Photo tks to Irish Typepad

“Are Health Apps the Cure for Anything that Ails You?” is the title of a post by Rochelle Sharpe in today’s The Health Care Blog . “With about 9,000 consumer health apps currently available in the iTunes store, it seems like almost all smart phone users can download their way to better health these days.”

Embedded in this statement is the assumption that data can lead to better health at the touch of an Icon.   Unfortunately,  data does not equal information,  much less understanding.

When I was a Navy attack pilot, one of our capabilities was to conduct attacks on  high-value targets which were protected by integrated air defense systems.  Our intelligence officers provided lots of data – types of anti-aircraft weapons, types and numbers of surface to air missile systems , types of early warning radar or signal collection systems.  All this data was interesting, but often just led to confusion.   What was desired and needed for a successful strike were things like:

-          Reaction time from first radar hit to getting a missile lock on our aircraft

-          The realistic operational (as opposed to design) range and minimum altitude for a surface to air missile battery.

-          I could go on, but you get the point.

In other words, I needed to know how these threats would operate and respond to our air strike.  Answer to these questions required understanding, which rarely came from piles of data.

The fact that there are 9000 or so consumer health apps, would indicate that lots of folks are looking for answers to health and health care questions.   For me the most effective path to understanding health is prayer, not technology.  It’s moments, minutes and sometimes hours of quiet contemplation of spiritual truths.  In my experience this is the best way to hit the target.

Explosive! That’s how correspondent Lesley Stahl described it.¹ And a study on the implications it raises for all drug-based therapy would be impossible – or would it?

In her recent 60 Minutes report on Placebos, Stahl interviewed Irving Kirsch, Associate Director of the Placebo Studies Program at Harvard Medical School. The explosive news: that placebos (inactive pills, such as sugar pills) have virtually the same effect as antidepressant drugs for those who are mildly or moderately depressed. This certainly would seem to shatter the conventional view about antidepressant drugs. (She wisely also mentioned that patients taking such drugs should not drop their use cold turkey but consult their doctor).

Even if you didn’t see Stahl’s 02/19/2012 60 Minutes segment, you’ve probably heard of the placebo effect in which an inert pill has a therapeutic benefit because the patient expects it to. And maybe you’ve heard of the negative version of this – the nocebo effect, in which a patient experiences an expected harmful effect.

In both of these situations, the patient’s thought arms the inert pill with an effect, good or bad, indicating a mental component in the medicinal process. In Stahl’s report, she pressed Kirsh, “But people are getting better taking antidepressants. I know them. We all know them.” Kirsch responded, “People get better when they take the drug, but it’s not the chemical ingredients of the drugs that are making them better. It’s largely the placebo effect.”

This begs the question of what this might imply about drug-based therapy in general. Is a drug’s effectiveness the result of thought rather than chemistry?

If it is, here’s how this might work. A pharmaceutical company produces a drug and as a result of a clinical study decides that it has a therapeutic effect, adding a layer of placebo effect to the drug. The Federal Drug Administration approves the drug, adding another layer. Physicians then accept this determination and prescribe the drug, adding another layer of the placebo effect. The public is educated about the drug through the media and by physicians and they add another layer.

“The chemist, the botanist, the druggist, the doctor, and the nurse equip the medicine with their faith, and the beliefs which are in the majority rule” is how Mary Baker Eddy, a pioneer in mental, spiritual healing back in the 1800?s, describes this in Science and Health with Key to the Scriptures (pg 155).

Now, if I wanted to do a clinical study to test this hypothesis, I would want to have each of these participants who create and use a drug to do so without adding a belief or expectation in a therapeutic benefit – without adding a layer of the placebo effect.

Of course, such a study would be impossible, wouldn’t it? A drug company is not going to invest the time and expense to develop and produce a drug they believe to have no chemical therapeutic benefit. The FDA would not approve such a drug, physicians would not prescribe it, and so on. You just couldn’t remove all layers of the placebo effect and then have our health care system utilize such a drug (not to mention the ethical issues involved).

But what if a study could be conducted that would address just one layer of the placebo effect? Hypothetically, if you could take a drug (an actual drug, not a placebo) and have physicians NOT add their layer of the placebo effect to the drug, what result would we expect to see? Wouldn’t we expect to see a decrease in the therapeutic effectiveness of the drug? And wouldn’t this decrease be a measure of the placebo effect layer added by physicians?

