Question:

I’ll be glad to talk to you one-on-one about this, you know where to find me. — Peace, Gina "Crippled but free, I was blind all the time I was learning to see" – Garcia, Hunter Remove the nospam for email replies

Response:

I’ll be glad to talk to you one-on-one about this, you know where to find me.

Im too intermittently angry and depressed now but I will Gina.. regards, Bob – Hide quoted text — Show quoted text – — Peace, Gina "Crippled but free, I was blind all the time I was learning to see" – Garcia, Hunter Remove the nospam for email replies

Response:

Read the Weiner article.. Bill, You talk about a negative pressure pause, which I did not mean at all.

I understand that, but never the less in using the SIMT device, negative pressure and its effects can not be ignored IMHO. Sorry, my bad writing. I quite see you would be apprehensive about safety aspects with such pauses. The  article in Chest is on training muscle coordination and muscle strength by dynamic exercises. This max.

These tests were done and results obtained over a period of 6 months. I thought you admitted to much more rapid changes in symptoms than that. So I’m a bit confused by your attachment to the muscle tone theory. inspiratory pressure is tested statically as representative for progress made but is not meant as a maneuver to help breathing.

OK and so the muscle tone improved, and dyspnea possibly reduced. This might have a calming effect and allow slower respiration to be more comfortable. The article (Chest 1992, 1357-61) by Weiner tells us about coordination of inspiratory muscles being important for suction. Maybe the underlying mechanism is not pressure, as you say, but this would not seem to change the practical outcome.

However hyperinflation is the underlying problem with chronic respiratory disease, so wouldn’t it be better to reduce this, rather than fight it with increased force.  You might find this a loosing battle and do more damage by going beyond the elastic limit of the tissue. Fortunately an (side) effect of these tests reduces hyperinflation and also a bronchoprotective (side) effect, in my experience. But in order to make these effects more permanent, other steps need to be taken. See the first paragraph after the summary: "The hyperinflation of the lung flattens the diaphragm, shortens the inspiratory muscles, and places them at a mechanical disadvantage. In addition to the reduced efficiency of the inspiratory muscles, large amounts of pressure work are required to overcome the high airway resistance."

By working your breathing closer to Residual Volume where the diaphragm is not so flat and by concentrating on slow expiration rather than inspiration, these problems do not arise.  In fact you should never force the issue as it only compounds the problem, panic (and death) is the usual end result. Weiner’s external resistance puts the diapharagm through its paces quite effectively and produces clinically relevant improvements. See summary: "We conclude that SIMT, for six months, improves the inspiratory muscle strength and endurance, and results in improvement in asthma symptoms, hospitalizations for asthma, emergency department contact, absence from school or work, and medication consumption in patients with asthma."

Weiner himself admits that the real reason for the benefits obtained with SIMT are unknown.  My bet is the NP causes the beneficial effects for reasons I have outlined. On the face of it the effect of the exercises is not perfectly clear. Weiner does appear in part to be sticking to the old idea of toughening up the patient so that he can better handle the increased breathing effort in an attack. On the other hand the improvement noted would seem to speak for a general improvement in breathing all the time and – THIS IS THE CRUCIAL POINT – applying nose (or throat) resistance to get the

Yes sniffing also seems beneficial, I have always suggested fast inspiration through the nose.  Because it improves hydration and warming! suction.  If the upper airways were typically kept in the fully open gulp position then the acquired "diaphragm breathing potential" would simply be wasted

I have experimented with throat restriction, but I find it uncomfortable, and the additional dynamics have no "immediate" added effect.  If you must use NP a gentle epiglot obstructed lengthy pause at close to RV is easiest and a SIMTdevice is totally unnecessary. It is a general aim in asthma physical therapy to promote diaphragmatic breathing. This would obviously mean maintaining it between separate exeercise periods, if any, as well.

I don’t believe so much in intermittent practices, good hydration is a continuous requirement and so I prefer something that can become habitual and then you must not mouth breathe during sleep. I really do not know if my "respiratory intellegence" was particulary poor, but in my excruciating attacks in the past, I am reasonably sure now,  my only tactic was to gulp in as much air as seemed possible, that is to say with my mouth and throat wide open. My breathing was extremely thoracic. This meant a low suction.

Understandable. As I said SIMT solved my problem (cured my asthmatic but non medicated shortness of breath) by showing me a direct path from the one possible option of taking a reliever puff and getting a sort of sick, guilty pleasure on suddenly being able to take an invigorating diaphragmatic breath by drug usage to the healthy option of using a sophisticated muscular technique. I guess this is or was at one time the dream of half of those here.

Good for you! Putting it more provokingly still: it is as if I have a permanent, safe and healthy ventolin tucked away in my inside. Regards, Richard Friedel

Quite a calming effect I am sure. Good Health. Bill

Response:

Bill, You talk about a negative pressure pause, which I did not mean at all. Sorry, my bad writing. I quite see you would be apprehensive about safety aspects with such pauses. The  article in Chest is on training muscle coordination and muscle strength by dynamic exercises. This max. inspiratory pressure is tested statically as representative for progress made but is not meant as a maneuver to help breathing. The article (Chest 1992, 1357-61) by Weiner tells us about coordination of inspiratory muscles being important for suction. Maybe the underlying mechanism is not pressure, as you say, but this would not seem to change the practical outcome. See the first paragraph after the summary: "The hyperinflation of the lung flattens the diaphragm, shortens the inspiratory muscles, and places them at a mechanical disadvantage. In addition to the reduced efficiency of the inspiratory muscles, large amounts of pressure work are required to overcome the high airway resistance." Weiner’s external resistance puts the diapharagm through its paces quite effectively and produces clinically relevant improvements. See summary: "We conclude that SIMT, for six months, improves the inspiratory muscle strength and endurance, and results in improvement in asthma symptoms, hospitalizations for asthma, emergency department contact, absence from school or work, and medication consumption in patients with asthma." On the face of it the effect of the exercises is not perfectly clear. Weiner does appear in part to be sticking to the old idea of toughening up the patient so that he can better handle the increased breathing effort in an attack. On the other hand the improvement noted would seem to speak for a general improvement in breathing all the time and – THIS IS THE CRUCIAL POINT – applying nose (or throat) resistance to get the suction.  If the upper airways were typically kept in the fully open gulp position then the acquired "diaphragm breathing potential" would simply be wasted It is a general aim in asthma physical therapy to promote diaphragmatic breathing. This would obviously mean maintaining it between separate exeercise periods, if any, as well. I really do not know if my "respiratory intellegence" was particulary poor, but in my excruciating attacks in the past, I am reasonably sure now,  my only tactic was to gulp in as much air as seemed possible, that is to say with my mouth and throat wide open. My breathing was extremely thoracic. This meant a low suction. As I said SIMT solved my problem (cured my asthmatic but non medicated shortness of breath) by showing me a direct path from the one possible option of taking a reliever puff and getting a sort of sick, guilty pleasure on suddenly being able to take an invigorating diaphragmatic breath by drug usage to the healthy option of using a sophisticated muscular technique. I guess this is or was at one time the dream of half of those here. Putting it more provokingly still: it is as if I have a permanent, safe and healthy ventolin tucked away in my inside. Regards, Richard Friedel – Hide quoted text — Show quoted text – Slow reply due to ISP problems. My practical conversion to breathing with what seemed to me to be increased,  but probably normal, negative pressure, was as follows. I drove to somebody’s office, had to go up flights of stairs and noticed chest tightness due to tree pollen. How do you know it was tree pollen, this sort of breathlessness is commonly due to poor gas transfer across the alveolar membrane.  Possible cause is poorly hydrated surfactant.  Then I had to visit him again an hour later with the same amount of pollen flying around. On my way, I was  able to do 15 mins breathing through a commercial SIMT device with a large soft plastic mouthpiece to hold between my teeth. Free exhalation was through a valve and inhalation through an orifice giving a suction pressure of around 20 cms water. The effect on ease of climbing stairs convinced me that there was a "reliever" effect worth pursuing. Yes and as I said in a previous post the negative pressure adds to the influence of fluid across the afforesaid membrane into the alveolar space and rehydration corrects the problem. Imbued with the theory of SIMT (Chest, 1992, 1357-61) I then did around 5 mins SIMT on the device daily for a week and was able to detect the positive coaching effect on diaphragmatic action. One great attraction of the theory is the thought that everybody has a natural defense against bronchospasm, namely by proper diaphragmatic instead of thoracic respiration. There are plenty of studies on attempts to train diaphragmatic breathing. Mostly they are not based on pressure modification, but rather on posture. The said Chest study seems pertinent and reliable as it is on normal asthmatics in a reasonably healthy state. I Don’t aggree with these conclusions. As I said SIMT solved my problem (cured my asthmatic but non medicated shortness of breath) by showing me a direct path from the one possible option of taking a reliever puff and getting a sort of sickly, guilty pleasure on suddenly being able to take an invigorating diaphragmatic breath by drug usage to the healthy option of using a sophisticated muscular technique. I guess this is or was at one time the dream of half of those here NP sure does work for me too, I just worry about the safety aspects.  I use slow expiration and strict non mouth breathing to effectively achieve the same thing.  Although this is not quite as fast it is easy and can become a habit and hence continuaus.  Also the effective respiration rate drops as one learns to tolerate dispnea and this reduces dehydration effects.  The best trick is to learn to sleep with your mouth closed. Bill, it sounds a bit like your condition is not stable enough for SIMT although the author of the study said elsewhere that it was generally suitable for mild asthma. I made my own device using a ventolin inhaler without the capsule.  Stuffed with an appropriate amount of cotton wool it produced the required restriction.  But I found it less effective than a straight NP pause with the epiglot closed. Follow this by inspiration and a slow expiration.  Note the available fluid (from lymph tissue) is limited so you need time between successive NP pauses for this to be replenished. Good health, Bill

Response:

Slow reply due to ISP problems. My practical conversion to breathing with what seemed to me to be increased,  but probably normal, negative pressure, was as follows. I drove to somebody’s office, had to go up flights of stairs and noticed chest tightness due to tree pollen.

How do you know it was tree pollen, this sort of breathlessness is commonly due to poor gas transfer across the alveolar membrane.  Possible cause is poorly hydrated surfactant.  Then I had to visit him again an hour later with the same amount of pollen flying around. On my way, I was  able to do 15 mins breathing through a commercial SIMT device with a large soft plastic mouthpiece to hold between my teeth. Free exhalation was through a valve and inhalation through an orifice giving a suction pressure of around 20 cms water. The effect on ease of climbing stairs convinced me that there was a "reliever" effect worth pursuing.

Yes and as I said in a previous post the negative pressure adds to the influence of fluid across the afforesaid membrane into the alveolar space and rehydration corrects the problem. Imbued with the theory of SIMT (Chest, 1992, 1357-61) I then did around 5 mins SIMT on the device daily for a week and was able to detect the positive coaching effect on diaphragmatic action. One great attraction of the theory is the thought that everybody has a natural defense against bronchospasm, namely by proper diaphragmatic instead of thoracic respiration. There are plenty of studies on attempts to train diaphragmatic breathing. Mostly they are not based on pressure modification, but rather on posture. The said Chest study seems pertinent and reliable as it is on normal asthmatics in a reasonably healthy state.

I Don’t aggree with these conclusions. As I said SIMT solved my problem (cured my asthmatic but non medicated shortness of breath) by showing me a direct path from the one possible option of taking a reliever puff and getting a sort of sickly, guilty pleasure on suddenly being able to take an invigorating diaphragmatic breath by drug usage to the healthy option of using a sophisticated muscular technique. I guess this is or was at one time the dream of half of those here

NP sure does work for me too, I just worry about the safety aspects.  I use slow expiration and strict non mouth breathing to effectively achieve the same thing.  Although this is not quite as fast it is easy and can become a habit and hence continuaus.  Also the effective respiration rate drops as one learns to tolerate dispnea and this reduces dehydration effects.  The best trick is to learn to sleep with your mouth closed. Bill, it sounds a bit like your condition is not stable enough for SIMT although the author of the study said elsewhere that it was generally suitable for mild asthma.

I made my own device using a ventolin inhaler without the capsule.  Stuffed with an appropriate amount of cotton wool it produced the required restriction.  But I found it less effective than a straight NP pause with the epiglot closed. Follow this by inspiration and a slow expiration.  Note the available fluid (from lymph tissue) is limited so you need time between successive NP pauses for this to be replenished. Good health, Bill

Response:

– Hide quoted text — Show quoted text – Back-pressure keeps the small airways open long enough for the alveoli to empty, and this is the reason that those with emphysema can still play the oboe but not the trombone (study done with the Concertgebouw Orchestra of Amsterdam 30 years ago). Larry They still played a mean version of Bartok’s Concerto for Orchestra… They play a "mean" version of everything. What does that have to do with the point?     Lp

Well, let’s see Lp–it’s called irony.  Brass figures prominently in that piece and they obviously overcame the obstacle of emphysema well enough to play it.  A tepid attempt at humor to be sure.

Response:

My practical conversion to breathing with what seemed to me to be increased,  but probably normal, negative pressure, was as follows. I drove to somebody’s office, had to go up flights of stairs and noticed chest tightness due to tree pollen. Then I had to visit him again an hour later with the same amount of pollen flying around. On my way, I was  able to do 15 mins breathing through a commercial SIMT device with a large soft plastic mouthpiece to hold between my teeth. Free exhalation was through a valve and inhalation through an orifice giving a suction pressure of around 20 cms water. The effect on ease of climbing stairs convinced me that there was a "reliever" effect worth pursuing. Imbued with the theory of SIMT (Chest, 1992, 1357-61) I then did around 5 mins SIMT on the device daily for a week and was able to detect the positive coaching effect on diaphragmatic action. One great attraction of the theory is the thought that everybody has a natural defense against bronchospasm, namely by proper diaphragmatic instead of thoracic respiration. There are plenty of studies on attempts to train diaphragmatic breathing. Mostly they are not based on pressure modification, but rather on posture. The said Chest study seems pertinent and reliable as it is on normal asthmatics in a reasonably healthy state. As I said SIMT solved my problem (cured my asthmatic but non medicated shortness of breath) by showing me a direct path from the one possible option of taking a reliever puff and getting a sort of sickly, guilty pleasure on suddenly being able to take an invigorating diaphragmatic breath by drug usage to the healthy option of using a sophisticated muscular technique. I guess this is or was at one time the dream of half of those here Bill, it sounds a bit like your condition is not stable enough for SIMT although the author of the study said elsewhere that it was generally suitable for mild asthma. – Hide quoted text — Show quoted text – To me it seems likely that a negative pressure is needed for proper inflation of the lungs at the tissue level and regardless of how this pressure is produced. I too have used negative pressure.  It is easy to do without any devices and can bring immediate relief from constrictive symptoms.  I however attribute this to the drawing of fluid (minute as it might be) into the small airways thus improving hydration.  Hydration of the lower airways is controlled by residual surface tension and the hydrostatic pressures it causes in areas of high curvature.  Negative pressure adds to this.  There was a case reported where an intubated patient clamped the tube in her teeth.  The resulting gulping for air and negative pressure caused significant edema so I don’t consider this a safe technique. Bill As for the influence of the nose on the lower airways being hydrothermal, this would seem to be too slow. The coordinating effect of suction pressure on respiratory muscles seems much more plausible. Personally I do find that concentrating on a optimum suction pressure/inhaled volume function increases my inhaled volume enormously. If nose resistance somehow fails, the effect is like slipping and "losing hold". This is where SIMT is so valuable as a foolproof way of learning the benefits of nose resistance (or of warming effects, if you do not accept the pressure stuff). For years in the past I did have to rely on taking a puff from a reliever inhaler to get rid of a most uncomfortable chest tightness. I now find that boosting inspiratory negative pressure by nose breathing techniques gives just the same effect. Within seconds of using the reliever inhaler I felt my diaphragm doing a big and sort of voluptuous downward sweep, but of course I thought "damned asthma drug, why can’t I do this naturally?" Well, now it seems that I’ve have gotten onto the right path with SIMT and a corrected understanding of breathing. Regards, Richard Friedel A couple of decades ago I went through a COPD course.  One of the exercises they taught us was to inhale through the nose and exhale forcefully through pursed lips.  I’ve found this very helpful over the years when I’ve had congestion in the throat. OK! but if the congestion is in the nose this will not help. One common misconception of pursed lip B. is the theory that the pressure keeps the airways open longer during expiration.  This is incorrect as there is no net pressure increase inside the airways compared to the outside. There are other reasons why this technique works, not only for COPD sufferers but for asthma also.  1. the pressure may compress the airway walls but this is likely to be very slight.  2.the increased pressure will increase the condensation of moisture and tend to trap it in the airways on expiration.  3 the slowing of the expiration cycle will also allow more time for reclaim of moisture and heat.  4.  the slowing of expiration will increase the lamina flow ie. reduce turbulence esp. in constricted airways further increasing the moisture retention on the surfaces. 5. there is more time to get the air out, reducing the residual volume of trapped air. 6. there are changes in the alveolar membrane that occur with slow compression and increased capacity.  (evidenced by improved gas transfer.  My guess is improved hydration of the membrane and surfactant dynamics.) So as most of these effects are due to the slowing of expiration it is not necessary to create a backpressure and therefore not necessary to bypass the nose and lose the very real benefits of same.  Once you accept this then there are many other ways you can enhance the effect. Personally I have reduced airway reactivity to very low levels, both upper and lower using and extending these techniques. Its all about improved hydrothermal capacity of the WHOLE respiratory tract. Bill Al Al Fisher

Response:

Back-pressure keeps the small airways open long enough for the alveoli to empty, and this is the reason that those with emphysema can still play the oboe but not the trombone (study done with the Concertgebouw Orchestra of Amsterdam 30 years ago). Larry They still played a mean version of Bartok’s Concerto for Orchestra…

They play a "mean" version of everything. What does that have to do with the point?     Lp

Response:

As for pursed lips breathing. It is taught extensively for asthma in Germany as part of orthodox treatment. However, knowing the hypnotic effect of breathing routines, it might be counter productive.

I woder if you have had much actual exposure to people with advanced emphysema. They do pursed-mouth breathing not because they have been taught, but because that is the only way they can keep air going in and out. It just sort of comes to them that they need to be oxygenated and that this is the only way to accomplish it. Are you an engineer?     Larry

Response:

To me it seems likely that a negative pressure is needed for proper inflation of the lungs at the tissue level and regardless of how this pressure is produced.

I too have used negative pressure.  It is easy to do without any devices and can bring immediate relief from constrictive symptoms.  I however attribute this to the drawing of fluid (minute as it might be) into the small airways thus improving hydration.  Hydration of the lower airways is controlled by residual surface tension and the hydrostatic pressures it causes in areas of high curvature.  Negative pressure adds to this.  There was a case reported where an intubated patient clamped the tube in her teeth.  The resulting gulping for air and negative pressure caused significant edema so I don’t consider this a safe technique. Bill – Hide quoted text — Show quoted text – As for the influence of the nose on the lower airways being hydrothermal, this would seem to be too slow. The coordinating effect of suction pressure on respiratory muscles seems much more plausible. Personally I do find that concentrating on a optimum suction pressure/inhaled volume function increases my inhaled volume enormously. If nose resistance somehow fails, the effect is like slipping and "losing hold". This is where SIMT is so valuable as a foolproof way of learning the benefits of nose resistance (or of warming effects, if you do not accept the pressure stuff). For years in the past I did have to rely on taking a puff from a reliever inhaler to get rid of a most uncomfortable chest tightness. I now find that boosting inspiratory negative pressure by nose breathing techniques gives just the same effect. Within seconds of using the reliever inhaler I felt my diaphragm doing a big and sort of voluptuous downward sweep, but of course I thought "damned asthma drug, why can’t I do this naturally?" Well, now it seems that I’ve have gotten onto the right path with SIMT and a corrected understanding of breathing. Regards, Richard Friedel A couple of decades ago I went through a COPD course.  One of the exercises they taught us was to inhale through the nose and exhale forcefully through pursed lips.  I’ve found this very helpful over the years when I’ve had congestion in the throat. OK! but if the congestion is in the nose this will not help. One common misconception of pursed lip B. is the theory that the pressure keeps the airways open longer during expiration.  This is incorrect as there is no net pressure increase inside the airways compared to the outside. There are other reasons why this technique works, not only for COPD sufferers but for asthma also.  1. the pressure may compress the airway walls but this is likely to be very slight.  2.the increased pressure will increase the condensation of moisture and tend to trap it in the airways on expiration.  3 the slowing of the expiration cycle will also allow more time for reclaim of moisture and heat.  4.  the slowing of expiration will increase the lamina flow ie. reduce turbulence esp. in constricted airways further increasing the moisture retention on the surfaces. 5. there is more time to get the air out, reducing the residual volume of trapped air. 6. there are changes in the alveolar membrane that occur with slow compression and increased capacity.  (evidenced by improved gas transfer.  My guess is improved hydration of the membrane and surfactant dynamics.) So as most of these effects are due to the slowing of expiration it is not necessary to create a backpressure and therefore not necessary to bypass the nose and lose the very real benefits of same.  Once you accept this then there are many other ways you can enhance the effect. Personally I have reduced airway reactivity to very low levels, both upper and lower using and extending these techniques. Its all about improved hydrothermal capacity of the WHOLE respiratory tract. Bill Al Al Fisher

Response:

Bill, Firstly congratulations on your success with nose breathing. The key point here seems to be that the medical view that the nose is only for warming, moisturizing and cleaning the air we breathe is a dogma based and just a concession to patients’ feelings. If we assume that negative pressure due to the nose is essential for the efficiency of respiration, everything falls into place. Studies on nasal resistance show that it varies and that the nose tends to "amplify" suction as a starling resistor. But the authors of papers insist on speaking of a collapse of the upper airways. Medical writers also speak of the work of breathing as if it should be minimized.  However this springs from a doctrinaire compartmentalization of the body. It is obvious that increasing respiratory effort will, if the diaphragm is working properly, improve hemodynamics and massage the abdominal organs. The following aspects speak for an error in medical theory: 1       It seems an old-fashioned not to say simple-minded approach to nature to more or less decree that the enormous work of nasal breathing of, say, a galloping horse (which cannot breathe through its mouth), is all wasted. What do these people understand by vitality, one might ask. 2       Attempting breathing exercises such as za-zen with mouth instead of the prescribed nose breathing fail miserably. See my posting to sci.skeptic of May on this. 3       Diaphragmatic breathing is promoted by upper airways resistance, because such resistance forces coordination of the diaphragm with other breathing muscles. 4       Common sense speaks for the utility of diaphragmatic breathing not just being a popular error. 5       The unusual amount of attention given by quacks to asthma. This might well mean that conventional asthma treatment is itself not so very sound. As for pursed lips breathing. It is taught extensively for asthma in Germany as part of orthodox treatment. However, knowing the hypnotic effect of breathing routines, it might be counter productive. To me it seems likely that a negative pressure is needed for proper inflation of the lungs at the tissue level and regardless of how this pressure is produced. As for the influence of the nose on the lower airways being hydrothermal, this would seem to be too slow. The coordinating effect of suction pressure on respiratory muscles seems much more plausible. Personally I do find that concentrating on a optimum suction pressure/inhaled volume function increases my inhaled volume enormously. If nose resistance somehow fails, the effect is like slipping and "losing hold". This is where SIMT is so valuable as a foolproof way of learning the benefits of nose resistance (or of warming effects, if you do not accept the pressure stuff). For years in the past I did have to rely on taking a puff from a reliever inhaler to get rid of a most uncomfortable chest tightness. I now find that boosting inspiratory negative pressure by nose breathing techniques gives just the same effect. Within seconds of using the reliever inhaler I felt my diaphragm doing a big and sort of voluptuous downward sweep, but of course I thought "damned asthma drug, why can’t I do this naturally?" Well, now it seems that I’ve have gotten onto the right path with SIMT and a corrected understanding of breathing. Regards, Richard Friedel – Hide quoted text — Show quoted text – A couple of decades ago I went through a COPD course.  One of the exercises they taught us was to inhale through the nose and exhale forcefully through pursed lips.  I’ve found this very helpful over the years when I’ve had congestion in the throat. OK! but if the congestion is in the nose this will not help. One common misconception of pursed lip B. is the theory that the pressure keeps the airways open longer during expiration.  This is incorrect as there is no net pressure increase inside the airways compared to the outside.  There are other reasons why this technique works, not only for COPD sufferers but for asthma also.  1. the pressure may compress the airway walls but this is likely to be very slight.  2.the increased pressure will increase the condensation of moisture and tend to trap it in the airways on expiration.  3 the slowing of the expiration cycle will also allow more time for reclaim of moisture and heat.  4.  the slowing of expiration will increase the lamina flow ie. reduce turbulence esp. in constricted airways further increasing the moisture retention on the surfaces. 5. there is more time to get the air out, reducing the residual volume of trapped air. 6. there are changes in the alveolar membrane that occur with slow compression and increased capacity.  (evidenced by improved gas transfer.  My guess is improved hydration of the membrane and surfactant dynamics.) So as most of these effects are due to the slowing of expiration it is not necessary to create a backpressure and therefore not necessary to bypass the nose and lose the very real benefits of same.  Once you accept this then there are many other ways you can enhance the effect. Personally I have reduced airway reactivity to very low levels, both upper and lower using and extending these techniques. Its all about improved hydrothermal capacity of the WHOLE respiratory tract. Bill Al Al Fisher

Response:

A couple of decades ago I went through a COPD course.  One of the exercises they taught us was to inhale through the nose and exhale forcefully through pursed lips.  I’ve found this very helpful over the years when I’ve had congestion in the throat. Al Al Fisher

Response:

A couple of decades ago I went through a COPD course.  One of the exercises they taught us was to inhale through the nose and exhale forcefully through pursed lips.  I’ve found this very helpful over the years when I’ve had congestion in the throat.

