Allopathic path?

Saw my therapist today. We have one more session after today. She wants me to keep an activity log. She has a form for me to fill out but I can’t pick it up till Wednesday.

I slept ok. Good number of hours despite my being up between 4 and 5 a.m. Just watched our Evensong service from last night. Pretty good!

Was feeling a histamine flare about half an hour ago so, as directed by my allergist, I took a Zyrtec as needed. It took care of the flare but I’m afraid I’ll get dried out and/or have urinary retention as I seem prone to both of these. Let’s hope not!

OMG! I can't believe this but I got a call from my regular pharmacy saying my psych nurse called in a prescription for Vraylar and would I like it in my blister packs in two weeks? I checked out my blister packs that I have on hand - no Vraylar! This means I've not taken Vraylar for two weeks! Wtf? No wonder! A script for Vraylar was sent to the pharmacy the same day that I saw my psych np. Nobody caught this until today!

I think my psych np messed up and the pharmacy didn’t notice until today! They’re both at fault!

No, @MuddyBoots, @Crazy Hitch @amandalouise, it is not exactly that. True, it is used by people such as the person who essentially attacked Moose to mean evidence-based approach (in a derogatory sense), but it does not mean that or at least it did not mean that historically.

Allopathic meant the opposite of homeopathic. So it is one pole in the artificial dichotomy between allopathy and homeopathy. Homeopathy is treating with the "same" (homeo), and allopathy is treating with the "opposite" (allo).

Modern evidence-based medicine is far, far wider than allopathy. It also includes preventive care, which may not even involve any treatment, with the "opposite" OR with the "same". And some vaccinations function as treating with the same, and yet they are evidence-based. So there is no clear demarcation line anyway. And, say, talk therapy is not treating with the same, nor is it treating with the opposite - it is orthogonal to the supposed axis where same and opposite are the opposite poles. Unless you consider exposure therapy for anxiety part of talk therapy, and if you do, then such talk therapy is homeopathy, because it is treating with the same – like some older vaccinations, it is exposing the patient to what triggers the illness in small, but increasing doses, until the patient overcomes the anxiety. If the person is afraid of social situations, the therapy prescribes social situations. It is treating with the same. In literal terms, it is homeopathy and not allopathy.

Actual homeopathy does not actually treat with the "same" because it does not treat at all: the multiple dilutions involved in preparing homeopathic "remedies" render the resultant product devoid of any active substance. If you use homeopathy, then, unless you believe that water can possess "memory", you are taking a sugar pill, a placebo. The only benefit can be attributed to the placebo effect, which does exist. I have recently heard a good analogy: we are more likely to be drinking Hitler's urine than finding any active substance in homeopathic "remedies". This is because the number of dilutions necessary to obtain such a remedy is higher than the number of dilutions it would have taken for Hitler's urine to reach our municipal water supply. Of course, this makes homeopathic remedies highly profitable, because the profit margin is insane (the main cost is advertising, distribution, and managing the supply chain and not producing the stuff).

Homeopathy caused the evidence-based medicine to develop. The first experiments with controls that gave rise to modern evidence-based medicine were performed in the 19th century specifically to disprove homeopathic claims. And they did! But homeopathy survived and continues to survive, being the ultimate form of quackery. Still, we should be thankful for homeopathy because who knows, maybe evidence-based approach to medicine would have taken many more decades to be born if not for homeopathy. That is homeopathy's main contribution to humanity, and it is, hands down, a very important contribution. A key contribution. But that is all.

Since then, allopathy has become a swear word used by people who would use any type of snake oil as long as it is "alternative". Which by itself would be innocuous enough, as people should be free to experiment on their own bodies. But when such people experiment on their children or demented elders who cannot consent, or when they undermine the efforts of genuinely ill people, such as Moose, to obtain genuinely effective treatments for their real diseases, it is rather disgusting. It has become a weaponized term.

To sum up, allopathy has never been defined carefully enough to begin with, and now it is used to demean other people, the way this person demeaned Moose.

Actually, ostheopathic medicine literally means an approach to medicine that prioritizes the musculoskeletal system as the cause of most ailments and also the locus where treatments should be applied to be effective. I think this is what it meant historically, but I have not fact-checked.

As such, it is not evidence-based, because it is not the fact that most ailments are due to musculoskeletal system problems. Some are and some aren't.

