Originally Posted by The Rani

You mentioned the causes of diseases as they relate to the treatment. Just wondering how much you know about them. No "point."

Ok

Originally Posted by Roadbldr '59

The problem with Western medicine, as practiced in the United States at least, is that it operates 'for profit' rather than for the benefit of humanity. Profit for the insurance companies, profit for the drug companies, profit for the hospitals, profit for the lawyers, profit for the doctors, profit for pretty much everyone except the patients, who are sometimes driven into bankruptcy by severe illness even WITH health insurance.

About ten years ago or so urban legends started popping up about cures being available for all sorts of 'incurable' afflictions, cures that were being suppressed by the drug companies (and others) because there was more profit in keeping people chronically ill and treating the symptoms. I thought it was bullcrap then. I'm no longer certain. Indeed, every time I see one of those stupid TV commercials that tout the benefit of some new drug... then go on to inform of the horrible things that can happen to you if you take their product... the more convinced I become that they aren't urban legends at all.

I am particularly offended by all the woo woo BS snake oil being sold to gullible parents told it will "cure autism", for obvious reasons. Several autistic kids have been killed by Chelation Therapy, for example.

Originally Posted by Chas'88

I must say that this conversation more and more reminds me of Moliere's play The Imaginary Invalid:



This play resounds quite well with me since I grew up watching supposedly well meaning doctors literally experiment on my mother. She had a strange tendency to adapt to whatever pain medication they gave her and was allergic to asprin--the reason I know for a fact the doctors were simply experimenting was that my mother had a life long allergy to asprin, and the doctors once assigned an asprin-based medicine. Luckily the pharmacist was a good enough friend to catch the doctor's folly in time. That brought attention to a revelation I had about doctors, health care, and the whole industry of modern medicine--the majority of them are simply poking around in the dark. I'll grant that there's a minority of them which probably do believe that they are doing good or want to do so, but most I think aren't taken in by the romanticism modern society has weaved around modern medicine. Instead I think most of them are in medicine for the oldest reason in the book: it's a good way to make a lot of money.

Even the more expensive doctors which we could get for a short time when my dad finally was able to get a teaching job back in 2006, weren't that much better. Granted I will say that there have been modern advances in diabetic treatment, however my mother had gained a sensibility and knowledge of her own brittle type I diabetic tendencies and how to manage and handle them. My mother had a way of mixing R & N insulin together and knew just how much to take and how much to balance it against what she was eating. When she was in the nursing home under this new medication--it was also a very good nursing home considering my mother was a member of the O.E.S. and could therefore get into a Masonic nursing home. The doctors there instead of listening to her, gave her a newer insulin where the R & N factors were already pre-mixed at a standard level. Every night she took it she had an insulin reaction. Each time she told the doctors she knew how to manage her diabetes, they took one look at the methods she was asking for and pooh-poohed her. After three weeks of consistent nightly insulin reactions the doctors grudgingly gave in to my mother's handling of her own diabetes. She didn't have another insulin reaction while she was there.

Another case which sounds silly would be that not all people have the same normal body temperature as others. It's a well held misconception that if a person has a body temperature of 98.6--when this is not the case. It' is only an AVERAGE body temperature, around which individuals tend to be. Some have a body temperature higher than 98.6, and some have it lower as I do. My normal body temperature is 97.7--which most people roll their eyes until I end up with a clear fever at 98.9.

Ultimately the only person who can cure you is yourself, and the best person who knows about your body and it's idiosyncrasies is yourself. If you lay your trust in others to do the job for you, you'll end up sorely misled and fooled. That's not to say that modern surgery doesn't have some benefits, but I will agree with The Rani and say that some surgery is unnecessary.

The ultimate goal of doctors and doctoring should be aimed towards getting a person more involved with their own health or be there to act as a general reference point--like an encyclopedia. Specialists interested in finding out more information on diseases, etc. should go into fields of research and add to the larger community's knowledge. If necessary surgery is needed, then those same specialists come into play. Doctors in general however should not make it their goal to cure people but rather act as an educational tool for those who take an active role in their own healths and as a last resort where the person is beyond being able to do something themselves (like doing a necessary surgery).

~Chas'88

I guess that I am fortunate that my doctor as a teen was the local well-respected expert on developmental disorders and who certainly isn't in it for the money, he's simply a wonderful doctor.

I have the same temperature thing, my normal temperature is about the same as yours.

Originally Posted by The Rani

Probably not as many as have been given diabetes by Zyprexa/Risperdal.

folks on the spectrum shouldn't be really getting those anyway, those are anti-psychotic medications.

