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Chinese and Alternative Medicine for Sleep Apnoea
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Post: #31
RE: Chinese Medicine & Sleep Apnoea
(08-16-2015 05:12 PM)me50 Wrote:  Is there a difference between homeopathic and holistic? I can look up the definitions but that isn't my question. I am not sure how thorough the FDA is in the US.

Good point. Many people confuse these.

Wiki has a good writeup on the technical details of homeopathy.

There is some variation, but it basically works like this. Take one ounce of some "active" ingredient. Mix it with 9 ounces of pure water and "succuss" it. That's basically a specialized mixing process. That's a 1X dilution. Repeat the dilution and succussion once and you get 2X. 30x is a common dilution.

Yep, that's right, you're basically getting water. With a 30x homeopathic dilution, there may be none of the original substance left.

The actual homeopathic preparations are often crazier and less scientific than that.

Holistic is less well defined. In concept it's a "whole patient" type of thing, physical, mental, social, etc. Unfortunately, the "holistic" term has been almost entirely co-opted by the crystal energy, cosmic experience, psychedelic, herbal crowd. Not to mention the for profit quacks. The concept may have some value, but in general, if anyone claims to be holistic, they're probably a quack, or a self-deluded nutjob.

There's a lot wrong with "traditional Western" medicine. Unfortunately, most of the "alternative" medicine treatments are useless, if not actually harmful.

Herbs and natural treatments can be good or bad. The ones that work become part of "Western" medicine. Just because something is a plant or animal product doesn't mean it's good for you.

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08-16-2015 11:11 PM
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Post: #32
RE: Chinese Medicine & Sleep Apnoea
I wish I could find it, but there was an actual study (probably many more) that tested prayer. I think it was in the 1980s. It showed a statistically significant difference between prayed for individuals and those that were not. Ironically, there was no significant difference between good prayers and no prayers, but there was difference between prayer for calamity and no prayer at all.

So, yes prayer may make more difference than homeopathy, naturopathy, or osteopathy. Just maybe not in the way you might think.

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08-17-2015 12:11 AM
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Post: #33
RE: Chinese Medicine & Sleep Apnoea
Actually, osteopathy, when done correctly, works well - but then again, it is more or less medical deep massage combined with physiotherapy, isn't it Wink? I have worked with many osteopaths (British qualified, I can't speak for the US type, who seem to be a bit differently trained), and those that practice it as a sort of physiotherapy system, which the bulk of British trained osteopaths do, complement my work as a orthopaedic surgeon nicely. I am more cautious about chiropracty, but again, the school counts - the graduates of the CMCC in Toronto have a totally different philosophy than US trained chiropractors, and don't make exaggerated claims about the benefit of their work - in fact, they go through a rigorous four year training that is as thorough as any well trained P.A. or physiotherapist - the odd adjustment does bring some relief - how much is real and how much perceived depends. Heck, I've been known to crack the odd back and see the patient walk away free of pain, so something is there....

However, homeopathy, there is nothing there. Ayurveda, which is very popular here, is essentially a relaxation technique, and when used to treat more than that, doesn't work. There are maybe a small handful of herbal remedies that work, and those that do, we actually use and prescribe - Valerian, for instance. It is common practice here for cosmetic surgeons to prescribe Arnica pre and post op, as it seems to lessen bruising, but as an orthopaedist I have never seen any real evidence of it and I have my doubts - certainly at homeopathic levels it doesn't work, but it has been often prescribe as a herbal preparation, so there is real arnica in it, and it is the helenalin in the arnica that reduces the bruising. Herbal remedies, within certain constraints, are part of normal Western schooled Swiss medicine (what the heck do you think aspirin is, or the vitamin C tablets that you chew? It all falls under "natural ingredients") - our approach tends to me a bit more holistic than US doctors, in that we try and look at the gestalt, the whole, of the patient and not just a single set of symptoms - a lot of what I teach in my department has to do with how to think about a patient when confronted with a given problem or disease. We are open to what works, and what doesn't, and know how powerful the placebo effect is, and aren't afraid to use it, because sometimes the mind is the thing that needs the curing or can seriously help in the cure - when someone gets the yips about what is wrong with them, it can actually delay the healing process.

