the symptom called asthma-a case study

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page.crow

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the symptom called asthma-a case study

Recently, a 5-year old girl presented to my office with the symptoms medics call asthma. They call it a disease. The child has been diagnosed with asthma since the age of 1. She has been taking all the asthma drugs, including "rescue inhalers" since age 1. She has had multiple trips to the emergency room to get under an oxygen tent. The drugs never cured the problem. She could not run and play, participate in gymnastics with her friends, or exert herself much at all going into breathing distress. Her mother reported she was anxious and hyperactive following the administration of the asthma drugs.

Physical examination from a chiropractic perspective demonstrated what we call "lock-stress pattern" in the para-musculature of the cervical\thoracic region. That is-her neck and shoulder musculature were chronically hyper-contracted, with never any muscle relief. Her mother reported she stayed tense like this all the time. Deeper study of the spine yielded multiple levels of vertebral subluxation-a condition more easily described as hyper-tight & hyper-stuck in the functionality of the spine.

We began treatment for this child by specifically adjusting (bonesetting) the cervical & thoracic spine at the specific levels that were stuck. Easy and gentle. No drama. No adverse reaction from the child. She loved it. "It felt good" was her comment. We taught the child and her mother how to routinely massage the musculature of the neck\back\shoulders\chest. We taught the mother and child the acupoints to massage that are classical for lung impairment (lung channel: Lu 1, Lu 11, Lu 7, Lu associated point, CV 14 & CV 17). That was it. We repeated this treatment one time per week for the last 4 weeks.

The results have been fantastic. The child was used to daily impairment and crisis. That no longer happens for the first time in this little girl's life. She is breathing normal and her mother took her off all the expensive & addictive drugs. She can run and play with her friends now no problem. She can do gymnastics without having to quit and sit down. She is healing and overcoming the symptom called asthma disease.

BTW: This girl was a referral from another mom & daughter, same age, who had the same problem a few months ago. She got better too. She CURED herself of asthma, got off the drugs, and is now leading a normal drug-free life. She referred this latest child to the office.

If you dive, suffer from the symptoms of asthma, and are concerned the problem can impair or prevent you from diving, try this treatment approach. It works over and over. We do this all the time in this office. It's fun to get the kids and adults off the drugs and healing their breathing problems. It's a kick!

At the same time this is going on, I encountered a 25 year old man that has been doing the asthma drugs since he was a child. 20+ years on many different drugs, never got better, always has breathing crisis, changes drugs as the makers keep changing the forumulas, with the promise that this new drug will work better. They never do. In addition to the asthma drugs, he's been on prednisone for over 20 years for the diagnosis of lupus. Recently, he stepped off a curb hard, and both quads muscules blew out and ripped apart. Body degeneration and failure secondary to chronic drug consumption.

Some divers give up the sport because they are afraid they will run out of air at depth, due to "their asthma". If you have this problem, try the methods I suggested with someone in your own town and see what happens.

I wish you all well fellow divers.

page crow DC
 
Hey DocVikingo:

Before you rip into my post, please validate yourself.

What kind of a doctor are you? I've asked you this several times and you do not answer. Your profile is intentionally blank. Curious.

Regards,
page crow DC
 
(Part 1- the board post length limit made me split the post. Sorry for the length.)

Very interesting claims, Dr. Crow. Worthy of further study, I’d say. But not all would agree with your conclusions, however- not even all chiropractors.

You have said in posts on this board:

page.crow:
Chiropractic has a very narrow scope of practice-the vertebral spine. But since the spinal column influences the nervous system affects EVERY cell in the body, anatomy and physiology, chiropractic has a very full-body effect on structure and function.

page.crow:
"Unsubstantiated assertions based on clinical experience" (docvikingo quote) works for me.

