Medical Minefield – Avoiding Common Errors

 

Finding Your Way Through Today’s Complex Medical Minefield

 

If you take a step and hear a “click” under your foot, stop and think what is about to happen next, before you take an irreversible action.

 

It may take great wisdom and personal discipline to find your way through today’s complex minefield of bad advice from board-certified medical professionals, quacks, charlatans, profit-motivated liars and sales people. (See Pervasive Pill Pushing Quacks). When you see an advertisement for a product or service, realize that the people who paid for the ad probably have an economic incentive to get you to do something that you would otherwise not be interested in doing if you had not seen the ad (unless it is altruistic public information).

 

Sometimes, the very best certified medical professionals unintentionally or unknowingly make deadly mistakes (See Iatrogenic Deaths Caused By M.D.s). After heart disease and cancer, iatrogenic mistakes made by licensed medical professionals may be the number three cause of death in America. Thousands of unnecessary deaths are caused each year by elective surgery, prescribed by those who profit greatly from it.

 

The April 2, 2003 issue of the Journal of the American Medical Association reported a 7-year study of 909 patients who were admitted to hospitals for drug toxicity. The study clearly documented the fact that most of these admissions occur shortly after the improper prescription and administration of a drug that is well known to cause drug-to-drug interactions. Most of these damaging toxic drug interactions could be avoided by competent physicians, IF they would pay more attention to readily-available information.

 

Frequently, young-and-old doctors do not have good answers to complex age-related questions and life-shortening common diseases (especially those with long feedback cycles). Medical doctors are in “practice” (because much of medicine is an “art,” not a “science”. Very few M.D.’s are effective investigative scientists.

 

All of us (including doctors) try to learn from our mistakes. Doctors take the “Hippocratic Oath” to do no harm, but iatrogenic mistakes and oversights clearly do great harm to millions of unique individuals. There are valid actuarial reasons that malpractice insurance is very expensive today. The number of people injured by medical doctors increases every year. Obviously, malpractice must be rampant, but what alternative options do we have to the best medical knowledge available anywhere, and millions of people honestly trying to make us as well as possible? Putting a cap on valid malpractice claims is being considered, but it would be far better if we could find a way to limit that actual death and injury being caused by board-certified medical professionals.

 

Nothing on this entire website is intended to diagnose or treat any individual’s specific medical problems. If you have any medical problems, write down your detailed symptoms, questions, concerns and related medical history, and see a licensed physician who understands your problems and has time to get to know your unique characteristics. When multiple doctors are involved in your healthcare, make sure that they know about the findings and treatments recommended by others. It will be rare that general practitioners, various medical specialists and board-certified healthcare professionals will agree about precise diagnosis and “best” treatment for many diseases. Ultimately, YOU must sort out the conflicting professional opinions and decide on who’s advice you will follow. Sometimes, the choices determine the difference between life and death.

 

Humans are at least as different and unique as our fingerprints. A treatment that is effective for one may kill another. What worked for you when you were younger (like consuming sugar, iron supplements, etc.) may be a deadly thing to do when you get older.

 

You must communicate what you know about yourself, your medical history, and current status with those who provide your medical care. Be sure that your doctor knows about any allergies you have and history of disease in your family (and those you have been intimate with). Doctors must know any medications you are taking, including over-the-counter drugs, vitamins, special diet, dietary supplements, physical activities, aches, pains, questions and concerns. Writing it all down and keeping a file of blood test, etc. is much better than merely talking about it with a busy physician (you will forget many details, and so will they).

 

Ultimately, YOU must also sort out the conflicting advice of multiple specialists with widely varying training and experience in treating others (who are not exactly the same as you). Remember that the “majority opinion” among medical doctors has often been proven to be incorrect by those who dare to disagree with obsolete ineffective “business as usual” medical (mal)practices. When the first recommendation of medical doctors is not working, dig much deeper and learn what you can about the issues for yourself.

 

General information offered freely on this site is an attempt to help you ask better questions of the specific healthcare professionals who help care for you. Our research materials and the comments that we discuss about particular lifestyle choices, foods, drugs, supplements, exercises (mental and physical) consist of broad overviews that cannot possibly include every detail and exception known to mankind.

