Busting modern medical myths

[Pooeypants]

In the early days of medicine, physicians might diagnose patients using bumps on their head, or dispense a couple of leeches to draw off "ill humours". Yet a medieval doctor might give a more confident response than his modern equivalent if a patient asked for the evidence to support their treatment. These days, it seems many of our "tried and tested" approaches to disease are nothing of the kind. Researchers writing recently in the British Journal of Surgery concluded the practice of daubing patients with a disinfectant skin gel prior to operations made little or no difference to the rate of infections they suffered afterwards. Simple soap and water was just as effective. However, despite this, it's more than likely that, in future, waking up after your operation in many British hospitals, you'll have that tell-tale orange stain around your wound. You'll have been given a treatment that doesn't work. This isn't a single example. Many techniques in common use today don't have cast-iron evidence that they do any good. In some cases, firm evidence suggests the opposite is true.

Read further. Is anyone surprised by these findings? I certainly am, even though I'm not a medical student I do study certain aspects (microbiological) and they never taught me that using simple soap and water is just as effective as disinfectant skin gel for use prior to surgery.

[Compugasm]

Quote by: Pooeypants Is anyone surprised by these findings?

I don't get it. My initial reaction is ... that's all they found? Soap works just as good? They didn't ask a surgeon what the orange stuff does... or supposedly they have some lengthy list of treatments that don't work, but only talk about two? Big deal. If anything, I get pissed off at the person who wrote this article. Either his editors totally murder this article, or Martin Hutchinson isn't a very good writer.

[The Bacon Guy]

Regarding soap and water being as effective a disinfectant as iodine solution, the article isn't taking into account practicality. I would imagine that it's much easier to work on an area of skin disinfected with iodine than one covered in soap and water.

[italiangm]

From the article:

"An example is PSA [prostate specific antigen] screening for prostate cancer. What the best studies tell us is that patients who have the test are equally likely to die from prostate cancer compared with those who don't," he says. "This actually does harm, because patients who test positive may undergo unnecessary prostate surgery. But the test is still being carried out."

Not as much as 10 years ago. Once evidence-based longterm studies showed this form of cancer often develops slowly, many docs take a wait and see approach. A man may die of old age before the cancer gets him.

Another set of conflicted issues revolve around treatments for obesity, type 2 diabetes, and cholesterol. The various medical associations emphasize medications first, then diet and exercise. But the simple act of limiting grains, starches and sugars, replacing them with protein, healthy fats, and carbohydrates with lower glycemic values work better than medications. Weight, insulin resistance, vessel plaques, and the various medical biomarkers of health all improve without expensive meds.

[The Thinker]

In the past when it was your time to die, you died. Nowdays they rush you to the hospital and if in a coma you are hooked up to life supports. If you get well you most likely feel like being dead once you see all the costs sents to you. In other words, keeping you alive was to make big money for the Medical Association whoall worked on you and the hospital boarding you had to stay in. And of course all the procedures they did. Yes, hopefully you have insurance, me I have no medical insurance just auto insurance. I have not been to a doctor in 20 years (since my divorce and then I was taken off my exhusband's terrific plan). I just eat right, get enough sleep and don't drink booze or smoke. At 61 I am doing pretty good.

[Pooeypants]

Quote by: Compugasm I don't get it. My initial reaction is ... that's all they found? Soap works just as good? They didn't ask a surgeon what the orange stuff does... or supposedly they have some lengthy list of treatments that don't work, but only talk about two? Big deal. If anything, I get pissed off at the person who wrote this article. Either his editors totally murder this article, or Martin Hutchinson isn't a very good writer.

The article highlights the fact that medical research is far outpacing what doctors can learn at the moment. It's telling us that some of the things practised in medicine can be ineffective and to some degree, a waste of resources.

[italiangm]

Quote by: Pooeypants The article highlights the fact that medical research is far outpacing what doctors can learn at the moment. It's telling us that some of the things practised in medicine can be ineffective and to some degree, a waste of resources.

On the other hand, such waste often provides a significant revenue stream to doctors and pharma companies, at least in the US.

Focusing on the UK, there are strong government restrictions on the use of benzodiazepines (ativan, xanax, klonopin, etc) due to tolerance and withdrawal effects after longterm regular use. Unfortunately, UK health officials severely restrict them as a prescribing choice instead of understanding and respecting the well-documented requirements for successful start-up and taper-off from this beneficial and inexpensive class of medications. This is a sad state of affairs for UK patients with treatment-resistant anxiety disorders.

