Dueling Medical Studies - Who to Believe?

People who primarily get their health information from the evening news, the local newspaper, or non-medical Internet sites are in big trouble. The amount of conflicting information about the risks or benefits of just about anything is staggering. I guess I am particularly troubled by television news. I use coffee as an example:

"New Study Shows that Coffee Consumption Linked to Breast Cancer"

This was a story that I heard over 30 years ago (before the Internet!). It was so shocking at the time, that women stopped drinking coffee all over the country. In one, highly-publicized study, coffee was blamed for fibrocystic breast disease and tentatively linked to breast cancer. This alarming coffee/breast cancer link was later disproven, but that news never seemed to make it to the media. This is really like having your neighbor hauled off by police as a possible child molester. The evening news shows him being put into a police car. The police quickly realize that they got the wrong man, apologize, and release him. All your neighbors really remember is that there is a child molester that lives in that house. The news that this was a mistaken identity doesn't really filter down. The accusation of being a child molester, even after being vindicated, is reason enough to move away. Capturing a child molester is a big story. The man not being a child molester is boring news.

A doctor in a nearby community was accused of fondling his patient's breasts. He was arrested in his office and put in jail. It made the evening news top story and the front page of the newspaper for weeks. After spending tens of thousands of dollars to defend his medical license and good name, he was finally exonerated after the victim admitted to lying. She had made up the entire story. What was once front-page news, complete with pictures, was now a tiny write-up on page seven. Most of his patients never saw that he had been exonerated. His practice and reputation was ruined by the news media jumping to sensationalism. People are supposed to be considered innocent until proven guilty, but the media can prematurely imply guilt.

Coffee has been vindicated, too. As a matter of fact, coffee has completely recovered from that story that it causes breast cancer. Coffee is now considered medically beneficial, assuming of course, that those recent studies were not funded by Maxwell House or Starbucks. People spend billions of dollars every year on this valuable commodity, so having a safe reputation is essential. According to WebMD there have been 19,000 studies that have examined coffee's impact on health. It appears that the benefits of coffee greatly outweigh any hazards.

Coffee contains a significant amount of caffeine, about 85 mg. - a potent stimulant. It can zip you up when you are tired, boost your concentration, but it can also raise your pulse and blood pressure, and make you a bit jittery, at least until it wears off. If you are not used to drinking strong coffee, those effects can be frightening.

When my daughter was in high school, she worked part-time at a neighborhood coffee shop. I worked for a university at the time, with a remote campus about ninety miles away. At the time, I was not a coffee drinker. I was a coffee virgin. Since I had to leave very early, I thought that I would try drinking coffee to keep me awake on the long, boring drive, so I ordered mocha. I assumed this was primarily chocolate. The guy behind the counter asked me if I wanted a "single or double". I figured this referred to the size of the cup. It was a long drive, so I said "double". I had absolutely no idea that he was referring to two shots of espresso. In about twenty minutes, the palpitations of my heart were so severe that I had to pull off of the highway. Now, my entire coffee consumption is just one cup in the morning - no double shots of anything. When driving non-stop back from Mexico, I did drink one of those new "energy drinks" heavy in caffeine. I definitely felt those effects and remained alert while driving the last six hours of an 18 hour journey.

As parents, we typically don't let children drink coffee, perhaps because we feel that kids are zippy enough without it. Believe it or not, no studies have shown that coffee is harmful to kids. Even if it is safe, I am not going to ever suggest that parents give their kids a cup of joe before heading off to school. With teenagers dozing off in math and social studies on a regular basis, perhaps coffee would not be a bad idea for them. Of course, we all worry about "complimentary behaviors" in coffee drinkers. I just can't picture a five-year sipping on a cup of coffee in one hand, a cigarette in the other, and looking for the newspaper. Okay, I know this is a bad stereotype, but you get the idea. Maybe coffee is a gateway drug? Perhaps we need a study.

Studies have now concluded the coffee is good for us; or most of us, at least. Coffee drinkers are less likely to develop Parkinsonism, decreased the risk of colon cancer, less chance of gallstones, and even less dental cavities. There is even evidence that asthmatics who are also coffee drinkers, have less asthma attacks. Coffee appears to be a good diuretic, too. There are just some of the positive health benefits that have been linked to coffee, if we are to believe those studies.