At the same time, DO (Doctors of Ostheopathic medicine) can do the same things that MDs do. My former OB-GYN was a DO, and she practiced exactly the same as MD OB-GYNs. For example, when I asked about preventative HRT (before menopause), she reached for a tool to calculate risks and benefits given my particular parameters. Together, she and I decided that HRT would be indicated for me, and I was started on the lowest dose estrogen patch. Collaboration between doctor and patient and transparent analysis of risks and benefits are hallmarks of modern medicine at its best and are evidence-based (we have ample evidence that when patients are involved in their care, outcomes are better).

Modern osteopaths depart from the narrowly musculoskeletal focus and try to distinguish their approach as treating the whole body instead of a collection of disjoint systems and symptoms. There is something to it, but at the same time it is a grand statement, meaning that as you start poking holes in it, you might discover that "treating the whole body" is poorly defined. But it is still entirely benign, as an aspirational statement. It does not involve snake oil or sugar pills.

When applied to medicine, the word "traditional" also lacks a clear definition. Traditional Chinese Medicine (TCM) was Mao's clever invention. It may purport to go back thousands of years (hence, traditional), but in reality it stemmed from a conscious decision to unify many different treatment modalities practiced in different places in a huge and diverse country in order to offer people something that was accessible and cheap, something that could give them the impression that they were cared for. In contrast, actual medicine was not affordable for such a huge country back then, with a huge population. These days, a whole lot of evidence-based research originates in China. It is not that in China all they have these days is TCM.

Is ECT traditional? In what sense? Modern ECT is rather mild compared to the electric shock treatments of the past, like those depicted in the "Beautiful Mind" movie. That is one reason we now use the term ECT and not "shock." T is therapy in the acronym ECT. When my mother received such treatments for her deep depression in the early 1980s, it was called "shock". We do not use this term anymore. So is ECT traditional or modern? And even shocks back then, were they traditional? In what way? they did not go back centuries, did they? Traditionally, meaning, for most of humanity's history, people did not know what electricity was, and ECT did not exist and could not have existed. But if the word traditional means what is currently the mainstream approach, then ECT is not traditional, either, because it is typically the last resort treatment, due to costs. So most people in the mainstream do not receive ECT (even though purely by effectiveness and safety profile, it would make sense to administer ECT more widely and earlier). This illustrates the trouble with the word "traditional" - what does it mean?

Exercise plans are part of modern evidence-based medicine. The adage goes that doctors should write "exercise" on their prescription pads so that patients will take them seriously. Another adage goes that no pill is as effective for longevity as exercise (including for cognitive health, and not just physical health). Is exercise traditional? No, in a sense that until very recently, few people exercised for the sake of exercising. Yes, in a sense that traditionally, people played sports and physical games, wrestled, raced, and danced. But in groups or competitively against one another, or team against team. Or they ran from danger. Or they swam to cross a river in the absence of bridges, airplanes and helicopters. But walking on a treadmill is a highly modern phenomenon. Our ancestors would think we were completely crazy if they rose from their graves and observed us on treadmills, ellipticals, or stationary bikes. So it is not possible to say whether exercise is or is not traditional. But it is evidence-based. Again, the trouble with the word traditional is that it does not have a good definition. Similarly to the term natural: it does not have a good definition and usually is used to mean good, even though cyanide is natural and so is arsenic, yet neither is good . Evidence-based has a definition. At the same time, evidence-based is not a gold standard, either: sometimes we do not need an evidence-based approach, as in the case of deciding whether parachutes improve safety outcomes when a person jumps from a plane. Basic knowledge of physics should suffice.

If anything, yoga is traditional because yoga actually goes back far. Yoga is also ostheopathic in the original sense of the term ostheopathic because yoga places such an emphasis on the musculoskeletal health. But it also places an emphasis on breathing and, in some of its variants, the mind.

Mindfulness and meditation help many people and are useless to many others, and there is a lot of hype surrounding their claims to being evidence-based. For example, there are claims that MRi studies show how much meditation helps, but in reality, the studies simply show that meditation can be detected as some activity in the brain, not necessarily beneficial (nor harmful), just some activity. It is a stretch to conclude from observing some sort of detectable activity on the MRI that meditation is hugely helpful. Some years ago I was in several IOPs which pushed meditation and mindfulness as the first line of defense and gold standard, which irritated me. To me, it seemed yet another way to do something cheap and at scale - depth psychology, analysis, psychodynamic therapy all require time and an individualized approach and years of training for the practitioner, whereas mindfulness can be practiced in groups with one group leader facilitating the process for many participants. And insurance pays for it. And it requires far less training for a mindfulness facilitator to learn the skills than for a depth psychologist.

