Towards a New Paradigm of Health (or the T-DOMES concept)

So this is meant to be an outline of my ideas concerning how disease is caused and how it may be prevented and managed. There is a standard framework set up in advance by the institution of medicine that has its own philosophy pertaining to how the body is to be viewed and treated and this is challenged in specific ways by alternative and complementary medicine. Nevertheless, these are all techniques that manage bodily conditions once illness has struck. When it comes to prevention, there is a lot of obvious and simple advice given about what one must do. Your average text on health tends to construct a simplified conceptual framework of how health functions in order to organize the activities that produce wellness into a whole that may be conceived and acted upon. I have not yet found an author, however, whose way of doing this has completely satisfied me so this is my attempt to produce my own simplified but hopefully useful way of conceptualizing disease treatment and prevention.

Toxicity

The central concept that relates to health is the idea of toxicity. This is the master concept that is usually at work whenever a problem arises whether the matter has to do with nutritional, pharmacological, psychic, or mechanical toxicity. I am thus using this term in a very broad way to include within it any life stress that is chronically maintained or which is beyond the threshold of benefit. Beneath the idea of toxicity are the various specific objects which we must be careful to be aware of in order to maintain wellness. Toxicity is thus the T in the T-DOMES acronym I have produced, the DOMES being a specification of the possible toxicities to avoid, manage, dissipate, and neutralize depending on your desire, circumstance, and temperament.

Digestion

Digestion is the first and most important part of the health equation, the one most likely to be disrupted, and the one that shall bring the most benefit once it is under control. A compromised gut is implicated in a wide range of problems including, obviously, the digestive problems but also autism, fibromyalgia, chronic fatigue syndrome, obesity, muscular pain and so on. In other words, it’s always good to rule out the gut as a causative factor as it may be playing a role in a variety of ailments. Good digestion is also important for the sake of extracting the most nutrition from food, having good energy balance, and so on. Below the macro idea of digestion lies several things. The most obvious one is to have a proper diet that is good for digestion and nutrition and to go through a therapeutic diet if necessary so that the gut may be healed. As far as therapeutic diets specifically for gut healing, it seems the GAPS or SCD diets work in many people. As a quick summary: eliminating lactose, casein, and/or polysaccharides may be useful for a limited time in allowing the gut to heal. Besides the diet, is the issue of having healthy and beneficial probiotic colonies in the gut through consuming fermented foods and supplements. Enzymes as well as betaine HCL (or apple cider vinegar) may also be needed to help weak digestion and/or low stomach acid production. There are also basic things of importance like the proper chewing of food and reduced meal frequency. Chronic stress is also a factor that may reduce stomach acid production. The goal of this level is then to deal with and avoid a wide variety of digestively related ailments and to improve energy production as well as our nutritive status and thereafter to maintain a nutritious and low toxin diet (i.e. PHD style diet or my regular diet).

Outlook

Outlook in life is extremely important both physiologically and psychologically (as if there were a difference) as the physiological tension from stress, depression, anxiety, and so on can affect digestion, the amount of adipose tissue that you have and where it is deposited, brain function, sleep quality, and the adrenal glands. As much as people attempt to turn into machines, our basis in biology cannot and will not be denied. The fact that we have a biological basis means that we need to understand that we all have certain social, sexual, and physiological needs and that we need to accept them and embrace them. Of course, I cannot delve into this topic deeply right now as this is just a cursory summary but the basic point is that we should not be experiencing chronic stress and isolation and learn to take our activities lightly and accept our circumstance as this will lead us towards a better life. In my view, however, this is the most difficult task to manage as the untangling and dissolution of neuroses is no easy feat due to the structural role that neuroses play in the psychic economy of the individual. Nevertheless, progress may be made such as through having valuable relationships, goals in life, practicing meditation, getting sufficient rest, and so on. The goal of this level is to avoid the problems of chronic psychological stress and self-defeating behavior, loneliness and so on.

