Another CAM post. Get yo' ammo ready. ;)

[Little Etoile]

I was going to respond to this in the Reader's Digest Secrets thread, but I realized that it would probably start a huge debate and I didn't want to hijack the thread. So....

Secret 134:

CAM is ******ed. People who believe in it are ******ed. I refrain from rolling my eyes and calling you a ****** when you tell me about your homeopathic medications because I am a good Southern boy and my mama raised me better than that. A shrug and a "Well, it's your money, do what you want with it," is not an endorsement of whatever idiotic crystal or mind-body crap you are into this week.

Not all CAM. That's a huge, sweeping generalizing you made.

Example: A few months ago I got sick. Fever, congestion, etc. I have health insurance, but I don't go to the doctor with symptoms unless I think it is absolutely necessary and my body is no longer able to manage on its own. I don't want to clog up the health care system with my cold symptoms. However, when I started coughing up blood, fever persisted for more than three days, and I was experiencing throbbing pain in my head, I made an appointment. I'd never had a sinus infection before, but my symptoms lead me to believe I had one.

Before I even went to my appointment, the doctor ordered me to get sinus cavity x-rays to confirm that it was a sinusitis. Went to the appointment, the doctor told me yes, it was indeed a sinus infection, and here's a script for penicillin. Let it be known that I *hate* antibiotics. I avoid them like the plague if at all possible, so I asked my doctor if I could instead use a Neti Pot (http://en.wikipedia.org/wiki/Nasal_irrigation) first. He agreed to try it for a week, come back for a follow-up, and if I'm still having symptoms I would proceed with the antibiotic.

Lo and behold, I used the neti pot and was instantly relieved of my symptoms. I continued to use it for one week. My sinusitis cleared and I was given the okay at my follow-up visit.

Allopathic care cost:
$30 co-pay x2= $60
PCN script copay (though it was never filled)= $20
X-rays= $115
Total cost= $195

And that's just the cost to me. That's not taking into account the drain on the health care system of a patient with a simple sinus infection who could have just dealt with it at home with a neti pot first. Not to say that you shouldn't seek medical care when necessary, but this is an example when a simple at-home, CAM remedy does the trick.

CAM care cost:
Neti pot + salt= $8
Total cost= $8

Not only is the CAM method more cost effective, it is also more accessible to patients. You can go down to your local Whole Foods and grab a neti pot. It also frees up hospital resources for patients who actually *need* medical care. That's a huge bonus. And Panda, with all your (absolutely valid) complaints about patients coming to the hospital wasting resources with issues that could be resolved at home, I would think that you would be in support of methods that relieve these strains, be them CAM or otherwise. (So long as they work, of course, and in the case of neti pots, they absolutely do.)

Now, I'm not saying CAM should *replace* allopathic care. That's where the complimentary comes in and why I prefer the term "integrative medicine".

I'm also not trying to claim that all CAM methods are effective or should be taken seriously. Some are them are seriously unbelievable. But I also think it's ridiculous to make sweeping generalizations about the practices and automatically dismiss them simply because they fall under the CAM category.

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[tiedyeddog]

Anecdotal evidence reminds me of Cinderella for some reason...

 

[bcat85]

A netipot isn't really CAM. Just because it has some mystical sounding name doesn't mean you wouldn't be better suited to just call it "Washing junk out of your nose."

 

[Little Etoile]

A netipot isn't really CAM. Just because it has some mystical sounding name doesn't mean you wouldn't be better suited to just call it "Washing junk out of your nose."

Haha. You fell for my trap!

Use of a neti-pot is an ancient ayurvedic practice. I don't know a single person that wouldn't consider ayruveda CAM.

If you don't know what ayurveda is:
http://en.wikipedia.org/wiki/Ayurveda

So that's part of my point and one of the unfortunate catch-22s of CAM methods. Once they are deemed medically appropriate- like in the case of the neti pot- they are accepted into mainstream medicine and are no longer considered CAM. People forget where those ideas originally came from in the first place, so CAM continues to be lumped together as a misfit gang of bogus medicine. It's not given the credit it deserves in those cases.

 

[Little Etoile]

Anecdotal evidence reminds me of Cinderella for some reason...

Using an anecdote to illustrate the effectiveness of a method doesn't invalidate it.

 

[VneZonyDostupa]

Using an anecdote to illustrate the effectiveness of a method doesn't invalidate it.

No, but lack of evidence other than anecdotes does.

 

[punkindrublic]

Haha. You fell for my trap!

Use of a neti-pot is an ancient ayurvedic practice. I don't know a single person that wouldn't consider ayruveda CAM.

If you don't know what ayurveda is:
http://en.wikipedia.org/wiki/Ayurveda

So that's part of my point and one of the unfortunate catch-22s of CAM methods. Once they are deemed medically appropriate- like in the case of the neti pot- they are accepted into mainstream medicine and are no longer considered CAM. People forget where those ideas originally came from in the first place, so CAM continues to be lumped together as a misfit gang of bogus medicine. It's not given the credit it deserves in those cases.

If you don't even consider a neti-pot to be CAM, what exactly is this thread supposed to support?

 

[pianola]

I'm interested...can you give other examples of legitimate CAMs? I tend to only hear the really weird stories of people doing voodoo dolls and crazy stuff like that.

I'm just curious and not pronouncing judgment one way or the other.

