Sunday, October 24, 2010

New Improved Blog

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Friday, October 8, 2010

Facts Not Fear For Flu

As winter ends in the southern hemisphere it is worth looking at the winter flu season just passed and see how our friends the “experts” fared this year.

In May we had dire predictions of a “horror” flu season due to the H1N1 virus. These predictions came at around the time that vaccination of children under five was suspended sue to side effects including seizures and the death of a toddler after being vaccinated.

The government continued to promote the importance of being vaccinated against swine flu due to a much-feared “second wave”. Exactly how you can have a second wave when there was no first wave is another question. Of course the government had paid some $AUD140 million for vaccines which were not being used.

The facts speak for themselves. Figures from the Federal Health department shows that between January and the start of September some 417 cases of H1N1 had been notified. Now to be fair there may be many people with a flu like illness where the test to identify the strain is not done so more people likely had the flu.

And therein lies the first key point. This was just another winter like all others-no horror; no second wave just some people getting ill and the vast, vast majority getting better. Every year some people die with the flu (mostly these people have other illness already) and this year was no different.

Despite all the hysteria from health “experts” and the offer of a free vaccine, only 18% of Australians were vaccinated. The two main reasons were that people perceived swine flu as a mild illness and not a serious threat to their health. The other main reason given was concerns about the vaccine itself.

Here the plot thickens. The program to vaccinate children under age five was suspended due to side effects. A significant number had febrile convulsions (seizures) and there was at least one death. The coroners report ultimately found the vaccine might have contributed to the toddler’s death. Proving causation was never going to be possible. The child was well before the vaccination and died after it. We can draw our own conclusions.

And given the number of hospitalizations and issues with this vaccine, what was the main concern of the authorities? That an “important “ vaccination program was being held up. Never mind that more harm than good was being done.

Regular readers will know my views on swine flu, which are on the record from April 2009. This was always a normal flu like illness and there was no need for panic, hysteria and the waste of billions of dollars. Inquires are being held into the behavior of the WHO and conflicts of interest by those giving advice to governments and also advising vaccine makers.

At no time were the public given the truth. At no time was any useful advice about how to strengthen your immune system given. Basic things like drinking enough water, getting enough sleep, managing stress, eating enough fruits and vegetables. Let alone more specific information about having adequate intake of zinc, antioxidant vitamins, folate and vitamin D.

The web of deceit is starting to unravel. A major analysis published in the journal Eurosurveillance shows the flu vaccine caused more harm than good. For every hospital admission prevented there were two or three hospital admissions due to seizures.

Yet the response of the “experts” remains the same. According to the Australian TGA “the overall risk-benefit balance …remains positive” and the chief medical officer feels that the vaccine should not be withdrawn but that the government would reassess.

There is no point relying on so-called experts or the government. There is no need to get caught up in hysteria. The best way to stay healthy and keep your children healthy is to be in charge of your own health.

Friday, October 1, 2010

Reliance On Drugs HasA Human And Economic Cost

When too many of us take too many drugs, there are consequences. These are both economic and human. The solution is to use drugs judiciously and not as a replacement for being responsible for what we put in our mouths.

Human inventions are not intrinsically good or bad. It is how they are used which determines this. For example a knife is useful to cut your food but can also be used to stab someone. Fire can warm us on a cold night but has the potential to burn the house down if not used correctly.

And so it is with pharmaceutical agents. They have the capacity to do enormous good when used correctly. However when misused or used inappropriately or when they are not really needed problems can and do occur.

Figures from the USA show that almost one in two Americans take at least one prescription drug per month, an increase of 10% over ten years. A staggering one in five children 11 years and younger were in the same boat. Spending on prescription drugs more than doubled to USD 234 billion over the decade to 2008.

Amongst the commoner medications used were those for cholesterol and depression in adults and for ADHD in adolescents.

British researchers have previously noted that 7% of NHS spending on drugs went on drugs for diabetes. Between 2000 and 2008 the number of prescriptions had risen 50% but costs had risen 104%. This reflects use of newer and more expensive (but not always better) medications. One of these is rosiglitazone.

The fundamental question that never gets asked is whether the best way to manage a problem is with medication? The second question which also is rarely asked is what other consequences might occur if medications are used?

We have just seen the withdrawal of diabetes drug rosiglitazone (Avandia) from sale in Europe and severe restrictions on its use in the USA. A report in the British Medical Journal (BMJ) had earlier called for the drugs withdrawal and questioned whether its use should ever have been approved.

The drug has been shown to lead to an increase in rates of heart attack and strokes in people taking the drug compared to those not. In 2007 a study showed a 43% increased risk of heart attack.

John Yudkin of University College London said in the BMJ “We need to be absolutely certain that our long term treatments for type 2 diabetes are not causing the very harm they are meant to prevent”.

Type 2 diabetes comes about predominantly from people eating too much processed and sugary foods, being obese and not exercising. Logic would dictate that the primary treatments would be correcting what led to the problem. Some people may still end up needing drugs but it would be far fewer and they may not need drugs as potent (or costly) as rosigltizone.

It has also emerged that another diabetes drug, pioglitazone (Actos) is being investigated as it may increase the risk of bladder cancer. It has also been shown that bisphosphonate drugs used for osteoporosis can double the rate of esophageal cancer.

None of this is to say that there is not a role for drugs. However when we are dealing with conditions that come about from lifestyle choices we make, reliance on drugs in preference to making the necessary lifestyle changes are not without other consequences. These examples show that just “popping a pill” may seem an easy option but may not be.

Friday, September 24, 2010

We Need More Fun Not More Fun Police

The stupidity of government never ceases to amaze me. So far this year we have seen one local government wanting to charge people to exercise in its parks and a councilor in another claim that the City to Surf race should be “run somewhere else” (rather than to the beach).

Now just in time for summer we have Cottesloe council proposing a new raft of laws to make a day at the beach as much fun as a day listening to the thoughts of councilors. As usual this is all done in the name of making the beach safer and claims to be targeting “bad behavior”.

So what sort of dastardly crimes do the law abiding beach goers of Perth need to be protected from?

A few of the activities to be outlawed are digging holes (which are too big), flying a kite, taking photographs, playing with toy vehicles and having a gathering of more than ten people.

Just who will determine when a hole is too big? Will wee see rangers with tape measures deciding whether the hole dug by a five year old meets council standards. And too bad if your family has more than ten members, or if you have a group if friends, who you like to go to the beach with. And naturally any child caught bringing a toy car to the beach will rightly have it confiscated.

Ultimately this is all about petty bureaucrats and small-minded councilors trying to decide what people can do at the beach and raise some revenue into the bargain. The excuse is that the propose laws are in response to incidents. Even if there have been isolated incidents of “problems” due to a kite is banning flying kites for everyone the answer?

Of course not!

The increasing attempts by petty officials and small minded politicians at all levels of government to control each aspect of peoples lives needs to be stopped. Already a protest is being planned for Cottesloe Beach and a facebook group ha started. There are signs that due to the publicity the council is already backing away and is trying to blame some junior official for “misunderstandings”.

Fun and purpose is one of the pillars of DIY health. Petty laws which make it almost impossible to have fun at the beach without tripping over some ridiculous by-law is actually bad for the health of the community.

We need to have more fun, not engage more fun police.