Originally Posted by The Rani

Um, you do know that Risperdal is FDA-approved to treat aggression associated with autism in children?

Yes, and it's crap. maybe people would work on preventing the sensory overload that leads to autistic meltdowns instead of turning us into Zombies?

The only medication that I have seen that consistently helps those of us cope with neurotypical society is Ritalin. In my case it reduces my sensory sensitivities and helps with my executive system dysfunction.

Originally Posted by The Rani

Um, you do know that Risperdal is FDA-approved to treat aggression associated with autism in children?

I presume that means that neither manufacturer nor prescriber can be held liable for the harms caused by using it to "treat aggression associated with autism in children"?

That's sort of the way I imagine FDA-approval to work... am I right?

I'm thinking that by the time this is over people who live in Arkansas could end up with a free blow job on the moon.

Originally Posted by The Rani

As an aside, the FDA has been under fire in recent years for bending to pressure from drug companies to get their meds approved, resulting in new drugs being released with many harmful side effects and maybe little efficacy to boot. As a result, the process is now much harder, although I've seen things get "approved" quickly, and I have a feeling (no proof here, just a feeling) that there are some underhanded tactics at work.

I heard one grumble about the FDA a while back from some natural healing folk in the martial arts and new age occult communities. There are a large number of traditional herbal remedies that have been used for quite some time. Being natural substances, they cannot be copyrighted, trademarked or otherwise owned by corporate entities. However, there is an alleged Evil Conspiracy that prevents such substances to become FDA Approved.

On the other hand, allegedly at least, the drug companies will commonly study natural herbal remedies, isolated the active ingredient, learn how to synthesize something nigh on identical to the active ingredient, and then copyright the synthetic.

Now, medicine isn't my field. I just Googled some appropriate keywords. Others might do the same. There are lots of opinions on the subject out there. Among other things, The Establishment will warn that plants vary, and preparation will vary. Even if one understands what a natural drug can do, it is often hard to hit a given dosage reliably.

But, yes, there are a number of people who smell something fishy in the FDA. They are too much in bed with the industries they are supposed to be managing and regulating. At least some of the new age freaks and traditional herbalists are grumbling.

Originally Posted by The Rani

Not really. Physicians are held to a "standard of care," which in this case means monitoring weight, blood sugar, lipids, etc. on a regular basis, and switching or stopping medications if there are problems. If they don't, they can certainly be held liable in court for damages. Drug manufacturers getting sued is a relatively new thing, and I'm not familiar with enough cases to comment on that part.

What FDA approval means is more about money for the drug companies than anything else. They can market their drug as "FDA approved to treat such and such," which means that more physicians will prescribe it. Most psych med consent forms now include an "FDA approved" part, so if you give someone a medicine for a condition "not FDA approved" you have to explain why you are doing so. It's not a big deal for specialists to explain something like that, but primary care docs usually go for the FDA approved stuff to be on the safe side, and that's a HUGE market share for these meds. Plus, drug companies can more easily get their drugs on formulary with insurance companies, including Medicare/Medicaid, if they are FDA approved for the condition that the patient has.

As an aside, the FDA has been under fire in recent years for bending to pressure from drug companies to get their meds approved, resulting in new drugs being released with many harmful side effects and maybe little efficacy to boot. As a result, the process is now much harder, although I've seen things get "approved" quickly, and I have a feeling (no proof here, just a feeling) that there are some underhanded tactics at work.

Fortunately I have a good psych. He's actually the one who told me that giving Risperdal to autistics is crap.

Originally Posted by The Rani

It's not a conspiracy. It's the law. There are certain requirements for a drug to be FDA approved, which include testing on animals first and then controlled studies on humans. This requires a lot of money, and nobody is going to waste time testing a substance that can not be patented and then used to make a profit.

This makes sense if the objective of the system is to maximize profits for the companies while minimizing competition from natural alternatives. It makes less sense if the objective is affordable health care.

How absurdly expensive is the testing? Could a university looking for research projects manage it, or is the bar set so high that only a major for profit corporation would be able to clear it?

I am imagining a UC Berkeley project to get FDA approval for using Marijuana for pain relief. ™

Originally Posted by The Rani

Ask yourself who is more trustworthy, the one who tells you to keep believing in the system that benefits them, or the one who tells you the problems with the system that they are a part of.

There is no way to tell without more information.