Seeing is believing? I don’t know about you, but I’m not powering my home with a cold fusion generator. The people who claimed that cold fusion worked believed quite fervently in what they saw in their studies. They believed it so fervently that they thought it vitally important to get their findings out to an energy-hungry world as soon as possible and they released their findings to the lay media before their work could be peer-reviewed or published in the scientific literature. Unfortunately for them, once their data was critically examined and attempts were made to duplicate their findings, they turned out to be wrong. They believed so fervently in what they saw that they were totally blinded to the truth. (Of course conspiracy theorists claim that the Big Oil Companies suppressed the truth of cold fusion. Yeah. Uh, huh&#8230:wink: Some people have a tendency to cling tenaciously to the idea of “seeing is believing”. You can see for yourself every day of the world that the Sun circles the Earth. As recently as 1600 true believers in what they saw burned Giordano Bruno at the stake for claiming instead that the Earth orbits the Sun. But unbiased scientific research eventually proved him right. Believing in what you see wasn’t good enough.

You seem to share the view of a subgroup of chiropractors who believe that since the nervous system connects throughout the body, manipulating one part of the nervous system can effect the function of virtually any part of the body. Interesting idea. “Traditional” medicine carried views similar to that for centuries, but in another fashion. That famed physician Hippocrates (460-377 BC) applied the idea of “humours” (various body fluids) to medicine. It was quite clear to him that since fluids (like nerves) pass throughout the body and therefore affect every part of the body, disease must be caused by an imbalance (subluxation?) in those fluids right? It made perfect sense based on the limited knowledge of the time.

So thousands of years ago physicians began to try to “balance” (adjust, manupulate?) those humours through bloodletting, emetics (to cause vomiting), and purges. And darned if it didn’t really work for some illnesses! There is real scientific basis for some of what they did, and physicians still reduce blood volume (although usually by means other than bleeding!) in cases of congestive heart failure, certain blood disorders, etc., still “pump stomachs” in some cases of poisonings, ileus, etc., etc. Those ancient physicians, and their patients, could see with their own eyes that balancing humours worked in some cases, so they came to believe that it must be of benefit in nearly all cases. People came to physicians to get bled or purged and they got well so they kept going back to physicians to keep getting bled and purged and continued getting well for 2000 years. It worked, by golly! Seeing is believing! Those physicians and patients didn’t need no stinkin’ badges of clinical research to prove what they could see with their own eyes. Unsubstantiated assertions based on clinical experience worked for them!

But unfortunately they were wrong. For over 2000 years they were wrong because they simply believed what they saw and didn’t investigate it beyond that.

Those physicians and patients didn’t really appreciate the marvelous capacity of the human body to recover, and they certainly didn’t appreciate the capacity of the human mind to perceive recovery. Sure balancing the humours worked, and even though some of the flawed theory behind humours finally began to drop by the wayside in medieval times the practices associated with balancing the humours continued until enlightened researchers began to question those practices scientifically in the 19th century. “Balancing humours” didn’t really work in near the broad spectrum of disease that it was applied to, and it certainly didn’t work for the reasons that were initially attributed to it. Nearly all of the ideas behind balancing humours were found to be hokum, hogwash, and quackery when it was finally really looked into scientifically.
 
Now I know that you have pooh-poohed scientific research in some of your posts on this board Dr. Crow, but to paraphrase Winston Churchill- scientific research is the worst method of seeking the truth, except all the others that have been tried. People’s perceptions of what they see are easily manipulated by their preconceived notions and outside influences. The goal of modern double-blind, controlled, peer-reviewed, published scientific research is to try to minimize those biases and distortions. In those studies patients are subjected to either the real proposed treatment, or a sham (placebo) treatment to see if there’s a real difference between the two. Neither the researcher nor the patient knows whether the particular person received real or sham treatment so their own personal biases about what they perceive as the effect of treatment are hopefully eliminated. Why is this important? Because a fair percentage of the people who received the sham treatment will get better! The effect of the mind is amazing when it comes to getting well. It’s important to show that more people get better with the “real” treatment than with the sham treatment before saying the “real” treatment really works. Why are studies published (and published with a great deal of detail as to exactly how the study was set-up and run)? So that others can review the data, decide for themselves if the study was well-designed and valid, perhaps try to reproduce the findings in their own study, and use the information if it seems to be good. Why are studies often peer-reviewed prior to publishing? Because errors and preconceived biases can be (intentionally or unintentionally) built into the design of a study. Having a panel of “experts” review studies prior to publication culls out a large number of poorly designed studies that don’t really show what they claim to show. Is the system perfect? No, of course it isn’t- nothing devised by humans will ever be perfect. Is it better than “seeing is believing”? You bet it is!