OK! but if the congestion is in the nose this will not help. One common misconception of pursed lip B. is the theory that the pressure keeps the airways open longer during expiration.  This is incorrect as there is no net pressure increase inside the airways compared to the outside.  There are other reasons why this technique works, not only for COPD sufferers but for asthma also.  1. the pressure may compress the airway walls but this is likely to be very slight.  2.the increased pressure will increase the condensation of moisture and tend to trap it in the airways on expiration.  3 the slowing of the expiration cycle will also allow more time for reclaim of moisture and heat.  4.  the slowing of expiration will increase the lamina flow ie. reduce turbulence esp. in constricted airways further increasing the moisture retention on the surfaces. 5. there is more time to get the air out, reducing the residual volume of trapped air. 6. there are changes in the alveolar membrane that occur with slow compression and increased capacity.  (evidenced by improved gas transfer.  My guess is improved hydration of the membrane and surfactant dynamics.) So as most of these effects are due to the slowing of expiration it is not necessary to create a backpressure and therefore not necessary to bypass the nose and lose the very real benefits of same.  Once you accept this then there are many other ways you can enhance the effect. Personally I have reduced airway reactivity to very low levels, both upper and lower using and extending these techniques. Its all about improved hydrothermal capacity of the WHOLE respiratory tract. Bill – Hide quoted text — Show quoted text – Al Al Fisher

Response:

A couple of decades ago I went through a COPD course.  One of the exercises they taught us was to inhale through the nose and exhale forcefully through pursed lips.  I’ve found this very helpful over the years when I’ve had congestion in the throat. OK! but if the congestion is in the nose this will not help. One common misconception of pursed lip B. is the theory that the pressure keeps the airways open longer during expiration.  This is incorrect as there is no net pressure increase inside the airways compared to the outside.

My understanding has been that pursed-mouth breathing helps when there is over-inflation of alveoli, due most often to destruction of interalveolar walls. This is the picture in emphysema. The overdistention also occurs, reversibly, in asthma. Purse-mouthed breathing obviously works, or you would not see patients with advanced emphysema performing it unconsciously, and of necessity. With airways like this it is necessary that there be slow emptying, or air-trapping occurs. If there is external pressure on the lungs, due to the respiratory motion of the chest wall and the diaphragm, obviously the volume of the lung must also decrease. If this volume change occurs too rapidly for the overdistended alveoli to empty through narrowed airways, that volume change must involve other structures. The air-containing bronchial tree is the only candidate left. the major airways are rigid enough that they cannot collapse, but the smaller airways can, and do, before the lung has deflated. In that circumstance you have alveoli that have no communication with the outside. They then cannot empty and cannot dispose of the CO2 that has been brought to them by the pulmonary circulation. Rapid breathing thus leads to CO2 build-up, rather than to the excess blow-off it will cause in the lung that can empty rapidly. Back-pressure keeps the small airways open long enough for the alveoli to empty, and this is the reason that those with emphysema can still play the oboe but not the trombone (study done with the Concertgebouw Orchestra of Amsterdam 30 years ago).     Larry

Response:

Back-pressure keeps the small airways open long enough for the alveoli to empty, and this is the reason that those with emphysema can still play the oboe but not the trombone (study done with the Concertgebouw Orchestra of Amsterdam 30 years ago).     Larry

They still played a mean version of Bartok’s Concerto for Orchestra…

Response:

I can give you a good breathing excercise.  I will also see if I can get the info from the Jewish ( which are you talking about?  I am Jewish and contacted the Jewish medical learning center)  But with all the medical problems I have especially the pain part the best breathing excercise for your lungs is inhaling as much as you can through your nose and slowly exhale out your mouth.

Opinion : Never breathe through the mouth (in or out) The nose is not just a filter, it also has important heat and moisture exchange properties.   As you describe is likely to dry the sinuses and nasal passages in most environments.  Atmospheric moisture is usually less important than internally generated moisture (humidity) although perhaps less so in Fl. or the tropics. Bill not an MD.  Do it all slowly to expand the lungs to the maximum – Hide quoted text — Show quoted text – hold it briefly and slowly release through the mouth.  This I was taught by my pulmonary (actually the one in Tampa, Fl and again here in Coral Springs Fl)  It works great.  And you do it anytime you want but try to do it at least 3 times a day.  In no time you will see a big difference.  Oh a hint, if you live somewhere with extreme heat esp. humidity it feels better when you first start in a better environment.  If you are dealing with pain, slowly breath in and out Nose and mouth almost like panting.  The same way us women are taught for child birth.  I do both of these.  If you still want me to get the information just say yes.  UM MOM Susan Susan, I was asking about breathing exercises, specifically about SIMT. My understanding is that when Bob asked about Buyteko, Jewish hadn’t heard of it. Then they stated they did use breathing exercises, so I wondered which ones they thought had value.

Response:

I can give you a good breathing excercise.  I will also see if I can get the

  info from the Jewish ( which are you talking about?  I am Jewish and   contacted the Jewish medical learning center)  But with all the medical   problems I have especially the pain part the best breathing excercise for   your lungs is inhaling as much as you can through your nose and slowly   exhale out your mouth.  Do it all slowly to expand the lungs to the maximum   hold it briefly and slowly release through the mouth.  This I was taught by   my pulmonary (actually the one in Tampa, Fl and again here in Coral Springs   Fl)  It works great.  And you do it anytime you want but try to do it at   least 3 times a day.  In no time you will see a big difference.  Oh a hint,   if you live somewhere with extreme heat esp. humidity it feels better when   you first start in a better environment.  If you are dealing with pain,   slowly breath in and out Nose and mouth almost like panting.  The same way   us women are taught for child birth.  I do both of these.  If you still want   me to get the information just say yes.  UM MOM Susan Any information on breathing exercises, I am certainly interested.  I have tried breathing out and holding that way as long as comfortable, before I ever saw the name Buteyko.  Or I might breathe in through the nose as much as possible, then slowly exhale, and subsequently, though not necessarily on the same breath, breathe out and hold that way. How hot is extreme?  Normal temperature inside the lungs would be 37 C, humidity 100%, so breathing air near that temperature shouldn’t irritate the lungs, though somewhat lower temperatures might feel more comfortable.

Response:

I checked out your site and I have used this many times.  When ever I have to take test that require me to have anesthesia and when I had my resection I had it before to prepare my lungs the 3 times a day while I was recovering in the hospital.  I also had it for er visits when I was bleeding and needed transfusion.  I don’t remember what my dr order for the med I just know it helped immensely after the 2nd day.  It was hard with the resection surgery because of the need of a coughing pillow and it hurt the stomach a lot to cough well move as far as that goes but I had a magic button that helped me not care about the pain its called every 3 minutes of valium and Demerol! UM MOM Susan

– Hide quoted text — Show quoted text – I can give you a good breathing excercise.  I will also see if I can get the info from the Jewish ( which are you talking about?  I am Jewish and contacted the Jewish medical learning center)  But with all the medical problems I have especially the pain part the best breathing excercise for your lungs is inhaling as much as you can through your nose and slowly exhale out your mouth.  Do it all slowly to expand the lungs to the maximum hold it briefly and slowly release through the mouth.  This I was taught by my pulmonary (actually the one in Tampa, Fl and again here in Coral Springs Fl)  It works great.  And you do it anytime you want but try to do it at least 3 times a day.  In no time you will see a big difference.  Oh a hint, if you live somewhere with extreme heat esp. humidity it feels better when you first start in a better environment.  If you are dealing with pain, slowly breath in and out Nose and mouth almost like panting.  The same way us women are taught for child birth.  I do both of these.  If you still want me to get the information just say yes.  UM MOM Susan Susan, I was asking about breathing exercises, specifically about SIMT. My understanding is that when Bob asked about Buyteko, Jewish hadn’t heard of it. Then they stated they did use breathing exercises, so I wondered which ones they thought had value. Susan, Thanks for the offer. I was asking because someone asked me about THE BREATHER.  http://www.betterairways.com/ It appears that this is regularly given to patients who have had major thoracic surgery. It doesn’t seem like the recommendation has made it from the heart docs to the lung docs yet, but people seem to think it helps after heart surgery. So I got to wondering.

Response:

Thanks Bob. One day when my phone isn’t busy from being on the computer, I may try it. Seems like she is a person who could answer many of my questions (since my case is so ODD).

– Hide quoted text — Show quoted text – Thanks.  Do you have an "in" or do you know if she minds a stranger contacting her? No "in" JAR.  I just called her from her site.  She did return my call immediately though, but we missed each other.  Then all hell broke loose with the fire. Here is another information line you can call, if she doesn’t get back to you: http://nationaljewish.org/diseases/d1.html

Response:

I can give you a good breathing excercise.  I will also see if I can get the info from the Jewish ( which are you talking about?  I am Jewish and contacted the Jewish medical learning center)  But with all the medical problems I have especially the pain part the best breathing excercise for your lungs is inhaling as much as you can through your nose and slowly exhale out your mouth.  Do it all slowly to expand the lungs to the maximum hold it briefly and slowly release through the mouth.  This I was taught by my pulmonary (actually the one in Tampa, Fl and again here in Coral Springs Fl)  It works great.  And you do it anytime you want but try to do it at least 3 times a day.  In no time you will see a big difference.  Oh a hint, if you live somewhere with extreme heat esp. humidity it feels better when you first start in a better environment.  If you are dealing with pain, slowly breath in and out Nose and mouth almost like panting.  The same way us women are taught for child birth.  I do both of these.  If you still want me to get the information just say yes.  UM MOM Susan

– Hide quoted text — Show quoted text – Susan, I was asking about breathing exercises, specifically about SIMT. My understanding is that when Bob asked about Buyteko, Jewish hadn’t heard of it. Then they stated they did use breathing exercises, so I wondered which ones they thought had value.

Response:

Thanks.  Do you have an "in" or do you know if she minds a stranger contacting her?

No "in" JAR.  I just called her from her site.  She did return my call immediately though, but we missed each other.  Then all hell broke loose with the fire. Here is another information line you can call, if she doesn’t get back to you: http://nationaljewish.org/diseases/d1.html

Response:

– Hide quoted text — Show quoted text – I can give you a good breathing excercise.  I will also see if I can get the info from the Jewish ( which are you talking about?  I am Jewish and contacted the Jewish medical learning center)  But with all the medical problems I have especially the pain part the best breathing excercise for your lungs is inhaling as much as you can through your nose and slowly exhale out your mouth.  Do it all slowly to expand the lungs to the maximum hold it briefly and slowly release through the mouth.  This I was taught by my pulmonary (actually the one in Tampa, Fl and again here in Coral Springs Fl)  It works great.  And you do it anytime you want but try to do it at least 3 times a day.  In no time you will see a big difference.  Oh a hint, if you live somewhere with extreme heat esp. humidity it feels better when you first start in a better environment.  If you are dealing with pain, slowly breath in and out Nose and mouth almost like panting.  The same way us women are taught for child birth.  I do both of these.  If you still want me to get the information just say yes.  UM MOM Susan Susan, I was asking about breathing exercises, specifically about SIMT. My understanding is that when Bob asked about Buyteko, Jewish hadn’t heard of it. Then they stated they did use breathing exercises, so I wondered which ones they thought had value.

Susan, Thanks for the offer. I was asking because someone asked me about THE BREATHER.  http://www.betterairways.com/ It appears that this is regularly given to patients who have had major thoracic surgery. It doesn’t seem like the recommendation has made it from the heart docs to the lung docs yet, but people seem to think it helps after heart surgery. So I got to wondering.

Response:

Did the Doctor from Jewish ever get back to you about the breathing exercises?

Response:

Did the Doctor from Jewish ever get back to you about the breathing exercises?

JAR, she and I played phone tag, then I emailed her with everyones’ questions on June 6.  She was out of the office, then returned to the big fire they had there, so my email has not yet been returned.  Here is her website.  Call or email her; hopefully you will have better luck than I did.   http://nationaljewish.org/faculty/kraft.html

Response:

Thanks.  Do you have an "in" or do you know if she minds a stranger contacting her?

Response:

I’ve spoken to them before.  Don’t have any contact but they did respond in a reasonable amount of time.  I’d be more than happy to try for you just let me know your questions.  UM MOM Susan

– Hide quoted text — Show quoted text – Thanks.  Do you have an "in" or do you know if she minds a stranger contacting her?

Response:

Susan, I was asking about breathing exercises, specifically about SIMT. My understanding is that when Bob asked about Buyteko, Jewish hadn’t heard of it. Then they stated they did use breathing exercises, so I wondered which ones they thought had value.

Response:

Question:

Friends – Doctors and Patients, I am now beginning a research on the patients’ role in the doctors’ decisions of treatment. I believe that in this era when the Internet is open to everybody and patients can use it, their knowledge is sometimes as good as the doctor’s. Such a newsgroup helps understanding better the illness and its treatments. In my opinion the patients come to the doctor as consultants with knowledge and then influence the doctor about the treatment. Please let me know what do you think about this idea. Thank you for your help. Alice

Response:

– Hide quoted text — Show quoted text – Friends – Doctors and Patients, I am now beginning a research on the patients’ role in the doctors’ decisions of treatment. I believe that in this era when the Internet is open to everybody and patients can use it, their knowledge is sometimes as good as the doctor’s. Such a newsgroup helps understanding better the illness and its treatments. In my opinion the patients come to the doctor as consultants with knowledge and then influence the doctor about the treatment. Please let me know what do you think about this idea. Thank you for your help. Alice

Interesting question.  No, I don’t believe that the knowledge is as good as the doctor’s.  But in very specific targeted areas it can be more detailed relative to a given treatment or medication, since a doctor has to have a broad knowledge, very broad in the case of a GP, narrowing as a doctor specializes.  The patients have interest in their cases and peculiarities and by selective reading can amass knowledge beyond what is reasonable to expect a generalist to have.  But the doctor/generalist will always have the base of experience in broad effects of treatments that a patient would not be able to assimilate, the question is one of need for the broad applic- ability vs. specifically targeted application.  The doctor having the training in broad vision will usually be able to appreciate specific questions whereas the patient, lacking the training, probably will not be able to make the jump from specific detail to overview and broad effects. Given the above it follows that an informed patient will influence the doctor in the treatment, and the doctor will be able to add to the patient’s bank of knowledge in the same exchange.  This is a give-and- take process that has been customary with accountants and lawyers but only recently as you observe has become practical in dealings with medical professionals. pavane

Response:

Friends – Doctors and Patients, I am now beginning a research on the patients’ role in the doctors’ decisions of treatment. I believe that in this era when the Internet is open to everybody and patients can use it, their knowledge is sometimes as good as the doctor’s. Such a newsgroup helps understanding better the illness and its treatments. In my opinion the patients come to the doctor as consultants with knowledge and then influence the doctor about the treatment. Please let me know what do you think about this idea.

Hi Alice, I think I have influenced doctors when perhaps I shouldn’t have.  I firmly believe we all need to be very active in our health care and have questioned prescriptions many times and for the right reasons.  But I am the first to admit I’m not an MD. Patrice

Response:

I expect to see my Dr. this Friday. I intend to suggest some very specific changes in my medications, and will offer my reasons. I will follow whatever he decides on, however. I also follow dosages and instructions as exactly as possible. He has the experiences of all of his asthma patients to draw from, I have only my own experiences, and opinions of others on ngs like this one. Having said that, I believe that it is MY responsibility to look after my well being at least as much as the Dr.’s. He is not an asthma specialist, but a F.P.  We get along well on this basis, too. Boyd — "The cure for boredom is curiosity. There is no cure for curiosity."

Response:

Lowenton wrote… I am now beginning a research on the patients’ role in the doctors’ decisions of treatment. I believe that in this era when the Internet is open to everybody and patients can use it, their knowledge is sometimes as good as the doctor’s. Such a newsgroup helps understanding better the illness and its treatments. In my opinion the patients come to the doctor as consultants with knowledge and then influence the doctor about the treatment. Please let me know what do you think about this idea.

Interesting research topic! Certainly, the Internet provides another avenue for patients to do research. However, a collaborative relationship with one’s physician is a must, especially when managing a chronic condition. I am fortunate to have a physician who encourages such a collaborative relationship. As another poster mentioned…  As an allergy patient, I have my own individual experience to draw on. However, my allergist has his entire patient population and years of practice to draw on. At the same time, I know my limits and *my experience* of my condition. Example:  I may or may not consider certain medication side effects tolerable. Another patient may feel otherwise. Having said that, there was a time a few years ago when I had a chronic sinus infection. I finally read everything I could find on Medscape.com, and then asked my physician to give me 30 days of antibiotics. It worked. My physician and I work together to help provide me with the best quality of life possible. — Karen

Response:

Friends – Doctors and Patients, I am now beginning a research on the patients’ role in the doctors’ decisions of treatment. I believe that in this era when the Internet is open to everybody and patients can use it, their knowledge is sometimes as good as the doctor’s. Such a newsgroup helps understanding better the illness and its treatments. In my opinion the patients come to the doctor as consultants with knowledge and then influence the doctor about the treatment. Please let me know what do you think about this idea.

I am very active in my drug choices and dosages. On the dose side I am pretty much in control on most drugs as I am taking severl that are phycoactive and interact. I keep the doctors informed and we only adjust one at a time. Those are for MS and associated problems. For asthma I do the flovent, servent, antihiatmine with out fail. I may drop the servent if my peak flow is great and I have no problems and I will drop back to one puff of 110mcg 2X when evey thing is going great but at the first hint of trouble or if I know I am going to go some where I will have problems I will start uping the dose a couple days early. As soon as I start to get in trouble I can call the doc for burst dose of steriods or anitbodics. I have been years building this relationship with my doctors you have to show them you know what you are talking about several time before they will trust you to this extent. Gordon Gordon Couger Stillwater OK

Response:

– Hide quoted text — Show quoted text – Friends – Doctors and Patients, I am now beginning a research on the patients’ role in the doctors’ decisions of treatment. I believe that in this era when the Internet is open to everybody and patients can use it, their knowledge is sometimes as good as the doctor’s. Such a newsgroup helps understanding better the illness and its treatments. In my opinion the patients come to the doctor as consultants with knowledge and then influence the doctor about the treatment. Please let me know what do you think about this idea. I am very active in my drug choices and dosages. On the dose side I am pretty much in control on most drugs as I am taking severl that are phycoactive and interact. I keep the doctors informed and we only adjust one at a time. Those are for MS and associated problems. For asthma I do the flovent, servent, antihiatmine with out fail. I may drop the servent if my peak flow is great and I have no problems and I will drop back to one puff of 110mcg 2X when evey thing is going great but at the first hint of trouble or if I know I am going to go some where I will have problems I will start uping the dose a couple days early. As soon as I start to get in trouble I can call the doc for burst dose of steriods or anitbodics. I have been years building this relationship with my doctors you have to show them you know what you are talking about several time before they will trust you to this extent.

Most doctors like it when a patient is able to follow a plan and decreased AND increased their meds as needed and know when to call for help. Unfortunately, what I see much more often is that the person comes in feeling bad and I find that they stopped their meds during a time when they felt good and then didn’t go back when they got worse; they stopped their meds because they felt good but they are still wheezing in the office; or they have been steadily increasing the doses and not comming in until in extremis. What you are doing is pretty much what I do with my own asthma treatment. Obviously I had an easier time convincing my doctor that I didn’t need as close supervision. — CBI, MD

Response:

– Hide quoted text — Show quoted text – Most doctors like it when a patient is able to follow a plan and decreased AND increased their meds as needed and know when to call for help. Unfortunately, what I see much more often is that the person comes in feeling bad and I find that they stopped their meds during a time when they felt good and then didn’t go back when they got worse; they stopped their meds because they felt good but they are still wheezing in the office; or they have been steadily increasing the doses and not comming in until in extremis. What you are doing is pretty much what I do with my own asthma treatment. Obviously I had an easier time convincing my doctor that I didn’t need as close supervision.

