Some Health News

[sadluxation]

Quote:

UK researchers are extending a project to investigate the effects of “spiritual healing” on people with asthma.

Researchers from the University of Aberdeen began the Aberdeen Spiritual Healing in Asthma Study, the largest of its kind in the UK, in April 2002 with backing from the university’s department of General Practice and Primary care.

Spiritual Healing Study

Quote:

Experts are calling for authorities to ban or restrict access to the herbal supplement ephedra – often used for weight loss or to boost energy – after US research suggested it poses a threat to people’s health.

A study at the San Francisco VA Medical Center found that, in 2001, ephedra was responsible for 62 per cent of all herbal-related reports made to poison control centres in the US.

Herbal Suppliment ban in US

I would think that asthma would be an illness for which the placebo effects might be significant. Sud, I know you are a scientist, your thoughts?

[sadluxation]

As far as I know, this is one of the better studies with a good control group. Using actors as the control could cause problems, as they might not be as convincing as the actual "healers".

I'm just not entire;y sure why they need yo 'expand' the study.
Changing the study before it's finished will just cost more (NHS money) and the results should not be that different from a smaller scale study, if properly conducted.

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As to the banning of Ephedra, seems like it is too late.
Then again, you can't really ban anything successfully. We still have people blowing each other up in the UK, even though guns are banned.
What makes banning a phyto-medicine any different?
You have to instil some resoning into a prohibition of a substance.
That's probably why you always hear " It's natural, so it must be safe." arguments from people, even though they are ingnorant of the risks.

[Soapy Sam]

I wonder who proposed the study- the university, the NHS Trust, or the local spiritual healing practice? Might be worth watching this.

[Zep]

As a card-carrying, grade-A, life-long asthmatic scientist myself, I think I may be qualified to comment here.

As you are most likely aware, asthma comes in many forms and grades - from mild intermittent childhood wheezes to chronic permanent breathlessness. The causes of it are now well known, and due to well-conducted medical studies that continue to reveal facts, treatment has improved out of sight in the last decade. I myself have been involved as a guinea-pig on a number of asthma research programs here in Australia.

These new treatments range from simple breathing exercises to removing underlying asthma triggers to drugs. Many children with mild asthma will lose it as they grow. Workers in dusty environments, or smokers or people with chronic bronchitus, lose their asthma when they change environments, stop smoking, or get cured. Not every asthmatic is a wheezing wreck, not every cure is drug-related.

Regarding this study involving "healers", it does seem to be suffering from the same problems that some other "wonder cures" came up against. Put simply, they claimed cures for patients who were not actually sick, and were ignoring recidivism of symptoms. Best example was Buteyko - specific studies on it here in Australia gave it a very poor report card.

So I would be asking first if there is any pre-testing to determine the frequency and severity of asthma in the subjects. Are the subjects being allowed to include themselves as "asthmatics" without medical proof that they actually are? Is there some sort of entry-level of severity? Commonality of symptoms? Commonality of environments?

Second, what level of "cure" has been claimed, and has this been borne out by the results? What standards are being used to measure the subjects?

To be honest, it all looks very vague to me, and I wonder if it is not just a mechanism to measure the placebo effect of the healers in general practice rather than cure asthma.

cheers
Zep

[Cecil]

Quote:

Originally posted by hal bidlack
I would think that asthma would be an illness for which the placebo effects might be significant.

Actually, Stephen King used this as a plot device in It. One of the characters had asthma, and used a water-vapour inhaler to control it.

I was reading an article on Medscape just the other day that talked about asthma remission and how it is not always what it seems. Biopsies of airway tissue from asthmatics apparently no longer exhibiting any symptoms or having greatly reduced symptoms showed continuing presence of inflammation and abnormality associated with asthma. The warning here is that people with 'mild' asthma, even people who are thought to have grown out of it, may still have hyper-responsive airways and are in fact at greater risk of hospitilisation or death than asthmatics with chronic or serious disease. This is because mild asthmatics don't take their medication - they don't think they need it. All it takes is a trigger event and they're in big trouble.

I know - I've been there.

