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From: Doc on 12 Jun 2008 16:41
jinhale(a)gmail.com wrote in
news:e18d7c32-98a9-4470-863c-a89b4f0197b2(a)m45g2000hsb.googlegroups.com:

> http://alan.kennedy.name/crohns/chemo.htm

Not sure why that link is included. I know Alan Kennedy has done a lot of research into
MAP, but as you can see from that link there hasn't been much done in years. His site
is a pretty good look into this aspect of the disease and treatment.

>>> Note the �in time� part, that could take
>>> generations. And some cases of CD strike in the mid to late 40s, a
>>> time when many people have already had children.
>
> How long has Crohn's disease been around? Also there are ways to
> scientifically account for the inability to properly diagnose patients
> in the past. Cystic Fibrosis is very common supposedly for reasons -
> resistance to TB and other diseases; how does CF compare in numbers to
> CD? If CD is a recent invention or old hat at your discretion what
> could offer an explanation of why CD patients are ill so soon in life
> typically and yet reproduce more than healthy people? After all the
> numbers are clearly on the up and up any way you look at it and
> quickly rising compared to true common genetic diseases like Cystic
> Fibrosis. There is an alternative theory that does have good reasons
> and is backed by science; is a genetic link even more compelling?

Where do you find that the numbers of Crohn's patients is rising? The studies I was
finding indicate a stagnation. Some areas do show an increase, others a decrease. I
wasn't able to find any definitive numbers though. Wikipedia indicates 6-7.1 per
100,000 in population for Crohn's. While carriers of CF is 1 in 22 to 25 and 1 in 3900
infants are born with CF, according to Wikipedia.

<note: I am not saying Wikipedia is the definitive source, but since you use it and it
does tend to have much of the information in one place, it is a decent starting point>

> A quote from wikipedia: "Smoking has been shown to increase the risk
> of the return of active disease, or "flares". The introduction of
> hormonal contraception in the United States in the 1960s is linked
> with a dramatic increase in the incidence rate of Crohn's disease.
> Although a causal linkage has not been effectively shown, there remain
> fears that these drugs work on the digestive system in similar ways to
> smoking." What this says to me is that at best CD patients have a
> genetic vulnerability, as Doc suggests. Smoking is not genetic,
> despite what people say. I have observed that this is true for me as
> well. I have less problems now that I have quite smoking, drinking
> alcohol, and other non-genetic lifestyle changes. Let me explain; if
> you have Cystic Fibrosis, some things are predictable. The age of
> onset is fairly predictable, The effects of medications are fairly
> predictable, etc. With CD we find smoking is harmful but non-smokers
> still get ill. Most CD patients are of a certain age but could be
> anywhere from an enormous range of years old. While diseases like CF
> and Sickle Cell anemia are common as genetic diseases go because they
> have a counterbalancing benefit and they are typically very
> predictable. Also the number of patients with genetic diseases isn't
> on the rise like CD. To date no gene has been discovered that can
> explain CD. The human genome has been mapped for years. Although CD
> tends to kinda run in families it isn't predictable like say Dwarfism,
> or sickle cell anemia. Two CD patients can give birth to a healthy
> baby and the opposite is true. How can that be genetic?

Well, the same Wikipedia article you got the other information from also addresses the
genetic component.

"Mutations in the CARD15 gene (also known as the NOD2 gene) are associated with Crohn's
disease"

Two people with blue eyes can give birth to a child with hazel eyes. Genetics isn't a
direct 1+1=3 equation. There are many (I have heard infinite) combinations possible
within each person. It is quite possible for 2 people with the disease to be lucky
enough to have a child without the disease. Just as it is possible for 2 people who are
disease free to have a child who does have the disease. This is true, as far as I know,
with any genetic based object, be it disease or hair/eye colour.

If the genetic research could show which gene is potentially an open door for the
disease, and a person could modify thier diet or habits to keep from being exposed to
the triggers, that would be of benefit.