It helps that I have degree in animal science and haveing done a great deal of research in reproductive physology and being able read medical papers and talk to a doctor intelegently. I have kept up on astha and MS as well. When they tell me someting I can ask relevent questions. It helps a lot to understand what the drugs do if when I try to adjust them and why I have to keep taking them when I feel good. I know I have to stay in front of asthma. Being able to dig things out of the literture have found a few problems that the doctors missed. Nothing big but they made a difference in my comfort. Gordon Couger Stillwater OK

Response:

Patients should know what medications they have taken in the past, and how they reacted to them. In addition, the patient should know of any allergies they have. There are some antibiotics which I don’t react well to, and if the doctor suggests one, I ask for a different one, and explain why. I’ve done research via the internet on several medications. The fact is, there are so many new meds available, that I don’t think that doctors can keep up with all the possible interactions, especially with drugs used for rare conditions. At the very least, you should be aware when adding a new drug to your mix what the possible side effects can be. You can also go to web pages like drkoop.com to check for drug interactions. Yeah, I know, the pharmicist should be checking for interactions, but if it is a new medicine, their database may not be entirely up-to-date. In addition, there are often alternatives if you have trouble taking medications 3 or 4 times a day. When ever possible, I prefer meds I only have to take once or twice a day, and ask the doctor for such. Hope this helps.

Response:

Question:

Egad!  The situation is worse than I had imagined!

Yeah, it seems to concern you much more than all those needless Jan

Response:

Needles deaths?  From TCM?  What are you babbling about? Egad!  The situation is worse than I had imagined! Yeah, it seems to concern you much more than all those needless Jan

Response:

Jan, Yes, indeed, many other factors are involved.  While bedside manner is important, it is easier to verify licensing and other credentials. Also make sure that your acupuncturist is didactic.  You don’t want somebody who clings to the bronze age (literal) belief in Qi. – Hide quoted text — Show quoted text – Indeed!  One should always make sure their acupuncturist is licensed and has passed the national exam (the latter usually being a requirement for the former)   Also, one should look for someone who actually went to acupuncture school, not an MD or Chiro (tee-hee) who took a 100-200 hour course on where NOT to stick the needles. It takes about 3 years to be a fair to decent acupuncturist, it takes another 2-3 years to learn the herbal system.   For best results, also look for an acupuncturist that has passed the national herbal exam. And after that you might want to learn what kind of person he/she is? Judgment based of how they treat other people.  Licensing and schooling isn’t the all in all, many other things to be considered. Jan

Response:

Indeed!  One should always make sure their acupuncturist is licensed and has passed the national exam (the latter usually being a requirement for the former)   Also, one should look for someone who actually went to acupuncture school, not an MD or Chiro (tee-hee) who took a 100-200 hour course on where NOT to stick the needles. It takes about 3 years to be a fair to decent acupuncturist, it takes another 2-3 years to learn the herbal system.   For best results, also look for an acupuncturist that has passed the national herbal exam.

And after that you might want to learn what kind of person he/she is? Judgment based of how they treat other people.  Licensing and schooling isn’t the all in all, many other things to be considered. Jan

Response:

- Hide quoted text — Show quoted text – As you have noticed, the only a few people on the NG actually have a serious bone of contention with TCM.  Peter B is perhaps the most "anti" Acupuncture person on the group. Hey – I’m so skeptical I that I doubt that Rene Descartes could be sure that he could think. What I have found with acupuncture is that the proponents make such vague claims about what they can do and how they can do it that it’s a bit hard to get worked up about it. I get much the same feeling when I go to the Mind Body Wallet Festival here and see the crystal wavers, qi-gongers and vegie sandwich makers. I’m glad, though, that I didn’t go to Jasmuheen’s lecture at the last festival because she is now featuring in her act the people she has killed. I would have needed lots of bail money. This is very understandable given Peter’s geographic situation.  Australia has perhaps the world’s highest co-efficient of Wank in its medical Frank Macfarlane Burnet, Howard Florey, Peter Doherty, Fred Hollows, Gustav Nossal, even more … (and alternative medical) systems. Now that’s a different matter! The University that educated me was probably the first in the world to have an officially accredited chiropractic school. I thought (hoped) that it might concentrate on the areas where chiro might possibly be of use, but, alas, the head of the school describes herself as a "paediatric chiropractor", therefore signifying that all hope is lost. I turn my testamurs toward the wall each Friday. I took the (US) national boards with some Australian trained students and wasn’t surprised to hear that all four failed….both sections.  Heck, if I hung out with those guys long enough, even I might doubt TCM’s validity! Unfortunately, consumer protection against quackery is almost non-existent here. There was an article in Saturday’s paper at http://www.smh.com.au/news/0012/30/review/review3.html which shows that it is difficult to get anyone to do anything even about something as hoary and ridiculous as that perennial icon of quackery, the Rife machine. The TCM students that Andrew met could have come from somewhere as prestigious as RMIT in Melbourne or could have just simply called themselves practitioners. The nutritionist Rosemary Stanton likes to tell about how her late sheep dog was a member of the American Association of Nutritional Consultants, but I know someone who went one better than that and got accreditation for a school of naturopathy where his dog was both the proprietor and teaching staff. He could then have his dog issue him with certificates of competency so that he could hang up a shingle and start treating, say, shingles. Scary, isn’t it?

Yep, *almost* as scary as all the needless deaths each year. Jan – Hide quoted text — Show quoted text – The bad-mannered fascist at "Quintessence of the Loon" http://www.ratbags.com/loon

Response:

Hi, Acupuncture and Herbs work fine for asthma,

i have seen some literature that supports the part of your claim where herbs are concerned, but none for the part about acupuncture. can you point out any gold-standard studies that support the idea of using acupuncture to treat asthma? are there even any published collected case studies that are not peer reviewed that support this? i have read several that do NOT support its use. anyway, how DOES acupuncture affect the lungs according to any current replicated studies of the modality? (other than causing pneumothorax if used incorrectly?) the only requirement is : Find a State License  acupuncturist.

good idea. or perhaps it would be a better idea to only use acupuncture  in conjunction with a regular MD’s supervision/inclusion in the treatment process. oddly enough, i have read that many folks are reluctant to tell their regular MDs that they have used or do currently use acupuncture. anyone considering using acupuncture for asthma may want to read thru some of the following pages: http://asthma.about.com/health/asthma/library/weekly/aa080299.htm http://www.update-software.com/abstracts/ab000008.htm http://www.icmart.org/icmart00/abstract/abst33.html  "There is no better soporific and sedative than skepticism." -Nietzche interesting "skepticism" critiques: http://www.discord.org/skeptical/Critiques/

Response:

Egad!  The situation is worse than I had imagined! – Hide quoted text — Show quoted text – This is very understandable given Peter’s geographic situation.  Australia has perhaps the world’s highest co-efficient of Wank in its medical Frank Macfarlane Burnet, Howard Florey, Peter Doherty, Fred Hollows, Gustav Nossal, even more … (and alternative medical) systems. Now that’s a different matter! The University that educated me was probably the first in the world to have an officially accredited chiropractic school. I thought (hoped) that it might concentrate on the areas where chiro might possibly be of use, but, alas, the head of the school describes herself as a "paediatric chiropractor", therefore signifying that all hope is lost. I turn my testamurs toward the wall each Friday. I took the (US) national boards with some Australian trained students and wasn’t surprised to hear that all four failed….both sections.  Heck, if I hung out with those guys long enough, even I might doubt TCM’s validity! Unfortunately, consumer protection against quackery is almost non-existent here. There was an article in Saturday’s paper at http://www.smh.com.au/news/0012/30/review/review3.html which shows that it is difficult to get anyone to do anything even about something as hoary and ridiculous as that perennial icon of quackery, the Rife machine. The TCM students that Andrew met could have come from somewhere as prestigious as RMIT in Melbourne or could have just simply called themselves practitioners. The nutritionist Rosemary Stanton likes to tell about how her late sheep dog was a member of the American Association of Nutritional Consultants, but I know someone who went one better than that and got accreditation for a school of naturopathy where his dog was both the proprietor and teaching staff. He could then have his dog issue him with certificates of competency so that he could hang up a shingle and start treating, say, shingles. Scary, isn’t it? The bad-mannered fascist at "Quintessence of the Loon" http://www.ratbags.com/loon

Response:

As you have noticed, the only a few people on the NG actually have a serious bone of contention with TCM.  Peter B is perhaps the most "anti" Acupuncture person on the group.

Hey – I’m so skeptical I that I doubt that Rene Descartes could be sure that he could think. What I have found with acupuncture is that the proponents make such vague claims about what they can do and how they can do it that it’s a bit hard to get worked up about it. I get much the same feeling when I go to the Mind Body Wallet Festival here and see the crystal wavers, qi-gongers and vegie sandwich makers. I’m glad, though, that I didn’t go to Jasmuheen’s lecture at the last festival because she is now featuring in her act the people she has killed. I would have needed lots of bail money. This is very understandable given Peter’s geographic situation.  Australia has perhaps the world’s highest co-efficient of Wank in its medical

Frank Macfarlane Burnet, Howard Florey, Peter Doherty, Fred Hollows, Gustav Nossal, even more … (and alternative medical) systems.

Now that’s a different matter! The University that educated me was probably the first in the world to have an officially accredited chiropractic school. I thought (hoped) that it might concentrate on the areas where chiro might possibly be of use, but, alas, the head of the school describes herself as a "paediatric chiropractor", therefore signifying that all hope is lost. I turn my testamurs toward the wall each Friday. I took the (US) national boards with some Australian trained students and wasn’t surprised to hear that all four failed….both sections.  Heck, if I hung out with those guys long enough, even I might doubt TCM’s validity!

Unfortunately, consumer protection against quackery is almost non-existent here. There was an article in Saturday’s paper at http://www.smh.com.au/news/0012/30/review/review3.html which shows that it is difficult to get anyone to do anything even about something as hoary and ridiculous as that perennial icon of quackery, the Rife machine. The TCM students that Andrew met could have come from somewhere as prestigious as RMIT in Melbourne or could have just simply called themselves practitioners. The nutritionist Rosemary Stanton likes to tell about how her late sheep dog was a member of the American Association of Nutritional Consultants, but I know someone who went one better than that and got accreditation for a school of naturopathy where his dog was both the proprietor and teaching staff. He could then have his dog issue him with certificates of competency so that he could hang up a shingle and start treating, say, shingles. Scary, isn’t it? The bad-mannered fascist at "Quintessence of the Loon" http://www.ratbags.com/loon

Response:

Indeed!  One should always make sure their acupuncturist is licensed and has passed the national exam (the latter usually being a requirement for the former)   Also, one should look for someone who actually went to acupuncture school, not an MD or Chiro (tee-hee) who took a 100-200 hour course on where NOT to stick the needles. It takes about 3 years to be a fair to decent acupuncturist, it takes another 2-3 years to learn the herbal system.   For best results, also look for an acupuncturist that has passed the national herbal exam. – Hide quoted text — Show quoted text – Hi, Acupuncture and Herbs work fine for asthma, the only requirement is : Find a State License  acupuncturist. Jay, Are you interested in discussing Acupuncture (TCM) for Asthma? The asthma treatment involves some pretty deep needling. Anybody have experience with it? No, it does NOT require deep needling.  Acupuncture treatments for the 27 varieties of Asthma vary greatly as to the number of and type of points used.   I have treated over 2 dozen asthmatics. Acupuncture AND herbs together are far more effective than one or the other. Anybody here use it for asthma?

Response:

Hi, Acupuncture and Herbs work fine for asthma, the only requirement is : Find a State License  acupuncturist.

– Hide quoted text — Show quoted text – Jay, Are you interested in discussing Acupuncture (TCM) for Asthma? The asthma treatment involves some pretty deep needling.  Anybody have experience with it? No, it does NOT require deep needling.  Acupuncture treatments for the 27 varieties of Asthma vary greatly as to the number of and type of points used.   I have treated over 2 dozen asthmatics.  Acupuncture AND herbs together are far more effective than one or the other. Anybody here use it for asthma?

Response:

Jay, Are you interested in discussing Acupuncture (TCM) for Asthma? – Hide quoted text — Show quoted text – The asthma treatment involves some pretty deep needling.  Anybody have experience with it? No, it does NOT require deep needling.  Acupuncture treatments for the 27 varieties of Asthma vary greatly as to the number of and type of points used.   I have treated over 2 dozen asthmatics.  Acupuncture AND herbs together are far more effective than one or the other. Anybody here use it for asthma?

Response:

- Hide quoted text — Show quoted text – Jan, You poor, dear old lady! Hey Buster,,,,,,,,,who ya callin *old*??  I hope that you aren’t suffering mercury related dementia.   I told you that I retired at age 29, not that I was a millionaire at age 29.  How ever did you conjure up that notion? Really? Well, maybe you did? If so how does that fit with the post made recently saying *What would I do with *another* million? But maybe you did just say retired, I have been wrong before. Jan, I wrote, "besides, what would I do with an extra million dollars ?    For all you know, I could be a (former) dot-com billionaire.

Yeah that’s true, works both ways also. Jan, do you know just how powerful the electrical field generated by a motorcyle motor is?   It is very scary, far worse than a washing machine or dryer.  Hulda would not approve…. What makes you think I go by what Hulda approves of?? Got your wires crossed again?? Making *more* assumptions? Well Jan, according to YOU, you had your amalgams removed per her advice.

That’s where I first learned about it, I also did much research.  You searched your stool for liver flukes.   You used a syncrometer.

Wrong again Andrew.   You used her anti-helmitic herbal formula.   Why stop there?  Why not avoid the electrical field generated by your motorcycle motor?  BTW, do you know how much more emissions per mile are given off by motorcyles compared with automobiles?

Nope, please tell me. Here I offered to let ya blow your hairs be Unlike yourself, my work experience is centered around adults.

Which means? Tell ya what Andrew, forming life long personalities is a very sobing and heavy responsibility. I did it well.   I enjoy what I do more than I would playing "easy-rider".

Good for you! You’ve just started, I loved what I did and I loved when I stopped. I sure do love what I am doing now, it’s a whole lot more than playing   Since you are in Florida, why not stop in and see one the states fine Doctors of Oriental Medicine.   The didactic TCM experience awaits….

I don’t have a need for it now, but if the occasion should arise, I may do just that. I certainly have heard some very good things about TCM. I always maintain an open mind. Now I’m off to the chiropractor, as my neck doesn’t do well with traveling. Jan – Hide quoted text — Show quoted text –

Response:

– Hide quoted text — Show quoted text – Jan, You poor, dear old lady! Hey Buster,,,,,,,,,who ya callin *old*??  I hope that you aren’t suffering mercury related dementia.   I told you that I retired at age 29, not that I was a millionaire at age 29.  How ever did you conjure up that notion? Really? Well, maybe you did? If so how does that fit with the post made recently saying *What would I do with *another* million? But maybe you did just say retired, I have been wrong before.

Jan, I wrote, "besides, what would I do with an extra million dollars ?    For all you know, I could be a (former) dot-com billionaire. Jan, do you know just how powerful the electrical field generated by a motorcyle motor is?   It is very scary, far worse than a washing machine or dryer.  Hulda would not approve…. What makes you think I go by what Hulda approves of?? Got your wires crossed again?? Making *more* assumptions?

Well Jan, according to YOU, you had your amalgams removed per her advice.  You searched your stool for liver flukes.   You used a syncrometer.   You used her anti-helmitic herbal formula.   Why stop there?  Why not avoid the electrical field generated by your motorcycle motor?  BTW, do you know how much more emissions per mile are given off by motorcyles compared with automobiles? Here I offered to let ya blow your hairs be

Unlike yourself, my work experience is centered around adults.   I enjoy what I do more than I would playing "easy-rider".   Since you are in Florida, why not stop in and see one the states fine Doctors of Oriental Medicine.   The didactic TCM experience awaits….

Response:

- Hide quoted text — Show quoted text – Frank, Well, the proof is in the pudding.  You won’t see Atlas/Backcracker here again.  His little charade has expired. As for TCM, I NEVER use the "1.2 Billion Chinese can’t be wrong" nor the "its worked for 3000 years" as proof of TCM effectiveness (although, gosh darn it, that’s more than Chiropractic could ever claim!) As you have noticed, the only a few people on the NG actually have a serious bone of contention with TCM.  Peter B is perhaps the most "anti" Acupuncture person on the group.   This is very understandable given Peter’s geographic situation.  Australia has perhaps the world’s highest co-efficient of Wank in its medical (and alternative medical) systems.   I took the (US) national boards with some Australian trained students and wasn’t surprised to hear that all four failed….both sections.  Heck, if I hung out with those guys long enough, even I might doubt TCM’s validity! The majority of the anti-tcm babble comes from Jan Drew & Kaalga.  I could not be happier than to have both of them opposing me on any serious issue.  Besides, Jan believes in TCM, her desperate pleas are just "payback" for my views on Hulda, Amalgams, and scare tactics.

will remember, I even ask you what TCM was. I have had acupuncture three times and I believe it helped me. I have no experience with TCM. Neither do I have any interest in paybacks. My biggest gripe with you is that all you do is trash people, you won’t even discuss acupuncture. You demand proof from others but have NONE for your own profession. You haven’t learned that you don’t expect from others what you won’t do yourself. You still have much to learn. You constantly get things confused, make assumptions, state things that have never what you believe about amalgams. Even with that subject you continually accused me of saying it was a great public health concern, when I have never said any such thing. I note that you little boys think you have really done something big in fact all you have done is proved that all of you still need to grow up. to be proud of. Jan – Hide quoted text — Show quoted text -Frank, in this crazy, mixed up world we live in, TCM is like the North Star. It is the constant beacon of light & hope that validates the pursuit of Alt-Med. The anti-sceptic light of truth has claimed another chiro-scammer! Perhaps in his next usenet incarnation he’ll choose facts over dogma. Further, I hope he realizes that within the healthcare industry, the stakes are far too high for someone to place the marketing dogma of their trade over the well-being of patients. Andrew, give me a break and spare me your "holier than thou" and pompous attitude. A new poster comes on to this n.g. and does an effective job of smearing another person. As far as what I read, there wasn’t any conclusive proof of anything that was stated. So it essentially comes down to one word against another. Again, I have not seen any concrete black and white evidence- just an R.N. into guitars suddenly coming onto the newsgroup. Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please) and it may not be long where you will have to defend YOUR field again soon in this n.g.. Gloating does not become you Andrew. frank

Response:

Sure, I don’t mind.  I’m a doctor of chiropractic.  I worked in a clinic where acupuncture was done regularly . what is your field, if you don’t mind me asking?

Great, it’s safer than aspirin and will get people off drug dependence (an into an acupuncture addiction . Yes, the problem is that it makes a great ‘complimentary’ service; especially after the person’s ‘underlying’ causes have been identified. also, is it *temporary* relief that these people are experiencing— with no addressing the actual underlying medical problems?

The asthma treatment involves some pretty deep needling.  Anybody have experience with it? Anybody here use it for asthma?

Jay Hafner, DC

Response:

The asthma treatment involves some pretty deep needling.  Anybody have experience with it?

No, it does NOT require deep needling.  Acupuncture treatments for the 27 varieties of Asthma vary greatly as to the number of and type of points used.   I have treated over 2 dozen asthmatics.  Acupuncture AND herbs together are far more effective than one or the other. Anybody here use it for asthma?

Response:

Jan – Hide quoted text — Show quoted text – The anti-sceptic light of truth has claimed another chiro-scammer! Perhaps in his next usenet incarnation he’ll choose facts over dogma. Further, I hope he realizes that within the healthcare industry, the stakes are far too high for someone to place the marketing dogma of their trade over the well-being of patients. Andrew, give me a break and spare me your "holier than thou" and pompous attitude. A new poster comes on to this n.g. and does an effective job of smearing another person. As far as what I read, there wasn’t any conclusive proof of anything that was stated. So it essentially comes down to one word against another. Again, I have not seen any concrete black and white evidence- just an R.N. into guitars suddenly coming onto the newsgroup. Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please) and it may not be long where you will have to defend YOUR field again soon in this n.g.. Gloating does not become you Andrew. frank

Response:

Jan, You poor, dear old lady!

Hey Buster,,,,,,,,,who ya callin *old*??  I hope that you aren’t suffering mercury related dementia.   I told you that I retired at age 29, not that I was a millionaire at age 29.  How ever did you conjure up that notion?

Really? Well, maybe you did? If so how does that fit with the post made recently saying *What would I do with *another* million? But maybe you did just say retired, I have been wrong before. Jan, do you know just how powerful the electrical field generated by a motorcyle motor is?   It is very scary, far worse than a washing machine or dryer.  Hulda would not approve….

What makes you think I go by what Hulda approves of?? Got your wires crossed again?? Making *more* assumptions?  Here I offered to let ya blow your hairs Hang loose man, Jan – Hide quoted text — Show quoted text – your MOUTH gets ahead of your care less what you believe about amalgams.

Response:

Jan, You poor, dear old lady!   I hope that you aren’t suffering mercury related dementia.   I told you that I retired at age 29, not that I was a millionaire at age 29.  How ever did you conjure up that notion? Jan, do you know just how powerful the electrical field generated by a motorcyle motor is?   It is very scary, far worse than a washing machine or dryer.  Hulda would not approve…. your MOUTH gets ahead of your care less what you believe about amalgams.

Response:

In my clinical experience, I’ve seen Acupuncture work great for migraines and back pain (not having seen it used for other things).

what is your field, if you don’t mind me asking? i am not saying that some people (in some instances) do not  find acupuncture effective. there has been much speculation on the placebo effect where acupuncture is concerned. i AM saying that it is an unproven modality. (and possibly underscrutinized by legal entities) also, is it *temporary* relief that these people are experiencing—with no addressing the actual underlying medical problems? Anybody here use it for asthma? Jay H

this could make for an interesting discussion.  "There is no better soporific and sedative than skepticism." -Nietzche interesting "skepticism" critiques: http://www.discord.org/skeptical/Critiques/

Response:

In my clinical experience, I’ve seen Acupuncture work great for migraines and back pain (not having seen it used for other things). Anybody here use it for asthma? Jay H – Hide quoted text — Show quoted text – Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please) yes, he used to use this standard phrase quite often. and, as a matter of fact, MOST skeptical, sci-med types think that acupuncture is junk science. (ones outside of MHA, anyway) two of the more outspoken types would be barrett and randi, actually. and it may not be long where you will have to defend YOUR field again soon in this n.g. nah, prolly not. at least not from me. since andrew kingoff was always far too eager to start spouting insults and not eager enough to actually attempt to seriously debate the topic with me i filtered him last summer. besides, as i recall, andrew was never able to satisfactorily answer ANY of the questions people asked him (even those who believe in and use acupuncture). quite odd that a fellow wouldn’t even want to discuss his own chosen profession of which he is obviously so inordinately proud. at least the others who post here (chiros, nutritionists, whatever) are not so intimidated by skepticism. anyway, i have no desire to attempt to discuss something with posters who get rather psychotic-sounding because i question them.  it is amusing that andrew has never seen how similar he is to those zappers and crackers that he so loudly (and often wrongly) reviles. who knows, though, maybe some other acupuncture proponent will step up to the plate and be able to hold a reasonable discussion…… Gloating does not become you Andrew. well, old habits and all that…..  "There is no better soporific and sedative than skepticism." – Nietzche interesting "skepticism" critiques: http://www.discord.org/skeptical/Critiques/

Response:

The anti-sceptic light of truth has claimed another chiro-scammer! Perhaps in his next usenet incarnation he’ll choose facts over dogma. Further, I hope he realizes that within the healthcare industry, the stakes are far too high for someone to place the marketing dogma of their trade over the well-being of patients.

