so wrong it boggles the mind. It is full of 'snake oil salesmen', some legitimised (they think) by being actual Doctors, MD's that is, not simply graduates of some obscure institute on the 'net. Some will flog you a pendant, that will change your life, or a bracelet to cure your arthritis. Others will promise you explosive sex if you take their herbal concoction. But beneath it all are some good and honest practitioners, who utilise the best of both schools of thought and will resort to drugs when needed. One particular area dear to my heart, as a Diabetic carer, is the reckless use of antibiotics for Urinary Tract Infections.

A simple treatment with a sugar derivative, called D-Mannose, cures the bulk of UTI's that stem from E-Coli, but by a different mechanism. It simply attaches to the bacteria preventing it adhering to the bladder wall and is flushed out. It cures about 80% of common UTI's

Closed minds. Hubris. They all contribute to the arrogance displayed by many in Medicine. The dismissing of everything outwith drug protocols peddled by 'Big Pharma', or the politicised advocacy of useless or even harmful diets, displays the lack of any real pragmatism in Healthcare. There is some light; some are now looking to supplements such as Vitamin D3 and CoQ10 as a means of supporting patients immune systems. Some will even advocate lifestyle changes as a means of curing rather than simply treating symptoms with spurious drugs that prove to be more dangerous to the patient than the ailment with which they present. More power to them.

There is a place in Medicine for all that is science based, but sometimes a gamble has to made. You can't do a double blind placebo trial in humans for UTI's with D-Mannose. It would be unethical. But I can attest to it working. And I became very seriously ill with it, and had three courses of antibiotics and was diagnosed with possible cancer. It wasn't I'm pleased to say, but I and many others (not all) could be spared that and the NHS much cost if this simple protocol was invoked. There are many others; most inherently benign. Is it not time at least to try a middle road?

Tuesday, 5 October 2010

Andrew Lansley, Evidence Based Nutrition and the NHS.

Chis Kresser aka the healthy sceptic highlights the fact, that the new 'Dietry Guidelines for Americans' is not an evidence based document in any way. Considering it is the first complete update since 1977, with the intervening years being significant, in that despite the uptake of low fat, high carbohydrate diet, both CVD, CHD and Diabetes have increased dramatically. The Committee, seems to have conveniently ignored this fact in its deliberations and closed it's mind to any view, outwith conventional one's peddled by the moron's that govern Healthcare in the US and of course, in the UK as well. Because it is certain, that these guidelines will form the basis for those recommended for UK citizens be they Diabetic, Obese or suffering from heart disease

 Some scientists, so affronted by the lack of science displayed by the report and its lack of evidence in its conclusions, have seen fit to write a critique. You can read this here.  It is important to do so, to realise the depth of stupidity that is often displayed in advice handed down to the populace by this or indeed almost any Government.

In the UK, we will soon see, the closure of the Food Standards Agency (hurray) with the role being assumed by the Dept. of Health (boo). And we are told by the Secretary of Health, one Mr Lansley that;  “I am committed to improving the public’s health by providing evidence-based advice to support people in making healthier choices. The transfer of nutrition policy in England to the Department of Health means we can give the general public more consistent information". 

I do not know, whether to be pleased to hear this or not. It depends greatly, which evidence he will base this policy upon, and whether there is any real desire by the current coalition, to make a sea change in policy that will effect real improvements in Health, for the populace and at the same time save money, because there is little doubt in my mind that basing criteria for nutrition upon  real evidence based guidelines, will indeed achieve significant cost savings and real improvements in health.

If we are to view some policy decisions already made, such as the 'scrapping' of the piss poor Private Finance Initiative for Schools, which would have seen huge, but 'off balance sheet' costs being borne by council tax payers to fund schools, planned by  'NuLabour', then there is hope. So far this model, for Hospital building has created worse constructs, than would otherwise have been the case, together with huge costs to the Taxpayer. For instance, the new Birmingham 'super' Hospital, as reported in Private Eye, will cost some £2.6bn over 35 years for a build cost of £627m. However in that same journal we learn that despite the criticism leveled at 'NuLabour' for their "flawed PFI model"  by a Mr. Osborne, that there are now "no plans to review the use of the private finance initiative, as a procurement vehicle in the National Health Service".

The future looks even bleaker for justice and candour too. With the emphasis on GP commissioning and Foundation Trusts as the future of Healthcare, we will no longer have any sort of public scrutiny of , well just about everything. Public access, to what will be Private Consortia, in the case of GP's and closed meetings, as is the case with Foundation Trusts, will make the public even less informed than now. Which is little hard to contemplate. As 'social enterprises' they will also be immune to Freedom of Information requests. If the LibCons, really want enjoin with people in discussing our futures, this decidedly seems the wrong way to go about it. Nothing new there then!