Archive for the ‘Allopathic Medicine’ Category

What is septoplasty and what is the evidence for its effectiveness?

September 5, 2008

Readers I have been “on the sick” this week. Quite shocking really usually I am like Patrick Holford and never have the need to see a doctor. However, for the first time in my life I have been confronted with a document known as the GP note.

The reason I have been taking some time off is that last week I had a bit of minor surgery known as septoplasty. Before I went to see the ENT consultant on 25 June I had never heard of the condition. This week, with a bit of time on my hands, I thought I would do a bit of research. According to Wikipedia, “Septoplastry is a corrective surgical procedure done to straighten to the nasal septum, the partition between the two nasal cavities. (…) When it deviates into one of the cavities, it narrows that cavity and impedes air flow.”

The nasal septum impeding air flow can have a number of consequences. Most importantly off all your breathing is rather irregular and you may have difficulties with exercise. This may mean that you conclude you are not a sporty person and that you give up on exercise which itself may have consequences for your health. A few months ago some one asked me if I smoked, presumably because I get out of breath rather easily. Other problems could include bad snoring and a poor sense of smell both of which I have suffered from. It can also have an effect on the sinuses.

Now for many years I have had problems with concentration and often felt tired even when I had managed to obtain a good night’s sleep. Sometimes the lack of sleep was so bad that I was left with a headache. In short, I was one of those vaguely unwell people looking for something or some one to put him on the path to health and happiness. I spent about £700 on counselling to try to turn myself in to a normal person, but that did not seem to work. Back in January 2004 I had an appointment with the local Patrick Holford representative. He prescribed me with lots of pills and a new diet, both of which were soon discarded.

I then began wonder whether it my destiny to be permanently miserable, apathetic and unsuccessful. After all it would not be possible for Mr Holford and his friends to be successful if there were not lots of people like me around? However, feeling sorry for yourself is never a good idea in the long term especially if it involves comparing yourself negatively to some one like Mr Holford.

You may be asking yourself if there are any alternatives to septoplasty. It appears not: “Nasal drops, sprays or tablets will not relieve an obstruction caused by a bent nasal septum. They may improve nasal breathing a little, but problems return when the treatment stops. Using nasal drops for a long time may actually damage the lining of the nose (muscosa) and make the blockage worse.” http://www.privatehealth.co.uk/private-operations/ear-nose-and-throat/septoplasty/ So that little potion you get from a Chinese herbalist is not actually herbalist is not actually going to help you and make the problem worse. If you remember, going back to my first post, the only bit of original advice the nutritional therapist I saw in 2004 could offer me was to give up citrus fruits! Rather bizarrely, the author of this alternative medicine site: http://www.health-diseases-tips.com/does-septoplasty-work-44699.html says a doctor told him “that septoplasty rarely works”. This contradicts what my ENT consultant and all the anecdotal evidence I found on the internet. (Nonetheless, the site does advise those with sinus problems to let chiropractors put some micro balloons up their noses. I suppose some people like furry handcuffs and plastic whips whilst others go in for chiropractors and mini-balloons: whatever turns you on.)

The anecdotal evidence looks good, but that’s never enough really for those who believe in evidence-based medicine rather than quackery is it? What about the evidence gained from clinical practice, preferably clinical trials. See http://www.emedicine.com/ent/topic128.htm “which states Literature documenting the outcomes of septal surgery is not abundant. Siegal et al and Samad et al have reported patient satisfaction and clinical improvement rates after septoplasty, and both agree that success rates for septoplasty are approximately 70%.” When it comes to obstructive sleep apnea hypopnea syndrome septoplastry can be performed “to straighten a deviated nasal septum (cause of substantial nasal obstruction). This procedure has a very high rate of success in improving the nasal airway if the nasal septal deviation is the major etiology of the nasal obstruction. There are, however, no controlled studies that evaluate the long-term effect of septoplasty on OSAHS.” (See http://www.guideline.gov/summary/summary.aspx?doc_id=10809&nbr=5634&ss=6&xl=999) Also it would appear “nasal septoplasty results in significant improvement in disease-specific quality of life, high patient satisfaction, and decreased medication use.” (See Journal of Otalyngology: Head + Neck Surgery http://linkinghub.elsevier.com/retrieve/pii/S0194599803021673 ) I could go on, but I hope the above goes some way to proving the clinical effectiveness of septoplasty.