The article was interesting for another reason. They showed that chronic hayfever type symptoms in asthmatics aren't a separate problem - for some sufferers, it's all one long oversenstive airway from nose to lungs that needs to be considered as one disease. I found this interesting, because I get the sneezes and sniffles all the time and didn't realise this was part of my asthma (my doctor never realised it either). Not being able to breathe through your nose also contributes to the severity of your lung problems (dry, unfiltered air, etc) so I need to look after that part of me as well.

As for whether asthma is a disease with a major psychological component: I guess I can't say. I don't find my symptoms are worsened by stress in the workplace or other negative events, only by seasonal variations or exposure to triggers like smoke, dust or cosmetics. I have used relaxation techniques instead of medication and it wasn't good. I've even tried ignoring symptoms and attempted to sleep them off - also a bad move. In the end, it is acceptance of medical knowledge and compliance that keeps me healthy.

[kittynh]

My younger daughter has mild asthma, but when she has an attack (about 4 times a year) she gets scared. We learned if she can stay calm and relax, sip some water, then we buy a lot more time. When she gets tense and tightens up, she goes down hill fast. Since she has so few attacks she isn't as used to the symptoms as more severe asthmatics.

[Zep]

kittynh and daughter: I can confirm from first-hand experience that relaxation certainly helps during an asthma attack, although as spoonhandler says, sleep is not ideal either. If the symptoms can't be reduced then the intention should be to minimise activity to below the available rate of oxygen exchange. That is, don't use more air than you can get through your lungs. Remember that asthma affects breathing both in and out so CO2 removal is affected as well as oxygen uptake.

For children, this can be difficult - they can be understandably frightened and naturally active, both not helpful during an asthma attack, especially for infrequent attacks which children don't get used to. Until I found a medically recommended reliever, I found that sitting reading an absorbing book was a good way to avoid problems - I distracted myself enough to not be distraught, and I stayed awake but inactive and calm. (I also read a LOT of good books!) Watching TV is NOT good - kids get twitchy watching TV...

Quite a number of excellent medications have been developed that provide good relief from the symptoms of asthma with few side-effects if any. The most common is salbutymol (eg. Ventolin) which can easily be used even by children for instant relief of infrequent attacks. It's no cure, but it is certainly a confidence booster for kids to know that if they need it they don't have to be frightened.

But please ensure that you speak to a qualified specialist about this subject. Children do not usually "grow out of" asthma - it is usually symptomatic of something more serious that needs proper management. And constant use of reliever medications like Ventolin are NOT a long-term solution either (think of it more as a "get out of jail" card!).

And PLEASE don't try "herbal" or "health food" remedies - some of these have actually been found to be harmful to asthmatics, eg. royal jelly (contains concentrated pollen, a known common and severe allergen!).

Good luck!
Zep

[edthedoc]

OK, medic's turn:

I agree with some of the above posts: asthma is a difficult beast to define or measure. It has a vast spectrum of symptoms and signs and the effects of treatment are difficult to assess.

This study is going to have to be extremely well run to have any validity.

I suspect it will go the same way as many studies of "alternative" treatments: it will either show some very very small statistical effect which may or may not be significant and believers will use this as proof of the treatments success or it won't show any effect in which case believers will dismiss the study as "poorly run" or "too small".

Either way emotions will get in the way of the truth of studies and the nature of statistics.

I don't think it will change anything.

I think current evidence is very much in favour of controlling asthma not by relying solely on medication or methods of dealing with the acute symptoms only ('attack') but on treating the underlying inflammation/hyper-responsiveness using daily medication for that purpose.

Personal experience has taught me to be disciplined in taking my daily dose of anti-inflammatory inhaled steroids but always keep my reliever medication close to hand. It's sometimes hard to do this when I feel perfectly well, but as I said earlier, I've learned the hard way not to believe I've suddenly stopped being an asthmatic just because my symptoms disappear.

[Zep]

Ditto for me, spoonhandler. I'm well enough to do regular karate at nearly black-belt level, plus other regular strenuous activities (and I'm nearly 50!), so my asthma doesn't slow me down when it is controlled. In fact I barely know it's there unless I forget "my drugs" for a day or two.

Interestingly, right now I'm trying to reduce my medication intake while still controlling the symptoms. I've done the whole battery of lung-function and airway twitchiness testing a few times over (I'm a regular guinea-pig for Sydney Uni!), and we are still working out that balance.

Zep