There are enough laws to deal with antisocial behavior by the few. Infringing the rights of the majority with petty, stupid laws which seek to restrict and codify every possible use of the beach is an attempt by the totally humorless to inflict their view of the world on those who want to have fun. It is also a lazy way for governments to try and stamp out the behavior of a few by penalizing the many.

Freedom is one of those intangibles that we can take for granted until it is gone and you wake up one day to find you cannot play with your children at the beach. Health and freedom are related. Attacks on freedom need to be resisted.

Friday, September 17, 2010

Low Libido Can Be An Issue But Is Not A Disease

The knockback by the FDA of a new drug for female sexual desire again casts a spotlight on the medicalization of life. The drug was knocked back for the simple reason that it had not been found to actually work

Interestingly the comparison is made with drugs like Viagra (sildenafil), of which there are three on the market. Some have claimed that it is discrimination that drugs are made for men whilst women do not have any. Others question the existence of what is described as hypoactive sexual desire disorder.

So lets look at the facts. Tablets such as sildenalil do not actually stimulate desire for sex (libido) in males. They relax blood vessels allowing increased blood flow to the penis. This only happens if a man is actually in the mood or has been stimulated. The tablet does not affect libido.

Hence calling the new drugs a “female Viagra” is wrong as the proposed new drug is designed to work on the brain and affect libido not work on the blood vessels once desire is already established.

The other key issue is whether a low interest in sex is a disease. The fact that it exists does not make it a disease nor does it mean there is something “wrong” with women (or men) who may have a lower interest in sex than others. It becomes a problem it troubles the individual or is a problem in a relationship.

A problem can be real but not every problem is a disease and hence the answer is not necessarily a drug and may lie elsewhere. Worse still, labeling it as a disease, and looking for a drug as the answer, distracts people from the real cause and hence the real solution.

Sexual desire is influenced by a large number of things. Keep in mind that humans are almost unique in nature in that they have sex other than purely for reproduction of the species. Furthermore what constitutes “normal” is impossible to define. Whilst countless surveys are done to determine how often people have sex and their level of interest, all of these studies rely on self reporting and hence people may report what they want to rather than what they do.

Libido is influenced by tiredness, stress, diet, fitness levels, hormones and our emotions to name just a few. Obesity alone has a major impact on people’s sex lives. Obviously how a relationship is going to have a major influence too. At times other issues in life take precedence. When people are focused on work or on raising children, interest in sex can take a back seat. When people reach bed and are exhausted and really ready to sleep it is not surprising that they do not feel like having sex.

There is at times a clash between the mind which says, “we ought to be having sex” and the body which has not got the energy. As a society we also have very mixed attitudes to sex. Bar maids have been arrested for showing a glimpse of nipple yet half the videos watched don the Internet are pornographic. We express concern about teenagers having sex and yet bombard them with sexualized images. Marketers have known from day one that sex sells.

So what are we to do? A low interest in sex is only a problem if it bothers you. If it does then you need to realistically examine what is going on in your life. It may be that you need to change your eating patterns, or get fitter. It may be that you need to get more sleep. It may be that your relationship needs tending. Maybe you need some injection of romance. It may be that at present other things in your life are actually more important.

There is no absolute right or wrong. What matters is honest with yourself (and your spouse/partner) and making changes if you need and want to. Turning aspects of life into a disease and taking a pill is not the solution.

Friday, September 10, 2010

Women Are Smarter Than Governments And Health Experts

When messages get confusing, people switch off. This has been demonstrated in dietary advice, where it has been shown that the more complicated the diet; the less likely people are to follow it. It has now been shown that official government guidelines on drinking alcohol have little impact on the behavior of expectant mothers.

A study in the Medical Journal of Australia shows that 80% of Australian women consume alcohol while pregnant. The study looked at consumption before and after changes in guidelines in 2001. Prior to 2001, the government recommendation was to drink no alcohol during pregnancy. This was changed to a safe limit of 6 standard drinks per week or less than 2 per day. In 2009, the guidelines were changed back to total abstinence.

What has been shown is that the behavior of women during this time was unchanged. Some 60% of women consume a small amount of alcohol (consistent with the 2001 guidelines), 20% drink less than that and a little fewer than 20% don’t drink at all during pregnancy. Less than 1% were found to consume a level regarded as dangerous.

Much effort and expense goes into developing guidelines. Governments and health experts often wring their hands about people not following their advice

What is really interesting in these figures is that the vast majority (over 99%) of women can figure out what is reasonable themselves. The vast majority of women can work out what is a reasonable and safe amount of alcohol to drink. They are clearly dismissive of scare campaigns about the dangers of even one drink. The reason for this of course is that small amounts of alcohol have not actually been shown to do any damage to the fetus. In turn, the reason for this is that small amounts of alcohol are easily processed by the body ,with no adverse effects.

There are of course, renewed arguments over labeling of alcoholic beverages. Governments and in particular, public health officials, love to be seen as doing something and they particularly love to hector the general public who they generally regard as being stupid. This survey shows that women are actually much smarter than government guidelines and health officials.

Interestingly, at about the same time, another study emerged which suggested that women who drank one glass of wine a day might have children who were better behaved than those who either drank no alcohol or drank heavily. To be honest, I would be very suspicious of these findings. There is no reason why one glass of wine consumed during pregnancy should influence the behavior of a child later in life.

What was really interesting though is that the researchers, despite making this finding, advised women to continue to observe Government recommendations of total abstinence. If the finding is valid, then you think they would be advising one glass of wine per day. If this finding is not valid, then why has it been published at all?

It is easy to imaging the noise that would have been generated had the study shown that one glass of wine per day led to worse behavior in children. This would be hailed as vindication of Government guidelines.

Whilst many in health claim to be guided by science, it is fascinating to see how when the results of their science contradicts their pre-existing beliefs that results can be dismissed.

Rather than being guided by confusing and changing guidelines, clearly women are best guided by their own intuition.

Tuesday, September 7, 2010

Drug Usage Is Not Black And White

The airing of the Ben Cousins story recently has certainly fired up passions. It seems everyone has an opinion and so do I. Interestingly within the next week we saw more drug related headlines from another AFL player, Travis Tuck and actor Matthew Newton. Drug problems are not uncommon.

Ben Cousins has been a champion footballer in the Australian Football League (AFL) but his story could equally apply to a baseball, soccer or rugby or basketball player. It is the story of a kid who was thrust into the limelight at a young age and went off the rails and got into drugs. The television documentary followed the path of his journey through rehabilitation.

To be honest there was not a whole lot new revealed in the program. Most of the events had been reported in the media previously. However candid interviews with his family and his father in particular were revealing. In addition Cousins himself was straight up about his addiction.

There has been much debate as to whether the program sent the “right” or “wrong” message about drug use. Did it glamorize the use of drugs or show the downside. Good questions but they miss the point.

The documentary was about the journey of Ben Cousins. It was showing what happened to him. It was not about a message –it was a story. Rightly or wrongly this is a man who managed to combine a successful sports career with ongoing use of illegal substances. This happened under the noses of his club and the officiating league.

During this time he won the Brownlow medal (for fairest and best in the competition) and played in two grand finals. He managed to slip through various tests for substances and despite drug problems being an “open secret” in his hometown somehow nobody at the club seemed to notice. It is fair to say that drug users are good at deception. It is also fair to say that sporting teams do not want to know things about star players that might rock the boat.