 

None of this material applies equally to everyone. Much of it (like low fat versus low carbohydrates) is extremely controversial with strong and valid professional opinions on both sides (that can NOT possibly both be true for everyone). Much of such information will change next year and beyond, as new research is published.

 

If licensed physicians offer you no hope of any treatment for your specific problems, you should very carefully consider introspection, meditation, fervent prayer and alternative approaches, but proceed with great caution and skepticism, since much of alternative medicine involves unregulated areas with many extremely-complex (chaotic) interacting unknowns that are unique for different individuals.

 

Sometimes, regulation inhibits innovation and exploration. Everything that is common, regulated, “good practice” today, was at one time unknown, unregulated, and viewed by many as the wrong thing to do.

 

New Drugs, Foods and Food Supplements

 

Advice from a research scientist: Introduce new things that you ingest (eat, breathe or apply to your skin) slowly – one at a time. If you have an adverse allergic or toxic reaction, it may be easier to identify the reason and take rapid action. Cause-and-effect is often very difficult to understand (especially for lifestyle changes that have long feedback cycles). Things interact in unique individuals in complex ways (sometimes in multi-step, cascading, interrelated biological processes). What helps one, may eventually injure or kill another through difficult-to-understand mechanisms. If you introduce new things slowly, in isolation, it should be easier to understand the cause-and-effect (of things with shorter feedback cycles).

 

For example, suppose you are having joint pain or nerve pinches in your lower back. There are several over-the-counter food supplements that may be effective for you. I have found that glucosamine sulfate is effective for me, but it may not work well for you, since it is made from shellfish. Suppose you try glucosamine and within a week you develop a minor skin problem. You may be allergic to shellfish. If you had failed to read about glucosamine, and you did not know that some people are allergic to it, you might not have noticed the connection between it and your skin problem. When an allergic reaction develops, you should discontinue the use of new product(s), and investigate alternatives. In the case of glucosamine, you may find that hyaluronic acid is more effective, with less chance of allergic reaction. Do your research. Investigate alternatives. Evaluate them carefully – you life, heath and happiness are at stake!

 

It may be possible that a new product conflicts with another (less beneficial) product or food that you are taking. It may be a good idea to discontinue the use of a less-effective product that you have used for a long time, in order to receive the benefit of the new product. This issue can be very complex.

 

One of the more serious drug / food interactions is between common (otherwise beneficial) grapefruit. This powerful antioxidant is known to interact negatively with over 200 prescription and over-the-counter medications, including caffeine and:

 

Condition - Medications That Interact Badly With Grapefruit

Anxiety - Xanax, Buspar, Versed, Halcion

Depression - Luvox, Zoloft

Allergies - Allegra

Antihistamines - Terfenadine and many other prescription and over-the-counter medications

Antiviral - Saquinavir

Abnormal Heart Rhythm - Cordarone, quinidine

Heart Disease, Stroke and Blood Clots - Coumadin and other blood thinners

Immunosuppressent - Cyclosporine

Epilepsy - Tegretol

Cancer - Cyclophosphamide, etoposide, ifosfamide, tamoxifen, vinblastine, vincristine

Cough - Dextromethorphan (found in many over-the-counter cold medicines)

HIV - Agenerase, Crixivan, Viracept, Norvir, Fortovase

Prostate Enlargement - Proscar

Heart Disease, High Blood Pressure and calcium channel blockers - Adalat, Calan, Cardene, Cardizem, Coreg, Covera, Felodipine, Nifedipine, Nimotop, Plendil, Procardia, Sular, Verapamil, Verelan

Erectile Dysfunction - Viagra, Cialis

Asthma and Emphysema - Theophylline

High Cholesterol (Statins) - Lipitor, Lescol, Mevacor, Zocor

Pain - Codeine, Alfenta, Duragesic, Actiq, Sufenta

Infection - Biaxin, Sporanox, erythromycin, troleandomycin

Hormones - Estradiol

Stimulants – Caffeine, ephedrine, ephedra and other similar natural and laboratory-made stimulants

 

If you ever eat grapefruit, please take the time to read about it in our material on antioxidants.

