Resisting GMOs

If you’re a regular reader of this blog, you were probably conscientious about avoiding GMOs long before Prop. 37′s failure last November. Maybe you’re even more so now. As consumers and stewards of our own health, we didn’t throw up our hands in failure. So long as GMOs are in our food supply, we continue to seek responsible labeling. And we choose to take control over the foods we eat.

This week, you can stand up to the personal, social and environmental damage being wrought by Monsanto and its ilk by taking part in the global March Against Monsanto taking place this Saturday, May 25. In the words of Occupy Monsanto,

We will not stand for cronyism. We will not stand for poison. That’s why we March Against Monsanto.

Check out the full list of events to find the one closest to home.

Why does the fight against GMOs matter so much? Studies show that genetically engineered foods “can be toxic, allergenic or less nutritious than their natural counterparts.” Their health risks are higher for children than adults.

Also, consider the results of a recent experiment done with fruit flies. One group ate only organic foods (by definition, non-GMO), and the other ate only nonorganic. Those that fed on organic foods fared better in their health. A peer reviewed paper published last month in Entropy found that Roundup – the herbicide many GMOs are designed to withstand – may cause various illnesses, including cancer and Parkinson’s Disease. Earlier research showed an increased risk of organ failure from GMO corn in particular.

The best way to make sure your diet is GMO-free is to stick with organic whole foods – fruits, vegetables, legumes and meat. (Beef and other meat from grazing animals should come from 100% grass-fed stock.) In the US, foods that are labeled 100% organic cannot contain GMOs. An added benefit of sticking with unprocessed foods: far less salt and fewer industrial fats.

Sometimes labels are easy to read, but sometimes food producers intentionally make it difficult to tell if the foods are from organic sources. If you are concerned about the food you bring into your home, here are some resources you may find helpful:

• If you garden, stick with GM-free seed from companies that have taken the Safe Seed Pledge. Mother Nature News lists their “15 Best Vegetable Seed Companies” here.
• The George Mateljan Foundation offers comprehensive information on organic foods and labeling, and how to read those labels.
• Caitlin Junkin offers 8 useful tips for avoiding GMO foods.
• You can find non-GMO products and restaurants from the Non-GMO Project.
• Analiese Paik covers mobile apps to use while shopping – and much more – on the Fairfield Green Food Guide.

Of course, we can’t always eat food prepared at home. Happily, there are resources to help us think about the processed foods available to us:

• New York Times investigative reporter Michael Moss talks with CBS News about his book Salt, Sugar Fat: How the Food Giants Hooked Us. You can visit the book page here.
• Mark Bittman, also of the New York Times, rounds up (no pun intended, of course) a group of recently published books on processed foods.
• People want to eat good, fresh, healthy foods, even when out and about. This poses a problem to the fast food industry. Will fast food companies meet the demands of their customers? Tom Laskawy of the Food & Environment Reporting Network explores fast food’s response to the movement towards health.
• Find places to eat healthfully on the road with the Eat Well Guide to local and/or organic restaurants, caterers and other food providers in the US and Canada. Organic Travel offers a guide to restaurants, too.

We can be diligent about choosing healthy foods not contaminated with GMO foods by buying from trusted companies, understanding food labels and eating organic whole foods, especially produce. However, we shouldn’t become complacent and give up the demand for all foods to be labeled. We should be able to easily tell whether a product includes GMO crops or not.

Earlier this month, Vermont’s House finally passed their own labeling bill. Here in California, Prop 37 was just one initiative; there will be more – here and beyond.

Breast Cancer, Fear & Informed Choice(s)

As we were taking a look back at the first 5 years of this blog, maybe you heard a little something about a certain celebrity who had a “preventive” double mastectomy.

How “brave” and “heroic”, folks said of Angelina Jolie’s going public about her decision, which others rushed to validate as “the right medical choice.”

Was it a well informed choice?

During last year’s Pink Ribbon Month, our local paper ran a story about two Modesto sisters who took the same route. Their choice, according to the article, was driven by two key factors: their mother being “a four-time cancer survivor” and finding out that they carried the BRCA1 gene themselves.

“I think watching my mom and knowing her story and then being given this knowledge, it was power,” said [one of the sisters]. “I said if I can block this cancer out, I am going to do it. It just made sense.”

Through decades of “awareness”-building, we have bought into the notion that cancer is something foreign and fearful, an outside invader (rather than a biological response) we must fight with every power we have. We see “early detection” as a worthy goal, even going so far as to equate it with cancer prevention. This trend is wonderfully critiqued in a recent essay by Peggy Orenstein who, herself,

used to believe that a mammogram saved my life. I even wrote that in the pages of this magazine.

