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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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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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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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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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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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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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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laughter (Photo credit: withrow)

In a bizarre twist, I was looking for information on the “Laughter Yoga” movement and happened upon presentation notes (click for link) from a couple who must have faces like lemon eaters and attitudes to match.

Before we enter into this couple’s work, let me say I just attended a Laughter Yoga workshop and you never hurt quite that much doing anything as laughing for fifteen minutes.  Afterward, I felt closer to the people around me and we had a wonderful conversation for several hours afterwards.  But evidently, it was all in my mind.

According to the “lemon-eaters,” I couldn’t possibly have felt better, I just thought I did.  “These results suggest that, although high humor individuals do not seem to have objectively better health, they are somewhat more subjectively satisfied with their health.”

I should cease and desist all laughter, because:

and more likely to be obese.”

English: Contagious Laughter (Photo credit: Wikipedia)

My goodness, it’s horrible, this laughter.  An addiction I tell you!  Quick, join the LA (Laughers anonymous).

But it’s also a terrible use of medical resources, didn’t you know?  “Baptist East Hospital in Louisville, Kentucky has a player piano, humorous books, cartoon albums, and Nintendo game sets for patients and family members to use together.”

Dreadful, dreadful, all this family time and joyful material.  Don’t those parents know that laughter can make their children obese?  They should be very careful putting the material in a hospital, because:  “People have individualized senses of humor, and what makes one person laugh might annoy or insult someone else.”

But do not fear, the lemon eaters have already lost.  “Almost every major hospital in the United States now uses clowns, pets, clergy, and humor intervention as a regular part of their care systems.”  Really, I don’t recall clowns or dogs available in the local ER.

And what are we to make of the inclusion of ”clergy” into the above statement.  Are religious ministers inherently funny?  I think adding in clergy gives the lemon eaters a much broader “threat” than if they just included hospitals that had clowns.  I think the clergy were there before the laughter movement took hold.  The tip off here is that the clergy are usually available for condolences for the grieving.  I have yet to see one with a red rubber nose and tiny bicycle peddling for the cancer wards.

So what are we to make of the lemon eaters?  Evidently someone needs a stooges film festival and a whoopie cushion, STAT!

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Mating male and female Phidippus clarus jumping spiders from from Big Prairie, Ocala National Forest, Marion County, Florida, USA (Photo credit: Wikipedia)

Scientists make “frankensquitos” to test vampire jumping spiders.

When did reality become a mad house?  Did I miss the “Last Exit Before Insanity” turn off?  Now all we need is to remix this title with some political news and really let the fun begin.

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A senior police officer of the Hamburg police on assignment at Hamburg city hall, Germany. Français : Capitaine de la police de Hambourg en faction devant l’hôtel de ville de Hambourg, en Allemagne. (Photo credit: Wikipedia)

Bath salts, drug alleged “face-chewer” Rudy Eugene may have been on, plague police and doctors – Crimesider – CBS News.

If you’ve looked at my previous post on face eating people (just use Zombie-B-Gone), I called this one right.

People selling bath salts should be sued for truth in advertising.  They need to tell people that they will go insane, rip off their clothes and be a terrible menace to themselves and their friends until they are sedated and held down by eight police officers.  Hoo boy, what a great trip?  Why would you do that to yourself?

If I was a police officer, I would seriously be asking for maximum penalties for anyone selling this stuff.  It turns a human being into a berserker.  That’s what we need to change the name to:  Berserker Salts.  Then people at least know the kind of “high” they’ll be experiencing.

Truthfully, if you want to live in hell for a few hours, get a round trip ticket to any of the world’s slums or conflicts.  You can walk around in the slum, get beat up and shot at, and bring post cards back.  It’s just like bath salts but you can skip the whole “Satan whispering in my ear” soundtrack.

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