Re: If we could just raise our standards and publish, then they w...

[Guest guest]

In a message dated 9/15/2006 11:19:23 AM US Mountain Standard Time, deadmed@... writes:

The elephant in the room is the question of "How many other conditions

should also be wait and see before an antibiotic is administered because of

germ resistance?" Yes it's true that they didn't include any other possible

treatment methods for ear infections, but no matter how evidence based we

become it is also true they won't mention us in that realm unless there is a

glaring study that indicates chiropractic will work. Work not once in while,

but 9 of 10. I

When I did my pediatric rotation, the pediatrician was reading an article in a standard medical pediatric literature journal. It had a study published by a osteopathic medical school (in Oklahoma) I believe, that demonstrated the effectiveness of adjusting on ear infections as well as some article on how children with ear infections fared no better with antibiotics than without (done in Europe). Anyway, he was very interested at asked me to demonstrate how I adjusted children and he had me adjust several infants in the office.

Anglen

[Guest guest]

Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:

http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf

W. , D.C., M.D.

Cacades East Family Practice

Klamath Falls, Oregon

[Guest guest]

,

With respect to the medical community for “discovering” a trend that antibiotics are inappropriate management of otitis media, this is exactly what we have been screaming about for at least 20 years. Joe Medlin was happy to note that the medical community is embracing this awareness; seeming to miss the point entirely that accepting something years after it was pointed out to you, and every sentient being in the known universe is aware of it, is not responsible behavior. How many millions of dollars and millions of hours of suffering by parents and children have been damaged by this thick headed refusal to listen? Do I sound too passionate to be rational?

Pardon the crudeness of the analogy.

The professors at the med. school were given a bunch of new toilets by Merk. They loved the new toilets because they could go into the water closet and be done in a jiffy in lieu of the arduous trip to the outhouse. A janitor (chiropractor) schooled in common sense kept telling them to put the toilet seat up when they only needed to pee. Of course being only a janitor, he was ignored. After 20 years, a trend began to take shape. Professors noticed that when the toilets had just been cleaned the night before and the seats left up, the result was a dry seat for the next person. The difference in the experience was noticeable but more study was needed. More pee on the seat, less pee, even a placebo of pure water was used. At the AMA conference 23 years ofter the toilets were intalled, a paper was proudly presented stating that actually putting the seat up was better in some cases. Everyone congratulated each other on their incisive intellect. The janitor hearing this could only shake his head and say, “Hmm”.

( E. Abrahamson, D.C.)

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

From: & <bradandange@...>

Date: Sat, 16 Sep 2006 16:43:52 -0700

<Oregondcs >

Subject: Re: If we could just raise our standards and publish, then they w...

Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:

http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf>

W. , D.C., M.D.

Cacades East Family Practice

Klamath Falls, Oregon

[Guest guest]

Alright already. There are ear infections and there are ear infections. It is flat wrong that all ear infections are viral. Some may have started out as viral and then developed a secondary bacterial infection. Some may have been bacterial from the beginning. Can you visualize which one is which ? Many people have had their hearing impaired from failure to treat ear infections and some, I repeat some, have developed bacterial meningitis from an initial and improperly treated and monitored ear infection. The brain damage and hearing loss from meningitis isn't pretty - that is if the patient survived.

I know of which I speak I have worked on and the prosecution of these cases.

It is wrong for us to say that for '20 years 'we have been 'right'. Right about what ? We can't make blanket statements because that puts us into the realm of others,who I don't hold to have high intelligence, who blanket us as 'quacks' ( although I did read one of us call 'them' quacks no too many posts back).

So, define exactly what you are talking about. Give explicit details of the physical exam and vitals of the patient. Make a working diagnosis and watch it like a hawk. You could think you are 'right' but be flat out wrong.

sharron fuchs dc

From: [mailto: ] On Behalf Of AbrahamsonSent: Monday, September 18, 2006 2:15 PM & ; Oregondcs Subject: Re: If we could just raise our standards and publish, then they w...

,With respect to the medical community for “discovering” a trend that antibiotics are inappropriate management of otitis media, this is exactly what we have been screaming about for at least 20 years. Joe Medlin was happy to note that the medical community is embracing this awareness; seeming to miss the point entirely that accepting something years after it was pointed out to you, and every sentient being in the known universe is aware of it, is not responsible behavior. How many millions of dollars and millions of hours of suffering by parents and children have been damaged by this thick headed refusal to listen? Do I sound too passionate to be rational?Pardon the crudeness of the analogy.The professors at the med. school were given a bunch of new toilets by Merk. They loved the new toilets because they could go into the water closet and be done in a jiffy in lieu of the arduous trip to the outhouse. A janitor (chiropractor) schooled in common sense kept telling them to put the toilet seat up when they only needed to pee. Of course being only a janitor, he was ignored. After 20 years, a trend began to take shape. Professors noticed that when the toilets had just been cleaned the night before and the seats left up, the result was a dry seat for the next person. The difference in the experience was noticeable but more study was needed. More pee on the seat, less pee, even a placebo of pure water was used. At the AMA conference 23 years ofter the toilets were intalled, a paper was proudly presented stating that actually putting the seat up was better in some cases. Everyone congratulated each other on their incisive intellect. The janitor hearing this could only shake his head and say, “Hmm”.( E. Abrahamson, D.C.)Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com

From: & <bradandangegmail>Date: Sat, 16 Sep 2006 16:43:52 -0700<Oregondcs >Subject: Re: If we could just raise our standards and publish, then they w... Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf> W. , D.C., M.D.Cacades East Family PracticeKlamath Falls, Oregon

[Guest guest]

Sounds like “Practice afraid. Practice very afraid.”