> Some of the comments are either factually false or quite close:
>>> Better medical care might explain the increase
>>> too; people that would have died young without children get care and
>>> go on to have children of their own.
>
> Again from wikipedia: "The usual onset [of CD] is between 15 and 30
> years of age but can occur at any age." Another source I forget the
> name put the median age at 26, I think, but correct me if I'm wrong.
> America would need to have very bad medical care indeed for it to
> effect the age of onset to the extent needed to have a birthing
> impact. This disease typically strikes in the prime of life when
> babies are made. The fact that CD usually occurs at a young age but
> can occur at any age doesn't suggest the typically predictable nature
> of genetics either.

The other issue to consider is the randomness of remission. Flares are noticed and that
is when treatment is started. It doesn't mean that a person isn't diseased prior to
that time. They could have had the disease since birth, but some other factor
(environment has also been postulized) brings out a flare and at that point the disease
becomes "known". And not all suceptabilities are ever realized. It is possible to test
positive for a disease you never get, but carry the code for.

> Although there are many strange theories out in the world, I will need
> evidence to stop believing the overwhelming evidence that CD is
> bacterial in origin, and start believing studies that have been tried
> but have had less success. One of the studies I first referenced
> points out that greater than 90% of severely affected CD patients were
> put into remission longer than their 2 year treatment w/ antibiotics,
> w/o the use of steroids, surgery, etc. This percent is arrived at by
> not counting that couple patients that dropped out early otherwise the
> number is around 80%. They needn't be included, in my opinion, because
> they didn't undergo treatment, but 80% is still significant.
>
> From this site: http://alan.kennedy.name/crohns/welcome.htm#medical I
> found that Kosh's postulate has been fulfilled at least in part, and
> possible to a greater extent than leprosy, for MAP and CD! This small
> study in particular is very interesting:
> http://alan.kennedy.name/crohns/research/animal/chicken.htm The study
> is from 1991, but CD is still the same disease, people haven't changed
> much, and chickens haven't changed much either. The studies are out
> there and researchers would like to conduct more research if you
> believe what they write, and I do. Regrettably more funding is put in
> disease management.

Alan has always had a good site. Which is why I am thinking that there is less interest
in MAP since he doesn't seem to have much new information. His site is where I would
expect to find mention of new studies. I admit I haven't regularly perused his site,
but I do look at it from time to time. Even the PARA website doesn't appear to have
been updated in quite a while. I would think they would have breaking news on thier
website. I understand Alan is not as active as he once was, but if there was something
new, as much as he was involved with this, at least a mention would be expected. And
nothing at all on the PARA website since 2004. They are where he suggests a person goes
to look up information on MAP/RMAT/etc.

>>> Under most health plans, longer treatment = less income. It becomes
>>> more tiresome and costly for the doctors to
>>> continue treating since many programs put time limits on treatments,
>>> or don't cover them at all.
>
> I strongly disagree. Dr.s are only a part of the equation, but the
> truth still holds - supply and demand is a law not a theory. If
> patients want to avoid reinfection that is probably very simple as MAP
> is an obligate pathogen it is typically found in milk that was under-
> pasteurized, such as in America. Further explanation are found in
> previous links (look for got milk).

The trouble with the milk postulate is that if it were MAP in milk, then one would
expect that everyone who drinks milk would be diseased. However, that is not the case.

Which is why I am thinking that MAP and other "causes" are just opportunists. There is
something else which creates the opening. So far, genetics is the direction this seems
to indicate.

> Prescription drug manufactures
> which are now a multi billion dollar industry do in fact clearly
> benefit from selling a lifetime of medication as opposed to less than
> 2 years worth of antibiotics. Sad to say, surgeons also benefit from
> our illness more than health. Some Dr.s are undoubtedly altruistic
> and very bright. I read about Dr.s that to this day still treat CD
> patients with antibiotics - heroes in my book especially considering
> the opposition. But if everyone were healthy where would that leave
> Dr.s and pharmaceutical companies? The problem for Dr.s is that if MAP
> is the cause - evidence points to yes more that competing theories as
> verified by more stages of Kosh's postulate being fulfilled etc. -
> then not only can patients stop paying for drugs, but they can avoid
> further problems, and future customers/patients can also avoid this
> misfortune. Milk, and only under-pasteurized milk is the principal
> problem for humans, as other foods are typically cleaner or cooked
> more.