 

Drug and food interactions can involve very complex genetics and biochemistry. If you take several new products during the time frame when an allergic reaction develops, or you have made changes to your diet, environmental exposures, etc., you may not have a clue about what may have caused your reaction (since skin reactions, drug overdoses, etc. may be caused by a great many different environmental, ingestion, genetic and disease sources). Lack of cause-and-effect knowledge may make you to do something that makes your problem much worse, like applying a skin cream to an allergic rash, which further increases the problem complexity.

 

Ask, read and study when to take new things (before/after/during meals, empty stomach, morning, bedtime, etc.). For example. Calcium should be ingested in an acid environment (NOT in an antacid). The body normally needs vitamin D and magnesium to regulate calcium metabolism. Calcium plus magnesium are a mild muscle relaxant, which should therefore be taken just before going to sleep. Potassium and sodium are also linked to calcium and magnesium metabolism, since they use the same intake channel. They all influence water retention and systolic blood pressure. Simply popping calcium supplements because “they are good for you” is an overly simplistic view of important nutrition decisions.

 

Keep medical records for your various healthcare providers. Modern pharmacists now have computer systems that can catch potential drug interaction problems that overworked prescribing physicians frequently overlook. However, if you use more than one pharmacy, they may not realize what you have purchased from others. The pharmacy computing systems usually do not know what food you are eating (like grapefruit), food supplements or over-the-counter drugs you are taking, what allergies you have (and may not be aware of yet), etc. Ultimately YOU know more about yourself than others who prescribe and deliver medications to you. YOU are the one who will suffer if they make a mistake, or you fail to tell them about yourself and you lifestyle, nutrition, drugs, allergies, etc.

 

Do your homework. Read readily available up-to-date information from multiple reliable sources on the Internet, etc. Changes in life such as pregnancy, menopause, out-of-range blood tests, disease diagnosis, or other physical changes should be carefully researched by the patient or loving caregivers, and then discussed with licensed physicians and healthcare providers.

 

Do NOT rely on doctors alone, since they often miss details or make a variety of human errors. Doctors seldom inform you of all of the risks, contraindications, drug / food interactions, and potential adverse reactions of the treatment (pills, therapy, surgery, etc.) that they prescribe.

 

You should read what is available about any new drug, food, or food supplement that you add to your diet. Pay close attention to all information given to you by your pharmacist. As you read information from the Internet, remember that pill-pushing quacks are a biased information source, ESPECIALLY late night cable television infomercials.

 

Independent sources (who are not paid by product vendors), clinical trials, etc. (although often biased by funding) can offer different points of view. You need to understand all concerns about the things you ingest, when they should be taken (time of day, with-or-without certain foods, synergies-or-adverse-interactions with other drugs, foods, activities, etc.).

 

Here are a few basic resources to jumpstart your important study effort:

 

Layman’s Descriptions of Prescription Drugs, Over-The-Counter Drugs, Herbal Medicine and Nutritional Food Supplements

Important Drug, Herb and Food Supplement Information, Concerns, Interactions, etc.

Physician’s Desk Reference (PDR) - Home Page

Physician’s Desk Reference (PDR) for Nutritional Supplements

 

Take minimum amounts of food supplements, especially to start off. (This is generally a good practice, but NOT always, as in the case of antibiotics that REQUIRE a minimum level dosage and duration to be effective. Taking too little of such medications or stopping before the prescribed time can be dangerous.)

 

Profit-motivated companies want you to buy and consume more of their product than the minimum that may be sufficient for you. Some products may be beneficial if taken only once or twice a week. Excess quantities of many products can become toxic (especially oil-soluble products, like vitamin A, and minerals, like iron, that may accumulate to harmful levels over time).

 

Sometimes, tissue levels of food supplements can become overloaded and adverse toxic reactions can take place. Beta-carotene is one such example. In natural food levels, it prolongs life. In some food supplements, the large amount of beta-carotene has irrefutably shortened the life of studied individuals.

