Posts Tagged Medicine

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

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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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Nick Cannon Diagnosed With “Lupus Type of Thing.” The Medical Mystery Continues.

Nick Cannon

Image via Wikipedia

A little while ago Nick Cannon almost died from “mild kidney failure,” which is sort of like “mild gunshot wound,” it doesn’t really exist.

Nick Cannon continues to be a medical mystery.  Soon after recovering from “mild kidney failure” he now has a “Lupus type of thing.”  Is this Lupus, or another autoimmune illness?  It’s going to be hard for Nick to be a spokesperson for his foundation to find a cure for a Lupus type of thing.  It doesn’t even look good on a T-shirt. “Cure Lupus type of thing.”  Heck, it doesn’t even fit on a baseball cap.  His wife can’t find a rhyme for it to work it into a song.

So here’s one celebrity I wish would have a medical doctor announce his illnesses from now on.  No more of these weird un-diseases that sound more ominous than the real thing.  If it truly is unknown, I want a medical profession to state that.  “It’s a Lupus-type thingy,” would be at least worth a laugh.

If Nick has Lupus bad enough to have had kidney failure from it, this is what we’d call a “way bad sick” case.  Not only is his Lupus advanced, as an African-American his risk of failure after kidney transplant is not good.  (unfunny abstract below).

I think it’s time for Nick to re-evaluate his public presentation about what’s going on.  Here in Maine we’d say:  “He’s wicked sick, and we’re holding a bean supper to help him and the missus out.”  There’s a time for cool, and there’s a time to avoid the “death type of thing.”

Lupus. 2012 Jan;21(1):3-12. Epub  2011 Oct 5.

Kidney transplantation outcomes in African-, Hispanic- and Caucasian-Americans with lupus.

Source

Division of Nephrology, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Suite 360E, Miami, FL 33136, USA. gcontrer@med.miami.edu

Abstract

African-American recipients of kidney transplants with lupus have high allograft failure risk. We studied their risk adjusting for: (1) socio-demographic factors: donor age, gender and race-ethnicity; recipient age, gender, education and insurance; donor-recipient race-ethnicity match; (2) immunologic factors: donor type, panel reactive antibodies, HLA mismatch, ABO blood type compatibility, pre-transplant dialysis, cytomegalovirus risk and delayed graft function (DGF); (3) rejection and recurrent lupus nephritis (RLN). Two thousand four hundred and six African-, 1132 Hispanic-, and 2878 Caucasian-Americans were followed for 12 years after transplantation. African- versus Hispanic- and Caucasian-Americans received more kidneys from deceased donors (71.6%, 57.3% and 55.1%) with higher two HLA loci mismatches for HLA-A (50%, 39.6% and 32.4%), HLA-B (52%, 42.8% and 35.6%) and HLA-DR (30%, 24.5% and 21.1%). They developed more DGF (19.5%, 13.6% and 13.4%). More African- versus Hispanic- and Caucasian-Americans developed rejection (41.7%, 27.6% and 35.9%) and RLN (3.2, 1.8 and 1.8%). 852 African-, 265 Hispanic-, and 747 Caucasian-Americans had allograft failure (p < 0.0001). After adjusting for transplant era, socio-demographic-immunologic differences, rejection and RLN, the increased hazard ratio for allograft failure of African- compared with Caucasian-Americans became non-significant (1.26 [95% confidence interval 0.78-2.04]). African-Americans with lupus have high prevalence of risk factors for allograft failure that can explain poor outcomes.

PMID: 21976401

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Reiki, Human Touch and Other Silly Things That Work.

So, when you’re five, and you get a boo-boo, what happens?  You might get a bandaid if it’s bleeding but otherwise… That’s right!  Mommy kisses it and makes it better. We all know this.  It does make it better.  How many times did I go face first into a door and start shrieking in agony.  I was convinced my brain was coming out of my forehead.  But three minutes of cuddling and a kiss, and I was back in whatever imaginary battle was going on, ready to slay the dragon.

I think it was a nasty 13th century king who provided a bunch of orphans with food and water but divided them up and deprived them of human touch.  They died.  We know that premature babies do better when held.  Every teenage boy knows that the touch of a girl is second only to full body Tasering in terms of response.

But according to the skeptic crowd, once we reach adulthood, human touch is no longer an effective treatment to help people feel better.  Really?  Being touched gently for forty-five minutes by a caring member of the human race does nothing for these guys (and they are all guys- except for one).  Ok, that’s a lot of therapy necessary and maybe some good old-fashioned primal screaming at their parents.  But a little introspection might go a long way for them, and it’s not a strong point.

But of course touching works.  In technical terms we call it “chronic pain suppression”  or “less screaming like a harpooned banshee so the other patients can sleep without resorting to Thorazine or a hammer.”  Bring on the Reiki nurses.

When you start the arguments, the skeptics usually back off and say something like, well, yes, human touch can help with pain (even they remember boo-boo land).  But that Reiki stuff isn’t even touching.  No, it’s an extended period where another human being is caring about you and gives you undivided attention.  Hello?  It’s therapy without having to discuss the loss of your rubber ducky.  It’s psycho-analysis with a more comfy chair and the ability to just fall asleep like you always wanted to.  For goodness sake, it’s nap time.

What happened to nap time?  Let’s bring it back.  I want Google to spearhead this, because it’s right up their alley.  Institute nap times, with Reiki masters and kindergarten teachers patrolling the Googleplex. (is there a difference? When they are good, not really.  My kindergarten teacher could sense misbehavior with her back turned.  She would watch Bruce Lee movies and scoff at “the amateur”). How about in the hospital?  Right now we have inspection police who patrol to make sure people wash their hands.  Just increase the job description.  “Did you wash you hands?  Good.  Did you touch your patient with your washed hands (no non-latex funky purple nitrile glove touching please, that’s just sad)?  Good.  Did you listen to how your patient is feeling for at least twenty seconds?  No?  Go back and do it, stat!”

Let’s bring back touching.  The guys who say it doesn’t help need it the most.

 

 

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The Tyranny of Averages: Imaginary Naturopathic Doctors Who Make More Than I Do.

Presque Isle River

Image by chief_huddleston via Flickr

I was looking about at Maine Naturopathic Doctors, a topic of personal interest.  According to a website that gives averages of salaries for every job, everywhere, Naturopathic doctors in Presque Isle make an average of 56k a year, with options to earn more far more.

Very disturbing, because I know for a fact that we have no N.D.s currently in Presque Isle.  My current location, Augusta, isn’t even listed on the averages charts, so evidently the four of us who practice locally don’t exist.

But in this case I have a very real sounding number, based on absolutely nothing at all.  How much of our current debates about finances and public policy are based on averages that fail to even come close to touching reality anywhere?

Now, I’m thinking about moving to Presque Isle if I can get this averages website to give me some guarantees about my possible salary.

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