Posted by: Christopher Maloney, Naturopathic Doctor | July 9, 2015

Looking Back At Lyme.

One of the things about living in an endemic state with Lyme cases all around is losing perspective that once upon a time we didn’t have a lot of Lyme.

Look at the 2001 chart of Lyme cases:

Reported Cases of Lyme Disease 2001

You see a smattering of Lyme along the southern border. Now look at 2012:

Reported Cases of Lyme Disease 2012

If there’s one thing this points to, it’s that we aren’t winning any battles with Lyme. I would love to see a consensus statement (long overdue) about Lyme treatment from within the two camps (chronic Lyme/no chronic Lyme).

Posted by: Christopher Maloney, Naturopathic Doctor | June 22, 2015

Are Essential Oils Absorbed Through The Skin?

You can love essential oils and still wonder how and if they are absorbed through the skin.

The answer is yes, at least in terms of lavender, and much faster than you would think. Within fifteen minutes of starting a massage the lavender is in the bloodstream. And it’s gone much faster than you would think as well, with a half-life (time it takes to halve the amount in the body) of less than a half hour. (http://ndnr.com/mindbody/dermal-absorption-of-essential-oils/)

Image result for image essential oils

Now, apply the same logic to something like a fragrance, a soap, an underarm deodorant, a toothpaste, a mouthwash, a gasoline spill on your hand, Uncle Joe’s cigar smoke, and every scent you experience throughout the day.

What is the blood effect of that odd-smelling fragrance you get in alcohol antibacterials that you rub on your hand and go about your day? Chances are they don’t have to test for it and no systemic studies have been done because since it is applied topically they don’t need to worry if it is absorbed. But if the highly volatile essential oil scents pass through the skin, it is likely that other fat-soluble fragrances do as well.

Most recently, I found myself surrounded by the odor of acetone, a “harmless solvent” used to carry such things as fingernail polish. In organic chemistry, our instructor talked about another “harmless solvent” benzene, which they used to dunk their hands in while washing away the crud from their flasks. Later on, they found out it was carcinogenic, so they switched to acetone. But chances are we’ll find that acetone is also volatile in the body.

Several of my patients have experienced chronic exposure to toluene, a “harmless solvent” that makes that nice smell from your ink toner cartridges.  Unfortunately decades of exposure in a closed room to an industrial copier slowed the speech and thought processes of one patient enough to qualify her for disability.

So the next time you enjoy your essential oils, breathe deep. They beat the heck out of a lot of the other things you could be breathing and putting on your skin.

Posted by: Christopher Maloney, Naturopathic Doctor | June 14, 2015

Lyme Disease And Neurological Symptoms: Coming Back from the Brink.

In this inspiring video, Ben Ahrens talks about what it is like to come down with advanced Lyme disease and also how to fight your way back to health. While his results are not necessarily yours, it is worthwhile to hear his story.

Posted by: Christopher Maloney, Naturopathic Doctor | May 23, 2015

How Much Do You Know About Your Microbiome?

Quick, answer these questions:

1) By how much do the bacteria in your gut outnumber the cells in your body?

2) By how much does the DNA available to the bacteria in your gut outnumber your own DNA?

3) Do the bacteria in your gut have direct effects on mood using the vagal nerve?

4) How many of the species of the bacteria in your gut are uniquely yours, not even shared with your identical twin who lives in the same house?

5) What does it take to sterilize an area of all bacteria?

6) Can you have a healthy gut once you’ve been through a series of antibiotics?

7) Do your bacteria interact with the drugs you are taking?

My new book!

If you knew the answers to all these  questions, then you’ll be interested in my new book: Tending Your Internal Garden (published for those patients who just needed to know now). If you didn’t know the answers to all those questions, and especially if you think they aren’t important, then you need to read this book. It’s short, and may change the way you view the area between your chest and your bottom.

I think this subject is so important I’ve started a separate blog called The Microbiome and Health. Very exciting new insights are coming out all the time, and I’ll be sharing those as I come across them.

Posted by: Christopher Maloney, Naturopathic Doctor | May 19, 2015

Are You Paying For Unnecessary Cancer Testing?

There is some debate about cancer screening, but when the majority of women who have no cervix are still screened for cervical cancer, hopefully we can agree that we’re screening too much.