This is the key point and it applies across the board. For as long as you are “useful” your indiscretions will be overlooked or excused. Here was a popular and extremely good player at a club looking for (and winning) a premiership. So long as he did his “day job” and kept his drug use discreet, neither the club the league or the fans really want to know. As soon as he ceased to be discreet and the issue was played out in public then there was outrage sacking and hand wringing over the game being brought into “disrepute”.

Much elite sport is played by men aged 18 to 30.This is the same demographic which has the highest levels of drug alcohol and violence related problems. Give some of these young men large salaries, lots of spare time and “hero” status because they can throw or kick leather around a park and you are inviting trouble. When it arrives everyone acts surprised. What is really surprising is that there are not more young sports people going off the rails.

Ultimately the outrage over Ben Cousins is not that he used drugs and “got away with it”. It is that he has dared to state this publically. The reality is that not all drug users are in the gutter, they live among us and we do not recognize them because they do not fit stereotypes. The notion of addiction, which is promoted by governments and health authorities, applies to a small percentage of users. Disturb this image and you get the sort of response Ben Cousins got.

Drug usage is not as black and white as health authorities and governments like to portray it. Some people go quickly downhill. Others function “normally in society. Some use often, some occasionally. Young people are not scared by horror stories because they see a different spectrum of reality day to day.

Honesty rather than lecturing would be far more productive.

Use of illicit drugs can and does destroy lives. So too at times does use of prescription drugs-witness Heath Ledger and Michael Jackson. Rather than demonize people perhaps we need to understand what drives them to make these choices. It is through this type of understanding rather than making the drug the problem that we may be actually able to advance our capacity to help people heal and regain their health and their lives.

Saturday, September 4, 2010

Tales From The City To Surf

The City to Surf run saw over 40,000 participants this year in Perth. I did the 12km run from the City for the first time and was pretty pleased with my effort. Yes with a bit more training I could have sliced a few minutes off the time but the aim is participation and completion. Next year I can aim to beat this year’s time.

Running along there were a number of interesting things to observe. The first and most obvious is that such a large number of people get involved in the run on a Sunday morning and that there is a genuine community feel about it. Authorities often get worried when large numbers of people gather yet here was a huge gathering and no problems whatsoever.

There were people of all shapes sizes and ages. From babies being pushed in prams through to people in their 70’s.Everyone is out to do their best and enjoy the journey. Whilst there are a handful of “professional “ runners at the front the vast majority are people who are running for fitness and enjoyment.

There were a few “casualties” along the way. Not surprisingly these were more towards the end of the run. A few people had pushed themselves a bit too hard and needed to lie down at the side of the road. Some needed assistance from first aid workers.

Little things also caught my eye. A child was holding a sign which read” Go Pop” around the half way mark. A woman had brought a chair and was sitting on the grass watching the runners go by. This is a different form of entertainment no doubt.

Near the base of the second major hill (just near the half way mark) there was a pleasant surprise. A group of people from one of the sponsors was offering high fives to runners going by and had placards with encouraging words. I must say that this was really good. Knowing that a steep hill was looming and getting to that half waypoint where energy and motivation can sag a bit, this sort of encouragement gave me a lift. So a big thanks to the Westpac Bank crew in their red T-shirts.

Much is made of the cost of these events and the disruption. Yes there were many policemen on patrol at closed roads. To be honest this is a better use of their time than standing around with speed radar guns on dual carriageways catching people doing 5kph over the limit (no I have not been caught). This is actually police work which supports the community.

And yes there is some disruption to traffic. Roads are closed and people have to find alternate routes. Given the large amount of warning time in advance this is hardly an issue. Part of the proceeds from the run goes to charity too.

So the councilor who wondered why the run could not be done somewhere else will be pleased no doubt to find the world still spinning.

A large number of people had a run on a Sunday morning, getting some fresh air sunshine and exercise together with a sense of purpose and in many instances connecting with other people too. All of us have covered four pillars of DIY health in one outing. If you then add the fact that everyone was kept hydrated through the event and will sleep well tonight we are up to six.

Not bad for a Sunday morning.

Tuesday, August 24, 2010

Dealing With Stress

It is easy to get caught up in what goes on around us day to day and see problems as bigger than what they may actually be. Everything looks bigger from close up and smaller if looked at from a distance.

I have been thinking about this in relation to the issues, which seem to have gotten people “fired up” in Australia (particularly during the election) but in general too compared to what is going on in other parts of the world.

Currently in Pakistan there are 20 million people affected by flooding. Many of these people have lost their homes, their livelihoods and in some cases family members. This figure is close to the entire Australian population and is around 15 times the number of people affected in New Orleans by Hurricane Katrina.

Maybe it is because Pakistan is far away or maybe because it is not seen as “important” but news of this is usually in the middle of the papers with the exploits of sports people or other celebrity indiscretions getting onto page one. The media by and large reflects rather than dictates the mood of the people so this does tell us something about what we see as important.

I was staggered to read (in the Economist Aug 14) that in the last four years there has been 28000 deaths in Mexico associated with drug cartels. Most of these people were murdered. This is nearly 25 times the annual road toll in Australia. All of these people no doubt had families who are affected by this and I am certain the vast majority were young people.

Meanwhile back home the issue, which the Greens are most fired up about, is Gay Marriage. Now to be honest I do not have a strong view either way-it does not affect me. If people love each other then a piece of paper will not strengthen that and if they do not neither will it make them do so. The world will keep turning. Married or not their life will continue.

Many other issues are also given life and death seriousness when in reality they are just about peoples opinions.

Much is made about the increase in mental illness in western countries. It seems increasingly that much of this is worry reclassified as an illness. We are fortunate to have enough to eat and roofs over our heads and by any historic measure, a high level of safety.

This gives us the time to get stressed over who will win the football, or the election. We have time to shop and then stress about paying the credit card bill. We can build a bigger house and stress over interest rates. We have time to get involved in the lives of celebrities whose activities we follow closely and then pontificate on.

Many are whipped up into fear by the latest pronouncement of doom and gloom by some academic who wants more “funding” for their next project. Tales of individuals who are aggrieved over something not going their way also ignite passions and lead people to feel stressed.

Whilst it is true that for each person, that which affects them most, seems the most important, the stress we feel is a product of our mind rather than our circumstances. It is our reaction to events and not events themselves, which are the cause of stress. In western society much of the “stress” we feel is a product of our expectations not being met. The problem is not reality it is our expectations.

In turn we are 100% responsible for our expectations as well as our response to the reality we find ourselves in. This means we have the capacity to change how we respond. It is entirely normal to want things to be “better” and work towards this. Your starting point must be an acceptance of how things are right now. It is only from there that you can go forward.

So rather than stressing or seeking to blame something or someone for any problems you face start with accepting your situation. Then look for a solution and implement it. Sometimes this solution will be to walk away. Always it will involve a choice.

