Evidence-based medicine? April 7, 2008

I went to a naturopathic medicine conference this past weekend.  One of the keynote speakers was John Abramson, MD.  Dr. Abramson took a sabbatical from his busy Massachusetts practice to write a book on the medical research community, trends in U.S. healthcare, and how big drug companies are paying for the evidence to get skewed in their favor.  He scoured drug research, and he also poured through research on diet, exercise, and lifestyle modifications and their effectiveness against heart disease, weight management, and mood disorders.  Guess what he found?  Changing diet, nutrition, and exercise was more effective than taking medication in almost all cases.  We’re not even talking just a little bit more effective.  In most cases, taking prescription meds was less than half as effective compared to making lifestyle changes.  We as a nation spend twice as much as any other nation on healthcare and yet we are the second sickest nation in the industrialized world when it comes to preventable disease.

It’s easy to place the blame on MD’s and say that they should be reading the research and limiting the amount of drugs they prescribe.  However, there were a number of MD’s at this conference who explained that they had been indoctrinated into the world of pharmaceuticals as soon as they began medical school.  Some even explained that their professors had been paid to discuss certain drugs during lectures.  The MD’s rely very heavily on the research to guide their prescribing.  This in itself is not a problem.  The problem lies in the fact that large drug companies are paying to have certain research published and other research pushed to the back burner.  It all comes down to money, and very little of it has to do with patient care.

Dr. Abramson’s book Overdosed America covers these statistics and others.  This week there was an article in the Willamette Week about the same topic.  It seems that MD’s are getting fed up with prescribing drugs that aren’t necessarily warranted and aren’t making their patients better.  As a naturopathic physician, I feel fortunate in knowing that the treatments I use really work and really help people become healthy individuals.  I have a newfound gratitude for being able to use whatever medicines I want to use in my practice, not the ones I have been paid to promote.  I commend the MD’s who are starting to question big pharmacy.  It’s time to bring the balance back to patient care.

Catastrophizing and the power of positive thought. January 18, 2008

I went to a peer review in medical research the other day that really got me inspired.  The presenters were Dr. Beth Darnall and Dr. Heather Zwickey, and they presented research they had conducted on catastrophizing pain, and it’s effect on the immune system.  Catastrophizing is a cognitive distortion where an individual tends to focus on the worst possible outcome in any given situation.  It turns out that thinking about our pain, particularly thinking about it getting worse actually DOES make it worse.   There are certain signaling compounds that get stimulated just by thinking about pain that feedback into pain cycles.

A handful of my patients deal with ongoing pain issues, and although many health professionals now believe that there is a connection between what we think and how we feel, we’re now seeing the proof of the fact that the connection exists.  Patients have been told for years that their symptoms are all in their head.  In a way, the doctors have been correct, but what we need to account for now is the reality of these thoughts producing real symptoms.

It seems that people are either prone to catastrophizing or they’re not.   Women are more likely to catastrophize than men it seems.  In addition, women are more prone to pain and (lucky us!) have more pain receptors than men.  Also, as the amount of Estrogen decreases in the system (naturally during our menses and during menopause), the number of pain receptors actually increases.

The way that naturopathic medicine can be helpful in working with mind-body pain issues is via body work, lifestyle counseling, diet, and stress management, all helping the body to decrease inflammation .   Homeopathy and flower essence therapy can also be extremely beneficial to help reprogram our thoughts to focus on healing and positivity.  I urge anyone who has chronic pain to pay close attention to their thoughts around pain, health, and healing.  Your mind may be the key to achieving wellness!