What does it mean when a doctor’s group needs to clarify the guidelines for doctors? It means that the guidelines aren’t based on the available evidence, and that we’re screening willy-nilly. To quote the LA Times article: “About 6 in 10 adults submitted to a colonoscopy more often than they needed to. One-third of men who got a PSA test to screen for prostate cancer couldn’t remember being asked by their doctor to do so.”

The paper published in the Annals of Internal Medicine tries to make things sound more balanced: “High-value strategies provide a degree of benefits that clearly justifies the harms and costs incurred; low-value screening provides limited or no benefits to justify the harms and costs.” In other words, some cancer screening is useful, other cancer screening is not.

For me, as a consumer, I’m not interested in getting “low value” testing. No testing for cancer is without dramatic stress. If that test will save my life or my patients’ life, I’m all for it. But if it won’t impact my patients’ lives positively, then what I’ve done is harm my patient by testing unnecessarily. No doctors who have been tested themselves recommend the sleepless nights of waiting and worrying.

The thing I like best about the new guidelines is the focus on not testing patients who have already got a serious illness and a lowered life expectancy. I’ve seen patients in heart failure who are still be told to come in for a prostate cancer screening. They make me almost as mad as the patients who are in end-stage cancer who are advised to go on statin drugs because their cholesterol is a little high. At some point, we are simply becoming silly, and harming those who rely on us to watch out for their best interests.

If you can’t read the slide below, go to the original here.

Posted by: Christopher Maloney, Naturopathic Doctor | May 11, 2015

Are You Paying For Unnecessary Healthcare?

One of the things about being sick is that you are vulnerable. Anyone, (yes-anyone- I see too many neighbor-marketed health solutions) who has anything to offer you seem plausible. But add a white coat and a big, shiny medical building, and we’re all buying. And buying. But what we’re getting may not give us anything of value. In Atul Gawande’s New Yorker article he says bluntly: “Millions of people are receiving drugs that aren’t helping them, operations that aren’t going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm.”

Image result for overkill gawandeWhen we ask doctors to decide which procedures to do, they will always err on the side of too much. Doctors remember their mistakes, not the unnecessary testing they’ve done. One missed diagnosis haunts a doctor for decades, leading to untold thousands of unnecessary, “just-in-case” tests.

But every procedure, (yes-every procedure) has risks. So unnecessary can become fatal. Everyone has those horror stories, of the testing procedure or minor surgery that went terribly awry. What no one remembers is the much more common uncomfortable, painful, and lingering side effects from a mildly botched test: the massive bruise from a poor blood draw, the discomfort from a laparoscopy scar, the pain associated with most medical procedures that are supposed to make you feel better.

What can a patient do? Unfortunately, we need to educate ourselves. You don’t need a medical degree, you need to find someone with one. Have them do a little basic research. I answer questions on Quora, an online question site frequented by numerous doctors.  Or venture forth yourself. Ask your doctor for the most “up to date” research (which is a company who compiles research for doctors), get a medical dictionary and reading glasses, and slog through it. You’ll have questions, and getting those answers is the definition of informed consent.

Those feeling braver can venture onto pubmed themselves. Type your condition and the word “Cochrane” to get a listing of the reviews of all the studies regarding your condition. Print them out and write down your questions. If possible, send your questions ahead of you before the next appointment. When in doubt, get a second opinion from another, non-affiliated doctor. Sometimes one doctor will recommend something and another will recommend against it. Make up your own mind and remember that you can never ask a doctor to tell you not to get a test or procedure done. That’s a decision he or she can’t make without medical liability if something happens to you.. You can ask if they would have the procedure done themselves, given your circumstances. That might give you a more truthful answer. In the end, it is your healthcare.

Posted by: Christopher Maloney, Naturopathic Doctor | May 2, 2015

Ebola As A Sexually Transmitted Disease: AIDS Part II?

If you look at the WHO site for Ebola, it’s clear that we’ve known Ebola is transmitted sexually. On the site the WHO recommends: “Men who have recovered from the illness can still spread the virus to their partner through their semen for up to 7 weeks after recovery.” But that information is, unfortunately, wrong. A woman contracted Ebola and died, and the only contact with Ebola was  “sex with an Ebola survivor on March 7, five months after the survivor was discharged from a clinic. Health officials said previous studies showed the virus could be found in the semen of recovering men up to 82 days after the onset of symptoms. But the new finding suggests the virus can persist in seminal fluid for longer than previously recognized, and potentially lead to sexual transmission of the virus.”