In general, I would call yoga and massage self-care, which can be hugely beneficial. I think acupuncture acts in the same way - there have been studies when needles were pressed in the "wrong" points, or the needles themselves were "wrong" but looked "right", and yet the treatment outcomes were unchanged, demonstrating that the effect was placebo. There is also something about all the fuss involved in getting acupuncture treatment – it is pleasant to be the object of all that fuss. I had it once and it felt very pleasant. But given how short life is, I think it is better to spend time and money on activities that have, behind them, far more proof of effectiveness, such as swimming, strength training (especially for women as they age), or dancing (proven to help alleviate symptoms of Parkinson's). If I had extra time and extra money (say, another hour on the day to make my day last 25 hours), and lived closed to an acupuncturist I liked, I would definitely get acupuncture for the pleasure of it, but under a severe time constraint, I do not spend time and money on something that does not have a solid evidence base. There is also something to be said for getting multiple benefits from one activity. Say, if the goal is to relieve stress, yes, acupuncture achieves this goal, but so does swimming. However, swimming helps the lungs, circulation, and, of course, the musculoskeletal system (in that sense, swimming is on the osteopathic path), so you get more out of the time spent swimming than out of the time spent being poked with needles. At the same time, acupuncture does not involve extra time before and after treatment, and swimming outdoors does (you need to change, apply sunscreen, then take a shower, change again... a drag), so maybe acupuncture sometimes is a more economical way (time-wise) to obtain stress relief.

The general point I wanted to make is that all of those words and dichotomies used so frequently suffer from being either poorly defined or non-existent in reality, meaning that they exist as claims, but not in reality.

"Same" and "opposite" as what though?

As the disease itself. I will write more on the history of homeopathy, but basically, use the same offender (what is believed to be the offender) in tiny quantities to cure the disease caused by the offender.

Like anti-biotic, anti-inflammatory. Whereas homeopathic medicine - per my vast knowledge of it from a gf lecturing me in the aisles of Whole Foods 30 years ago - serves you diluted essences of flowers that caused your itchiness to begin with. But in the CUTEST tiny (however expensive) containers!

I have a rash from the constant diarrhea! It burns but no sign of yeast. Plus there’s some unknown problem with my mouth. It hurts so bad I can’t eat!

Plus I’m seeing Pdoc Monday. I just saw her a week ago almost. I’m guessing it’s about the pharmacy messing up and not including my Vraylar for a whole month! I had no idea until they called offering me the second two weeks worth!

Will putting Vaseline around the **** before going help? That was my solution when the pre colonoscopy prep caused diarrhea which in turn caused rash. Vaseline saved the day. I think the GI I structions should advise the use of Vaseline preemptively.

My aunt had to have her butt surgically repaired because of the prep. No polyps, just from the pooping. Im not sure what they did. Worst case scenario, they grafted... i dont want to think what!

Ive been using a zinc oxide cream as a barrier.

My mouth is so dry I can barely eat! It hurts! I think it’s the Zyrtec allergy med my doctor prescribed for allergic reactions along with my regular psych meds drying my mouth out. It hurts so bad!

Now my mouth hurts all the time and gets worse if I try to eat. I called off of choir for Sunday. :-(. Wrote the director an email. They said to try Mylanta for my mouth. Just drank a protein shake as it hurts too much to eat solid food.

Have you tried xylitol mints? My dentist recommended them. You can get them at Walmart so probably at most drugstore type places. The xylitol really helps with the dryness.

The prep experience made me think of all the diarrheal disease epidemics and pandemics in ages past. How did they deal? Without Vaseline, toilets, toilet paper, washing machines? How did they deal? How about now, in Africa? How do they cope with diarrheal diseases?

I get them from Amazon on Subscribe and Save - no dry moth, luckily, but xylitol has been proven to protect against dental caries. I have used them for years. Lemon flavor is my favorite.

They don't cope.

the runs in Italian.

There was no way to save them back then. nothing to help with dysentery. Nothing to even rehydrate, no Pedialyte. Nothing.

Just home from Costco with my mom.Was able to eat Panera Mac n cheese! And ice cream. My apartment is a disaster. Need a shower but it will burn my rash! May just wash my hair.

Rash has bumps now and has spread- I can feel it but tried to use a hand mirror but that was too difficult.. Using clotimazole an anti fungal and if it’s not better by Tuesday I’m to call back but to use it for a week.

Washed my hair.

You might need to layer a steroid cream over antifungal, but after speaking to the dermatologist first, of course.