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  1. #16
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    Quote Originally Posted by Chris Parks View Post
    Nothing annoys me more than a doctor insisting that exercise and weight loss is a necessity when that same doctor is clearly overweight and does no exercise.
    Annoying yes but in no way a reason for you not to follow his/her advice.....
    Whatever note you blow youre never more than a semitone away from the correct one....(Miles Davis)

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  3. #17
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    Unfortunately not all Doctors are created equal: According to the majority of Doctors Gluten is linked to celiac disease - nothing else! And, removing gluten from your diet will not help wiith RA, urticaria or any other condition. And yet there are scores of people who report the opposite. So should we blindly accept what our Doctors tell us and ignore any evidence to the contrary?

    Similarly statins are precribed to lower cholesterol levels, they also cause a myriad of other well documented problems, I think it wise to weigh up the benefits against the potential side effects and decide what is worse. I stopped statins and certainly will never take them again, I would rather risk a heart attack than spend the rest of my life tearing my skin apart.

    Of course you can always take another pill to combat those side effects, and then another to combat the side effects the new pill brings on - ad nauseum...

    Unfortunately, Doctors are locked in on prescribing pills: take this pill! for that condition. In no way does this cure the condition, it simply treats the symptoms of that condition - I can see no logic in that!

    My Doctor prescribed corticosteroids for a condition he diagnosed as PMR. He was wrong, now I will be on corticosteroids for years, possibly forever, suffering moon face, puffy eyes, rashes,tingling and numbness in feet and lower legs, terrible pain whilst trying to taper and I'm sure many more side effects yet to come. Probably wouldn't mind these side effects so much if the steroids helped but they don't. Never, never follow your Doctors advice without doing your homework first, after all there's no reason your 'guess' will be any better/worse than his/hers!.

    After months on corticosteroids my Doctor advised me to taper thus:

    Take four 5mg tablets daily for one week then taper by one tablet per week - you don't want to know what that does to you!

  4. #18
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    People need to realise, also, that if you have had a very active and hard life as a youngin, that will impact on how your body will react as it gets older. Me, I was into cycling and motor bikes and was hit by a truck, whilst out training one morning and I'm paying dearly for my injuries.

    Foo

  5. #19
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    Know how you feel, I was also into motorbikes; not to mention bodybuilding, caving, bushwalking, canoeing, climbing, cycling, surfing, snorkeling, sailboarding and so on. Nothing wrong with these pastimes of course, but I now realise I probably should have stuck with one or two, all is a bit much I think. SWMBO always thought I was hyperactive. Along the way I did discover (a little late) that motorbikes should never meet cars, trucks, fences trees and so on at speed, most importantly though neither should your body. Imagine my surprise when I discovered I wasn't indestructible, think I could have gotten by very well without having to suffer my youth.

  6. #20
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    Corticosteroids, if used for more than a few days, are a real problem. I suspect that they'll only be used for the most serious life threatening indications in a few years. Those who have a physical dependency are in a very tough spot.
    Innovations are those useful things that, by dint of chance, manage to survive the stupidity and destructive tendencies inherent in human nature.

  7. #21
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    Too many doctors and patients both want the silver bullet. It's easier than making 'lifestyle' changes and today most of our problems lie in non-communicable diseases: hypertension, diabetes, arthritis, kidney disease and so on.

    Western medicine does well with acute episodic care. Not so well with multiple or chronic conditions.

    There is a lot of research into common health conditions, but you have to understand what they do and can't say about one individual. They are based on group or population studies, and they often find a lot of variation. If eg. they find that 60% of the users of a particular drug showed improvement after 1 year, you can only extrapolate this to yourself with a 60% chance of being right - and that only if on all key indicators you are representative of the group. No study can include all the relevant dimensions of a condition so your doctor will talk about your risk factors, which is just a statement of probability. From then on it's trial and error so your GP should be actively monitoring those indicators in you. If s/he doesn't, give them the flick.