 

[Little Etoile]

No, but lack of evidence other than anecdotes does.

Lack of evidence? Look it up:

http://www.ncbi.nlm.nih.gov/pubmed/16025044?dopt=abstractplus
http://www.ncbi.nlm.nih.gov/pubmed/10892694?dopt=abstractplus
http://www.ncbi.nlm.nih.gov/pubmed/12540331?dopt=abstractplus
http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

There are tons.

From one of the studies published in Journal of Family Practice:

"Daily hypertonic saline nasal irrigation improves sinus-related quality of life, decreases symptoms, and decreases medication use in patients with frequent sinusitis. Primary care physicians can feel comfortable recommending this therapy."

Or from another, in Otolaryngology-Head & Neck Surgery:

"Daily nasal irrigation using either a bulb syringe, nasal irrigation pot, and daily reflexology massage were equally efficacious and resulted in improvement in the symptoms of chronic sinusitis in over 70% of subjects. Medication usage was decreased in approximately one third of participants regardless of intervention."

Don't tell me there is a lack of evidence. Do your research first.

 

[LucidSplash]

The issue here is that "CAM" is a pretty vague term and means different things to different people.

The "alternative" in CAM generally signifies anything that hasn't been tested via double-blind placebo controlled studies and has unverified efficacy, relying entirely on anecdotal evidence -- OR has been show to be ineffective through DBPC studies but CAM advocates will go right on believing in anyway.

In our culture saying something is "alternative" or "complementary" means it isn't subject to the same rigorous standards applied to proven/researched "western" therapies. This is the kind of ridiculousness that Panda is referring to.

Once something's been shown to be effective using the same standards applied to "western" therapies, it should no longer be referred to as CAM because there is evidence to back it up.

 

[Little Etoile]

If you don't even consider a neti-pot to be CAM, what exactly is this thread supposed to support?

*I* consider it to be CAM and I think in some regards, physicians do, too. If it was widely accepted and used, I'm sure my doctor would have suggested it. (Or maybe not, because it's easier to just write a script and know that you covered your bases). Instead he prescribed me antibiotics as the course of treatment. Most physicians would do the same. Wouldn't you thus consider the use of a neti pot as an alternative treatment? Or perhaps used as a treatment complimentary to the use of over-the-counter nasal decongestants?

Point is, it derives from a school of medicine that is absolutely, undoubtedly considered CAM and the neti pot practice is underutilized as a treatment, perhaps because of the mystique surrounding it. So yes, I would consider it CAM.

However, regardless of its infrequency of use, it is accepted as a viable treatment now, so in that regard, many people would not first think to classify it as CAM. This is in large part because a lot of people still mistakingly think that CAM is nothing but crystals and chanting and does not actually include reputable treatment options. Pianola above is a perfect example of this. (Not that I'm not judging you pianola; you just happened to illustrate my point. There is a lot of misinformation out there and it's good that you're open minded enough to ask questions at least!)

Do you see how it straddles the line? At this point it becomes tricky even defining what CAM is. Nature of the beast, I guess.

 

[Vihsadas]

Okay, I feel really strongly about this so I'm going to try and say this as clearly as possible.

You guys are smart enough to realize that the artificial categories that have been created boxing medicine into 'Allopathic' and 'CAM' are not meaningful.

Every therapy, every medication, ever concoction must be independently and individually validated for effectiveness.

CAM does not exist. Allopathic medicine doesn't exist.

All there is, is what works and what doesn't. Show me the data for a therapy, if its shown to have efficacy, then great. If not, junk it.

The problem with your general discourse, Little Etoile, is that your line of reasoning can be misinterpreted to mean "Well because nasal irrigation is considered CAM, and it works, then there must be something to this whole CAM thing."

Do you see how that is problematic? It doesn't matter whether you consider it CAM or consider it allopathic. Those terms in and of themselves are completely meaningless. So far, all that we've seen is that there might be some evidence that nasal irrigation, and only nasal irrigation works. Okay great, if it's efficacious enough, then we'll add it to the regular line up of suggested treatments...

The problem happens when people try and group these medications into these broad sweeping categories. In general, it causes the people who associate themselves with 'CAM' to irrationally distrust allopathic medicine, and those that are hard-lined toward allopathic medicine to be less rigorous scientits, since when they hear 'CAM' they immediately run for the hills without necessarily evaluating the therapy itself.

 

[LucidSplash]

Okay, I feel really strongly about this so I'm going to try and say this as clearly as possible.

You guys are smart enough to realize that the artificial categories that have been created boxing medicine into 'Allopathic' and 'CAM' are not meaningful.

Every therapy, every medication, ever concoction must be independently and individually validated for effectiveness.

CAM does not exist. Allopathic medicine doesn't exist.

All there is, is what works and what doesn't. Show me the data for a therapy, if its shown to have efficacy, then great. If not, junk it.

The problem with your general discourse, Little Etoile, is that your line of reasoning can be misinterpreted to mean "Well because nasal irrigation is considered CAM, and it works, then there must be something to this whole CAM thing."

Do you see how that is problematic? It doesn't matter whether you consider it CAM or consider it allopathic. Those terms in and of themselves are completely meaningless. So far, all that we've seen is that there might be some evidence that nasal irrigation works. Okay great, if it's efficacious enough, then we'll add it to the regular line up of suggested treatments...