* * *

Sixteen years later, my thinking has changed. As study after study revealed the limits of screening — and the dangers of overtreatment — a thought niggled at my consciousness. How much had my mammogram really mattered? Would the outcome have been the same had I bumped into the cancer on my own years later? It’s hard to argue with a good result. After all, I am alive and grateful to be here. But I’ve watched friends whose breast cancers were detected “early” die anyway. I’ve sweated out what blessedly turned out to be false alarms with many others.

In the words of a Reuters headline from last year, though, “in cancer science, many ‘discoveries’ don’t hold up.” The value of “preventive” double mastectomies certainly doesn’t seem to. According to research presented in San Diego last fall at the American Society of Clinical Oncology’s Quality Care Symposium, “Many women with cancer in one breast are choosing to have their healthy breast removed, too.”

The researchers looked at nearly 1,500 women who had been treated for early-stage breast cancer. Of those who chose mastectomy instead of lumpectomy, nearly 20 percent opted to have both breasts removed.

But of those who chose double mastectomy, three-quarters had no medical justification, [study co-author Sarah] Hawley tells Shots.

In fact, many women had a diagnosis of ductal carcinoma in situ or DCIS, considered a so-called stage zero breast cancer — a type many say shouldn’t really be considered cancer at all.

Says breast surgeon Monica Morrow in the same article, “People want absolute certainty. Unfortunately, even having a double mastectomy doesn’t provide certainty that breast cancer will not recur. So it’s a false sense of security.”

Another study, cited by Orenstein, found that most women who opted for “preventive” mastectomy weren’t even genetically predisposed to cancer. Its lead author “speculated they were basing their decisions not on medical advice but on an exaggerated sense of their risk.”

It’s not just “awareness” campaigns and the like that fuel our misapprehension of risk. Sometimes, physicians feed into it, too. This is shown in a powerful essay by a physician who tested positive for a marker of breast cancer and is opting not to go the surgical route. It’s well worth quoting at length:

[My breast surgeon]…tells me that my chances of developing cancer are 80 percent and that if she were in my shoes she would “just have them both removed.” I question her about her statistics and say that I thought my odds were much lower. She acknowledges that her numbers might be off but that surgery is still highly recommended. Her offhand manner suggests something deeply unserious—like a manicure.

I’m not ready for another operation. I was scared to do the first procedure and had canceled it twice. Although I used to be a vociferous advocate for aggressive medical interventions, my perspective changed radically when I began working as a house-call physician. My patients are too debilitated to go to the doctor’s office—and many were disabled by botched surgeries. I support them through the amputations, the infections, the intractable pain, the memory loss.

Most physicians don’t see these patients. When I had an office-based practice, I never saw the one-in-eight surgical patients who end up back in the hospital in 30 days. I didn’t see the problems with hospital-acquired infections. I didn’t know that clinician texting in the operating room is rampant or that medical administration errors are, according to the Emergency Care Research Institute, “among the most common errors in healthcare.”

With these not-so-uncommon problems, our current cavalier attitude about surgery is troubling. I’m concerned about my surgeon’s flippancy and I suggest alternatives: “There’s growing data that this is a lifestyle disease. You know the Women’s Health Initiative shows exercise can greatly decrease risk.”

“I don’t know. That may be true,” she shrugs. “If we don’t do surgery, then we’ll just do mammograms every six months.” When I object, saying that LCIS doesn’t show up on mammogram, she responds, “I know. It doesn’t make sense to me either.” It becomes evident that we don’t know how to deal with my condition. The medical system does not tolerate ambiguity well, so breast amputation has become the answer. When I point out that surgery has risks, she minimizes my concerns, since she’s “never had a problem.”

It’s hard to see how any patient’s choice could be truly informed in such circumstances.

Image by Topeka & Shawness County Public Library, via Flickr

KTH Flashback: Harder Than Doing Your Taxes? Hardly!

Originally posted May 30, 2012

There are some stunning statistics in the International Food Information Council (IFIC) Foundation’s latest Food & Health Survey, released last week. Here’s one mind-blower:

Nine out of ten Americans describe their health as good or better, a significant increase from previous years. The majority (60%) report that their health is either excellent or very good, and only nine percent report that they are in fair or poor health.

90%!

Must be a very peculiar definition of health. More than 50% of Americans have at least one chronic condition and each month, nearly 50% take at least one prescription drug. (Just over 20% – 1/5 of the population – take three or more!)