( E. Abrahamson, D.C.)

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

From: Sharron Fuchs <sharronf@...>

Date: Mon, 18 Sep 2006 14:34:30 -0700

<Oregondcs >

Conversation: If we could just raise our standards and publish, then they w...

Subject: RE: If we could just raise our standards and publish, then they w...

Alright already. There are ear infections and there are ear infections. It is flat wrong that all ear infections are viral. Some may have started out as viral and then developed a secondary bacterial infection. Some may have been bacterial from the beginning. Can you visualize which one is which ? Many people have had their hearing impaired from failure to treat ear infections and some, I repeat some, have developed bacterial meningitis from an initial and improperly treated and monitored ear infection. The brain damage and hearing loss from meningitis isn't pretty - that is if the patient survived.

I know of which I speak I have worked on and the prosecution of these cases.

It is wrong for us to say that for '20 years 'we have been 'right'. Right about what ? We can't make blanket statements because that puts us into the realm of others,who I don't hold to have high intelligence, who blanket us as 'quacks' ( although I did read one of us call 'them' quacks no too many posts back).

So, define exactly what you are talking about. Give explicit details of the physical exam and vitals of the patient. Make a working diagnosis and watch it like a hawk. You could think you are 'right' but be flat out wrong.

sharron fuchs dc

From: [mailto: ] On Behalf Of Abrahamson

Sent: Monday, September 18, 2006 2:15 PM

& ; Oregondcs

Subject: Re: If we could just raise our standards and publish, then they w...

,

With respect to the medical community for “discovering” a trend that antibiotics are inappropriate management of otitis media, this is exactly what we have been screaming about for at least 20 years. Joe Medlin was happy to note that the medical community is embracing this awareness; seeming to miss the point entirely that accepting something years after it was pointed out to you, and every sentient being in the known universe is aware of it, is not responsible behavior. How many millions of dollars and millions of hours of suffering by parents and children have been damaged by this thick headed refusal to listen? Do I sound too passionate to be rational?

Pardon the crudeness of the analogy.

The professors at the med. school were given a bunch of new toilets by Merk. They loved the new toilets because they could go into the water closet and be done in a jiffy in lieu of the arduous trip to the outhouse. A janitor (chiropractor) schooled in common sense kept telling them to put the toilet seat up when they only needed to pee. Of course being only a janitor, he was ignored. After 20 years, a trend began to take shape. Professors noticed that when the toilets had just been cleaned the night before and the seats left up, the result was a dry seat for the next person. The difference in the experience was noticeable but more study was needed. More pee on the seat, less pee, even a placebo of pure water was used. At the AMA conference 23 years ofter the toilets were intalled, a paper was proudly presented stating that actually putting the seat up was better in some cases. Everyone congratulated each other on their incisive intellect. The janitor hearing this could only shake his head and say, “Hmm”.

( E. Abrahamson, D.C.)

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

From: & <bradandange@...>

Date: Sat, 16 Sep 2006 16:43:52 -0700

<Oregondcs >

Subject: Re: If we could just raise our standards and publish, then they w...

Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:

http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf>

W. , D.C., M.D.

Cacades East Family Practice

Klamath Falls, Oregon

[Guest guest]

Just free associating here...I saw an excellent piece from a law firm describing how they successfully litigated a case where a woman had breast lumps. Her GYN told her they were fibrocysts and not to worry [beyond regular checkups and self exams].

A year later she was diagnosed with cancer and they successfully sued for a ton...because it’s GOT to be someone’s fault.

They concluded that every breast lump should have a biopsy and should be paid for by...someone else!

My complaint is that amoxicillin management for acute otitis media is a travesty and they act like they just discovered it. A good doc partnered with watchful parents can monitor an earache safely and effectively. And yes, some will turn out to be frank infections so there will be lawsuits...because it’s GOT to be someone’s fault.

Here in Lake Oswego, we practice anxious mother reasoning. We took out the teeter totter. Risky! Then we took out the merry go round. Dangerous! Last year a kid dove from the diving board at the swim park and cut his hand on a piece of glass in the mud on the bottom of the lake. You guessed it! They took out the diving boards.....because it’s GOT to be someone’s fault. Eventually the children will have a foam rubber playground where no one will ever get hurt.

( E. Abrahamson, D.C.)