This is what I was trying to say, only said about 100 times better.

 

[VneZonyDostupa]

Lack of evidence? Look it up:

http://www.ncbi.nlm.nih.gov/pubmed/16025044?dopt=abstractplus
http://www.ncbi.nlm.nih.gov/pubmed/10892694?dopt=abstractplus
http://www.ncbi.nlm.nih.gov/pubmed/12540331?dopt=abstractplus
http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

There are tons.

From one of the studies published in Journal of Family Practice:

"Daily hypertonic saline nasal irrigation improves sinus-related quality of life, decreases symptoms, and decreases medication use in patients with frequent sinusitis. Primary care physicians can feel comfortable recommending this therapy."

Or from another, in Otolaryngology-Head & Neck Surgery:

"Daily nasal irrigation using either a bulb syringe, nasal irrigation pot, and daily reflexology massage were equally efficacious and resulted in improvement in the symptoms of chronic sinusitis in over 70% of subjects. Medication usage was decreased in approximately one third of participants regardless of intervention."

Don't tell me there is a lack of evidence. Do your research first.

I never said there wasn't any evidence that Netipots work as an irrigation device. What I was referring to was the previous poster's statement that using anecdotal evidence doesn't immediately invalidate an idea. Nice leap in logic and hostile tone, though. You're doing wonders for the CAM field.

 

[LucidSplash]

*I* consider it to be CAM and I think in some regards, physicians do, too. If it was widely accepted and used, I'm sure my doctor would have suggested it. (Or maybe not, because it's easier to just write a script and know that you covered your bases). Instead he prescribed me antibiotics as the course of treatment. Most physicians would do the same. Wouldn't you thus consider the use of a neti pot as an alternative treatment? Or perhaps used as a treatment complimentary to the use of over-the-counter nasal decongestants?

I'm sure I wouldn't have known what you were talking about if you said "Neti pot" either. But if you had said "nasal irrigation" that would have been clear. Nasal irrigation IS used as an accepted therapy.

But frankly most patients would rather have the antibiotics than have warm saline squirted up their nose.

 

[Little Etoile]

I never said there wasn't any evidence that Netipots work as an irrigation device. What I was referring to was the previous poster's statement that using anecdotal evidence doesn't immediately invalidate an idea. Nice leap in logic and hostile tone, though. You're doing wonders for the CAM field.

You made a simple statement: "No, but lack of evidence other than anecdotes does."

It sounded like you were supporting the idea that my argument was based on anecdotal evidence alone and that there was no sound, evidence-based medicine to support the use of a neti pot. I think you would agree that your statement could easily be interpreted as this. Why counter my point by stating that a lack of evidence invalidates the arugument, if that was not the case here? It is irrelevant. I hope you can see how that would be confusing and how I came to the conclusion that I did.

So if that wasn't your intention, I apologize. Unfortunately misunderstandings like this come with the territory of internet communications.

 

[VneZonyDostupa]

So if that wasn't your intention, I apologize. Unfortunately misunderstandings like this come with the territory of internet communications.

I would understand, had I not directly quoted the post I was referring to when I made my comment, but meh, not worth arguing about considering this whole thread is a moot point, anyways.

 

[AmoryBlaine]

I was going to respond to this in the Reader's Digest Secrets thread, but I realized that it would probably start a huge debate and I didn't want to hijack the thread. So....



Not all CAM. That's a huge, sweeping generalizing you made.

Example: A few months ago I got sick. Fever, congestion, etc. I have health insurance, but I don't go to the doctor with symptoms unless I think it is absolutely necessary and my body is no longer able to manage on its own. I don't want to clog up the health care system with my cold symptoms. However, when I started coughing up blood, fever persisted for more than three days, and I was experiencing throbbing pain in my head, I made an appointment. I'd never had a sinus infection before, but my symptoms lead me to believe I had one.

Before I even went to my appointment, the doctor ordered me to get sinus cavity x-rays to confirm that it was a sinusitis. Went to the appointment, the doctor told me yes, it was indeed a sinus infection, and here's a script for penicillin. Let it be known that I *hate* antibiotics. I avoid them like the plague if at all possible, so I asked my doctor if I could instead use a Neti Pot (http://en.wikipedia.org/wiki/Nasal_irrigation) first. He agreed to try it for a week, come back for a follow-up, and if I'm still having symptoms I would proceed with the antibiotic.

Lo and behold, I used the neti pot and was instantly relieved of my symptoms. I continued to use it for one week. My sinusitis cleared and I was given the okay at my follow-up visit.

Allopathic care cost:
$30 co-pay x2= $60
PCN script copay (though it was never filled)= $20
X-rays= $115
Total cost= $195

And that's just the cost to me. That's not taking into account the drain on the health care system of a patient with a simple sinus infection who could have just dealt with it at home with a neti pot first. Not to say that you shouldn't seek medical care when necessary, but this is an example when a simple at-home, CAM remedy does the trick.

CAM care cost:
Neti pot + salt= $8
Total cost= $8

Not only is the CAM method more cost effective, it is also more accessible to patients. You can go down to your local Whole Foods and grab a neti pot. It also frees up hospital resources for patients who actually *need* medical care. That's a huge bonus. And Panda, with all your (absolutely valid) complaints about patients coming to the hospital wasting resources with issues that could be resolved at home, I would think that you would be in support of methods that relieve these strains, be them CAM or otherwise. (So long as they work, of course, and in the case of neti pots, they absolutely do.)

