Robert McFerran 1
ARTHRITIS — Searching for THE TRUTH — Searching for THE CURE
Chapter 1
I am constantly humbled by the fact that there is so much that we do not know. Physicists, who thought that they had a pretty good handle on the size of the universe, recently found that they were only off by a factor of ten. With this discovery of a much larger universe there has been a flurry of activity — and with it a renaissance of thought as scientists scurry to re-think old theories and formulate new ones about our world.
It might be easy to deride them but these physicists should be applauded. They are brave indeed to offer up theories that are built upon so many abstract mathematical formulas and so little in the way of direct observation. They live with the fact that their ideas will only have a limited lifetime, some embarrassingly short. Nonetheless they stake out their position and go about proving it in the face of the usual opposition from their peers. This is the way they move our knowledge forward.
Whether the universe consists of 10 billion or 100 billion galaxies probably won’t have much impact on our lives. On the other hand what you learn in this book will have a profound effect, especially if you suffer from any kind of arthritis.
I recently read a newspaper article that suggested men tend to be more goal oriented while women had a greater appreciation for the process involved in attained a goal. Obviously we all have a bit of both and that’s a good thing. Both will be needed to piece together the underlying source of your arthritis. You will find that questions will lead to answers, but at the same time even more questions. Let the process begin!
When Joe E. initially attended the clinic he was 24 years old. He was afflicted with what had been diagnosed as a combination of rheumatoid arthritis and ankylosing spondylitis. The problems in his joints had started when he was 14. By the following year the joint pains were very severe and complicated with chronic rhinitis (runny nose) as well as bouts of depression.
Joe was unable to walk and had to be carried into the doctor’s office. He looked extremely ill and emaciated. His feet were so swollen that he was forced to wear slippers several sizes larger than his real foot size. He had problems with allergic reactions to the drugs that he was prescribed for his arthritis.
The doctor discovered that Joe’s arthritis was closely linked to a variety of food and airborne allergens. Within a few months of starting treatment Joe was back at work and living independently. He has remained very well and has developed a successful career in the world of graphic art. Anyone meeting him in the past few years would never guess the agonies that he endured from age 14 to 24, as now he is entirely well in every respect.
The physician that treated Joe was Dr. John Mansfield. Joe was far from an isolated case. Dr. Mansfield has successfully treated over 2,000 cases of arthritis by sorting out individual sensitivities to chemicals, foods and airborne allergens.
Lauriane Riley was only two when she was diagnosed with juvenile rheumatoid arthritis. Onset occurred shortly after she developed a fever and a rash. She lost her appetite and showed signs of chronic fatigue. Pain and stiffness developed in her knees which made her reluctant to walk. Her sedimentation rate was abnormally high and she was suffering from anemia. She was treated with small doses of oral antibiotic and within three weeks all of those symptoms had disappeared. Six months later, not a single sign of arthritis remained.
A year after treatment Lauriane did not have a trace of stiffness in her legs or any reluctance to do all of the normal things — running, playing — that healthy children do. She eats well, has grown normally, and has lots of energy. She is completely recovered.
The physician that treated Lauriane was Thomas McPherson Brown, M.D. He was a board certified rheumatologist with over 25 years of experience in treating all forms of rheumatoid disease with tetracycline antibiotics.
The patient was female, aged 43 years. Her mother suffered from rheumatoid arthritis and diabetes. Her rheumatoid disease began some 5 months before being seen with pain in the balls of her feet. The toes were painful on flexion and the ankles painful on any movement. Two years prior she experienced pains across the lower abdomen and lumbar spine, which persisted. In the last three months pains and swelling had spread to the fingers, thumbs, wrists, shoulders and neck, which was stiff. She suffered from night sweats. There was marked morning stiffness and the rheumatoid factor was positive.
She was treated with a combination of different antibiotics in pulsed doses. During this time her ESR rose to as high as 80 mms/hour. Her symptoms rapidly disappeared three days after cessation of treatment when she complained of only occasional sharp pains in various joints, but there were no physical signs of rheumatoid disease to be seen. Four months after being treated the ESR had fallen to 12 mms/hour, blood count showed Hb 15 g/dl. Over the course of the next three months she became completely symptomless and has remained so for eight months.
Dr. Roger Wyburn-Mason, M.D., Ph.D. supervised this patient’s treatment. Over 100 physicians in the U.S. follow his protocols for treating all rheumatoid disease.
Myra L. was 55 years old and initially complained of chronic fatigue, insomnia, occasional depression and fibromyalgia, especially in her lower back, neck and shoulder blade area. She experienced bloating in her abdomen accompanied by gas and alternate constipation and diarrhea. She also stated that she was approximately 15 to 20 pounds overweight, and that as hard as she might try, she found it impossible to lose weight. Myra had tried a number of different therapies, both nutritional and otherwise, all to no avail.
Dr. Rudolph Wiley assisted Myra in finding her appropriate metabolic type. She matched her eating habits to her metabolic type and the majority of her symptoms vanished over the next week. Any remaining pain dissipated over the next three months. She experienced huge increases in energy while her weight normalized.
Dr. Wiley credits George Watson, M.D. with discovering this phenomenon some 25 years prior to his work. Dr. Wiley, a Ph.D. biochemist, has spent 20 years helping solve chronic problems like Myra’s.
By this time you might be asking yourself why your rheumatologist doesn’t know this stuff. A better question is why don’t you know this stuff? You’re the one that has arthritis.
Chapter 2
As best I can recall, it wasn’t until I was 18 years old before I fully realized that my parents weren’t just my parents. They were people. They had aspirations, concerns and interests beyond my own. Like all individuals they had their strengths and weaknesses. It really is a tribute to them that I was insulated from this reality for so long. I just went merrily along during childhood and adolescence, never even giving a thought to the mechanics of how they were able to provide for me. I just knew they would.