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

From: Sharron Fuchs <sharronf@...>

Date: Mon, 18 Sep 2006 14:34:30 -0700

<Oregondcs >

Conversation: If we could just raise our standards and publish, then they w...

Subject: RE: If we could just raise our standards and publish, then they w...

Alright already. There are ear infections and there are ear infections. It is flat wrong that all ear infections are viral. Some may have started out as viral and then developed a secondary bacterial infection. Some may have been bacterial from the beginning. Can you visualize which one is which ? Many people have had their hearing impaired from failure to treat ear infections and some, I repeat some, have developed bacterial meningitis from an initial and improperly treated and monitored ear infection. The brain damage and hearing loss from meningitis isn't pretty - that is if the patient survived.

I know of which I speak I have worked on and the prosecution of these cases.

It is wrong for us to say that for '20 years 'we have been 'right'. Right about what ? We can't make blanket statements because that puts us into the realm of others,who I don't hold to have high intelligence, who blanket us as 'quacks' ( although I did read one of us call 'them' quacks no too many posts back).

So, define exactly what you are talking about. Give explicit details of the physical exam and vitals of the patient. Make a working diagnosis and watch it like a hawk. You could think you are 'right' but be flat out wrong.

sharron fuchs dc

From: [mailto: ] On Behalf Of Abrahamson

Sent: Monday, September 18, 2006 2:15 PM

& ; Oregondcs

Subject: Re: If we could just raise our standards and publish, then they w...

,

With respect to the medical community for “discovering” a trend that antibiotics are inappropriate management of otitis media, this is exactly what we have been screaming about for at least 20 years. Joe Medlin was happy to note that the medical community is embracing this awareness; seeming to miss the point entirely that accepting something years after it was pointed out to you, and every sentient being in the known universe is aware of it, is not responsible behavior. How many millions of dollars and millions of hours of suffering by parents and children have been damaged by this thick headed refusal to listen? Do I sound too passionate to be rational?

Pardon the crudeness of the analogy.

The professors at the med. school were given a bunch of new toilets by Merk. They loved the new toilets because they could go into the water closet and be done in a jiffy in lieu of the arduous trip to the outhouse. A janitor (chiropractor) schooled in common sense kept telling them to put the toilet seat up when they only needed to pee. Of course being only a janitor, he was ignored. After 20 years, a trend began to take shape. Professors noticed that when the toilets had just been cleaned the night before and the seats left up, the result was a dry seat for the next person. The difference in the experience was noticeable but more study was needed. More pee on the seat, less pee, even a placebo of pure water was used. At the AMA conference 23 years ofter the toilets were intalled, a paper was proudly presented stating that actually putting the seat up was better in some cases. Everyone congratulated each other on their incisive intellect. The janitor hearing this could only shake his head and say, “Hmm”.

( E. Abrahamson, D.C.)

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

From: & <bradandange@...>

Date: Sat, 16 Sep 2006 16:43:52 -0700

<Oregondcs >

Subject: Re: If we could just raise our standards and publish, then they w...

Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:

http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf>

W. , D.C., M.D.

Cacades East Family Practice

Klamath Falls, Oregon

[Guest guest]

"Joe Medlin was happy to note that the medical community is embracing this awareness; seeming to miss the point entirely that accepting something years after it was pointed out to you, and every sentient being in the known universe is aware of it, is not responsible behavior."

Ha ha, I love you . Actually, i was commenting as to the subject and point of the post in which you claimed that no matter our internal progress, we will continue to be "unliked" and that the article was anti-alternative and pro pharmaceutical. I continue to be unable to draw that conclusion from this article my friend. All natural based health care providers i'm sure said to themselves "it's about time", but we must be careful in assuming that we (chiros) should be given credit for such thinking. Is that what you believe would have been prudent and Pro alternative -for the Oregonian to state "and Chiropractors have been touting this approach for 100yrs?" That would be great, but it hasn't been only us and we should be happy that they are recognizing a more conservative approach. Baby steps my man baby steps.

BTW, leave the seat up will ya???!!!

Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204

Re: If we could just raise our standards and publish, then they w... Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf> W. , D.C., M.D.Cacades East Family PracticeKlamath Falls, Oregon

[Guest guest]

Yeh but..... viral vs bacterial is VERY easy to ddx: one causes a fever and one does not .... a simple hand-to-the-forehead is an excellent tool here and highly diagnostic. The parent is the one then to make the call. course, after a small bit of teaching, they understand to get the child adjusted, remove the dairy so it doesn't progress, watch the kid overnight and call me in the morning.

The mennigitis cases are frequently the ones where they (the parent or the person IE a yound adolescent) decide to 'wait'...have a glass of milk and go to bed.

It is not about 'saving another person from antibiotics ' .... it is teaching the person cause and effect. If they chose to take the lesson, great! If not, there is always antibiotics and then I'll treat them downline for the intestinal and immunological problems.

my 2 cents. Sunny

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C

Eugene, Oregon, 97401

541- 344- 0509; Fx; 541- 344- 0955

From: "Sharron Fuchs" <sharronf@...><Oregondcs >Subject: RE: If we could just raise our standards and publish, then they w...Date: Tue, 19 Sep 2006 10:21:35 -0700

Everything depends on the facts. What did the lady's mammogram show ? How did each 'lump' feel? Had the 'lumps' changed from the prior year ? Questions, questions, questions - which we all should ask, and then, What is the answer ?