Now, I'm not saying CAM should *replace* allopathic care. That's where the complimentary comes in and why I prefer the term "integrative medicine".

I'm also not trying to claim that all CAM methods are effective or should be taken seriously. Some are them are seriously unbelievable. But I also think it's ridiculous to make sweeping generalizations about the practices and automatically dismiss them simply because they fall under the CAM category.

1. Assuming you're a healthy, immunocompetant person what's to say this irrigation did anything at all? If you did in fact have bacterial sinusitus it can be a self-limiting disease, not to say that Abx don't help but I'm sure a healthy person could clear it 90% of the time.

2. Nasal irrigation with warm saline is hardly CAM. CAM would be for you to take a extract of hymenoptera testicles and dilute them to 1:1000 strength to clear your infection. CAM would be for someone to try to heal your energy with their touch.

3. Why do you hate antibiotics? Do you have bad reactions to multiple different classes? Are there any other pharmaceutical categories to which you are not favorably disposed?

 

[tiedyeddog]

Don't tell me there is a lack of evidence. Do your research first.

How about you leave out the anecdotal evidence next time and just insert the links to the supportive research?

 

[pianola]

How about you leave out the anecdotal evidence next time and just insert the links to the supportive research?

Give her a break for crying out loud. This isn't the reference section of the library.

It was an interesting story. (Even if I would never voluntarily squirt saline up my nose)

 

[dienekes88]

I think one of the issues that people have with calling it "complementary and alternative medicine" is that saying that it's an "alternative" essentially puts it on equal standing with allopathic medicine.

I think AmoryBlaine has a good point. You cleared the crap out of your sinuses, and you felt better. On top of that, you got better within a week. Nothing too earth shattering there.

One thing that "might" be considered CAM (but only by virtue of its CAM roots) does not validate the entire field.

However, I don't see a problem with people pursuing CAM, because there's always the placebo effect, and a patient who feels like every possible route is being pursued will feel better about his treatment... and probably get better more quickly. When people start talking about CAM replacing allopathic medicine (have had several people do this to me), I worry for their health. These people pursue CAM and specifically avoid allopathic (Evidence-Based) medicine.

Give her a break for crying out loud. This isn't the reference section of the library.

It was an interesting story. (Even if I would never voluntarily squirt saline up my nose)

Hahaha. It's not that bad. It's like washing your hands or brushing your teeth... for your nose.

Another "CAM" that works? Would massage count? At that point, though... you've crossed over into mainstream medicine.

 

[8744]

Most "sinus infections" are viral, not bacterial, and all the antibiotics in the world are not going to do a thing for them. I go around and around with my family about this but they insist on getting antibiotics and ascribe to these drugs talismanic properties they simply do not have. The difficulty of treating sinusitis with antibiotics is getting the antibiotic to the infection anyway, not to mention that the first line therapy for outpatient bacterial sinusitis is either augmentin or a second generation cephalosporin, not plain old penicillin.

The OP did not have bacterial sinusitis if the symptoms cleared up instantaneously. Bacterial sinusitis causes swelling, maxillary tenderness, fever, and other symptoms that are not going to go away just by relieving congestion. She had some congestion. Big whoop. I could have told her that in ten minutes and sent her home with some neosynephrine.

Just as an aside, I have relatives who go to Mexico, purchase large quantiities of powerful antibiotics (or what used to be powerful antibiotics) and take them every day as some kind of ill-conceived prophylaxis. I can talk myself blue in the face about the dangers of doing this, both to my relatives and society in general as they breed super-resistant bacteria, but they know
better so I may as well be talking to a wall.


"An estimated more than 30 million patients in the United States have sinus disease. Upper respiratory infections (URIs) are one of the most common presentations in the ED. A viral infection associated with the common cold is the most frequent etiology of acute sinusitis. Only a small percentage (as low as 2%) of viral sinusitis cases are complicated by bacterial sinusitis. The challenge is to differentiate a simple URI and allergic rhinitis from sinusitis. Medical treatment is expensive, with an estimated $5 billion spent annually; another $60 billion is spent on surgical treatment each year." (from http://www.emedicine.com/emerg/topic536.htm )

 

[dienekes88]

Most "sinus infections" are viral, not bacterial, and all the antibiotics in the world are not going to do a thing for them. I go around and around with my family about this but they insist on getting antibiotics and ascribe to these drugs talismanic properties they simply do not have. The difficulty of treating sinusitis with antibiotics is getting the antibiotic to the infection anyway, not to mention that the first line therapy for outpatient bacterial sinusitis is either augmentin or a second generation cephalosporin, not plain old penicillin.

The OP did not have bacterial sinusitis if the symptoms cleared up instantaneously. Bacterial sinusitis causes swelling, maxillary tenderness, fever, and other symptoms that are not going to go away just by relieving congestion. She had some congestion. Big whoop. I could have told her that in ten minutes and sent her home with some neosynephrine.

Just as an aside, I have relatives who go to Mexico, purchase large quantiities of powerful antibiotics (or what used to be powerful antibiotics) and take them every day as some kind of ill-conceived prophylaxis. I can talk myself blue in the face about the dangers of doing this, both to my relatives and society in general as they breed super-resistant bacteria, but they know
better so I may as well be talking to a wall.


