Archive: Apr 2010

  1. Holistic GPs under scrutiny from the GMC

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    Please watch the attached clip. Its regarding one of the many GPs under severe scrutiny from the GMC who practice outside what they consider to be “normal” boundaries. These GPs are being hauled up and questioned about their practices and many of these will not continue to work under the GMC. I thought the role of a GP was to heal, and keep people alive for as long as possible.

    http://news.bbc.co.uk/1/hi/wales/8651442.stm

    Holistic GPs work in a slightly different way than conventional GPs. What you get is someone who can prescribe medications if you need them (which is vital) but are also looking at the causes for disease. This particular woman had heart disease and was given magnesium, a known vital nutrient for the heart and B12, and a change of diet.This is exactly what I would have done.

    These are the doctors I want to see. I want someone to take their time to really check me over and this might mean getting off their chairs and actually taking the time to see me like GP’s used to. Is it any wonder that more and more people are looking for GPs like this? Thirty years ago, the role of the GP was completely different. If you were ill, you had their home number and you got them out of bed in the middle of the night. Often ours would come in his pyjama top over jeans. We felt cared for and he was an important part of our lives (I’ve written before about our beloved family GP). Those days are sadly gone and as much of medicine now is about targets and money, more and more GPs are becoming prescription writers whilst more and more patients want to understand why they are ill. These fantastic holistic GPs are now being sidelined as alternative and if removed from the GMC cannot prescribe drugs which I think is a scandal.

    I’m not against GPs at all so please don’t read this as such, but I do feel passionately that people are listened to and not vilified if they want to try a dietary approach to bringing down their cholesterol rather than swallowing a statin. People are allowed choice. So many of my patients are writing letters to their GPs saying how disappointed they are at the way they are being treated if they take responsibility for their own health – surely this is a good thing? People should be praised for this. You cannot run a health service on take a pill, stop questioning me and live with it. It doesn’t matter whether the latest pharmaceutical drug works or a glass of beetroot juice, as long as all doctors and practitioners are highly qualified where is the harm?

    For your information this is one of the modern versions of the Hippocratic Oath

    I swear to fulfill, to the best of my ability and judgment, this covenant:

    I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

    I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

    I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

    I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

    I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

    I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

    I will prevent disease whenever I can, for prevention is preferable to cure.

    I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

    If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

    The original oath is discussed here.

    Please let me know your thoughts on this and what you would like from your GP.

  2. Coeliac Awareness Week – 10th-16th May 2010

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    If you are in doubt, get tested and look out for the following symptoms:

    The symptoms can be subtle, and you may feel unwell for some time for no reason before the diagnosis is made. It used to be thought that coeliac disease affected about 1 in 1500 people. More accurate diagnosis through blood tests has shown that the condition affects up to 1 in 300 people in the United Kingdom, Europe and the USA. It is more common in some areas of the world, particularly on the west coast of Ireland, where 1 in every 100 people are thought to have coeliac disease. Coeliac disease can affect you at any age. It was thought to be more common in men, but probably occurs equally in men and women. One definite risk factor is a history of the condition in your family. Coeliac disease occurs in people who are genetically prone to it. If you have a parent, sibling or child with coeliac disease, you have a 10 per cent chance of also developing it. If you have an identical twin with coeliac disease, your chances increase to more than 70 per cent.

    Coeliac disease has many and varied symptoms, and symptoms in adults are different to those in children.

    Childhood symptoms

    In childhood symptoms do not appear until gluten-containing foods are introduced into the diet.

    • Poor appetite, irritability and a failure to gain weight are usually the first symptoms.
    • Pale, bulky stools that smell nasty.
    • Vomiting and diarrhoea, which can lead to a wrong diagnosis of gastroenteritis.
    • Swollen stomach.
    • Arm and leg muscles may become wasted and thin.

    Adult symptoms

    • weight loss with pale, offensive diarrhoea
    • constipation
    • abdominal bloating with wind.
    • extreme tiredness – which is a sign of anaemia
    • psychological problems like depression
    • bone pain and sometimes even fractures – which are due to thinning of the bones
    • ulcers in the mouth
    • a blistering, itchy skin rash mostly on the elbows and knees, called dermatitis herpetiformis.