And there is dangerous playground equipment. Let someone dive into their own pool and become a quad.

As far as ear infections are concerned you make sense. I don't say go for the antibiotics first but certainly don't pat yourself on the back thinking you have saved another child from antibiotics when they just may well need them. These things must be watched and watched by someone who knows what the heck they are doing.

sharron fuchs dc

From: Abrahamson [mailto:drscott@...] Sent: Monday, September 18, 2006 5:53 PMSharron Fuchs; Oregondcs Subject: Re: If we could just raise our standards and publish, then they w...

Just free associating here...I saw an excellent piece from a law firm describing how they successfully litigated a case where a woman had breast lumps. Her GYN told her they were fibrocysts and not to worry [beyond regular checkups and self exams].A year later she was diagnosed with cancer and they successfully sued for a ton...because it’s GOT to be someone’s fault.They concluded that every breast lump should have a biopsy and should be paid for by...someone else!My complaint is that amoxicillin management for acute otitis media is a travesty and they act like they just discovered it. A good doc partnered with watchful parents can monitor an earache safely and effectively. And yes, some will turn out to be frank infections so there will be lawsuits...because it’s GOT to be someone’s fault. Here in Lake Oswego, we practice anxious mother reasoning. We took out the teeter totter. Risky! Then we took out the merry go round. Dangerous! Last year a kid dove from the diving board at the swim park and cut his hand on a piece of glass in the mud on the bottom of the lake. You guessed it! They took out the diving boards.....because it’s GOT to be someone’s fault. Eventually the children will have a foam rubber playground where no one will ever get hurt.( E. Abrahamson, D.C.)Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com

From: Sharron Fuchs <sharronf@...>Date: Mon, 18 Sep 2006 14:34:30 -0700<Oregondcs >Conversation: If we could just raise our standards and publish, then they w...Subject: RE: If we could just raise our standards and publish, then they w... Alright already. There are ear infections and there are ear infections. It is flat wrong that all ear infections are viral. Some may have started out as viral and then developed a secondary bacterial infection. Some may have been bacterial from the beginning. Can you visualize which one is which ? Many people have had their hearing impaired from failure to treat ear infections and some, I repeat some, have developed bacterial meningitis from an initial and improperly treated and monitored ear infection. The brain damage and hearing loss from meningitis isn't pretty - that is if the patient survived. I know of which I speak I have worked on and the prosecution of these cases.It is wrong for us to say that for '20 years 'we have been 'right'. Right about what ? We can't make blanket statements because that puts us into the realm of others,who I don't hold to have high intelligence, who blanket us as 'quacks' ( although I did read one of us call 'them' quacks no too many posts back).So, define exactly what you are talking about. Give explicit details of the physical exam and vitals of the patient. Make a working diagnosis and watch it like a hawk. You could think you are 'right' but be flat out wrong.sharron fuchs dc

From: [mailto: ] On Behalf Of AbrahamsonSent: Monday, September 18, 2006 2:15 PM & ; Oregondcs Subject: Re: If we could just raise our standards and publish, then they w...,With respect to the medical community for “discovering” a trend that antibiotics are inappropriate management of otitis media, this is exactly what we have been screaming about for at least 20 years. Joe Medlin was happy to note that the medical community is embracing this awareness; seeming to miss the point entirely that accepting something years after it was pointed out to you, and every sentient being in the known universe is aware of it, is not responsible behavior. How many millions of dollars and millions of hours of suffering by parents and children have been damaged by this thick headed refusal to listen? Do I sound too passionate to be rational?Pardon the crudeness of the analogy.The professors at the med. school were given a bunch of new toilets by Merk. They loved the new toilets because they could go into the water closet and be done in a jiffy in lieu of the arduous trip to the outhouse. A janitor (chiropractor) schooled in common sense kept telling them to put the toilet seat up when they only needed to pee. Of course being only a janitor, he was ignored. After 20 years, a trend began to take shape. Professors noticed that when the toilets had just been cleaned the night before and the seats left up, the result was a dry seat for the next person. The difference in the experience was noticeable but more study was needed. More pee on the seat, less pee, even a placebo of pure water was used. At the AMA conference 23 years ofter the toilets were intalled, a paper was proudly presented stating that actually putting the seat up was better in some cases. Everyone congratulated each other on their incisive intellect. The janitor hearing this could only shake his head and say, “Hmm”.( E. Abrahamson, D.C.)Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com

From: & <bradandange@...>Date: Sat, 16 Sep 2006 16:43:52 -0700<Oregondcs >Subject: Re: If we could just raise our standards and publish, then they w... Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf> W. , D.C., M.D.Cacades East Family PracticeKlamath Falls, Oregon Try the new Live Search today!