 

When natural foods fit into our busy lifestyles, natural foods are often better sources of essential nutrients. For example, the complex antioxidants in fresh blueberries in season are thought to be more beneficial than blueberry (or bilberry) extract, (except for the fact that beneficial food extracts like bilberry and grape seed usually have less sugar than natural fruit). Some natural foods like beta carotene should NOT be taken in concentrated form, whereas there is no evidence that foods like bilberry and grape seed extract cause problems for people who are not allergic to the natural fruit. It import that you read about, and understand, any food supplements that you chose to consume.

 

Some helpful products (like the natural melatonin sleep aid) are typically marketed in very high doses (like 3mg). One tenth of that amount (300mcg) is often quite effective and life-improving, whereas too much of some food supplements may negatively impact the liver, etc. and have a cascading, age-accelerating impact.

 

Super sizing your bad nutrition fast food (soda, pizza, cheese burgers, french fries, etc.) is very unhealthy, and no bargain at all. So too, mega doses of drugs, vitamins and food supplements. For example, too much vitamin A or iron can be deadly, in some cases.

 

Never take any food supplement until you have studied when to take it, the minimum effective amount, the maximum amount that can be tolerated, and potential negative side effects to watch for. Pay close attention to allergic reactions like skin rashes, etc.

 

Self-medicating with over-the-counter natural hormone products (DHEA, HGH, steroids, etc.) is extremely dangerous without proper informed blood level monitoring. Prescription steroidal hormones (like cortisone), and natural products that enhance steroid production or uptake, can cause the body to sense the excess and shut down normal production (making health problems much worse). This can trigger uncontrolled life-shortening inflammation, painful joints, etc. throughout the entire body, which makes the naive consumer very addicted to the harmful product.

 

Taking some things (like multi-vitamins supplements containing iron or products like bread with iron supplements, etc.) can unknowingly damage many internal organs (if your iron levels are already too high, as in some men over 40, some post-menopausal women, and people with inherited genetic traits that trigger “hemochromatosis”).

 

Regular blood tests and good biofeedback monitoring are essential to determine individual different requirements. Buying a product that advertises a broad general solution to “tired blood” may actually do great damage in some sensitive individuals. Do NOT take a product, just because someone advertises it, or a friend tried an advertised product and coincidentally got better. The actual cause and effect is often difficult to understand.

 

Study the issues. Confirm what you find from multiple reliable unbiased sources (where possible). Try to find sources with little financial bias to sell you a particular product or service, which may be difficult to do. Do NOT believe anyone who offers “snake oil” that solves all problems for everyone.

 

Popular talk show host Larry King wrongly endorsed Saint John’s Wort for depression for a long time. The natural over-the-counter, uncontrolled product has a seldom-mentioned side effect of an irritating skin rash in many individuals. Eventually, studies were published showing that Saint John’s Wort had essentially no reduction of depression in research subjects (other than a psychosomatic “placebo effect”, which Larry King apparently suffered from).

 

Another similar study documented that a diet including salmon every day often performed better than prescription antidepressant medications (a big surprise that continues to be ignored by pill-pushing medical doctors).

 

Antidepressant prescription drugs plus alcohol have been implicated in many tragic unnecessary deaths (including the tragedy of Phil Hartman and his wife).

 

Many qualified professionals believe that psychotropic antidepressants are badly abused and over prescribed by misguided medical doctors and psychiatrists. Their usage and high expense have expanded rapidly in recent years. Many informed individuals and high profile people like Tom Cruise call for banning addictive psychotropic drugs altogether, especially for innocent children.

 

Do NOT take our word for it (or any other single source). Research important issues on your own and confirm what you discover. You might never understand these things if you listen only to pill-pushing pharmaceutical company advertisements, profit-motivated quacks, medical doctors and psychiatrists. Independent study of the literature and “digging for diamonds” can be extremely valuable to you, and the health and happiness of those you care for. Lifelong Learning can bring you a happier, longer life.

 

Read food labels and ingredients. Carefully study and learn to recognize the things that should always be avoided or minimized within known limits (like trans fatty acids, saturated fats, excitotoxins, sugar, simple carbohydrates, sugar substitutes, high-fructose corn syrup, etc.). Learn to recognize the good things that you should add to your grocery basket. Learn what was seriously wrong with the 1992 USDA Food Pyramid and what you need to do to customize the latest 2005 nutrition guidelines to your individual age-dependent nutrition needs.