Less surprising is the finding that 52% of Americans find it easier to do their taxes than to know how to eat healthfully. Over 1/3 of consumers (76%) “feel that changes in nutritional guidance make it hard to know what to believe.”

Probably, this has a lot to do with something we touched on here last week: hype and spin, often focused on isolated ingredients. Research gets reduced to announcements of new “superfoods” or things to avoid. Little context is given for understanding the findings, so new studies can seem to contradict older ones. One week, you hear coffee is good for you; the next week, not so much. Which is it? Does it matter? Why should it? There’s a new superfood to tell you about. Eating lots of it will change your life!

Then there’s all the hoop-de-doo around “functional foods” and the health haloes cast by faux food marketers. Did you know 7-11 now has lo-cal Slurpee? Ah! A “healthier” choice! Splenda, artificial flavoring and ice are just what a body needs, right?

Here’s the thing: “Nutritional guidance” really doesn’t change all that much.

Sure, there have been some shifts – the USDA’s introduction of MyPlate, for instance – and new interest in things like organics, sustainability and eating local; new concern with food safety and GMOs. But when you get right down to it, healthful eating is actually pretty simple:

h/t Dr. Dawn Ewing

KTH Flashback: From “Patient” to “Consumer”

Originally posted April 8, 2011

One of the most interesting changes in how Americans think about healthcare has been the transformation of “patients” into “consumers.”

As a result, more people are also becoming self-advocates. Thanks to the Internet, we have more access than ever to information on health problems and treatments, physicians, and current medical research. As a result, we can make more informed choices about the care we receive. (In fact, almost all of Dr. Verigin’s clients have done a good amount of research before they first visit our office.) There’s also greater understanding – even among conventional practitioners – that a person’s health is best served when doctors and patients work together as partners in health, even if it doesn’t always occur in conventional medical practice.

At the same time, though, healthcare has come to be seen more and more as just another consumer product – not so different from a kitchen appliance or car. The drug, medical device, hospital, clinic and treatment center ads that bombard us daily are just the most obvious sign. But you see it, too, in the way we increasingly shop for healthcare.

Consider the Wealthy Dentist Survey on patients’ most common questions about dental implants. The results show a real disconnect between the dentists and their clientele. While dentists want patients to be concerned about things like whether the treatment is right for them, what the risks are and so on, almost all of the top five patient questions had a consumerist bent:

• How much do dental implants cost?
• How long do dental implants last?
• Are implants painful?
• How long will it take to get my new teeth?
• Does dental insurance cover implant surgery?

These kinds of questions aren’t exclusive to implants, of course. We commonly hear them asked about other restorative procedures, such as crowns and bridges, as well. (Dr. Verigin neither places nor recommends implants. Here’s why. And more.)

They’re not bad questions, either. They’re good and important questions.

But it’s just as important to ask about a treatment’s appropriateness, benefits and risks – including its potential effects on overall health. The concern is both physical and financial. For instance, although mercury amalgam is the cheapest option for dental fillings in the short run, their potential to harm the rest of the body (mercury is a poison after all) is so great that the potential long-term costs are apt to be much more than the cost of even a whole mouthful of more expensive but nontoxic and biocompatible “white” fillings. Likewise with root canals: the risk to health and the potential future costs of dealing with illness generally make root canals an unwise investment both physically and economically.

In short, “cheaper now” usually means “more expensive later.” In the best case, you wind up replacing work sooner and more often. In the worst case, cutting corners causes more extensive and expensive problems down the road.

The smart consumer looks at the big picture.

Or as a small plaque hanging in our office has it, “Beware of bargains in parachutes, brain surgery and dental care.”

KTH Flashback: The Cost of Dental Work – and the Cost of Avoiding It

Originally posted March 1, 2010

A few months ago, one of our dental team members was out shopping when a store manager, not knowing her occupation, asked if she had any good tips for dealing with a toothache. One of his employees had a broken root canal tooth and was in severe pain. Indeed, the employee – a young man of about 20 – looked very pale and held onto the counter the whole time they spoke, as if he would fall over were he to let go. Explaining that although she wasn’t a dentist, our team member said that she did work for a dental office and suggested some stop-gap remedies.

“But really, you should see a dentist as soon as possible,” she insisted. “You shouldn’t let something like that go for too long. It’s not just hellish to endure the pain and not being able to eat. If there’s infection, it can be really dangerous.”

“I know, but I can’t afford it,” replied the clerk. “I’m on my mom’s insurance, but it won’t kick in until February. I don’t get insurance here. And I just paid $1700 to Western Dental for the root canal.”