[Guest guest]

Yeh but..... viral vs bacterial is VERY easy to ddx: one causes a fever and one does not .... a simple hand-to-the-forehead is an excellent tool here and highly diagnostic. The parent is the one then to make the call. course, after a small bit of teaching, they understand to get the child adjusted, remove the dairy so it doesn't progress, watch the kid overnight and call me in the morning.

The mennigitis cases are frequently the ones where they (the parent or the person IE a yound adolescent) decide to 'wait'...have a glass of milk and go to bed.

It is not about 'saving another person from antibiotics ' .... it is teaching the person cause and effect. If they chose to take the lesson, great! If not, there is always antibiotics and then I'll treat them downline for the intestinal and immunological problems.

my 2 cents. Sunny

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C

Eugene, Oregon, 97401

541- 344- 0509; Fx; 541- 344- 0955

From: "Sharron Fuchs" <sharronf@...><Oregondcs >Subject: RE: If we could just raise our standards and publish, then they w...Date: Tue, 19 Sep 2006 10:21:35 -0700

Everything depends on the facts. What did the lady's mammogram show ? How did each 'lump' feel? Had the 'lumps' changed from the prior year ? Questions, questions, questions - which we all should ask, and then, What is the answer ?

And there is dangerous playground equipment. Let someone dive into their own pool and become a quad.

As far as ear infections are concerned you make sense. I don't say go for the antibiotics first but certainly don't pat yourself on the back thinking you have saved another child from antibiotics when they just may well need them. These things must be watched and watched by someone who knows what the heck they are doing.

sharron fuchs dc

From: Abrahamson [mailto:drscott@...] Sent: Monday, September 18, 2006 5:53 PMSharron Fuchs; Oregondcs Subject: Re: If we could just raise our standards and publish, then they w...

Just free associating here...I saw an excellent piece from a law firm describing how they successfully litigated a case where a woman had breast lumps. Her GYN told her they were fibrocysts and not to worry [beyond regular checkups and self exams].A year later she was diagnosed with cancer and they successfully sued for a ton...because it’s GOT to be someone’s fault.They concluded that every breast lump should have a biopsy and should be paid for by...someone else!My complaint is that amoxicillin management for acute otitis media is a travesty and they act like they just discovered it. A good doc partnered with watchful parents can monitor an earache safely and effectively. And yes, some will turn out to be frank infections so there will be lawsuits...because it’s GOT to be someone’s fault. Here in Lake Oswego, we practice anxious mother reasoning. We took out the teeter totter. Risky! Then we took out the merry go round. Dangerous! Last year a kid dove from the diving board at the swim park and cut his hand on a piece of glass in the mud on the bottom of the lake. You guessed it! They took out the diving boards.....because it’s GOT to be someone’s fault. Eventually the children will have a foam rubber playground where no one will ever get hurt.( E. Abrahamson, D.C.)Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com

From: Sharron Fuchs <sharronf@...>Date: Mon, 18 Sep 2006 14:34:30 -0700<Oregondcs >Conversation: If we could just raise our standards and publish, then they w...Subject: RE: If we could just raise our standards and publish, then they w... Alright already. There are ear infections and there are ear infections. It is flat wrong that all ear infections are viral. Some may have started out as viral and then developed a secondary bacterial infection. Some may have been bacterial from the beginning. Can you visualize which one is which ? Many people have had their hearing impaired from failure to treat ear infections and some, I repeat some, have developed bacterial meningitis from an initial and improperly treated and monitored ear infection. The brain damage and hearing loss from meningitis isn't pretty - that is if the patient survived. I know of which I speak I have worked on and the prosecution of these cases.It is wrong for us to say that for '20 years 'we have been 'right'. Right about what ? We can't make blanket statements because that puts us into the realm of others,who I don't hold to have high intelligence, who blanket us as 'quacks' ( although I did read one of us call 'them' quacks no too many posts back).So, define exactly what you are talking about. Give explicit details of the physical exam and vitals of the patient. Make a working diagnosis and watch it like a hawk. You could think you are 'right' but be flat out wrong.sharron fuchs dc

From: [mailto: ] On Behalf Of AbrahamsonSent: Monday, September 18, 2006 2:15 PM & ; Oregondcs Subject: Re: If we could just raise our standards and publish, then they w...,With respect to the medical community for “discovering” a trend that antibiotics are inappropriate management of otitis media, this is exactly what we have been screaming about for at least 20 years. Joe Medlin was happy to note that the medical community is embracing this awareness; seeming to miss the point entirely that accepting something years after it was pointed out to you, and every sentient being in the known universe is aware of it, is not responsible behavior. How many millions of dollars and millions of hours of suffering by parents and children have been damaged by this thick headed refusal to listen? Do I sound too passionate to be rational?Pardon the crudeness of the analogy.The professors at the med. school were given a bunch of new toilets by Merk. They loved the new toilets because they could go into the water closet and be done in a jiffy in lieu of the arduous trip to the outhouse. A janitor (chiropractor) schooled in common sense kept telling them to put the toilet seat up when they only needed to pee. Of course being only a janitor, he was ignored. After 20 years, a trend began to take shape. Professors noticed that when the toilets had just been cleaned the night before and the seats left up, the result was a dry seat for the next person. The difference in the experience was noticeable but more study was needed. More pee on the seat, less pee, even a placebo of pure water was used. At the AMA conference 23 years ofter the toilets were intalled, a paper was proudly presented stating that actually putting the seat up was better in some cases. Everyone congratulated each other on their incisive intellect. The janitor hearing this could only shake his head and say, “Hmm”.( E. Abrahamson, D.C.)Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com