Consider this. In his book entitled, “Timeless Healing – The Power and Biology of Belief” (see page 30), Herbert Benson, M.D., a graduate of Harvard Medical School, shares what he learned from a 1979 study he and Dr. David P. McCallie Jr. made of therapies used to alleviate a condition called “angina pectoris” (chest pain). He explains that techniques used in years past that have since proved to be “misguided” nonetheless often worked even though there was “no physiologic reason” they should have.

He relates that when these therapies “were used and believed in, they were effective 70 to 90 percent of the time…” “Later, when physicians began to doubt whether these treatments worked, their effectiveness dropped to 30 to 40 percent.”

In this situation, the therapy lost over half of its effectiveness. Same therapy! What changed? Was this a result of the physicians’ layer of the placebo effect being removed as a more accurate assessment of the therapy surfaced over time? Was the higher rate of effectiveness early on the result of the physician’s layer of the placebo effect being included?

This all points to thought and the mental nature of the healing process. Stahl said her story involves “how the mind is so powerful over the body“¹. If this be the case, then how powerful would thought – influenced for the better by a single, all-good, infinite mind – an all-powerful, all-loving divine Mind – be to do the body good?

¹ http://www.cbsnews.com/8301-505269_162-57380096/inside-60-minutes-placebo-story/

We all know that there is big money in TV advertising and even bigger money in successful drug sales.  To have a former insider who is now on the outside question whether these Pharma ads really serve any useful purpose is refreshing.  It’s worth a quick read.

Michele Asslin New York Times

Helping without judging; breaking up chaos with uncompromising love; unwinding snarls of frustration.

Melissa Fay Greene’s in depth account in Sunday’s NYT magazine, of how a service dog named Chancer, connected with a troubled young boy in a way that loving, caring parents or medicine could not has deeply moved many readers, judging by the extensive comments on the NYT magazine web site. (256 comments)

As a story within a story, Ms. Greene tells of the physical life-threatening challenges of one women, whose persistent nurse encouraged her to seek a service dog, which lead to a career of helping others by training and providing highly trained service dogs.   Ms. Greene then circles back to the story of a family who adopted a young boy and a baby girl from Russia.  At a young age the boy exhibits symptoms of pre-natal alcohol abuse that results in raging chaotic behavior that  no amount of family affection, attention or pharmaceuticals could control.

The two stories connect when this family from Atlanta are lead to acquire a service dog for their troubled son.

The description of how the dog connects with the boy, engaging the boy when the boy would begin to spiral into rage – literally standing on top of the boy to calm him is precious.

In the Bible, in the book of John, the beloved disciple tells us that “God is love” (1^st John 4:8).   He doesn’t tell us how God’s love is expressed of manifest.

Reading this story we can all take a lesson from Chancer,  the golden retriever with  unbounded love.

In the January 22^nd, New York Times Magazine cover feature, Oscar Pistorius, the double-amputee 400 meter track star from South Africa tells the author, Michael Sokolove, the following story from his childhood.  He and his older brother Carl were getting ready to go out and play one morning.

“His mother, a school guidance counselor, turned to her older son and said, “You put your shoes on.” Then she turned to Oscar: “And you put your legs on.  And that’s the last I want to hear of it.”

Oscar Pistorius, often called “the blade runner” because of the Cheetah prostheses blades serve as the lower part of both legs, competes against full bodied track athletes and hopes to qualify for the 400 meter event on the South African team for this summer’s Olympics in London.

Oscar was fitted with prostheses at 13 months of age and was walking at 17 months.   In 2007, the governing body for international track competition ruled that Oscar’s blade prostheses gave him an unfair advantage.  Oscar appealed to the Court of Arbitration, and the ruling was overturned by a unanimous vote – stating that Oscar had “no overall net advantage”.

I love this story and encourage readers to go to the link and read the full story.    Oscar has reached the level of world class track and field 400m runners, not because of technology, but because of his single focus to compete and his unwillingness to see himself as disadvantaged.

His example shows us that thought can influence performance –when unencumbered by prejudice.