    In one neurology clinic, several patients who, for no apparent reason, had difficulty walking and coordinating (ataxia) were tested for coeliac antibodies in the blood. A significant number were found to have coeliac disease, although many of them did not have any gut symptoms. Your doctor may also want to know whether you have lost weight or whether you have symptoms of anaemia (tiredness, exhaustion, pallor). The doctor may:

    • examine your abdomen
    • look for a blistering rash on your skin
    • check for mouth ulcers
    • Your doctor will check for anaemia, testing the levels of iron, folic acid and calcium in your blood

    Another blood test detects antibodies that are often found in coeliac disease. Several antibodies are linked to the condition, but the most specific is anti-endomysial antibody. If this is present in the blood, you are very likely to have coeliac disease.

    An endoscopy test is often used to diagnose coeliac disease. Your doctor should arrange this test at the endoscopy unit at your local hospital.

  3. Was Susan Boyle ready for fame?

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    I read this morning of another alleged incident regarding Susan Boyle – this time she was having a shrieking fit in a plane and had to be sedated. It seems clear to me that to take a 48 yr old virgin who has seen no life and put her into this kind of pressure without adequate support is negligent. She obviously has some sort of learning difficulty or behaviour disorder that is just going to get worse if things don’t change. She was in the Priory I believe soon after the Britain’s Got Talent finals with stress and on stage was certainly coming across as someone who was not mentally well. The price of fame is high and I wonder how happy she really is with all this money and fame, travelling the world. I feel terribly sorry for her and hope very much that she is not being manipulated by the greed machine that is Simon Cowell Enterprises. Instant fame is like fast food, it feels good for a bit then makes you feel sick and ill soon after, regretting that you ate it – let’s hope Susan is getting something out of this for herself.

    The success of artists that last come from giving themselves time to get albumns together and pacing themselves, not being put through a machine like a processed sausage.

  4. Swine flu and volcanic ash

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    Here I go again being slightly controversial. I’ve been looking at some reader feedback to articles on swine flu and the volcanic ash scenario – all in the broadsheets I might add. It’s interesting what people think and write. Many are cynical about swine flu – it’s set to return this autumn and this has made people question whether a) it’s about getting rid of all the unused vaccines sitting going to waste, or b) is it being used as a method of population control (yes I did write that) or c) GSK and the government have our best interests at heart. There are people that think the vaccine has some seriously nasty stuff in it, which will slowly break down your immune system, and I’m not just talking about mercury. But as I said these are not my thoughts but the British general public. The H1N1 vaccination certainly divided us into those who took it without question and those who’d quite frankly prefer to tightrope walk across the Niagra falls with a small pony on their back.

    The volcanic ash situation is similar, so called “experts” are divided as to whether all these flights actually needed to be cancelled or was it used as another way to assess Britain’s security when no one could come in and out of the UK for a while. Again these are not my personal thoughts, just thought you folk out there who read my blog would like to know how some of the population are exercising their freedom of speech!

  5. ADHD (cont.): Environmental versus Genetic Factors

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    I said I’d talk about ADHD in more detail later so here it is. As it’s so complicated I thought I’d share a real life case study so you can see quite clearly what is going on in the boy’s environment.

    Tom is a 10 yr old male, diagnosed with ADHD at 5 yrs old. Pre-conceptually, Tom’s father had been a heavy drinker and his mother a smoker. Tom was bottle fed and weaned early, developing colic when he was 9 months old. During the early years of his childhood he was treated for an e.coli infection with antibiotics and thereafter became lactose intolerant. He had the MMR vaccination. Between the ages of 3 yrs and 5 yrs Tom only ate white food and it was during this period that he visited the local hospital for clear outs with Movicol due to an impacted bowel. His bowel only moved on the ingestion of lactose, when he suffered severe diarrhoea. At 6 yrs old Tom’s teeth showed signs of early decay and like his mother, he was prescribed fluoride drops which he has been taking for three years.