In the specific case (a case of one) that I am familiar with, the doctor was not
interested in surgery. He intended to treat with anti-inflammatories and other known
treatments (I don't recall antibiotics though) and the patient almost died. The
medications were masking the damage being done, and the intestines were perforating.
Blood tests never showed an elevated white count, so it wasn't until extreme pain and
the decision for an exploratory surgery that the extent of the damage was found.
Afterwards, the standard maintenance drugs (Pentasa comes to mind) seemed to help. It
wasn't until Remicade that there was noteable improvement. During times of antibiotic
treatment for other ailments, no noteable improvement was seen (the Dr. did check). We
were fortunate to have a doctor that did listen, as we learned more about the disease so
did he. We did discuss with him the MAP and he felt that there was no benefit _in this
case_.

>>> If MAP proved out, you don't think the community wouldn't get behind
>>> it?
> History says no, and I agree with history because it is predictable in
> this regard. Medical practitioners will ignore mounting evidence as
> long as possible if the incentives are right. This is of course a rule
> not everyone is a good little pharma scout. I'm curious what you mean
> by "community" as this isn't a united front. If by community you mean
> patients, then I wish to point out that you are very reluctant to
> believe evidence that isn't supported by a majority opinion, either
> majority of authority figures or in general. Your statement 'If ....
> don't you think ...?' is strikingly similar to the fallacious thinking
> 'if something is a good idea then the good idea must be supported
> popularly.' There are plenty of instances of times when the majority
> of the population believes total rubbish. Authority often endorses
> rubbish ideas as well. Instances would be ulcers and stress, Zeus,
> blood letting, etc. We can't wait for a heroic Dr. to figure it out to
> know what is in our best interest.

I would rather have testing done and the product shown to have merit than just jump into
a product because preliminary evidence suggests assistance.

This is something I have seen time and time again. Studies are done, they show promise
and people get behind the idea and want to know why it isn't available yet. Other
drugs/treatments which show promise and do get released end up showing longer range
drawbacks and the company (and agency which allowed the release) get vilified.

I agree, MAP does show promise. And apparently there are no long term drawbacks since
the tests and research were done a while ago and no one is screaming lawsuit for health
problems today. But I do think there is more to the disease than just MAP, and it does
vary from individual to individual. My understanding of the MAP problem is that MAP
isn't as easy to detect in humans as Johne's is in cattle. Unless that has changed.
Maybe more research should be into identifying MAP in humans, then people with MAP
induced Crohn's could be correctly and effectively treated.

>>> No, my take on it is that when the very people who were pioneering
>>> the research stop researching it, and stop
>>> trying to get funding, then it must not be proving out.
>
> There are many more quotes like this in the papers I quote; this one
> is from http://alan.kennedy.name/crohns/research/chemo/htfull.htm :
> "In conclusion, these data suggest that treatment with rifabutin in
> conjunction with a macrolide antibiotic is a safe combination that may
> induce and maintain remission as well as abolish steroid dependency in
> refractory Crohn's disease. As a proportion of patients with extensive
> Crohn's disease resistant to standard medical therapy respond to RMAT,
> further evaluation of this treatment as an additional therapeutic
> option is of great importance. These results justify a randomized,
> controlled trial to assess the efficacy of this therapeutic approach
> taking into account the standards for approval of new drugs for
> inflammatory bowel diseases."

Yes. The evidence does/did suggest that more research was needed. There was a doctor,
whose name escapes me, who was discussed here several years ago. He was doing RMAT/MAP
research. His first two studies were promising, but the third was a disappointment. At
least that is what I remember. Didn't hear anything about him after that.

> These patients were not mild, they were severe cases. Despite the
> failings of the past the good scientist Gui, still recommends "a
> randomized, controlled trial". The researchers do in fact want to
> continue with their research as it is so successful, not the other way
> around. I can find more quotes if that is helpful. The researchers are
> very bright and explain why research in the more distant past was
> unsuccessful where here and with many other underfunded studies there
> was so much success. Remember the researchers don't get funding
> directly from us, they TYPICALLY do applied research for a
> pharmaceutical company or other group with more money than God.
> Thankfully the pharmaceutical companies occasionally let something
> good slip through the cracks.