From: & <bradandange@...>Date: Sat, 16 Sep 2006 16:43:52 -0700<Oregondcs >Subject: Re: If we could just raise our standards and publish, then they w... Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf> W. , D.C., M.D.Cacades East Family PracticeKlamath Falls, Oregon Try the new Live Search today!

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A fever with an ear infection is indication of a systemic affect. This is not good. This is where you have be very , very careful. And with an early bacterial infection the symptoms may be the same as a viral as well as the visual aspect.

All I am saying is that we can't just write off all ear infections as viral and pat ourselves on the back for not going the antibiotic route.

The meningococcal cases of meningitis indeed are often missed or delayed - not everyone notices the rash - or the implications of a stiff neck..........but the cases related to an ear infection is a bit different. The cases of H-flu Type B meningitis have dropped - do I dare, dare, to say it, due to the H-flu Type B vaccine !

Nothing is VERY easy to be absolutely correct on. This thinking is what leads us down a dangerous path. No body is that good to be right on everything. This is why we are doctors - we have to look at the big picture and consider everything, including at times, the use of antibiotics. We are smart professionals not techs.

sharron fuchs dc

From: sunny Kierstyn [mailto:skrndc1@...] Sent: Tuesday, September 19, 2006 11:30 AMSharron Fuchs; Oregondcs Subject: RE: If we could just raise our standards and publish, then they w...

Yeh but..... viral vs bacterial is VERY easy to ddx: one causes a fever and one does not .... a simple hand-to-the-forehead is an excellent tool here and highly diagnostic. The parent is the one then to make the call. course, after a small bit of teaching, they understand to get the child adjusted, remove the dairy so it doesn't progress, watch the kid overnight and call me in the morning.

The mennigitis cases are frequently the ones where they (the parent or the person IE a yound adolescent) decide to 'wait'...have a glass of milk and go to bed.

It is not about 'saving another person from antibiotics ' .... it is teaching the person cause and effect. If they chose to take the lesson, great! If not, there is always antibiotics and then I'll treat them downline for the intestinal and immunological problems.

my 2 cents. Sunny

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C

Eugene, Oregon, 97401

541- 344- 0509; Fx; 541- 344- 0955

From: "Sharron Fuchs" <sharronf@...><Oregondcs >Subject: RE: If we could just raise our standards and publish, then they w...Date: Tue, 19 Sep 2006 10:21:35 -0700

Everything depends on the facts. What did the lady's mammogram show ? How did each 'lump' feel? Had the 'lumps' changed from the prior year ? Questions, questions, questions - which we all should ask, and then, What is the answer ?

And there is dangerous playground equipment. Let someone dive into their own pool and become a quad.

As far as ear infections are concerned you make sense. I don't say go for the antibiotics first but certainly don't pat yourself on the back thinking you have saved another child from antibiotics when they just may well need them. These things must be watched and watched by someone who knows what the heck they are doing.

sharron fuchs dc

From: Abrahamson [mailto:drscott@...] Sent: Monday, September 18, 2006 5:53 PMSharron Fuchs; Oregondcs Subject: Re: If we could just raise our standards and publish, then they w...

Just free associating here...I saw an excellent piece from a law firm describing how they successfully litigated a case where a woman had breast lumps. Her GYN told her they were fibrocysts and not to worry [beyond regular checkups and self exams].A year later she was diagnosed with cancer and they successfully sued for a ton...because it’s GOT to be someone’s fault.They concluded that every breast lump should have a biopsy and should be paid for by...someone else!My complaint is that amoxicillin management for acute otitis media is a travesty and they act like they just discovered it. A good doc partnered with watchful parents can monitor an earache safely and effectively. And yes, some will turn out to be frank infections so there will be lawsuits...because it’s GOT to be someone’s fault. Here in Lake Oswego, we practice anxious mother reasoning. We took out the teeter totter. Risky! Then we took out the merry go round. Dangerous! Last year a kid dove from the diving board at the swim park and cut his hand on a piece of glass in the mud on the bottom of the lake. You guessed it! They took out the diving boards.....because it’s GOT to be someone’s fault. Eventually the children will have a foam rubber playground where no one will ever get hurt.( E. Abrahamson, D.C.)Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com