    Tom’s family live near a busy airport with overhead pylons only metres away. Tom’s father is a painter and decorator and DIY enthusiast. When Tom was 6 yrs old his father used fungicide in the garden which caused Tom to fit. Since then Tom has suffered from weekly headaches. He has a TV and computer in his bedroom and spends long periods of time in front of a screen doing little exercise. Unhappy and teased at school, his tantrums often happen before and after school times. His diet is high in saturated fat, sugar and artificial sweeteners.

    When Tom was diagnosed with ADHD, he was displaying a range of symptoms including: anger, disruptive behaviour, little concentration, severe constipation, poor teeth, anxiety, insomnia, swings from hyped up excitement to fatigue and strange food choices. These range of symptoms can feel overwhelming not only for the child but the parents, although the family decided against medication. They were aware of some of the issues but little realised to what extent Tom had been environmentally exposed. To find one cause for these symptoms would be impossible as would proof. This is a multi-exposed child that would need a multi-disciplinary approach.

    Ok, so this poor child has been exposed to many environmental factors, so why is the research heavily biased on genetics?

    Environmental versus Genetic Factors

    The question much disputed by policy makers and scientists is whether environment or heredity issues are more relevant. A fierce debate on the causes of autism/ADHD has pitted genetics against environmental toxins. Although we are aware that there is a genetic component in autism, researchers are now looking at whether the huge increase in autism rate might be linked to a combination of both environmental factor and genetic susceptibility. Children who are genetically susceptible, for example, being exposed to eating gluten or low levels of mercury may then go on to trigger autism. Unfortunately, research resources are currently heavily skewed towards genetic factors – funding for studies conducted on such causes of autism is 10 to 20 times as much as funding for environmental factors. “The advances in molecular genetics have tended to obscure the principle that genes are always acting in and on a particular environment. said Dr Bernard Weiss, a professor of environmental medicine and paediatrics at the University of Rochester Medical Centre. He also said that “excessive emphasis has been placed on genetics as a cause”.

    And it is time for mindsets, especially those of people controlling research funds, to change. “It’s time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California,” said Dr Hertz-Picciotto, an epidemiology professor at University of California, Davis, the leader of the study. “There`s genetics and there`s environment. And genetics don`t change in such short periods of time,” she also said.

    There needs to be a nationwide shift in autism research, moving from studies on genetic factors towards potential environmental ones, such as infant and foetal exposure to pesticides, chemicals found in common household agents, and viruses. Along those lines, the dangers and effects of childhood vaccinations should be carefully investigated, too – this is likely to be a significant factor. What is quite clear is that there are many possible causative factors, and extensive research will have to be carried out to reveal more – there is no one “smoking gun.”

    As I said its complicated, but going back to America’s Medicated Kids it’s crystal clear to me that there are two camps. One, the child is just naughty, playing up, has issues at home, is being bullied or has been overloaded and overburdened with the above environmental and genetic factors.

    By the way the child above whose name has been changed is now completely 100% better. Yes it was difficult and hard going but the parents chose to find out why their son was ill, and not choose the easy option of a pill. They worked hard and it paid off.

    If you would like to do your own research on the topic of ADHD and environment, take one of the issues above: ie diet, stress, nutrient deficiencies, artificial sweeteners, gut problems, mercury, lead, organophosphates, pesticides, Electro magnetic frequency (EMF) and just google that word with ADHD and see what you get – you will be surprised!

  6. America’s medicated kids (cont.)

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    These are not my particular thoughts or words but I thought some of you may find this of interest – it’s written by the investigative journalist Evelyn Pringle.

    An American Phenomenon: The Widespread Psychiatric Drugging of Infants and Toddlers

    The United States has become the psychiatric drugging capital of the world for kids with children being medicated at a younger and younger age. Medicaid records in some states show infants less than a year old on drugs for mental disorders.

    The use of powerful antipsychotics with privately insured children, aged 2 through 5 in the US, doubled between 1999 and 2007, according to a study of data on more than one million children with private health insurance in the January, 2010, “Journal of the American Academy of Child & Adolescent Psychiatry.”

    The number of children in this age group diagnosed with bipolar disorder also doubled over the last decade, Reuters reported.

