Medical Myths

[canuck31003]

Last month the British Medical Journal published an interesting article, titled "Mixed Messages: Medical Myths" (Vreeman and Carroll, BMJ 2007; 335: 1288-1289). In the article researchers from the Indiana School of Medicine examined common medical beliefs endorsed by some physicians and the lay public.

Here are seven medical myths the authors focused on:

1. People should drink at least eight glasses of water a day.
2. We use only 10% of our brains.
3. Hair and fingernails continue to grow after death.
4. Shaving hair causes it to grow back faster, darker, or coarser.
5. Reading in dim light ruins your eyesight.
6. Eating turkey makes people especially drowsy.
7. Mobile phones create considerable electromagnetic interference in hospitals.

You can follow the above link to the article if you want to read the authors' supporting evidence and references.

For myself I thought 1, 2 and 5 were true.

Anywhoo, the authors conclude their article by saying:

"Despite their popularity, all of these medical beliefs range from unproved to untrue. Although this was not a systematic review of either the breadth of medical myths or of all available evidence related to each myth, the search methods produced a large number of references. While some of these myths simply do not have evidence to confirm them, others have been studied and proved wrong.

Physicians would do well to understand the evidence supporting their medical decision making. They should at least recognise when their practice is based on tradition, anecdote, or art. While belief in the described myths is unlikely to cause harm, recommending medical treatment for which there is little evidence certainly can. Speaking from a position of authority, as physicians do, requires constant evaluation of the validity of our knowledge."

[Greenmandmz]

I can guarantee you one thing with this thread. When he logs-in, jeriddian is going to be all over this one!

I've heard of some of those, but never paid much heed to them for the most part. Don't think I've heard of 3, 5, or 6 though.

[jeriddian]

Last month the British Medical Journal published an interesting article, titled "Mixed Messages: Medical Myths" (Vreeman and Carroll, BMJ 2007; 335: 1288-1289). In the article researchers from the Indiana School of Medicine examined common medical beliefs endorsed by some physicians and the lay public.

Here are seven medical myths the authors focused on:

1. People should drink at least eight glasses of water a day.
2. We use only 10% of our brains.
3. Hair and fingernails continue to grow after death.
4. Shaving hair causes it to grow back faster, darker, or coarser.
5. Reading in dim light ruins your eyesight.
6. Eating turkey makes people especially drowsy.
7. Mobile phones create considerable electromagnetic interference in hospitals.

You can follow the above link to the article if you want to read the authors' supporting evidence and references.

For myself I thought 1, 2 and 5 were true.

Anywhoo, the authors conclude their article by saying:

"Despite their popularity, all of these medical beliefs range from unproved to untrue. Although this was not a systematic review of either the breadth of medical myths or of all available evidence related to each myth, the search methods produced a large number of references. While some of these myths simply do not have evidence to confirm them, others have been studied and proved wrong.

Physicians would do well to understand the evidence supporting their medical decision making. They should at least recognise when their practice is based on tradition, anecdote, or art. While belief in the described myths is unlikely to cause harm, recommending medical treatment for which there is little evidence certainly can. Speaking from a position of authority, as physicians do, requires constant evaluation of the validity of our knowledge."

Well, canuck, I see I will have to clarify a few things here..........

First off, yes, the eight things you decribed above are indeed old wives tales that has been well known in the medical community not to be true. This is not the first time it has been publicly made known. Unfortunately, there are a few physicians (who should know better), but mostly other health professionals (nurses, PA's, etc.), who promulgate these myths because they haven't learned any better. We physicians are very much aware about the evidence of our decision making so the above bolded statement is actually incorrect.

Unfortunately, despite the fact we very often make such information known to the laity, it is not heeded. Witness for example the forty to fifty year campaign the medical community has waged against smoking and the damage and injury it can cause, yet there are people out there who do not know or do not believe the evidence that we have gathered to support the warnings we give them. These eight items are simply some of the myths that we have debunked over time. It's just that not many people have listened. People go see their doctor because they have to do it, not because they like to do it. They usually aren't interested in reading up on that sort of stuff.

