Medical self-help

How can we handle medical situations doctors do not treat? Why do we need to use self-help at all? Is it dangerous? How to use Dr. Google properly? The things doctors will not tell unless we ask…

How to find a treatment online

Dr Google is often surprisingly good. Some online databases can rival professional medical datasets. The rules are simple.

For condition X, the search keywords “X causes”, “X supplements”, “X treatment”. You will usually get www.mayoclinic.org, www.nhs.uk and a bunch of other sites.

1. Look for professional recommendations. Anyone can recommend anything. Try to understand the background. Is there a specific physiological mechanism discussed? Does it make sense?
2. Check controversies. Anything medical has scary side effects. Many experiments are inconclusive. I often do not even bother to cite the articles I use: you should perform your own independent investigation in any case.
3. Never assume the worst. Really. The worst-case scenarios are very rare. You are likely to suffer from a stretched muscle, tendron pain, a migraine, high blood pressure, and viral infections. Cancer or lupus can happen, but they are highly unlikely in your case.
4. Wait before you act. Most of our sicknesses have very clear dynamics. For example, we get worse during the first three days, then improve sharply over three days, and then there is a week of side effects. Quite possibly, if you can wait a week, no treatment is necessary. This does not work for certain issues like abscesses or appendicitis, but these things can be checked.
5. Read some original research if you want, but do not trust it.
6. Never ever trust social media

But why even do this kind of search?

Do no harm

Medicine is a science. Its premise is “do no harm” and help everybody in need. While medicine is extremely old, until the 1930s it was arguably doing more harm than good.  Several huge discoveries of the 19th century changed everything.

1. Sterilization. Before the early 20th century, a lot of people died due to medical infections. Getting to the doctor’s tent was the most dangerous part of any military operation, and up to 30% of the patients died from complications. Mothers giving birth had very good chances unless doctors interfered, but something C-section was a death sentence. Not since the 20th century.
2. Vaccination. Louis Pasteur’s miraculous discovery. Again, 19th century. It is our best bet against the most dangerous infections. It stopped people from dying in their prime.
3. Anesthesiology. Anesthesiologists get the highest salary in USA. Due to their effort, patients feel little pain, and long operations are possible. Before anesthesiology surgeons prided on FAST operations, which were dangerous to all parties involved.
4. Antibiotics. OK, sulfa drugs predated antibiotics and were also very effective starting from 1930s.  Hence this is the time that medicine finally became effective.
5. Imaging. X-rays at the beginning of the 20th century. Helped with broken bones, tumors, and other things. Probably the fastest-growing field of medicine in our lifetime. We have MRI, CT, ultrasound, and much more.
6. Laboratory tests. The human ABO blood groups were discovered in 1901. The blood tests and tests of other body fluids followed.

These discoveries were GREAT. Medical doctors use them effectively. Whatever you do to help yourself, allow the doctors to use at least these six tools, because otherwise, the results might be catastrophic.

As self-help rule: if the doctors know what they are doing, let them do their job. If they have no idea, do not force them to help you.

Why doctors fail

The doctors are very suspicious of all new developments. Rightfully so.

There were too many procedures used ineffectively in the past. Double-blinded tests vs placebo removed some unnecessary surgical operations and ineffective medicine. For some reason we do not understand, placebo is VERY effective, and doctors find it hard to compete.

Syphilis used to be one of the scourges of medieval and early modern societies. The treatment was a very painful mercury injection, with people dying from mercury poisoning well before they could die for syphilis. Doctors of the past had a very hard time telling people “there is nothing I can do to help”.

Today there are several schools of what to do if regular medical protocols fail. One is more traditional, and the doctors will provide you with dangerous pills and procedures, e.g. experimental or banned in some other countries, because they just might help you, especially if you have cancer. A second school will send you to an enormous number of expensive lab tests and CT sessions just to say that they did all they can and bear no further professional liability, especially if you are a hypochondriac with good insurance. A third school, especially in psychiatry, will experiment with various treatments trying to guess correctly which treatment will help.

Doctors are partially ignorant of lifestyle choices. They know that sports are good, obesity is bad, alcohol and tobacco are very very bad. And that’s about it. Approving any sort of medical treatment can take a decade, and the treatment may cost a fortune as a result. Moreover, medical companies are financially interested in treating chronic desease, rather than providing prevention or full cure.