Movement

The idea of movement encompasses both exercise and posture as these are two important things that affect our bodies. Exercise is a necessary activity in life in order to keep us strong and able to engage in a wide variety of activities not to mention that muscle cushions us from injury and provides a reserve store for our immune system to feed upon when necessary. I personally believe in the primacy of high intensity, but slow, weight lifting plus leisure and locomotive activities throughout the rest of life (walking to places, playing sports). Posture is important in weight training to avoid injury but it is also important in general as chronic bad posture can lead to a variety of spinal and muscular problems over time not to mention the fact that out culture is geared towards sitting and inactivity which is generally bad for posture. In this realm I suggest the Gokhale method as it very clearly explains what properly balanced posture is and how to achieve it. The goal of this level is then to avoid the mechanical injuries that arise from bad posture and to avoid other bodily injuries that become easier to incur when one is weaker in the body.

Environment

This is a very broad category that relates somewhat back to outlook in that it is important to exist in an environment that is conducive to your optimal functioning. However, one can be more specific in that many environments have stale or dry air, toxins present from the production of the carpets, furniture, and so on not to mention those present in various products used such as shampoo. The idea is to avoid unnecessary exposure to these sorts of things and also to balance it with being outside and in the sun as this is an activity that produces vitamin D in the body among other benefits. To this we may also relate the idea of time, the body responds to the environment and perceives time. When we engage in shift work and sleep all day, this can have a negative hormonal impact so it is recommended that one sleeps in the right environment at the right time. The goal of this level is to avoid the problems of vitamin D deficiency, exposure to toxicity, disconnection from nature, and so on.

Sanitation

This refers to a specific idea of cleanliness as I do not in any way advocate antibacterial cleaners as they are damaging to yourself and the environment. What I mean is the management of space. This includes the space of the body and as such can be seen as being synonymous with the idea of hygiene. Being “clean,” for me, does not mean the destruction of bacteria but rather the proper colonization of it especially as far as bodily entry points are concerned. The mouth, the nose, the anus, and genitals are all possible points of entry into the body from the exterior environment. If one maintains these areas in proper bacteriological balance then the likelihood of disease diminishes so I suggest probiotic treatments for these areas when warranted. For instance, one may wish to use a suppository or enema to help with the colon if a person has severe digestive issues from a loss of colonic bacteria. If a person is prone to chronic ear infections or sinusitis, it may be useful to introduce probiotics into that area of the body via a netipot. Also UTIs in women can be prevented through probiotic treatments which may be done orally or genitally. As for the mouth, there are many ways of modulating dental hygiene through the food consumed and the products used. The goal of sanitation is thus to control the entry points to the body as well as maintain the space around you in such a way that is does not constitute a threat to you. This does not mean destroying bacteria but, rather, being aware of them.

The Healing Modalities (SHOPP): Supplements, Herbalism, Osteopathy, Probiotics, Psychotherapy, Allopathy

The preceding sections outline the most salient concepts for the maintenance of health and prevention of disease, however, it is inevitable that one will become ill at some point and so it is necessary that one should have a plan for this eventuality. The “plan” that I have produced is constructed of several healing modalities that should be applied to the situation depending on the nature and gravity of the situation and the amount of harm and benefit the medicine is likely to produce in the patient. In life threatening situations, there is no option but going to conventional medicine (allopathy from now on) as this is what allopathy is best at, however, for all other ailments I believe a different approach is warranted due to the amount of problems that allopathic remedies tend to produce in individuals and the fact that this sort of medicine is based on symptomatic treatment as opposed to snuffing out causes.

Supplements

Many diseases are caused by vitamin toxicity or deficiency, as such supplemental vitamins constitute an important healing modality as anyone who has ever heard of scurvy can tell you. Even in the case of vitamin toxicity, vitamins may help since they work synergistically together and thus may be able to modulate one another such as vitamin A and D where toxicity in one is often present because of deficiency in another. Besides vitamins, there are many other compounds that can help in alleviating problems. For instance, alpha lipoic acid can chelate some heavy metals and could thus be useful for people with heavy metal toxicity.