If you want things to be other than they are you will need to do things differently to how you have done them

Tuesday, August 17, 2010

Politics Or Entertainment

“There’s only two types of people in this world- The ones that entertain and the ones that observe”
Opening line from Circus by Britney Spears

The Australian election campaign has really shown the truth of these words. In a complete policy vacuum where stage-managed appearances and scripted lines are the norm one bright light has actually stood out for entertainment and indeed thought provoking comment

That is Mark Latham, the former Labour leader turned commentator and part time journalist. Clearly he is in the category of those who entertain. His appearances and words have been as widely reported as those of the two “leaders”. The difference is that Latham is actually genuine. You may not like him or agree with him. You may even feel that his views are colored by spite or other emotion. However what he says he actually believes and he has a unique perspective having played the game of politics.

What is most fascinating is the reaction he generates. Journalists and politicians are “outraged”. His meeting with Julia Gillard was big news. Why? He is entitled to ask the Prime minister a question as a citizen and even more so wearing his “journalist” hat. There was absolutely nothing untoward in this other than he beat the Canberra press gallery at its own game.

Meanwhile his meeting with opposition leader Tiny Abbott was a media event in itself. On Sky news the studio was eagerly anticipating the live “cross” to Latham meeting Abbott. When it happened the camera was on Latham the whole time. So who is actually running for prime minister?

And so what is really aggravating the politicians and journalists is that because he knows the game from the inside he is able to give out trade secrets. When Latham talks about how media events are set up he knows this from personal experience. When he talks about leaks to senior Canberra journalists he also knows from personal experience.

Apparently 1.3 million Australians watched his piece on 60 minutes where at the end he stated that he would not fill in the ballot paper and urged others to do the same. This is the ultimate in not playing the game.

Not surprisingly the media has gone into hyper drive. I have heard more about Latham’s no vote line than about Julia Gillard’s policy launch today. The camps split into two. Those who were suitably “outraged” and those, who were entertained.

It says a lot about this election campaign and the games that are played, that the musings of a former politician can get so much traction. The simple reason for this is that Latham is entertaining. But that by itself may not gather so much attention. The ability to entertain coupled with insights into the political games by a former insider is a potent mix.

Like him or not Latham has nothing to lose by being honest. He is no longer part of the “ game”. Regardless his motives for telling it like it is, he is doing it. Those whose livelihoods depend on the game continuing as is are of course threatened.

In a dull colorless and boring campaign where the focus of each party is not on what they offer the country but to attack the other, the appearances of Mark Latham have been a breath of fresh air. He is a man who has come over from the “dark side” and is now shining a light on political spin.

It is a positive reflection on how fortunate we are to live in Australia that there is so little interest in who governs it and that it probably makes very little difference.

As for his idea on not filling out the ballot paper- it is an idea worth considering.

Friday, August 13, 2010

Pandemic Ends And The Sky Has Not Fallen

A firecracker goes off with a bang, loud noise and bright light. When it fades such there is no more noise and the last bit of light disappears almost imperceptibly. Then there is nothing again but sky.

The swine flu has run a similar path. It arrived with a bang and lots of noise. This week it faded with the “official” announcement by the WHO that the pandemic has ended. The disappearance was like the firework going out, hardly noticeable. And we are left with sky, which despite the hysterical claims by health officials did not fall.

The whole issue of swine flu has been badly mismanaged from day one. The closing of schools for a week because a child had a sore throat runny nose and a cough was the first obvious sign that a massive over reaction was happening. Other than appearing in Mexico and getting a fancy name, this was always flu like any other flu. Every year some people get the flu and some die with it.

Yet we have witnessed a full scale health scare, which has wasted billions of taxpayer dollars. Governments on the advice of “experts” ordered millions of vaccines and stockpiled anti viral drugs. The vast majority of these were not used, despite advertising campaigns urging people to be vaccinated. Pharmaceutical manufacturers made significant profits.

As it turned out last year was no different to any other year with regards flu In fact not only was swine flu no more serious than any other strain, in most instances the illness was milder. There were fewer cases and less deaths than usual in the southern winter of 2009 and northern winter of 2010.

Some will defend the authorities on the basis of caution in the face of the unknown. This argument falls down, as flu is known. This was just another strain.

The reason most of the vaccines were not used is that most people very sensibly did not want a rushed out and inadequately tested vaccine against a mild illness. It turned out that those who had previous flu shots were more likely to get reactions to the new one. Worse still there has been a high rate of febrile convulsions in children under five having the flu shot this year leading the Australian government to (belatedly) suspend the use of it in this age group. This was after one child died and dozens more were hospitalized after having the vaccine.

Two weeks later this became public and the main concern of health authorities was not that children had been harmed or exposed needlessly to potential harm but that “an important vaccine program” was being disrupted. A report into how this was handled has called for sweeping changes.

There is another sleeper in all this. Serious questions have been raised in Europe and the USA about conflicts of interest with those advising governments also having ties to vaccine manufacturers. The European Commission has called hearings to investigate this. A New York Times article reported over 60% of advisers to the CDC had potential conflicts of interest including being paid by vaccine makers. In Australia questions have been raised about how close the government is to certain vaccine makers.

The fact that swine flu has been a non-event was largely foreseeable. The waste of taxpayers’ dollars and whipping up of fear in the community is not acceptable. I do not see that anyone is being held accountable. At no time did any “official” provide useful information to the public about what they can do to support their own immune system. The only answers to the “problem” were a vaccine, which was not needed, or an anti viral drug, which does not even work.

I wrote about this on May 28 2009 (and subsequently) and have consistently said that this issue has been mismanaged and that there was never any need for fear, panic or waste of billions of dollars. The public response in ignoring calls for needless vaccination and panic has been far superior to the so called ‘experts” who have been running around with the self importance and attention seeking behavior of Chicken Little.

The reality is that the sky was never going to fall. The firework of swine flu has now faded and the sky remains where it always was.

Sunday, August 8, 2010

Australian Election - Leadership Goes AWOL

“And so my fellow Americans, ask not what you country can do for you; ask what you can do for your country” - John F. Kennedy

The late American President said these words half a century ago. The same principle applies in almost any country and its validity has not changed. It certainly should apply in Australia in 2010.

But it does not. Why attitudes have changed so much in 50 years so that today people ask what can the government do for me (or my interest group)? Australia is in the middle of what is the worst election campaign I have seen in my life. The two parties and “leaders” are battling it out to see who can offend the least number of interest groups and offer the “most “ in government largesse.

The aim is to be the government, which offers to do most for you whilst expecting the least is done by you. This is fuelled by an ever-increasing number of lobbies and special interest groups all of who could do a great job if only they had the right amount of funding.

This week the mental health lobby came out swinging on how mental health had been ignored and needed more funding. No mention was made of how this lobby (in my opinion) artificially increases the numbers of people with mental health illness by reclassifying everyone who may have a bit of stress or a bad hair day as having some form of illness.

We are also told health is “underfunded” in a variety of ways. More funding is needed for hospital beds, and for a plethora of “programs”. General practice too is “underfunded”.

Environmental groups, and education groups also need funding. The list goes on. In fact it is hard to think of an interest group, which does not have its hand out for more money whilst claiming the end of the world if they are not adequately “funded”.

Nowhere in this is there any suggestion of people needing to be responsible for their own actions. Nowhere is there any suggestion that answer may lie somewhere other than government funding. Nowhere is it pointed out that the world will keep spinning very nicely even if various interest and lobby groups do not get as much “funding” as they feel entitled to.

Politicians and governments have reached the point of being seen as our “parents” and we behave like children looking to them for protection and provision. The idea of John F. Kennedy that it is up to citizens to contribute rather than take has vanished.