I was trying to think about how you could provide a placebo with this type of procedure. The only way I could think of would be to give 50% of patients in a given hospital the anaesthetic, tell them they had had the surgery and then ask them how their breathing was two months later. Presumably you would think it would be worse than those who had actually had the surgery! Still behaving like that would be a bit mean wouldn’t it?

Apparently, about 20% of randomly surveyed adults have problems that could be resolved or relieved by septoplasty. Possibly you are one of them. Many of those individuals will be wasting money consulting various quacks and therapists not realizing that the solution to their problems is very simple. The first thing to do is consult your GP. If necessary she will refer to an ENT consultant who will examine your ears, nose and throat to check what he thinks is causing the problems with your breathing. The waiting list on the NHS is four to five months, though could be a bit longer depending on where you live in the country. The only harmful side effects you may experience are nosebleeds. For the first few days after surgery you will find it difficult to eat and your nose will be blocked up. However, as time goes on your breathing should improve and hopefully will be better than when you went in. I’ll certainly report back. Who knows, as Patrick Holford, puts it the procedure may, “add life to your years.”

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Experiencing Allopathic Medicine First Hand

August 29, 2008

You may be wondering why I have not be around for a couple of weeks. Well, rather than just writing about so-called allopathic medicine I thought I would try it out first hand.

For many years I have often felt tired, a little bit unwell and sometimes rather down.  As anyone who has ever filled out a Patrick Holford questionnaire will know the previous sentence proves that I was seriously unwell.  Moreover for as long as I can remember I have had a very poor sense of smell. So, as I related in my first post, back in January 2004 I went to see one of Patrick Holford’s nutritional therapists. He prescribed me lots of pills and recommended a rather-difficult-to-follow diet.  Both the diet and pills were discarded rather quickly.

However, I still found it difficult to get a good night’s sleep.  Earlier this year one of my work colleagues told me about how he had made a claim on the company health insurance policy which led to him getting a rather helpful dose of physiotherapy. So I thought to myself, “Why don’t I make a claim?”.  Back in April I went to see my GP.  He was unable to see any source of infection so referred me to an ENT consultant.

I asked her whether she thought I had an allergy.  After all everyone else has one so why not me ?!!  But no, it turned out the solution to my problems was simpler than I thought. The left and right nostrils in my nose were twisted over.  By correcting this my nasal breathing could be regulated which would possibly help me to sleep better as well.  Such a simple problem with no need to consult any quacktitioners.  The consultant recommended a septoplasty of nose and excision of trubinate of nose – whatever that means!  After several lots of forms the insurers agreed to the claim.

At 7am on Wednesday morning I turned up at the hospital and fortunately I was first in the queue for morning surgery at 8:30am.  Having an anaesthetic was less painful than my last visit 25 years ago.  They no longer gas you, but rather put the noxious substances directly in to your blood.  How civilised. By 10:30am I was back in my room. I was hoping to be released  early afternoon, but alas my nose refused to stop bleeding until 6:00pm.  Still, I suppose there are side effects to all treatments even natural ones offered by natural practitioners, but more about that another time perhaps.  The consultant came to see me just before 6:00pm. He pronounced the operation a success and said my breathing was going to get better and better over the next two months. He did not quite say a la Patrick Holford, “this procedure will add years to your life and life to your years” but the implication was there!

Currently I feel worse than when I went in. I am very tired and my nose feels extremely sore.  Perhaps I should take some chamomile tea and evening primrose oil to help me out …..? Then when I get better I can offer myself as proof that chamomile works. Think of the TV tie ins and books to be written.