Where to Go Before You Go Woo

I'm constantly amazed by the crazy shit people will believe.  Comes to that, I'm constantly amazed by the crazy shit I used to believe.  There was a time, for instance, where I believed that there might be something to Complementary and Alternative Medicine (CAM).  That, of course, was before I began reading about it.

Really, people?  Really?  You really believe water without a single bloody molecule of active remedy in it can cure you?  Or that ear candling works?  Or that shooting coffee up your butt's a cure rather than a fetish?

Some of the people I know IRL, otherwise sane and sober people, fall prey to this crazy crap.  They drop way too much money on woo.  And they believe in all sorts of nonsense, like vaccines causing autism (they don't).

They're not stupid.  It's just that there's so damned much misinformation out there, and the snake-oil salespeople have silver tongues.  So I think it's time to put up, in one post which I can then point them to, a nice set of resources that might keep them from falling prey.  Especially now that homeopathic "remedies" are finding their way onto supermarket shelves, right alongside legitimate medicines, as if they belong there (they don't).

Those of us who already like our medicine science-based could still use these sites.  They're always good for a belly-laugh.  Sometimes for a primal scream.

Respectful Insolence: Orac's delicious blog, in which all manner of cranks, woo-meisters, and ridiculous nonsense gets smacked down at length and without mercy.  His main focus is anti-vaccine nonsense, but he'll battle any woo that strikes his fancy, and he's especially useful for combating cancer woo, seeing as how he's a surgeon and breast cancer researcher.

Science-Based Medicine: A blog on a wide range of woo-tastic topics by a stellar stable of medical bloggers.  It's not as insolent as Respectful Insolence, but it's solid stuff and sometimes hysterically funny.  There's nothing quite like a science-based physician expressing their frustration at the more obstinate sorts of woo.  It's also a good place to learn how science-based medicine works, how it could be improved, and why it's different from evidence-based medicine.

Quackwatch: This should be your first stop in your quest to avoid all things quack.  It's a tremendous resource.  No false balance, just facts.  Relentless, uncompromising facts.  Woo does not stand a chance here.

What's the Harm?  The definitive answer to that question is contained in these pages.  Woo's last defense is claiming that, even if it can't cure absolutely everything just like it claims, it at least does no harm.  Wrongo.  You'd be amazed at the harm even the most harmless-seeming woo can do.

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Mothering magazine: Peddling dangerous health misinformation to new mothers

Thank you.

Poisons, Doses, and Ammunition Against Anti-Vaxers

This has been sitting in my open tabs for far too long.  Kept meaning to blog it, but what with House and the Wheel of Time and the onset of the winter writing season, I never got round to it.  It's a wonderful post on Neurodynamics entitled Toxicology: the poison and the dose. 

Those of you enamored of mystery novels and/or crime shows may have heard the little phrase, "The poison is the dose."  All too true - and now you'll have an actual scientist's perspective on it.  And you'll also have a very useful question to ask:

What’s it do?

That’s the first thing I think when I hear someone say something is a toxin. There is no single “toxic” reaction out there. Every toxicologically active chemical entity out there has its own mechanism, its own target. Some are more recoverable than others, some have pretty dire consequences; some we have antidotes for, some not. Some exert an effect quickly, while others can take their time. They can target any physiological system, or multiples.  Cause death, permanent injury, reversible injury, minimal harm, or anywhere in the middle. Locally, regionally, systemically. There are many, many examples of different actions that a given compound could do. The severity of the effects is important to evaluate.

Lob that one at the next idiot who starts going on about toxins.  There are other questions answered there that are equally grenade-like and shall prove quite useful when people babble about all of those awful toxins making all of us sick although they're only found in vanishingly small quantities, if at all, in our vaccines.

And then remind them of that old crime show/mystery novel truism: the poison is the dose.  Not just any old dose will do.

Touring Evergreen Hospital

Evergreen Hospital

Last month, I got to visit Evergreen as a patient.  This month, I got to poke around the place for fun and education.  Thanks to Sherry in the marketing department, my intrepid companion and I got to attach ourselves to a tour group who were there for professional reasons, rather than mere curiosity. 