Originally Posted by Bob Butler 54

How absurdly expensive is the testing? Could a university looking for research projects manage it, or is the bar set so high that only a major for profit corporation would be able to clear it?

http://www.bg-medicine.com/content/n...r/news/q/id/24

It takes about eight years per test, 90% of drugs fail testing, and its estimated that this ends up costing around $800 million per new drug approved. Do you know how many people with borderline and off-label symptoms you'd have to sell to just to break even?

Of course, if you're actually reading FDA reports on new drugs, you'll almost always find the following lines somewhere: "The mode of action [of drug] is unknown," and "This is not a cure." Most of the testing is designed to ensure it does what it says it does, without causing short-term consequences worse than the original symptoms. For long term medications, patient = lab rat.

Originally Posted by Bob Butler 54

I am imagining a UC Berkeley project to get FDA approval for using Marijuana for pain relief. ™

Well now, that's just illegal outright. Doctors and researchers can't just pick up the most effective medical plants we know of (cannabis, opium, coca) and start doing "experiments" with them. That would be crazy. Instead, they'd have to apply for a limited number of federal licenses for study, and those have only been opened up in the last few years. If you're interested in this line of study, you'll need to buy a Senator or two first.

Originally Posted by Bob Butler 54

This makes sense if the objective of the system is to maximize profits for the companies while minimizing competition from natural alternatives. It makes less sense if the objective is affordable health care.

Welcome to the American regulatory regime? The bold part could be applied to medicine, inter-generational entertainment copyrights, most stock market regulations [that are actively enforced], big-farm subsidies...

About 75% of drugs are still actually extracts from a naturally occurring plant, but here's how it goes. They find something that is used in traditional medicine somewhere, then try to isolate the most active chemical. The process of isolating the single chemical is often patentable, so they have the single chemical tested under the FDA rules rather than the entire plant. Alternatively, they might find a different starter chemical that can be manipulated until it matches the original plant source.

In the other cases, they'll tweak the chemicals with a few reactions, ie: turning opium into morphine or heroin.

A major problem arises in not studying how the other chemicals effect our biology. IE: Cannabis has dozens of active chemicals, but Marinol only includes one or two of them. Patients say it just isn't as effective, and the Marinol pill can actually deliver a lethal dose where smoking the plant itself can't.

The only botanical mixture currently approved by the FDA is actually an ointment made from green tea, the same chemicals they came out loudly decrying just years before:

"FDA concludes that there is no credible evidence to support qualified health claims for green tea consumption and a reduced risk of gastric, lung, colon/rectal, esophageal, pancreatic, ovarian, and combined cancers. Thus, FDA is denying these claims. However, FDA concludes that there is very limited credible evidence for qualified health claims specifically for green tea and breast cancer and for green tea and prostate cancer, provided that the qualified claims are appropriately worded so as to not mislead consumers." On May 9, 2006, in response to "Green Tea and Reduced Risk of Cardiovascular Disease", the FDA concluded "there is no credible evidence to support qualified health claims for green tea or green tea extract and a reduction of a number of risk factors associated with CVD."
However in October 2006, the FDA approved an ointment based on green tea. New Drug Application (NDA) number N021902, for kunecatechins ointment 15% (proprietary name Veregen) was approved on October 31, 2006, and added to the "Prescription Drug Product List" in October 2006. Kunecatechins ointment is indicated for the topical treatment of external genital and perianal warts.

Amazingly though, the FDA still doesn't recognize a single health benefit of actually drinking green tea, but they'll approve a prescription ointment to put on your junk.

I would literally not trust American medicine until I was on my death bed. Then I'd say: "Experiment away! I've got nothing left to lose."

Originally Posted by Bob Butler 54

But, yes, there are a number of people who smell something fishy in the FDA. They are too much in bed with the industries they are supposed to be managing and regulating. At least some of the new age freaks and traditional herbalists are grumbling.

Well, I'm neither a new age freak nor a traditional herbalist, but I'll grumble right along with them. If we're going to have a regulatory agency, it should regulate and work in the public interest, not cut side deals with big pharma.

http://online.wsj.com/article/SB125694764832619997.html

A report issued by the nonpartisan Congressional Budget Office highlights faults with both sides of the argument to create a public health-insurance plan...

The House's public plan would save money by having lower administrative costs than private plans, according to the CBO's findings. But several other factors would drive up its costs, the report said... The CBO says its findings aren't conclusive.

-Please keep in mind that the CBO has a long track record of underestimating the cost of government programs.

