On its site, the American Massage Therapy Association (AMTA) reports that more people are turning to massage therapy for medical purposes rather than for relaxation. But the baby boomers are more committed to massage than the young with an average seven session in the last year. This reflects a general trend. Its most recent survey reports 24% of adult Americans received one massage during 2007. More people now use massage as a component in their wellness programs or pain management strategies. This does not deny the importance of tramadol and other painkillers. They are complementary. Almost three-fifths reported an increase in referrals from healthcare professionals. The use of massage therapy in hospitals is also rising with a one-third increase in the number of hospitals nationally offering therapy for pain and stress management. This represents a groundswell in favor of physical therapy with 20% reporting that their doctors and healthcare providers had strongly encouraged massage. This is echoed in figures from the registered AMTA members. Curiously, 70% also make the service open to their own staff. If it was better integrated into healthcare, the AMTA believes there would be a significant improvement in quality of treatment for chronic pain and stress. Massage with a judicious use of Posted in Uncategorized | No Comments »
October 10th, 2008
Back in July, McCain was asked about his voting record on long term health insurance. With abortion such a extra important issue in the Presidential Election campaign, someone asked him a direct question - makes a refreshing change to find someone asking a politician for a straight answer on Viagra. It went along the lines, “Did you vote in the Senate against a proposal to require insurance companies to cover contraceptives?” To give you a little background information, most private medical insurance companies will not cover the cost of any contraceptive product but will pay for their male policy holders to get their Viagra. When women are good enough to be appointed as the policy makers, they can pay out for the women to get their contraceptives. Now far be it for me to suggest this is a tad sexist - men set the terms of every policy and they favor the men who pay the premiums. No. Perhaps that is fair.
Anyway, let’s not get into that. When asked the question, McCain gave one of those straight answers he is so famous for, “I don’t know enough about it to give you an informed answer because I don’t recall the vote.” The FDA is going to require a warning on labels. Looks like McCain has been using cheap Viagra just a little too long if he can’t remember how he votes on important political issues. And just so you don’t get confused, I’m against gender discrimination in any and every form.
Posted in Uncategorized | No Comments »
July 14th, 2008
Perhaps I am growing more cynical, but every time I see a new piece of research only lasting one or two years, I wonder why it stopped early. I suppose it is always a balancing act. If you have a specific hypothesis, evidence for or against should be apparent fairly quickly. Thus, if a company believes it has the new blockbuster drug, administering it to some brave volunteers should produce good results or lose credibility in months. Anyway, the longer a trial goes on, the more difficult it gets to distinguish between potential causes and their effects. So when one or two participants develop a heart condition or get depressed, is this a side effect of the medication under test or a coincidence? In many cases, the answer only emerges over time. But no-one is systematically collecting longitudinal data. This is very convenient for the manufacturers which might have to pull a medication from the market if adverse evidence emerged. This leaves a moral question: who puts a value on one or two lives lost when millions may be benefiting from the medication?
Anyway, I am inspired by a study published in this month’s Sleep which, unusually, collected evidence over twenty years. Long-term studies like this should be the norm when human health and lives are at risk. This research in Switzerland took a sample of just under six hundred young adults who were suffering from moderate to severe insomnia. This was a study of insomnia itself and not of any medication used to treat it.
The study shows that most of the group found the insomnia growing steadily more pronounced as the years passed. You might wonder why they were not all given ambien or an equivalent. The answer, of course, is that they were and to excellent short-term effect. But these powerful medications are only used in moderation and not over long periods of time. Further, the medications are not cures in the literal sense of the word. They merely give relief during which time those who suffer may attempt to relearn the art of sleep. Thus, even though ambien and other sleeping pills produced the promised sleep artificially, the majority of participants could not recapture the natural sleeping patterns of their youth. Curiously, women were more at risk of insomnia patterns stabilising and expanding. More worrying was that about 35% of those who had episodes of insomnia lasting more than two weeks subsequently suffered a major depressive disorder. The study concludes that insomnia is persistent and increases the risk of depressive conditions. This leaves me with three ad hoc conclusions:
- once formed, the habit of not sleeping the usual seven or eight hours a night can be hard to break - only cognitive behavioural therapy or counselling can modify habits over the long term;
- ambien can only be used to provide temporary relief because of the risk of dependence. But this use is necessary. Without ambien, a persistent insomniac’s health is damaged more quickly and more seriously; and
- the disruption to sleep patterns is more closely linked to depression - as the medical profession is wont to say, they are comorbid conditions.
The final thought has to be that if you are unlucky enough to suffer from insomnia, take ambien as directed by your doctor and work intensively with a therapist or counsellor. The combination is the best chance of avoiding long-term problems.
Posted in Uncategorized | No Comments »