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Orthomolecular Medicine News Service, June 27, 2019
A Real Doctor-Patient Relationship Means Mutual Learning
Especially about nutritional alternatives to drugs
Commentary by Ralph K. Campbell, MD
(OMNS June 27 2019) I started my pediatric practice decades before the internet existed. I came out of internship and residency training with a head full of medical facts, eager to get this show on the road. I had learned of many, sometimes exotic, disorders that I might never actually see in practice. I was shocked to find that I had little experience in listening to my patients. Not that knowing about these diseases wasn't important, but finding simple, practical remedies and having them understood and applied was essential. In this post WWII era, I was becoming aware of the shift from attributing good nutrition's contribution to health to prescription drugs. By listening, I learned from my patients about the varied staples in their diets and what vitamin supplements they were taking. I checked out the nutritional value of their diet so as to encourage them to stay on track. Some told me how they had come across a nutrition study of a vitamin deficiency that seemed to square with their current health problem, took extra amounts (in addition to their daily multivitamin) and in time noticed improvement. It is in this way that patients provided me with very useful input.
Taking a look at the cuisine of different cultures became popular years ago. Many of us picked up on the value of cultured milk as shown in a study of those living at the base of the Himalayas, many who were leading active lives while in their 90s or even at 100 years of age. The fountain of youth appeared to be cultured milk (long before any thought of the human biome). We know, of course, that milk is only tolerated by some adults, who have the enzymes to digest lactose. Yogurt is often better tolerated and enhances the biome with its beneficial bacteria. A corollary of this kind of thinking, for many of us, was an almost irrepressible desire to quiz healthy people in an attempt to find out how they got that way. One old guy I talked to explained his theory: "I have a couple of shots in the morning to get the engines running." This reply somewhat dampened my enthusiasm for interviews.
"So what seems to be the problem?"
Before a prescription is filled, the doctor needs the input of his patients: a description, in the patient's own words, of the chief complaint and what they have attempted to do about it. Then the doctor carefully explains what he has concluded from listening and an examination. A "tentative" diagnosis is made and sometimes, after some tests to rule in or out some more plausible diagnoses, a trial of a drug is started if there can be assurance of follow-up, by phone or another visit.
With access to the internet, the patient can find an almost overwhelming amount of information. The trick is in being discerning about which is true and which is misleading. For example, in searching for a type of illness that seems to fit the description of what is going on, if the first thing that comes up is where you can purchase the remedy, that should put a damper on trusting that source. There well could be a profit motive stronger than any altruistic idea of benefiting the buyer.
Outside the medical box
On the other hand, a search might come up with a remarkable article, composed by someone thinking out of the box, that any doctor should be interested in. Physicians are chronically pressed for time and may not have seen these unconventional studies. After a good doctor-patient relationship is established, it could be of great value to give the doctor this information and let him see for himself. However, without the good relationship, such a suggestion might seem threatening as it questions who the more knowledgeable one is here.
As more and more new drugs were approved by the FDA and appeared on the market, I was interested in hearing the stories from new patients who had been taking a drug prescribed by another doctor. Often the patient described side effects, some of which matched up with the internet description of the known side effects. Yet, too often, these had never been discussed with their doctor. Among friends in my age group were many taking statin (cholesterol-lowering) drugs prescribed by their doctors. They were suffering from muscle pain which could be the precursor to a very serious condition called rhabdomyolysis. This is when muscle breaks down into particles of myoglobin that kidneys cannot handle, as they apparently clog the kidneys, leading to kidney failure. A much preferable alternative for many is to wean off of statins and start taking adequate doses of vitamins C (3,000-10,000 mg/day in divided doses), D (2,000-5,000 IU/d), E (400-1200 IU/d), and magnesium (300-500 mg/d, chloride or citrate form, in divided doses), along with a daily multivitamin supplement.
The harmful ramifications of such rapid changes in medical care can be somewhat limited with good feedback derived from both doctor and patient. Also, the pharmacist can play an important role in both patient education and as a check on a busy doctor's prescribing, since being too busy can lead to error.
Drugs and still more drugs
My understanding of medicine rapidly expanded as I took on the duties of being the County jail doctor for 13 years, starting in the mid-80s. Whenever I could, I tried to continue the medical regimen their private physicians had prescribed (even through telephone conversation with the local doctor), but many times I found incompatibilities between what I was learning from current studies and what the doctors were prescribing and I could not abide by their treatment. I soon realized that doctors rarely had time to analyze new drug studies and merely went with a biased study summary. For example, Motrin 800 was being prescribed all too freely. The "800" refers to the equivalent of four over-the-counter (OTC) ibuprofen (Advil) tablets in a single dose. I had seen the story of an NFL player who had kidney failure due to an overdose of ibuprofen, and at the same time had found 200mg to be an adequate dose as long as the patient didn't realize that this was only a quarter of the former amount.
It amazed me, and still amazes me, that so little thought is given to the potential for serious side effects of these relatively new drugs that lacked a long track record. The attitude seems to be "If you can't trust your doctor or government agencies like the FDA, designed to protect our health, who can you trust?" I've found that, in many cases, pain that has dictated use of pain killer drugs could be ameliorated simply with vitamins and minerals (vitamins C, D, E, magnesium, multivitamin) that help the body rapidly repair itself. The reason this works is that when stressed and needing repair, the body needs higher levels of the essential nutrients.
Beware of new drug studies with a low number of participants; drug studies that make claims of superiority over similar medicines; and drug studies that were conducted over a period of time too short to be able to assess long-term side effects.
Together, you and your doctor should seek solutions with excellent nutrition (including vitamins and essential nutrients) rather than drug therapy. And even though some illnesses are attributed to a genetic defect, no "drug deficiency" gene has been found as a cause of disease. Even some ramifications of genetic defects can be sidestepped with an excellent diet. This has been verified clinically. (1-4)
Keep on studying and learning while enjoying better health. This goes double for doctors. If a doctor isn't learning from his patients, he isn't doctoring.
[Note: I equally respect men and women physicians; but as I'm describing my own experience, it seems cumbersome to write in "he/she" or "him/her" every time I refer to a doctor; so I have decided, with no prejudice in mind, to use the old literary style of "he" much the same as the universally understood word, "mankind."]
(Contributing editor and retired pediatrician Dr. Ralph Campbell celebrates his 92nd birthday July 29, 2019. Birthday greetings sent in advance to the editor care of the email address below will be delivered to him at the right time.)
1. Turkel H. Medical amelioration of Down's syndrome incorporating the orthomolecular approach. Orthomolecular Psychiatry, 1975. 4:2, 102-115. http://orthomolecular.org/library/jom/1975/pdf/1975-v04n02-p102.pdf
2. Turkel H, Nusbaum I. Medical treatment of Down syndrome and genetic diseases. Ubiotica; 4th ed, 1985.
3. Saul AW. The pioneering work of Ruth Flinn Harrell: Champion of children. J Orthomolecular Med, 2004. 19:1, 21-26. http://www.doctoryourself.com/downs.html
4. Saul AW. Down syndrome: The nutritional treatment of Henry Turkel, M.D. http://www.doctoryourself.com/turkel.html
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