And that is a problem. Put simply government generates no money other than that which it takes in taxes. Government money is our own money funneled back in various ways, minus what gets used up on bureaucracy. Calls for “funding” are people saying, no one will actually pay for the goods or services I have to offer so we will get you to pay via government redistributing money from you to us.

In health the solution is not funding or more hospital beds or more aged care beds. This makes, as much sense as saying the way to stop cars breaking down is to build more repair shops regardless the fact that the reason the cars are breaking down is due to people not looking after their cars.

The solution is people being responsible for their own health. Rather than ask for “funding” for gastric banding surgery, eat proper food instead of manufactured and processed food, and do regular exercise.

Rather than seek more funding for diabetes treatment how about not developing it? Again via eating real food and not overeating. Rather than seek more “funding” for mental health how about accepting that life is not always a bed of roses and not turning every emotion into a disease.

Government is not the solution and will never be. If anything government policies are more part of the problem. Politicians love to be seen as saviors and encourage people to believe they are helpless and in need of the “saving” hand of government. So we get promises to “fix” health (what your government can do for you) rather than the truth, which is that the individual is responsible (what you can do for your country).

Real leaders would say that the solution is not to “fund” more beds but to reduce demand for beds. The solution is not more disease care funding but people being responsible for their health.

In this woeful campaign between two “leaders “ who are followers of focus groups and not leaders in any sense of the word, do not expect the truth of John F. Kennedy’s words to get an airing.

As an individual you can rise above this by simply being responsible for what you do and hence “detaching” from the teat of government.

Tuesday, August 3, 2010

Who Really Profits From Disease?

Every so often you suddenly see things, which taken together are another part of the jigsaw.

So it was that within the space of 24 hours I read about a grill in Arizona called the Heart Attack Grill, which claims to serve the worlds unhealthiest food and about calls for more gastric banding surgery to treat obesity.

The Heart Attack Grill “prides itself” on offering unhealthy high calorie foods with names like flat liner fries and the quadruple bypass burger. The place is decked out like a hospital and the waitresses wear skimpy nurses uniforms. There is even a wheelchair to wheel you back out to the car.

Interestingly the sign on the door says “Caution this establishment is bad for your health”. You can not be more blatant than that. Anyone who goes in knows what is on offer. Over 90% of diners are tourists. This shows that people do not eat there regularly.

With no advertising the grill has generated huge publicity on the backs of the, predictable, calls for it to be closed down. Apparently the owner has plans for more. Nurses, doctors and other members of the health lobby have picketed the grill, which has been accused of profiting from obesity, heart disease and diabetes.


The other item was the call by Associate Professor John Dixon, the head of obesity research unit at Melbourne’s Monash University for bariatric surgery to be standard treatment for people with a Body Mass Index (BMI) of over 40 and for those with a BMI over 35 with diabetes.

He claimed that General Practitioners (primary care physicians) should refer more people for surgery and not pursue lifestyle measures or be deterred by the 12% re operation rate. He failed to mention the longer term complications such as fractures and kidney stones.

He did declare that he had consulted for several companies with interests in bariatric surgery.

So who is actually profiting from obesity, diabetes and the like? A grill selling clearly labeled foods to people who would see a visit to such a place as a one off fun night out or the people pushing surgery and drugs which they are paid to do or prescribe, in preference to obvious lifestyle measures which they are not earn money from?

Pharmaceutical companies also profit handsomely from diabetes. The drug Avandia has generated billions in sales yet it now has been shown that those taking the drug for diabetes have higher rates of heart attacks then those not on the drug.

So not only does the company and other parts of the medical establishment profit from the treatment of diabetes it may well further profit from the treatment of problems caused by the initial treatment.

This adds to the already expensive “disease care” costs facing western societies.

So in actual fact it is the medical industrial complex which profits from obesity, diabetes and other lifestyle related conditions, rather than an over the top grill. This is never more clearly demonstrated than in the call of the Monash Professor, who is paid to consult for companies with “interests in surgery” and pushes expensive surgery in preference to inexpensive dietary change and exercise.

Things are not always as they seem.

Friday, July 30, 2010

Inventing Disease

With the huge amount of research that surfaces each day, it is not surprising that the quality varies considerably. Sometimes, you actually have to wonder whether the researchers are having a joke at our expense. Dubious research coupled with the tendency to disease mongering and the creation of new conditions can lead to hilarious outcomes.

If this story had appeared on April first, it could easily be dismissed as an April fool joke. However, as it appeared at the end of June, it seems these researchers take themselves seriously. With straight faces, they warned that Australian teenagers are becoming text addicts and in turn, risk a “range of serious mental and physical disorders from depression to repetitive thumb syndrome”.

To help legitimize this nonsense, new terms have been created. “Textaphrenia” is defined as hearing texts arrive when they haven’t and constantly checking to see if a message has arrived. “Textity “is the anxiety felt when they haven’t received a text or are unable to send texts. Post traumatic text disorder are injuries that occur when texting such as walking into things and feeling depressed when people don’t contact them. Binge texting is sending lots of texts. One can only wonder who pays for this sort of research.

This sort of research can be easily dismissed as absolute nonsense. Clearly, texting, which is a relatively new phenomenon by human existence standards, can, like anything, can be taken to extremes by some individuals if they chose to do so. There is no disease entity involved in this. Unfortunately, creating terms like the ones above, allow people to make excuses for their behavior. One wonders if somebody crashes their car while texting will be able to claim that they were suffering from one of these text related conditions and offer that as an excuse.

Furthermore, it continues the trend to medicalise human behavior. Texting is a form of communication. In exactly the same way some people talk more than others, some people will send more texts than others. Some people have brown eyes and some have blue. None of these represent abnormalities or disease processes. Some people will over do activities be it texting, eating, drinking or any other form of human past time.

The solution to this is not to create fancy new medical terms and pseudo diseases. The answer will certainly not be in developing medications to control these non-existent diseases. The continued medicalisation of life is an invitation to people to not be responsible for their actions. The solution is in fact for people to take ownership of their behavior. If they send too many texts, then the simple solution is to send less. If you walk into walls while texting, then the solution is to look where you are going if you are not able to multitask.

Life can be actually fairly simple when researchers are not involved.

Sunday, July 11, 2010

Spending On Disease Does Not have to Keep Rising

You would need to be living under a rock not to know that health (disease) care spending is continuing to increase. The total spending in the OECD is increasing faster than economic growth and inflation in the OECD.

The USA spends the most at around 16% of GDP nearly double the OECD average of 8.3%. This average has gone up from 7.3% in the 1990s . Governments are generally responsible for half or more of this spending. Virtually all the focus at a government level is on how are we going to pay for more disease care in the future.

A different question would be how can we keep healthy so as not to have to spend so much. There are two aspects to this. The first and (dare I say obvious) one is people actually being healthier. With three quarters of spending on “health” being spent on preventable lifestyle related conditions there is plenty of scope . For example 80% of cases of stroke come about in people who are overweight or eat poor diets, smoke or do not exercise. Strokes are extremely costly both in dollar and human terms

There is another aspect as well. One of the big costs in the system is pharmaceuticals particularly those which are “lifelong” treatments. You would think that there would be a interest in making sure that the money was well spent and that there was value, once again, both in dollar and human terms.

