Friday, November 19, 2010

Dr Weaselword will speak with you now.

The weasels deserve better.  These sleek and wondrous mustelidae have been unfairly tarred with the brush of what is sadly an increasingly common term (sad because it's needed more and more often): 'weasel words.'

They're everywhere, those words that purport to mean something that they don't exactly mean, like "Up to 50% off!" also means that there may be no discount at all, whereas the implication is that things will be half price.  Politics is especially fertile ground.  But the arena that sorely gives me the crunchy irrits the most is where people's health and wellbeing are directly affected.  The issues of dishonesty and disingenuity in medical speak.

Anyone familiar with my recent history knows I've had ample opportunity and motivation to learn lots and lots on a wide range of medically-related subjects.  This is not just on my own selfish behalf, as my journey has found me also somewhat engaged with a whole teeming subgroup of humanity who share my experience of feeding through a tube, or who care for someone who does.  And you get a tube placed for an enormous variety of reasons.  Through these folks I have learned much, and deeply.  And, you know, I care.

Even the definition of diagnosis has come in for some weaselling recently.  It used to run:

Diagnosis (n, medical):  The identification of the nature and cause of an illness; The identification of the nature and cause of something (of any nature)

but now it's been expanded in what I see as a butt-covering sort of way to:

Diagnosis (n, medical):  A label given for a medical condition or disease identified by its signs, symptoms, and from the results of various diagnostic procedures.

See what's happened there?  It used to be that for a medical professional to make a pronouncement that usefully encompassed a medical condition, thereby leading directly to a body of knowledge and experience able to be employed in the treatment of said condition, both the nature and the cause of an illness had to be clear, unquestionable, explicable. Otherwise it was just a description, not a diagnosis.  Now, just fitting some set of symptoms or descriptions agreed upon by who-knows-what process and who-knows-what panel of arbiters is enough to pronounce a diagnosis.  Which would be fine, except for one very large thing:  We, the plebs, still tend to believe - and in the throes of fear and uncertainty about our health or that of our loved ones want to believe - that a diagnosis is still somehow indicative of a cause, and thus a vital foundation of treatment and a hopeful cure.

Just found this pic - anyone know what on earth it's all about???

So let's talk about things like FTT and GERD (or if you're in the non-American anglophone world, GORD).

There's a certain certainty to an acronym, as there is to a scientific-sounding long word.  Whenever I read on a forum somewhere some mother saying how her child has been 'diagnosed with FTT (Failure To Thrive)' my heart sinks a little and I do a conscious double-check of what has been written.  My heart sinks not from sadness - compassion does not make my heart sink, it more just sort of swells a bit - but from the possibility that this person has been on the receiving end of a sale by some doctor somewhere.  Hence the double-check, I read very carefully to try and gauge the belief and feeling of the author to see if they bought the line or not.  Because FTT is not a diagnosis, it's a description.  And doctors are increasingly buying the BS of their own profession too.  (BS may be a diagnosis, I'm not sure :-).

This isn't just rogue pedantry here, because there's a serious danger to this phenomenon.  FTT is a very, very confronting thing to be presented with as a parent especially, as it all too often carries with it some direct implication that you are somehow at fault.  It also holds out a false sense of control, and thus perhaps misplaced hope.  Going back to the need for a 'probable cause' component to a diagnosis, FTT could have a whole plethora of possible contributing causes.  It's used pretty loosely too, in that it can be applied to any person who is an outlier on the 'normal' weight/age charts, and it has anecdotally been abused too - I have heard more than one story where a parent has been threatened with a "diagnosis of FTT and having child services called in" for daring to question a doctor's directions.  I should clarify that the usual first-recourse response of the medical profession with FTT is to simply 'insert more calories' and that typically means forcing in more canned formula.  Sometimes it works for a while.  Sometimes.  But it doesn't address the root cause usually, does it?

Just giving something a diagnostic name gives the impression of some power over the condition, and the cultural hangover of diagnosis=knowledge of cause too often means both medicos and caregivers backpedal or even entirely cease in their efforts to find cause - to heal, rather than treat.  The emphasis shifts not surprisingly onto getting some measurable outcomes using the 'scientific' tools available:  get that child back in the middle percentile on the weight charts, even if it's all fat and too much weight for their fragile small bones to safely bear.  Even if it means living in a world of vomit, retching and pain.  Even if it means otherwise clinical malnutrition.  At least then we've got the FTT licked, eh?

A bogus diagnosis like this too often means real healing is pushed right out of the frame, as cause is not sought, and the 'whole person' approach withers in the face of a potent-sounding acronymic lump of weasel droppings.

But wait, there's more.

GERD (GORD) stands for Gastro-Esophageal (Oesophageal) Reflux Disease.  And it's not even a disease, let alone a diagnosis.  It's been going on in humans since the dawn of time - certainly much more prevalent these days due to the whole modern diet and lifestyle catastrophe but it's only recently been given it's shiny new name.  By the pharmaceutical companies.

The described set of symptoms encompassed by the acronym GERD can be caused by any number of wildly varying factors and effects.  Including, say, standing on your head too often.