While there is an art to medicine (at least for the time being....a subject I will not expound on at this time......), please be very aware that we do NOT recommend medical treatment based on myths, tradition, or art but rather on the best scientific evidence available. We are scientists after all. We just happen to be scientists that put our knowledge to work in a practical manner, i.e. applied science which does incorporate elements of human interaction which may not be science based (as oppossed to pure science as you would find in the laboratory or in research) which can be described as the "art" of medicine.

Telling a physician that "he would do well to understand the evidence supporting their medical decision making" is like telling a professional photographer he has to take the lenscap off the front of the camera if he wants to get a picture. This statement was made by a journalist who doesn't know anything about medicine thinking he has made some profound statement, and not realizing it is basic doctrine taught in the first days of medical school. The first rule of medicine is still "Primum Non Nocere". In latin, this means "First, do no harm". That means you have to be very very careful in what you prescribe in terms of treatment of a patient, whether it be surgery, medication, diagnostic studies, referral to another physician, or even just observation.

What this means is that in order to procure the best chance of helping your patient and minimizing the chance of harm is that whatever action is taken must be proven to to be the best available option. That can only be done using the scientific method, and yes, that does mean using Koch's postulates and everything that is derived from that scientific method. That will always be done first. A good physician always practices evidence based medicine. His or her diecisions are always based on the best available scientific evidence as to what is the best thing to do. This is why physicians are required to continue to study and learn. Every physician must continue to study as licensure in every state requires it. A physician must accumulate a certain number of hours of continuing medical education per year in order to renew a physician's license every year (or every two years in some states). The actual number of hours required varies from state to state.

The art of medicine comes in when dealing with people. For example, when a physician has to go in and tell a patient he has a fatal disease such as cancer (a situation I might add I have encountered a good number of times), there is an element of compassion and human relationship that is not defined by the scientific part of medicine. This is part of the "art" of medicine. How a physician would act the proper part of a physician in such circumstances cannot be defined by science.

Other skills are requried that are not scientific, thus the "art" of being a physician is partially defined by these skills among others. The "art" also requires being able to relate positively and courteously with people in all walks of life, be it patients, hospital workers, nurses, administrators, other physicians, government officials, lawmakers, lawyers, and other related professionals, often in very trying or even adversarial situations. This is required to be able to set up the environment in which the treatment of patients can even be done in the first place. This does not involve the sceince part of medicine so much although it will generally have bearing.

For example, how I would approach one patient about treatment may not be the approach I would use with another patient that has a different personality. How I would treat one patient with a certain disease may not be the same way I would treat a different patient with the same disease. That are many many factors that the laity does not realize come into play that may make a physician's decisions seem haphazard, but really are not.

For example, a 47 year old male who just had is first heart attack and has normal renal function would get far more aggressive care and treatment than the 87 year old woman with pre-existing heart disease and renal insufficiency. Chances are good that no aggressive preocedures would even be done on the old woman whereas doing that to the 47 year old man could almost be construed as malpractice.

In conclusion, the elements involved in making a decision on how to treat a patient are myriad, and the vast majority of them are simply not apparent to the patient or the laity when the decisions are made. This does not mean a physician should not explain what is being done to the patient. On the contrary, he is required to do so (at least in my oipinion), and which I do on a regular basis (something that unfortunately many primary physicians cannot do in their practice simply because they don't have the time for it. They are so squeezed financially, they would literally go out of business if they tried to spend the time to do it. The reason is simple. They don't get paid to talk to the patient, which is a sad state of affairs.). However, I am also somewhat limited in trying to explain in as simplified a manner as I can that they can understand some very complex scientific concepts and terms. So even that is an art in and of itself.

But be assured, a true doctor always practices evidence based medicine, based on solid scientific research. This does not mean that tradition or anecdotal evidence cannot play a part in his or her decision making, but those things always play a secondary and supporting role only, if at all, in the treatment of a patient.

[TransWarpDrive]

Originally posted by jeriddian:

Telling a physician that "he would do well to understand the evidence supporting their medical decision making" is like telling a professional photographer he has to take the lenscap off the front of the camera if he wants to get a picture. This statement was made by a journalist who doesn't know anything about medicine thinking he has made some profound statement, and not realizing it is basic doctrine taught in the first days of medical school.