Sometimes it is something else, and the placebo effect won't work - we are trained to look at both sides of that coin, and increasingly that idea is filtering out to the US as well. In fact, one should say it is returning to the US, as it was standard medical practice until we got all technologically sophisticated - back when the patient was a black box, we had to do a lot by feel, intuition and looking at the entire box to figure out what was really wrong, and now, with the box more or less three quarters open, we need to get back to looking at the whole patient, at least the GPs should. Specialists should be there for when the whole patient approach of the GP is not enough, and the GP has identified as single area of failure in the patient, one that requires a specialist. That is the Swiss way, more or less, with the important exception that we don't have a gatekeeper concept, unlike Canada, the UK and HMOs in the US - anyone here can make an appointment with a specialist whether their GP knows of it or not. However, to keep the time wasters at bay, we tend to fast track appointments from GP referral over anyone who calls in off the street. And my department is almost entirely by referral, since it a last resort department when no one knows what to do with the patient. Fun, actually, if you are into puzzles. sometimes I send them to an osteopath I know. Wink
(This post was last modified: 08-17-2015 04:18 AM by DocWils.)
08-17-2015 04:17 AM
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Post: #34
RE: Chinese Medicine & Sleep Apnoea
(08-17-2015 04:17 AM)DocWils Wrote:  Actually, osteopathy, when done correctly, works well - but then again, it is more or less medical deep massage combined with physiotherapy, isn't it Wink? I have worked with many osteopaths (British qualified, I can't speak for the US type, who seem to be a bit differently trained), and those that practice it as a sort of physiotherapy system, which the bulk of British trained osteopaths do, complement my work as a orthopaedic surgeon nicely. I am more cautious about chiropracty, but again, the school counts - the graduates of the CMCC in Toronto have a totally different philosophy than US trained chiropractors, and don't make exaggerated claims about the benefit of their work - in fact, they go through a rigorous four year training that is as thorough as any well trained P.A. or physiotherapist - the odd adjustment does bring some relief - how much is real and how much perceived depends. Heck, I've been known to crack the odd back and see the patient walk away free of pain, so something is there....

However, homeopathy, there is nothing there. Ayurveda, which is very popular here, is essentially a relaxation technique, and when used to treat more than that, doesn't work. There are maybe a small handful of herbal remedies that work, and those that do, we actually use and prescribe - Valerian, for instance. It is common practice here for cosmetic surgeons to prescribe Arnica pre and post op, as it seems to lessen bruising, but as an orthopaedist I have never seen any real evidence of it and I have my doubts - certainly at homeopathic levels it doesn't work, but it has been often prescribe as a herbal preparation, so there is real arnica in it, and it is the helenalin in the arnica that reduces the bruising. Herbal remedies, within certain constraints, are part of normal Western schooled Swiss medicine (what the heck do you think aspirin is, or the vitamin C tablets that you chew? It all falls under "natural ingredients") - our approach tends to me a bit more holistic than US doctors, in that we try and look at the gestalt, the whole, of the patient and not just a single set of symptoms - a lot of what I teach in my department has to do with how to think about a patient when confronted with a given problem or disease. We are open to what works, and what doesn't, and know how powerful the placebo effect is, and aren't afraid to use it, because sometimes the mind is the thing that needs the curing or can seriously help in the cure - when someone gets the yips about what is wrong with them, it can actually delay the healing process.

Sometimes it is something else, and the placebo effect won't work - we are trained to look at both sides of that coin, and increasingly that idea is filtering out to the US as well. In fact, one should say it is returning to the US, as it was standard medical practice until we got all technologically sophisticated - back when the patient was a black box, we had to do a lot by feel, intuition and looking at the entire box to figure out what was really wrong, and now, with the box more or less three quarters open, we need to get back to looking at the whole patient, at least the GPs should. Specialists should be there for when the whole patient approach of the GP is not enough, and the GP has identified as single area of failure in the patient, one that requires a specialist. That is the Swiss way, more or less, with the important exception that we don't have a gatekeeper concept, unlike Canada, the UK and HMOs in the US - anyone here can make an appointment with a specialist whether their GP knows of it or not. However, to keep the time wasters at bay, we tend to fast track appointments from GP referral over anyone who calls in off the street. And my department is almost entirely by referral, since it a last resort department when no one knows what to do with the patient. Fun, actually, if you are into puzzles. sometimes I send them to an osteopath I know. Wink

That’s a pretty amazing post. Not the kind of thing I’m used to hearing from orthopaedic surgeons at all. Almost floored me. Well done!
08-17-2015 04:52 AM
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Post: #35
RE: Chinese Medicine & Sleep Apnoea
@doc - ha ha. placebo effect is fun. I was known as a bit of a magician with my child, doing things like lightly stroking eyebrows for relief of their wicked headaches. thank you for clearer picture of these things with so many clinical experiences. it must be hard to see people wasting time on the approaches that do not have promise, all the while distracted from getting the help they really need.