People are more likely to believe the last thing that they read in the newspaper, magazine, or on television news. We tend to quickly forget that a conflicting story may have been highlighted a few weeks prior, or even a rebuttal or disclaimer announced later. Once we glom on to a story, it becomes part of our belief system - one that we will freely share with others.

Every day in my clinic, I am defending vaccinations and dispelling junk-science about their presumed hazards. Once a parent is convinced that vaccinations may be harmful to their child, perhaps causing autism, it is very difficult for a medical provider to convince them otherwise. For some, holding on to those beliefs are like a religion - they are deep and personal.

I watched an anti-smoking documentary the other day that effectively used the Scared Straight technique. The anti-smoking lecture was given by a surgically-deformed cancer survivor who had most of his face removed. Those kids were listening. I think it would be a good idea to get a group of survivors of vaccine-preventable diseases, like polio, meningitis, or mumps, to have a talk with some of these parents.

Until I hear otherwise, from a well-designed, scientifically-controlled medical study, I am going to continue to promote vaccines, and of course, drink my one cup of coffee in the morning. Let the fools continue to smoke, avoid seat belts, drink booze, drive crazy, take drugs, have unsafe sex, and believe that vaccines are a government plot to control and harm us. Nature has some unique ways of dealing with them.

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• Ear, Nose & Throat Message Board with Rod Moser, PA, PhD
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Doing Your Part

Your Responsibilities as Member of a Community and of the Human Race

In the last two weeks, we are starting to administer the seasonal flu vaccine. You would be surprised how many people are refusing it because they do not think they need it. But, what about the rest of us?

We all share this small planet; a planet with limited natural resources, and a planet that is progressively becoming more polluted and damaged. Globally, steps are being made to limit greenhouse gases, preserving the protective ozone layer, finding cleaner fuel sources, and replacing some what has been exploited and raped over the centuries.

I grew up in a strip coal mining area, where beautiful topsoil was moved aside in order to get at a narrow layer of soft coal. Thanks to the efforts of environmentalists, much of that land has been restored. The air and our streams are no longer stinky and yellow. It was commonplace to run sewer lines directly into a pristine creek. A generation ago, people mindlessly dumped their trash along the side of rural roads, or simply threw out their fast-food bags from a moving car. Thanks to Lady Bird Johnson's efforts, our roadsides are no longer piles of discarded junk and rubbish. Little by little, America became more beautiful when people started caring.

A week ago, we were given evacuation orders when a wild fire threatened our neighborhood. Over eighty homes were burned to the ground. Had the wind changed directions, our home would have been lost, too. The cause of this fire is yet undetermined, but arson is a possibility. A few minutes ago, the Department of Forestry spotter plane buzzed and circled my house. There was another fire; this time only a mile away and the wind was blowing in our direction. The quick efforts of our local fire department quickly got this fire under control. According the Highway Patrol, a motorist threw a cigarette out of the window, starting a roadside brush fire. Throwing a burning cigarette out of a moving car deserves jail time, in my opinion. Of course, they will never catch the culprit.

Are we all doing our share? Do you turn out the lights in rooms that are unoccupied? Do you use energy-efficient bulbs? During the summer months, do you set that thermostat a little higher? Do you drive the speed limit and wear your seat belts? Do you recycle your aluminum cans, glass, and plastic? Are you immunized against vaccine-preventable illnesses? Do you wash your hands? Do you smoke? All of these seemingly little things help our planet and your community. As members of the human race, these are your responsibilities.

As a child, we did not have seat belts in our vehicles. Children were not restrained in infant car seats; they could freely jump from the back seat to the front if they chose. Motorcyclists were not required to wear helmets. So, how does wearing seat belts impact our role in the community or the human race? A non-seat-belted person is more likely to sustain serious head and neck injuries, assuming they are not killed. If they have health insurance, the bills could be astronomical for their care. This will raise rates for all of the other insured people who do wear seat belts. If the person does not have health insurance, the state and federal government will end up footing the bills, and of course, guess who pays the state and federal government through taxes?