---

Originally Posted by haymarket martyr

WARNING: The poster known as jamesdglick has a history of engaging in fraud. He makes things up out of his own head and attempts to use these blatant lies to score points in his arguments. When you call him on it, he will only lie further. He has such a reputation for doing this that many people here are cowed into silence and will not acknowledge it or confront him on it.

Anyone who attempts to engage with glick will discover this and find out you have wasted your time and energy on an intellectual fraud of the worst sort.

-So cry many Boomers like Haymarket & Playwrite whenever they fail to explain their hypocritical self-justifications, their double-standards, and their double-think forays into evil. Perhaps their consciences bother them, perhaps not. Who knows.

Originally Posted by The Rani

Opinions are like assholes. My own personal one, since you brought it up, is that giving Ritalin to autistics is "crap."

Ritalin is the only medication that has ever reduced my sensory sensitivities and increased by ability to multi-task, so your opinion is crap.

Originally Posted by Odin

Ritalin is the only medication that has ever reduced my sensory sensitivities and increased by ability to multi-task...

Wow. That's like the exact opposite effect crank had on me. Isn't biology cool?

Of course, the brain keeps developing until the early 20s. Does anyone know the effects of chronic methamphetamine use on developing organisms? It can't be good...

Originally Posted by Justin '77

Wow. That's like the exact opposite effect crank had on me. Isn't biology cool?

Of course, the brain keeps developing until the early 20s. Does anyone know the effects of chronic methamphetamine use on developing organisms? It can't be good...

Actually, I have read that in people with ADHD and many on the autism spectrum Ritalin and other stimulants (like caffeine) have almost the opposite effect to what they do with "normal" individuals. I have noticed this myself, caffeine actually calms me and can even make me a little sleepy. Which is why the people that get Ritalin illegally to use thinking it will help them study are morons, it will just make them hyper.

Just to nitpick, Ritalin is an amphetamine derivative, but it is not nearly as powerful as meth.

Originally Posted by The Rani

As I said, they're like assholes.

Hey - if it worked for him?

We had a local case in which a woman had a nasty physical condition that was being relieved by a medication - that she was suddenly deprived of because it "hadn't been proven to work." On being told that it worked for her, she was told "Anecdotal evidence isn't clinical proof."

Well, for mass distribution, no. OF course not. But for a case in which is HAS been proven to work?

We're only at the very edge of individualized medications, probably with a genetic base. So one person's crap is another person's cure and vice versa.

Originally Posted by The Rani

Urban legend.

I'm an urban legend?

Listen, I know several people with ADHD with that experience, it's NOT an urban myth.

Originally Posted by The Rani

Exactly. I wonder if drug companies will eventually try to extend their patents to entire plants, the same way that manufacturers of GMOs have already extended their patents to crops that have been accidentally cross-pollinated.

I don't think a patent like that would be valid. A valid patent has to be a new thing. Suppose a company went to the effort to show that a medicinal plant works and patented the plant,

Such a patent likely would not withstand challenge because knowledge that the plant had medicinal properties was previously known to practitioners of traditional medicine.

Originally Posted by The Rani

Try again genius.

Why don't you explain what you're talking about? As far as I know you're the only doctor in the house and that's even your specialty, so I assume you know what you're talking about and we could all benefit from your knowledge, but it's not reasonable to expect people to take your word for things without at least explaining.

Odin reported personal experiences with stimulant drugs that seem to support the idea of the inverse effect; what do you know that refutes this idea? I'm asking because I'm genuinely curious. What is the effect that leads Odin to believe he's being slowed down by stims?

Originally Posted by independent

About 75% of drugs are still actually extracts from a naturally occurring plant,

That's not exactly correct. About 75% of medicines are compounds or derivatives of compounds found in naturally occurring plants or fungi. For example penicillin is an antibiotic produced by bread mold. Penicillin is produced at a big scale today (50,000 tons annually), all of it from penicillium fungal strains derived from an original isolate obtained from a rotten cantaloupe in a Peoria farmer's market during WW II.

but here's how it goes. They find something that is used in traditional medicine somewhere, then try to isolate the most active chemical.

Few new drugs are obtained in this way today. Some have tried, but they have not been very successful.

Originally Posted by Mikebert

That's not exactly correct. About 75% of medicines are compounds or derivatives of compounds found in naturally occurring plants or fungi. For example penicillin is an antibiotic produced by bread mold. Penicillin is produced at a big scale today (50,000 tons annually), all of it from penicillium fungal strains derived from an original isolate obtained from a rotten cantaloupe in a Peoria farmer's market during WW II.