I had a very similar awakening when I first started working behind the scenes with physicians as a practice management consultant. I found that doctors were fallible just like us. Even worse they were pressed to their limits spreading time among patients, family, friends, hobbies and other outside interests. The idea that physicians had much time to study new treatment techniques or contemplate why a certain patient wasn’t doing so well with a prescribed therapy quickly vanished. I found that their main source of new medical information was the occasional 15 minute visit from a pharmaceutical representative or perhaps a day or two away with their peers at a semi-annual academy meeting.
There is one other concept that you’ll need to get under your belt to realize the true limitations placed on your physician — it’s called ‘standard of care’. Say you have a chronic sinus infection and present the problem to a local ear, nose and throat doc who subsequently recommends that you require immediate surgery. Upon getting a second opinion you find that the ear, nose and throat specialist just down the street thinks that surgery isn’t necessary at all and instead prescribes a series of antibiotics. Now who are you supposed to believe?
Years ago doctors saw that this type of inconsistency could lead to a loss of confidence by the public. They started to create medical boards to develop standards for certain medical situations so that physicians could be consistent. It seemed apparent that patients were enormously ignorant of proper medical procedures and that these medical boards were needed to protect them from bad doctors. Standard of care would also serve an important dual purpose by protecting the physician from being sued by their patient. If a patient had a terrible outcome but the physician followed the standard of care there was a much smaller chance that the patient would receive a desired verdict in a lawsuit.
All this sounds prudent until you realize that all the doctors in any specialty, including rheumatology, were now forced to walk in lock-step. Any innovation, discovery or improvement suddenly breaks step with the local standard of care. The physician who does anything different has suddenly painted a large bullseye on his back saying sue me — and shortly there will be lawyers there to oblige.
There are exceptions, but the majority of today’s doctors have turned over all responsibility for improving the medicine within their specialty to the ‘boys in research’. The eggs are definitely ‘all in one basket’ and we’re waiting for a miracle answer.
As you read this book you’ll develop an understanding of what causes your arthritis and why those waiting for research to solve their problem are doomed to be disappointed. Modern researchers may represent our best and brightest minds, but they are much too far from patients to really understand the problem they are working on. Dr. Dean Ornish (the now famous cardiologist) would have never recognized the connection between diet and coronary disease (which today has widespread acceptance) if he hadn’t literally lived among his patients.
Modern research will provide less toxic drugs that match today’s pharmaceuticals in effectiveness, but they will always exact a cost to overall health. Much like the story of the little Dutch boy. He used his finger to plug the leak in the dam only to find that when he did, another leak would form. In the case of arthritis, even if a drug stops inflammation today, new leaks appear tomorrow. They take form as other chronic conditions including fatigue, depression, anxiety, mental fog, severe allergies, headaches, disrupted sleep, diabetes, weight gain or loss; gastric, urinary, thyroid and reproductive problems.
Now you’ll be able to appreciate why your rheumatologist doesn’t know the connections that you will discover in this book. So don’t be surprised when you feel better than you have in years that your physician doesn’t share your excitement — he can’t. Medicine and your doctor are in a deep rut and we’ve helped put them there.
Chapter 3
Right about now you might be wondering how rheumatology can break their terrible lockstep to improve the plight of those actually suffering with arthritis. The answer quite simply is with the proof. Unfortunately it will take lots of proof and the right type of proof before budging things in the field of rheumatology an inch. If there is a discovery or a breakthrough it must be put to the test. However the manner in which today’s medicine tests something is strongly biased.
The test that medicine values the most is the ‘double blind crossover placebo controlled study.’ Here both the patient and doctor are unaware of who is receiving the real treatment and who is receiving the placebo. This type of study requires gathering a group (or sample) of patients that have the same disease. Usually researchers look for folks who are ‘matched’ or generally have the same type of arthritis, with the same severity and have suffered roughly the same number of years.
The placebo is a fake treatment used in the place of the real thing. Researchers have found that some patients will often improve for no reason at all other than the fact that they think they are receiving treatment. In these studies half the patients get the appropriate treatment while the others get the placebo. There is more than a little ethical problem in asking patients (in the placebo group) to suspend treatment for an extended period of time when they have severe disease. It is the hope and intent of the study to prove that the placebo group will do quantifiably worse than the group receiving treatment. As you know, worse can mean irreversible joint damage. Many physicians refuse to submit their patients to the above testing protocols for these ethical reasons.
The double blind crossover placebo controlled study is uniquely well suited for testing drugs while at the same time ill-equipped to test the effectiveness of non-drug therapies. In most non-drug therapies the treatment is impossible to hide so the placebo effect cannot be removed from the equation. Running any kind of extended trial can be prohibitively expensive. A simple trial involving only 40 or so patients can easily run in excess of $100,000. Larger follow-up trials at other locations must be performed by other investigators to validate initial findings. For reasons that we’ll discuss later, results from different studies rarely have strong correlation. The consequence is that even more studies are demanded to demonstrate that a therapy is effective.
The great majority of drugs used to fight arthritis have been grandfathered in. A recent drug that showed great promise for both anti-inflammatory and possibly disease modifying effects was Tenidap. The drug research was completed and initial trials looked good but the manufacturer ultimately decided to shelve the product. The reason was economic. Even though they were already somewhere in the middle of the approval process, they believed that the cost of completing the needed trials and bringing the drug to market would not recoup expenses and a reasonable profit.
Arthritis research is faced with searching in two different haystacks. Out of necessity they’ve chosen the one with money in it. The other stack doesn’t have any money but has the cure. The good news is that you have the ability to search the other haystack for yourself.