Minor Miracles: Fixing the Bikes.

Bike chain and chain tool on the ground (Photo credit: londoncyclist)

Today should have been a very bad day.

It was one of those sunny New England fall days when you just have to get outside.  Since my house is shaded, I had no leaves to rake.  So it was time to get the bikes out for a ride.

Unfortunately, I hadn’t fixed the bikes.  But I had purchased what I needed.  I had a new valve for the back tire of my son’s bike, and I had a doo-hickey to help me shorten the chain on my bike so it doesn’t come unglued every time I go uphill (nothing quite like a chain losing its cool and jumping the tracks when you’re half way up a long hill).

So, feeling smug, I took out my equipment and started.  After all, I have an advanced degree and got a fairly high score on my SATs back when they were the “real” SATs.  So I should be able to master a few gears.

First problem.  My son’s valve doesn’t just not work.  It has broken into bits.  Bits that I proceed to jam down into the tire with a tiny screw driver.  So I do what any man would do.  I move on, leaving the first project unfinished.

Anyone who has tried to shorten a chain will appreciate the following.  Anyone who has not tried to shorten a chain should run screaming from the prospect.  If necessary, purchase a new bicycle before engaging in this particularly brutal form of masochism.

An hour later, I was no closer.  But I’d just been reading Dale Carnegie, so I had that “can do until I’m dead” attitude.  Didn’t help much.

I can only describe the following in miraculous terms.  I hit upon the idea of using one bit of chain to “channel” the bit of steel I needed into the chain I was now trying to repair.  It worked beautifully.  How that idea came to me after an hour of jiggering, I’ll never know.

Looking back at my first unfinished project, I hit upon the idea of simply pumping up the tire, letting the bits of the first valve hold in the air.  It worked.  I have no logical explanation.

So we got our afternoon bike ride.  Not really any thanks to me.  Maybe we all look for “major” miracles in our daily lives, when it is really the minor miracles that matter.

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Longest Zipline In U.S. Used For Local Commute In Maine.

Newry Maine (Photo credit: Bill Ruhsam)

If you love long ziplines, you’ll have to go to Alaska or South Africa to get a better ride.  Or you can visit the son of Jim Sysko and then drop down to his dad’s house for supper.

In order to shorten the trip between houses, engineer Jim Sysko built one of the longest ziplines in the world.  Now his fifteen minute commute is down to two minutes.  Can city ziplines be far behind?

Here’s the article.  http://www.mainenewssimply.com/content/sun-journal/mile-long-zip-line-connects-newry-homes

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Should You Ice Your Boo-Boo? More Studies Necessary, Says Meta-Analysis.

IMG_5789 (Photo credit: creativevictuals)

If you don’t care about the discussion, just skip down to the boo-boo in bold.

In my recent post about most scientific studies being wrong, I began questioning the very basis for evidence-based medicine.  How can we know what we know?  When we do a large scale human study, we have to trust the results.  We can’t run off to a lab and have them do it again.

So I thought a quick check into alternative medicine advances might be in order.  As expected, most studies are small and underfunded compared to the massive studies produced by drug companies.  And it is those massive  drug studies that are in question for their ability to give us truthful answers about what will work.  If they cannot be reproduced in a consistent manner, then what chance does alternative medicine have?

There is another avenue for medical knowledge, largely disregarded by current researchers but widely used by the public.  It is the school of what works.  One of the basics, something we are taught from the school yard, is that ice helps boo-boos.  In more medical terms, cryotherapy is largely regarded at efficacious for the treatment of minor acute trauma.  But is it true?

Do Boo-Boos Get Better With Ice? 

 

According to the Cochrane Meta-Analysis entitled:  Does Cryotherapy Improve Outcomes With Soft Tissue Injury? (free full article here) the researchers concluded:  “no authors have assessed the efficacy of ice in the treatment of muscle contusions or strains.”

That’s right, mothers across America.  You are applying ice to those boo-boos without a shred of scientific evidence that the ice is effective.

Until medical researchers address this “ large void in the literature,” you could be harming your child, or engaging in a worthless placebo effect.

Yes, icing has been shown to be effective after: “ligament repairs and knee and hip replacements. The results of these studies cannot be generalized to muscle strains and contusions.”

But ice works?  You’ve seen it work?  Mere anecdotal evidence.  Unreliable and prone to patient bias.  The researchers tenatively regarded ice as possibly helpful for pain, but concluded that: “Many more high-quality studies are required to create evidence-based guidelines on the use of cryotherapy.”

So until they do that, don’t waste your hard-earned health care dollars on ice cube trays and washcloths.

Let’s all wait until definitive studies conclude that ice does indeed help with boo-boos.  It may not happen anytime soon, because ice is not patentable (although you know they keep trying).  So we may need to create the “Boo-Boo Foundation” to fund ice research.  Get ready to march in “Stop the Boo-Boos” marches and send your dollars in.  Who knows?  In a few decades we might just be able to apply ice to those bumps with the knowledge that it actually works.

Or, if you’ve been following the discussion about studies, we might conclude that good-hearted researchers might want to spend a little less time in the lab and a little more time in the playground.   If they banged themselves on the monkey bars, they might just ask for a little ice.

Some things, because they work consistently and well, do not have research.  Giving a hug and a kiss are also tried-and-true, unscientific, aids for boo-boo relief.

 

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Study Concludes: Most Studies Are Wrong.

The Scientific Method (Photo credit: afagen)

As the number of scientific studies exponentially mount, surely we are advancing scientific inquiry at an ever increasing rate.  But perhaps we are simply increasing the scientific “noise.”