Smokers feel that they have a right to smoke. Apparently, "Freedom to Smoke" is protected by our Constitution somewhere. Smokers pay the same insurance premiums as you and I, but of course, smokers tend to get more respiratory illness, such as pneumonia, asthma, or emphysema, use the emergency room more often, and have a higher rate of cancer, requiring expensive surgeries and cancer treatments. Smokers have higher absenteeism at work and lower productivity. Again, the insurance companies (and we non-smokers) foot the bill, as well as the government. When smokers flick their cigarettes out of a moving car and start a fire, someone else still has to pay for those damages. When a person chooses to smoke, they impact more than just their own lungs. They seriously impact ALL of us, directly and indirectly, in so many ways.

If people defend their right to smoke, do they also defend their right not to wash their hands? Is personal hygiene (or the lack of) protected by the Bill of Rights? Someone comes out of a public restroom and doesn't wash their hands. They put their contaminated (poopy) hands on the door handles. A little child touches that handle and becomes seriously ill. The simple act of washing your hands can have a major impact on the community.

There was a major public health effort in the 1950's. If people had the right to refuse vaccinations, no one really exercised those rights. Everyone felt that it was our community responsibility - our duty - to be vaccinated, so that people would not get polio, or measles, or whooping cough. In less than a decade, the incidence of these vaccine-preventable diseases plummeted. Everyone, by getting vaccinated, did their part. These public health efforts have saved millions of lives and billions of dollars, yet now, people feel they have the right to refuse vaccinations for personal reasons...stupid reasons. They don't care if they, or their children get the diseases, and they certainly don't care if they spread it to others in the community. You cannot achieve "herd immunity" unless all or most of the herd has been inoculated. Just like one bad apple making the others rotten, if there is an unimmunized person in a community, the disease will survive. An epidemic starts with one.

There are people in the community that count on "herd immunity". Our efforts to vaccinate ourselves and our children is their only protection. They want others to take any risks, but then expect the insurance companies and society to take care of them if they get one of these serious, preventable diseases. Medical care is God-awful expensive, not just in dollars but in emotional toll. Are their calculable risks to taking vaccines? Sure, very small ones. The risks of serious vaccine reactions are considerably less risky than the chance of getting struck by lightening, but yet people are afraid. Some of these fears are created and nurtured by the Internet, backed up by pseudo-science and charlatans.

Perhaps the real barrier is trust. Since the 1950's, Americans seem to have lost faith in their government, perhaps for good reasons. Remembering thalidomide and other recalled drugs, they do not trust the pharmaceutical companies. They do not trust the FDA that approved these drugs. Often, they do not even trust their medical providers - the people that they chose to participate in their health care. People do not trust banks, the post office, the military leaders, or our President. What happened? Right now, President Obama is trying to make a complacent and mistrusting population aware of the serious health threat that influenza can cause. Millions of Americans died in 1918 and it can happen again. Why don't people listen?

In order for people to share responsibility, we have to have trust. We have to trust that everyone will do their part and not opt out or make excuses. We have to trust our elected leaders and our scientists, and we need to come down hard on those who betray basic, human trust. It has been said that we can trust, but verify. It is perfectly normal to question recommendations, but at some point, it will come down to trust. Do you trust your government? Do you trust your medical providers? Do you trust your own judgments?

As a medical provider, I am on the front line. I had to take four nasal swabs for a pertussis test this week on a 15-month old. The mother does not "believe" in vaccines, so none of her children are immune. I can take care of her because I am immune to pertussis. I took my vaccine. Otherwise, I would be putting my own life at risk. I can take care of people with influenza and other life-threatening illness because I am vaccinated, and this is my job. Vaccines are not perfect; few things in life are perfect, but vaccines are and will remain one of our best defenses. It is much easier to prevent an illness than treat one, I can assure you.

Please do your part. Don't throw trash out of the window. Turn off unnecessary lights and use energy-efficient bulbs. Wear your seat belts or helmets, and secure your children in car seats. Don't smoke, and if you do, stop. Wash your hands. Unless you have a true contraindication, take the recommended vaccines. Be honest and learn to develop trust (again). We live in the same community; on the same planet. We are all in this together.

Related Topics:

• Ear, Nose & Throat Message Board with Rod Moser, PA, PhD
• Living Better Newsletter - Wellness news to keep you healthy and strong!