Now, having started with that rather long introduction, here’s what the published scientific literature is saying about chiropractic and asthma:

In a review of the scientific literature by the Palmer Center for Chiropractic Research the authors concluded, “There is insufficient evidence to support the use of manual therapies for patients with asthma” and they suggested further study. ( http://www.ncbi.nlm.nih.gov/entrez/..._uids=15846609&query_hl=1&itool=pubmed_docsum )

A study by the Canadian Memorial Chiropractic College concludes, “There is currently no evidence to support the use of chiropractic SMT (spinal manipulative therapy) as a primary treatment for asthma or allergy. Based on reported subjective improvement in patients receiving chiropractic care, certain clinical circumstances may warrant a therapeutic trial in patients with asthma. Further properly designed, collaborative research is needed to determine if there is a role for chiropractic SMT in the care of asthma or allergy.” ( http://www.ncbi.nlm.nih.gov/entrez/..._uids=15330012&query_hl=1&itool=pubmed_docsum )

A literature review published in the Journal of Asthma that looked complementary and alternative medicine (CAM) studies (including chiropractic care) stated (in part) “Although CAM therapy is being used in the management of asthma, these 15 studies show a tendency to little or no significant difference between placebo or sham therapy.” ( http://www.ncbi.nlm.nih.gov/entrez/..._uids=15115165&query_hl=1&itool=pubmed_docsum )

A study in the New England Journal of Medicine concluded, “In children with mild or moderate asthma, the addition of chiropractic spinal manipulation to usual medical care provided no benefit.” ( http://www.ncbi.nlm.nih.gov/entrez/...t_uids=9761802&query_hl=1&itool=pubmed_DocSum )
 
A randomized blinded study in Demark showed, “Using the cross-over analysis, no clinically important or statistically significant differences were found between the active and sham chiropractic interventions on any of the main or secondary outcome measures.” ( http://www.ncbi.nlm.nih.gov/entrez/...t_uids=7728627&query_hl=1&itool=pubmed_DocSum )

It’s not really a study, but an article published in the Canadian Medical Assn. Journal titled “’Scientific’ Chiropractors Hope to Improve Status of Chiropractic Within Scientific Community” has some interesting comments. For example, Dr. Nancy Abram, a chiropractor and family physician says in that article that she teaches her chiropractic students, “that chiropractic adjustments might make asthmatic patients feel better because they loosen the muscles in their back. However, she also points out that asthma is an inflammatory disease and spinal adjustments do not treat airway inflammation. ‘I tell my students they can treat an asthmatic’s back, but they should not think they are managing his or her asthma. I see all kinds of asthmatic kids and I adjust their backs and I know it doesn’t cure asthma.’” ( http://www.ncbi.nlm.nih.gov/entrez/...t_uids=7828106&query_hl=1&itool=pubmed_DocSum )