From: Sharron Fuchs <sharronf@...>Date: Mon, 18 Sep 2006 14:34:30 -0700<Oregondcs >Conversation: If we could just raise our standards and publish, then they w...Subject: RE: If we could just raise our standards and publish, then they w... Alright already. There are ear infections and there are ear infections. It is flat wrong that all ear infections are viral. Some may have started out as viral and then developed a secondary bacterial infection. Some may have been bacterial from the beginning. Can you visualize which one is which ? Many people have had their hearing impaired from failure to treat ear infections and some, I repeat some, have developed bacterial meningitis from an initial and improperly treated and monitored ear infection. The brain damage and hearing loss from meningitis isn't pretty - that is if the patient survived. I know of which I speak I have worked on and the prosecution of these cases.It is wrong for us to say that for '20 years 'we have been 'right'. Right about what ? We can't make blanket statements because that puts us into the realm of others,who I don't hold to have high intelligence, who blanket us as 'quacks' ( although I did read one of us call 'them' quacks no too many posts back).So, define exactly what you are talking about. Give explicit details of the physical exam and vitals of the patient. Make a working diagnosis and watch it like a hawk. You could think you are 'right' but be flat out wrong.sharron fuchs dc

From: [mailto: ] On Behalf Of AbrahamsonSent: Monday, September 18, 2006 2:15 PM & ; Oregondcs Subject: Re: If we could just raise our standards and publish, then they w...,With respect to the medical community for “discovering” a trend that antibiotics are inappropriate management of otitis media, this is exactly what we have been screaming about for at least 20 years. Joe Medlin was happy to note that the medical community is embracing this awareness; seeming to miss the point entirely that accepting something years after it was pointed out to you, and every sentient being in the known universe is aware of it, is not responsible behavior. How many millions of dollars and millions of hours of suffering by parents and children have been damaged by this thick headed refusal to listen? Do I sound too passionate to be rational?Pardon the crudeness of the analogy.The professors at the med. school were given a bunch of new toilets by Merk. They loved the new toilets because they could go into the water closet and be done in a jiffy in lieu of the arduous trip to the outhouse. A janitor (chiropractor) schooled in common sense kept telling them to put the toilet seat up when they only needed to pee. Of course being only a janitor, he was ignored. After 20 years, a trend began to take shape. Professors noticed that when the toilets had just been cleaned the night before and the seats left up, the result was a dry seat for the next person. The difference in the experience was noticeable but more study was needed. More pee on the seat, less pee, even a placebo of pure water was used. At the AMA conference 23 years ofter the toilets were intalled, a paper was proudly presented stating that actually putting the seat up was better in some cases. Everyone congratulated each other on their incisive intellect. The janitor hearing this could only shake his head and say, “Hmm”.( E. Abrahamson, D.C.)Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com

From: & <bradandange@...>Date: Sat, 16 Sep 2006 16:43:52 -0700<Oregondcs >Subject: Re: If we could just raise our standards and publish, then they w... Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf> W. , D.C., M.D.Cacades East Family PracticeKlamath Falls, Oregon

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Why on earth don't they just take a culture of it. Wouldn't that be prudent? They do it for suspected strep throat.

Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204

Re: If we could just raise our standards and publish, then they w... Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf> W. , D.C., M.D.Cacades East Family PracticeKlamath Falls, Oregon

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too expensive for the #s involved...too long to get results back: 24 - 48 hours. sk

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C

Eugene, Oregon, 97401

541- 344- 0509; Fx; 541- 344- 0955

From: "deadmed" <deadmed@...>"sunny Kierstyn" <skrndc1@...>,<Oregondcs >,"Sharron Fuchs" <sharronf@...>Subject: Re: If we could just raise our standards and publish, then they w...Date: Tue, 19 Sep 2006 12:40:32 -0700

Why on earth don't they just take a culture of it. Wouldn't that be prudent? They do it for suspected strep throat.

Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204

Re: If we could just raise our standards and publish, then they w... Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf> W. , D.C., M.D.Cacades East Family PracticeKlamath Falls, Oregon

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Thats exactly what an MD told me once as well. SO let me get this straight: They used to presribe anti-biot for virtually all forms of OM without knowing whether viral or bact. for safety reasons even though the chances and numbers were remote. In the meantime they have created some super germs with drug resistance and so the policy now is to wait and see.

Ok, on the other hand you have Strep throat. Obvious exudate and bacterial presentation across the board and here a culture is warranted before the adminstration of antibiotics despite cost and numbers in the opposite direction. ONe would think that due to the dangerous location of a possible OM bacterial infection would warrant a culture to rule it out and get the Pt. on antibiotics as soon as possible. The 48 hours is just about in the time frame of "Wait and See" so i don't see why time has anything to do here either.

Perhaps it's a matter more of getting an adequate sample in the middle ear that can be difficult and therefore provide a false negative. But, then theres always wait and see.

As far as Expense is concerned, can we really assume that this enters their thinking at all? More importantly should it, if these can potentially be as dangerous as touted?