Herbalism

Before getting to pharmacological substances to which bacteria (among other vectors of disease) can more easily adapt to due to their simplicity, it is important to attempt to treat disease with herbal substances. Of course, one should not assume that herbs are safe and nontoxic, it all depends on the herb but these are less likely to cause issues in individuals and are thus worth a try before getting to more dangerous treatment options. These are especially good with more minor ailments as there are many herbs that are antiseptic, antiviral, and antibacterial such as garlic and ginger.

Osteopathy

I do not know so much about osteopathy but do know that it has been shown to be effective and involves manipulation similar to chiropractic practice. As such, it seems to be a prudent option if you have some sort of mechanical difficulty and since osteopaths are full doctors they will move you towards allopathy if they believe it is necessary.

Probiotics

Probiotics are very important in preventing and treating disease as these bacteria constitute our endogenous bacterial army that battles against pathogenic bacteria. When a person has insufficient friendly bacteria, that individual becomes more susceptible to disease and when a person is given probiotics during illness, the illness tends to resolve faster. In most cases, except for gut dysbiosis, this will be either a complementary method or a preventative method, nevertheless, it is still very important as it may save you from recurring infections of the same sort as explained above.

Psychotherapy

If you have a psychological problem then psychotherapy should be your first option of treatment. It is just as effective, if not more so, than pharmacological treatment but gets the shaft because it’s easier and more profitable to prescribe medicine instead. In any case, using drugs to treat these sorts of disorders usually functions as symptomatic treatment that does not untangle any issues in the individual thus forsaking him/her to lifelong medication with the associated side effects.

Allopathy

Like I mentioned before, allopathic medicine is very good for emergencies. If you have a life threatening situation on your hands then you do not have the luxury of shopping around for the best treatment but instead need to just stay alive and allopathy knows how to do that. Besides this very special circumstance, I recommend that you use allopathy once other options have been exhausted as its treatments are the most damaging and dangerous. It may be useful, however, to go to an allopathic physician for the sake of certain diagnostics which you may then use for your own purposes and I believe this is the best use of them.

Other Considerations: Saunas, Laughter, Chiropractic, Acupuncture

There are other activities that can help health that are not treatment modalities in themselves or with which I am not familiar enough with to really endorse fully. I will quickly outline these here now.

Saunas

Saunas have been used for health for quite a long time and it makes sense as the sauna is nothing more than a simulation of the fever. The fever in the disease process does not happen for no reason, rather it is an immune defense. By increasing bodily temperature, the immune system is attempting to kill pathogens. This is why fevers should be allowed to run their course so long as they are mild. In any case, this appears to be the basic idea behind the sauna and why it is associated with longevity.

Laughter

Laughter is an activity which can help bring oxygen into the body, reduce stress, and improve outlook. As such, it seems to be something that should be included in a well rounded healing strategy especially considering how easy it is to get dreary when one is sick.

Chiropractic

So far, chiropractic practice has appeared to me as nothing more than a less professional form of osteopathy with fewer qualifications and more possible injury (especially if the manipulations are done on the neck). For this reason, I do not really see why someone should want to see a chiropractor when that person can simply just go and see an osteopath instead. Nevertheless, chiropractic does have a plausible method of functioning so feel free to go to them if you do have certain mechanical problems and prefer them.

Acupuncture

Acupuncture also has a plausible physiological method of functioning (that is, the needles stimulate bloodflow to the areas being pricked thus improving healing), however, I have not seen much in the way of proof that this does, in fact, work except when it comes to headaches and some muscular and joint pain. As such, I recommend that if you believe in it then go ahead and use it, it is unlikely to do you much harm, however, it does not seem very necessary and the clinical evidence behind it does not seem particularly large.