 

Do not mix similar drugs (like nonsteroidal anti-inflammatory drugs (NSAID) including aspirin (in a great many products), ibuprofen (Advil, Motrin, Nuprin, others), acetaminophen (paracetamol, Tylenol and many other over-the-counter and prescription drugs),  naproxen (Aleve, Naprosyn, Naprelan, Anaprox, others), ketoprofen (Orudis KT, Orudis), indomethacin (Indocin), etodolac (Lodine), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), tolmetin (Tolectin), and others; warfarin (Coumadin); ardeparin (Normiflo); dalteparin (Fragmin); danaparoid (Orgaran); enoxaparin (Lovenox); heparin).

 

A great many people try one product for a headache and then try another, while the other is still in their system. This common bad practice seriously injures thousands of Americans every year – most have no idea why they are suffering (from their own avoidable self-medication mistakes).

 

Do not overdose on pervasive products (like acetaminophen, which appears in many different prescription drugs and over-the-counter home remedies for colds, aches and pains). Overdoses and interactions do very serious internal damage. READ THE LABELS CAREFULLY. Ask a qualified pharmacist or healthcare professional if there are conflicts or interactions with other prescriptions and OTC’s you are taking. Your life is in your own hands. You may unknowingly be playing with deadly fire when you purchase an indiscriminately advertised popular product (like pain killers, cold remedies, vitamins with iron supplements, etc).

 

Be careful about mixing drugs and food supplements in general. Unless drugs are specifically known to be synergistic (they work well together like calcium + magnesium + vitamin D, or glucosamine + MSM). You should NOT take several at the same time in one handful (or in a little cup in the hospital from a nurse’s aid that you are seeing for the first time). It is often (but not always) better to take two lower dose food supplements, spread out over the day, than one large mega dose pill (which causes a high and low bioavailability swing in the blood stream throughout the day).

 

Prescription drugs are for the most part only clinically tested in isolation. When you take a new drug, you may be among the first few people to unknowingly test how it interacts with other drugs, foods and genetics in your unique body. Drug vendors are obviously reluctant to report a small number of serious problems, until AFTER overwhelming cause-and-effect information is well documented (which is difficult to do for long-term feedback cycles).

 

Thousands of men have already died within a few hours of taking the world’s most popular new prescription drug, but the rich vendor of the profitable product has no incentive or legal requirement to advertise this fact on television (even if an ex-senator / presidential candidate did endorse it).

 

There have been many cases of two different drugs chemically crystallizing in the liver and killing patients. Two different popular diet drugs interacted and caused permanent heart damage, etc. Just because something makes some people (temporarily) lose weight, does NOT mean that it is a good thing to do.

 

Stomach viruses clearly make people lose weight. Should we therefore prescribe stomach viruses for millions of obese Americans? (Absolutely NOT!) Diuretics and laxatives can cause temporary (unhealthy) weight loss and lowering of systolic blood pressure. Diuretics are currently sold over-the counter in “weight loss” categories to unknowing customers who are sadly accelerating dehydration, and thus the aging of every cell in their body. Should we dehydrate overweight people to make them weight less? NO! Should doctors commonly prescribe powerful diuretics to lower systolic blood pressure? Is the treatment worse than the disease?

 

You should probably separate new drugs and take them at least an hour apart, unless you are specifically told to take them together by a qualified medical professional (that you literally trust with your life). Be sure you tell your prescribing physician about ALL over-the-counter things and food supplements that you are taking. In some cases (like grapefruit) you need to tell them about foods that you like. Write down everything you need the doctor to know, and hand the list to your doctor, to make sure that it is in your medical history file.

 

Medical Doctors (M.D.’s) are NOT trained on most over-the-counter products. They may ask you to stop taking all vitamins, etc. *since they do not understand them), until the possible interactions can be sorted out. This may be a complex good-and-bad process with complicated analysis and results, which very few doctors are willing (or take the time) to do.