Did they do more research? Did they continue? This was 10 years ago, is there any more
information?

>>> No, your doctor prescribed what he knew. Are you saying that
>>> somehow all doctors should know instantly what will
>>> and won't work, and that they should embrace every new discovery?
>>> Instead of doing what they have done before and
>>> had good luck with?
>
> The good Dr. should have knows because his job as a gastroenterologist
> is to know guts, and the misinformation he has been using was obvious
> wrong well before he treated me (he had about 2 decades to get things
> straight on a topic of crucial importance to his field of work). The
> Dr. believed what he wanted to believe not what was logical. And yes,
> Dr.s should embrace every new discovery that is tested for years and
> proves itself to be the most likely correct solution. When to start a
> new treatment is a gray area, but horrible theories that have no basis
> for reality should never be adopted. The point is that he never really
> had "good luck" with the traditional treatments.

I have met several Gastro's. Some are surgeons, and obviously those opt for surgery
more often than others. Some are more cautious. Some are more open to suggestion.
Oddly, I have found all 3 in one practice together. :(

> A Dr. had to infect himself, document health before, gastritis after
> infection, and health after antibiotic treatment to get decent
> attention for this causal relationship. Before that Dr. the evidence
> was mounting similar to MAP and CD, but he made it in our face so only
> really stubborn Dr.s totally deny the powerful connection to this day.

Sorry, I don't agree that this proves anything. I am not always sold on the other tests
done on lab rats or other animals. If something is induced, then all the test
accurately and positively shows is that the treatment works (or doesn't work) on the
induced condition. Unless the people have the disease induced, I am not completely
convinced that the experiment and results prove anything beyond a casual relationship
that may need further testing and research.

Inducing a problem may be a valid research tactic, but people are more complex and the
causes of diseases may be more than what appears on the surface. If you induce a
disease, or at least the symptoms of the disease, have you -really- created an accurate
example? Or have you just created conditions that will prove your theory (a staged
example)?

> Similar to CD and MAP people pointed out that more people have H.
> Pylori than have ulcers and gastritis. And this is where I expect you,
> Doc, would chime in and say, 'genetics and environment have a role to
> play, but H. Pylori is the principal causative agent and is necessary
> to develop full blown ulcers.' I get the impression you would point
> out the complexity of the situation, and I would point out that one
> bacteria is absolutely necessary in the majority of cases to cause
> disease where genetics can't be proven to a reasonable threshold to
> have an effect. In short there is some noise to the equation
> (genetics, environment, stress?) but still a great deal of
> predictability. The only way to cure an ulcer reliably is with
> antibiotics, which partly demonstrates a causal relationship. By the
> way the second leading cause of ulcers is NSAIDS. How many Dr.s warned
> us that aspirin can cause ulcers? The answer is a shameful amount.

Ulcerations can be caused by any medication. I can swallow acid and get ulcers.
Antibiotics won't cure that one!

That is an extreme example, I use it to illustrate the problem with a one size fits all
solution.

Stress can still cause ulcers. Asprin can cause ulcers. Pentasa can cause ulcers.
It's a question of where is the ulcer located, what has happened in that area, what has
the person been doing/eating/breathing prior to the ulcer. H. Pylori causes some
ulcers. That is great news and helps a lot of people. I haven't researched H. Pylori
enough to know how many people are exposed to it that don't get ulcers, so I don't know
if it actually relates to exposure to MAP or not, so I can't postulate on whether it is
an opportunist or the cause.

I do know that people on long term medications can get ulcers in the esophagus,
especially on the LES, which leads to a form of GERD where the person will need to
regulate thier stomach acid content due to the LES no longer closing properly. Which
means more medications... :(

I do know that NSAIDS and other drugs can cause ulcerations in the system, those are
healed by withdrawing the medication and allowing time to heal the ulceration.
Antibiotics would only assist if the ulceration is infected (which it might be) but are
not healing the ulcer, just allowing the body to heal it by removing any other unwanted
attackers. As I understand the H. Pylori issue, it IS the cause of the ulcer and the
antibiotics remove it and the ulcer heals.

