[NPInfo] Homeopathy & other "delusions" (was: Iron
DeficiencyAnemia)
ROBERT DOERFLER
redoerfler at verizon.net
Sat Aug 23 18:33:27 PDT 2008
That is HILARIOUS! Obecalp :))
When I was an ER nurse we had a few things:
I packed multicolored cookie sprinkles in gelatin caps "Take 3 blue ones at
0100, 5 red ones at 0200,..." etc. :| hmm
Layered bentyl syrup, benadryl, donnaltal, etc in small amts in medicine
cup--looked really cool
Had a doc who once shined OR lamp on forehead of anxious pt telling her it
was a "beam"
...ok ok, maybe we were mean...or maybe just invoking the power of ritual.
Not one of those pts went away unhappy, or felt uncared for (or had a bad,
unaddressed, medical outcome {I mean, we WERE careful}). We had something we
could DO (and so many times pts walk away without that)
Not sure how I feel about placebos now--on the other hand, one could argue
that homeopathy IS placebo. But maybe so is (good) nursing and
medicine--some comfort, some ritual.... (cf the internal mamary artery graft
study done in, what '53? '57? The more recent arthroscopy trial. It goes
on...)
e.d.
-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of David Mittman
Sent: Friday, August 22, 2008 10:56 PM
To: NP Info
Subject: Re: [NPInfo] Homeopathy & other "delusions" (was: Iron
DeficiencyAnemia)
I still have a bottle of "Obecalp" caps 50mg one BID or possibly two at HS.
Used to prescribe in A.F. commonly. I did only once in my life and felt very
bad about "fooling" the young airman.
The capsules are day glow reddish pink and look serious.
This was the mid-late 70s.
Dave
On Aug 22, 2008, at 5:08 PM, Stephanie Walker wrote:
> I think that placebos do have a demonstrable effect. (I believe we
> call it "the placebo effect."<g>)
>
> I recall years ago working a summer job as a camp nurse. I visited a
> neighboring camp and the nurse there showed me a bottle of red liquid,
> which was her bellyache cure. A few spoonfuls of it (& a little TLC
> from the nurse) and bellyaches miraculously went away.
> (That would be the typical bellyaches that are not truly illnesses,
> that kids get when they are feeling stressed--in school usually by
> classroom demands that are beyond their abilities, and at camp usually
> when they're homesick or don't have a chum.) All that was in the
> bottle was some sugar water and red food coloring.
>
> I knew a child who was prone to constipation and Fletcher's Castoria
> (an old fashioned senna laxative with a delicious vanilla flavor)
> would get results within 5 minutes. Just the taste of it had to be
> doing it--it would hardly be into the GI tract before there were
> results.
>
>
> The problem with placebos is that ethically you should inform the
> patient what you're doing. None of those "sterile hypos" and other
> tricks of the trade. Sure they worked--but it's against the rules of
> fair play now. But if you tell someone there's no active ingredient in
> what you're recommending, you lose the "magic."
>
> Stephanie
>
> On Aug 22, 2008, at 11:13 AM, ROBERT DOERFLER wrote:
>
>> Stephanie is on the money. The problems with homeopathy:
>> 1) The dilutions, which may exceed Avogadro's number (10 -23) ought
>> to contain no molecules of the original substance.
>> 2) Moreover, there is no known physiological theory that would
>> explain why "like cures like" or anything about how remedies can
>> influence an organism to heal under their influence.
>> 3) The paradigm of health and disease in homeopathy is completely
>> antithetical to "classical" notions of pathophysiology, and in fact
>> tends to ignore them, or at least make them of secondary importance
>> to understanding the "essential imbalance" as it were.
>>
>> However, I would note that "curved spacetime" would have been
>> gobbledgook to a scientist of the late 19th century, and yet in only
>> 30 years Einstein would shatter the mechanistic model of the universe
>> with the relativity theories. A short time later we would learn that
>> matter can literally "vanish" out of existance--only to reappear
>> elsewhere later--as we discovered quantum physics.
>>
>> So my point is: maybe yer right...but wait around a while. Maybe
>> homeopathy is a trace of things to come. Benchtop studies in
>> immunochemistry, immunology, and chemistry have provided at least a
>> glimmer of support for alternative hypotheses that would account for
>> homeopathy, if not yet explain it. Clinical trials of varying quality
>> have shown that homeopathy appears to work. Contrarily, some
>> meta-analyses have suggested both that homeopathy's effects exceed
>> those of placebo, and that they do not! Moreover, there are authors
>> who have argued that "placebo" effects (what Kaptchuk prefers to call
>> "context effects") are indeed legitimate therapeutics that we should
>> employ deliberately.