Response:

Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please)

yes, he used to use this standard phrase quite often. and, as a matter of fact, MOST skeptical, sci-med types think that acupuncture is junk science. (ones outside of MHA, anyway) two of the more outspoken types would be barrett and randi, actually. and it may not be long where you will have to defend YOUR field again soon in this n.g.

nah, prolly not. at least not from me. since andrew kingoff was always far too eager to start spouting insults and not eager enough to actually attempt to seriously debate the topic with me i filtered him last summer. besides, as i recall, andrew was never able to satisfactorily answer ANY of the questions people asked him (even those who believe in and use acupuncture). quite odd that a fellow wouldn’t even want to discuss his own chosen profession of which he is obviously so inordinately proud. at least the others who post here (chiros, nutritionists, whatever) are not so intimidated by skepticism. anyway, i have no desire to attempt to discuss something with posters who get rather psychotic-sounding because i question them.  it is amusing that andrew has never seen how similar he is to those zappers and crackers that he so loudly (and often wrongly) reviles. who knows, though, maybe some other acupuncture proponent will step up to the plate and be able to hold a reasonable discussion…… Gloating does not become you Andrew.

well, old habits and all that…..  "There is no better soporific and sedative than skepticism." -Nietzche interesting "skepticism" critiques: http://www.discord.org/skeptical/Critiques/

Response:

The anti-sceptic light of truth has claimed another chiro-scammer! Perhaps in his next usenet incarnation he’ll choose facts over dogma. Further, I hope he realizes that within the healthcare industry, the stakes are far too high for someone to place the marketing dogma of their trade over the well-being of patients.

Andrew, give me a break and spare me your "holier than thou" and pompous attitude. A new poster comes on to this n.g. and does an effective job of smearing another person. As far as what I read, there wasn’t any conclusive proof of anything that was stated. So it essentially comes down to one word against another. Again, I have not seen any concrete black and white evidence- just an R.N. into guitars suddenly coming onto the newsgroup. Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please) and it may not be long where you will have to defend YOUR field again soon in this n.g.. Gloating does not become you Andrew. frank

Response:

Frank, Well, the proof is in the pudding.  You won’t see Atlas/Backcracker here again.  His little charade has expired. As for TCM, I NEVER use the "1.2 Billion Chinese can’t be wrong" nor the "its worked for 3000 years" as proof of TCM effectiveness (although, gosh darn it, that’s more than Chiropractic could ever claim!) As you have noticed, the only a few people on the NG actually have a serious bone of contention with TCM.  Peter B is perhaps the most "anti" Acupuncture person on the group.   This is very understandable given Peter’s geographic situation.  Australia has perhaps the world’s highest co-efficient of Wank in its medical (and alternative medical) systems.   I took the (US) national boards with some Australian trained students and wasn’t surprised to hear that all four failed….both sections.  Heck, if I hung out with those guys long enough, even I might doubt TCM’s validity! The majority of the anti-tcm babble comes from Jan Drew & Kaalga.  I could not be happier than to have both of them opposing me on any serious issue.  Besides, Jan believes in TCM, her desperate pleas are just "payback" for my views on Hulda, Amalgams, and scare tactics. Frank, in this crazy, mixed up world we live in, TCM is like the North Star. It is the constant beacon of light & hope that validates the pursuit of Alt-Med. – Hide quoted text — Show quoted text – The anti-sceptic light of truth has claimed another chiro-scammer! Perhaps in his next usenet incarnation he’ll choose facts over dogma. Further, I hope he realizes that within the healthcare industry, the stakes are far too high for someone to place the marketing dogma of their trade over the well-being of patients. Andrew, give me a break and spare me your "holier than thou" and pompous attitude. A new poster comes on to this n.g. and does an effective job of smearing another person. As far as what I read, there wasn’t any conclusive proof of anything that was stated. So it essentially comes down to one word against another. Again, I have not seen any concrete black and white evidence- just an R.N. into guitars suddenly coming onto the newsgroup. Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please) and it may not be long where you will have to defend YOUR field again soon in this n.g.. Gloating does not become you Andrew. frank

Response:

Question:

Jan, Yes, indeed, many other factors are involved.  While bedside manner is important, it is easier to verify licensing and other credentials. Also make sure that your acupuncturist is didactic.  You don’t want somebody who clings to the bronze age (literal) belief in Qi. – Hide quoted text — Show quoted text – Indeed!  One should always make sure their acupuncturist is licensed and has passed the national exam (the latter usually being a requirement for the former)   Also, one should look for someone who actually went to acupuncture school, not an MD or Chiro (tee-hee) who took a 100-200 hour course on where NOT to stick the needles. It takes about 3 years to be a fair to decent acupuncturist, it takes another 2-3 years to learn the herbal system.   For best results, also look for an acupuncturist that has passed the national herbal exam. And after that you might want to learn what kind of person he/she is? Judgment based of how they treat other people.  Licensing and schooling isn’t the all in all, many other things to be considered. Jan

Response:

Needles deaths?  From TCM?  What are you babbling about? Egad!  The situation is worse than I had imagined! Yeah, it seems to concern you much more than all those needless Jan

Response:

Egad!  The situation is worse than I had imagined!

Yeah, it seems to concern you much more than all those needless Jan

Response:

Hi, Acupuncture and Herbs work fine for asthma,

i have seen some literature that supports the part of your claim where herbs are concerned, but none for the part about acupuncture. can you point out any gold-standard studies that support the idea of using acupuncture to treat asthma? are there even any published collected case studies that are not peer reviewed that support this? i have read several that do NOT support its use. anyway, how DOES acupuncture affect the lungs according to any current replicated studies of the modality? (other than causing pneumothorax if used incorrectly?) the only requirement is : Find a State License  acupuncturist.

good idea. or perhaps it would be a better idea to only use acupuncture  in conjunction with a regular MD’s supervision/inclusion in the treatment process. oddly enough, i have read that many folks are reluctant to tell their regular MDs that they have used or do currently use acupuncture. anyone considering using acupuncture for asthma may want to read thru some of the following pages: http://asthma.about.com/health/asthma/library/weekly/aa080299.htm http://www.update-software.com/abstracts/ab000008.htm http://www.icmart.org/icmart00/abstract/abst33.html  "There is no better soporific and sedative than skepticism." -Nietzche interesting "skepticism" critiques: http://www.discord.org/skeptical/Critiques/

Response:

- Hide quoted text — Show quoted text – As you have noticed, the only a few people on the NG actually have a serious bone of contention with TCM.  Peter B is perhaps the most "anti" Acupuncture person on the group. Hey – I’m so skeptical I that I doubt that Rene Descartes could be sure that he could think. What I have found with acupuncture is that the proponents make such vague claims about what they can do and how they can do it that it’s a bit hard to get worked up about it. I get much the same feeling when I go to the Mind Body Wallet Festival here and see the crystal wavers, qi-gongers and vegie sandwich makers. I’m glad, though, that I didn’t go to Jasmuheen’s lecture at the last festival because she is now featuring in her act the people she has killed. I would have needed lots of bail money. This is very understandable given Peter’s geographic situation.  Australia has perhaps the world’s highest co-efficient of Wank in its medical Frank Macfarlane Burnet, Howard Florey, Peter Doherty, Fred Hollows, Gustav Nossal, even more … (and alternative medical) systems. Now that’s a different matter! The University that educated me was probably the first in the world to have an officially accredited chiropractic school. I thought (hoped) that it might concentrate on the areas where chiro might possibly be of use, but, alas, the head of the school describes herself as a "paediatric chiropractor", therefore signifying that all hope is lost. I turn my testamurs toward the wall each Friday. I took the (US) national boards with some Australian trained students and wasn’t surprised to hear that all four failed….both sections.  Heck, if I hung out with those guys long enough, even I might doubt TCM’s validity! Unfortunately, consumer protection against quackery is almost non-existent here. There was an article in Saturday’s paper at http://www.smh.com.au/news/0012/30/review/review3.html which shows that it is difficult to get anyone to do anything even about something as hoary and ridiculous as that perennial icon of quackery, the Rife machine. The TCM students that Andrew met could have come from somewhere as prestigious as RMIT in Melbourne or could have just simply called themselves practitioners. The nutritionist Rosemary Stanton likes to tell about how her late sheep dog was a member of the American Association of Nutritional Consultants, but I know someone who went one better than that and got accreditation for a school of naturopathy where his dog was both the proprietor and teaching staff. He could then have his dog issue him with certificates of competency so that he could hang up a shingle and start treating, say, shingles. Scary, isn’t it?

Yep, *almost* as scary as all the needless deaths each year. Jan – Hide quoted text — Show quoted text – The bad-mannered fascist at "Quintessence of the Loon" http://www.ratbags.com/loon

Response:

Indeed!  One should always make sure their acupuncturist is licensed and has passed the national exam (the latter usually being a requirement for the former)   Also, one should look for someone who actually went to acupuncture school, not an MD or Chiro (tee-hee) who took a 100-200 hour course on where NOT to stick the needles. It takes about 3 years to be a fair to decent acupuncturist, it takes another 2-3 years to learn the herbal system.   For best results, also look for an acupuncturist that has passed the national herbal exam.

And after that you might want to learn what kind of person he/she is? Judgment based of how they treat other people.  Licensing and schooling isn’t the all in all, many other things to be considered. Jan

Response:

As you have noticed, the only a few people on the NG actually have a serious bone of contention with TCM.  Peter B is perhaps the most "anti" Acupuncture person on the group.

Hey – I’m so skeptical I that I doubt that Rene Descartes could be sure that he could think. What I have found with acupuncture is that the proponents make such vague claims about what they can do and how they can do it that it’s a bit hard to get worked up about it. I get much the same feeling when I go to the Mind Body Wallet Festival here and see the crystal wavers, qi-gongers and vegie sandwich makers. I’m glad, though, that I didn’t go to Jasmuheen’s lecture at the last festival because she is now featuring in her act the people she has killed. I would have needed lots of bail money. This is very understandable given Peter’s geographic situation.  Australia has perhaps the world’s highest co-efficient of Wank in its medical

Frank Macfarlane Burnet, Howard Florey, Peter Doherty, Fred Hollows, Gustav Nossal, even more … (and alternative medical) systems.

Now that’s a different matter! The University that educated me was probably the first in the world to have an officially accredited chiropractic school. I thought (hoped) that it might concentrate on the areas where chiro might possibly be of use, but, alas, the head of the school describes herself as a "paediatric chiropractor", therefore signifying that all hope is lost. I turn my testamurs toward the wall each Friday. I took the (US) national boards with some Australian trained students and wasn’t surprised to hear that all four failed….both sections.  Heck, if I hung out with those guys long enough, even I might doubt TCM’s validity!

Unfortunately, consumer protection against quackery is almost non-existent here. There was an article in Saturday’s paper at http://www.smh.com.au/news/0012/30/review/review3.html which shows that it is difficult to get anyone to do anything even about something as hoary and ridiculous as that perennial icon of quackery, the Rife machine. The TCM students that Andrew met could have come from somewhere as prestigious as RMIT in Melbourne or could have just simply called themselves practitioners. The nutritionist Rosemary Stanton likes to tell about how her late sheep dog was a member of the American Association of Nutritional Consultants, but I know someone who went one better than that and got accreditation for a school of naturopathy where his dog was both the proprietor and teaching staff. He could then have his dog issue him with certificates of competency so that he could hang up a shingle and start treating, say, shingles. Scary, isn’t it? The bad-mannered fascist at "Quintessence of the Loon" http://www.ratbags.com/loon

Response:

Egad!  The situation is worse than I had imagined! – Hide quoted text — Show quoted text – This is very understandable given Peter’s geographic situation.  Australia has perhaps the world’s highest co-efficient of Wank in its medical Frank Macfarlane Burnet, Howard Florey, Peter Doherty, Fred Hollows, Gustav Nossal, even more … (and alternative medical) systems. Now that’s a different matter! The University that educated me was probably the first in the world to have an officially accredited chiropractic school. I thought (hoped) that it might concentrate on the areas where chiro might possibly be of use, but, alas, the head of the school describes herself as a "paediatric chiropractor", therefore signifying that all hope is lost. I turn my testamurs toward the wall each Friday. I took the (US) national boards with some Australian trained students and wasn’t surprised to hear that all four failed….both sections.  Heck, if I hung out with those guys long enough, even I might doubt TCM’s validity! Unfortunately, consumer protection against quackery is almost non-existent here. There was an article in Saturday’s paper at http://www.smh.com.au/news/0012/30/review/review3.html which shows that it is difficult to get anyone to do anything even about something as hoary and ridiculous as that perennial icon of quackery, the Rife machine. The TCM students that Andrew met could have come from somewhere as prestigious as RMIT in Melbourne or could have just simply called themselves practitioners. The nutritionist Rosemary Stanton likes to tell about how her late sheep dog was a member of the American Association of Nutritional Consultants, but I know someone who went one better than that and got accreditation for a school of naturopathy where his dog was both the proprietor and teaching staff. He could then have his dog issue him with certificates of competency so that he could hang up a shingle and start treating, say, shingles. Scary, isn’t it? The bad-mannered fascist at "Quintessence of the Loon" http://www.ratbags.com/loon

Response:

Indeed!  One should always make sure their acupuncturist is licensed and has passed the national exam (the latter usually being a requirement for the former)   Also, one should look for someone who actually went to acupuncture school, not an MD or Chiro (tee-hee) who took a 100-200 hour course on where NOT to stick the needles. It takes about 3 years to be a fair to decent acupuncturist, it takes another 2-3 years to learn the herbal system.   For best results, also look for an acupuncturist that has passed the national herbal exam. – Hide quoted text — Show quoted text – Hi, Acupuncture and Herbs work fine for asthma, the only requirement is : Find a State License  acupuncturist. Jay, Are you interested in discussing Acupuncture (TCM) for Asthma? The asthma treatment involves some pretty deep needling. Anybody have experience with it? No, it does NOT require deep needling.  Acupuncture treatments for the 27 varieties of Asthma vary greatly as to the number of and type of points used.   I have treated over 2 dozen asthmatics. Acupuncture AND herbs together are far more effective than one or the other. Anybody here use it for asthma?

Response:

Jay, Are you interested in discussing Acupuncture (TCM) for Asthma? – Hide quoted text — Show quoted text – The asthma treatment involves some pretty deep needling.  Anybody have experience with it? No, it does NOT require deep needling.  Acupuncture treatments for the 27 varieties of Asthma vary greatly as to the number of and type of points used.   I have treated over 2 dozen asthmatics.  Acupuncture AND herbs together are far more effective than one or the other. Anybody here use it for asthma?

Response:

Hi, Acupuncture and Herbs work fine for asthma, the only requirement is : Find a State License  acupuncturist.

– Hide quoted text — Show quoted text – Jay, Are you interested in discussing Acupuncture (TCM) for Asthma? The asthma treatment involves some pretty deep needling.  Anybody have experience with it? No, it does NOT require deep needling.  Acupuncture treatments for the 27 varieties of Asthma vary greatly as to the number of and type of points used.   I have treated over 2 dozen asthmatics.  Acupuncture AND herbs together are far more effective than one or the other. Anybody here use it for asthma?

Response:

- Hide quoted text — Show quoted text – Jan, You poor, dear old lady! Hey Buster,,,,,,,,,who ya callin *old*??  I hope that you aren’t suffering mercury related dementia.   I told you that I retired at age 29, not that I was a millionaire at age 29.  How ever did you conjure up that notion? Really? Well, maybe you did? If so how does that fit with the post made recently saying *What would I do with *another* million? But maybe you did just say retired, I have been wrong before. Jan, I wrote, "besides, what would I do with an extra million dollars ?    For all you know, I could be a (former) dot-com billionaire.

Yeah that’s true, works both ways also. Jan, do you know just how powerful the electrical field generated by a motorcyle motor is?   It is very scary, far worse than a washing machine or dryer.  Hulda would not approve…. What makes you think I go by what Hulda approves of?? Got your wires crossed again?? Making *more* assumptions? Well Jan, according to YOU, you had your amalgams removed per her advice.

That’s where I first learned about it, I also did much research.  You searched your stool for liver flukes.   You used a syncrometer.

Wrong again Andrew.   You used her anti-helmitic herbal formula.   Why stop there?  Why not avoid the electrical field generated by your motorcycle motor?  BTW, do you know how much more emissions per mile are given off by motorcyles compared with automobiles?

Nope, please tell me. Here I offered to let ya blow your hairs be Unlike yourself, my work experience is centered around adults.

Which means? Tell ya what Andrew, forming life long personalities is a very sobing and heavy responsibility. I did it well.   I enjoy what I do more than I would playing "easy-rider".

Good for you! You’ve just started, I loved what I did and I loved when I stopped. I sure do love what I am doing now, it’s a whole lot more than playing   Since you are in Florida, why not stop in and see one the states fine Doctors of Oriental Medicine.   The didactic TCM experience awaits….

I don’t have a need for it now, but if the occasion should arise, I may do just that. I certainly have heard some very good things about TCM. I always maintain an open mind. Now I’m off to the chiropractor, as my neck doesn’t do well with traveling. Jan – Hide quoted text — Show quoted text –

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– Hide quoted text — Show quoted text – Jan, You poor, dear old lady! Hey Buster,,,,,,,,,who ya callin *old*??  I hope that you aren’t suffering mercury related dementia.   I told you that I retired at age 29, not that I was a millionaire at age 29.  How ever did you conjure up that notion? Really? Well, maybe you did? If so how does that fit with the post made recently saying *What would I do with *another* million? But maybe you did just say retired, I have been wrong before.

Jan, I wrote, "besides, what would I do with an extra million dollars ?    For all you know, I could be a (former) dot-com billionaire. Jan, do you know just how powerful the electrical field generated by a motorcyle motor is?   It is very scary, far worse than a washing machine or dryer.  Hulda would not approve…. What makes you think I go by what Hulda approves of?? Got your wires crossed again?? Making *more* assumptions?

Well Jan, according to YOU, you had your amalgams removed per her advice.  You searched your stool for liver flukes.   You used a syncrometer.   You used her anti-helmitic herbal formula.   Why stop there?  Why not avoid the electrical field generated by your motorcycle motor?  BTW, do you know how much more emissions per mile are given off by motorcyles compared with automobiles? Here I offered to let ya blow your hairs be

Unlike yourself, my work experience is centered around adults.   I enjoy what I do more than I would playing "easy-rider".   Since you are in Florida, why not stop in and see one the states fine Doctors of Oriental Medicine.   The didactic TCM experience awaits….

Response:

Jan, You poor, dear old lady!

Hey Buster,,,,,,,,,who ya callin *old*??  I hope that you aren’t suffering mercury related dementia.   I told you that I retired at age 29, not that I was a millionaire at age 29.  How ever did you conjure up that notion?

Really? Well, maybe you did? If so how does that fit with the post made recently saying *What would I do with *another* million? But maybe you did just say retired, I have been wrong before. Jan, do you know just how powerful the electrical field generated by a motorcyle motor is?   It is very scary, far worse than a washing machine or dryer.  Hulda would not approve….

What makes you think I go by what Hulda approves of?? Got your wires crossed again?? Making *more* assumptions?  Here I offered to let ya blow your hairs Hang loose man, Jan – Hide quoted text — Show quoted text – your MOUTH gets ahead of your care less what you believe about amalgams.

Response:

Jan, You poor, dear old lady!   I hope that you aren’t suffering mercury related dementia.   I told you that I retired at age 29, not that I was a millionaire at age 29.  How ever did you conjure up that notion? Jan, do you know just how powerful the electrical field generated by a motorcyle motor is?   It is very scary, far worse than a washing machine or dryer.  Hulda would not approve…. your MOUTH gets ahead of your care less what you believe about amalgams.

Response:

The asthma treatment involves some pretty deep needling.  Anybody have experience with it?

No, it does NOT require deep needling.  Acupuncture treatments for the 27 varieties of Asthma vary greatly as to the number of and type of points used.   I have treated over 2 dozen asthmatics.  Acupuncture AND herbs together are far more effective than one or the other. Anybody here use it for asthma?

Response:

Jan – Hide quoted text — Show quoted text – The anti-sceptic light of truth has claimed another chiro-scammer! Perhaps in his next usenet incarnation he’ll choose facts over dogma. Further, I hope he realizes that within the healthcare industry, the stakes are far too high for someone to place the marketing dogma of their trade over the well-being of patients. Andrew, give me a break and spare me your "holier than thou" and pompous attitude. A new poster comes on to this n.g. and does an effective job of smearing another person. As far as what I read, there wasn’t any conclusive proof of anything that was stated. So it essentially comes down to one word against another. Again, I have not seen any concrete black and white evidence- just an R.N. into guitars suddenly coming onto the newsgroup. Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please) and it may not be long where you will have to defend YOUR field again soon in this n.g.. Gloating does not become you Andrew. frank

Response:

Sure, I don’t mind.  I’m a doctor of chiropractic.  I worked in a clinic where acupuncture was done regularly . what is your field, if you don’t mind me asking?

Great, it’s safer than aspirin and will get people off drug dependence (an into an acupuncture addiction . Yes, the problem is that it makes a great ‘complimentary’ service; especially after the person’s ‘underlying’ causes have been identified. also, is it *temporary* relief that these people are experiencing— with no addressing the actual underlying medical problems?

The asthma treatment involves some pretty deep needling.  Anybody have experience with it? Anybody here use it for asthma?

