Jul 25 2008

A Bit of Extreme Alternative Medicine Nastiness

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All interventions have their risks. No medical treatment that actually does something is completely without risk. That is why the standard method for evaluating a treatment is to assess the risk vs benefit ratio, as applied in an individual clinical situation. Risks are therefore justified if they are outweighed by the benefit. It is therefore not reasonable to cite instances of bad outcomes in order to impugn a treatment or a profession, without putting such outcomes into the proper context of the benefit of such treatments.

Of course – if there is no benefit to the treatment because it is based upon abject pseudoscience, then any risk is unacceptable. Here are two recent tales of risk without benefit – otherwise known as malpractice and incompetence, euphemistically referred to these days as complementary and alternative medicine.

Detox Bullox

Dawn Page wanted to lose a few pounds so she consulted a nutrition therapist/life coach, Barbara Nash, who was trained at the College of Natural Nutrition. I can understand why this seemed perfectly reasonable to Page – she was seeing a trained professional nutritionist. That’s precisely the problem – the average citizen (lacking in honed skeptical skills) innocently seeking a health professional can easily wind up in the hands of an outright quack.

Nash prescribed for Page a hydration detoxification program, which included drinking 4 pints of extra water per day and reducing salt intake. There is no science behind such a program. The idea is to purge mysterious and unnamed toxins from the body. This is old-school quackery.

Any competent health-care professional should be able to tell you that such a treatment is dangerous. It is a prescription for disaster, a good idea only if you are trying to harm or kill your patient. It is designed to waste the body of salt producing dangerously low levels of sodium and chloride in the blood.

That is exactly what happened to Page. She began to feel ill, had nausea and vomiting, and became light-headed. She returned to Nash who told her that these symptoms were evidence that her treatments was working, so she upped the water intake to 6 pints per day and reduced the salt further.

This is the classic quack response – when the disease progresses or the treatment produces side effects, interpret that as a sign that the treatment is working. Before the germ theory was known, surgeons often interpreted pus in the wound as a sign of healing. Today it is not uncommon for homeopaths to interpret worsening symptoms as a sign that the illness is being irradicated. They even cite the Herxheimer reaction – a real phenomenon caused by the rapid killing of bacteria by antibiotics causing the release of endotoxins into the blood.

Quick tip – if you are getting worse after starting a treatment and your practitioner tells you it’s just a sign that their treatment is working – get a second opinion.

Page did not get a second opinion. She followed Nash’s advice until her sodium level dropped to unhealthy levels, causing a seizure. Details in the news reports are sketchy, but it seems that Page had permanent neurological symptoms following her misadventure with detox hydration therapy, and was recently awarded 800,000 pounds in a malpractice judgment.

Burned by CAM

Unfortunately, having an MD is insufficient guarantee of even minimal competence – making it even more difficult these days for patients to avoid nonsense in medicine. Family doctor Thuong Nguyen of Oslo decided to incorporate some alternative medicine methods into his practice – specifically cupping.

Cupping is another form of detoxification – cups are placed over the skin. Alcohol on the cups is burned to create a partial vacuum which is supposed to suck the toxins out through the skin. Yes – it’s that stupid. It is just another far-fetched treatment that is completely free of evidence or scientific rationale.

Odd-Inge Haagensen was seeing Dr. Nguyen as a patient when this treatment was offered. Instead of running from the room Odd-Inge submitted to this nonsense. According to Dr. Nguyen when he was rubbing alcohol on the patient it spontaneously burst into flames. I suppose he thinks that everyone else is as scientifically illiterate as he apparently is.

According to Mr. Haagensen, after Dr. Nguyen placed the cup on him he could feel a little of the alcohol dripping down his neck and back, and when the good doctor lit the alcohol Mr. Haagensen caught on fire. He has apparently suffered significant burns and will need treatment for about a month.

Conclusion

There is no such thing as legitimate “detoxification” treatment. Anyone claiming that a treatment detoxifies the body is a charlatan of one type or another. The concept has a psychological appeal – it is easy to imagine bad stuff being drawn out of or purged from our bodies. We evolved an emotion of disgust to help us avoid true toxins and harmful substances in our environment and food – so the detox scam is just playing off of this emotion. But there is no science behind it – so beware.

In the first case with the hydration therapy – the treatment itself was harmful. It was designed to cause direct harm, and only someone lacking basic medical knowledge would have prescribed it, and then doubled-down by increasing the treatment when the patient was harmed by it.

In the second case, the treatment itself is just worthless, but not necessarily directly harmful. It was only made so by botched application. But it demonstrates that even benign treatments may not always be so benign and can cause harm when things go wrong. If the treatment is without any benefit, and is pseudoscientific in its concept, then the risk of even quirky harm is not justified.

The harm done to these patients is a product of a deeper problem – the tolerance of abject nonsense in medicine because it comes under a friendly and marketable label of “alternative medicine.” It seems that in practice the label “alternative” is short-hand for – turn off whatever critical thinking skills you may possess.

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