Just like with FTT, all too often seeking a root cause or addressing the real reasons for ill health get ignored when so succinctly wrapped up in four capital letters.  It gets all normalised - it's just a thing that sooooo many people have and isn't it great we have these marvellous drugs to so effectively treat it?  Except that the drugs don't.  Treat it, that is.  The main drug prescribed and marketed throughout the world is esomeprazole (Nexium, Prevacid, a hundred other commercial names) and even some doctors seem to believe it successfully treats acid reflux.  No.  It de-acidifies whatever does reflux and true, in some cases the less-acid stomach contents mean reflux happens less often or less severely but in the main it just stops it hurting and damaging the esophagus when reflux does occur.  Oh, and over time it can rather tend to destroy your stomach lining.  And other stuff.

(Disclosure: I take Nexium.  I have yet to find an alternative that works effectively.)

So whenever I hear someone talking about GERD my first instinct is to urge further questioning.  Yes, but why?  Again, too many will stop at the controllable-seeming catch-all that is a 'diagnosis' and currently-preferred treatment.

But is it any wonder?  Viewing the news media with any scope or objectivity we can quickly come to realise that we are simply being fed what it is we are most willing to believe, at least when it comes to opinion if not selection of what is 'newsworthy'.  In a scary health situation we even more want our alpha figures, our parent-types who will tell us what is wrong and what to do.  We want the comfort of a century's scientific experimentation and experience behind it, and we want most of all to believe there is a straightforward answer.  Some say this is precisely why we invented religion.  But in the end, we do ourselves a grave disservice by disempowering ourselves in the face of a profession as commercially-driven as it is driven by the best of intentions.  We must always be the final decision makers in our own health, and that of those who rely on us.

My beef is that it's just downright dishonest, and I suppose in the case of GERD (and just too many other 'diseases' to name) to big money.  Pardon the pun, but I don't buy it.

And lastly, of course I'd like a proper diagnosis for myself, not just a great antiqued funky steampunk-sounding name for a disease.  But then I know that the cause is elusive to modern science, and by now, essentially irrelevant.  Can't help a curious mind though eh?


  1. Hi Aadhaar,

    always a good read. I'm sorry to hear about your heartburn, mate. I'm going to play amature doctor for a bit if you don't mind. I have a book called "Prescription Alternatives" and I've found it useful a few times for myself. I have heaps of other books too, but this one was the first one that came to mind when I read your article so I'll paraphrase in horrible, crude and possibly unreadable gibberish what it says just in case something there is of some benefit to you, which is my sincere wish. I'm not teaching you how to suck eggs or anything with this... you could teach me more about things than I could teach you about things, but information flows round in round about ways, hey?

    Here goes:

    If you don't know what triggers your heartburn, here are some common culprits. Overeating, too much fat or fried foods, processed meats with nitrates or nitrites in them, too much sugar, alcohol, chocolate or drugs, stress, tight pants, obesity, pregnancy (obviously this is your main problem), not enough green organic food, (I've heard food processors can destroy enzymes if they spin too fast. There processors available that extract juice slowly preserving enzymes), drinking too much hot or cold liquids with meals... try drinking half an hour before meals to increase stomach acid and aid proper digestion, add a tablespoon of apple cider vinegar to the drink if simply leaving the half hour gap doesn't work, take betain hydrochloride suppliment with meal unless you have an ulser (this is said to be a good anti aging strategy), two 380mg tablets of deglycyrrizinated licorice extract on empty stomach 3 or 4 times a day, raw cabbage, potato juice, herbal teas like fenugreek, slippery elm, compfey, licorice and meadowsweet (lukewarm, no lemon)(they say the teas can bring quick relief), fresh papaya or banana. If you need to lower stomach acid, 1000mg MSM in supplement form daily, limit fat, grog, chocolate, overeating, don't eat on the run or lie down after eating, increase the peace with excercises and meditation.

    That's my best paraphrasing. I hope something in there is helpful.

    Also, "Prescription for Nutritional Healing" says:

    80 to 100mg or as directed on label of Pancreatin plus bromelain, Papaya tablets, vitamin B complex plus extra B12, Acid-Ease from Prevail, Acidophilus, 300mg 2 daily of calcium, 150 to 200mg 2 daily of magnesium, 100mg daily of potassium, MSM as directed on label, Aloe vera juice, A tea of catnip, fennel, ginger, marshmellow root and papaya, Chamomile tea, Deglycyrrihizinated licorice (do not use if you have high blood pressure), potato juice, fresh cabbage and celery juice. Avoid citrus, fatty foods, caffeine, dairy, carbonated drinks, sugar, eggnog, gravies, onions, peppermint, poultry skin, spearmint, spicy foods, tobacco, tomatos.

    I hope this helps you, dude. Forgive me if I come across like a bighead or smallhead or in some other way like a nutter for sending you all this. I don't mean to preach, papa, but information like to be free.

    Digging your articles. I don't catch all of them, because I'm a lazy internetarian, but keep 'em coming.

    Sending you good vibes.

    Dave Evans

  2. I think your "diagnosis" of that image is incomplete. It's not a weasel, it's a mongoose. They're completely different animals, not even all that closely related.