Embassy of Italy, Washington DC

One of the world’s leading researchers in the neurobiology of placebos, Fabrizio Benedetti , M.D. of the University of Turin Medical School, Italy,  delivered the final  lecture of a three day conference on placebo’s Friday night at the Italian Embassy in Washington, D.C.   This conference was sponsored by the National Institute of Health and the Samueli Institute.

Although the first two days of the conference were invitation only, this final lecture was open to the public.  In addition to Dr. Benedetti,  Luana Collca, M.D. (educated in Italy but now working at the Complementary and Alternative Medicine at NIH).   Also presenting was Franklin Miller, Ph.D. ( medical ethics ) from NIH.

I was in the audience of about eighty people in the beautiful new embassy building Friday night.  Most of Dr. Benedetti’s research is in the area of pain management.  As a neurobiologist he studies how the body responds physiologically to a placebo or nocebo.

Here are a few of the high points from Dr. Benedetti’s lecture

“Placebo Effect = Context Effect”   I always thought about a sugar pill as a placebo, and that a patient’s faith in the pill (thinking that it has a beneficial drug) is what triggers the placebo effect.

Not so.

Dr. Benedetti’s research indicates that is it the ritual surrounding receiving a pill that triggers a physiological response that lessons pain.  This ritual includes the surroundings of the doctor’s office, the doctor, what the doctor says, etc.

Benedetti showed photos of a woman who had undergone surgery on her back that limited the range of motion of her left arm – how high she could lift it.

• With no drug about 90 degrees
• After receiving a placebo – she could raise her arm about 140 degrees (180 would be straight up)
• After receiving a nocebo  (a sugar pill with guidance from the doctor that it would limit her motion) she only raised her arm about 45 degrees

He had numerous examples of similar results from other studies.   How and when physicians should use a placebo in practice was covered in remarks by Frank Miller.    I came away from the evening with sense that research is now documenting this phenomenon, but the medical community is still wrestling with how to incorporate it into practice.

To end his lecture Dr. Benedetti  put up a slide with the following quote:

“Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing.”

Voltaire

Florida is always an important state when it comes to Presidential politics. We have 27 electoral college votes (10% of the winning total). We’re a “swing state” as was highlighted in the 2000 Bush/Gore election. And now we’ve got the Republican National Convention coming to town. Yikes!

For people who believe in the power of prayer to bring healthy outcomes to anything and everything, including politics, this seems like a great opportunity. But how to go about it? Try Googling prayer and politics and you’ll likely get lost in a maze of different takes on the issue of religion and politics. But not much for the person who wants to know “how” to pray about Presidential elections.

There were a few exceptions. One was a Huffington Post offering by Jim Wallis from 2008 titled, My Prayer for Election Day. I liked it for these reasons:

1. It was inclusive and unlimited, not favoring a particular party or candidate. No battle lines.
2. It was a prayer of gratitude for good already received, acknowledging the history of successful struggles for voting rights.
3. It was an unselfish prayer, including those who represent ideas different from our own.
4. It was a fearless prayer, encouraging a vote based on the positive values we embrace rather than negativity and fear based manipulation.
5. It was a BIG prayer for all nations, not just our own.

I felt good just reading about this kind of prayer and it made we want to get busy and start praying. My own prayer will include gratitude for the availability of this kind of prayerful thinking online. And actually the more I looked the more I found.

Here’s an example of an online forum which asks the question, “Can prayer make a difference when it comes to politics?”

The fascinating answers come from all over the world…Kenya, California, Ethiopia, South Carolina and right here in Florida.

Check it out, add your own answer…and offer your own prayer.

Here is a guest post from Eric Nelson, Christian Science Practitioner and spokesperson in Northern California,

Thanks Eric!

My morning news scan began by reading an article in The Christian Science Monitor about the Reverend Dr. Martin Luther King Jr. and “8 peaceful protests that bolstered civil rights.”  As someone who was little more than three years old when Dr. King was assassinated, these were not events I remembered personally but nevertheless appreciate being reminded of.

 

Dr. King’s legacy runs broad and deep.  But for me the most important lesson I continue to learn from his example is that even the most aggressive and persistent forms of tyranny can and will be defeated.

 

Of course, tyranny has many faces – racial prejudice, discrimination, segregation, economic injustice, and so on – all of which require constant vigilance in order to keep them in check.  But there’s another kind of tyranny that, although perhaps less obvious than the rest, deserves equal vigilance and against which increasing numbers are taking a stand.