In other words, this reporter's being "Captain Obvious," huh? :P

I remember a medical myth we heard in high school. We were warned not to take a drink of water after vigorous exercise - IIRC, it had something to do with the possibility of getting sick to one's stomach. (This was even mentioned in one of those 1950s-vintage health movies we were shown back then.) I vividly remember my freshman-year gym teacher yelling at one of my classmates once about using the drinking fountain right after the kid had finished running a few laps. Boy, talk about ignorant...

[Fireand'chutes77]

I knew it was only a matter of time before Jeriddian took a crack to it.

1. People should drink at least eight glasses of water a day.
2. We use only 10% of our brains.
3. Hair and fingernails continue to grow after death.
4. Shaving hair causes it to grow back faster, darker, or coarser.
5. Reading in dim light ruins your eyesight.
6. Eating turkey makes people especially drowsy.
7. Mobile phones create considerable electromagnetic interference in hospitals.

I'm sorta on the fence about #1. I know it's important to remain hydrated, and that body functions and mental sharpness increase when given enough water; most times, we don't drink enough. As taught in the Scouts, it's sometimes good to drink large amounts of water, such as when at altitude or backpacking. At the same time, it's not good to have *too* much water, as graphically shown by that one "water drinking contest" that killed somebody. My view is that they tell us to drink 8 glasses of water each day, knowing it will motivate us to drink 6.

I'd known #2 was wistful thinking on humanity's part that "we can do 3000% better if we just do _____", #3 was bogus, #6 was simply due to redirection of blood away from the brain to the stomach, and if #7 was true, we'd have had a lot more uproar about it and cell phones would've been banned from hospitals already. Mythbusters showed that cell phones don't affect avionics, so they probably wouldn't affect hospital equipment.

I thought #4 was true, since "Good god, I just shaved yesterday!!" I was skeptical that reading in dim light *ruins* your eyesight, but I knew it contributed to eye strain and isn't very comfortable.

I vividly remember my freshman-year gym teacher yelling at one of my classmates once about using the drinking fountain right after the kid had finished running a few laps. Boy, talk about ignorant...

My dad's told me stories about stuff like that from his high-school football team days back in the late 1950's. He said the coaches would say, to paraphrase, "Warrrgggh! You sissies! Water?! You don't need water! Water is for wimps! Here, take these salt tablets!"

To which my reaction was:

They're just lucky none of the team had heart failure right on the field...

EDIT: We were warned not to take a drink of water after vigorous exercise - IIRC, it had something to do with the possibility of getting sick to one's stomach.

I can see some truth in that one, though. While doing some strenous workout on my mom's fitness trampoline, I have to be careful about downing Gatorade, since it makes me feel like I'm going to sick/choke/backwash. I envision it's akin to throwing cold water into a boiling radiator.

[jeriddian]

Originally posted by jeriddian:

Telling a physician that "he would do well to understand the evidence supporting their medical decision making" is like telling a professional photographer he has to take the lenscap off the front of the camera if he wants to get a picture. This statement was made by a journalist who doesn't know anything about medicine thinking he has made some profound statement, and not realizing it is basic doctrine taught in the first days of medical school.

In other words, this reporter's being "Captain Obvious," huh? :P

I remember a medical myth we heard in high school. We were warned not to take a drink of water after vigorous exercise - IIRC, it had something to do with the possibility of getting sick to one's stomach. (This was even mentioned in one of those 1950s-vintage health movies we were shown back then.) I vividly remember my freshman-year gym teacher yelling at one of my classmates once about using the drinking fountain right after the kid had finished running a few laps. Boy, talk about ignorant...

The reason for that myth was that when you exercise heavily, you take blood flow away from the splanchnic circulation (the circulation to the gut adn GI tract), so it's somewhat blood deprived. It was thought stressing it at that time by ingesting fluids would cause the upset and vomiting, but this has been found to not be true in the vast majority of cases.

I knew it was only a matter of time before Jeriddian took a crack to it.

1. People should drink at least eight glasses of water a day.
2. We use only 10% of our brains.
3. Hair and fingernails continue to grow after death.
4. Shaving hair causes it to grow back faster, darker, or coarser.
5. Reading in dim light ruins your eyesight.
6. Eating turkey makes people especially drowsy.
7. Mobile phones create considerable electromagnetic interference in hospitals.

