Guided digital medicine: the law of unintended consequences and non-disease treatment of diseases—part 1

Townsend Letter for Doctors and Patients,  April, 2004  by Savely Yurkovsky

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Once upon a time (a real story), there was a beautiful, large lake plentiful with fish that had fed many generations of tens of thousands of people in the vicinity. Yet, one day, some industrious folks had decided to bolster its fishing capacity and introduce big fish into its midst. So, many big fish were delivered and dumped into the lake in anticipation of turning its rebirth as a fishing paradise. But, regretfully and quite contrary to high expectations, strange things took place instead.

As the big fish took to the waters and prospered, small fish became its prey and began shrinking in numbers. Because of this, the surface algae that was normally consumed by the small fish began growing abundantly, decaying in large numbers and sinking to the bottom. There, they consumed much oxygen that another population of small fish needed for survival and they started perishing, too. This drastically reduced population of small fish had led to another unforeseen problem, an overgrowth of smaller living things in the lake, mollusks among them, that carried parasites. As they overgrew, so did the parasitic population and people living off the lake became sick in large numbers. In addition, due to the drastically reduced population of small fish, the big fish could no longer prosper and decreased in numbers, too. Furthermore, the agrarian people in the area who had managed to dry smaller fish before, for long-term conservation, by simply having them exposed to the sun, could not get away with this simple process once it came to the big fish, as they had to be smoked over fire. This led to cutting much wood and, thereby, diminishing the surrounding forest. As a consequence, the lake's banks, having lost the necessary ground support provided previously by the trees, began disintegrating and sliding into the lake. Over time, tons of mud and sludge ended up polluting the waters and further destroying the lake's natural habitat.

Today, decades later, the once beautiful lake is reminiscent of a swamp. Experts in marine biology state that it will take hundreds or even thousands of years before the damage can be undone.

"The specialists are destroyers of cure. For one knows something about this, the other about something else. Yet, all together, they know nothing of essence."

--T. Paracelsus, MD (1493-1541)

"Modern science suffers from structural problems that have their roots in conceptual issues .... The rewards of academic life are given for becoming expert in a specialty or subspecialty. It is important, however, that although the major work of science must be done by specialists they should all realize that they are contributing to a mosaic and their work fits, like a piece of a jigsaw puzzle into an overall picture."

--James G. Miller, MD, PhD, author Living Systems, 1995

Some years later, there was a young girl (sadly, a real story, too) in her early twenties, in good health except for the fact that she had vulvodynia, who went to see her OB-GYN specialist. The doctor recommended a special diet in accordance with the vulvodynia foundation's treatment plan for this disease. It did help, somewhat, but not much. She then went to see another MD, a sub-specialist in this condition. He gave a drug but it did not work.

The next health practitioner was a chiropractor who attempted to help the matter by adjusting her low spine which was out of place. This did not do anything either.

A biofeedback specialist with subspecialty in vulvodynia was approached afterwards. No difference.

Another OB-GYN, specializing in vulvodynia, was tried, who ordered blood tests for food allergies and candida infection and prescribed some heavy treatment. It consisted of physical therapy and massive anti-yeast drugs: Sporonax, Nizoral and Diflucan. She felt the heavy treatment as it worsened the pain.

By the time she presented herself to my office very recently, her medical record consisted literally of a good battalion of health practitioners, 32 to be exact, most of whom were specialists. I would be pressed for space to present the rest of her medical ordeal, but will do so in a rather abbreviated fashion by briefly mentioning the specialty of the practitioners she saw, the treatments and outcomes.

* A nutritionist: candida diet, many supplements and herbs. Vulvodynia worsened.

* A rheumatologist (assuming vulvo-dynia was a symptom of fibromyalgia since she started complaining of some muscle aches): six drugs, most of them for fibromyalgia, including one anti-depressant. No change in vulvodynia plus new gastrointestinal and sinus problems; the alleged fibromyalgia worsened, too.

* A chiropractor: NAET. Didn't work.

* A nutritionist: Fibromyalgia diet. Worsened: More muscle pains and GI distress, irregular periods, brain fog, weight loss (very thin to begin with).

* Internist, MD, integrative medicine: Based on a comprehensive stool analysis yielding heavy candida growth, prescribed many supplements, and physical therapy for vulvodynia. No help. Food allergies worsened.