Our team member sympathized and shared some of the tips and resources for finding affordable care that we’ve shared with you here. The young man thanked her, then went on break to buy some ibuprofen and Anbesol to try to kill the pain so he could at least make it through the rest of his shift.

With the persistent problems of unemployment, underemployment, job insecurity and a sketchy economy, many of us are feeling economic pressure as never before and look for more and more ways to cut back our spending to make sure our money lasts.

Unfortunately, a good number of people are cutting back on dental care, or at minimum, putting it off as long as possible and then looking for the lowest cost option possible, whether or not it’s the best option. Consequently, many dentists are seeing a significant uptick in emergency cases. According to a Wealthy Dentist survey, 63% of dentists report such an increase.

But economic hardship isn’t the only reason people defer care. After all, before the economic crisis, dentists still saw many people putting off treatment as long as possible.

We think there are a couple reasons why deferring dental care is so easy. For starters, many dental conditions – such as periodontitis (gum disease) and caries – don’t cause pain or discomfort until the problems become severe. Only then will some people contact a dentist. But at this point, problems typically require much more treatment at much greater cost than they would had they been treated earlier in the disease process.

Second, there is still a strong tendency – even amongst those in dentistry – to view the dentist as a sort of glorified mouth mechanic. Consider this post from Dentist Love, the blog of 1-800-DENTIST:

As I guy, I like to think of myself as a handyman.

I’ve fixed leaky faucets, broken toys, faulty light switches … you know, lots of around-the-house projects.

But when it comes to my truck or my motorcycle, I must admit I leave it ALL to my mechanic. Why? Because I’ve tried engine repair on my own in the past and had horrible results.

I think the same goes for my dentist.

When you take this perspective, it’s easy to think as dental care being only something you pursue when something goes wrong. But as Dr. Verigin writes,

I question their philosophy, which I variously call “industrial dental medicine,” “corporate dental medicine” or “Western school medicine.” This outlook views the decay process as an abnormality in a functioning machine. Primary symptoms are suppressed with specific “silver bullets.” The patient plays victim. The dentist is a glorified mouth mechanic, tooth engineer or oral plumber. Disease processes are reduced to computer code.

Our 21st century outlook, integrated, biological dentistry, focuses first on the parents and their children. We work together to develop health strategies for their lives. They become clients and students, not patients. The dentist by definition is a doctor, which also means “teacher.” Since our dentistry focuses on the underlying mechanisms of the disease process, my staff and I teach and coach our clients by enhancing awareness of the whole body implications of dental disease. Beyond teaching basic cleaning techniques, we encourage proper nutrition to chemically and electrically enhance the body and reduce the risks of decay.

Obviously, this is much more involved and more demanding of the individual’s active participation in maintaining his or her dental – as well as systemic – health. But it also provides the tools and knowledge for the most cost-effective approach to dental and oral health: preventive care. If you take care of your teeth and oral tissues through proper hygiene, nutrition, exercise and lifestyle choices, you minimize the risk of chronic and costly dental health problems that will really put a dent in your bank account.

If problems do arise – say, an accident occurs and you lose, break or loosen a tooth, or a tooth or the gums become painful for any reason – it is vital to your overall health to see a dentist as quickly as possible. Not only can a dentist help with pain relief but correct the problem and prevent infection which, if left untreated, can affect other areas of the body and even, in extreme cases, cause death.

One handy resource for knowing what to do – including how quickly to seek help for dental injuries – is Dear Doctor’s “Field-Side Guide to Dental Injuries” (PDF). This simple and clear chart lets you know in what cases immediate treatment is called for and those in which treatment is less urgent. It also provides some useful tips for tending the injury until you can get to a dentist.

Of course, there are situations other than direct injury that should also prompt you to see a dentist as soon as possible for evaluation and treatment – particularly if you have pain and/or sensitivity that doesn’t go away, or if you have heavy bleeding in the mouth or abscesses. These are all signs of oral problems such as decay, infection and exposed roots that will not fix themselves on their own or get better over time. Once you are aware of the problem, again, it is in your best interest to contact a dentist immediately. An untreated problem will only get worse and be more expensive to take care of properly.

Fortunately, when it comes to the financials, you do have options for paying for the care you need:

If you have dental insurance, it will likely cover at least part of the cost. If you don’t have insurance, there are other financing options you can pursue, from in-office payment plans to consumer credit plans (e.g., CareCredit) specifically designed to cover dental and medical costs.

If money is an issue, be up front about it. If you get public assistance of some kind but can’t find a dentist who will accept it, ask about other payment options. If you live near a city with a dental school, you can get low-cost services at their clinic.