I'm sorta on the fence about #1. I know it's important to remain hydrated, and that body functions and mental sharpness increase when given enough water; most times, we don't drink enough. As taught in the Scouts, it's sometimes good to drink large amounts of water, such as when at altitude or backpacking. At the same time, it's not good to have *too* much water, as graphically shown by that one "water drinking contest" that killed somebody. My view is that they tell us to drink 8 glasses of water each day, knowing it will motivate us to drink 6.

The kidneys of a healthy young person such as yourself are capable of excreting a maximum of about 20 liters a day if you tried to drink that much, so trying to overload yourself that way would actually be very difficult. Can you see yourself drinking five gallons of water in a 24 hour period?:P But it can be done, and there are cases of psychogenic water drinkers who have succeeded in getting themselves into trouble that way.

I'd known #2 was wistful thinking on humanity's part that "we can do 3000% better if we just do _____", #3 was bogus, #6 was simply due to redirection of blood away from the brain to the stomach, and if #7 was true, we'd have had a lot more uproar about it and cell phones would've been banned from hospitals already. Mythbusters showed that cell phones don't affect avionics, so they probably wouldn't affect hospital equipment.

I thought #4 was true, since "Good god, I just shaved yesterday!!" I was skeptical that reading in dim light *ruins* your eyesight, but I knew it contributed to eye strain and isn't very comfortable.

Well, I don't know about the shaving. Mr. Barkin may certainly have been an exception.:P

I vividly remember my freshman-year gym teacher yelling at one of my classmates once about using the drinking fountain right after the kid had finished running a few laps. Boy, talk about ignorant...

My dad's told me stories about stuff like that from his high-school football team days back in the late 1950's. He said the coaches would say, to paraphrase, "Warrrgggh! You sissies! Water?! You don't need water! Water is for wimps! Here, take these salt tablets!"

That was predicated on the fact that sweat had salt in it, and it was thought you lost salt that way. But that was a faulty assessment. Sweat is actually hypotonic, which means you lose more water than salt, so you relly need water.

To which my reaction was:

They're just lucky none of the team had heart failure right on the field...

EDIT: We were warned not to take a drink of water after vigorous exercise - IIRC, it had something to do with the possibility of getting sick to one's stomach.

I can see some truth in that one, though. While doing some strenous workout on my mom's fitness trampoline, I have to be careful about downing Gatorade, since it makes me feel like I'm going to sick/choke/backwash. I envision it's akin to throwing cold water into a boiling radiator.

Not really, See my statement above. It may apply in extreme exhaustion conditions coupled with lack of proper intake of fluids and electrolytes.

[Fireand'chutes77]

EDIT: We were warned not to take a drink of water after vigorous exercise - IIRC, it had something to do with the possibility of getting sick to one's stomach.

I can see some truth in that one, though. While doing some strenous workout on my mom's fitness trampoline, I have to be careful about downing Gatorade, since it makes me feel like I'm going to sick/choke/backwash. I envision it's akin to throwing cold water into a boiling radiator.

Not really, See my statement above. It may apply in extreme exhaustion conditions coupled with lack of proper intake of fluids and electrolytes.

After doing the exercise thing today, I think I can see the problem. It's not the water itself that produces my reaction; it's the temperature of the water. Sloshing water directly out of the fridge into a hot throat produces the radiator effect. I've found I don't have a problem if I first run the bottle under hot water to bring it to room temperature.

[Ace Ian Combat]

EDIT: We were warned not to take a drink of water after vigorous exercise - IIRC, it had something to do with the possibility of getting sick to one's stomach.

I can see some truth in that one, though. While doing some strenous workout on my mom's fitness trampoline, I have to be careful about downing Gatorade, since it makes me feel like I'm going to sick/choke/backwash. I envision it's akin to throwing cold water into a boiling radiator.

Not really, See my statement above. It may apply in extreme exhaustion conditions coupled with lack of proper intake of fluids and electrolytes.

After doing the exercise thing today, I think I can see the problem. It's not the water itself that produces my reaction; it's the temperature of the water. Sloshing water directly out of the fridge into a hot throat produces the radiator effect. I've found I don't have a problem if I first run the bottle under hot water to bring it to room temperature.

I typically burp to remove that feeling after downing a few gulps of water after exercising. In my case it seems that I take in too much air and happen to swallow it when I'm drinking it after having worked myself over.