Now here’s a study that you might actually want to quote, Dr. Crow! (But be sure you don’t give its reference because someone might actually read and understand it.) A study written by chiropractors, funded by the Foundation for Chiropractic Education and Research, and published in the Journal of Manipulative and Physiological Therapeutics (which says right on its cover, “Dedicated to the Advancement of Chiropractic Health Care Principles and Practice”- you’ve mentioned this journal as a chiropractic reference to us before) described a randomized, controlled, peer-reviewed study on chiropractic spinal manipulation therapy (SMT) and asthma in kids. Personally, I found the abstract of the article confusing- their conclusions seemed contradictory to their findings. So I pulled the whole article. (Silly me.) They took a group of 30 asthmatic kids, put them all on optimal medical therapy for their asthma, and treated 20 of them with “real” SMT and 10 with “sham” SMT (where the kids and their parents thought they were getting chiropractic care, but really weren’t). All treatments- real and sham- were given by the same chiropractor. In this study, they couldn’t show any real lung function improvement in the kids given the real chiropractic care, and the parents and their doctors didn’t notice any improvement in their daily function, but the kids said that they felt better (their “quality of life” score and the patient-rated “asthma severity” score improved) and they reduced their bronchodilator inhaler use 20%. Launch the fireworks, break out the champagne, chiropractic works!! Ooops, but wait just one minute. The authors of the study said that this was just a “pilot study” and didn’t even report the results for the other kids given “sham” chiropractic- they said that part of the study was just to look at the feasibility of doing further studies (nudge-nudge, wink-wink?) But in their discussion of their findings in the study, the authors (you know, those chiropractors who want to show that chiropractic care works for asthma) made several interesting observations based on their findings. Since they couldn’t show any real improvement in lung function because of SMT they asked, “What then are likely explanations for the patient-rated improvements in quality of life and patient-rated asthma severity?” They answered that “Overall, our study corroborates the findings of (other) studies; collectively the studies suggest that factors other than the specific effects of SMT are contributing to most of the changes in quality of life and patient-rated asthma severity and improvement observed in these studies”. They note that just massaging kids helps sometimes, patient education makes a difference (they spent a substantial amount of time in the study educating the patients and their families about asthma), family support- or even therapy- is important. They go so far as to note that just keeping the daily logs of their asthma that they asked the kids to work on has been shown to improve children’s perception about how they feel and reduce their need for bronchodilator medicine. When they really looked at what they thought they were seeing, these chiropractors did not find that it was the chiropractic spinal manipulation that mattered. (
http://www.ncbi.nlm.nih.gov/entrez/..._uids=11514813&query_hl=2&itool=pubmed_docsum )

I found NO studies that support your claim that chiropractic “really” works for asthma. Even the chiropractic studies suggest it doesn’t “really” work.

But now mind you, I believe you when you say that you perceive improvement in your patients. But the difference between “traditional” and “alternative” medicine is that traditional medicine insists that there be a demonstrable “real” effect (or at least a rational mechanism of action) for their treatments above and beyond the placebo effect. Once a treatment achieves that standard it is (at least eventually) adopted by “traditional” practitioners and becomes traditional. IMHO, the primary problem with traditional practitioners in this day and age is that they are sooo cock-sure that their treatments really work that they too easily dismiss the importance of those other intangible and unmeasurable influences that help people get well. Also IMHO, that’s often where the “alternative” practitioner steps in. They use unproven (and often unprovable) treatments and they (and sometimes their patients) don’t really care if there’s a “real” benefit or not, just so long as it “works”. Personally, I think that it would be better for patients to find a “traditional” practitioner who still remembers how to care for people, or find an “alternative” practitioner who sticks with what “really” works, but alas such is not always the case.

My 2¢ X 3,

Bill
 
page.crow:
Hey DocVikingo:

Before you rip into my post, please validate yourself.

What kind of a doctor are you? I've asked you this several times and you do not answer. Your profile is intentionally blank. Curious.

Regards,
page crow DC


DocV is something of an enigma, isn’t he? He doesn’t say just a whole lot about himself from a personal standpoint, and I’ve often wondered about him myself. How do we even know that he really is a doctor? Heck, how do we even know that he’s really even a Viking? But “validate” himself? You have got to be kidding, Dr. Crow.

People can say anything they want about themselves on the Internet, and it “validates” nothing. For example, while I claim no special qualifications on this board I can tell you that I have an old and yellowing certificate on the wall of my office that says that I was once a Diving Medical Officer- but I also once (jokingly) claimed on this board to be Brad Pitt too. So what? I find it more reliable to “validate” people on the Internet by what they say (and whether they’re willing to back up what they say with verifiable sources), not who they say they are. I don’t always agree with DocVikingo, but I do always respect his opinion. He has shown an incomparable level of knowledge for diving in general and dive travel in particular, and I have always found his general and diving medical knowledge and advice sound and well reasoned. He has published medical articles (under the Doc Vikingo name) in DAN’s “Alert Diver” magazine, in Scuba Diving Magazine, and in Undercurrent. I don’t care if he’s really a plumber- his knowledge base is sound. I personally requires no further “validation” from him, thankyouverymuch, and frankly I really can’t imagine what more you would need.