QAL

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You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
08-17-2015 05:05 AM
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Post: #36
RE: Chinese Medicine & Sleep Apnoea
In the US, most doctors still have that mentality that they are almost equal to "God" That is the mindset of most of the doctors in the US.

I had a doctor that I really liked but his "receptionist" would not let you talk to the doctor even if the doctor instructed you to call or do something. This same doctor told me to bring in a list of medication and OTC vitamins, etc. for him to review and then if I didn't hear from him in a few days (he wanted to make sure that none of what I prescribed would not interact with any others or that I needed to take some of them or if he needed to adjust the mg., etc.) for me to call him. His receptionist looked at my list and said "Oh, you can take this with no problem" That is when I looked at her and asked her what medical school she graduated from and reminded her that it is not legal for a person without medical training to practice medicine. I then went to another doctor because she never gave the doctor the list and no matter what I tried to do to, I could not get in touch with the doctor despite what he told me to do, which is sad because I think the doctor was a good one.

While I like some things about my current doctor, I get a little nervous when my blood work shows something on the slightly high side and I am told that it isn't high enough to worry about and my thoughts are that this is the time to worry about it and try to figure out what is causing it before it gets higher or causes a medical condition that could have been prevented. I am due to have a repeat blood test in October and if things are still of a concern to me, I am going to be doing some heavy duty question asking.

Doctors in the US, and maybe elsewhere, because of insurance companies dictating the price they will pay for a particular service(s), doctors cannot make enough money and so they try to see patients every 15 minutes or so and rush through the appointments. Most doctors, at least in the US, have huge school loans to pay back, malpractice insurance and the overhead of running an office, staff, etc., and they have to see more patients in a day to get all of that taken care of. Back in the day when doctors charged their fee for an office visit and the insurance company paid their fee less what the patient was required to pay, the doctors could keep their head above water without having to see patients every 15 minutes. It isn't that way today. Doctors get tired because they have to see so many patients to survive and this can cause mistakes to be made or something to get missed.

My eye doctor (opthamalogy) is in practice with a doctor that came from the era when the insurance company didn't dictate what they would pay and he will retire with a nice nest egg. My doctor, on the other hand, who is an excellent eye doc, said that he doesn't know what he will do when his business partner retires because he can't afford to buy his business partner out.
(This post was last modified: 08-17-2015 05:43 AM by me50.)
08-17-2015 05:35 AM
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Post: #37
RE: Chinese Medicine & Sleep Apnoea
(08-17-2015 05:35 AM)me50 Wrote:  In the US, most doctors still have that mentality that they are almost equal to "God" That is the mindset of most of the doctors in the US.
Not in my experience. Surgeons, yes, especially cardiac, GPs, non. Just overworked and harried.
(08-17-2015 05:35 AM)me50 Wrote:  I had a doctor that I really liked but his "receptionist" would not let you talk to the doctor even if the doctor instructed you to call or do something.
Now receptionists definitely have a God complex - they are the gatekeeper, and none shall pass. Seen lots of those over the years, sacked every one who ever pulled that rubbish in my department.
(08-17-2015 05:35 AM)me50 Wrote:  While I like some things about my current doctor, I get a little nervous when my blood work shows something on the slightly high side and I am told that it isn't high enough to worry about and my thoughts are that this is the time to worry about it and try to figure out what is causing it before it gets higher or causes a medical condition that could have been prevented.

No, your doc is probably right (not knowing how your levels are looking, admittedly). Blood values tend to swing a lot and have a lot of latitude for many, and things edging up to the upper levels of tolerance don't have a lot of meaning in and of themselves. If you are already suffering form a condition, then yes, it could be meaningful, but if not, no, on the whole and speaking only in general, and not being conversant with your particular worries (you haven't said what worries you) so long as it within the tolerance range there is nothing to concern yourself about - everyone is different, and the ranges reflect the variety that has been found over the last two hundred years of haematology.