As self-help rule: the doctors will often fail because we still do not know more than we actually know about the human body.

Preventive medicine is questionable

The biggest failure of modern medicine is the prevention of medical treatment. Prevention is a very complex issue. Most medical tests are executed on small numbers of patients: this reduces the costs. There is no real incentive to execute prevention tests on hundreds of thousands of people unless treating a really serious issue. Possibly only for cancer, we have reasonably reliable prevention statistics.

Even when we have statistics, some lifestyle choices are very hard to check. If there is no acute deficiency, there is no real proof about vitamins and food supplements. A person needs to take the substances for years for any measurable effect. And if someone takes vitamin C, he is also likely to take vitamin D, Omega 3, and other supplements.

Instead of checking proven medical data, we search online for possible medical indications. Like selenium and asthma. There is no real proof, but it might be working.

The same thing goes for specific physical activities. Should I run, work with weights or swim, and if so – how much? The evidence is inconclusive. Possibly everything works, but not the same way. We know for example that professional wrestlers die young. Aerobic endurance sports help. Team sports not so much. And if there is orthopedic damage or use of steroids, the life expectancy may actually suffer.

As self-help rule: preventive medicine is your own concern. Nobody cares about you enough to do it for you.

Remember the placebo effect!

So why am I such a vocal proponent of narrow-range food supplements? Do I really have some knowledge not shared by the medical community? Yes and no. I know one simple thing: placebos are extremely effective in treating a wide range of conditions. All homeopathic drugs with a very high dilution range are probably placebo, and they are often more powerful than less diluted products.

Providing a placebo treatment may be extremely effective, often as effective as the real drugs without the side effects. Notice that the drugs need to actually be clinically more effective than placebo, so do not rely on placebo too much.

Not all kinds of placebo are equal. The perceived value of the placebo correlates with its efficiency. Narrow-range professionally prescribed placebo is usually more effective than wide-range stuff everybody takes.

Also the procedure of taking the placebo matters. Take the pill, think it will help you, and then try to observe the actual effect on your body. The feedback parts actually helps.

Thus placebos in medical experiments will be very powerful. Placebos of traditional or alternative medicine will be good enough. Food supplements will be slightly less effective. And healthy superfood will have a very small placebo effect.

As self-help rule: if something is not too bad, try to find a homeopathic treatment or food supplement for the issue.

Do not try to live forever

Due to the placebo effect, most self-help plans originally work. With time, however, things often do not work that well. Why?

Traditional Chinese medicine is probably dangerous for you and the planet. Rhinos, sharks, snakes, and less prominent animals die for no good reason. Also, the dead wildlife is not controlled by vets and can carry deadly diseases.

Vitamins and food supplements in large quantities can actually be dangerous. For example, calcium in small quantities prevents fragile bones, but in large quantity contributes to blood pressure. Iron poisoning can also be deadly. Prescription drugs are usually worse than simple supplements, but at least theoretically doctors monitor the consumption.

The first emperor of China tried to live forever. He asked the best doctors in the land to generate him immortality drug. They tried so hard that they discovered gunpowder in the process and called it “fire medicine”. They failed, were killed and their schools parished. Soon after the emperor died in young age, quite likely due to poisoning from an immortality drug.

There was also an experiment with starvation. Controlled starvation in some animals increased their life span. With further starvation, the effect stopped and reversed. The common disease range of the animals in captivity was replaced by a new set of conditions researchers rarely encounter in captivity.

As self-help rule: some gentle health boost will work. If you increase the boost further, you put yourself in harm’s way.

To vaccinate or not?

In the case of COVID19, polio, and some other hard diseases, vaccination is probably the best strategy. But not always. For example, I am not sure that flu vaccination is a good idea. Why?

• You will not get transparent data. If someone gets chronically sick and does not die, his case may never surface.
• The vaccine itself may get contaminated. For example, if not stored in sufficiently good conditions. Such cases are rare but they do happen.
• The immune system’s reaction to the proteins of the disease may be violent. It may cause serious damage which could easily be avoided.
• Most vaccinations have a certain longevity. If the chances of you encountering the disease within the time the vaccine is active are very low, you might not even need the vaccine.

I am not in the pro-vaccination or anti-vaccination camp. I think any situation needs to be analyzed separately, with its own unique set of pros and cons.