 

Hospital Risks

 

If you must go to a hospital, be very careful that you recognize and understand every medication you are given and medical procedure that is performed. Talk to the busy staff members on every shift. Make sure they understand your particular situation and concerns. Important information is often lost from shift to shift. Nurses make deadly mistakes ever single day. Be pleasant and always treat them with respect. Statistically, hospital and nursing home patients who constantly complain receive poorer treatment, but remember that iatrogenic errors made by certified medical professionals kill about a quarter million Americans every year, and needlessly injury millions. The pervasive iatrogenic problem IS serious and well documented in multiple medical journals. Do NOT assume that the treatment you are given is what was prescribed, or that it was prescribed correctly.

 

Pay very close attention to hospital (and nursing home) hygiene. Hospitals are well known to be a dangerous place for a sick or unconscious person to be. Where possible, take responsibility for confirming details that should be done for you and the medicines you are given. Remember that the porous skin of a hospital attendant can transfer disease from one patient to another. Direct skin contact is the most common way that many contagious viruses are unknowingly transferred from one person to another. A nurse with a cold is an obvious hazard, but a virus can be transferred long before its symptoms are manifest. The likelihood of this happening in a hospital is elevated.

 

Think twice about the risk of unnecessary cosmetic surgeries. Take aggressive control of your nutrition and exercise, rather than having weight-reduction surgery.  Monitor your weight regularly on an accurate scale. Keep managing what you eat and refining your diet until you learn what works for your unique metabolism.

 

We truly love, appreciate and applaud every medical professional who has dedicated their life to sincerely helping others, but every last one of us does make (small or large) mistakes almost every day of our lives. Where possible, we should strive to avoid unnecessary risks and dependency on other people to never make any mistakes that might adversely impact us. There has never been, and never will be, a flawless medical profession who never makes mistakes. Disease prevention is far superior to hospital treatment for an avoidable disease.

 

When we are forced to turn complete control of our life over to flawed medical professionals, we can merely pray that they do not make the common mistakes that we know do happen almost everyday in almost every hospital.

 

We highly recommend that you do your own literature search and use multiple sources to confirm anything you read or are told, before you decide what to do. Try to filter out the strong bias of those who will clearly profit if you believe what they say, whether it is buying a product or having elective surgery.

 

Be aware that a lot of bad advice comes from biased, profit-motivated insurance, pharmaceutical and nutriceutical companies. Pharmaceutical companies in particular heavily advertise and promote new, patented, unnatural medications, when there may (or may not) be a set of natural foods or lifestyle behavior changes that may be adequate, safer and cost much less.

 

Not all medical doctor recommendations are good. Not all alternative medicine recommendations are good either. There simply is no single source available for critical lifestyle choices, anywhere. For difficult problems, seek multiple source opinions before making irreversible decisions, but be aware that for every important new piece of critical knowledge, at one point in time, there was only one person on earth who discovered it and understood it.

 

Sometimes a minority opinion is superior to widespread conventional medical practices. Many FDA-approved drugs have had to be withdrawn from the market AFTER killing or injuring many naive patients who trusted what their friendly family doctor prescribed. The hints and clues about the underlying risks were often available as small statistics in the early clinical trials and product contraindications that were ignored or misunderstood. Nutriceuticals like beta carotene and St. John’s Wort have been found by clinical trials to be ineffective, counterproductive and even deadly, but they are still widely marketed to consumers who have failed to do their own literature study and make wise decisions.

 

No human knows everything about anything. You are unique. General rules and desired lifestyle change responses may or may not apply to you at a particular point in time. Sometimes, doctors are forced to make decisions based on partial information, before expensive, time-consuming, lab tests are complete.

 

YOU are ultimately responsible for all important lifestyle decisions that impact your joy, productivity and longevity. Gather the best information you can from multiple sources on multiple topics, and then CHOSE WHAT YOU DO WISELY as an informed consumer.

 

When you realize that a previous decision was wrong, make the necessary effort to change your habitual behavior, based on the best-available information, all things considered. Do not be surprised to learn that what was thought to be good medical practice today is found to be harmful tomorrow. Be open minded and able to change your previous decisions (which were based on incomplete or inaccurate information).

 

EMBRACE LIFELONG LEARNING

 

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