 

More and more these days we read about people who are discovering that their health is not restricted to the dictates of drug-based medicine.  Instead they’re realizing that consciousness plays a key – even essential – role in the process.

 

One of the most intriguing of these individuals is Dr. Lissa Rankin.  This physician cum mind-body expert from the North Bay recently gave a TED talk that began with this provocative question: “What if I told you that caring for your body was the least important part of your health?”  Either you’d say she’s nuts… or that maybe she’s onto something.

 

If you listen to her entire talk, you’ll learn that Dr. Rankin is not suggesting that anyone adopt an unhealthy lifestyle or even one that gives up all use of drugs – only one that acknowledges that there’s a direct correlation between consciousness and health.

 

Of course, there are many others who have joined in the crusade to find better, more reliable approaches to health care.  But perhaps the most important ones are people like you and me – regular folks who are discovering that things like gratitude and compassion, patience and forgiveness can have a significant and lasting impact on our health.

 

I’m a Christian Scientist who likes to follow and write about trends in science, theology, and medicine (see www.norcalchristianscience.com). I also serve as a media and legislative spokesperson for Christian Science in Northern California. My … View Profile

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Alex Rodriguez photo tks to Keith Allison

As  reported in the L.A. Times, Alex Rodriguez of the New York Yankees ,  flew to Germany last month to get platelet-rich plasma injections, or PRPs on his right knee and left shoulder.  According to the paper, this procedure was recommended to Rodriguez by the Lakers Kobe Bryant, who had similar treatment.

What’s interesting is that this procedure is questioned by medical professionals as having little positive effect.  From the LAT article:  “Take a study published in January 2010 in the Journal of the American Medical Assn., which found that injecting patients’ Achilles’ tendons with platelet-rich plasma had about the same effect as injecting them with a saline solution.”

What’s going on here may be another case of the” placebo effect”.

Recent Wall Street Journal and New Yorker Magazine articles discuss the growing interest and debate about the efficacy of the “placebo effect”.  Dr. Kaptchuk, the newly appointed director of Harvard’s Program in Placebo Studies and Therapeutic Encounter is featured in both articles.

On Thursday, January 5^th, WAMU.org’s  Kojo Nnamdi talk radio show featured Dr. Kapchuk and Wayne Jonas from the Samueli Institute in Alexandria, VA talking about the placebo effect.  There were not shortage of calls or comments on their web site.

Whatever the efficacy of the “placebo effect” may be, it certainly suggests that there is growing interest by patients and providers in the effect of thought on the body and health.

I will be watching Kobe on the court and A-Rod on the diamond to see if their trips to Germany were worth the effort.

High School Swim Finals tks to knightfoto

Recognizing that individual behavior can drive health care costs, more health insurance companies, hospitals and employers are turning to “wellness” coaches.  Wellness coaches are often nurses or nutritionists who stay in touch with patients dealing with long standing illness, those recovering from surgery or someone who desires to shift to and maintain a more healthy life style.

According to a December 25^th article in the Virginian Pilot by Elizabeth Simpson, about the growing profession of wellness coaching:

“A Kaiser Family Foundation survey of employer health benefits in 2011 found that 27 percent of companies are offering employees access to health coaches, with some giving financial incentives for working with one.”

I was blessed to have two wellness coaches growing up – their names were Mom and Dad. Mom stressed the importance of good manners at all times, and the discipline and responsibility of household chores.  Dad got us all ( 3 brothers & me) into competitive swimming that burned up any excess energy that may have gotten us into trouble.

More than anything my folks taught us that prayer was the best preventative and curative medicine.  Prayer with an underlying moral science required work, but was readily at hand and required no trips to the hospital or doctor’s office.

Looking back over the decades I can see how this coaching paid off in stable and happy marriages, healthy and productive lives.  It shaped our behavior.

A recent ABC news story stated that “The majority of U.S. doctors — 56 percent — believe that religion and spirituality influence patient’s health”.

Now that health insurance companies and employers are turning to professionals to help those struggling to regain or maintain health I would hope that  the inclusion of the spiritual/prayer component in the tool kit of a wellness coach will not be overlooked.