"An estimated more than 30 million patients in the United States have sinus disease. Upper respiratory infections (URIs) are one of the most common presentations in the ED. A viral infection associated with the common cold is the most frequent etiology of acute sinusitis. Only a small percentage (as low as 2%) of viral sinusitis cases are complicated by bacterial sinusitis. The challenge is to differentiate a simple URI and allergic rhinitis from sinusitis. Medical treatment is expensive, with an estimated $5 billion spent annually; another $60 billion is spent on surgical treatment each year." (from http://www.emedicine.com/emerg/topic536.htm )

I don't know if this is appropriate, but... pwned?

Do you think the doctor just gave Little Etoile penicillin, because he figured she wanted something and would leave the office faster with a scrip for penicillin than a long-winded discussion of her simple need for rest and fluids? Most would agree that patients want drugs no matter what... and both your anecdote and the cardiologist in the RD article are in line with this thought.

 

[45408]

Let it be known that I *hate* antibiotics. I avoid them like the plague if at all possible, so I asked my doctor if I could instead use a Neti Pot (http://en.wikipedia.org/wiki/Nasal_irrigation) first. He agreed to try it for a week, come back for a follow-up, and if I'm still having symptoms I would proceed with the antibiotic.

Lo and behold, I used the neti pot and was instantly relieved of my symptoms. I continued to use it for one week. My sinusitis cleared and I was given the okay at my follow-up visit.

You know, for thousands of years, people had neither "allopathic" medicine or "CAM." They just had immune systems. Why would your immune system - obviously carried via a lineage of people who were capable of surviving to reproductive age - suddenly fail on you? It wouldn't, of course, and it probably successfully cleared up your infection. Take a look at what someone without an immune system - advanced AIDS, for example - will get: MAC, tuberculosis, Candidiasis, Aspergillus, you name it. You don't get those infections, and it's not because of modern medicine - it's because of your immune system.

 

[Charles English]

three cheers for immunity!! YEAH!!

 

[Haemulon]

Allopathic (traditional Western medicine) = rational, logical, evidenced based standard of care

CAM = without proof of efficacy at the level of traditional treatments, often outside of reason and logic, ouside of accepted standard of care

Whem "CAM" meets the same standards of proof of efficacy and safety as traditional treatments, it ceases to be CAM. Therefore CAM, by definition, consists of unproven treatments that have not met the academic and clinical challenges required for their application in modern medical care.

 

[Little Etoile]

Most "sinus infections" are viral, not bacterial, and all the antibiotics in the world are not going to do a thing for them. I go around and around with my family about this but they insist on getting antibiotics and ascribe to these drugs talismanic properties they simply do not have. The difficulty of treating sinusitis with antibiotics is getting the antibiotic to the infection anyway, not to mention that the first line therapy for outpatient bacterial sinusitis is either augmentin or a second generation cephalosporin, not plain old penicillin.

The OP did not have bacterial sinusitis if the symptoms cleared up instantaneously. Bacterial sinusitis causes swelling, maxillary tenderness, fever, and other symptoms that are not going to go away just by relieving congestion. She had some congestion. Big whoop. I could have told her that in ten minutes and sent her home with some neosynephrine.

My understanding is that he believed it *was* bacterial. If you read my post, you would see that I did have a fever and maxillary tenderness (although maybe the latter wasn't so clear, but that's what I meant by throbbing pain in my head), and the x-rays confirmed swelling. I didn't just have "some congestion".

Also, I should have been more specific: I wasn't instantly relieved of *all* symptoms- I still had a fever, for example- and the symptoms did return after time, throughout the week. What I meant was that if instantly offered me relief from some of my symptoms, such as congestion and sinus pressure.

I agree about overuse of antibiotics and the unfortunate false, golden reputation they have with the general public. There are many reasons why I only take antibiotics as a last resort, and in this case I was once again alarmed by how quickly the physician whipped out his script pad to prescribe them. I get why they do it, but eesh... and especially in this case where, as you said, it's difficult to even get the antibiotic to the site of infection.

 

[AmoryBlaine]

My understanding is that he believed it *was* bacterial. If you read my post, you would see that I did have a fever and maxillary tenderness (although maybe the latter wasn't so clear, but that's what I meant by throbbing pain in my head), and the x-rays confirmed swelling. I didn't just have "some congestion".

Also, I should have been more specific: I wasn't instantly relieved of *all* symptoms- I still had a fever, for example- and the symptoms did return after time, throughout the week. What I meant was that if instantly offered me relief from some of my symptoms, such as congestion and sinus pressure.

I agree about overuse of antibiotics and the unfortunate false, golden reputation they have with the general public. There are many reasons why I only take antibiotics as a last resort, and in this case I was once again alarmed by how quickly the physician whipped out his script pad to prescribe them. I get why they do it, but eesh... and especially in this case where, as you said, it's difficult to even get the antibiotic to the site of infection.

Yeah but dude that's not CAM. You didn't need to see some quack "practioner" to get it. Is buying a bulb sucker to, for lack of a better word, suck the snot out of your congested 6 month old CAM?

Incidentally your point about the relative cost of CAM vs. "traditional medicine" is poorly taken. Even if I allow you the point that your therapy was somehow CAM there are still two major problems.

1. You didn't see a practioner, many of whom charge plenty of money, take cash at the door, and sometimes dangerous discontinue actual proven therapies given out by those evil sciencemongering MDs/DOs.

2. Assume that some form of CAM can treat the symptoms of bacterial sinusitis more cheaply than an MD could. So what? What about prostate cancer? What about acute bacterial pneumonia in a 75 year old? What about outpaitient blood sugar/blood pressure/lipid control? Anaphylaxis? Sepsis? SLE? You get it... It seems like many of the CAM success stories are in one of two categories: the questionable hastening of the course of self-limited illnesses or the semi-alleviation of the same stuff that regular medicine can only semi-alleviate (low back pain).

 

[ManualEvac]

Allopathic (traditional Western medicine) = rational, logical, evidenced based standard of care

CAM = without proof of efficacy at the level of traditional treatments, often outside of reason and logic, ouside of accepted standard of care

Whem "CAM" meets the same standards of proof of efficacy and safety as traditional treatments, it ceases to be CAM. Therefore CAM, by definition, consists of unproven treatments that have not met the academic and clinical challenges required for their application in modern medical care.

Careful! Allopathic is actually etymologically derived from "allo=other" and "pathic=from/than the disease." That is, it is a derogatory term originally used to peg these types of physicians as causing more problems than they fixed. Hahnemann and the early homeopaths coined the term, I believe. We have still not managed to removed this unfortunate term from common usage.

As for CAM, true it ceases to be CAM after rigorous testing sanctifies it, but keep in mind that almost all medical research is funded by the pharmers. To think that we have still not seen a large scale study of the efficacy of saw palmetto in prostate health or any number of other therapies with extremely favorable anecdotal evidence is laughable. Besides, many CAM practices appear to "work" consistently according to anecdotal reports, but it is impossible to do a conclusive double-blind study in these areas due to the complexity of the interactions going on. For example, GSR, heart rate, etc. are OK as experimental variables, but don't really give us the whole picture in pain management, which many CAM practices target.

We don't have to abandon the biomedical tradition of deification of reason and logic, but don't fall into the false dichotomy of "reason" vs. uncertainty. It is as hard to disprove many CAM practices as it is to prove them.

 

[8744]

My understanding is that he believed it *was* bacterial. If you read my post, you would see that I did have a fever and maxillary tenderness (although maybe the latter wasn't so clear, but that's what I meant by throbbing pain in my head), and the x-rays confirmed swelling. I didn't just have "some congestion".

Also, I should have been more specific: I wasn't instantly relieved of *all* symptoms- I still had a fever, for example- and the symptoms did return after time, throughout the week. What I meant was that if instantly offered me relief from some of my symptoms, such as congestion and sinus pressure.

I agree about overuse of antibiotics and the unfortunate false, golden reputation they have with the general public. There are many reasons why I only take antibiotics as a last resort, and in this case I was once again alarmed by how quickly the physician whipped out his script pad to prescribe them. I get why they do it, but eesh... and especially in this case where, as you said, it's difficult to even get the antibiotic to the site of infection.

Hey, a little bottle of neo-synephrine, 2 bucks at Target, would have fixed you right up. We have certainly come down from "I wuz cured, praise the Lord." Now it's, "Well, I still had most of my symptoms."

Dude, he gave you the antibiotic to get rid of you. And you had a viral sinusitis.

 

[Raryn]

Careful! Allopathic is actually etymologically derived from "allo=other" and "pathic=from/than the disease." That is, it is a derogatory term originally used to peg these types of physicians as causing more problems than they fixed. Hahnemann and the early homeopaths coined the term, I believe. We have still not managed to removed this unfortunate term from common usage.

As for CAM, true it ceases to be CAM after rigorous testing sanctifies it, but keep in mind that almost all medical research is funded by the pharmers. To think that we have still not seen a large scale study of the efficacy of saw palmetto in prostate health or any number of other therapies with extremely favorable anecdotal evidence is laughable. Besides, many CAM practices appear to "work" consistently according to anecdotal reports, but it is impossible to do a conclusive double-blind study in these areas due to the complexity of the interactions going on. For example, GSR, heart rate, etc. are OK as experimental variables, but don't really give us the whole picture in pain management, which many CAM practices target.

We don't have to abandon the biomedical tradition of deification of reason and logic, but don't fall into the false dichotomy of "reason" vs. uncertainty. It is as hard to disprove many CAM practices as it is to prove them.

Allopathic was coined by the homeopaths, but you mistake the origin.

Allo meaning other refers to allopaths treating the disease with something that counteracts the symptoms, as in treating inflammation with something believed to be an anti-inflammatory (i.e. common sense).

Homeopaths on the other hand believed in treating patients with magically diluted amounts of something that would CAUSE the symptoms (treating watery eyes with dilute onion for example), and that was their big idea. Of course, this basically amounted to giving the patient water and watching them get better on their own, which is why homeopaths were often more successful than their snake-oil dealing leach using counterparts of the 18th century.

Of course, modern evidence-based "allopathic" medicine is by far the most superior treatment today, and most things labeled "CAM" are nothing but thinly disguised quackery. I'm afraid the OP won't get any other sort of consensus on a board like this, where the majority of us are scientifically minded driven individuals with an interest in medicine.

 

[facetguy]

I'm afraid the OP won't get any other sort of consensus on a board like this, where the majority of us are scientifically minded driven individuals with an interest in medicine.

This is true, and reasonably so. However, we do have to admit that there is a certain degree of closed-mindedness (I could have said arrogance, but that would be a little too harsh) when it comes to allopathic medicine. For example, I saw a comment the other day from Tim Russert's physician who said that Tim Russert was "doing all he could" to prevent the heart attack he ended up suffering. "Doing all he could" totals taking his blood pressure and cholesterol meds and "trying to lose weight". Now, that is closed-minded, I think we'd all agree. There are many other factors that reduce risk and improve health that allopathic medicine just doesn't do well, and these things should be recognized and continued to be studied. But to paint with a broad brush and say that all things non-allopathic are quakery is short-sighted and frankly a bit naive. Things are slowly changing, however, which is a good thing.

 

[Haemulon]

Careful! Allopathic is actually etymologically derived from "allo=other" and "pathic=from/than the disease." That is, it is a derogatory term originally used to peg these types of physicians as causing more problems than they fixed. Hahnemann and the early homeopaths coined the term, I believe. We have still not managed to removed this unfortunate term from common usage.

As for CAM, true it ceases to be CAM after rigorous testing sanctifies it, but keep in mind that almost all medical research is funded by the pharmers. To think that we have still not seen a large scale study of the efficacy of saw palmetto in prostate health or any number of other therapies with extremely favorable anecdotal evidence is laughable. Besides, many CAM practices appear to "work" consistently according to anecdotal reports, but it is impossible to do a conclusive double-blind study in these areas due to the complexity of the interactions going on. For example, GSR, heart rate, etc. are OK as experimental variables, but don't really give us the whole picture in pain management, which many CAM practices target.

We don't have to abandon the biomedical tradition of deification of reason and logic, but don't fall into the false dichotomy of "reason" vs. uncertainty. It is as hard to disprove many CAM practices as it is to prove them.

Your point is well taken about the use of the term "Allopathy", even though its origin was derived from Homeopaths, as Raryn pointed out. I use it because it is recognisable and everyone seems to know what kind of medicine is being referred to. Though I don't really like the term, since by using it there also seems to be an implication that there is an equivalency among various approaches to medicine, indeed the implication may be that there are really many legitimate approaches to medicine to choose from. Of course, this type of consumer choice really doesn't exist, since choosing between allopathy and say ... homeopathy is not really a choice between equal medical approaches at all. One is medicine and one not, and the result to one's health would become all too evident, sooner or later.

You also make a good point though that there are traditional medical approaches that seem to be of questionable efficacy or that may have less impressive supporting evidence. Many of these examples, however, tend to be for conditions in which there just are no better treatment options. Many people turn to CAM in such situations. But as far as mainstream medicine is concerned, the lower-efficacy treatmentments represent the best that we have to date that has met at least the minimum standards for proof of efficacy and safety. Otherwise, they are labled as experimental and the patients are informed as such. If there are blatant examples of unproven or untested treatments from mainstream medicine, then I am as much for questioning them as I am CAM therepies.

 

[cpants]

Etoile's logic is how some of this CAM nonsense gets mainstreamed. Sick patient takes tea, rubs coins on himself, squirts salt water up her nose, or whatever the treatment is. Then the patients immune system naturally clears the disease. The patient falsely associates whatever wacky treatment they were doing with curing the disease. They pass on the "cure" to children, friends, relatives who have the same results. Soon a whole population is chugging olive oil every time they get sick.

The good news is that this stuff can combat overprescription of drugs by doctors. Not everything needs to be treated. If a patient is satisfied eating something or doing something which does no harm while their immune system works, that is often BETTER than taking prescription drugs of any kind.

 

[Haemulon]

... snip ...

Besides, many CAM practices appear to "work" consistently according to anecdotal reports, but it is impossible to do a conclusive double-blind study in these areas due to the complexity of the interactions going on. For example, GSR, heart rate, etc. are OK as experimental variables, but don't really give us the whole picture in pain management, which many CAM practices target.

We don't have to abandon the biomedical tradition of deification of reason and logic, but don't fall into the false dichotomy of "reason" vs. uncertainty. It is as hard to disprove many CAM practices as it is to prove them.

True. Which is why many of them keep on hanging around. Then again, we can't disprove the invisible mass-less 10-foot flying dragon in my house either, right? So acceptance based upon not being disproven is problematic. I am not saying that there is zero possibility of any positive effects from cam therapies, just that they are so clouded with superstition and hocus pocus (and in some cases down right fraud) that any potential merits get obliterated.

As far as treatments for pain, even traditional medicine is still struggling with long term chronic pain management. The science just hasn't progressed as far as we need it to yet. But it will get there eventually. Chronic pain patients can be very difficult, even frustrating, to treat. And since pain perception is so individual and subjective anyway, it is not surprising that strong psychosomatic effects can be elicited from a variety of alternative treatments, whether or not there are any real causative physical impacts from the treatments. Are there physiological mechanisms that could support some of the cam approaches in this area? Sure. I can see how endorphins might be released or nerve activity be plausibly hyper-stimulated or supressed through some of the approaches. But we have traditional non-pharmacological methods that use essentially the same principles (TENS units for example) without the hocus pocus and mysticism associated with it. The crucial difference is that mainstream techniques are more standardized and predictable, having been through more rigorous population studies. It all comes back to standards and quality assurance, and above all safety for the patient.

 

[ManualEvac]

Of course, modern evidence-based "allopathic" medicine is by far the most superior treatment today, and most things labeled "CAM" are nothing but thinly disguised quackery. I'm afraid the OP won't get any other sort of consensus on a board like this, where the majority of us are scientifically minded driven individuals with an interest in medicine.

Obviously, as an aspiring allopathic doctor, I unequivocally agree that it is the most rigorous treatment paradigm today. However, as a scientific-minded group, we need only a rudimentary statistical understanding of medical research to-date to know that MOST "CAM" have been under-, poorly, or completely un- tested. Simply curious myself, not advocating. I would like to see ALL options on the table tested as vigorously as Viagra. I'm sure giving patients mold for bacterial infections used to seem like quackery until someone actually researched and applied Penicillin on a large scale.

 

[Haemulon]

Etoile's logic is how some of this CAM nonsense gets mainstreamed. Sick patient takes tea, rubs coins on himself, squirts salt water up her nose, or whatever the treatment is. Then the patients immune system naturally clears the disease. The patient falsely associates whatever wacky treatment they were doing with curing the disease. They pass on the "cure" to children, friends, relatives who have the same results. Soon a whole population is chugging olive oil every time they get sick.

The good news is that this stuff can combat overprescription of drugs by doctors. Not everything needs to be treated. If a patient is satisfied eating something or doing something which does no harm while their immune system works, that is often BETTER than taking prescription drugs of any kind.

Very true. Of course, the danger in letting the mumbo-jumbo go unchecked is that the public continues to become less and less educated about their own health. This can only spell more headaches for healthcare providers and higher costs for everyone in the long run. I think part of the answer here lies in a long-term education effort, starting with children in the public schools but also including adults through the media and various other outlets, that focus's on teaching people more about their own bodies and how to live healthy. What are antibiotics used for? How are infections spread? What happens to your body as a result of being overweight? What happens if you do or don't excersize? Why is having your blood pressure checked important? Why is it that mega doses of vitamins not only don't help you, but can actually harm you? Why should you quit smoking, other then the scary lung cancer stuff everyone keeps talking about? and on and on and on. I'm not talking a medical education here, just the basics for good healthy living and being able to participate in understanding one's own healthcare.

 

[Haemulon]

Obviously, as an aspiring allopathic doctor, I unequivocally agree that it is the most rigorous treatment paradigm today. However, as a scientific-minded group, we need only a rudimentary statistical understanding of medical research to-date to know that MOST "CAM" have been under-, poorly, or completely un- tested. Simply curious myself, not advocating. I would like to see ALL options on the table tested as vigorously as Viagra. I'm sure giving patients mold for bacterial infections used to seem like quackery until someone actually researched and applied Penicillin on a large scale.

I appreciate and share your desire to see everything evaluated to its fullest. However, there may be a reason that many cam approaches have not had scores of randomized placebo controlled trials published in respectable peer reviewed journals. I mean, would you want to spend your own time and money disproving that a super diluted solution of water has a "memory" of the chemical formerly in it, the properties of which can treat a disease by inducing similar symptoms as the disease its self? (a rough discription of homeopathy). Not to mention, before human trials could begin (not that any IRB in the country would approve of such a thing for this anyway without significant supporting evidence in advance) there would need to be animal trials. Where is the animal research from all of the pro-homeopath people?

The burden must be upon those proposing the novel treatment. And as we all know, extraordinary claims require extraordinary evidence. There really is no mass conspiracy to stop CAM research. It's out there for anyone to do should they desire. But I think we can all guess why everyone isn't running to dedicate their careers to it. It is just common sense for most things. There is no logical reason to suspect that most of them could even work, no matter how much anecdotal evidence is offered and what one's positive personal experiences have been with them.

 

[facetguy]

Etoile's logic is how some of this CAM nonsense gets mainstreamed. Sick patient takes tea, rubs coins on himself, squirts salt water up her nose, or whatever the treatment is. Then the patients immune system naturally clears the disease. The patient falsely associates whatever wacky treatment they were doing with curing the disease. They pass on the "cure" to children, friends, relatives who have the same results. Soon a whole population is chugging olive oil every time they get sick.

The good news is that this stuff can combat overprescription of drugs by doctors. Not everything needs to be treated. If a patient is satisfied eating something or doing something which does no harm while their immune system works, that is often BETTER than taking prescription drugs of any kind.

Yes, there is no doubt that the placebo effect is at work in many cases. The temporal association between the application of Remedy X and improvement/resolution of Condition Z can be a powerful thing in the mind of the untrained. But...and you need to be around awhile to see enough of these things...there are enough cases of a 'CAM' treatment working where other standard treatments have not. I realize that this is not a popular place to post such a notion, but in time you will likely experience this phenomenon yourselves. Allopathic medicine will always be the top tier, of course. But we shouldn't be so shallow as to completely dismiss the effectiveness of any and all non-allopathic interventions. Believe it or not, there WILL be things in your future practices that you will not be able to explain, and this includes seeing a CAM treatment work where all prior efforts have failed. Just food for thought.

 

[BigRedder]

Say what you will, I still believe in Zicam. It works better than anything else I've tried for colds, and technically it is homeopathic.