Statin drugs, which are used to lower cholesterol, generate billions of dollars in sales on the basis of reducing heart disease. Yet there has never actually been any evidence, which shows that cholesterol in the bloodstream is the problem.

Furthermore there has been a trend to place more and more people on these drugs as a form of “prevention”. Yet a major analysis has shown that for people without heart disease there is no decrease in mortality in those with risk factors who take a statin. Fully three quarters of the people taking these tablets are in this group.

Basically millions of people are taking an expensive drug, which is not actually doing them any good. Questions have also emerged about a study in 2008, which showed benefit from one statin in reducing heart disease given that nine other trials found no such benefit. These focus on the independence of the researchers.

Meanwhile an expensive diabetes drug (Avandia) is under question due to evidence that those taking it had higher rates of heart attacks and strokes than those not taking it. These two conditions are more common in diabetics and one of the aims of managing diabetes is to reduce these conditions. Again you would think that this would raise alarm bells in medical and government circles.

There are more and more examples of this emerging with long term drug use. Medications are trialed over short time periods and then used over long periods. Problems not apparent after two years might become apparent after ten years.

Our reliance on pills is costing us in both dollar and human terms. Every person taking a tablet they do not need is risking side effects for no benefit not to mention enduring cost to their hip pocket. Every time a use for a pharmaceutical is widened to capture more people being in a “risk” group the more this cost increases.

It is time we rejected unnecessary use of pharmaceuticals and were far more questioning of the cost benefit equation in the ones we do use.

Friday, July 2, 2010

Facebook and Bikinis

Facebook is an interesting beast. Over the last year or so I have grown to over 1000 friends some of whom I actually know, most of whom I do not know personally and some of whom I have actually got to know which has been great.

The other interesting thing as the number of friends grows is the invitations to events, causes, groups and pages. The range of these is incredibly diverse. In turn it got me thinking, what does publicly joining a group, cause or page say about the person. It may say a lot more than what is contained in the bio or even what appears on the wall.

Exactly how we get these invitations is not absolutely clear to me. The diversity of what I get invited to though is enormous. Recently I have been invited to like wrestling girls as well as peace in the Middle East. Both have their supporters and although they are poles apart obviously different people felt both might be of interest to me.

Sometimes I click through to have a look at the page in question before forming a view. Other times I “judge the book by its cover” in deciding whether to join, like or ignore. In some respects it is a click of the mouse. In another, it is a public announcement about my likes, interests and even beliefs.

This came home the other week when I “liked” a draw Mohamed page and drew the ire of someone. Now I am happy for people to follow the religion of their choice and absolutely respect their right to do so. However there is no reason why other people cannot have a laugh, be it about religion or anything else.

The interesting thing about offense is that it can actually only be taken not given. Whether or not a person takes offense is a choice they make. It is not a function of what is said or done as nothing causes equal “offense” to all people. Those who choose to take offence will generally blame the other party rather than accept ownership of their own feelings.

The other interesting phenomenon is that after the mouse is clicked that may be the last I see of the group or page. Whilst I can search and find groups I have joined unless I can remember what I am looking for it will be difficult to find.

So what am I do with the invitation, which got me thinking about this whole issue? It is an invitation to like the page “I love sexy bikinis”. It was sent by a friend and promotes a retail website selling, well, bikinis. To be honest they look pretty OK. If the page was “I love pretty landscapes” or “I love stunning architecture” would that be different?

All three are about something, which is visually appealing. If I like the architecture or landscapes no one would bat an eyelid. If I like the bikinis will there be a range of comments from the nudge nudge variety to the morally outraged?

In liking such a page what am I saying publicly? The answer of course is that I like the look of women in bikinis. This puts me in the company with 90% or so of the male population and a high percentage of women too. Serious swimmers do not wear bikinis. They are, of course, worn for appearance not functionality.

So do I publicly declare my like of bikinis or not? You will have to check my Facebook status to find out.

Tuesday, June 29, 2010

Collateral Damage In The War On Cancer

Since the war on cancer was declared by then president Nixon in 1971 much effort has been devoted to the war. So how are we doing? In 2007 there were 12 million new cases of cancer reported world wide and 7.5 million deaths.These numbers are projected to rise to 27 million new cases and 17.5 million deaths by 2050.

These figures do not suggest that what we are doing is working a s well as it might be. The other figure which, does not get quoted much is the collateral damage which is done in the war. Hang on a minute, what is collateral damage? Surely screening for and treating cancer is all good even if it doe not always work.

There is a view which is promoted in the media and by doctors(particularly those involved in cancer screening) that screening is all good and that early detection is important. There is no argument that early detection is better than late detection. There is also no doubt that some people have had their lives “saved” by early detection.

Do we know how many people are in this particular boat? Do we know how many people had unnecessary procedures including biopsies and surgery not to mention needless stress because screening tests picked up cancers that were not actually there? Do we know how many people have early cancers which f not found would not actually develop and lead to a reduction in life expectancy?

Figures are starting to emerge. The British Medical Journal published figures on mammography. The difference in deaths in women aged 40 to 55 that can be attributable to mammography screening is 0.06%. Looked at another way for every woman who would otherwise not have found the cancer and died, 1610 women need to have tests. In addition to this ten women will undergo surgery, which will provide no benefit to them, only potential complications.

With prostate screening the situation is even worse. For every cancer successfully detected and treated early, 48 men will have unnecessary surgery, which can lead to urinary incontinence and impotence in one third of cases. Another review suggested that screening led to no decrease in death rates. The inventor of the PSA test, which is used for screening(but was not developed for that use) described prostate testing as like flipping a coin.

The positioning of cancer screening as saintly leads to criticism of anyone who questions the current orthodoxy. Keep in mind that there are considerable vested interests invested in screening programs and those advocating screening may have a conflict of interest, which would not be acceptable in any other field.

Every person who has surgery or other unnecessary procedures is collateral damage in the war on cancer. Some will say this is a reasonable price to pay. Others may not see it this way. The key point is that you can only make a decision on how you want to proceed if you know all the facts.

Friday, June 25, 2010

A Week Used To Be A Long Time

It is an old adage that a week is a long time in politics. With the world speeding up it seems like a day is now a long time. It is highly unlikely that Wednesday morning that many Australians would have thought there would be a new prime minister within 24 hours.

The fall of Kevin Rudd is quite remarkable. Twelve months ago he was riding high in the polls and at one point enjoyed record high approval. This is a first term government, which came to power after over 11 years in opposition.

Certainly the popularity of politicians goes up and down. Polls, which seem to dominate all thinking these days are necessarily done on small numbers of people and the results extrapolated. Often they are close to the mark but as all the politicians know there is only one poll that really counts.

Clearly the labour party formed the view that they were likely to lose those years election with Rudd in charge and replaced him with his …deputy.

This raises the real question of style versus substance. Were people turning “against” the prime minister because of the policies of his government or him personally? It is worth remembering that as his deputy, new Prime Minister Julia Gillard was involved in policy making. So it is not likely that a new face will bring about huge change in policy. One of the key issues has been the mining profits tax and I wrote about the connections between wealth and health previously.

So is the issue the message or the delivery of the message. Are the governments’ approval ratings falling because people do not like what they are doing or is it simply that what they are doing has not been “sold” in the right way.