Jay Hafner, DC

Response:

Frank, Well, the proof is in the pudding.  You won’t see Atlas/Backcracker here again.  His little charade has expired. As for TCM, I NEVER use the "1.2 Billion Chinese can’t be wrong" nor the "its worked for 3000 years" as proof of TCM effectiveness (although, gosh darn it, that’s more than Chiropractic could ever claim!) As you have noticed, the only a few people on the NG actually have a serious bone of contention with TCM.  Peter B is perhaps the most "anti" Acupuncture person on the group.   This is very understandable given Peter’s geographic situation.  Australia has perhaps the world’s highest co-efficient of Wank in its medical (and alternative medical) systems.   I took the (US) national boards with some Australian trained students and wasn’t surprised to hear that all four failed….both sections.  Heck, if I hung out with those guys long enough, even I might doubt TCM’s validity! The majority of the anti-tcm babble comes from Jan Drew & Kaalga.  I could not be happier than to have both of them opposing me on any serious issue.  Besides, Jan believes in TCM, her desperate pleas are just "payback" for my views on Hulda, Amalgams, and scare tactics. Frank, in this crazy, mixed up world we live in, TCM is like the North Star. It is the constant beacon of light & hope that validates the pursuit of Alt-Med. – Hide quoted text — Show quoted text – The anti-sceptic light of truth has claimed another chiro-scammer! Perhaps in his next usenet incarnation he’ll choose facts over dogma. Further, I hope he realizes that within the healthcare industry, the stakes are far too high for someone to place the marketing dogma of their trade over the well-being of patients. Andrew, give me a break and spare me your "holier than thou" and pompous attitude. A new poster comes on to this n.g. and does an effective job of smearing another person. As far as what I read, there wasn’t any conclusive proof of anything that was stated. So it essentially comes down to one word against another. Again, I have not seen any concrete black and white evidence- just an R.N. into guitars suddenly coming onto the newsgroup. Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please) and it may not be long where you will have to defend YOUR field again soon in this n.g.. Gloating does not become you Andrew. frank

Response:

- Hide quoted text — Show quoted text – Frank, Well, the proof is in the pudding.  You won’t see Atlas/Backcracker here again.  His little charade has expired. As for TCM, I NEVER use the "1.2 Billion Chinese can’t be wrong" nor the "its worked for 3000 years" as proof of TCM effectiveness (although, gosh darn it, that’s more than Chiropractic could ever claim!) As you have noticed, the only a few people on the NG actually have a serious bone of contention with TCM.  Peter B is perhaps the most "anti" Acupuncture person on the group.   This is very understandable given Peter’s geographic situation.  Australia has perhaps the world’s highest co-efficient of Wank in its medical (and alternative medical) systems.   I took the (US) national boards with some Australian trained students and wasn’t surprised to hear that all four failed….both sections.  Heck, if I hung out with those guys long enough, even I might doubt TCM’s validity! The majority of the anti-tcm babble comes from Jan Drew & Kaalga.  I could not be happier than to have both of them opposing me on any serious issue.  Besides, Jan believes in TCM, her desperate pleas are just "payback" for my views on Hulda, Amalgams, and scare tactics.

will remember, I even ask you what TCM was. I have had acupuncture three times and I believe it helped me. I have no experience with TCM. Neither do I have any interest in paybacks. My biggest gripe with you is that all you do is trash people, you won’t even discuss acupuncture. You demand proof from others but have NONE for your own profession. You haven’t learned that you don’t expect from others what you won’t do yourself. You still have much to learn. You constantly get things confused, make assumptions, state things that have never what you believe about amalgams. Even with that subject you continually accused me of saying it was a great public health concern, when I have never said any such thing. I note that you little boys think you have really done something big in fact all you have done is proved that all of you still need to grow up. to be proud of. Jan – Hide quoted text — Show quoted text -Frank, in this crazy, mixed up world we live in, TCM is like the North Star. It is the constant beacon of light & hope that validates the pursuit of Alt-Med. The anti-sceptic light of truth has claimed another chiro-scammer! Perhaps in his next usenet incarnation he’ll choose facts over dogma. Further, I hope he realizes that within the healthcare industry, the stakes are far too high for someone to place the marketing dogma of their trade over the well-being of patients. Andrew, give me a break and spare me your "holier than thou" and pompous attitude. A new poster comes on to this n.g. and does an effective job of smearing another person. As far as what I read, there wasn’t any conclusive proof of anything that was stated. So it essentially comes down to one word against another. Again, I have not seen any concrete black and white evidence- just an R.N. into guitars suddenly coming onto the newsgroup. Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please) and it may not be long where you will have to defend YOUR field again soon in this n.g.. Gloating does not become you Andrew. frank

Response:

In my clinical experience, I’ve seen Acupuncture work great for migraines and back pain (not having seen it used for other things).

what is your field, if you don’t mind me asking? i am not saying that some people (in some instances) do not  find acupuncture effective. there has been much speculation on the placebo effect where acupuncture is concerned. i AM saying that it is an unproven modality. (and possibly underscrutinized by legal entities) also, is it *temporary* relief that these people are experiencing—with no addressing the actual underlying medical problems? Anybody here use it for asthma? Jay H

this could make for an interesting discussion.  "There is no better soporific and sedative than skepticism." -Nietzche interesting "skepticism" critiques: http://www.discord.org/skeptical/Critiques/

Response:

The anti-sceptic light of truth has claimed another chiro-scammer! Perhaps in his next usenet incarnation he’ll choose facts over dogma. Further, I hope he realizes that within the healthcare industry, the stakes are far too high for someone to place the marketing dogma of their trade over the well-being of patients.

Andrew, give me a break and spare me your "holier than thou" and pompous attitude. A new poster comes on to this n.g. and does an effective job of smearing another person. As far as what I read, there wasn’t any conclusive proof of anything that was stated. So it essentially comes down to one word against another. Again, I have not seen any concrete black and white evidence- just an R.N. into guitars suddenly coming onto the newsgroup. Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please) and it may not be long where you will have to defend YOUR field again soon in this n.g.. Gloating does not become you Andrew. frank

Response:

In my clinical experience, I’ve seen Acupuncture work great for migraines and back pain (not having seen it used for other things). Anybody here use it for asthma? Jay H – Hide quoted text — Show quoted text – Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please) yes, he used to use this standard phrase quite often. and, as a matter of fact, MOST skeptical, sci-med types think that acupuncture is junk science. (ones outside of MHA, anyway) two of the more outspoken types would be barrett and randi, actually. and it may not be long where you will have to defend YOUR field again soon in this n.g. nah, prolly not. at least not from me. since andrew kingoff was always far too eager to start spouting insults and not eager enough to actually attempt to seriously debate the topic with me i filtered him last summer. besides, as i recall, andrew was never able to satisfactorily answer ANY of the questions people asked him (even those who believe in and use acupuncture). quite odd that a fellow wouldn’t even want to discuss his own chosen profession of which he is obviously so inordinately proud. at least the others who post here (chiros, nutritionists, whatever) are not so intimidated by skepticism. anyway, i have no desire to attempt to discuss something with posters who get rather psychotic-sounding because i question them.  it is amusing that andrew has never seen how similar he is to those zappers and crackers that he so loudly (and often wrongly) reviles. who knows, though, maybe some other acupuncture proponent will step up to the plate and be able to hold a reasonable discussion…… Gloating does not become you Andrew. well, old habits and all that…..  "There is no better soporific and sedative than skepticism." – Nietzche interesting "skepticism" critiques: http://www.discord.org/skeptical/Critiques/

Response:

Sorry to break the news to you- many people think that acupuncture is junk science (spare me the "tcm has been around 3 zillion yrs" spiel please)

yes, he used to use this standard phrase quite often. and, as a matter of fact, MOST skeptical, sci-med types think that acupuncture is junk science. (ones outside of MHA, anyway) two of the more outspoken types would be barrett and randi, actually. and it may not be long where you will have to defend YOUR field again soon in this n.g.

nah, prolly not. at least not from me. since andrew kingoff was always far too eager to start spouting insults and not eager enough to actually attempt to seriously debate the topic with me i filtered him last summer. besides, as i recall, andrew was never able to satisfactorily answer ANY of the questions people asked him (even those who believe in and use acupuncture). quite odd that a fellow wouldn’t even want to discuss his own chosen profession of which he is obviously so inordinately proud. at least the others who post here (chiros, nutritionists, whatever) are not so intimidated by skepticism. anyway, i have no desire to attempt to discuss something with posters who get rather psychotic-sounding because i question them.  it is amusing that andrew has never seen how similar he is to those zappers and crackers that he so loudly (and often wrongly) reviles. who knows, though, maybe some other acupuncture proponent will step up to the plate and be able to hold a reasonable discussion…… Gloating does not become you Andrew.

well, old habits and all that…..  "There is no better soporific and sedative than skepticism." -Nietzche interesting "skepticism" critiques: http://www.discord.org/skeptical/Critiques/

Response:

The anti-sceptic light of truth has claimed another chiro-scammer! Perhaps in his next usenet incarnation he’ll choose facts over dogma. Further, I hope he realizes that within the healthcare industry, the stakes are far too high for someone to place the marketing dogma of their trade over the well-being of patients.

Response:

Question:

How would someone get involved in a clinical trial of nuvance? * Sent from AltaVista http://www.altavista.com Where you can also find related Web Pages, Images, Audios, Videos, News, and Shopping.  Smart is Beautiful

Response:

How would someone get involved in a clinical trial of nuvance?

Call the Immunex Professional Services Department at 800-IMMUNEX. Joan

Response:

I saw something on the news about a new drug that you take only once a week or something, but I was in the other room when they said what it was called. Anyone know anything about this new drug?  (It might start with an N)

Response:

I saw something on the news about a new drug that you take only once a week or something, but I was in the other room when they said what it was called. Anyone know anything about this new drug?  (It might start with an N)

It’s Nuvance, and it’s still in clinical trials (that is, not generally available). Joan

Response:

I saw something on the news about a new drug that you take only once a week or something, but I was in the other room when they said what it was called. Anyone know anything about this new drug?  (It might start with an N) It’s Nuvance, and it’s still in clinical trials (that is, not generally available). Joan

http://www.pslgroup.com/dg/138DD2.htm Nuvance Stabilizes Lung Function In Asthma Patients MADRID, SPAIN — October 13, 1999 — Nuvance

Question:

The link that you provide unfortunately did not have accurate USA prescribing information. I would suggest that you check drug company’s web site for this information. http://www.astrazeneca-us.com/cgi-bin/az_pi.cgi?product=pulmicort_th&…

Response:

schreibt: Here’s more information. Fluticasone propionate: Pharmacological & Clinical Properties For comparison to Pulmicort [Budesonide] See:  #20, #21, #22, and #23 http://www.glaxowellcome.ch/gw/dt/pulmo/fluticasone/index.html Hope that answers your questions.

ask you the wolf to be the shepheard? As all european pharmaceuticals  meds. etc knews, there is an old struggle between AstraZeneca and GlaxoWellcome and i cant believe, astra had ever accepted, Budesonid would not be as strong as flixotide and both twice as strong than BDP (Glaxos old shit).  As you say is the lung deposed part of corticosteroids causal for systhemic effects, and surprisingly its for flixotide a little bit more than for BUD. First part effect is only a small part of pharmacology in a human body and i would be a little restrictive with recommandations of flixotide for osteoporose etc. Lothar

Response:

How does this compare with Flovent220? Are the strengths relatively the same? Fluticasone propionate has a potency approximately twice that of beclomethasone and budesonide when given through comparable devices.

So they are saying she would have to take twice as much Pulmicort to get the same effect?  She is currently on Flovent 220, 4 puffs 2x daily as well as oral.  We would like to find something that gets the oral dose down.

Response:

You can use Pulmicort Suspension for nebulizer (in Germany allowed is a max. Dosis of 2 x 2000

Question:

I went to pick up my ventolin inhaler at the drug store today (not my usual drug store, mind you) and as I was paying, the pharmacist told me I shouldn’t have to use more than 2 puffs per week.  Now maybe there’s some new miracle drug out there that I haven’t heard about, but at this time a year I’m lucky if I can get away with 2 puffs per day!!  Nobody else has ever told me this… I’m on Pulmicort twice daily and ventolin as needed (usually one or two puffs per day in the winter).

Response:

I went to pick up my ventolin inhaler at the drug store today (not my usual drug store, mind you) and as I was paying, the pharmacist told me I shouldn’t have to use more than 2 puffs per week.  Now maybe there’s some new miracle drug out there that I haven’t heard about, but at this time a year I’m lucky if I can get away with 2 puffs per day!!  Nobody else has ever told me this… I’m on Pulmicort twice daily and ventolin as needed (usually one or two puffs per day in the winter).

Current asthma guidelines (US) indicate that for asthmatics with Mild Asthma who are taking albuterol as their only asthma drug, use more than twice a week indicates the need for adding long acting preventor meds like inhaled corticosteroids. However for those taking inhaled corticosteroids, use of albuterol more than once/day indicates the possible need to increase the corticosteroids; however albuterol can be used for exercise as needed. Perhaps the pharmacist didn’t realize you were already using inhaled corticosteroids (Pulmicort). Check with your doctor if concerned. Here’s a link to the asthma treatment guidlines posted at the JAMA site. http://www.ama-assn.org/special/asthma/treatmnt/updates/stepwise.htm Treatment Updates  A Stepwise Approach to Pharmacologic Therapy

Response:

I went to pick up my ventolin inhaler at the drug store today (not my usual drug store, mind you) and as I was paying, the pharmacist told me I shouldn’t have to use more than 2 puffs per week.  Now maybe there’s some new miracle drug out there that I haven’t heard about, but at this time a year I’m lucky if I can get away with 2 puffs per day!!  Nobody else has ever told me this…

Well, my first question would be why he felt this was accurate information. Then, I would have referred him to any number of references on the variability of asthma symptoms. Chris Owens

Response:

isn’t 2 puffs only one dose? so then shouldn’t it be maybe two DOSES a week? admittedly I use mine about twice that but that’s before exercise as a preventive, which does not count. I went to pick up my ventolin inhaler at the drug store today (not my usual drug store, mind you) and as I was paying, the pharmacist told me I shouldn’t have to use more than 2 puffs per week.  Now maybe there’s some new miracle drug out there that I haven’t heard about, but at this time a year I’m lucky if I can get away with 2 puffs per day!!  Nobody else has ever told me this… I’m on Pulmicort twice daily and ventolin as needed (usually one or two puffs per day in the winter).

– Emily …delete SPAMSTOP to email.

Response:

Question:

My dr. and pharmacy haven’t heard of singulair — am I to assume it’s not available in Canada yet?  Does anyone know when it might be?

Response:

My dr. and pharmacy haven’t heard of singulair — am I to assume it’s not available in Canada yet?  Does anyone know when it might be?

Singulair is a Canadian discovered drug, now available in 17 countries, but not Canada. It supposed to be available there soon. See: http://www.newswire.ca/releases/April1998/23/c5313.html Excerpts: " MONTREAL, April 23 /CNW/ – Two Canadian scientists have been awarded the Merck Directors Award, the company’s highest honour, by the Board of Directors of Merck & Co., parent company of Merck Frosst Canada Inc., for their historic contribution to pharmaceutical research.     Robert J. Zamboni, PhD, Executive Director of Medicinal Chemistry and Marc Labelle, PhD, Director of Medicinal Chemistry, both from Merck Frosst, were honoured for their roles in the discovery and development of SINGULAIR(TM) (montelukast sodium) for the treatment of asthma.  SINGULAIR(TM) is the result of two decades of pioneering work of new asthma treatment at Canada’s largest bio-medical research facility, the Merck Frosst Centre for Therapeutic Research in Montreal. The “monte” in the product’s generic name (montelukast sodium) recognizes Montreal, the city where it was discovered. This drug is expected to be available for use in Canada by asthma patients in the near future. Montelukast sodium is now approved for use in 17 countries around the world." For further information: Claudine Renauld, Manager, Public Affairs,  Merck Frosst Canada Inc., (514) 428-3455, Adele MacLean/Laurel Swartz,  NATIONAL PharmaCom, (416) 586-0180 Ellis

Response:

Question:

That’s the spirit Aaron!  What I learned in Chiropractic college is exactly what that study said.  A method of pounding on the spine in the areas of t1-5 and T8-L2 will cause your Sympathetic nerves to fire however.  It gives asthma sufferers some relief, but it obviously cant compete with a powerful (liver destroying) drug. Asthma treatment is now focusing on controlling the inflammation rather than treating the symptoms (thank god we’re coming out of the dark ages-even with what DC’s do…). Stop whining about Chiropractic research and find it on MEDLINE: http://www.ncbi.nlm.nih.gov/PubMed/ RPG Greyhawk:  http://members.aol.com/emirikol7——-

Response:

When was the last time you asked your local MD about how much education he’s had in nutrition?  If you ask, he’s likely to tell you that he had ZERO to TWO credits of education in the area.  Ask him how much continuing education he’s had in the subject since med school.  He’s likely to tell you,"none, but I’ve been to a lot of drug seminars." . . .

And it goes on.  It is unfortunate that some few who are committed to Alternative methods of health have a tendency to "bash" those who have an MD in what we term "Western" medicine.  Western medicine has done great good and made some incredible advances that have helped people to live longer, more fulfilled lives. There are two MDs in our organization who are committed to alternative methods as well as the more standard drugs (many of which start as botanicals). Aloe Vera Studies Organization http://www.aloe-vera.org

Response:

   Good luck.  It’s not unlikely that you will find that the putative nutrition-disease connection knowledge of any purported expert here, is not without major epistemological problem.  Why ridicule doctors for lack of that which is not possessed by anyone at present?                                   Tangledly Yrs,                                     Steve

That is not unfunny. hazmat

Response:

MD’s know alot about the "practice of medicine" you know how it works – practice long enough and you will get right just my twocents — Kelley Greene Sedona SuperNaturals, Inc "Your Source for Healthy, Natural Products" 888.239.3558 phone 520.204.2476 fax http://www.sedonanaturals.com <<<<<<<<<<<<<<<<<<<<<<<<<

Response:

When was the last time you asked your local MD about how much

education he’s had in nutrition?<<     "It’s not the things you don’t know that hurt you, so much as the things you know, that just ain’t so!"   — Josh Billings      Education in nutrition is a funny thing, you know.  When our orthodox doctors don’t get classroom time in it, it obviously means they don’t know anything about it, QED.  But when the guy talking about nutrition is Gary Null or Dirk Pearson or Linus Pauling or Nathan Pritikin or John Diamond or even Andrew Weil, M.D., somehow we’re willing to cut them quite a lot of slack for the lack of classroom time.  For one thing, we know they must have read each other’s books… <g.                                          Steve Harris, M.D.  

Response:

writes: – Hide quoted text — Show quoted text -Another case in which chiropractic will help.  A subluxation of a segment, may cause mechanical change to the cell body (soma) of a sensory nerve cell in the dorsal root ganglion (DRG), which happens to lie in the intervertebral foramen (between two vertebrae).  This mechanical change will cause the nerve cell to become facilitated; therefore, it will fire more easily.  Since the stimulus to the nerve occurs at the cell body instead of in the peripheral tissues, the impulse will travel both towards the spinal cord (normal direction) and also in an antidromic pattern (or in a way opposite from expected).  Note that this antidromic flow is inhibited in normal nerve function by the absolute refractory period of the cell.  In many cases this sensory neuron receives it’s input from mast cells, so when the impulse "hits" this mast cell, it will stimulate the cell, which releases histamine, causing an inflammatory reaction in the end organ, which may then cause pathology (of virtually any organ). Now, having said all that, this is a theory which shows how chiropractic may affect end organs, and the theory needs to be fully tested (hopefully more quickly than not).  Hope you enjoyed your reading  (now time to go see http://members.aol.com/DrsPage/humor.htm to lighten things up.  :) Thanx for the explanation of the theory with the caveat that it needs to be tested. Could you share with me the evidence that the nerve conduction is the opposite direction in vivo. Thanx again.

That article would be "Antidromic vasodilatation and nerurogenic inflammation" written by J. Szolcsanyi published in Agents and Actions, vol. 23, 1/2 (1988) For how segmental dysfunction (subluxation) affects neurons please see "Lumbar facet pain:  Biomechanics, neuroanatomy and neurophysiology" by John Cavanaugh, published in Journal of Biomechanics, vol 29, no. 9, pp 1117-1129 (1996).

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writes: Chiropracter students NEED to take twice as many hours as their average intelligence is markedly lower than MD students.

Rich, are you suffering from constipation? If you are, you could go to an MD who would tell you to drink more water, increase your intake of bulky food, and maybe suggest a laxative.  If the problem continues for an extended period of time (months or years even), he then refers you to a Gastroenterologist who does a series of invasive and very expensive tests all to tell you there is nothing physically wrong.  How is your home life?  Suggests more anti-gas drugs and maybe a Psychiatrist.   He did his job, didn’t he?  At least you know you are not suffering from a dis-ease that would show up on Ex-rays (of all kinds). Or, I could recommend a good Chiropractor who will start with your spine and just maybe find that area which directly relates to your intestines and with a little manipulation can begin to correct a problem that started years ago with minor symptoms. But that’s not all.  From the symptoms you describe, he suspects food intolerance (not allergies).  He has ways of testing you to determine which foods may be aggrevating your condition.  You eliminate those foods from your diet and find that your symptoms are much improved.   From personal experience, (1981-1983) I discovered that MD’s rule out serious disease and TREAT symptoms.  (1985-current) I have found the Chiropractor to help me achieve OPTIMUM health.  I have only had to see an MD in the last 15 years 4 times.  I have 4 very healthy children delivered by an MD. Linda "There are many ways to skin a cat."  STOP Bashing the Chiropractors. ‘Have you hugged your Chiropractor today?’

Response:

And why is that? Why do we know all about Tamoxifen, but not about soy

or some other dieatary connection?<    Well, I think you know the reason.  People don’t like to pay for information at reasonable rates, and won’t really do so except with lawyers, and they hate lawyers for it.  It costs millions of dollars to do a good scientific clinical study, and when the results come out, people want to have them for the price of a newspaper.  They do NOT want to pay their fair share of the costs of getting the information. The patent process is what forces them to do that, and that taxing of people for information is what drives research in pharmaceuticals. So there is money to study Tamoxifen.  And, to some extent, also of course new stuff in agriculture, so long as it’s novel and of a certain kind. That soy in your soy milk may be high yield hybrid soy, and you pay for the research that way.  But only if somebody can figure out how to market a product.  Information, at present, is still hard to charge for. The original poster, whose point you’ve snipped, stated that MDs’ knowledge about nutrition vis-a-vis health is far superior to anyone else’s. I guess you’re saying it’s not.<

   We don’t know more than nutritionists and other science types (including the best of the naturopaths), but we do well by comparison with many of the "health practitioners" who THINK they know a lot about nutrition.  It ain’t the stuff you know that hurts you, as Josh Billings says, "it’s the stuff you know, that just ain’t so!" BTW, the use of a double negative is not uncommon (there it is

again) for emphasis. It’s appropriate in this particular case where the information is not unequivocal (AGAIN!!) as in the POSSIBLE connection between diet and fibroids. I don’t have studies – I’m asking the purported experts for it.<<    Good luck.  It’s not unlikely that you will find that the putative nutrition-disease connection knowledge of any purported expert here, is not without major epistemological problem.  Why ridicule doctors for lack of that which is not possessed by anyone at present?                                     Tangledly Yrs,                                     Steve

Response:

Troldahl) writes: I have also noticed this about hospitals.  You would think that they would do a better job of feeding heart patients, stroke victims, etc., something that their doctors would approve of.  I know the wife of a stroke victim who actually had to bring food into the hospital with her because at least 2 of his 3 meals a day were food that his doctor had ordered him not to eat!!!