    You should ask your GP, if medication or surgery is suggested: What is the number needed to treat for one person to benefit? What is the rate of adverse effects?

    With common drugs, this data is available. In the case of statins for example, a significant number of people are treated with only one benefiting. And in fact the adverse outcome rate is higher than the benefit rate. But you might be the one for whom it works.

    And as has been posted, even if the science is good, at the leading edge of every field there's debate and uncertainty. The general conclusion about relationships may be corrected. That's happening with the link between cholesterol and heart disease. The US body responsible for issuing dietary advice to the nation every 5 years said there was no link in its last draft report.

    You can read up on summary reviews of key therapies in the Cochrane review reports. They do plain language versions.

    And when you go through those reports you may be blown away as I was by the range of conditions that can be avoided or improved by regular exercise.
    Cheers, Ern

  8. #22
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    Drug trials involve comparing the drug with a placebo (a sham pill). The drug doesn't get approved unless it's better than the benefits placebo brought. Yes, taking a sham pill makes some folk feel better and in fact some folk feel worse too.

    That's harder to do with surgery but it is done and the results are significant enough for you to be curious about any surgery advice. Eg. when old folk fall over a fractured vertebra is a common result and the treatment is a very expensive dose of glue applied to it in theatre. A study ran mock surgery among folk with this problem and found there was no significant difference in outcomes.

    One review of studies like this found:

    Results In 39 out of 53 (74%) trials there was improvement in the
    placebo arm and in 27 (51%) trials the effect of placebo did not differ
    from that of surgery. In 26 (49%) trials, surgery was superior to placebo
    but the magnitude of the effect of the surgical intervention over that of
    the placebo was generally small. Serious adverse events were reported
    in the placebo arm in 18 trials (34%) and in the surgical arm in 22 trials
    (41.5%); in four trials authors did not specify in which arm the events
    occurred. However, in many studies adverse events were unrelated to
    the intervention or associated with the severity of the condition. The
    existing placebo controlled trials investigated only less invasive
    procedures that did not involve laparotomy, thoracotomy, craniotomy,
    or extensive tissue dissection.

    Conclusions Placebo controlled trial is a powerful, feasible way of
    showing the efficacy of surgical procedures. The risks of adverse effects
    associated with the placebo are small. In half of the studies, the results
    provide evidence against continued use of the investigated surgical
    procedures.


    The report is on open access and if you have an appetite for wading through it, it's here: Use of placebo controls in the evaluation of surgery: systematic review | The BMJ
    Cheers, Ern

  9. #23
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    It would be interesting to find out whether the surgeon "applying" the placebo surgery still charges the non-placebo fee?

  10. #24
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    Quote Originally Posted by Big Shed View Post
    It would be interesting to find out whether the surgeon "applying" the placebo surgery still charges the non-placebo fee?
    Paying the bill would be considered part of the treatment
    I got sick of sitting around doing nothing - so I took up meditation.

  11. #25
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    Quote Originally Posted by doug3030 View Post
    Paying the bill would be considered part of the treatment

    No gain with no pain.
    Hugh

    Enough is enough, more than enough is too much.

  12. #26
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    Quote Originally Posted by rsser View Post


    You can read up on summary reviews of key therapies in the Cochrane review reports. They do plain language versions.

    And when you go through those reports you may be blown away as I was by the range of conditions that can be avoided or improved by regular exercise.
    A Cochrane analysis is well worth looking at. What they do is do a wide ranging analysis on every study/trial they can find involving a particular drug/treatment and amongst other things they look at the validity of each individual study and whether or not the study matches the criteria for a valid study (eg double blind, degree of randomization..size of study population etc). The results can be surprising....eg it was found that consumption of antioxidants can actually lead to shortening of life rather than prolonging same: Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases | Cochrane
    Whatever note you blow youre never more than a semitone away from the correct one....(Miles Davis)

  13. #27
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    Quote Originally Posted by A Duke View Post
    No gain with no pain.
    Hmmm, I have plenty of pain, but absolutely no gain whatsoever.

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