Enter the Reproducibility Initiative, which will try to reproduce your findings for you by an independent lab.  Yes, we’ve come to a point where you will need to pay to have the results you think you have confirmed by someone else.

Consider the NewsDaily’s article that “Bayer Healthcare reported that its scientists could not reproduce some 75 percent of published findings in cardiovascular disease, cancer and women’s health.” Or that “Amgen reported that when the company’s scientists tried to replicate 53 prominent studies in basic cancer biology, hoping to build on them for drug discovery, they were able to confirm the results of only six.”

How is that possible?  Don’t we have scientists dedicated to publishing whatever results occur?

Anyone who remembers science class knows the answer.  When you got the results you expected, you didn’t go over the equipment and the method with a fine toothed comb.  You assumed you did the experiment right and turned it in.  Only when you got wildly odd results that didn’t agree with what you were looking for in the slightest did you go back over your method and equipment to find the error.  Even if you had the highest ethics, it would be perfectly possible to miss some error as long as the results fell into a “reasonable” outcome.

Having more people do the same testing can lead to better results, but if you are all testing in the same area and watching one another’s results, chances are good that you started looking for the same results in your experiments.  A friendly classmate might even help you by telling you how to change your equipment to get a desired result.  So more tests do not necessarily lead to more accurate results.

But don’t believe me.  Have a gander at the most read PLoS article ever, entitled: Why Most Published Research Findings Are False.

In this appetizing little mathematical jaunt, the author takes us down the reality that false positives are far more likely than finding the truth.   Even before we add in publication bias, tenure track pressures, and financial incentives, it is just too easy to find the results you’re looking for.  The author Ioannidis states:  “manipulation could be done, for example, with serendipitous inclusion or exclusion of certain patients or controls, post hoc subgroup analyses, investigation of genetic contrasts that were not originally specified, changes in the disease or control definitions, and various combinations of selective or distorted reporting of the results. Commercially available “data mining” packages actually are proud of their ability to yield statistically significant results through data dredging.”

So just how many of us are taking drugs created for an illness, supported by studies created to support that drug’s ability to treat that illness, and prescribed by doctors who believe that the drug will effectively treat our illness despite all of our claims that the drug really isn’t working?  Meanwhile we as patients want to have something that works for our illness, so we spend a lot of time giving the drug “time to work” when it really never does anything to help us.

As someone who works in the alternative healthcare field, I don’t know whether to laugh or cry.  It feels like the rug just got pulled out from under all the work we’ve done to start bringing the field up to the standard of scientific inquiry.  Suddenly what was clinically relevant information is in question, and the standard drugs that we’re trying to compare to the alternatives are also in question.  How do we know what works?

Fortunately, I’ve got an ace up my sleeve.  I’ve been working with ornery, independent minded patients for years who don’t mince words when things don’t work.  So I’ve got an ongoing practice based on what is working in the field, using my patients as my resources.  Maybe it is time for all doctors to use their patients, rather than the drug reps, as their resource for what really works.

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A Dark Knight Indeed: The Colorado Shooting Spree.

English: Memorial for the victims of the spree shooting in Urfahr 1995 Deutsch: Denkmal für die Opfer des Amoklaufs 1995 am Bezirksgericht Urfahr-Umgebung (Photo credit: Wikipedia)

As the reports pour in, we all hang our heads and send our thoughts and prayers to those involved.

http://www.eonline.com/news/331806/the-dark-knight-rises-horror-gunman-kills-12-injures-38-at-colorado-screening

What can we do to prevent these from happening?  What is it about our culture that allows this to take place again and again?  There is no single, simple solution, but we all need to examine this most recent tragedy and look to our own communities about how to prevent it in the future.

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Alas, Stephen Covey Did Not Write Seven Habits of Effective Bicycle Riding Before He Passed.

Professor Stephen R. Covey (Photo credit: Wikipedia)

When I heard that Stephen Covey had died at the relatively early age of 79, I wondered if he’d had some sort of long-standing illness.  Surely someone so efficient and so directed in his life would not allow his health to slip away.  Then I heard he died of complications after a biking accident.  At a time when others are busy in rockers, he was still rocking it a little too fast and furious.

We never think anyone like Stephen Covey will pass.  In my mind he has joined others like Cary Grant who may have passed but still live on as part of our collective memories.  Somewhere in heaven, he is making things more proactive.

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We All Need Statins, STAT!

Rafael Statin [6685Crop] (Photo credit: Juan N Only)

English: Statin Pathway from WikiPathways (Photo credit: Wikipedia)

Family Medicine – Focus on… News Article | The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials |4075225.

In a stunning analysis, researchers found that the healthiest among us do as well or better on statins than the sickest.

The results found that:  “Reduction of LDL cholesterol with a statin reduced the risk of major vascular events (RR 0.79, 95% CI 0.77–0.81, per 1.0 mmol/L reduction), largely irrespective of age, sex, baseline LDL cholesterol or previous vascular disease, and of vascular and all–cause mortality.”

In other words, we all need statins, STAT!  Everyone should take them, because they are good for everyone.  Forget all those silly risk factors, and above all, forget that life could possibly be lived without taking prescription medications.

All this brings up another question:  wouldn’t we be better off taking everything?  Hypertension meds, anti-diabetic meds, statins, anti-depressants, etc.?

These are the answers to life’s ailments and gosh, they would all individually be good for our statistical lives.  But somewhere in all that goodness is a creeping uncertainty.  We just haven’t done the studies on the interactions between all these miracle pills.

The term polypharmacy applies to an ever increasing portion of the population.  At five or more medications (and yes, we include your multi in that mix)  no expert in the world can truly tell you what’s going on in your body over time.

I wonder if they factored that into the glowing report that statins are great for everyone.

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