   Sounds like some doc forgot to write good dietary orders.  I mean, really– they have dieticians on staff, and if you (the doc) know what you want in the way of diet as therapy, you WILL generally get it.  And the nice nutritionists will help you order it, if you’re not quite sure what you need (300 mg cholesterol, 20% fat, ADA, 2 gram sodium, lactose free diet?  No problemo.  You want that kosher, too?  You might even be able to get that).  The only thing not guaranteed in any hospital is the taste.  But taste is in the mouth of the beholder, so to speak.                                    Steve Harris, M.D.

Response:

writes: Thanx for the explanation of the theory with the caveat that it needs to be tested. Could you share with me the evidence that the nerve conduction is the opposite direction in vivo. Thanx again.

There are in vivo articles, but I do not have copies of the articles, and I won’t pretend to quote them without rereading them, as if I would expect you to believe me without the bibliography to quote .  It may be a few days though, as I am entering finals, for which I need to study.  Also, the articles are not in any journals that our college will have in the library, so I will need to travel to the local med school to get to them. I’ll post the information as soon as I can. Lee Weathers  

Response:

Then why are they so unwilling to discuss it? Is it some sort of secret they are conspiratorially keeping to themselves? I’ve never been to any doctor who has given me nutritional information as part of a treatment program, nor do I know anyone else who has received any.<    You must not know anybody with obesity, heart disease, or diabetes.

That’s the point – why do they wait until there is a "disease" underway, such as those you’ve mentioned, to talk about nutrition (if they in fact do)? Why not do some preventive counseling? And in fact, my father, who is a coronary patient, was not given any substantive nutritional advice and was served a high fat meal after his bypass. – Hide quoted text — Show quoted text – Is this because I didn’t have any "disease" per se, but rather just a malady? A recent experience is a friend who had a hysterectomy; no nutritional advice was offered there, though the connection of diet to uterine fibroids is not unknown.<    The connection of diet to uterine fibroids is not unknown?  If we can untangle the grammer there, you’re claiming a connection. Okay, let’s see you make it.  Cite science.  We want to know if this doctor screwed up by not telling the patient something that had been firmly established as human knowledge, but he was just ignorant of it. Cite your sources. What doctor out there can tell me how one should modify one’s diet to receive the same preventative benefits against breast cancer that Tamoxifen offers, without the side effects?     None, because no proof of such a thing exists.  There is suggestive epidemiology only.  Your doctor can say: "Eat like the Japanese– very low fat and lots of soy."   And probably will.  But we all know that this is just a guess.  The effect of Tamoxifen is no longer a guess. We know.                                    Steve Harris, M.D.

And why is that? Why do we know all about Tamoxifen, but not about soy or some other dieatary connection? The original poster, whose point you’ve snipped, stated that MDs’ knowledge about nutrition vis-a-vis health is far superior to anyone else’s. I guess you’re saying it’s not. BTW, the use of a double negative is not uncommon (there it is again) for emphasis. It’s appropriate in this particular case where the information is not unequivocal (AGAIN!!) as in the POSSIBLE connection between diet and fibroids. I don’t have studies – I’m asking the purported experts for it. And since you managed to untangle the GRAMMAR (note spelling), why bother making that point? How about sticking to the content? hazmat

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x-no-archive:  yes I seriously doubt the average chiropracter knows half as much biochemistry or physiology as the average MD.      I invite you to hang out with me for a week at Palmer.

Now THAT’S a safe invitation to hand out:-)  Somehow I have a feeling that Aaron would rather stay in NYC than coming to Iowa to "hang out" with someone who is fixated in some pregenital stage of development.  I think you’d change your opinion of a chiropractor’s knowledge of biochemistry AND physiology. In a BIG way.

The legend in YOUR own mind continues I see. Backcrkr

Aloha, Rich Far better to be uncertain Than to be sure and be wrong Note: Remember to remove the antispamming "NOT" in email address  before sending me email

Response:

    The polls have closed, and the results are in.  KalalauRich won the "most full of shit" contest by a landslide.  I dub thee Captain Bullshit. You may wear your title proudly – like a badge on your sleeve.

Was it YOU Backcracker was hoping that I was not an MD because you would be embarrassed for my profession?? Guess you are demonstrating quite clearly the respect that YOU have for chiropracty by YOUR infantile remarks. But considering the admission requirements for Chiropractic School it is not surprising at all. YOU are really giving the chiropractic profession a real shot in the arm (so to speak). Keep up  the good work. Actually I never got my GED if you must know. Hope that makes you feel better:-)     Ah, don’t feel too bad. You’ll have more chances. And then you can retire from working the deep fryer at Burger King.

No actually I am NOW planning to go to Chiropracty School. You have convinced me. Backcrkr

Aloha, Rich Far better to be uncertain Than to be sure and be wrong Note: Remember to remove the antispamming "NOT" in email address  before sending me email

Response:

Then why are they so unwilling to discuss it? Is it some sort of

secret they are conspiratorially keeping to themselves? I’ve never been to any doctor who has given me nutritional information as part of a treatment program, nor do I know anyone else who has received any.<    You must not know anybody with obesity, heart disease, or diabetes. But your lack of experience is YOUR problem, not ours. Is this because I didn’t have any "disease" per se, but rather just a

malady? A recent experience is a friend who had a hysterectomy; no nutritional advice was offered there, though the connection of diet to uterine fibroids is not unknown.<    The connection of diet to uterine fibroids is not unknown?  If we can untangle the grammer there, you’re claiming a connection. Okay, let’s see you make it.  Cite science.  We want to know if this doctor screwed up by not telling the patient something that had been firmly established as human knowledge, but he was just ignorant of it. Cite your sources. What doctor out there can tell me how one should modify one’s diet to receive the same preventative benefits against breast cancer that Tamoxifen offers, without the side effects?

    None, because no proof of such a thing exists.  There is suggestive epidemiology only.  Your doctor can say: "Eat like the Japanese– very low fat and lots of soy."   And probably will.  But we all know that this is just a guess.  The effect of Tamoxifen is no longer a guess. We know.                                    Steve Harris, M.D.

Response:

x-no-archive:  yes And this shows me that you are claiming to have met EVERY chiropractor in existence.     Oh, that’s a brilliant extrapolation.  Did you actually come up with that all by yourself?  Or did your parents help you?  I’d be willing to bet that I’ve met a whole heck of a lot more chiropractors AND M.D.’s than has Aaron.

Yeah. So what?  You sound like a second grader claiming "Mine is bigger than yours". 3.89 avg huh:-) After all how else would you know about the knowledge of the chiropracters that Aaron has met??     Hmmm. Could it be that the pre-medical/pre-chiropractic requirements for organic chemistry are the exact same thing?

Hmmm. Does a person’s knowledge come from spending many hours in a classroom?? Just because a chiropracter takes these courses does NOT mean he/she understands them. This seems to be a point that is going quite over your head (surprise, surprise). Ahhhhh. Even if it were true that chiropracters complete more hours of classroom education (which it is not)     Yes it is.

I encourage those who are interested in getting curricula from Palmer College of Chiropractic and John’s Hopkins Med School and decide for yourself. Chiropracter students NEED to take twice as many hours as their average intelligence is markedly lower than MD students.     I imagine that you know this from one of your famous medline fishing expeditions?  Or is this just yet another example of how full of shit you really are?  

I will allow others to decide who is full of shit as you put it. It just takes them longer to get it. And some never do get it.     Speaking of never getting it…  How long till you get that GED?

Actually I never got my GED if you must know. Hope that makes you feel better:-) But you really don’t need to understand much chemistry  to crack backs anyway.     The depth of your ignorance is truely astonishing.  

I love these self referential statements. Aloha, Rich Far better to be uncertain Than to be sure and be wrong Note: Remember to remove the antispamming "NOT" in email address  before sending me email

Response:

 lf.   I will agree that some chiropractors (probably more than I want to admit) exaggerate claims, in that they make claims that have not been proven in randomized clinical trials.

Thank you for acknowledging this.  But then on the other hand not all medical protocols have been either.

This is true.   As far as chiropractic is concerned, I will say that not only musculoskeletal conditions will be helped, but that other conditions might also.

Again an honest response tempered with caution (note the word "might"). – Hide quoted text — Show quoted text -And aren’t there some chiro’s who still reject the germ theory of disease entirely? Probably, but I’m ashamed to admit it. Lee Weathers Chiropractic student Another case in which chiropractic will help.  A subluxation of a segment, may cause mechanical change to the cell body (soma) of a sensory nerve cell in the dorsal root ganglion (DRG), which happens to lie in the intervertebral foramen (between two vertebrae).  This mechanical change will cause the nerve cell to become facilitated; therefore, it will fire more easily.  Since the stimulus to the nerve occurs at the cell body instead of in the peripheral tissues, the impulse will travel both towards the spinal cord (normal direction) and also in an antidromic pattern (or in a way opposite from expected).  Note that this antidromic flow is inhibited in normal nerve function by the absolute refractory period of the cell.  In many cases this sensory neuron receives it’s input from mast cells, so when the impulse "hits" this mast cell, it will stimulate the cell, which releases histamine, causing an inflammatory reaction in the end organ, which may then cause pathology (of virtually any organ). Now, having said all that, this is a theory which shows how chiropractic may affect end organs, and the theory needs to be fully tested (hopefully more quickly than not).  Hope you enjoyed your reading  (now time to go see http://members.aol.com/DrsPage/humor.htm to lighten things up.  :)

Thanx for the explanation of the theory with the caveat that it needs to be tested. Could you share with me the evidence that the nerve conduction is the opposite direction in vivo. Thanx again. Aloha, Rich Far better to be uncertain Than to be sure and be wrong Note: Remember to remove the antispamming "NOT" in email address  before sending me email

Response:

I have yet to hear from a chiropracter on this list or elsewhere who gives evidence of knowing as much organic chemistry or epidemiology as any MD I know and trust.     And this shows me that you have never met a chiropractor in your entire life.

And this shows me that you are claiming to have met EVERY chiropractor in existence. After all how else would you know about the knowledge of the chiropracters that Aaron has met??   The difference between how much chemistry education a chiropractor has far exceeds that of an M.D.  Chiropractors generally must complete 325 hours of classroom education. Wheras for an M.D. it’s only 165 hours.

Ahhhhh. Even if it were true that chiropracters complete more hours of classroom education (which it is not) than MD’s you perhaps are missing the point. Chiropracter students NEED to take twice as many hours as their average intelligence is markedly lower than MD students. It just takes them longer to get it. And some never do get it.  But you really don’t need to understand much chemistry  to crack backs anyway. Most of the chiropracters that I have spoken to really could not understand the necessity of taking so many basic science courses as they never really used any of it in their practice. Aloha, Rich Aloha, Rich And I have *never* met a non-MD/non-PhD "nutritionist" with such knowledge.     I suggest that you get out more. Assistant Professor of Music (Ethnomusicology)      Hmmm. Perhaps we would be better off discussing 16th century (Palestrina era) counterpoint. Backcrkr

Far better to be uncertain Than to be sure and be wrong Note: Remember to remove the antispamming "NOT" in email address  before sending me email

Response:

I never saw Backcrack’s original reply to my post, so I’ll respond to this follow-up  from Rich.  I specifically said "I have yet to meet a chiropracter on this list," first of all, which means that no chiropracter posting to this list has said anything (I’ve been here  afew months and there are several chirporacters who have posted regularly in that period) which was informed by a particularly deep knowledge of the principles and language of  basic science, let alone a deep knowledge of the specific subjects i discussed.  Of course, it’s true, they may have had no reason to bring in such knowledge to this discussion, or they haven’t posted to discussions where such knowledge might be useful (but they have, actually).  But I also said I had met other chiropracters.

Since I have just joined this newsgroup, I can’t say about chiropractors competently discussing topics here.  However, I will also say that when I make any posts, I usually don’t address myself as a Chiropractor, as it is usually extraneous information and not relevant to the topic. Look, I’m not dissing chiropractic entirely here.  I have also said some *nice* things about chiros here before — I have two relatives who have had good results from chiropracters (one of whom I’ve talked to at length) with *back pain,* and I don’t deny the efficacy of chiropractic for musculoskeletal problems, and back and neck problems in particular, although I think the claims of chiropractic in general are vastly over-stated, and I have my doubts about the comparability of chiropractic education and medical school education for MDs.  I’ve discussed this  at length here before, so I’ll forego repeating myself.  

I will agree that some chiropractors (probably more than I want to admit) exaggerate claims, in that they make claims that have not been proven in randomized clinical trials.  But then on the other hand not all medical protocols have been either.  As far as chiropractic is concerned, I will say that not only musculoskeletal conditions will be helped, but that other conditions might also. (Should be another thread, but I will include an instance at the very end of this post, if you are so interested).  Also I will include at the bottom of my post a list of hours by a few subjects that are required by DCs and MDs respectively. I seriously doubt the average chiropracter knows half as much biochemistry or physiology as the average MD. However, I’m fairly certain that the *most* scientifically literate chiropracters aren’t as knowledgable about biochemistry as medical doctors in specialties like endocrinology, immunology, infectious disease, epidemiology, reproductive medicine, neurology, or psychiatry,   Hours in the classroom in a specific subject don’t automatically translate into superior knowledge anyway.

I will refrain from commenting on the average DC or MD, as I am not in a position to say what is average, but I won’t agree to the exaggeration of half the physiology or biochemistry.  I will agree that most literate DCs aren’t as knowledgeable in biochemistry as the specialist MDs that you mentioned, but then neither of us should expect them to be, as that is not our specialty.  I would dare say that I would not expect primary care physicians to have the same level of knowledge either.  It is true that hours of study do not the knowledge make, but one does for sure follow the other. We’ve been around and around on this.  The standards for admission to chiropractic school are lower than for admission to a good medical school. You can’t deny that.

I don’t, but that is changing rapidly.  In the next 3 -5yrs BS degrees will be required (they should have been required quite some time ago).  I am not sure about GPA requirements going up or not, though. But I’m willing to be proved wrong.  What it would take would be contributions to threads on this list which deal with biochemistry and molecular biology and complex issues in immunology, epidemiology, virology, etc. from chiros. which displayed a commanding knowledge of the basic science.  Very few posters here ever get into such subjects.

Again, I’m not sure that people always post their degrees, or areas of study. And aren’t there some chiro’s who still reject the germ theory of disease entirely?

Probably, but I’m ashamed to admit it. Lee Weathers Chiropractic student The following class hours were compiled following a review of catalog requirements from 11 chiropractic and 22 medical colleges and updated from the National Health Federation bulletin. Hours are listed as the minimum required. Subject                                         Medical                 Chiropractic Anatomy                                           508                           520 Physiology                                       326                           420 Pathology                                         335                           271 Chemistry                                         325                           300 Bacteriology                                    130                           114 Diagnosis                                          374                          370 Neurology                                        112                           320 Radiology                                         148                            217 Psychiatry                                         144                             65 Obstetrics and Gynecology           198                              65         Orthopedics                                      156                           225 Total                                                 2,756                         2,887 Other required classes for DCs include adjusting and kinesiology among others. Other required classes for MDs includte pharmacology, immunology, and genderal surgery among others.   Grand Total class hours                4,248                          4,485 Another case in which chiropractic will help.  A subluxation of a segment, may cause mechanical change to the cell body (soma) of a sensory nerve cell in the dorsal root ganglion (DRG), which happens to lie in the intervertebral foramen (between two vertebrae).  This mechanical change will cause the nerve cell to become facilitated; therefore, it will fire more easily.  Since the stimulus to the nerve occurs at the cell body instead of in the peripheral tissues, the impulse will travel both towards the spinal cord (normal direction) and also in an antidromic pattern (or in a way opposite from expected).  Note that this antidromic flow is inhibited in normal nerve function by the absolute refractory period of the cell.  In many cases this sensory neuron receives it’s input from mast cells, so when the impulse "hits" this mast cell, it will stimulate the cell, which releases histamine, causing an inflammatory reaction in the end organ, which may then cause pathology (of virtually any organ). Now, having said all that, this is a theory which shows how chiropractic may affect end organs, and the theory needs to be fully tested (hopefully more quickly than not).  Hope you enjoyed your reading  (now time to go see http://members.aol.com/DrsPage/humor.htm to lighten things up.  :)

Response:

<< An MD that stays current and is interested in nutrition will be much more adept at applying nutritional science to a patients treatment than a chiropractor or RD   [I always loved that term-jh]  since they are also more qualified in the areas of pharmocology and the treatment of disease. Pharmacology has little to do with nutrition except for drug interactions and side-effects, but I do envy the MD’s amount of Physiology.  After all, they’ve got to know what they’re poisoning.  Guess what though?  An NWCC chiro grad will get 150 hours of Physio, while a UofMinnesota MD get’s 84.  Chiro’s get 30 hours of Pharmacology (and could care less why), while the MD gets 83 plus continual usage of drugs to find all kinds of neato’ side-effects. I think the MD’s do an excellent job with drug therapy, but a horrible job with nutrition and any therapy regarding the muscles and joints. Stop whining about Chiropractic research and find it on MEDLINE: http://www.ncbi.nlm.nih.gov/PubMed/ RPG Greyhawk:  http://members.aol.com/emirikol7——-

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In article – Hide quoted text — Show quoted text – My M.D. knows a lot about nutrition.  I think in part it’s because courses in "nutrition" per se are no the only way to learn about the subject.  The much more sophisticated training one gets in a decent medical school (and pre-med program) in biochemistry, human physiology, immunology, and epidemiology helps to put the rather simplistic and ideological content of most "nutrition" discourse in a more total perspective.  Knowing how nutrients are metabolized, what role (if any) they play in disease processes and immune response,  how to interpret scientific studies of nutrition, etc.  are all key parts of any properly scientific understanding of the applied subject.  I have yet to hear from a chiropracter on this list or elsewhere who gives evidence of knowing as much organic chemistry or epidemiology as any MD I know and trust.  And I have *never* met a non-MD/non-PhD "nutritionist" with such knowledge. AF Aaron A. Fox Assistant Professor of Music (Ethnomusicology) Columbia University    web: http://roar.music.columbia.edu/~cecenter/afindex.html

Then why are they so unwilling to discuss it? Is it some sort of secret they are conspiratorially keeping to themselves? I’ve never been to any doctor who has given me nutritional information as part of a treatment program, nor do I know anyone else who has received any. Is this because I didn’t have any "disease" per se, but rather just a malady? A recent experience is a friend who had a hysterectomy; no nutritional advice was offered there, though the connection of diet to uterine fibroids is not unknown.  What doctor out there can tell me how one should modify one’s diet to receive the same preventative benefits against breast cancer that Tamoxifen offers, without the side effects? hazmat

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Actually many MD’s know quite a bit about nutrition.  What I think the problem is regarding a medical doctor and their nutrition knowledge is that since they are physicians and work to treat one’s illnesses, the public thinks they should know everything regarding drugs, medicine, exercise, nutrition, supplements, etc.  This is a ludricrous notion. The key is to find an MD that has an interest in nutrition and supplements who is current on the latest research.  People think that one’s schooling is what matters when it comes to nutrition and that is the wrong way to view this topic.  An MD that stays current and is interested in nutrition will be much more adept at applying nutritional science to a patients treatment than a chiropractor or RD since they are also more qualified in the areas of pharmocology and the treatment of disease. — PeakHealth.net http://www.peakhealth.net Check Out This Month’s Exclusive Interview With Strength Coach Charles Poliquin "Sex, Drug Alternatives, and Rock-Hard Muscle" Online at: http://www.peakhealth.net/CPI_4

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When was the last time you asked your local MD about how much education he’s had in nutrition?  If you ask, he’s likely to tell you that he had ZERO to TWO credits of education in the area.  Ask him how much continuing education he’s had in the subject since med school.  He’s likely to tell you,"none, but I’ve been to a lot of drug seminars." Of course there are exceptions, but really folks, why are we turning to people who have no knowledge in the area for help?  Ask you chiropractor, he’s knows his stuff, uses it everyday, and has nearly SIX TIMES the amount of training over an MD in the areas of nutrition, exercise, and WELLNESS.  For references, write to Northwestern College of Chiropractic (a 4-year postgraduate program), at:  2501 West Eighty-Fourth Street, Bloomington, MN 55431-1599 for a college catalogue. Comments? (Greyhawk Web Page:

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<<<Oh, and six times 2 hours is still only 12 hours, right? Actually the difference is 105 hours of nutrition training for a Chiropractor (not including continuing education), and 10 hours for an MD graduating from the University of Minnesota Med School.  MD’s graduating from the Mayo Clinic attachment get ZERO. I agree though.  Go to a nutritionist if you want advice on your diet or supplements.  I’m simply stating the fact that MD’s dont know shit about nutrition, yet the public thinks they’re "all-knowing." Comments and flames  welcome. (Greyhawk Web Page:

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<<<And exercise is relatively simple, when it comes right down to it nearly everyone knows how to walk. You gravely insult the Physical Therapists with this comment.  Not everyone knows how to walk, bike, lift weights properly, perform yoga or Tai-Chi, karate, or even paritcipate in lifeling sporting events.  Most of us simply sit on our cans and watch other people do it.  Most of our kids didn’t participate in school athletics (take a look at the numbers), and the schools want to cut back on the number of recess hours on top of that!?! (Greyhawk Web Page:

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Chiropracter students NEED to take twice as many hours as their average intelligence is markedly lower than MD students.

Is that why everybody calls me 69? Stop whining about Chiropractic research and find it on MEDLINE: http://www.ncbi.nlm.nih.gov/PubMed/ RPG Greyhawk:  http://members.aol.com/emirikol7——-

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(Emirikol7) writes: <<< and couldn’t treat things like broken arms and lacerations and problems requiring surgery. You haven’t been to Oregon lately have you?

   No, but if you’re right, I’ll stay away!                             James G. Blaine, M.D.