> Today almost the same exact story is being acted out with CD and MAP.
> Dr.s refuse to believe evidence. Big pharma takes Dr. Doe and his
> entire staff out for free lunch to discuss amphetamine deficiency in
> children. Dr.s are prescribing medicine that in the short term
> diminish symptoms but don't cure and, if MAP is the cause are doing a
> great deal of harm.
>
> For the sake of argument, assume I'm biased to hate big pharma. I have
> had very negative experiences that may not be characteristic of the CD
> population at large and their relationship with Pfizer or whatever.
> But I have had some positive experiences. The point still remains that
> there is a significant financial inventive for a capitalist based
> health system to maintain a certain level of symptoms. Countries like
> Sweden and a few other more socialized modern countries have taken a
> more aggressive approach. Sweden for instance, I have read, has signed
> an initiative to eliminate MAP in cattle because of the threat that it
> causes CD. Also this is part of a bigger pattern of medical denial of
> true science in favor of financial incentives.

I can't argue with your position. I do know that often the medicines a doctor
prescribes, especially the ones he can give out as free samples, are based on
advertising and sales pitches.

Until people are perfect, we will follow the dollar. And will continue to make mistakes
and errors. Can't be helped.

I'd rather all the research and medications were done to benefit man and not for
profit... but if I beleived it would happen that way I would be crazy. Don't you think
that if the MAP studies had proved out that the pharmacuetical companies wouldn't have
started marketting pills/elixers with the antibiotics you need? That they wouldn't have
been hardselling thier products over any natural ones? The more oportunities to make
money for them, the better. Why limit to one product to treat one disease when you can
sell multiple products for one disease. Better market presence and more income.

> Do the math. How much does each bottle cost that a typical CD patient
> takes in during the course of a month? How long do we typically live
> after diagnosis; over 2 years? Most patients already ARE lined up for
> the newest ineffective long term disease maintenance program
> available. How much does surgery cost? Follow they money and many
> answers will be revealed. Why cut the supply of income short?

CD patients can live to their "normal" date of death with minimal maintenance. Some
have it worse than others and will get ill faster and maybe wouldn't live as long if
untreated. Some spend their entire lives with minimal flares and mostly remission. The
disease isn't cut and dried, remissions aren't something you can count on.

> Reinfection is easy to avoid if you know the cause. If if we were
> reinfected once every other year mycobacteria grow slow. Also dairy
> would take a beating in the market. Most dairy tested in U.S.A. does
> have live MAP according to all but about one study done by the FDA I
> think. They froze the milk dehydrated it and then pasteurized it as
> normal.

Therein lies the problem with MAP being the cause. If it were the cause, such as H.
Pylori has been shown with some majority of ulcers, then more people would be diagnosed
with Crohn's since milk is a high consumption product. The fact that not everyone who
drinks milk gets Crohn's either suggests that not all milk has MAP in it (which you
state it does) or it isn't the cause, just an opportunistic bug. Granted, not all
people will react to a bug anyway, I am sure there are people who don't get ulcers from
H. Pylori either. But the incidence isn't high enough to prove out MAP=Crohn's. And
while the case I know if is a study of one, antibiotics did not make a noticeable
difference, especially in the long term while Pentase, Immuran, and ultimately Remicade
did make differences.

>>> There was, several years back, a lot of study being done on MAP. It
>>> didn't prove out, and so funding and studies
>>> have dropped off.
>
> Doc, on the topic of past research, one standard works both ways. If
> my studies are too old then ones before them are far too old. But all
> of this is relative so far. Now the situation is that the recent
> research - post macrolide treatments - are better overall than the
> past research before which used: 1. the wrong type of antibiotics 2.
> the wrong combination of antibiotics 3. antibiotics for a far too
> short duration etc. These and other facts easily explain the remaining
> 5 - 20% of the patients in these well done studies that don't show
> long term progress for a long period of time (more than 2 years in
> some studies), and these explanations according to researchers on this
> topic say explain why CD wasn't aided by antibiotics earlier. Old
> studies (by my standards pre-macrolide antibiotics) used antibiotics
> that were effective against TB but not MAP. You can't drown a fish
> even with lots of water, and MAP can't be killed with certain
> antibiotics even large amounts. Saying that many studies were
> fruitless while factually true is misleading by omission of facts. And
> any Dr. or person for that matter who holds this information from you
> is probably either deceptive or ignorant. The earliest studies should
> be disguarded when a better explanation replaces no explanation
> (superstition magic etc.), or a poor explanation, but not because they
> are old. Old is relative, besides.