[Compugasm]

Quote by: Pooeypants The article highlights the fact that medical research is far outpacing what doctors can learn at the moment. It's telling us that some of the things practised in medicine can be ineffective and to some degree, a waste of resources.

Just a few days ago, I talked with a friend of mine who discovered a process to find a protein marker for a disease, that normally took 6yrs to diagnose. Now, they clone some stuff, and do some fancy laser thingy to it, and find it in about a month or so. This 6yr vs 1 month turnaround sounds remarkably similar to what you're describing. In fact, using lasers and cutting off 6yrs of diagnosis time, would be far more interesting than soap.

What I don't understand, is why it the author didn't highlight something signifcant. Soap vs iodine is the "smoking gun"? The author didn't follow up with anyone who is in a position to make this critical decision. Even Bacon Guy came up with a plausible explanation. My opinion stands, the article is weak. Does Martin Hutchinson have any insight into what he's talking about?

[Mr.Vicchio]

Do you want to be the hospital that bucks the trend, a patient gets an infection and then sues cause you are different?


Yeah, didn't think so.

[Jack]

It's telling us that some of the things practised in medicine can be ineffective and to some degree, a waste of resources.

I see that as the normal evolution of knowledge. Every day we learn more, every day we find new applications for old treatments, or new treatments for existing diseases. Medical knowledge has to advance, and in doing so, some former practices may fall out of favor. I perceive that as a good thing.

[Keith Hamburger]

Quote by: Isherwood I see that as the normal evolution of knowledge. Every day we learn more, every day we find new applications for old treatments, or new treatments for existing diseases. Medical knowledge has to advance, and in doing so, some former practices may fall out of favor. I perceive that as a good thing.

But, we don't really learn anything. For example, there is no evidence, whatsoever, that reducing cholesterol through medications, for patients that have not had a heart attack, reduces the risk of heart attack. But, tens of millions in this country are spending billions of dollars per year on statins and other cholesterol reducing medications for minimal benefit.

Doctors don't even really know how that SSRI drugs work, but they have a name that indicates we know all about them. And, again, tens of millions of people are on these drugs at costs of billions of dollars per year, because they are not as "happy" as they would like to be.

The best advise that you could get for most "conditions" from your doctor would be to relax, eat a healthy diet, get some exercise, spend some time outdoors in the sunlight, get enough sleep, and don't waste your time or your money on expensive medications or doctor visits unless you're truly ill.

You will never hear a doctor limiting themselves to that advice, though.

Keith

[Ken Carman]

Quote by: Pooeypants Read further. Is anyone surprised by these findings? I certainly am, even though I'm not a medical student I do study certain aspects (microbiological) and they never taught me that using simple soap and water is just as effective as disinfectant skin gel for use prior to surgery.

I don't even have to read to comment. This is something that can be explained in two ways...

One...

100, years from now people will regard how we did things as barbaric, just like we regard how they amputated limbs on the field during the Civil War. This applies to medicine, style... just about anything. 100 years from then their children will say the same. Some old things will become new, but few will admit that the old folks may have had it right. They will act like they invented it, just like the school kid who was offended when I mentioned that bell bottoms were back in style. ("They are NOT bell bottoms!")

In regard to the specific case mentioned, I have always thought we should be more forgiving, socially, when others question such common medical practices. That doesn't mean we automatically change what we do, just that we are open to the possibility that maybe we should... eventually, and look into the possibilities. Change for the sake of change is usually a bad idea, and resisting change because it simply is change... just as bad; or worse.

Two...

Idiots will keep staying, looking back at us, "Oh, it was a more simple time back then." Horse manure. Every age has it's complexities, we often have been blinded by what is by what was.

[Ken Carman]

Quote by: Keith Hamburger But, we don't really learn anything. For example, there is no evidence, whatsoever, that reducing cholesterol through medications, for patients that have not had a heart attack, reduces the risk of heart attack. But, tens of millions in this country are spending billions of dollars per year on statins and other cholesterol reducing medications for minimal benefit. Doctors don't even really know how that SSRI drugs work, but they have a name that indicates we know all about them. And, again, tens of millions of people are on these drugs at costs of billions of dollars per year, because they are not as "happy" as they would like to be. The best advise that you could get for most "conditions" from your doctor would be to relax, eat a healthy diet, get some exercise, spend some time outdoors in the sunlight, get enough sleep, and don't waste your time or your money on expensive medications or doctor visits unless you're truly ill. You will never hear a doctor limiting themselves to that advice, though. Keith

I do know, from experience, the cure is always worse than the affliction. My numbers are so slightly off (somewhere slightly over 200, if I remember right) that they have finally given up because each medication they've tried turns my liver into the enemy... yet tests have come up with nothing, disease-wise. Blood pressure? Always excellent to too low... the last, if I behave myself, diet-wise.