Julia Gillard will, like all new leaders, have a honeymoon period. Many will like to see her succeed because she is the first woman to be Australian Prime Minister and this will in itself provide a boost in the polls and an air of goodwill, which will color people’s opinions and also media coverage.

Ultimately the problem though facing many countries is that there is a focus on personality rather than policy and a fixation on polls and the 24-hour news cycle. To grow an apple tree you need to pant the seed and tend it over many years before it grows and provides fruit. Expecting fruit after three months and declaring the tree a failure (and ripping it out) if that doesn’t happen would be ridiculous.

Equally with government policies, which have, long-term effects, judging policy success in a short time frame and then acting on that may make as much sense as ripping out the tree. Of course bad policies should be dropped as would trees, which are not growing be removed from the orchard.

With an election due within nine months it will be interesting to see whether we see changes in policy (particularly the unpopular mining tax) or simply a change in selling the message or perhaps a bit of both.

Most interesting will be the response of the people.

Tuesday, June 22, 2010

Relationships Do Not Have To Be Complicated

Relationships form one of the pillars of DIY Health. There are many different relationships that we have and over the last week we have seen examples of how the way we conduct these this impacts on people, for better or worse.

There are two separate events, which caught my eye; resignation of the CEO of David Jones department store after allegations of sexual harassment, and the furor over allegedly racist comments by a former footballer. Both say something about our relationships.

Firstly were the comments made at a private function by a former footballer Mal Brown who allegedly made references to Aboriginals and cannibals in jest. Not surprisingly this made the news for a few days and led to the usual screaming from those with a vested interest in doing so.

Now I was not at the function, so do not know the context of the comments. However following media reports millions of people became aware of the comments of one person instead of the small number in the room. More interesting are the claims that one person’s remarks are widened out to suggest it represents “systemic racism” either in football or society in general.

Of greater significance is that the man who made the comments has a long track record of playing and coaching Aboriginal footballers and has probably done much more to help their advancement than many of those now screaming out in “horror”. A sign of maturity in race relations will be when jokes whether bad or good are seen as jokes rather than put into a political context. Laughter is one thing we all have in common as humans.

The resignation of David Jones CEO Mark McInnes again highlights how traits, which serve people well, can lead to their downfall. There is a long long history of leaders be it in business or government having multiple affairs, relationships, mistresses or whatever term was popular at the time. This goes back to the days of Caesar and continued through to Bill Clinton. “Leaders” in other fields have a similar track record.

In this particular case the man has resigned and is forgoing something in the order of $16 million in lost entitlements compared to seeing out his contract. There is no way a fine of that magnitude would be imposed by a court. Furthermore nobody is disputing he was extremely good at his job.

None of this excuses behavior, which is unacceptable and he has paid a high price. Equally one can also wonder if the behavior is shaped by the fact that other women may well have warmly received or even sought his attention. It is likely that some did. It is also likely others did not but were not prepared to speak out. There will undoubtedly be more stories emerge over the next week or two

The problem is that often the exact same drive and personality traits which led to success and rising up the power ladder can send you right back down again. A football coach who calls a spade a spade may go far on the playing field but come unstuck at after dinner functions. A CEO who charms women does well in running a retailer but comes unstuck from his private dealings with people if he does not learn where to draw the line.

Relationships are often made more complicated then they need to be. They are never helped when people who are in no way affected jump in with opinions or interpret behaviors through their own biases or worldview.

The old golden rule of do onto others as you would have them do onto you does not even quite work in the politically correct age. You need to do onto others, as they would have you do onto them. For that to occur we need to be honest and open in our dealings with people. We can not expect others to be mind readers. We need to tell them what we do and do not accept and we need to act on that accordingly.

Maybe relationships are not that difficult after all.

Tuesday, June 15, 2010

Be Questioning

A survey of Australians shows that church attendance has fallen about one third over the last 16 years. A number of other “religion” parameters such as belief in heaven and god have also fallen although running in parallel with this is an increasing interest in spirituality, separate from religion.

This trend is part of a broader trend in society away from “authority” figures and institutions in general and to a greater desire to find ones own way rather than be told which way to go. We see this in declining church attendance but also declining regard for judges, police politicians (of course) and dare I say even doctors.

Ultimately the problem we have is that people have used authority badly and come to feel that it is the position they have which confers importance upon them rather than position being recognition of what they bring to it. In other words putting a robe on me does not give me moral authority if I do not have it without a robe. If a person is corrupt, putting them in a police uniform does not change who they are. Yet we see time and again the excuse of position being offered when people are caught out.

There is no doubt in my mind that the response to child sexual abuse by the church has contributed to its loss of credibility. There has been more energy expended trying to defend people and position than trying to resolve the issues.

In other fields similar problems emerge. Reports of two undercover policemen arresting and charging a skimpy barmaid for showing too much buttock will leave many wondering why the police are not spending their time investigating murders and robbery. A similar thought goes through my mind every time I cruise by two policemen under a shady tree holding a speed radar.

The medical profession is not immune to this trend and is also guilty of undermining public trust by its own actions. Reports of researchers and doctors being paid by pharmaceutical companies for research which invariably is favorable to the sponsors does not help credibility. Neither does beat ups like swine flu.

Despite overwhelming evidence that this is not a major threat, health authorities are at it again with claims of chaos and horror to come. This is after a vaccine, which was not needed, was rushed to market and then withdrawn from use in children under five following an unexplained death. Official pronouncements of safety do not sound good in these circumstances. Little wonder that peoples confidence is shaken.

Meanwhile we are constantly told that the whole reason for vaccination is that people are protected against the illness they are vaccinated against. This flies in the face of the actions of the WA health department after a case of measles was found. A frantic search was done to find all possible contacts. If the herd immunity principle works, then why the panic? Interestingly one of the three cases was a paramedic who you would assume was vaccinated.

A two page circular to doctors gives “useful “advice like conducting an examination in a room which can be left vacant for two hours and avoid “suspects” using the waiting room. And who are these suspects? People with a fever ,cough and sore throat. The average doctor would of course not see many of them in winter would they? Apparently people born before 1966 are automatically immune!

Now measles is not a pleasant illness and vaccination has contributed to its decline. However generations survived it in much lesser circumstances than we enjoy today. If the whole purpose of mass vaccinations is called into question when one case is found is it any wonder that people become questioning.

Friday, June 11, 2010

Wealth and Health are Connected

Whilst being rich does not of itself guarantee a long or happy life and many people with little by way of monetary wealth live a long and happy life wealth and health are linked.

As nations become wealthier the overall standard of health rises. We have seen over the course of the twentieth century that as nations industrialize, standards of living improve and so does health. This is not due particularly to medical science and owes very little to high technology medicine.

It comes about through people having clean water, better overall hygiene and sanitation, better protection from the elements and of course access to enough healthy food. The last one can go the other way as we see with problems of too much of the wrong sorts of food being consumed leading to a whole different set of health problems.

The other aspect that is important in health and is pillar eight of DIY Health is fun and purpose. As humans we need to be doing something that we feel matters and that we enjoy. As nations become richer the diversity of opportunities increases exponentially. Once we are free from having to spend much of our time looking for food or defending our territory we can focus on other things.

This may be a job, running a business, creating works of art travelling or a myriad of other things. The key things from a health perspective is that we enjoy what we are doing, that it has some challenge and that we feel there is a purpose. These three components are what the University of Pennsylvania has described as constituting authentic happiness.