BTW,Ironically I had a patient yesterday who had bacterial OM as a 10 yr old. Treated with antibiot., but the infection spread and caused a blood clot on the optic nerve affecting the left eye. This increased intraocular pressure to the point that many spinal taps were performed in order to relieve pressure. Eventually these became too much for the 10yr old and they instilled a lumbar shunt (permanent pressure reliever). SO, this was certainly a reminder that these things aren't to be underestimated. She could have easily died. However, the antibiotics did not work for her. I wonder why.

Now this patient presents with an onset of seizure 3 months ago with NO prior history of such or family hx of epilepsy. SHe's been diagnosed as epileptic by Neuro and is now medicated for such. She is a self described "Health Enigma"

Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204

Re: If we could just raise our standards and publish, then they w... Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf> W. , D.C., M.D.Cacades East Family PracticeKlamath Falls, Oregon

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Joe,

IMHO....this is a case where cranial adjsuting could have made a distinct difference. It could help at this point at well. The neuro group won't take her off of whatever drug they have deemed appropriate but she can downtrend the potential for another seizure much more than with the pharmaceutical. AND, she won't run the risk of losing teeth (phenobarbital) or some other side effect.

Not long after we have the discussion about the need for a neuro work-up here on the net, I got a 67 yr old in who had been diagnosed with epilepsy after a fall from the top of a barn. SHe was given the work-up and prescribed the 1/4 gr of daily phenobarb ... had daily 'serious' headaches until the age of 12 when her folks took her to a chiropractor. Another one of the 'one adjustment and I had no more headaches ever. Took the phenobarb for another year but 'my teeth were rotting and they finally pulled them all out when I was fourteen'. Now I certainly don't know what kind of dental history she had but have seen numerous instances theroug the years about that drug interfering with dental integrity. The pt self-discontinued the phenobarb about '3 days after the adjustment' and feels she should "never have been givent he drug in the first place". She places her dental problem directly to that drug.

Your logic about the timing and cost is right on...oit all comes back to 'selling pharmaceuticals' until we get to our current era where the current types aren't dealing with the bugs that have mutated to super-hero status. So, now they have to come up with different verbiage to c-y-a their stance.

It is only about money ... not health.

Sunny

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C

Eugene, Oregon, 97401

541- 344- 0509; Fx; 541- 344- 0955

From: "deadmed" <deadmed@...><Oregondcs >,<sharronf@...>,"sunny Kierstyn" <skrndc1@...>Subject: Re: If we could just raise our standards and publish, then they w...Date: Wed, 20 Sep 2006 09:34:19 -0700

Thats exactly what an MD told me once as well. SO let me get this straight: They used to presribe anti-biot for virtually all forms of OM without knowing whether viral or bact. for safety reasons even though the chances and numbers were remote. In the meantime they have created some super germs with drug resistance and so the policy now is to wait and see.

Ok, on the other hand you have Strep throat. Obvious exudate and bacterial presentation across the board and here a culture is warranted before the adminstration of antibiotics despite cost and numbers in the opposite direction. ONe would think that due to the dangerous location of a possible OM bacterial infection would warrant a culture to rule it out and get the Pt. on antibiotics as soon as possible. The 48 hours is just about in the time frame of "Wait and See" so i don't see why time has anything to do here either.

Perhaps it's a matter more of getting an adequate sample in the middle ear that can be difficult and therefore provide a false negative. But, then theres always wait and see.

As far as Expense is concerned, can we really assume that this enters their thinking at all? More importantly should it, if these can potentially be as dangerous as touted?

BTW,Ironically I had a patient yesterday who had bacterial OM as a 10 yr old. Treated with antibiot., but the infection spread and caused a blood clot on the optic nerve affecting the left eye. This increased intraocular pressure to the point that many spinal taps were performed in order to relieve pressure. Eventually these became too much for the 10yr old and they instilled a lumbar shunt (permanent pressure reliever). SO, this was certainly a reminder that these things aren't to be underestimated. She could have easily died. However, the antibiotics did not work for her. I wonder why.

Now this patient presents with an onset of seizure 3 months ago with NO prior history of such or family hx of epilepsy. SHe's been diagnosed as epileptic by Neuro and is now medicated for such. She is a self described "Health Enigma"

Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204

Re: If we could just raise our standards and publish, then they w... Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf> W. , D.C., M.D.Cacades East Family PracticeKlamath Falls, Oregon

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Certainly if the drum is ruptured you could do that.

sharron fuchs dc

From: deadmed [mailto:deadmed@...] Sent: Tuesday, September 19, 2006 12:41 PMsunny Kierstyn; Oregondcs ; Sharron FuchsSubject: Re: If we could just raise our standards and publish, then they w...

Why on earth don't they just take a culture of it. Wouldn't that be prudent? They do it for suspected strep throat.

Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204

Re: If we could just raise our standards and publish, then they w... Here is a link to the AAFP (Family Physicians) and AAP (Pediatrics) collaborative guidelines on Otitis Media:http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf <http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/otitismedia.Par.0001.File.dat/final_aom.pdf> W. , D.C., M.D.Cacades East Family PracticeKlamath Falls, Oregon

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