Saturday, October 30, 2010

DAY 26 – New Day…Old Story about Drugs Without Conversation

First, let me give you a little background.  I practice a combination of Chiropractic and Functional Medicine. Chiropractic has historically been a practice of “natural” healing, with a strong interest in treating the causes of disease, rather than the symptoms. Functional medicine is personalized medicine that deals with primary prevention and underlying causes, instead of symptoms, in the treatment of serious chronic disease.
(photo - Doctors Mac by owensoft)

The dominant mode of handling patients today in the US is to name their conditions (diagnosis) and then treat the conditions with drugs to stop the symptoms. It is uncommon for causes to be discussed with patients; and patients usually don’t ask.

It doesn’t take a genius to know that covering symptoms with drugs, and not addressing the lifestyle causes of ill health, are a recipe for disaster.

So, let me share with you a simple story from the office that carries, as the kids say, a “ginormous” lesson.

A 58 year-old returning patient reports that thanks to my encouragement, she had gotten her vitamin D level tested by her MD and learned that the level was still low. The MD had also run a single test for thyroid disease, which also showed a problem, and for which he had written a prescription. When I inquired, the patient shared that her neck pain from some months back had improved and that she was taking 1,200 mg per day of oxaprozin that her MD had prescribed to be used for 3 months.

And here is the rest of the story, and the short list of the dangers for the patient;
1)    while the patient’s test results showed low vitamin D, she received no counseling on her associated risk for cancers (including breast and colon), heart attack, stroke, diabetes, autoimmune disease, etc…, and she received no direction regarding how much vitamin D to take and when to retest,
2)    while the thyroid test has undoubtedly found a problem, no further testing was ordered to determine the type and cause of the hypothyroid condition,
3)    thyroid hormone replacement was prescribed with no discussion of the cause of the condition,
4)    given that 90% of hypothyroid conditions are caused by autoimmunity (the body attacking itself) it would have been wise to discuss why the body is attacking itself,
5)    additionally, the patient was not informed that of patients with autoimmune thyroid disease, 50-80% of them also have an autoimmune reaction destroying one or more other tissues of their bodies, such as joints-arthritis, pancreas-diabetes, etc….,
6)    the fact that low vitamin D is associated with autoimmune diseases was not mentioned,
7)    the patient was put on a drug for neck pain without discussion of the cause of her chronic degenerative arthritis; and no long-term functional care program was discussed,
8)    the patient was not advised that the drug, oxaprozin, an NSAID, is known to cause damage to the lining of the digestive tract in some individuals, thereby breaking down the barrier between the gut and the immune system, leading to increased inflammation, and potentially additional damage to the joints in this patient’s neck, remembering that pain in the neck is what the drug was being taken for to begin with,
9)    there was no conversation about the interesting probability that both the arthritis in the neck and the thyroid disease are  both autoimmune based, and that low vitamin D may be a factor in their progression.

All of us, doctors and patients, would be wise to think more and talk more about what causes our illness. We would not just be wiser to do so; we would be safer, and we would be setting a more functional example for our children.

Dr. Young

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