Thursday, February 26, 2015

Study group discussion: Chain messages

There was a chain message being circulated on Whatsapp which started our discussion. The discussion gave me a new perspective on things.

I never read chain messages because I find them stupid. But one awesomite pointed out on how we must be aware of chain messages, since as a doctor, we'd undoubtedly run into patients who've read things like that and we should be able to talk to them about those things.

Also, tell us about stuff you've read on the internet that had no proved scientific basis, incidents of people who have believed such messages and outcomes associated with them. I'm interested and open to these things now as I feel there is value in knowing them.

I'm posting the discussion we had here for ya'll to read -

This was the "Prevent Swine Flu" message forwarded on our study group:
1. Frequent hand-washing (well highlighted in all official communications).
2. "Hands-off-the-face" approach. Resist all temptations to touch any part of face (unless you want to eat, bathe or slap).
3. * Gargle twice a day with warm salt water (use Listerine if you don't trust salt).
* H1N1 takes 2-3 days after initial infection in the throat/ nasal cavity to proliferate and show characteristic symptoms. Simple gargling prevents proliferation. In a way, gargling with salt water has the same effect on a healthy individual that Tamiflu has on an infected one. Don't underestimate this simple, inexpensive and powerful preventative method.
4. Similar to 3 above, * clean your nostrils at least once every day with warm salt water.
* Not everybody may be good at Jala Neti or Sutra Neti (very good Yoga asanas to clean nasal cavities), but * blowing the nose hard once a day and swabbing both nostrils with cotton buds dipped in warm salt water is very effective in bringing down viral population.
5. * Boost your natural immunity with foods that are rich in Vitamin C (Amla and other citrus fruits).
* If you have to supplement with Vitamin C tablets, make sure that it also has Zinc to boost absorption.
6. * Drink as much of warm liquids (tea, coffee, etc) as you can.
* Drinking warm liquids has the same effect as gargling, but in the reverse direction. They wash off proliferating viruses from the throat into the stomach where they cannot survive, proliferate or do any harm.

Is this actually good medical advice (Except for the sensationalist language...)?
1 and 2 definitely sound like good advice, but 6 sounds a little bit questionable to me.

Forwards always sound questionable to me! I've never heard about "Drinking warm liquids to prevent viral proliferation" though.. I'll look it up!

I tried Googling all sorts of stuff for the warm tea bit and found nothing on the 6th point.
Then finally, I Googled, "Reverse Gargling" and the forward created by the same guy comes up! There is no such thing!

It seems like a publicity move by the doctor who wrote it. (Why would any one list the names of hospitals they visit in an educational advice?!)

I'm interested in understanding the yoga for nasal cleansing!?

You can Google for videos. And do not try unless you are confident enough that you can do it. Sometimes the water goes in the wrong pipe!

I didn't mean interested as in wanting to try it :P
I'm from Britain so these sort of techniques are rare to say the least.

Yoga for nasal cleaning is simply putting water in one nostril and getting it out through other nostril. Simply irrigation and drainage.

Nasal yoga reminds me of Neti pots. Anyone wants to weigh the scientific evidence of that?

I wouldn't really trust this advice. I speak this from personal experience. Some guy who used to believe in these things told my grandpa to do some of these practices. He told my granddad to basically eat upwards of 6 lemons a day and also convinced him that the lemons would reverse effects of hypertension and diabetes. It didn't work, my grandpa passed away. I know this isn't relevant to the group, but I'm always wary of advice such as this.

That sounds so much like bad advice...  Everything in moderation. Six lemons a day is not moderation. Also, lemons have so much sugar in them, wouldn't that exacerbate the diabetes?

It's so sad that people believe such things and over do it causing more harm than good.

I didn't read after I looked at the last line - "Forward this to everyone and 20 might live cause of this." :/
It's when you guys got it to my attention that I actually read the whole thing!

I'm pretty wary of any kind of chain email advice. I think there's value in discussing them and critically analyzing them from a more scientific point of view, though. Especially since as a doctor you'd undoubtedly run into patients who've read things like that, and you'd need to be able to talk to them about those things.

I agree with that!

I once read of a case where a young girl was told to rub almonds on her face to clear acne, but her "acne" just kept getting worse. Turned out she was allergic to almonds.

Our residents had a discussion on how each and every relative was asking about Ebola because of the forwards they were receiving!

My aunt is very into chain emails.   I usually try to find time to point out all the scientific inaccuracies in them.

I don't trust anything.. Except soup for cold and honey for soothing the throat!

Soup works wonders!

See some things do no harm, like old wives tales of rubbing a potato on warts then burying the potato... But others are strange and potentially harmful.