I didn't feel comfortable whipping out the camera like a raw tourist - I mean, we're talking about the ER, where people aren't exactly living the sort of memories they'll want to relive later - but let's see if I can get you inside anyway.  Picture yourselves in a comfortable waiting area with hardwood floors, nice chairs, and an artistic display of ceramic teapots.  Just don't picture yourselves there for long.  Evergreen built one of the prettiest waiting areas I've ever seen in a hospital, but people don't get to use it all that much.  They're whisked back to exam rooms too quickly.  While we waited for the rest of the group to arrive, we got to watch the average length of time people spent in the waiting room.  It seems to be around 2.2 seconds.

Should you have to go, you'll be met by helpful people who don't even let you have a full, frantic look around for where you should go before they're meeting you, asking what you need, and getting you into a small, glassed-in room where your temp's taken, an ID bracelet slapped on your wrist, and then zipped back to a room.  They say Sunday's their busiest day, so I may have to spend an afternoon in that waiting room just to see how much time that adds.  The way their system's set up, I doubt a crowd ever builds up in there.

So what's beyond Triage?  So glad you asked.  There are rooms designed to function well for all involved - patients, medical staff, and visitors.  Most rooms are semi-private - you don't get ogled by every passer-by, but you're within whimpering distance of helpful staff members.  You don't have to stare at a lot of scary medical equipment.  The bottles of gas (like oxygen) are tastefully concealed behind a painting at the head of the bed.  Extraneous medical equipment's kept to a minimum by carts: suture cart, pelvic exam cart, etc.  The proper cart's rolled in instead of having huge banks of equipment stuffed in cabinets.  All very tidy, and leaves plenty of room for folks.  Your medical staff gets one half of the room - the one with the counter space and monitor.  Your visitors get the other, where coats and things can be hung.  You get enthroned in the middle.

Things are laid out in a sort of triangle, with everything simple to get to, and the staff in the center where they can keep an eye on everybody as they work.  But if you're needing some serious solitude, there are special rooms for that, where all equipment is behind rollaway doors.  These are the rooms for the folks having a severe psychiatric episode, or the roaring drunk, where they can be watched carefully over monitors.  The windows of those rooms don't face out into the busy main areas, which strikes me as a good idea. It gives people there a sense of connection to the outside world - there is, after all, a window instead of blank walls - but doesn't give them views of things that might make them more excitable.  I've seen a fair few psychiatric setups, what with a mother who has bipolar disorder, and these are among the best.

We didn't, alas, get to see the trauma rooms this visit, but we got to go play in the decontamination showers.  They're in a room accessible from the outside.  Five you of can shower up at once before heading in to the hospital.  For some reason, the adjustable temp on the showers amused me.  I doubt I'll be worried about the shower being too cold if I'm ever in some unfortunate circumstance where I'm having to be decontaminated.  But at least now I know where I'll be if that day ever comes. 

I have to tell you, seeing the ER in its entirety eased a lot of nascent anxiety.  If a true emergency ever happens, the ER here is no longer an unknown quantity.  Should you get the opportunity, tour your own local hospital.  You'll find a lot of very good people working hard to ensure their communities stay healthy. 

Evergreen's doing an outstanding job of it.  So, you East Side residents - if you live near Kirkland and need excellent care, come on down!  You'll be in wonderful hands.

Although you might have to go back to appreciate the waiting room after your emergency's over.

Flu Shot Fears? Read This

Damn you, Connie Willis!  You made me abandon my readers to finish your damned book.  Stayed up until 7 in the ay-em to finish it, didn't I?  Now I'm dead on me feet.  I'm too old for this shit!

Makes me wish I'd got my flu shot a few weeks ago, because it takes two weeks to become effective, and right now people at my workplace are passing around all manner of horrible illnesses.  And here I am, exhausted, underfed, and vulnerable!  Not to mention, after having been up until well past bedtime, in no condition to go out and get one just now.  But I shall be doing it soon as I recover, and with this post from Mark Crislip, I won't be worried a bit.  Those who fear the flu shot should read this post, and take comfort.  Here are your risks, laid out in easy-to-understand comparisons:

The influenza vaccine is safe. Serious side effects are extremely rare and the risks from influenza are much greater. The vaccine is far safer than driving (30,000 deaths a year), taking a bath (450), or standing under a coconut tree (130). 