The difficulty is that there are no recent studies. No recent programs. Which leads me
to beleive that as a single cause, MAP has been ruled out. HOWEVER, I wish to point out
that I don't agree with just forgetting the research that has been done either.

I still think there is more than one form of Crohn's. Since the disease seems to affect
people differently. Not everyone gets the disease in the same areas. Not everyone
responds to the same treatments. I don't think a blanket solution will be found. I do
beleive there is more to it than just bacteria, but only time will tell on that as well.
Genetics looks promising, but even that hasn't found one single marker in every patient.

What the current research will show (to those who are willing to look) is that Crohn's
has many different variations or is different diseases with similar identifiers.

I do beleive that Crohn's is an autoimmune disease. I also beleive it could be
"caused" by MAP. As in MAP induced Crohn's or Automimmune Crohn's.

I don't like the way research tends to be done. All or nothing research seems to be the
norm. Absolutes don't really exist, and the way research and treatments are done does
exclude potential solutions that would benefit some people.

> What's amazing to me is that you can read over 90% of the patients are
> completely off of antibiotics, and all other prescription medication
> and have no signs of active disease, and write that the success
> stories are shaky science or unimpressive. The results were replicated
> several time, many studies showed a statistically significant
> relationship, and the logic is all quite convincing. I've tried every
> dim witted idea in the book as well, and your right to say that
> nothing is conclusive, but no theory will ever be absolutely
> conclusive with anything. MAP is a theory that explains CD better
> according to science and logic, but not special interests. And yes big
> pharma is not my friend; I don't think they are your friend either.

I attended a few CCFA meetings. Got to meet a gentleman who had tried everything that
had been proposed for Crohn's. He never quite got "cured". He was in his late 70s when
the disease suddenly went into complete remission. One the one hand, he was happy to be
limited to only a maintenance regime, but on the other hand he wished it had happened
back when he had more youth so he could enjoy himself more.

My problem with "cures" or continuing success is that the disease can and will go into
remission without any idea of why it did. Which brings up, in my mind, that anytime a
regiment shows a clear pattern like MAP of a solution, I would like to cheer... but only
time will tell if this is a solution or the stupid disease messing with these people.

Sorry, I would love to cheer... but have seen too much failure, pain and disappointment
to accept cures or solutions easily.

> What I'm doing now is to try to put together an over the counter
> regime that is equal in effectiveness to the prescribed ones that have
> proven their effectiveness already. This is difficult to say the
> least, but I have been experimenting and researching for years. I
> already have figured out enough to gain all my weight back plus some
> and most of my health w/o any prescription meds and with horrible
> advice from friends and family, well meaning of course. I already have
> a dietary and lifestyle regime that for me works 100% of the time but
> is too difficult to realistically follow for months at a time. No I'm
> not cured yet, but I feel pretty dam close and objectively measurable
> symptoms verify my opinion, and I'm not gonna stop experimenting on
> myself until I'm cured.

And by all means continue. Not that you need approval from me or anyone else, but I do
applaud your efforts. Keeping in mind that what works for you may or may not help
someone else. Of the diseases I have been aware of (direct contact with family or
friends) this one is an annoying one since there seems to be so many variables.

> I hope to hear from people that are fellow
> scholars whom experiment with different herbs. Eating more than a cup
> of coconut oil a day is difficult but it puts me in remission if I
> don't take in drugs as well - nicotine, caffeine, alcohol, etc.

Coconut has been mentioned as helpful before. Macaroon cookies seemed to be a fun
source of this, as I recall.