>>
>> We're so caught up in "evidence basis" that we forget: we're all just
>> shamans, magicians, trying to walk with people to the other side of
>> whatever suffering they're on. So what's the harm in a little ritual?
>> A little mystique? We persist in the belief that if we just take
>> things "apart"
>> enough, we'll know everything, cure everything. We won't. Part of the
>> human condition is the searching, and it seems that whenever we "get
>> it"
>> Nature
>> throws one more thing at us to remind us that we actually don't.
>>
>> That said, I support a regulatory environment that would limit
>> government control on relatively harmless products while ensuring
>> some manufacturing standards. One that would distribute the authority
>> to "prescribe"
>> more risky
>> products to those people who actually demonstrate a professional
>> facility with them (Chinese medicine practitioners, homeopaths,
>> nurses, chiropractors, etc.) as appropriate. Just because someone's a
>> physician doesn't mean he or she "knows" alternative medicine. It's
>> like any other specialty.
>>
>>
>> Peace
>>
>> Eric
>>
>> R. Eric Doerfler, CRNP, PhD(c), CCH
>> Instructor Of Nursing
>> RN-BS Program Coordinator
>> Penn State University, Capital Campus
>> 777 W. Middletown Pike, Middletown PA 17057
>> 717-948-6513 red1012 at psu.edu
>>
>>
>>
>>
>> -----Original Message-----
>> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On
>> Behalf Of Stephanie Walker
>> Sent: Thursday, August 21, 2008 3:19 PM
>> To: NP Info
>> Subject: Re: [NPInfo] Iron Deficiency Anemia
>>
>> Are homeopathic treatments useful other than as a placebo? They are
>> so extremely diluted that they must be about 99.999% diluent and on
>> top of that, are dosed in minute quantities. There used to not be any
>> research supporting their use, but there may be some now that I'm
>> unaware of.
>>
>> People very badly want alternative remedies but after about 25 years
>> of reading about the next great white hope, and various claims for
>> various products, and never seeing anything actually pan out all
>> these years, my conclusion is that there is no basis for any
>> recommendations for most of what's out there. I heard that St. John's
>> wort has a very mild effect for mild depression (with major CYP450
>> enzyme interactions), I recall hearing something positive about sam-
>> e, and something about silymarin for liver inflammation, but if you
>> have no idea how potent each individual dose or product is, that
>> problem seems to cancel out any benefit.
>>
>> Meanwhile, people are still buying echinacea thinking it prevents
>> colds, glucosamine and chondroitin thinking they are arthritis
>> treatments, and otherwise throwing money away on useless products.
>> This is a rip-off of the consumer.
>>
>> And if legislation is passed to make the "supplement" drugs comply
>> with the same FDA regulations as OTC and Rx do, so that they named
>> and quantified all ingredients and had to pass tests of potency, they
>> wouldn't have the same mystique for people that they have now. They'd
>> be no different from OTC and Rx drugs.
>>
>> A few years ago I purchased a huge fat book from Prescriber's Letter
>> called "Natural Medicines Comprehensive Database" (and boy is it
>> comprehensive).
>> Most of the supplements I looked up in there seemed to offer very
>> little to justify the price you pay for them.
>>
>> Stephanie Walker, FNP
>>
>> On Aug 20, 2008, at 10:08 PM, ROBERT DOERFLER wrote:
>>
>>> Conrad
>>> It sounds interesting. I don't know Daniel personally, nor do I know
>>> this course. It sounds like a number of similar surveys of
>>> homeopathy that give providers the background to confidently treat
>>> milder maladies with an array of common homeopathic remedies. The
>>> nice thing about this sort of course (I took a similar one from the
>>> New England School in 1993) is that it gets you into the theory
>>> behind homeopathy, while also giving one a set of "tools" to use for
>>> the sorts of things that patients often want something for, but for
>>> which prescription drugs are often inappropriate. Viral infections,
>>> sore throats, allergies, beestings, mild poison ivy, sprains and
>>> strains, and such are often covered in these courses. At the Beverly
>>> Hilton? It'll probably be expensive, so she might want to shop
>>> around. But Boiron is a good outfit, and if it's reasonable and
>>> she's interested, I bet she'd have fun.
>>>
>>> As for Alz dz, there's not a whole lot of experience with treating
>>> that.
>>> Most people don't think of homeopathy, let alone think of it for
>>> something as serious as that. There's no trial data, so any such
>>> case is a labor of treatment and careful observation...all in the
>>> midst of other things, such as concomitant treatment with regular
>>> drugs, etc.