Equally, we all need a certain amount of money to live. I am not talking about living in a palace or flying first class but enough to be comfortable and do most of the things we would like to do. People who are successful usually become wealthy because other people are attracted to the value they create. This can be in business or in the arts or any field of human endeavor.

When people have made an effort and created value it is fair and proper that they be rewarded for it. Furthermore, often these people create wealth for other people too either in the form of paid jobs or investment opportunities. Once again this is right across the board with regards human activity. Many who are successful increasingly put back into their community in a variety of ways.

The current debate about the mining tax in Australia highlights the passions aroused when those who create wealth and opportunity for themselves an others find themselves subject to arbitrary government rule changes. Governments by their nature can never create wealth or add value. This can only be achieved by individuals, acting alone or with others, in some form of business.

Different countries have prospered because of different industries. All countries, which have prospered, have done so because individuals and businesses were prepared to take risks in the hope of reward. To attack the reward after the risk has been taken will naturally arouse anger. I am not aware of any other country, which deliberately set out to weaken the business sector, which had been its most successful. Australia’s most successful industry is mining.

Governments argue that the taxation money can be spent in the community. Sadly governments of all persuasions have a bad record of efficient use of funds. Suffice to say the current one is true to this pattern. Excessive taxes and government interference in the economy leads to increased unemployment.

The best way to strengthen the community and for people to prosper is for people to have purpose, like a job or business, and the opportunity to invest their monies. Diminish this and you diminish the community and the nation.

When the wealth of the nation is collectively affected, the health of the nation will also be affected. It is little wonder passions are running so high and across so many levels of Australian society.

Tuesday, June 8, 2010

Human Emotion Is Not A Disease

One of the things one tends to do when in another city is use public transport. And so it was that I was waiting for a train at Sydney Town Hall Station when the billboard caught my eye.”7 out of 10 Australians will suffer a mental health illness” was the headline. Below the headline was a diverse looking group of people with thought bubbles above their heads.

Amongst the thought bubbles were things like, I am stressed at work, I am grieving for my mother who died, I have mortgage stress and I feel anxious at times. The billboard was promoting a charity, which amongst other things provides support for people with “mental health problems”.

There is an increasing tendency for a variety of medical groups, patient support groups and charities to make problems look bigger than they are so that they can get attention or raise money. To do so however, they reclassify normal parts of human emotion as an illness to boos the numbers and create a sense of crisis. In turn those who create the crisis stand ready to solve it with donations from the public.

If it is not a mental health illness to feel happy when you win a lottery why is it an illness to feel sad when a loved one dies. If it is not an illness to feel nervous before performing on a stage, why is it an illness to feel anxious sometimes? Stress in relation to work or finance is a normal response depending on the circumstances and is not an illness.

In a similar vein eating disorder “experts” are warning that anorexia nervosa is more prevalent than being reported. Part of the basis for this is that ninety per cent of teenage girls have allegedly been on a diet. The experts warned of an “alarming” number of young people developing eating disorders as they battle obesity.

Being on a diet is not the same as anorexia and people “battling” obesity are unlikely candidates for anorexia which in fact has nothing to do with food and is all about control issues. However “alarming numbers” and “experts” makes for great headlines, as did the claim that one in 10 women will develop an eating disorder.

One question though. How did they define eating disorder? Depending on the definition you could widen it to nine or even ten out of ten women.

Meanwhile it has been shown that Australians are being prescribed antidepressant medication for reasons other than those for which the drugs have marketing approval. This is particularly the case in the elderly. In the USA increasing prescribing rates for antidepressants over the last decade has not improved the overall mental health of the populace.

So here is the problem. Feeling stressed or down or a bit anxious is not the same as a mental illness. Conditions like anxiety and depression represent one end of a spectrum of human emotion and behavior. Labeling every emotion as a disease is good for sales of medications, for groups seeking to raise funds and for academics pushing research agendas.

It is not good for people. Reclassifying normal human emotion and experience as a disease portrays people as victims in need of the support offered by those raising the monies or selling the medication. As soon as you are not a victim you are in control of your own destiny and may not need the “support”.

None of this is to deny that some people have genuine mental health illness and need support and in some instances medication. It is to say that it is easy to reclassify human emotion and behavior as an illness and that doing so can be very profitable.

Friday, June 4, 2010

With Tests And Treatments Less Is More

In the previous blog I wrote about problems with long term use of medications particularly those used for lifestyle related conditions. It looks like The American Medical association agrees with me. The association’s Archives of Internal Medicine Journal has highlighted the often unpublicized downside of tests and treatments in a recent edition.

In an editorial titled “Less is more: How Less Health Care Can Result In Better Health” the spotlight has been turned on how extra tests and un necessary treatments not only do not help but can cause significant harm. The fractures and diarrheal illnesses associated with long-term proton pump inhibitors (used for heartburn) were one of the cases highlighted. According to Dr Deborah Grady of the University of California, San Francisco “There just seems to be this assumption that the more health care you get, the better”.

This is an incredibly important issue. The Archives Journal will have a regular “Less is More” feature looking at where treatments have expanded to the point where harm outweighs benefit. Doctors and patients have become conditioned to the notion that if tests are good, more are better and that pills are the answer for just about everything. Yet there is never such a thing as a free lunch. All pills have side effects. These can be justified when the benefits outweigh the risks and when no other treatment is available. When simple changes in lifestyle will have the same effect though they cannot be justified. The issue of cost is a whole other component of this.

Tests are also seen as wonderful because of their capacity to find “unexpected” serious illness such as cancer. Tests are fallible though and many people go through further tests and even surgery because of a finding in a test which may in fact be meaningless but “once found must be acted on”. Mass screenings add to this problem. Issues with PSA testing led the tests inventor to describe PSA testing for cancer as being like flipping a coin. The benefits of mammography screening have been significantly overstated.

So what drives the test and pop agenda? There are two main drivers. One is litigation and the use of defensive medicine. Ordering unnecessary tests on 1000 people will not get a doctor sued, regardless the cost and inconvenience but the one person where a diagnosis is missed may well sue. The other is commercial and vested interest.

Obviously the pharmaceutical industry has a legitimate interest in selling its products and is clever at marketing. It also drives a lot of research. If a study is done looking for a use for a drug there is a fair chance it will be found. Extending the number of people classified as needing treatment (for example by lowering cholesterol target levels) boosts sales.

Whole industries have sprung up behind screening too. Those involved in the mammography business dismiss any criticism of mammography, as an attack on women, usually. Unnecessary surgery on breasts is not seen in the same light.

There is no point saying that there is an across the board clear cut answer. And herein lies the real issue. One size fits all models do not fit all. Attempts to screen or treat everyone the same has led to this problem. Over emphasis on guidelines and protocols stop doctors (and patients) considering the individual circumstances of each case. Well meaning scare campaigns convert everyday bodily functions into danger signs of cancer leading to a race to exclude what was never there.

The answer then is in fact simple. Focus on being healthy rather than enter the obstacle course of avoiding disease. Have faith in your own body and what it is telling you. It knows more than most tests. Ask your doctor about the downside of tests and side effects of medications. Take the non-pharmaceutical option first. Do not buy into scare campaigns or disease mongering.