[Pooeypants]

Quote by: Keith Hamburger But, we don't really learn anything. For example, there is no evidence, whatsoever, that reducing cholesterol through medications, for patients that have not had a heart attack, reduces the risk of heart attack. But, tens of millions in this country are spending billions of dollars per year on statins and other cholesterol reducing medications for minimal benefit. Doctors don't even really know how that SSRI drugs work, but they have a name that indicates we know all about them. And, again, tens of millions of people are on these drugs at costs of billions of dollars per year, because they are not as "happy" as they would like to be. The best advise that you could get for most "conditions" from your doctor would be to relax, eat a healthy diet, get some exercise, spend some time outdoors in the sunlight, get enough sleep, and don't waste your time or your money on expensive medications or doctor visits unless you're truly ill. You will never hear a doctor limiting themselves to that advice, though. Keith

The problem is that the public is always demanding a panacea. One of the reasons why we're having an antibiotic crisis is because doctors were proscribing them to anyone who came to them with a cold/sore throat, even some who were caused by virus. Fact is, all people have to do in most cases is take some time off and get some rest (antibiotics don't work against a viral infection at any rate). But people don't want to hear that, they want to have something, anything to treat their ailment.

[ZNFYRH]

Triply exclaiming the correctness of The Bacon Guy's post #3.

If soap and water or the disinfectant are equally effective, then it all boils down to practicality.

Also, while soap and water are great for the external parts, do you want to worry about water and soap dripping into the body?

The iodine solution isn't as liqueous as soap and water. It soaks into the skin, so to speak. Soap and water need to be dried. Odds are that when you dry the water with something, that something already has germs on it.

[5010]

Quote by: Keith Hamburger You will never hear a doctor limiting themselves to that advice, though.

Good advice. Did you read "Eat, Drink, and Be Merry" by Dean Edell, M.D.? I think it's pretty good and reveals a lot of discrepancies between studies and what we think benefits health.

For example, he writes about one study that compared runners with non-runners from a certain college class over decades. They reported that those who ran regularly lived longer than those who didn't. Great! Unfortunately... the amount of time it extended their lives averaged about the same as the time they spent running!

[pikatore]

Soapy water can have adverse effects when dripped or spilled into an open wound. That's why iodine is used.

Soap is designed to dissolve and liquify dirt and grease, and disinfectant soap (like dettol) is a lot stronger, killing off bacteria very efficiently as well.

Iodine is used for a reason... it's not some useless arcane technique.

[ZNFYRH]

pikatore,

That crossed my mind too.

I think I remember reading once that soap doesn't "clean" anything.

It's highly "basic" and as such, doesn't so much clean skin as it does "burn" off the dirty layer. Hence why some people wash their hands with certain brands of soap and have very dry skin.

If I tell someone I'm going to rub their belly with water and a bar of acid before I cut them open, they'd say no, I would presume.

[Ken Carman]

Quote by: Pooeypants The problem is that the public is always demanding a panacea. One of the reasons why we're having an antibiotic crisis is because doctors were proscribing them to anyone who came to them with a cold/sore throat, even some who were caused by virus. Fact is, all people have to do in most cases is take some time off and get some rest (antibiotics don't work against a viral infection at any rate). But people don't want to hear that, they want to have something, anything to treat their ailment.

Drug companies and doctors have to stop sleeping with each other, business-wise. I also think we have too a mechanical view of the human body. Not operating exactly right? Just change the chemical mix and... problem solved!!!! There's are reasons why our bodies maintain a certain chemical and biological balance, and even if there's an imbalance I often wonder if just shifting it is always the wisest approach.

30 years ago my father said that, for example, cutting cholesterol is problematic because the body produces it naturally. From my experience the cure is worse than the problem. Plus I remember him citing several cases when no matter what they gave the patient the numbers remained high. My grandmother was just such a case, and her condition didn't kill her. She died, always excessively obese, at well over 100, of... being well over 100.

Plus, could the long term effects be worse than the "cure," or adjustment, of whatever condition we take drugs for? Especially when combined with multiple altering substances.

I'm not anti-drug, just think we need to be more careful and more thoughtful.

[Compugasm]

Quote by: Ken Carman Plus, could the long term effects be worse than the "cure," or adjustment, of whatever condition we take drugs for?

The scam seems to be cure one thing, cause side effects that require more pills. Like, if you take your car to get an oil change, and they loosen some bolts.