Conclusion

It is my opinion that the T-DOMES strategy should be a sufficient way to maintain very good health indefinitely. The problem is in implementing it fully as I believe many people likely have chronic digestive issues that require healing, chronic anxiety or stress, and may suffer from psychological problems such as anger, loneliness, depression and so on that put their bodies in compromised states of being. This is not even to mention the encouraged sedentariness of our culture and the bad posture that inheres in too much sitting and the toxic environments in which we often work and live. All these problems feed back into eachother very easily such as a job where you’re stuck at a desk all day in bad posture that leads to strain with a loved one which increases your stress and anxiety which you escape from by watching too much television while eating potato chips and ice cream. Here you have bad food with bad posture with bad environment with lack of movement working together to produce psychic and physiological stress that the person in question finds difficult to deal with except by indulging more fully in that which injures him/her. It is thus a difficult path to find a way to unravel ourselves from the traps of culture that attempt to tell us what to do, what to eat, what it is that is worthwhile to do with a life, who should be desired, how a person should act, what to buy and so on and so forth (not to mention the production of anxiety through news media). This often all eventually congeals into a clinically diagnosable disease which can then, through the cycle of unintended consequences and a faulty framework, lead to even more disease via the side effects of treatment if the treatment was even warranted in the first place. That is the additional insult here; that even people who are healthy can be made to be ill through the manufacture of imaginary diseases that need to be managed such as high cholesterol or the medicalization of problems that should be properly dealt with in psychotherapeutic ways such as depression or anxiety or through screening tests on the asymptomantic which often detect non-threatening phenomena that end up leading to unnecessary surgery. All this medicalization of the physiologically healthy even while the ill are symptomatically treated only thus allowing their diseases to progress further instead of instituting programs that reverse the disease process such as happens in GERD and diabetes. This is how one falls into the plague of iatrogenicity that must be avoided and this is why I suggest the T-DOMES framework above as a way to maintain health and to use allopathy only for diagnostics while using the other modalities (SHOPP) for actual healing if at all possible.

Filed under: Bacteria, Diet, Digestion, Hcl, Health, Iatrogenicity, Medicine, Nutrients, Pathogenesis, Supplements

The Problem with Modern Medicine

It’s been a while since the last post here but I have not been idle. I have been considering the topic of modern medicine and its modalities of healing. This was precipitated by my own recent encounter with the medical behemoth after a severe earache incapacitated me temporarily which led me to the clinic. This experience left me realizing just how vulnerable the patient is in the face of the authority of the doctor who hands down judgment upon the helpless patient desperate for an answer to the ailment that afflicts him/her. The doctor, usually, will give you an answer since that is what you seek. Whether this answer will in fact help your condition is another question entirely and it is in this way that it becomes easy for the doctor to prescribe medicine for conditions that don’t require it. This is all to say that going to the doctor is as much a psychological experience as anything else and that this must be taken into account in order so that the patient is not mislead or taken advantage of in his/her vulnerability. After all, the cures of modern medicine are not without their risks and to be taking a drug or undergoing a procedure simply because the doctor believed that that is what you wanted and without any proof of the efficacy of the drug or procedure is to be gambling with your health as hospitals are not safe places. Mistakes are made and antibiotic resistant infections breed there. No, we must be aware that doctors are people who make mistakes and who are subject to influence. That modern medicine is itself a pseudoscience based upon a lot of conjecture and questionable data and that it is sold like any other product, with lots of spin. I will now outline some of these problems.

Absolute Risk versus Relative Risk

Have you ever heard an advertisement for a drug where it was stated that it reduces the risk of some condition by let’s say 50%. This percentage refers to the rate of reduction as compared to another group, it is relative risk. This means that if there was a trial done with two groups of 1000 people and in group A, 1 person died while in group B 2 persons died then it could be said that the intervention done for group A reduced their risk of death by 50%, quite impressive despite the fact that the risk of dying in group A was 0.1% and the risk of dying in group B was 0.2%. This is one way in which unimpressive data can be made to appear much more impressive than it is in order to sell product. The problem with relative risk is that is meaningless unless you know what the percentages being compared are. If in the example trial above, 250 people died in group A and 500 people died in group B, the relative risk would be the same even though the risk of death in group A would have now been 25% been versus 50% in group B, a much bigger difference. This is but one example of why you should be very skeptical of procedures or drugs that are “proven.” You need to investigate the data yourself and do your own cost/benefit analysis to ensure that it’s not just hype and statistical abuse.