But why is he so secretive? Why doesn’t he tell us who he really is? You told us who you are, didn’t you? Or did you? How do we know that you’re not really a bitter old girlfriend of Dr. Crow’s or a disgruntled former business partner perpetrating an elaborate ruse to misrepresent the true thoughts of the real Dr. Crow or out to make him look the fool? And let’s look at what a simple Google search shows on this Page Crow, DC. (Before you privacy advocates jump all over me, all of this info is easily obtainable by anyone with an Internet connection and most of the more personal info Dr. Crow made available himself- and I’ll blank out some of the more sensitive stuff.)

Dr. Page Crow has a chiropractic practice at 3713 S Hardy Ave Independence, Missouri 64052 Phone: (816) 254-xxx1

He graduated from Truman High School in Independence, MO in ‘81

He has 2 children- H*****h age 11 and K***c age 9

His father Allen Page Crow worked for Standard Oil for 45 years and retired the year his son Page graduated from high school. Allen Page Crow was born in Shawnee, OK.

Dr. Crow’s father died in Nov. 2001 at age 72.

His mother Barbara died in 1996

He has a brother S*****t and a sister L** who live in Stockton

He has 3 nieces/nephews

He sailed a Prindle 18 catamaran named “Kat”

In October 2000 he attended a Scientology course on “Purification Rundown Procedure”

Shall I go on? There's a lot more. I don’t blame DocV, or anyone else for that matter, for not posting personal information on the Internet. Like you, I use my real name (Brad Pitt) sometimes on the Internet, but the other info that I post about myself is intentionally cryptic. It just makes sense to me.
 
Wow...great post BillP.

I have not seen good evidence for any chiropractic treatment except for low back pain, where its benefits over placebo are small but extant.

What recieves little attention is the very real danger posed by these "therapies". Chiropractic is dangerous for two reasons that I am aware of. One being the direct damage caused by manipulation, especially CVA (a stroke, caused by disloging the plaque lining the arteries of the neck that lead to the brain...this plaque travels to the brain and blocks the flow of blood to an area of the brain) and vertebral a. dissection. The risks of chiropractic adjustment are probably pretty low overall, but as are the potential benefits. The risks posed are more significant when the cervical spine is adjusted as opposed to the lumbar spine.

The second danger being that chiropractic like ear candleing, reflexology, and many other "treatments" tends to dissuade patients from seeking treatment from a physician. Alternative medicine practitioners are causing harm when they tell people not to take their medications or that all medications are bad or to do X instead of going to doctor.

--logos
 
I find the structure of the OP interesting.

Written to read like a medical report, it then goes into an horror-story example of a young person who instead took drugs, and suffered body degradation, presumably from the drugs.

So in reality it reads like an attempt at persuasive propaganda piece instead of a research report.

Not saying there's any falsehood here, not saying there's not. Just noticing the structure.
 
I can't improve on BillP's extensive piece, except to say one thing.

Using anecdotal evidence to try to convince patients to eschew well-studied, traditional medical treatments for a life threatening illness is, in my view, nigh upon unethical.

I use chiropractic care and think it has things to offer. I would never suggest that it can treat cancer, heart disease . . . or asthma. If someone wanted to pursue chiropractic interventions for asthma, I would hope they would do it as an adjunct to, and not in place of a full regimen of well-documented, effective traditional medical care.

Oh, and by the way -- UC Davis BS Math 1980; UC San Francisco Med School with honors 1984; UW Surgery Department residency 1984-1989; Faculty, UW School of Medicine 1989-1993; Emergency Physician 1993 through the present.
 
I'm not an M.D. but I do know a little about immunology...

...and asthma is not a symptom but a condition characterized by a few very similar immunological reactions in the lungs (similar in some respects to an allergic reaction). Bronchodilators (aka rescue inhalers) suppress inflammation within the lungs, thereby restoring lung function. They only treat a very specific problem and would not work if, say, some physical deformity was literally squeezing the pulmonary airways. If a bronchodilator helps, you have an inflammatory lung condition (one of which is asthma). Or you are a hypochondriac with a thing for placebo effects.

If you are using rescue inhalers to no effect and then get a little massage or something and everything is all better, you almost certainly do not and did not have asthma.

That isn't to say massage or something might not help - it seems reasonable to me that some kind of stress- or exercise-induced asthma might be alleviated by a nice relaxing massage or "re-alignment". Of course, in an emergency, I wouldn't give someone a massage without first pumping their lungs full of albuterol.
 
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