So the recommendation is that anyone who has ever contracted Ebola will use contraceptives indefinitely. But we’ve seen how effective that recommendation has been with HIV infection. The same areas that have experienced Ebola are also continuing in crisis with HIV.

For those of us who do not live in Sub-Saharan Africa, Ebola has been only a minor scare. But HIV infection is not aImage result for HIV Africa map distant issue. It’s a very current one. And the most recent generations have grown up thinking of HIV and its associated AIDS as a chronic, controllable infection rather than the death sentence it was when it was first discovered. As a result, we are not seeing the same level of concern and our HIV numbers are not where they should be after decades with the illness.

Image result for HIV over 55 U.S. map

If we are going to treat Ebola as a possible sexually transmitted disease with an indefinite infectious period, then we are looking at a possible repetition of the HIV epidemic.

Image result for AIDs over 65 U.S. map

Posted by: Christopher Maloney, Naturopathic Doctor | April 26, 2015

Does The MIND Diet Prevent Alzheimer’s Disease?

I’m always excited by a breakthrough diet, so I was thrilled by Prevention’s report of a diet that halved the risk of Alzheimer’s Disease. This particular breakthrough is a hybrid of the Mediterranean diet and the DASH diet, both mainstays of modern healthy eating.

According to the Prevention article, even sort of following the MIND diet (which stands for Mediterranean-DASH Intervention for Neurodegenerative Delay, which spells MDIND to me) lowers your risk of Alzheimer’s by a third. That’s great news!

Now we get to the difference between an article selling magazines and an article telling about a study. If you look at the original study abstract, they followed less than a thousand people for less than five years, and they based the findings on a questionnaire.

Not as robust as we’d like, but let’s still look for the MIND Diet: Alzheimer’s Cure book coming to bookstores near you in time for Christmas. Except the original study didn’t say that. It said: “High adherence to all three diets (DASH, Mediterranean, or MIND) may reduce AD risk. Moderate adherence to the MIND diet may also decrease AD risk.” So all three diets help reduce Alzheimer’s Disease risk, but that won’t sell magazines, so we focus on the second sentence that says even moderately following the MIND diet may help.

We’d like to see a larger group of people follow this sort of diet for a longer time, but the reality is that we really have no good treatments for Alzheimer’s Disease. So, in the interest of lowering all of our Alzheimer’s Disease risks, and with a nod to Prevention for supplying the summary, here’s the list of the things you should do to get MINDful with your diet.

salmon

“Perfect MIND dieters eat:

  • At least 3 servings of whole grains a day
  • 6 servings of leafy greens a week plus one other veggie serving a day
  • 2 servings of berries a week
  • 1 serving of fish a week
  • 2 servings of poultry a week
  • 3 servings of legumes a week
  • 5 servings of nuts a week
  • A daily serving of alcohol, preferably red wine for its long list of health benefits
Posted by: Christopher Maloney, Naturopathic Doctor | April 14, 2015

Have You Ever Had Alice In Wonderland Syndrome?

I read a lot of medical literature, and finding Alice In Wonderland Syndrome was a treat. The illness is described as: “bizarre perceptions of size and shapes of a patient’s body and illusions of changes in the forms, dimensions, and motions of objects.”

The total disturbance is described as a metamorphopsia, which can occur from imbalances in the brain. Lewis Carroll (really called Charles Dodgson) is thought to have possibly suffered from these during migraine attacks first documented in 1856. It would be fitting if the author was the first person diagnosed with Alice In Wonderland Syndrome.

More recently, a case of Alice In Wonderland Syndrome has been documented in a child with Lyme disease, which is a disturbing thought as we move into tick season in Maine.

Posted by: Christopher Maloney, Naturopathic Doctor | April 12, 2015

Is the Pineal Gland Really A Third Eye?

It’s rare to find something truly rare and amazing in medical literature. But the idea that researchers could transplant a tadpole pineal gland and have it turn into a normal eye counts as one of the oddest things I’ve read recently. Adding Vitamin A helped it grow, but the idea that a gland could become an eyeball is pretty bizarre. (More here).

When you look farther, the pineal gland is responsible for creating an inner rhythm in the absence of light. That makes it responsible for the basic rhythms of our lives, including our immune responses. Not bad for a little gland that had pretty much been written off as incidental.

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