Sunday, September 3, 2023

Spam: A nurse poses questions to social media

There is a post making the rounds that starts like this: 

"I’m a nurse. I’ve been one for 13 years. It wasn’t until about 5 years ago... I started asking these very questions."

It then goes on to pose a bunch of questions in all caps Unicode characters that criticize doctors for a variety of things the nurse apparently does not understand very well. Note that the highly unusual Unicode characters are almost certainly intended to avoid detection by automated systems looking for spam and are not at all likely to be actually created by some disgruntled nurse. They could be intended as a way to stealthily make malicious materials or as a way to scan for suckers willing to pass on such things. 

The post is not what it seems, but taking it at face value, I have several critiques of the claims made in this viral post:

It oversimplifies complex medical issues and promotes a "one size fits all" approach that can be dangerous. What works for one person may not work or could even harm another. Doctors have to consider many factors and the individual patient's needs.

It relies heavily on anecdotes and sweeping generalizations without providing scientific evidence to back up the claims.

Some of the claims are misleading or exaggerated. For example, emotions alone don't directly cause illness in most cases. The relationship between emotions and physical health is complex.

Some of the advice could be harmful if taken without medical supervision. For example, grapefruit does interact with many medications and can cause problems if mixed. Activated charcoal can decrease absorption of medications. Herbs can also interact with medications.

While lifestyle factors are very important for health, the post downplays the role of genetics, disease, and other factors outside individual control. Diet and lifestyle alone cannot cure everything.

Doctors do provide much of the diet and lifestyle advice mentioned. However, they have limited time with patients and have to focus on immediate medical issues. Separate appointments with dietitians may be warranted.

The post frames doctors as intentionally withholding or ignoring natural cures, which is not accurate. Doctors work within the constraints of available evidence and their medical training.

While the post raises some valid points about lifestyle factors, it makes many questionable claims and oversimplifies complex medical issues. Sweeping statements about mainstream medicine and doctors as a whole are not substantiated. Patients should be wary of medical advice on social media that is not backed by credible research and promoted by qualified experts. 

Point by point for as long as I can stand it:

SOMEONE TELL ME WHY..

Two huge broad issues pervade the answers here:

First: People are different and when they present they are a unique individual with a problem unique enough for them personally that they are seeing a doctor. If blanket advice applied to patients we would have a page of text with these ‘solutions’ and we wouldn't even need a doctor. The same advice for all these things cannot apply to all people at all times. 

Second: Depending on where they practice, Doctors take an oath to do no harm. The Declaration of Geneva contains the text: "THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration; I WILL RESPECT the autonomy and dignity of my patient; I WILL MAINTAIN the utmost respect for human life;" Some of the advice given by the person claiming to be a nurse is in conflict with that. 

WHY DON’T DOCTORS TELL YOU TO TAKE MAGNESIUM INSTEAD OF STOOL SOFTENERS? (WHICH DEHYDRATES THE BOWEL)

That blanket advice given to a patient sight unseen could be useless or even unhealthy. "Occasional irregularity is a fact of life, but you can minimize it with some basic steps. You should be sure you are eating a fiber-rich diet, drinking adequate fluids, and staying physically active. But when you have constipation, the best laxative is the gentlest and safest option, like a bulk-forming laxative. If laxatives don't work, ask for help. You should see your doctor and discuss it if you are constantly needing to take laxatives." Health.Harvard.edu (2023)

WHY DON’T DOCTORS TELL YOU TO CHANGE YOUR DIET WHEN YOU HAVE HEART BURN AND INDIGESTION INSTEAD OF GIVING YOU PRILOSEC? (THIS CAUSES MORE HEARTBURN, COLON CANCER & OSTEOPOROSIS AND LEAVES FOOD FERMENTING IN YOUR BODY)

That blanket advice could literally kill people. I know because I'm one of them. For some, proton pump inhibitors like Prilosec can ultimately make the difference between life and death. Meantime, on the road to consequences like Barrett's esophagus the patient would be in severe distress. Diet does not cure GERD. "Barrett's esophagus is a complication of reflux disease, in which acid leaking back from the stomach begins to erode the esophagus. The treatment for Barrett's esophagus is similar to the treatment for GERD." "PPIs are the most effective medication for healing erosive esophagitis and providing long-term control of GERD symptoms." John's Hopkins Medicine (undated) 

WHY DON’T DOCTORS TELL YOU THAT HERBS AND CERTAIN FOODS CAN ALSO HEAL?

For the most part, supplements have anecdotal claims, but little or no actual clinical evidence of their efficacy. More importantly, such trials also address safety. Not all supplements are effective or even safe for all people. Giving that vague advice would be irresponsible. "Although they are often labeled as “all-natural,” and safe, a researcher at Baylor College of Medicine says dietary supplements can cause potential health risks and serious side effects. In an article published in EMBO Reports, Dr. Donald Marcus, professor emeritus of medicine and immunology at Baylor, and Dr Arthur Grollman of Stony Brook University, wrote about the dangers of encouraging the use of all-natural dietary supplements made from herbal plants. The paper describes how this has become an international health hazard as The World Health Organization and China promote the safety and effectiveness of herbal medicines, despite evidence that they can cause adverse side effects, fatalities and have not been tested in clinical trials." Dusang (2021)

WHY DON’T DOCTORS TELL YOU TO LOWER TOXIC CHEMICALS IN YOUR HOME AND WHEN YOU HAVE CONSTANT HEADACHES AND ALLERGIES? (THESE FRAGRANCE & CHEMICALS CAUSE TOXIC BUILDUP IN OUR CELLS AND CAUSES MORE ALLERGIES AND HEADACHES)

Headaches can result from a variety of causes. In my family, migraine is an issue with a few of us. It's genetic. Importantly, "headaches can signal a more serious disorder that requires prompt medical care" National Institute of Health (undated). Just fobbing off a non-specific complaint like this could result in people having strokes and dying. 