How can you be afraid of something that's less risky than a day at a tropical beach?

For those still worried about potential side effects, Mark cites studies that show just how minimal those side effects really are.  For someone like me who's never thrilled with the idea of someone poking needles into me, it's a wonderful reassurance that the whole enterprise won't be as bad as all that - and your risks of side effects go down if you get one every year.  Nice, eh?

All right, so you've already got your shot, or you have no fear of the thing at all - so why read the post?  Well, for one, gives you something to point frightened folks back to when they tell you they're refusing to get their shot because of x, y and z.  If you need to persuade a loved one to protect themselves, it's handy to have around.  It also explores why it's important for health care workers to get vaccinated, and why mandatory vaccinations wouldn't be a bad idea at all. 

And then there's moments like this:

The Cochrane review, as always with influenza, gets it wrong. While noting that “pooled data from three C-RCTs showed reduced all-cause mortality in individuals >/= 60.”, they go on to say “The key interest is preventing laboratory-proven influenza in individuals >/= 60, pneumonia and deaths from pneumonia, and we cannot draw such conclusions.” No, it is not the key interest. Most deaths from influenza are secondary deaths from exacerbation of underlying medical problems. All-cause mortality is an important endpoint, especially if you are the one dying. [emphasis added]

Here, here!

So, within the next week, I'll happily be getting my jab.  Just so long as Connie Willis doesn't ambush me with another book, that is....

Real Home Remedies

Amazingly enough, there are a few that work, and a whole book dedicated to them that doesn't promise miracles, doesn't proffer total bullshit, and doesn't keep you from seeing the doctor until it's too fucking late:

I received a prepublication proof of The Mayo Clinic Book of Home Remedies: What to Do for the Most Common Health Problems. It is due to be released on October 26 and can be pre-ordered from Amazon.com. Since “quackademic” medicine is infiltrating our best institutions and organizations, I wasn’t sure I could trust even the prestigious Mayo Clinic. I was expecting some questionable recommendations for complementary & alternative medicine (CAM) treatments, but I found nothing in the book that I could seriously object to.

[snip]

Nowhere does it mention acupuncture, chiropractic, energy medicine, or homeopathy. It gives good, clear guidance about when a health problem should not be treated with home remedies. Its recommendations about diet and exercise are solid. It doesn’t recommend anything that can’t be supported by published studies and common sense. When it recommends herbal remedies and diet supplements, it is cautious about what it claims. 

ZOMG.  I didn't think that was possible.  Might have to actually buy this one, because having a handy tome on reliable home remedies that will tell me when it's time to put down the home remedy and pick up the phone would be ideal.  Also nice to have such things vetted so I'm not wasting money on total bullshit, or hours online trying to sort the useful bits from the bullshit.

Figured I'd pass the knowledge along in case you lot were yearning for such an item.

Talk to Your Friends About DD

No, not drunk driving:

I’m suggesting now that distracted driving is in the same category. People just don’t multitask behind the wheel as well as they think they do, and we should get up in their faces about it.  If you’re talking to a friend and you realize they are driving a car, say; “Are you driving?  Good bye” and hang up.  And if you know someone who texts and drives, refuse to text them at any time until they stop doing it.  

A car is no place for multitasking.  It's time to get Zen, folks: when you're driving, just drive.  Please.


And really, really don't call the phone company to troubleshoot your cell phone while you're behind the wheel.  If it's that important, find a place to pull over.  I trust none of my readers are stupid enough to try to navigate cell phone menus, remove cases and batteries, and all that other stuff while also trying to navigate traffic, so pass it on: don't make the poor rep you're talking to listen to you kill or maim yourself and others.  Don't turn an annoyance into a tragedy.  Okies?

Here endeth my lecture, but if you didn't visit George's post, go do it now.  Unless you're driving.  In which case, what the hell are you doing in my cantina?