(08-17-2015 05:35 AM)me50 Wrote:  Most doctors, at least in the US, have huge school loans to pay back, malpractice insurance and the overhead of running an office, staff, etc., and they have to see more patients in a day to get all of that taken care of.
Same here, minus the malpractice insurance (more or less illegal in our country), but add the massive cost of setting up a practice - most practices here cost around a million to set up, so you are out of pocket for a VERY long time. I have a friend who has a thriving OB/GYN practice and is one of the most respected surgeons in her field in this Kanton (State), but she works like the very devil because, even after being in practice for yonks, the sheer debt associated with opening her practice so huge that she is constantly at risk of losing it altogether - that is common here.

(08-17-2015 05:35 AM)me50 Wrote:  Back in the day when doctors charged their fee for an office visit and the insurance company paid their fee less what the patient was required to pay, the doctors could keep their head above water without having to see patients every 15 minutes. It isn't that way today. Doctors get tired because they have to see so many patients to survive and this can cause mistakes to be made or something to get missed.
Agreed, with caveats that your understanding of how this all works is a bit superficial, but the sentiment is one I share.
(08-17-2015 05:35 AM)me50 Wrote:  My eye doctor (opthamalogy) is in practice with a doctor that came from the era when the insurance company didn't dictate what they would pay and he will retire with a nice nest egg. My doctor, on the other hand, who is an excellent eye doc, said that he doesn't know what he will do when his business partner retires because he can't afford to buy his business partner out.


And now you know why I didn't go into private practice. My GP is well in his 70's, and when he retires his daughter will take over the practice completely (she now shares the load). I asked him if this makes things easier for her, and he answered, no, it makes it easier for him. He needn't worry about the loan ever defaulting - she will take it over and keep it in the family.

BTW, here all medical prices are fixed using something called tax-points, and it is the government that fixes it, for everyone - the insurance companies and the docs have to toe the line on that. When we treat someone, we have to submit an detailed itemised list of what we did, how long it took, etc and the tax points for each thing. That is how remuneration gets calculated. In the hospital now we have it all computerised with scanner codes and such, but private practice doesn't have that yet. Some private practitioners are using a tablet with a program to emulate how we do it, but most still have to tally up their notes after every patient and work it out by hand. Paperwork cost more than most medical exams do.....
08-17-2015 08:45 AM
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Post: #38
RE: Chinese Medicine & Sleep Apnoea
(08-17-2015 05:05 AM)quiescence at last Wrote:  @doc - ha ha. placebo effect is fun. I was known as a bit of a magician with my child, doing things like lightly stroking eyebrows for relief of their wicked headaches. thank you for clearer picture of these things with so many clinical experiences. it must be hard to see people wasting time on the approaches that do not have promise, all the while distracted from getting the help they really need.

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08-17-2015 08:46 AM
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Post: #39
RE: Chinese Medicine & Sleep Apnoea
(08-17-2015 04:52 AM)C-PAP Wrote:  
(08-17-2015 04:17 AM)DocWils Wrote:  Actually, osteopathy, when done correctly, works well...

That’s a pretty amazing post. Not the kind of thing I’m used to hearing from orthopaedic surgeons at all. Almost floored me. Well done!

Why? Is it unusual? Here it isn't.... Okay, we have a few knife jockeys that don't believe in physio, but they are just idiots with talent. Most of us realise the patient needs a whole range of treatment, not just a knife. The thing is, most surgeons never see the patient more than once or twice, unless they are oncologists or sports surgeons. The rest, including recovery and rehab, is handled by their referring doctor..... nature of the game - surgeons are like plumbers - they go in and fix the pipe, but they don't concern themselves with the house itself....
08-17-2015 08:49 AM
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Post: #40
RE: Chinese Medicine & Sleep Apnoea
DocWils

I sent it to you in a PM, not for you to figure out me but to show you why I am a little bit concerned and yea, I get the gatekeeper receiptionist thing so the doc can see patients but when a doc instructs a patient to do something then we need to do it and even more importantly, the receptionist should not be practicing medicine and telling a patient they can take certain things as they don't know the patient's medical issues and whether any of the medications can conflict with medication that the doc is considering.

Off my soap box but opinion remains the same
(This post was last modified: 08-17-2015 10:01 AM by me50.)
08-17-2015 09:59 AM
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