WHY AREN’T YOU INFORMED BY YOUR DOCTOR THAT IF YOU EAT A GRAPEFRUIT EVERYDAY, IT WILL LOWER YOUR CHOLESTEROL NATURALLY AND YOU DON’T NEED [a pill] ? (THIS IS WHY A PERSON CAN’T EAT IT WHILE ON STATIN MEDS)

That's just bad advice. It can interfere with needed medication and can be dangerous by amplifying the effects of other medication. "Grapefruit's culprit chemical ... binds to an enzyme in your intestinal tract known as CYP3A4, which reduces the absorption of certain medications. When grapefruit juice blocks the enzyme, it's easier for the medication to pass from your gut to your bloodstream. Blood levels will rise faster and higher than normal, and in some cases the abnormally high levels can be dangerous." Health.Harvard.edu(2021)

WHY DOESN’T YOUR DOCTOR TELL YOU TO TAKE ACTIVATED CHARCOAL FOR HEADACHES, BLOATING/GAS, SKIN ISSUES, COLDS, FOOD POISONING? (ACTIVATED CHARCOAL BONDS WASTE/TOXINS FOR THE REMOVAL FROM THE BODY)

That is bad medical advice. Hopefully you see someone besides the nurse promoting this. "Pulmonary aspiration and a resulting aspiration pneumonitis are the most concerning risks of administration of activated charcoal. Aspiration from emesis and misplaced nasogastric tubes for activated charcoal administration can lead to severe respiratory compromise and even death."

WHY DON’T DOCTORS TELL YOU ABOUT HERBS AND HERBAL TEAS TO SUPPORT IMMUNE AND DIGESTIVE FUNCTIONS? (DIFFERENT HERBS HELP DIFFERENT ORGANS DO THEIR JOBS TO KEEP THE BODY HEALTHY)

See info from Dusang (2021) above about herbs and foods. 

WHY ISN’T YOUR DOCTOR SUGGESTING THAT YOU TAKE A PROBIOTIC DAILY? (THIS BOOST IMMUNE FUNCTION, HELPS CLEAN AND BALANCE THE BOWEL, HELPS REGULATE ABSORPTION AND ELIMINATION, KEEPS COLDS AND ALLERGIES AT BAY)

Again, this blanket advice is poor medical advice and can lead to serious health complications. "The risk of harmful effects from probiotics is greater in people with severe illnesses or compromised immune systems. When probiotics are being considered for high-risk individuals, such as premature infants or seriously ill hospital patients, the potential risks of probiotics should be carefully weighed against their benefits. Possible harmful effects of probiotics include infections, production of harmful substances by the probiotic microorganisms, and transfer of antibiotic resistance genes from probiotic microorganisms to other microorganisms in the digestive tract. Some probiotic products have been reported to contain microorganisms other than those listed on the label. In some instances, these contaminants may pose serious health risks." National Institutes of Health (undated)

WHY DON’T DOCTORS CREATE DIET/LIFESTYLE PLANS FOR PATIENTS INSTEAD OF OFFERING PILLS? (DIET & LIFESTYLE CHOICES ARE 90+% CAUSE OF ALL ILLNESS)

Doctors are the primary gatekeepers for real medications that have undergone clinical trials to demonstrate both effectiveness and safety. They are not dieticians or lifestyle coaches. 

WHY DON’T DOCTORS TELL YOU TO TAKE SUPPLEMENTS TO BOOST YOUR HEALTH PRIOR TO BECOMING SICK AND THEN THEY RECOMMEND PILLS (SUPPLEMENTST/HERBS/TINCTURES CAN PREVENT ILLNESS BY BOOSTING IMMUNE FUNCTION AND SUPPORTING ORGANS WITH THEIR NATURAL FUNCTIONS)

Again, see the notes about clinical trials and safety above.

I just can't dignify the rest, I am sorry. This is typical of the kind of inflammatory post that gets attention (mea culpa). It would be funny if it weren’t so sad. 

Finally:

WE JUST AREN’T GETTING THE RIGHT INFORMATION!!

Amen to that. I’m a big fan of irony. People listening to this alleged nurse should spend more time getting their information from credible sources. 


References

Dusang, Kaylee (2021) Baylor College of Medicine Are herbal supplements safe?

Health.Harvard.edu (2021) Grapefruit and medication: A cautionary note

Health.Harvard.edu (2023) Laxatives: What to know about choosing the right one [Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing]

John's Hopkins Medicine (undated) Barrett's Esophagus Treatment

National Institute of Health (undated) National Institute of Neurological Disorders and Stroke Headache

National Institutes of Health (undated) Probiotics: What You Need To Know

Silberman, Jason; Galuska, Michael A.; Taylor, Alan (2023) National Library of Medicine Activated Charcoal


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