"Drowning Doesn't Look Like Drowning"

Everyone - whether you have a kid or not - needs to read this:

The new captain jumped from the cockpit, fully dressed, and sprinted through the water. A former lifeguard, he kept his eyes on his victim as he headed straight for the owners who were swimming between their anchored sportfisher and the beach. “I think he thinks you’re drowning,” the husband said to his wife. They had been splashing each other and she had screamed but now they were just standing, neck-deep on the sand bar. “We’re fine, what is he doing?” she asked, a little annoyed. “We’re fine!” the husband yelled, waving him off, but his captain kept swimming hard. ”Move!” he barked as he sprinted between the stunned owners. Directly behind them, not ten feet away, their nine-year-old daughter was drowning. 

I come from Phoenix, where the news keeps a daily count of the children who've drowned, and I still didn't know this stuff.  Read this article.  It will save lives.

There's some literature after the jump for ye, if you want to learn more about drowning behavior and the Instinctive Drowning Response.

Let's Talk About Boobs

Specifically, the boobs who are throwing a hysterical fit over the new breast cancer screening recommendations:

On Wednesday, a group of women GOP lawmakers held a press conference to denounce a new recommendation by the federal Preventive Services Task Force that women receive mammograms less frequently. “This is how rationing begins,” said Rep. Marsha Blackburn (R-TN). “This is the little toe in the edge of the water.”

[snip]

As the Washington Independent’s Mike Lillis notes, the concern of the congresswomen about rationed mammograms is especially ironic considering that they oppose legislation that “would require insurance companies that cover diagnostic mammograms also to cover routine, annual breast cancer screenings for all women 40 and older.”

Lessee.  Hypocrisy, check.  Ridiculous fearmongering, check.  Failure to comprehend simple words like "recommendation," check.  Pure Con dumbfuckery.

But if you're tempted to fall for a Con, or if you're just confused over what's best for your health, or if you want to see a breast cancer researcher take down the bullshit in stunning detail, you can head on over to Orac's Repectful Insolence blog and read the following:

"Obama's fixin' death panels for your mama," the misogyny gambit, and other idiotic responses to the updated USPSTF mammography recommendations

"Obama's fixin' death panels for your mama": The USPSTF recommendations for mammography used as a political weapon

A two-part takedown that is truly Oracian in scope and insolence.  And if you still want more, there's always really rethinking breast cancer screening.

Funny how Con talking points and fearmongering just don't have the same impact when you're armed with the facts, innit?

Raise a Tankard to a Recovering Captain

Our very own Captain Stephanie's off conquering cancer (with a little bit o' assistance from her ships' physicians, o' course).  Raise a glass o' yer very best for her, and join me in a cheer to her health, which will hopefully be so shamed by its undeserved adulation that it'll come slinkin' back to her beggin' forgiveness.

Here's to yer speedy recovery, Captain!

Public Service Announcement

Steve Benen highlights a sobering fact:

Remember to wash those hands: "Influenza is circulating unusually early this year with cases in all 50 states -- nearly all the swine flu variety, government health officials said Friday."

My coworkers and I got into a discussion about this a few days ago, after we learned that swine flu had struck the PAX convention - which two of our coworkers had just come back from. Another of our coworkers solemnly informed us that alcohol-based hand sanitizers aren't effective against viruses, and when I challenged him, stated he'd learned that working in a lab.

His lab apparently didn't know jack-diddly. I did some research, and what did I find but both the CDC and the WHO recommending alcohol-based sanitizers specifically for H1N1:

CDC guidelines: Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners* are also effective.

(Lest ye think that little * means "disclaimer," here's the relevant info from the link:

What if soap and water are not available and alcohol-based products are not allowed in my facility?

Though the scientific evidence is not as extensive as that on hand washing and alcohol-based sanitizers, other hand sanitizers that do not contain alcohol may be useful for killing flu germs on hands.)

WHO guidelines: clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated)

And, just for good measure, PalMD's guidelines: Frequent use of alcohol-based hand sanitizers when soap and water isn't available is a good idea, especially if you have to use your hands on frequently-touched objects such as doorknobs or handrails on the subway.

Three different science-based medicine sources, same answer at all. I'm convinced.

So load up with hand sanitizer for those times when you absolutely can't avoid touching icky public door handles and such, and use it religiously. I want all my readers happy and healthy.