The Authority of Medicine

Modern medicine has been able to occupy a position of power and authority that very few other institutions have and this has given them something of a carte blanche to do what they like. Everyone seems to accept that the doctor knows best or that modern medicine is usually the most effective or most proven. The problem with these conceptions of modern medicine is that they are wrong. There are many obvious and standard procedures in medicine which in fact have nothing to support them. Cardiology is a great example of a pseudoscience as it seems to have the highest prevalence of procedures and medicines that harm people while procuring no benefit. Trials have shown that stents, angioplasty, and coronary artery bypass grafts are essentially worthless not to mention the overprescription of statins which treat a number but not a condition and may increase the prevalence of cancer since really low cholesterol is correlated with higher cancer risk. If these procedures did not have any risks then I suppose using them would not matter but the fact is that people become ill and consent to these procedures which have not been shown to work only to become sicker from complications related to these procedures. It is in this way that going to see the doctor can, paradoxically, make you sicker than if you had stayed at home and done nothing. For instance, ear infections are self limiting conditions that don’t generally need antibiotics, nevertheless, doctors routinely prescribe antibiotics for ear infections and this can lead to diarrhea or constipation as a side effect due to the disruption of gut flora and in trials it has been shown that those who took antibiotics for ear infections have a higher chance of recurrence than those who did not. Nevertheless, doctors do not seem to inform patients that they should take probiotics with their antibiotics or that a shorter course may be just as effective as the longer course or even take the trouble to make sure the infection is bacterial or what sort of bacteria it is so that the narrowest spectrum antibiotic is prescribed.

The Problem of the Screening Test

The screening test has come to appear as a thing that saves lives by detecting life threatening problems way before they actually threaten life. Unfortunately, the screening test doesn’t really save lives as much as it turns perfectly healthy people into patients, patients who become survivors because the problem they had wasn’t a problem in the first place. A screening test in an asymptomatic individual is seldom necessary since many screening tests are unreliable and since most of the types of cancers detected by screening tests are not ones to worry about. There is the tumor that is static, the tumor that grows so slowly as to have no effect on mortality, the tumor that grows slowly and can have an effect on mortality, and the tumor that grows quickly. If you have one of the first two then you’ll be getting medicalized for no reason. If you have the last one then you will become symptomatic rapidly and will not be helped by any screening test. Thus, out of 4 types of cancer, only 2 are worth worrying about and of those 2 only 1 can be detected at a screening test. I personally am not interested in lining the pockets of the medical industry for a problem I may or may not have so I suggest avoiding all medical screening tests unless you actually have symptoms.

Iatrogenicity

All of this is to say that if one is to remain healthy one must avoid doctors, hospitals, drugs, and procedures as much as possible otherwise one risks falling into the trap of endless iatrogenicity and lifelong disease management. The approach of modern medicine is treatment of symptoms and this leads to treatments that mask the problem while allowing it to progress. For instance, GERD is a condition that usually is caused by low stomach acid but is treated in ways that further reduce stomach acid thus helping the disease to progress while only providing minor symptomatic relief. In this way, the individual can become a patient for life who manages his/her chronic illness as opposed to someone who is getting better and will cease being diseased at some point. There are few cases in which one must remain diseased and manage it, certainly many fewer than what modern medicine believes and, in any case, considering how harmful treatment through conventional methods is, it seems prudent to always begin with the least harmful treatments and work up to the more harmful ones. As such, modern medicine should always be a last resort for treatment and be used chiefly for diagnostic purposes. Herbalism, osteopathy, rest, relaxation, psychotherapy, saunas, placebos, probiotics, laughter, nutrition, and vitamins all have healing potential that should be exploited before one runs into the arms of allopathy where the possibility of unintended consequences greatly increases. I will be expanding on some of these topics more later but this serves as a general exposition of my position.

References:

Hadler, Nortin. Worried Sick.

Welch, Gilbert. Overdiagnosed.

Schmidt, Michael. Beyond Antibiotics.

Bremner, Doug. Before You Take that Pill.

Cohen, Elizabeth. The Empowered Patient.

Filed under: Health, Iatrogenicity, Medicine