There is some good science in some of these chain emails. But there is so much bad science.
Like the one that recommended aspirin to prevent heart attacks.   I mean, yes, it can certainly help, but it can also kill you if you have certain health conditions or if you try to overdo it.   Eating as much aspirin as you possibly can is also very much a bad idea.

The one I enjoyed most was the one that said cancer cells can't grow in alkaline environments so people should eat alkaline foods! I worked in a cancer research lab.  We grew cancer cells in alkaline medium!

Hahaha! This one is hilarious.

I was about to ask for hilarious incidents and here we have one!

Hahahaha my mum believed the alkaline treatment for cancer and my expression was basically: T_T
But there seems to be substantial information on alkaline treatments for cancer. Apparently, it's all over Google.

My aunt and mother believed it too.   But then I told them about the fact that we cultured cancer in alkaline medium with great success and they decided to believe me instead.

So umm what's alkaline food anyway?

Fruits are the main source of alkali in our diet. - Ganong

I tried looking up alkaline foods...  Orange was listed as one of them...

All I can think of is.. Food that alkalinizes urine. Cause citrus fruits do that!

Ah, that makes sense!

Hmm. I wonder if perhaps the foods that alkalinize urine can prevent cancer.  I doubt that causing the body to be more alkaline (Can that even be done?) would help with cancer, but perhaps the thing that makes foods alkalinize urine, or something else those foods have in common, also helps with cancer.

The only benefit alkalinizing foods can offer is prevention of kidney stones and maybe overdose of a few drugs, scientifically.

But then surely we would circulate "Food that contains this compound..." Rather than food that alkalised. If there was a common anticancer property that wasn't anything to do with alkaline food.

Hmm...  I'm disinclined to believe that The importance of knowing chain messages in modern Medicine it has any genuine anticancer properties, but I'm equally disinclined to reject the possibility.  I would like to see scientific evidence before forming an opinion either way. Medical research is constantly happening.  Just because we haven't discovered something doesn't mean it doesn't have merit.

I think the creator of the chain message (Considering he considered anything!) wanted to highlight that we should consume fruits to prevent colon cancer - so they used words like alkaline and stuff to make it all science-y and legit to the lay man?

That makes some sense, although I don't know why on earth they couldn't just use legitimate science.   It's possible to use fancy science words to make even basic science seem legitimate to people.   Especially with medicine where all the parts of the body can be expressed in fancy Latin.

But it spooks the lay-man into overdoing it. It's potentially harmful.

I agree so much. That's a very genuine concern. Even too much water can kill you, and I think that's a thing people fail to appreciate.

Yes, but in a perfectly healthy individual - Fruits would do no harm.

I must say, it's those who are affected by chronic diseases are more inclined to believe "Anything that could be of potential help" to them in curing their sickness.

*We discussed water intoxication syndrome. Since it's irrelevant to this post, I wrote a separate blog post on it here --> *

Woah. There are always some messages circulating on whatsapp regarding some wonder drug with a 100% guarantee.

My father gets influenced too. Due to some video.. I spent 15 mins explaining that white bread is bad for health and brown bread is good.

But but...Aren't the benefits of fiber well known?

White bread is simple nonsense.. It's bad for your intestines.. Plus no real nutrient benefit. It is refined wheat.. So there is hardly and fibre property to it.

How is it bad for the intestines?

I had come across a patient who had an intestinal onstruction. She was denied eating white bread. It reduces bowel movements.

“The Whiter The Bread, The Sooner
You’re Dead.” I've heard the phrase somewhere!


Wow. Seriously.

Whole wheat is all good. Except in patients suffering from celiac disease..I haven't come across any other condition where they shouldn't be eaten.

Gluten freeee.


My mother was convinced that she should go on a gluten free, casein free diet even though she isn't diagnosed with celiac disease or anything like that. Someone told her that going GF, CF was good for everyone regardless of medical history.

It's not a bad idea per se, but I reckon patients who are not trained or well informed about nutritional science are at higher risks of deficiencies especially if they restrict their food choices. I think as physicians we should inform them of the possible risks and still provide them the autonomy and explain how to alter their diet to prevent deficiencies. Like vegetarians basically.

I guess I minded more that she wanted me to go on a GF CF diet and I enjoy too many gluten and casein containing foods for that to make sense for me.

Lol. Well I feel the same way. But we shud be realistic about the risks and not overexaggerate the dangers of gluten free diet because then the Coeliac's society might be affected as well.

But vaccines on the other hand, I'm sorry but we need to jab everyone possible because it's a public health issue.

Yes. Vaccines causing autism is utter bull. People are forgetting how bad the vaccine preventable diseases are (Since they don't see them anymore, thanks to the vaccines) and are being ignorant!

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