> Perhaps I would be cured like the cows in one of the studies I
> referenced if/when I'm more disciplined, but for now I'll just try new
> herbal combinations w/ coconut oil until I can smoke, drink, etc. or
> at least eat less coconut oil. By the way, what I'm doing now is much
> much cheaper than taking prescription pills from America (China is
> much much cheaper for any route but I can't afford to go to China or
> other places yet). Also I just found some interesting studies on the
> in vivo effectiveness of herbal extracts on TB which is related to
> MAP. All the ingredients are less than a cup a day so that means I may
> possibly find a synergistic combination that allows me to eat less
> coconut oil - something that is much easier to comply with.

Great. And I hope you acheive health.

> Now, if you have something that makes prescription med and symptom
> free for over 2 years by the majority of severely afflicted CD
> patients seem unimpressive, I would really like to read about it. Even
> if you were a board certified gastroenterologist I would want to know.

Don't I wish. The closest we could ever become to this is if the government decreed
that all medical costs are now fixed, and all covered by the government with a modest
increase in taxes (which would be offset by the money we would no longer need to spend
on copays, private insurance, etc). The only way this will happen is if we get a
dictatorship with a benevolent dictator. Which will probably only last, at best, until
his death and then some greedy SOB would get into power and everyone would be shafted.

There is no easy solution.

> We may well just have to have a gentleman's disagreement as to what is
> truly biased. I believe that financial incentives create bias among
> other things, and I have a suspicion most people, perhaps you even,
> suspect those financial interests bias certain authority figures at
> least slightly. After all who would argue that a lawyer is moral by
> what a lawyer does? A lawyer is neither moral nor unmoral to defend a
> criminal, simply amorally defending a client. A Dr. has to feed a
> family, and will probably believe the constant drumbeat put forth on
> the tube just like most other people that watch it. I don't hate them
> personally but I don't trust them either (with good reason), as they
> are part of a broken system. My distrust of those with strong
> misaligned incentives and the distrust many others harbor, is really
> just a statement based on fact. Dr.s really are biased because their
> incentives are thus. Dr.s with different incentives will prescribe
> differently. All I'm saying is that you wouldn't call distrust of an
> opposing lawyer to you're defense bias any more than I would call your
> apparent trust in Dr.s bias. We all know that because a lawyer is paid
> more to get a certain outcome regardless of justice, we shouldn't
> trust the opposition to be just. We can rely on a fair amount of bias
> though. Sometimes even people that appear to be on our side are in
> fact still out to make a quick buck. As a slightly off topic example:
> Freakanomics a book has a chapter on real estate agents and the KKK.
> Real estate agents will typically sell their own house for much more
> than your house because they can get paid quicker then repeat another
> quick sale. I call that incentives; I call that bias. Why call me
> biased; do you think I own stock in garlic, coconut oil, or
> something?

We are all biased to some point. We have our beleifs and causes. Not always monetary.
I do come off as someone who beleives in doctors, maybe I have just been lucky enough to
find doctors who seem to care and are willing to listen to thier patients (even if they
have to have a "knocking at deaths door" scare to make them realize they might be
wrong). Or maybe I am just more annoying in person with these people that they listen,
prescribe, answer questions, etc just to get rid of me quicker. I spent a lot of time
reading links to studies and research. Buying books, perusing the library shelves,
reading reports, and talking with people to try and find solutions, or at best something
that would bring back a quality of life. I don't think I have found the answer, and at
times it doesn't seem to matter if I do. All the work I did was for my (now) ex-wife
and since she has left it seems moot. But my current wife has some problems. My mother
has Colitis (but won't talk to me about it much) and I suspect my daughter has a problem
but hasn't shown enough sign to be properly diagnosed. So I still read here, interject
a little and hope to learn from discussion such as this. I hope to come across as
someone who is questioning and learning, but I know I also come across pretty harsh
sometimes. My moods aren't perfect either.

I have tried to present my thoughts and comments here. I didn't answer immediately
because I didn't have time to fully read what you wrote until today. My life is pretty
hectic sometimes, and since I try to have intelligent discourse, I had to wait until I
could at least read your entire post and check the links you provided.

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