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<<<Walking:  Probably 85% of people do not harm themselves when walking, even atthe 4-5mph pace that I can maintain for an hour.  The rest should see an exercise physiologist or other trained professional. Tell me, Mr. Fancy-pants, how much walking do you need to do to get any benefit?  How much to raise your heart rate?  how many times per week?  What shoes do you need to wear? Stop whining about Chiropractic research and find it on MEDLINE: http://www.ncbi.nlm.nih.gov/PubMed/ RPG Greyhawk:  http://members.aol.com/emirikol7——-

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<<< and couldn’t treat things like broken arms and lacerations and problems requiring surgery. You haven’t been to Oregon lately have you? Stop whining about Chiropractic research and find it on MEDLINE: http://www.ncbi.nlm.nih.gov/PubMed/ RPG Greyhawk:  http://members.aol.com/emirikol7——-

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Question:

In <5v19v4$…@ocean.silcom.com> joan…@silcom.com (Joan Livingston Attorney at Law) writes: >: Ann Intern Med 1992 Jul 1;117(1):1-9   >: Treatment of postmenopausal osteoporosis with transdermal >: estrogen. >: >: OBJECTIVE: To evaluate the tolerance and effectiveness of >: transdermal estrogen for women with established postmenopausal >: osteoporosis and vertebral fractures. >    Estrogen equals castration. >Joan L.

    These are post-menopausal women.  If you want to consider them "castrated’ by virtue of the fact that they are post-menopausal, be my guest.  Your usage is nonstandard, however.  The study uses intact women, getting both estrogen and a progestin.  You may not like it. You may not believe it.  You may deny it until you are baby blue in the face.  But those are the facts.                                     Steve Harris, M.D.

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In article <5v2fgp$…@sjx-ixn9.ix.netcom.com>,   sbhar…@ix.netcom.com(Steven B. Harris) wrote: – Hide quoted text — Show quoted text -> In <5v19v4$…@ocean.silcom.com> joan…@silcom.com (Joan Livingston > Attorney at Law) writes: > >: Ann Intern Med 1992 Jul 1;117(1):1-9 > >: Treatment of postmenopausal osteoporosis with transdermal > >: estrogen. > >: > >: OBJECTIVE: To evaluate the tolerance and effectiveness of > >: transdermal estrogen for women with established postmenopausal > >: osteoporosis and vertebral fractures. > >       Estrogen equals castration. > >Joan L. >     These are post-menopausal women.  If you want to consider them > "castrated’ by virtue of the fact that they are post-menopausal, be my > guest.  Your usage is nonstandard, however.  The study uses intact > women, getting both estrogen and a progestin. >                                     Steve Harris, M.D.

<snip> Steve, you are bolstering Joan’s point about the misuse of the terms HRT/ERT here. The study you offered us speaks only of studying the effect of "estrogen" which can only be used alone (responsibly) on women without uteri- so one would expect that the women were in fact hysterectomized. You then point out that the women were in fact receiving progestins in addition. Her point has consistently been that speaking of estrogen’s effects without reference to the necessity to add a further hormone which is frequently badly tolerated is  deceptive at worst and misleading at best. Quite apart from that, what evidence is there that any changes that were noted did not come from the P? The presence of a second additive must surely contaminate the purity of the conclusions, mustn’t it? Pat ——————-==== Posted via Deja News ====———————–       http://www.dejanews.com/     Search, Read, Post to Usenet

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- Hide quoted text — Show quoted text -In <873823371.22…@dejanews.com> ti…@cheerful.com writes: >In article <5v2fgp$…@sjx-ixn9.ix.netcom.com>, >  sbhar…@ix.netcom.com(Steven B. Harris) wrote: >> In <5v19v4$…@ocean.silcom.com> joan…@silcom.com (Joan Livingston >> Attorney at Law) writes: >> >: Ann Intern Med 1992 Jul 1;117(1):1-9 >> >: Treatment of postmenopausal osteoporosis with transdermal >> >: estrogen. >> >: >> >: OBJECTIVE: To evaluate the tolerance and effectiveness of >> >: transdermal estrogen for women with established postmenopausal >> >: osteoporosis and vertebral fractures. >> >   Estrogen equals castration. >> >Joan L. >>     These are post-menopausal women.  If you want to consider them >> "castrated’ by virtue of the fact that they are post-menopausal, be my >> guest.  Your usage is nonstandard, however.  The study uses intact >> women, getting both estrogen and a progestin. >>                                     Steve Harris, M.D. ><snip> Steve, you are bolstering Joan’s point about the misuse of the >terms HRT/ERT here. The study you offered us speaks only of studying the >effect of "estrogen" which can only be used alone (responsibly) on women >without uteri- so one would expect that the women were in fact >hysterectomized.

     Pat, I posted the whole abstract so you could read beyond the title.  Try again.  Perhaps the scientists were lax in not mentioning in the title of the paper the medroxyprogesterone they also treated these women with.  But these women all got it. – Hide quoted text — Show quoted text ->Ann Intern Med 1992 Jul 1;117(1):1-9   >Treatment of postmenopausal osteoporosis with transdermal >estrogen. >Lufkin EG, Wahner HW, O’Fallon WM, Hodgson SF, Kotowicz MA, Lane >AW, Judd HL, Caplan RH, Riggs BL >Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, >MN 55905. >OBJECTIVE: To evaluate the tolerance and effectiveness of >transdermal estrogen for women with established postmenopausal >osteoporosis and vertebral fractures. >DESIGN: Double-blind, randomized, placebo-controlled clinical >trial lasting 1 year. SETTING: Referral-based outpatient clinic. >PATIENTS: Seventy-five postmenopausal women, 47 to 75 years of >age, with one or more vertebral fractures due to osteoporosis. >INTERVENTIONS: Thirty-nine women received dermal patches deliver- >ing 0.1 mg of 17 beta-estradiol for days 1 to 21 and oral >medroxyprogesterone acetate for days 11 to 21 of a 28-day cycle. >Another 39 women received placebo.

Pat: >You then point out that the women were in fact receiving >progestins in addition.

   Which they were, as you see. > Her point has consistently been that speaking of >estrogen’s effects without reference to the necessity to add a further >hormone which is frequently badly tolerated is      deceptive at worst and >misleading at best.

    And her point is incomprehensible, because we speaking of a study using both hormones.  Right?   There is nothing about them being "badly tolerated." > Quite apart from that, what evidence is there that >any changes that were noted did not come from the P? The presence of a >second additive must surely contaminate the purity of the conclusions, >mustn’t it?

    Not if the conclusion is that combination treatment with two hormones prevents a significant number of osteoporotic fractures, even over one year’s time. As to whether or not the progestin was doing the job, a number of studies of estrogen alone pretty much lays that idea to rest.  It is estrogen that preserves bone.  I know of no evidence that Provera does.                                               Steve Harris, M.D.

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I was just told an older woman (age 72) in my family has osteoporosis and will be taking Fostex (?).  She had not been on HRT. Does anyone have any information handy to e-mail me?  Wouldn’t soy products help along with the medication?  Thanks so very much.

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On 4 Sep 1997, Karen Kay wrote: > Joan Livingston Attorney at Law <joan…@silcom.com> wrote: > > This is a very complex multifactorial condition and is often > > a secondary condition associated with some other primary health condition. > Such as? (I’m just looking for one concrete example.) > — > Karen >   ka…@wordwrite.com

Secondary Causes of Osteoporosis: Drug related: Glucocorticoids Heparin Anticonvulsants Chronic litium therapy Thyroid hormone over-replacement Chronic ingestion of phosphate binding antacids Endocrine Related: Hyperthyroidism Cushings Syndrome Hyperparathyroidism Hypogonadism Type 1 Diabetes Hyperprolactemia Acromegaly Malignancy Associated: Multiple myeloma Leukemia Plasma cell disorders Genetic Disorders: Sickle cell anemia Homosystinuria Thalassemia Hypophosphatasia Osteogenisis imperfecta Miscellaneous Disorders: Anorexia nervosa Systemic mastocytosis Alcohol abuse Chronic liver disease Chronic renal disease Malabsorption syndromes Vitamin C deficiency Source: Practical Hygiene – May/June 1997 Joan L.

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On 4 Sep 1997, Karen Kay wrote: > Joan Livingston Attorney at Law <joan…@silcom.com> wrote: > > This is a very complex multifactorial condition and is often > > a secondary condition associated with some other primary health condition. > Such as? (I’m just looking for one concrete example.)

Karen.,  I made a very lengthy post from a dental hygiene journal few weeks ago setting out all of the primary conditions where osteo was a secondary factor. It is in the archives but I do not know what thread heading. I will try and find that journal. It was an extensive list of co-factors and was what I thought was a very important post. There were no comments on it.         I had an interesting experience today as a patient reported quite a significant increase in "bone density" after using Fosamax for perhaps a year. She went from the 600’s to the 800’s in her scanning measurements. However when she reported this to me by email her husband who is a retired endocrinology researcher added his own caution about the efficacy of this treatment protocol and raised a very interesting point.         The bone scan density measurement are recorded as "X" per square centimeter and he always felt density needs to be measured in -cubic- centimeters. So at this point the "density" appears to be only a measurement of surface opacity rather than increased bulk. But this may be way off in my understanding of his comment. Can any one explain his caveat on this? Thanks. Joan L.

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D,     Thyroid medication, especially in excess, or steroids for asthma or other chronic condition can both cause bone thinning. You say your relative "has been constantly on the go." To build bone requires weight-bearing exercise. Some authors suggest that the exercise needs to be something different from normal activity. For example walking may not do much to strengthen bone, but power walking, in which the person uses muscles otherwise not used, to build up muscle around the bone and create different stresses on it may be very effective. This is why weight lifting is considered so beneficial.     The long term safety of fossamax has not been established, since there have been no real time long term studies. If she starts taking it she should remember to take it with a full glass of water, and to remain upright for at least, I think it’s a half hour afterwards because fossamax can cause serious injury to the esophagus in susceptible people which I believe includes anyone with a hiatal hernia or significant esophageal reflux. Susan Hoch, if you’re reading this can you correct/confirm and add any other warnings?     Second opinions are always valuable, IMO. Terri – Hide quoted text — Show quoted text -DSands5000 wrote: > In article <5ul1qh$…@ocean.silcom.com>, joan…@silcom.com (Joan > Livingston Attorney at Law) writes: > >       And, yes exercise can give as good of density enhancing > benefits > >as any of the drugs. They only change the bone density reading by a > few > >percentage points and the ultimate -quality- of this density > improvement > >remains to be investigated. > >J > Thanks, Joan.  I plan to read as much as possible about osteoporosis. > What puzzles me is that my relative has been extremely active — > constantly on the go.  From the little I’ve read so far, her having > taken > thyroid medication may be a factor, but other than that the only > other factor I can see is heredity. > I would imagine it might also be prudent for her to take her test > results > and get a second opinion….just thinking out loud here…

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willi…@mcsi.net (williams) writes: >I always thought that osteoporosis was caused by or could be elevated by >additional calcium. Now i hear about vitamin D. >I’m not big into vitamin lingo…are these the same?

Calcium is a mineral.  It’s one of the components of limestone.  It’s also one of the components of bones and teeth, and it is necessary for proper blood clotting, the maintenance of connective tissue, and good nerve-impulse transmission. Vitamin D is a hormone.  It regulates the absorption and balance of calcium and phosphorus (another component of bone) and is also involved in muscle contraction and the transmission of nerve impulses.  The body can make vitamin D itself if you expose unprotected skin to sunlight.  Otherwise it has to come in food. (Sources — lots of reading, but I checked THE MEDICAL ADVISOR to make sure I wasn’t misremembering or getting confused.) The connection of either of these to osteoporosis or its prevention is complicated and I won’t venture into it.  But at least now you know what they are. — "Moreover, fantasticality does a good deal better than sham psychology."  – Virginia Woolf ———————————————————– Pamela Dean Dyer-Bennet                        p…@ddb.com

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On 9/3/97 11:19AM, in message <19970903181901.OAA01…@ladder02.news.aol.com>, DSands5000 <dsands5…@aol.com> wrote: > I was just told an older woman (age 72) in my family has osteoporosis > and will be taking Fostex (?).  She had not been on HRT. Does anyone > have any information handy to e-mail me?  Wouldn’t soy products > help along with the medication?  Thanks so very much.

I always thought that osteoporosis was caused by or could be elevated by additional calcium. Now i hear about vitamin D. I’m not big into vitamin lingo…are these the same? marcia

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williams wrote: > On 9/3/97 11:19AM, in message > <19970903181901.OAA01…@ladder02.news.aol.com>, DSands5000 > <dsands5…@aol.com> wrote: > > I was just told an older woman (age 72) in my family has osteoporosis > > and will be taking Fostex (?).  

Fosamax She had not been on HRT. Does anyone > > have any information handy to e-mail me?  Wouldn’t soy products > > help along with the medication?  Thanks so very much.

Following my signature is an edited copy of a posting I saved from sci.med.diseases.osteoporosis  (I deleted the HTML stuff as it was just a duplication of the first part.) giving several links to information about osteoporosis.  I have not visited those sites myself, so have no idea how helpful or accurate the information contained there, may be. You might want to subscribe to the osteoporosis newsgroup (above). I don’t think I’ve heard soy recommended for treatment of osteoporosis, but doubt it would be harmful. > I always thought that osteoporosis was caused by or could be elevated by > additional calcium. Now i hear about vitamin D. > I’m not big into vitamin lingo…are these the same? > marcia

No, they’re not the same.  Calcium is a mineral that’s used in building bone.  Vitamin D is a vitamin that’s gotten from sunshine (about 15 minutes per day is all that’s needed) or is added to milk and vitamin supplements.  Vitamin D helps faciliate the body’s use of calcium in bone-building.  So both are needed. Lianne — No spam.  Do not add my name/address to any mail lists. No announcements.  No commercial e-mail.  (Personal correspondence — use my other address or remove "seesig." from this.) Subject: Osteoporosis links Date:    Mon, 09 Jun 1997 18:06:46 -0500 From:    "Darren Tyson (remove spambuster!)" <tysondr.spambus…@slu.edu> Organization: Saint Louis University Newsgroups:  sci.med.diseases.osteoporosis Here’s a bunch of links to information on osteoporosis. Hope they’re helpful. Darren —————————- Here’s the list: http://www.housecall.com/sponsors/aafp/topics/womens_health/osteoporo… http://ihs2.unn.ac.uk/~ehs8/osteo.htm http://www.fda.gov/fdac/features/796_bone.html http://vm.cfsan.fda.gov/~dms/wh-oste1.html http://medic.med.uth.tmc.edu/ptnt/00000767.htm http://moe.csa.com/osteointro.html http://www.nof.org/ http://www.pslgroup.com/osteoporosis.htm http://text.nlm.nih.gov/nih/cdc/www/43txt.html#Head0 http://www.psyc.nott.ac.uk/~les/osteo.htm http://www.osteo.org/index.html http://www.priocal.se/ostinfo.html http://www.ih2000.net/osteoporosis/ http://members.aol.com/merasl/udpage23.htm http://medhlp.netusa.net/general/OSTEO2.TXT http://www.pharmiq.com/pat/htmlpage/osteop.htm

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In article <N.090497.123759.51@Default>, willi…@mcsi.net (williams) wrote: > On 9/3/97 11:19AM, in message > <19970903181901.OAA01…@ladder02.news.aol.com>, DSands5000 > <dsands5…@aol.com> wrote: > > I was just told an older woman (age 72) in my family has osteoporosis > > and will be taking Fostex (?).  She had not been on HRT. Does anyone > > have any information handy to e-mail me?  Wouldn’t soy products > > help along with the medication?  Thanks so very much. > I always thought that osteoporosis was caused by or could be elevated by > additional calcium. Now i hear about vitamin D. > I’m not big into vitamin lingo…are these the same? > marcia

Vitamin D is necessary for bones to incorporatae calcium;  this is why babies in northern climates often had rickets. Soy products are far too little too late for someone already diagnosed with osteoporosis at 72. k

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: DSands5000 <dsands5…@aol.com> wrote:

: > I was just told an older woman (age 72) in my family has osteoporosis : > and will be taking Fostex (?).  She had not been on HRT. Does anyone : > have any information handy to e-mail me?  Wouldn’t soy products : > help along with the medication?  Thanks so very much.         Good information about osteoporosis can be found in Better Bones; Better Bodies by Dr. Susan Brown. There are two excellent chapters on osteo in "The Menopause Industry." by Sandra Coney. There is little actually known to clinically relate osteo prevention to hormone use and bone density levels.  This is still in the land of hypothesis and speculation.  This is a very complex multifactorial condition and is often a secondary condition associated with some other primary health condition.         Only the drug marketer want you to associate the condition solely with women and hormones. Fosamax has only 2-4 year trials behind it. Please read the FDA product insert carefully before thinking this product is a "cure" or a prevention at this state of its very limited product research and testing. There have been false hopes before with other products such as Didrinal and mega-fluoride doses which led to denser brittle bones rather than denser healthier bones.         Please continue to read widely on this subject. There are no secure answers yet nor has it been determined that osteo is in fact a mineral density problem. It may be a condition of the surrounding protein matrix in the bone. Keep evaluating -all- the potential risk factors and be very cautious about over-zealous diagnosis as well. If you read these several books you will get a better understanding of what is presenlty known, and what is being commercially hyped, about this complex condition.         And, yes exercise can give as good of density enhancing benefits as any of the drugs. They only change the bone density reading by a few percentage points and the ultimate -quality- of this density improvement remains to be investigated. Joan L,

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In article <340E7D42.576CF…@erols.com>, kakkri…@erols.com writes: >D, >    Thyroid medication, especially in excess, or steroids for asthma or >other chronic condition can both cause bone thinning. You say your >relative "has been constantly on the go." To build bone requires >weight-bearing exercise. Some authors suggest that the exercise needs to >be something different from normal activity. For example walking may not >do much to strengthen bone, but power walking, in which the person uses >muscles otherwise not used, to build up muscle around the bone and >create different stresses on it may be very effective. This is why >weight lifting is considered so beneficial.

She’s always power walking…. and tends to be on the hyperactive side. I’ll definitely tell her about the weight lifting. >    The long term safety of fossamax has not been established, since >there have been no real time long term studies. If she starts taking it >she should remember to take it with a full glass of water, and to remain >upright for at least, I think it’s a half hour afterwards because >fossamax can cause serious injury to the esophagus in susceptible people >which I believe includes anyone with a hiatal hernia or significant >esophageal reflux. Susan Hoch, if you’re reading this can you >correct/confirm and add any other warnings?

I also read that it should be taken 1/2 hour before meals, but if you can delay eating longer, Foxamas has an even better absorption rate. Have you heard this, too? >    Second opinions are always valuable, IMO.

Thanks, Terri. – Hide quoted text — Show quoted text ->DSands5000 wrote: >> In article <5ul1qh$…@ocean.silcom.com>, joan…@silcom.com (Joan >> Livingston Attorney at Law) writes: >> >       And, yes exercise can give as good of density enhancing >> benefits >> >as any of the drugs. They only change the bone density reading by a >> few >> >percentage points and the ultimate -quality- of this density >> improvement >> >remains to be investigated. >> >J >> Thanks, Joan.  I plan to read as much as possible about osteoporosis. >> What puzzles me is that my relative has been extremely active — >> constantly on the go.  From the little I’ve read so far, her having >> taken >> thyroid medication may be a factor, but other than that the only >> other factor I can see is heredity. >> I would imagine it might also be prudent for her to take her test >> results >> and get a second opinion….just thinking out loud here…

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        The other things I would add for steroid induced osteoporosis in a patient with rheumatoid arthritis is 1) Whjile on prednisone, you need 1500 mg calcium daily 2.)You should be getting at least 400 ID of vitamin D per day 3) A recent paper in the New England Journal rather effectively shows that cyclic etiodronate (a bisphonphonate) can prevent prednisone induced bone loss so you might consider this. 4) No smoking 5) No ethanol 6) Weight bearing exercise 7) Watch the protein content of your diet – a high protein diet is another contributory factor. Regards, Susan Hoch, M.D. ho…@auhs.edu n 5 Sep 1997 09:30:08 GMT, cad…@aol.com (CADown) wrote: – Hide quoted text — Show quoted text ->>Subject: Re: Need osteoporosis info, please >>From: Karen Kay <ka…@wordwrite.com> >>Date: 4 Sep 1997 04:26:01 GMT >>Message-id: <5uld8p$h5…@samba.rahul.net> >>Joan Livingston Attorney at Law <joan…@silcom.com> wrote: >>> This is a very complex multifactorial condition and is often >>> a secondary condition associated with some other primary health condition. >>Such as? (I’m just looking for one concrete example.) >I have experienced bone loss from the use of low dose prednisone for >Rheumatoid Arthritis. The answer for me is certainly to wean off of the >pred, eat healthy, take calcium and do weight bearing exercise. >Carol                 >Human beings are flawed individuals…the cosmic bakers took us out a >little too early.  That’s why we’re as crazy as we are—Jimmy Buffett

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        Bone again.         Osteoporosis represents net loss of bone mineral density. Bone is a dynamic tissue.  How much bone you have represents the difference between new bone formation and bone resporption both of which are ongoing.  How much bone you can afford to loose depends on what you started with, i.e. peak bone mass.         At 72, your relative needs the following 1. 1500 mg of calcium daily.  If she wants to get that much from soy, that is fine.  If not she can use dairy products, 15 cops of broccoli daily or any other combination including supplements. 2. Vitamin D – Vitamin D is required to absorb calcium from the intestine.  As we age (men and women), the ability to convert the precurosor vitamin D to the active metabolite slows, so we need more vitamin D.  She needs 400 IU of vitamin D3 daily unless she has liver of kidney disease and then she will be unable to convert it to an active form and will need supplemental catcitriol (1,25 D) 3. She needs to reduce absorption of bone – choices here are ERT, bisphosphonates such as Fosamax, Didronal, etc. or Calcitonin. Of the non ERT choices, Fosamax is the most effective in terms of percentage increase in bone density. 4. Weight bearing exercise is helpful. 5. She should no smoke. 6. Alcohol should be decreased if not discontinued 7. If she is on thyroid, that dose should not be excessive. 8. High protein diet should be avoided.         If she also has high cholesterol and coronary artery disease, in addition to osteoporosis, she may wish to consider ERT, as Fosamax does not have any effects on heart or lipids. Regards, Susan Hoch, M.D. ho…@auhs.edu n 3 Sep 1997 18:19:06 GMT, dsands5…@aol.com (DSands5000) wrote: – Hide quoted text — Show quoted text ->I was just told an older woman (age 72) in my family has osteoporosis >and will be taking Fostex (?).  She had not been on HRT. Does anyone >have any information handy to e-mail me?  Wouldn’t soy products >help along with the medication?  Thanks so very much.

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Steven B. Harris (sbhar…@ix.netcom.com) wrote: : Hormone replacement therapy (HRT) has been the method of choice : for the prevention of postmenopausal osteoporosis since the early : 1990s. Although a number of routes of administration are now : cessation of monthly bleeding, is preferred. Clinical experience : to date clearly demonstrates that long-term HRT unequivocally : increases bone mass and reduces the risk of fractures in : postmenopausal women, with no significant differences between : sequential and continuous combined prescribing regimens.         "Clinical" testimony may be your idea of adequate "proof" to keep pushing these drugs for specious benefits on your women patients, but it certainly is not good enough for me. Wait until 2005 for some long term studies first before you unequivocally claim you know what you are talking about based upon mere "clinical" observations.  Steve, do you read any of the stuff ahead of time that you keep offering as "proof" for your positions? : Data demonstrating that antiestrogens such as tamoxifen may : preserve bone mass have led to the initiation of large-scale : trials to determine the potential clinical utility of such agents : for the prevention of osteoporosis in postmenopausal women.         Other studies have shown a relationship between long term use of Tamoxifin and uterine cancer. Please look at all impacts of drug use before touting only one putative, untested, testimonial praise of a single product. Use you own patients as experimenal lab rats, but I am sure glad you are now a known quantity so I can know who to avoid in the future for my own care. : Ann Intern Med 1992 Jul 1;117(1):1-9   : Treatment of postmenopausal osteoporosis with transdermal : estrogen. : : OBJECTIVE: To evaluate the tolerance and effectiveness of : transdermal estrogen for women with established postmenopausal : osteoporosis and vertebral fractures.         Estrogen equals castration. Joan L.

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Steven B. Harris (sbhar…@ix.netcom.com) wrote: : : Bone 1996 Nov;19(5 Suppl):179S-183S   : European and North American Experience with HRT for the : prevention of osteoporosis. : however, traditional HRT remains the regimen of choice for the : prevention of postmenopausal osteoporosis, given its additional : beneficial effects on acute menopausal symptoms, as well as on : the cardiovascular system and brain.         Any "medical" article that can make such sloppy, innacurate statements in its conclusions is immediately suspect as a commercial plant.         HRT is -not- interchangable for ERT. The product insert for ERT dicredits any cardiovascular benefit and the use of ERT, not HRT, for the "brain" is in the land of wishful thinking.         It is hard for any drug at this point in time to be touted as "prevention" of osteoporosis when its etiology is still so complex and unknown. This smells entirely of a commercial plant. Please show more discrimination when you offer "proof" to discredit my skepticims in the future, Steve. : : Ann Intern Med 1992 Jul 1;117(1):1-9   : Treatment of postmenopausal osteoporosis with transdermal : estrogen.         This is a -one year- study for a product that requies life long use. Is this really how you justify your treatment choices for the women in your practice. Demand that they get castrated, be put on life-time estrogen because you have total faith in a one year study? Is this was you really call the ethical practice of medicine.         My advice Steve, is that you put your ERT/HRT presription pad away for a while until you actually have some facts that can support putting all of your women patients at risk for all the other well known drawback associated with life-long use of a product which clearly states on its warining label regarding use beyond 10 years.         You are speaking out of two sides of your mouth on these issues. You get HRT and ERT mixed up continually. You use clinical observations with little inherent credibility along with one year trials to induce women to surgically lose their female organs and take ERT for life. And, you, and the studies, present surrogate end point data as if it had any validity to the underlying condition you claim to be treating.         Keep trying Steve, I think doing all of this research will eventually be good for you. It is certainly proving my point that this whole lifetime ERT/HRT is more of a hoax and a racket than even I originally suspected. Joan L.

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- Hide quoted text — Show quoted text -sbhar…@ix.netcom.com(Steven B. Harris) wrote: >>In <Pine.SUN.3.96.970904070343.15841A-100…@coyote.rain.org> Joan >>Livingston <joan…@rain.org> writes: >>>    And again since the only connection to bone density increases >have been shown comparing castrated women on estrogen to castrated >women not on estrogen or with some other suspected selection criteria, >there is really not much solid information to work from.<< >Comment: >The following abstracts are for Joan L., who seems to think that >all studies of osteoporosis and estrogen have been on castrated >women taking estrogen alone, and none have looked at normal >postmenopausal women taking estrogen and progestins combined. >This is nonsense, but Joan seems willing to repeat it ad nauseam. >Read this stuff, Joan, and educate yourself.  The first article >in particular should answer your questions about continuous >hormonal replacement therapy. >                              Steve Harris, M.D.

Actually Steve this raises even more questions about continuous hormonal therapy in my mind, you see these articles stress that there is a positive benefit over risk ratio for hormones for those AT RISK of osteoporosis. Yet even for these women, (those at risk of osteo) the continuous regime is not recommended til one year after menopause. Yet I have heard of several women on this ng that have been prescribed continuous HRT while still peri. But it is the evidence, over and over again that I have been reading that estrogen helps those AT RISK OF OSTEOPOROSIS that makes me want to respond to your post.  It seems to me that you are definitely slamming it to us that most of us had better take hormones, or else!!! Well I came across another viewpoint this morning titled  Menopause and hormone therapy and thought I would share it with the group.  The site is Therapeutics Intitiative Evidence based Drug Therapy, University of British Columbia, Vancouver, Canada.They have put out several Therapeutics Letters, on such things as asthma treatment etc. and one of them #14 is on Menopause and Hormone therapy. This letter can be found at http://www.interchg.ubc.ca/jauca/pages/letter14.htm It is too long to post here, but I will post one part, on osteoporosis to give you  the tenor of the whole. The bottom line is that  250 women would need to ge given hormones for 10 years in order to prevent <one> thats <1> hip fracture event. These are using Steve Harris’s same statistics for hip fracture incidence. [Now the quote from the letter] Does hormone therapy prevent fractures associated with osteoporosis? Menopause is associated with an accelerated decline in bone mass, which may lead to osteoporosis and bone fractures in susceptible women. RCTs involving estrogens (equivalent to 0.625 mg conjugated estrogen) are uniformly positive in attenuating the decline in estimated bone mass. A recent cohort study demonstrated that medroxyprogesterone plus estrogen therapy had a greater positive effect on bone mineral density than estrogen alone.(8) After cessation of estrogens the slope of the decline in bone mass increases and bone mass reverts to its pre-treatment value. Only hip fracture has an effect on longevity; a menopausal woman has a 15% lifetime chance of sustaining and 1.5% chance of dying of a hip fracture (median age, 79) (3). A recent meta-analysis (9) of the available literature on estrogen use gives pooled estimates of the reduction in risk of hip fracture from case-control studies, 0.57 (0.48-0.67), and cohort studies, 0.85 (0.68-1.07); the highest quality studies showed the least protective effect of estrogen therapy. Even if the evidence is accepted and we pool all studies to get a RR of 0.75, the absolute risk reduction is small (see Table 2), estrogens also reduce the risk of vertebral and wrist fractures (3), which may cause significant morbidity. The benefits probably outweigh the risks in patients with established osteoporosis (previous low trauma fracture) or patients with greater than 5 risk factors for hip fracture(10). Bone densitometry alone is not a useful screening test to identify patients who would benefit from hormone therapy.(9),(11) [If you need the list of references Steve, I will send them to you by email, just ask.] Kathryn droz…@direct.ca

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>In <Pine.SUN.3.96.970904070343.15841A-100…@coyote.rain.org> Joan >Livingston <joan…@rain.org> writes: >>        And again since the only connection to bone density increases

have been shown comparing castrated women on estrogen to castrated women not on estrogen or with some other suspected selection criteria, there is really not much solid information to work from.<< Comment: The following abstracts are for Joan L., who seems to think that all studies of osteoporosis and estrogen have been on castrated women taking estrogen alone, and none have looked at normal postmenopausal women taking estrogen and progestins combined. This is nonsense, but Joan seems willing to repeat it ad nauseam. Read this stuff, Joan, and educate yourself.  The first article in particular should answer your questions about continuous hormonal replacement therapy.                               Steve Harris, M.D. Bone 1996 Nov;19(5 Suppl):179S-183S   European and North American Experience with HRT for the prevention of osteoporosis. Eriksen EF, Kassem M, Langdahl B University Department of Endocrinology and Metabolism, Arhus Amtssygehus, Denmark. Hormone replacement therapy (HRT) has been the method of choice for the prevention of postmenopausal osteoporosis since the early 1990s. Although a number of routes of administration are now available, HRT is still predominantly administered orally. In the United States, HRT formulations traditionally comprise conjugated equine estrogens. In Europe, however, HRT preparations tend to be based on 17 beta-estradiol, a natural human estrogen. Furthermo- re, distinct patterns of HRT use are apparent based on the age of the woman receiving it. Current recommendations are that early postmenopausal women (in their early 50s) receive sequential combined estrogen/progestogen therapy with continued monthly bleeds, while in women who are at least 1 year postmenopausal, continuous combined HRT, which leads to endometrial atrophy and cessation of monthly bleeding, is preferred. Clinical experience to date clearly demonstrates that long-term HRT unequivocally increases bone mass and reduces the risk of fractures in postmenopausal women, with no significant differences between sequential and continuous combined prescribing regimens. Data demonstrating that antiestrogens such as tamoxifen may preserve bone mass have led to the initiation of large-scale trials to determine the potential clinical utility of such agents for the prevention of osteoporosis in postmenopausal women. Nonhormonal therapeutic approaches are now also vailable, most notably bisphosphonates and vitamin D analogs. At present, however, traditional HRT remains the regimen of choice for the prevention of postmenopausal osteoporosis, given its additional beneficial effects on acute menopausal symptoms, as well as on the cardiovascular system and brain. Ann Intern Med 1992 Jul 1;117(1):1-9   Treatment of postmenopausal osteoporosis with transdermal estrogen. Lufkin EG, Wahner HW, O’Fallon WM, Hodgson SF, Kotowicz MA, Lane AW, Judd HL, Caplan RH, Riggs BL Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN 55905. OBJECTIVE: To evaluate the tolerance and effectiveness of transdermal estrogen for women with established postmenopausal osteoporosis and vertebral fractures. DESIGN: Double-blind, randomized, placebo-controlled clinical trial lasting 1 year. SETTING: Referral-based outpatient clinic. PATIENTS: Seventy-five postmenopausal women, 47 to 75 years of age, with one or more vertebral fractures due to osteoporosis. INTERVENTIONS: Thirty-nine women received dermal patches deliver- ing 0.1 mg of 17 beta-estradiol for days 1 to 21 and oral medroxyprogesterone acetate for days 11 to 21 of a 28-day cycle. Another 39 women received placebo. MEASUREMENTS: Bone turnover assessed by biochemical markers and iliac bone histomorphometry; bone loss assessed by serial measurement of bone density; and vertebral fracture rate. RESULTS: Compared with the placebo group, the median annual percentage change in bone mineral density in the estrogen group reflected increased or steady-state bone mineral density at the lumbar spine (5.3 compared with 0.2; P = 0.007), femoral trochanter (7.6 compared with 2.1; P = 0.03), and midradius (1.0 compared with -2.6, P less than 0.001) but showed no significant difference at the femoral neck (2.6 compared with 1.4; P = 0.17). Estrogen treatment uniformly decreased bone turnover as assessed by several methods including serum osteocalcin concentration (median change, -0.35 compared with 0.02 nmol/L; P less than 0.001). Histomorphometric evaluation of iliac biopsy samples confirmed the effect of estrogen on bone formation rate per bone volume (median change, -12.9 compared with -6.2% per year; P = 0.004). Also, 8 new fractures occurred in 7 women in the estrogen group, whereas 20 occurred in 12 women in the placebo group, yielding a lower vertebral fracture rate in the estrogen group (relative risk, 0.39; 95% CI, 0.16 to 0.95). CONCLUSIONS: Transdermal estradiol treatment is effective in postmenopausal women with established osteoporosis.

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In article <5ul1qh$…@ocean.silcom.com>, joan…@silcom.com (Joan Livingston Attorney at Law) writes: >>        And, yes exercise can give as good of density enhancing benefits >>as any of the drugs. They only change the bone density reading by a few >>percentage points and the ultimate -quality- of this density improvement >>remains to be investigated. >>J

  This is unfactual.  While it applies in some respects to fluoride, it doesn’t apply to Fosamax or calcitonin, both of which have been proven to decrease fracture incidence in post menopausal women.     And no, there have been no studies showing that exercise increases bone density to the same extent as either of the above drugs.  Much less that exercise decreases fractures by this mechanism.   Exercise does decrease fractures, but does so basically because stronger people don’t fall down as often.  Not falling is good, but not the same thing as having stronger bones.  You’re rather have BOTH.                                          Steve Harris, M.D.

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In <Pine.SUN.3.96.970903224450.24234C-100…@coyote.rain.org> Joan – Hide quoted text — Show quoted text -Livingston <joan…@rain.org> writes: >On 4 Sep 1997, Karen Kay wrote: >> Joan Livingston Attorney at Law <joan…@silcom.com> wrote: >> > This is a very complex multifactorial condition and is often >> > a secondary condition associated with some other primary health condition. >> Such as? (I’m just looking for one concrete example.) >> — >> Karen >>   ka…@wordwrite.com >Secondary Causes of Osteoporosis: >Drug related: >Glucocorticoids >Heparin >Anticonvulsants >Chronic litium therapy >Thyroid hormone over-replacement >Chronic ingestion of phosphate binding antacids >Endocrine Related: >Hyperthyroidism >Cushings Syndrome >Hyperparathyroidism >Hypogonadism >Type 1 Diabetes >Hyperprolactemia >Acromegaly >Malignancy Associated: >Multiple myeloma >Leukemia >Plasma cell disorders >Genetic Disorders: >Sickle cell anemia >Homosystinuria >Thalassemia >Hypophosphatasia >Osteogenisis imperfecta >Miscellaneous Disorders: >Anorexia nervosa >Systemic mastocytosis >Alcohol abuse >Chronic liver disease >Chronic renal disease >Malabsorption syndromes >Vitamin C deficiency >Source: Practical Hygiene – May/June 1997 >Joan L.

    Yes, and when you get done looking at the list, and at your patient, you will find out that most (well over 90%) of cases of osteoporosis are primary, garden-variety age-associated osteoporosis. They are not "often" secondary.  They are rarely secondary.                                            Steve Harris, M.D.

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In <Pine.SUN.3.96.970904070343.15841A-100…@coyote.rain.org> Joan Livingston <joan…@rain.org> writes: >    Agreed, let’s all do a lot more reading on this subject and it is >good to have Dr. Hoch helping us to understand this condition from the >medical perspective. But one can not also underestimate the impact of >heavy advertising lately to scare just about everyone in to thinking they >are automatically at risk for this relatively rare condition, until they >changed the definition to include practically all post meno women >…without having ever done any real time studies to show this is so ….. >only a consensus panel made this the new operating definition for

osteo.     40% of women will have at least one osteoporotic fracture before they die.  This is not a "rare" condition.  Somewhere between 10 and 15% of women will suffer a hip fracture due to osteoporosis, and at least a quarter of these will not walk normally ever again. >    And again since the only connection to bone density increases have >been shown comparing castrated women on estrogen to castrated women not on >estrogen or with some other suspected selection criteria, there is really >not much solid information to work from.

    This is completely wrong. >    Most critically, only surrogate endpoints are being measured in >all of the current estrogen (castration) use, not the incidence of the >disease itself.

   Bone density is not a surrogate endpoint.  Unless you want to argue that bone density is not the critical variable which determines fracture risk at a given stress level?  And many studies use fracture incidence directly.   > No reproducible studies besides Dr. John Lee’s personal >testimony exist for progesterone use and osteo

   Well, here you make one true statement.  and the other drugs out >there for bone "enhancement" are woefully short term tested and use

the patients themselves as the beta test group, reporting "post-marketing >experiences" as women show their response.     Well, of course you use the patients as the beta testers.  Giving the drugs long term to people who didn’t have the disease would be unethical.  These drugs aren’t completely benign things, you know. There are studies showing fewer fractures for both Fosamax and Miacalcin, BTW.  Fewer fractures is not a surrogate endpoint. >    And intriguingly is this recent criticism that bone density >should be measured in cubic centimeters, not square centimeters.

    Measuring it in grams calcium per cm squared per total bone thickness (which is how it’s reported) is equivalent to reporting grams calcium per volume. >    In the ancient Chinese medical tradition, osteo was included

among the arthritic diseases and not a female-exclusive menopause affliction. Ony modern markteting efforts have created this connection. Fait accompli.<    Nobody said it was female exclusive.  But when women have 2 or 3 times the fracture incidence of men, and the big divergence doesn’t happen until after menopause, this does highlight the role of menopause in creating the problem for most women who have the problem.                                          Steve Harris, M.D.

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On Sat, 6 Sep 1997, Susan Hoch MD wrote: > 3. She needs to reduce absorption of bone – choices here are ERT, >    If she also has high cholesterol and coronary artery disease, > in addition to osteoporosis, she may wish to consider ERT, as Fosamax > does not have any effects on heart or lipids. > Susan Hoch, M.D.

       And she also needs to get castrated (fixed, neutered, spayed) in order to use ERT. Joan L.

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On Sat, 6 Sep 1997, Susan Hoch MD wrote: >    Get off your high horse about the drug companies. Besides, men

        No way, Susan. I have been in the health care business for 30 years too. I saw the huge changes in "information" management about drugs post-Tagamet. I will continue to sound the call for necesssary skepticism. Reminds me far too much of the tobacco companies whose corporate philosophy was to increase the sale of its products while protecting itslef from any liability from those products.         I have also been on a hospital bioethics committee for over 7 years and this intrusion of drug company marketing into the delivery of health care …. especially post Tagamet…. has been a topic of many lively discussions and fact-gathering sessions.         By way of history, about 15 years ago Tagamet (Rx ulcer medication) was introduced to the public first through the lay media, rather than to the prescibing physicians who would typically independently evaluate its place in their practice. Instead, patients after the media articles started clamoring for the drug first and the drug companies took note and quite frankly the practice of medicine (or even dentistry) has never been the same first.         Now the end consumer is courted agressively, rather than the primary emphasis on the prescribing physician. The "osteo"  docotrs in our area publish full page ad in our local newpapers with all sorts of inflammatory imagery and misrepresented text.         Artifical estrogen was also introduced as a media event with the publication of "Feminine Forever" so in fact Tagamet was not the first media drug event of such proportion. But the topic was more taboo and relied on word of mouth and book purchase and was limited to women’s publications. But the lessons were well learned by the marketing departments of the drug companies.         I don’t know how old you are Susan, but you may not have been practicing long enough to know there was another time when products and research had more independent credibility and when we in the profession had to pay money to subscribe to scientific journals and not receive them as free throw-aways sponsored by drug industry advertising.         Over my 30 year involvement, it has been a vastly changed market place.  And I will remind again that the pay off has been this WHO study showing a negative impact in the health of both US men and women in the last 10 years and several independent studies showing people are not getting healthier i nthe US with all this "health care," but simply paying more for it to get worse.         So telling me to "get off my high horse" is futile advice. I raise an important voice and it is time it started getting listened too rather than attempts to squelch by medical industry voices.         It is good to get your factual information on the subject of osteoporosis. We need to talk about this more. Far more. Basic reserchers I spoke with at the University of California Santa Barbara Materials Lab do not share your confidence that much is really known about bone physiology, and almost nothing about artifical attempts to alter it.         And they and lately almost every article I read on osteo makes reference to the possibility of it being a protein/organic problem and not necessarily a mineral/inorganic problem.  I am trying to do my homework on this subject too.      Along with your input, it will also be good to get my critial questions to be sure we are sticking to the facts and not indulging in commercial value judgments to drive future medical dependencies. Joan L.

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        I found this post quite disturbing but then, I recognize that Joan is not used to thinking about bone metabolism on a daily basis. See my comments below; @silcom.com (Joan Livingston Attorney at Law) wrote: >: DSands5000 <dsands5…@aol.com> wrote: >: > I was just told an older woman (age 72) in my family has osteoporosis >: > and will be taking Fostex (?).  She had not been on HRT. Does anyone >: > have any information handy to e-mail me?  Wouldn’t soy products >: > help along with the medication?  Thanks so very much. >    Good information about osteoporosis can be found in Better Bones; >Better Bodies by Dr. Susan Brown. There are two excellent chapters on >osteo in "The Menopause Industry." by Sandra Coney.

        There is actually a tremendous amount known about hormones and bones – for example, men with testosterone deficiency get osteoporosis and are treated by replacement of testosterone. There is little >actually known to clinically relate osteo prevention to hormone use and >bone density levels.  This is still in the land of hypothesis and >speculation

        Myabe lawyers are speculating but rheumatologists are not.         I agree with this statement. This is a very complex multifactorial condition and is often >a secondary condition associated with some other primary health condition.

        Get off your high horse about the drug companies. Besides, men get osteoporosis too, they just don’t abruptly increase their bone resoprtion at a certain time of life.  Furthermore, they tend to have higher peak bone mass, so they have more bone to lose before they get into trouble. >    Only the drug marketer want you to associate the condition solely >with women and hormones.

        Please read the Didronel literature – it is true that daily etiodronate was not efficacious but cyclic etiodronate has been used for at least 5 years and is quite efficacious and without the toxicities you mention.         In addition, you have not mentioned calcitonin at all – perhaps you are not familiar with it but it was used for years as an injection with good results and now is available as a nasal spray called Mia-Calcin which is well tolerated but probably less effective than the bisphophonates. hind it. >Please read the FDA product insert carefully before thinking this product >is a "cure" or a prevention at this state of its very limited product >research and testing. There have been false hopes before with other >products such as Didrinal and mega-fluoride doses which led to denser >brittle bones rather than denser healthier bones.

        Fluoride was associated with more brittle bones – because it affects on increasing bone formation not decreasing resoprtion.  There are new fluoride products in trial but I have no experience with them yet. >    Please continue to read widely on this subject. There are no >secure answers yet nor has it been determined that osteo is in fact a >mineral density problem.

Wrong again.  Osteoporosis is a problem with mineral density; osteomalacia is a problem with the bone matrix.  You can have both together or only one.  There are a number of conditions predisposing to osteomalacia such as use of anti convulsant drugs, liver disease, malabsorption states.  Often a bone biopsy is necessary to distinguish them. a condition of the surrounding protein >matrix in the bone. Keep evaluating -all- the potential risk factors and >be very cautious about over-zealous diagnosis as well. If you read these >several books you will get a better understanding of what is presenlty >known, and what is being commercially hyped, about this complex condition. >    And, yes exercise can give as good of density enhancing benefits >as any of the drugs.  

        Of, if it were as simple as that.  Just exercise and your bones will come back.  Exercise is part of a program for both prevention and tr5eatment of osteoporosis but exercise alone will not reverse established osteoporosis.         You need to bone up on this subject Joan Susan Hoch, M.D. ho…@auhs.edu change the bone density reading by a few – Hide quoted text — Show quoted text ->percentage points and the ultimate -quality- of this density improvement >remains to be investigated. >Joan L,

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