Splitting hairs? If you go in to a pharmacy, the majority of the chemicals inside those pills (or the precursers to them) can also be found in naturally occurring plants, fungi, etc.. I think we agree on that plus or minus the specificity of the language.

And while the pharma companies don't necessarily own patents on the chemical itself, they can patent methods for synthesizing or extracting those chemicals. Since the plant itself isn't tested for medical efficacy (no profit incentive), you have to go through the doctor and the patent to get the chemical you could have grown in the backyard. And with genetically modified crops as a precedent, what is stopping pharma from teaming up with Monsanto in creating and patenting a plant strain that boosts output of a particular active chemical?

Now, as far as penicillin goes, maybe the fact that we've pumped the whole population up with the extract of a single strain has something to do with why the antibiotic doesn't really work anymore? Maybe there are other chemicals in the mold that would suppress bacterial evolution, maybe allowing penicillium to evolve on its own would leave it more effective in the long run: but there's no financial incentive to ever find out.

Originally Posted by Mikebert

Few new drugs are obtained in this way today. Some have tried, but they have not been very successful.

Few new drugs are found today at all. Placebos have become so effective that its hard to get anything past late stage trials. Some of the most popular prescriptions (Prozac) probably couldn't get past FDA evaluation if they were introduced today.

Faith in a pill, faith in a god, faith in acupuncture, whatever. Its been my anecdotal experience that those with the highest faith in pills have the worst chronic medical conditions.

Originally Posted by Bob Butler 54

How absurdly expensive is the testing

It's expensive because the era of magic bullets is gone. Consider antibiotics and chemotherapy drugs. One of the first of these drugs was penicillin. Penicillin was strikingly effective. When given to people with bacterial infections almost all of them were quickly rid of the bacteria, that is, they were cured.

One of the reasons why this happened was that people sometimes cure themselves of bacterial infections. That is, their immune systems can destroy bacteria when present in manageable numbers. What an antibiotic does is kill the vast majority of bacteria, reducing their numbers to a manageable level that the immune system cas finish off. Another reason the antibacterials worked was that bacteria are so different from humans that compounds that wreck havok with their physiology often left ours untouched. This allowed lethal levels (to the bacteria) of antibiotics to be used.

In cancer, the bad guys are the patient's own cells gone rogue. They are still human cells and have human cellular physiology. Anything poisonous to them is going to be poisonous to the patient. The doctor cannot use lethal levels of anti-cancer drugs because they will will the patient too. Similarly, because the cancer cells are part of the body, they will not draw the same vigorous immune response as an utterly foreign agent like a bacteria.

What this means is it is much much more difficult to wipe out a cancer incursion with chemotherapy than it is a bacterial incursion with antibacterials. Thus, standard cancer therapy involves mechanical removal of as large a fraction of the cancer cells as possible, followed by (if necessary) cell-killing treatments (radiation, chemotherapy) designed to preferentially kill cancer cells over normal cells.

For example, my wife had stage I grade 2 endometrial cancer 11 years ago. She had a TAHBSO (Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy) and that was that. With stage I, about 90-95% of the time, the cancer has not yet escaped from the uterus. Removal of the uterus intact achieves mechanical removal of 100% of the cancerous cells and the patient is "cured"--although one cannot know this is the case for many years afterward, if ever. On other hand, if cancer cells are found outside the uterus, in the lymph nodes (stage III) or elsewhere (stage IV) the prognosis is worse or much worse. This is because they are (or were in 1998 at least) no really effective radiative or chemotherapies for endometrial cancer.

On the other hand, breast cancer is a cancer with a reasonably good prognosis (as cancers go) even though surgery fairly often does not remove all of the cancer. Radiative and chemotherapies are more effective for this cancer.

It's not like there was some "penicillin" for breast cancer. There will proably never been anything as effective against cancers as pencillin was against susceptible bacteria. Various new compounds were developed over time that had a modest improvement in efficacy or were better tolerated or had fewer side effects and doctors gained more things to try.

Since the improvements at each step were marginal at best, one has to test in lots of patients to see if a real improvement exists. Such large scale studies are expensive.

I recall a cancer drug at phase II trial about which there was a lot of excitment. One of the patients, who was terminal, got dramatically better, and ended up apparently "cured". But during phase three trial it simply was not sufficiently better than the control therapy and was dropped.

Our drug was markedly better than the standard drug for that one guy, but is was not better for most guys. And you have to consider the reverse, that for some other guy the standard drug might be markedly better and it would be bad if he got our drug instead.

It's not easy.