The Self-Treatment Guide

I ran across this rather amusing anecdote posted by GruntDoc about the guidelines for chiropractors in the ER, which I won’t quote from since he prefers that you read it in context.

However, what was also interesting was a comment about rebound headaches left on the post by A Bohemian Road Nurse that reads as follows:

I’ve also found a lot of people with constant “migraine” headaches whereby Immitrex, narcotics and NSAIDS are not working are really having “rebound headaches”. My sister, who suffered from just such a headache merry-go-round didn’t believe me about the existence of rebound headaches. But she reluctantly tried my suggestion of weaning herself from pain meds. After three days of misery, she was headache free. It worked. Now, she only gets the ocasional “real” migraine, around her menstrual cycle, for which Immitrex DOES now work. (I know this doesn’t cover everybody, but it is a thought to consider for some people with lots of headaches….)

I first heard of rebound headaches a few years back from (I believe it was) Dateline NBC. The gist of the story was that constant use of NSAIDS like Ibuprofen can actually lead to worse headaches once the medication wears off.

It eventually turns into a vicious cycle.

I can’t help but wonder if there might not be a similar “rebound back pain” associated with over-reliance on pain meds for the treatment of back and neck problems. It would explain why a lot of minor injuries develop into chronic problems.

I’m sure there is a flaw in my logic somewhere… I’m just thinking out loud.

Dean

A number of major news outlets have recently picked up on the AP news story
that an herbal supplement called forskolin may help treat recurrent
bladder infections. Here is the
main thrust of the article:

When taken with antibiotics, an herbal extract sold in
health food stores and promoted as an allergy and fat loss aid may
improve treatment of bladder infections, research suggests.

Some 90% of bladder infections are caused by E. coli bacteria. They
affect women four times more often than men, sometimes recurring over
and over.

According to an a recent study in the Journal of Antimicrobial Therapy, urinary tract infection recurs in 12-16% of patients treated, regardless of the antibiotic chosen.

The bladder is lined with small pouches that allow it to
stretch as it fills. Researchers at Duke University reported in
Sunday’s online edition of Nature Medicine that some bacteria were able
to hide in those pouches, escaping the antibiotics used to treat the
infection.

In tests in mice, an extract derived from the Indian coleus plant
can cause the pouches to kick out the bacteria, allowing antibiotics to
kill them, said the lead researcher, microbiologist Soman N. Abraham.

Medical blogger, Dr. Charles cautions that we shouldn’t read too much into this story. He points out that these
small pouches in the bladder are not the only reason urinary tract
infections recur. Among the other factors impacting urinary tract infection:

The largest group of patients with UTI is
adult women. The incidence increases with age and sexual activity.
Rates of infection are high in postmenopausal women because of bladder
or uterine prolapse causing incomplete bladder emptying; loss of
estrogen with attendant changes in vaginal flora; loss of lactobacilli,
which allows periurethral colonization with gram-negative aerobes, such
as E coli; and higher likelihood of concomitant medical illness, such
as diabetes.

Dr Charles goes on to quote more from Dr. Abraham, the lead researcher in this study:

“If we combine this with antibiotics we would be in a very
good position to eradicate urinary tract infection,” he said in a
telephone interview.

In the experiments, the extract forskolin was injected into some
mice and placed directly into the bladders in others, Abraham said.

The extract is available in health food stores and some people take
it by mouth as a supplement, he said. It is promoted as a treatment for
allergies, breathing problems and even fat loss.

That availability does “absolutely not” mean people should attempt to treat themselves for bladder infections,” Abraham said.

Dr. Charles then proceeds to make some very good points:

Much more study is needed to determine whether the addition of
forskolin to antibiotic therapy will make a difference in human UTIs.
It is also a big leap from injecting mice or catheterizing their
bladders to the convenience of a pill (with proven efficacy,
tolerability, safety, etc). It will be interesting to see what
proportion of UTI recurrence is due to these “pouches” and what
proportion is due to other factors such as antimicrobial resistance,
uterine prolapse, diabetes, etc… I would guess more is due to the
combined latter, but maybe I’m just being too hard on this study…

I think Dr. Charle’s conclusions are correct. More study needs to be done into this supplement before anyone decides to rush out and start buying it. Quite often the news media will run with a story just because they need to fill space and give you something to read. It doesn’t mean the item really works.

We consumers need to be very skeptical of any new “health breakthroughs” reported in the media. Investigate everything — gather all the facts — and finally, check with your doctor before adding any of these designer supplements to your diet.

One last note I want to add… there are some interesting comments on Dr. Charles post including this one:

Don’t laugh but I use a supplement called Cranactin, it’s the
concentrate of cranberries. I once ended up in the hospital with a
bladder infection so I’m really careful. As soon as I feel bad, I take
some Cranactin. It works for me so I recommend it. I don’t think it
would hurt you even if it doesn’t work for you.

I’ve also heard of cranberry juice and related products being used for urinary tract infections although I’ve never had the occasion to try them. Just something else to look into.

I ran across this post on Dr. Flea’s blog this morning that was too good not to share with you. For those of you unfamiliar with Flea he is a pediatrician and one of the more prevalent medical bloggers.

This quote is from his response to the question, Why Do You Blog?

Our culture is suffused with messages telling parents that their children are sick, or potentially sick: one sniffle away from certain doom. Flea’s message is that American children are the healthiest children that ever lived on planet Earth. We should celebrate our good fortune.

The culture tells us the children are defined by series of capital letters: ADD, ADHD, ASD, PDD-NOS, OCD. Flea wants children to be called by the names their parents gave them.

Pediatrics today consists of daily exercises in over-testing, over-diagnosing, over-treating, and over-admiting to hospital. Flea wants the folks to know that often the best thing to do for a child is to keep him or her the hell out of the pediatrician’s office!

Pediatricians who write for newspapers and magazines produce icky, squishy pap that bears only the faintest resemblance to expository writing, and that is astonishingly void of original points of view.

Flea is trying to keep it real.