>>> So it's hard to say what's having an effect. That said, I have
>>> treated a couple of cases of dementia of various types and have
>>> noted marked cognitive improvements, but I have never had enough
>>> follow up with those very few patients to know what the long term
>>> outcome was. The longer the existing problem, the poorer the
>>> response; the shorter the symptomatic period, the more robust the
>>> response.
>>>
>>> Peace
>>> Eric
>>>
>>> -----Original Message-----
>>> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On
>>> Behalf Of Conrad Rios
>>> Sent: Wednesday, August 20, 2008 6:11 PM
>>> To: NP Info
>>> Cc: 'NP Info'; npinfo-bounces at nurse.net
>>> Subject: RE: [NPInfo] Iron Deficiency Anemia
>>>
>>> Thanks Robert. I have a PA friend of mine who is also a Homeopath.
>>> I know he
>>> would understand your explanation better then I. Not to say you did
>>> not explain it well but it is a different language for me, and right
>>> now I do not have the time.
>>> I do have a question, another NP friend of mine who works in Alz
>>> dementia care she is thinking about attending a class. See below.
>>> Have
>>> you heard of it? She works mainly with demented patients and I asked
>>> her how she thinks Homeopathy would help with Alz. Dementia. Do
>>> Homeopath address this disease?
>>> Thanks.
>>> Conrad
>>>
>>> My name is Daniel Dereser, Pharmacist for Boiron, world leader in
>>> Homeopathy.
>>>
>>> I would like to take the opportunity to discuss with you about the
>>> Clinical Homeopathic Training Course for NP in Los Angeles.
>>>
>>> The CEDH - Continuing Education for the Development of Homeopathy
>>> has developed a course that offers practitioners 104 CMEs by the
>>> AAFP when they complete the course work of 136 hours. The course is
>>> held in Los Angeles at the Beverly Hilton Hotel from November to
>>> June, annually.
>>>
>>> This course is designed for physicians who would like to expand
>>> their daily practice and need answers to questions that often come
>>> up in today's medical practice.
>>>
>>> The CEDH - Continuing Education and Development of Homeopathy has 30
>>> years experience and is educating over 3,000 physicians in 20
>>> countries annually.
>>>
>>> Conrad J. Rios, NP, PA, MSN
>>> Faculty
>>> UC Davis, FNP/PA Program
>>> 559-281-8211
>>>
>>> Email: conrad.rios at ucdmc.ucdavis.edu
>>> Web: http://fnppa.ucdavis.edu
>>>
>>>
>>>
>>> "ROBERT DOERFLER" <redoerfler at verizon.net> Sent by: npinfo-
>>> bounces at nurse.net
>>> 08/20/2008 02:37 PM
>>> Please respond to
>>> NP Info <npinfo at nurse.net>
>>>
>>>
>>> To
>>> "'NP Info'" <npinfo at nurse.net>
>>> cc
>>>
>>> Subject
>>> RE: [NPInfo] Iron Deficiency Anemia
>>>
>>>
>>>
>>>
>>>
>>>
>>> Ok, I'll give this a go...
>>> I am a homeopath, and we look at disease not as "How do lump this
>>> patient into a diagnostic category?" rather as "What is unique about
>>> this patient?"
>>> We see symptoms--even specific diseases--not as just categorical
>>> problems, but as maifestations of the essential "imbalance" of a
>>> system that keeps everything working together.
>>>
>>> When taking a case, we work with symptom rubrics, under which are
>>> listed various homeopathic remedies associated with that symptom.
>>> The
>>> symptom GENERALS - ANEMIA, lists 183 remedies known to be associated
>>> with anemic patients. The symptom GENERALS - FOOD and DRINKS - ice -
>>> desire, lists 16 remedies. I noticed from Kimberly's references that
>>> not all anemic patients crave ice, thus we'll consider the
>>> intersection of those 2 sets, which includes only 9 remedies. (Many
>>> anemic patients DON'T crave ice, etc.)
>>>
>>> Calcarea carbonica: deficient in the metabolism of structure, they
>>> often crave foods or ingestants with "structure" such as starches,
>>> indigestible mineral substances (as in ordinary pica), cheese/dairy,
>>> etc. Calc carb patients often suffer from hemorrhagic problems, and
>>> uterine fibroids in women are an especially common complaint that
>>> might prompt a selection of this remedy.
>>>
>>> Phosphorus: imbalances related to fluid dynamics, these patients are
>>> often "open"--having boundary issues--and are often anxious. Fluid
>>> discharges (such as loose stools, nosebleeds, metrorrhagia, etc.)
>>> are a key feature of Phos pts.
>>>
>>> Veratrum album (white hellebore): again, fluid dynamics, but with a
>>> mental picture that is more hyperactive than anxious. These people
>>> often "go from both ends" in gastroenteritis, and hellebore
>>> poisoning is associated with a dysenteric type of diarrhea with
>>> nausea/ vomiting (much of what informs homeopathy is based on
>>> toxicology, since the treatment principle is "like cures like").
>>>
>>> Mercurius corrosivus (mercuric chloride): mucus membranes that "burn
>>> like fire", it is a remedy that is often helpful in ulcerative
>>> colitis, Crohn's disease, and other ulcerative conditions.
>>>
>>> These are just a sample of 4 remedies, but one can see how this view
>>> of disease and the symptoms (such as chewing ice) they manifest may
>>> make more sense. So is there a physiological cause across the board?
>>> Maybe.
>>> Maybe
>>> not.
>>> Maybe the cause arises from a behavioral drive (as in Calc carb), an
>>> amelioration of a pain (ice soothing "hot" membranes--as in the
>>> glossitis example in one of Kimberly's references), cooling/fluid
>>> replacement (as in Phos. Or Veratrum), and so on--or maybe we don't
>>> know in certain specific cases. But it provides a fascinating
>>> alternate way to view patient complaints.
>>>
>>> Eric
>>>
>>> R. Eric Doerfler, CRNP, PhD(c), CCH
>>> Instructor Of Nursing
>>> RN-BS Program Coordinator
>>> Penn State University, Capital Campus
>>> 777 W. Middletown Pike, Middletown PA 17057
>>> 717-948-6513 red1012 at psu.edu
>>>
>>> Certified in Adult Primary Care & Classical Homeopathy
>>> 1521 Cedar Cliff Drive, Suite 203
>>> Camp Hill PA 17011
>>> 717-761-6902
>>> http://www.altmedresearch.us
>>>
>>>
>>>
>>> -----Original Message-----
>>> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On
>>> Behalf Of Kimberly Coleman
>>> Sent: Wednesday, August 20, 2008 4:52 PM
>>> To: NP Info
>>> Subject: Re: [NPInfo] Iron Deficiency Anemia
>>>
>>> Thanks Priscilla. I had also googled it and really couldn't come up
>>> with a conclusive "why". I appreciate the links.
>>> ----- Original Message -----
>>> From: Priscilla Merrill
>>> To: 'NP Info'
>>> Sent: Wednesday, August 20, 2008 5:28 AM
>>> Subject: RE: [NPInfo] Iron Deficiency Anemia
>>>
>>>
>>> You got my curiosity up so I googled it and here are some links.
>>> Made me wonder if Vanilla Ice was anemic since he's so darn pale!
>>> Bottom line, no one knows, just theories. I thoguth it might be
>>> the iron in the pipes but then water shoud also be a craving. The
>>> best answer I saw was that it has oxygen in it from the freezing
>>> process. Here are some ideas.
>>>
>>> http://www.mayoclinic.com/health/chewing-ice/AN01278
>>>
>>> http://www.kevinmd.com/blog/2004/11/i-eat-lot-of-ice.html
>>>
>>> http://answers.yahoo.com/question/index?qid=20060616173903AAE8Jhc
>>>
>>> Priscilla Merrill FNP
>>>
>>>
>>>
>>> -----Original Message-----
>>> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On
>>> Behalf Of Kimberly Coleman
>>> Sent: Tuesday, August 19, 2008 9:56 PM
>>> To: NP Info
>>> Subject: [NPInfo] Iron Deficiency Anemia
>>>
>>> I was curious if anyone could tell me WHY? patients with iron
>>> deficiency anemia crave ice. I know it's a form of PICA and can
>>> only find general information. A pt. with low H&H (10, 30), low
>>> B12 (207), low ferritin (7), norm. TSH. The MD didn't want to do a
>>> TIBC (it wasn't needed right now).
>>> There is no hx. of abn. bleeding, had TAH >10yrs. C/O "eating a lot
>>> of ice", extreme fatigue/weakness and "a lot of joint pain and
>>> feels like muscles are drawing and stumbling". Going to be
>>> scheduling upper/lower scopes.
>>> Any
>>> suggestions on the joint pain and stumbling, and what does ice have
>>> to do with it? As I said, I have heard of it, know it exists, but
>>> don't know exactly why. Thanks. KC
>>> _______________________________________________
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