    Of antipsychotic-treated children in the 2007 study sample, the most common diagnoses were pervasive developmental disorder or mental retardation (28.2%), ADHD (23.7%), and disruptive behavior disorder (12.9%).

    The study reported that fewer than half of drug treated children received a mental health assessment (40.8%), a psychotherapy visit (41.4%), or a visit with a psychiatrist (42.6%) during the year of antipsychotic use.

    “Antipsychotics, which are being widely and irresponsibly prescribed for American children–mostly as chemical restraints–are shown to be causing irreparable harm,” warned Vera Hassner Sharav, president of the Alliance for Human Research Protection, in a February 26, 2010 InfoMail.

    “These drugs have measurable severe hazardous effects on vital biological systems, including: cardiovascular adverse effects that result in shortening lives; metabolic adverse effects that induce diabetes and the metabolic syndrome,” she wrote. “Long-term use of antipsychotics has been shown to result in metabolic syndrome in 40% to 50% of patients.”

    The lead researcher on the study above, Columbia University psychiatry professor Mark Olfson, told Reuters that about 1.5% of all privately insured children between the ages of 2 and 5, or one in 70, received some type of psychiatric drug in 2007, be it an antipsychotic, a mood stabilizer, a stimulant or an antidepressant.

    Psychiatric drugs bathe the brains of growing children with agents that threaten the normal development of the brain, according to Dr Peter Breggin, founder of the International Center for the Study of Psychiatry and Psychology (ICSPP), and author of about 20 books, including “Medication Madness.”

    The drugs themselves are causing severe disorders in millions of children in the US, he warns. “Substances like antidepressants, stimulants, mood stabilizers, and antipsychotic drugs cause severe, and potentially permanent, biochemical imbalances.”

    American Phenomenon

    A number of presentations at the annual meeting of the American Psychiatric Association in May 2009, addressed the diagnosis of bipolar disorder, including one titled, “Pediatric Bipolar Disorder: A Critical Look at an American Phenomenon,” at which Dr Peter Parry, a consultant child & adolescent psychiatrist, and senior lecturer at Flinders University in Australia, presented a survey on, “Australian and New Zealand’s Child and Adolescent Psychiatrists’ Views on Bipolar Disorder Prevalence and on Rates of Pediatric Bipolar Disorder in the USA.”

    Dr Parry and his colleagues conducted a survey of child and adolescent psychiatrists in Australia and New Zealand. Of the 199 psychiatrists who responded to the survey, 90.5% thought pediatric bipolar disorder was overdiagnosed in the US.

    In an October 1, 2009 article titled, “Medicating Our Children,” Dr Parry reports that since “the mid-1990s in the USA, some researchers have claimed that Paediatric Bipolar Disorder (PBD) frequently starts prior to puberty.”

    One of PBD’s main proponents, Harvard University’s Professor Joseph Biederman, stating onset “is squarely in the preschooler age group,” he notes.

    Parry explains that “PBD has been created by moving the diagnostic goalposts away from traditional concepts of bipolar disorder.”

    “In children,” he says, “episodes were redefined to last hours instead of days or weeks and, instead of manic elation, severe anger in children sufficed as mania.”

    “Unlike diagnoses like ADHD or depression, or simply accepting a child has serious emotional and behavioural problems in reaction to various stressors, PBD implies a lifelong severe mental illness requiring of strong psychiatric medication,” Parry warns.

    “In the USA,” he says, “the public is furthermore exposed to direct pharmaceutical advertising that can feed the natural desire parents of distressed and aggressive children have for a quick solution by suggesting a simple medication fix.”

    “The medicating of America’s children has become intensely controversial, highlighted by the tragic case of Rebecca Riley, a four-year-old Boston girl diagnosed at 28 months old with ADHD and PBD,” he points out.

    Evelyn Pringle is a columnist for Independent Media TV and an investigative journalist focused on exposing corruption in government.

  7. America’s Medicated Kids

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    It was with sadness that I watched America’s Medicated Kids last night on BBC2. As a fan of Louis Theroux I think he coped with interviewing these families very well asking questions (that we all wanted to ask) and not invading their space.

    However, it still made for uncomfortable viewing. I’m writing a paper at the moment on ADHD with regards to genetics and environment. There are so many multifactoral reasons for a child to get ADHD, none of which were covered in this programme, and too many to mention in this blog (perhaps I’ll write again on the subject later).

    To me the children’s behaviour (despite being medicated) was in the usual parameters of being a child or a stroppy rude insolent teenager – nothing new there. In fact if you look at the children Jo Frost aka SuperNanny has to deal with – some of these so-called ADHD children were polite in comparison.

    The medication seemed to be used to parent. A kid gets stroppy, plays up, doesnt concentrate in class, and they are labelled with a mental health issue and zoned out and tranquillsed on the latest drug that has been manufactured for the latest invented mental health issue.

    We also did not get to see behind the scenes of what was really going on in these children’s lives when the cameras were off. When Louis interviewed the 10 yr old Hugh, he replied like an actor who had been fed lines – something strange was going on in that family. In fact something strange and sinister seems to be happening all over mid-America with the numbers of ‘ADHD’ soaring every year…. and yes it’s spreading in the UK as well.

  8. Lorenzo’s oil revisited

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    In 1992 I watched the film Lorenzo’s Oil and found it moving and encouraging. Last night I watched it again and found it to be an astonishing piece of filmmaking. The sheer will and spirit of Lorenzo’s parents up against pretty much everyone has got to leave you feeling empowered.

    For those of you who havent seen the film it is based on the true story of Augusto and Michaela Odone, two parents in a relentless search for a cure for their son Lorenzo’s adrenoleukodystrophy (ALD). Failing to find a doctor capable of treating their young son Lorenzo’s rare disease, Augusto and Michaela Odone sought their own cure. They set out on a mission to find a treatment to save their child. In their quest, the Odones clashed with doctors, scientists, and support groups, who were skeptical that anything could be done about ALD, much less by laypeople. But they persisted, setting up camp in medical libraries, reviewing animal experiments, badgering researchers, questioning top doctors all over the world, and even organizing an international symposium.

    Lorenzo’s oil is a 4:1 mixture of glycerol trioleate and glycerol trierucate (the triglyceride forms of oleic and erucic acid), prepared from olive oil and rapeseed oil. It is used in the investigational treatment of asymptomatic patients of adrenoleukodystrophy (ALD). Augusto received U.S. Patent No. 5,331,009 for the oil. The royalties he now receives are paid to the Myelin Project which he and Michaela founded to further research treatments for ALD and similar disorders.

    Sadly, Lorenzo Odone died on May 30, 2008, after suffering from aspiration pneumonia caused by food getting stuck in his lungs, but survived 20 years more than expected.

    If there is anything to be taken from the film it is this. The will to survive can be greater than anyone can anticipate and it doesn’t matter what cures your ailment, a conventional or alternative approach, just as long as it does work.

  9. Brainwashing through marketing

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    As I often do, I got into a long discussion the other evening about branding and marketing. What was clear on going through the foods most marketed is how the british breakfast has changed. Gone are the eggs on toast and more and more people are being targeted to eat sugary cereals. As I told one patient the other day, look at what is not being marketed and that is what you need to eat. When was the last time you saw an advert for scrambled eggs on toast? Well of course you never have as it’s near impossible to brand or market eggs.

    The hot topic food products discussed were probiotic yoghurts and drinks, cereals, fast food chains and so called beneficial margarines. There is a kind of brainwashing going on which people need to wake up to. Going to work on a sugar-based cereal will not fill you up, protein fills you up. Eating a snack bar mid morning will not make you lose weight because it is full of sugar, and will leave you starving. A probiotic yoghurt is so low in good bacteria that it will not magically make your IBS disappear. Apart from anything these products are expensive. A large bag of jumbo oats lasts twice as long as a packet of cereal.

    GPs are still shocked when I tell my patients that a scrape of organic butter will not kill you. Fat is not the enemy remember. During the recession the media kept banging on about the second world war which frankly I found quite irritating but diet-wise they had it spot on. Hardly any sugar was eaten and of course processed foods had barely got off the ground. Butter was eaten and exercise was taken.

    Just stop a minute when you are next shopping and ask yourself what is it that you are buying, and is it really good for your health or has someone told you it is so……