[NPInfo] Homeopathy & other "delusions" (was: Iron DeficiencyAnemia)

Sat Aug 23 18:41:24 PDT 2008

Good point. Ever get those people who take their antidepressants prn--and it
works?
As for ethics: cf my other reply tonight. I tend to agree--but what if we
don't KNOW it's a placebo. Many medical therapies turned out to be placebos
later when subject to DB-RCT) So (in a Matrix mood) what IS real? The
arthoscopy study...you think docs have stopped doing arthroscopy? We find
ways to justify our delusions because our delusions service us, and
apparently, others. The best thing about nursing is that we explore this.
Nightingale wasn't just opening the windows and cleaning out the shitpots at
Scutari. She was a ritual presence, and that's why I think she was so
powerful, therapeutically. I think you are right to invoke that concern
about consent though. I have no answer to this problem.
e

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Stephanie Walker
Sent: Friday, August 22, 2008 5:08 PM
To: NP Info
Subject: Re: [NPInfo] Homeopathy & other "delusions" (was: Iron
DeficiencyAnemia)

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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