For more information on finding a dental school clinic or other source of reduced-cost services, see the NIDCR’s website or contact your state dental association about available assistance programs where you live.

Just don’t do nothing.

Image byme and the sysop/Flickr, via Flickr

KTH Flashback: Patients, Doctors & the Elephant in the Room

Originally posted March 30, 2009

Over the years, our practice has become increasingly specialized. Of course we continue to provide general dental services, but a large portion of our practice is made up of people with chronic illnesses and dysfunction, who want to see what role their dental and oral conditions might be playing in their health. When we first talk with these clients, we often hear stories about years spent seeing physicians and other practitioners while never gaining any insight to – let alone relief from – their myriad health problems. Some describe being told, ultimately, that their problems must be “all in their head.” Those who have dared to ask about possible “alternative” therapies have typically received withering looks or quick brush-offs about “quack medicine” – actions that both silence the individual and may be a cover-up for the fact that the practitioner just doesn’t know enough about “complementary and alternative medicine” (CAM) to have an intelligent or useful discussion about it with their patients.

The latter is suggested by a study recently published in the Annals of Family Medicine, “‘They Don’t Ask Me So I Don’t Tell Them’: Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine (TM/CAM). While the researchers found that most patients “did not expect clinicians to be experts on TM/CAM, beyond having broad awareness,”

We found that many clinicians believed their own understanding of the TM/CAM practices their patients were using was insufficient to be able to discuss the practices intelligently or to provide scientifically based medical advice to their patients should the topic come up. This perceived lack of understanding appeared to act as a barrier to the clinician in initiating discussions about TM/CAM.

While some of the medical professionals who participated in the study did describe making efforts to discuss TM/CAM with their patients, more seemed to leave the matter up to the patients – and then presumed that because patients seldom brought up the subject, few of them actually used TM/CAM in any way.

The main reason for patient reticence, the study notes, is fear of non-acceptance or judgment by their providers.

Patients’ perceptions of how their clinicians would react to their use of TM/CAM were generally the most important factor in their openness to discussions with the clinician about this topic. An accepting and nonjudgmental attitude by the clinician contributed to willingness by the patient to reveal use of TM/CAM. Many patients told stories about previous experiences during which they felt rebuked by a clinician for using TM/CAM; others avoided the discussion out of fear that the clinician would respond negatively.

[Patient] When my little boy was born, I used to give him herbs for his stomach aches. And I used to come in for his well-child check-up and I wouldn’t tell [the doctor] because…I’d be like, “she’ll get madder.” So I don’t tell them that I use herbs on the kids.

[Interviewer] And what makes you think the doctor would get mad?

[Patient] Well, when I had my first little girl they did get mad at me. They told me that I’m not supposed to give them anything for the colic.

While this study focused on care in clinics in primarily Hispanic and Native American communities, the results jibe with what we consistently hear from incoming biological clients at our practice, regardless of ethnicity, gender, class or other category. And it’s troubling. For when there are such barriers to communication,

1. Patients and practitioners may remain ignorant of the whole array of treatment options at their disposal.
2. Patients may find themselves at risk of negative interactions between drugs given by their doctor and homeopathic, herbal or nutritional supplements and medications they have chosen to take on their own.
3. Negative response on the part of the practitioner practically ensures that the patient will be less forthcoming about all the actions they are taking to maintain or improve their health.
4. Trust between practitioner and patient is eroded.

Thus, we nod in agreement with the study authors’ conclusion:

We believe that clinicians must initiate this discussion, yet in so doing they do not have to be experts in TM/CAM therapies; they simply need to show nonjudgmental interest and candor regarding limited knowledge. Such an approach was preliminarily confirmed during our video vignette process, but this model will require rigorous investigation with actual patients and clinicians. Open and nonjudgmental questioning is consistent with patient-centeredness theory, which is intended to facilitate eliciting the patient’s perspective, understanding the patient, acting in a manner consistent with patients’ values, and involving patients in medical decision making. As well, patient disclosure of TM/CAM is correlated with having a physician with a participatory decision-making style.

“‘They Don’t Ask Me So I Don’t Tell Them’: Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

KTH Flashback: 4 Off-Beat Dental Videos

Originally posted Sept. 10, 2008

Some odds and ends (with a slight emphasis on “odds”) that we’ve run across while searching for dental videos on YouTube…

We start with the amazing singing, dancing tooth:

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“How to Properly Brush and Floss Your Teeth,” shown in old school animation styles:

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A 1939 educational film on dental hygiene, as “Told by a Tooth”:

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And last, a fun animation of “My Shiny Teeth and Me”: