Which Stent for Your Older Patient with Coronary Artery Disease?

Which Stent for Your Older Patient with Coronary Artery Disease?


Good Medicine: Do As Much Nothing As Possible

Good Medicine: Do As Much Nothing As Possible

”The delivery of good medical care is to do as much nothing as possible”

~ Samuel Shem, The House of God

Medicine is undergoing an existential crisis today. Its core value proposition – to help and not hurt — is failing to manifest. Patients are suffering. Doctors are suffering. The only exuberant party on the battlefield against disease is the pharmaceutical industryAn industry whose annual causalities far exceed the death total from our two decade long involvement in the Vietnam war.

The entire system is on the precipice of a collapse, if not for economic reasons alone, then certainly for ethical and intellectual ones. The irony is that the system has become so ineffective and dangerous that avoiding medical treatment (excluding perhaps emergency care) has become one of if not the best healthcare strategy you can implement to protect your health and well-being.

Nowhere is this clearer than in the realm of cancer. Over the past few decades, billions have been spent on screening asymptomatic populations to “prevent cancer,” with the result that millions have been assigned with questionable diagnoses (e.g.,”early stage-” or “stage zero-cancers”) and then shepherded into chemo, radiation and surgery treatments as if watchful waiting, or better yet, making significant nutritional and lifestyle modifications, would be a suicidal approach vis-à-vis the inexorability and presumed lethality of genetically-determined cancer.

We needn’t detail the misery this approach has produced, but suffice it to say that despite the industry’s claims of thousands of “lives saved” from the detection of “early cancers,” breast and prostate cancer specific mortality has at best stayed the same, and may have actually increased in some cases. In light of the fact that the financial costs of misapplied treatment in some cases is so high that the uninsured, their families, and society as a whole, face bankruptcy, the situation is dire indeed.

Even after the cat was let out of the bag in 2013, and a National Cancer Institute commissioned expert panel concluded that labeling screening detected lesions known as ductal carcinoma in situ (DCIS) and high-grade intraepithelial neoplastic hyperplasia(HG-PIN) (colloquially labeled as “breast cancer” and “prostate cancer,” respectively) as carcinomas (“cancer”) is no longer justified. Instead they opted for redefining what were previously considered potentially lethal cancers as “benign or indolent lesions of epithelial origin.” Yet, you hear virtually no mention of this change anywhere. Tens of thousands are still being diagnosed with the same “cancers” and being cut, poisoned and burned, without informed consent.

The lack of acknowledgment and discussion about these tremendous diagnostic “errors” is less surprising when you consider that about 1.3 million U.S. women were wrongly treated for breast cancer in the past 30 years, with prostate and lung cancer representing two additional icebergs upon which the Titanic cancer industry is presently running itself aground upon, regardless of whether the medical establishment will accept responsibility. Ignoring the truth that millions suffered needlessly, it would seem, is less painful than admitting wrong, and dealing with the psychological and financial fallout that inevitably follows. But is it possible to stem the tide much longer against the inevitable transformations brewing?

If you check the pubmed.gov statistics, interest in “overtreatment” and “overdiagnosis” has grown exponentially from only a few decades ago, when the terms were rarely mentioned. A new editorial, titled,  “It Is Overtreatment, Not Overdiagnosis,” points out the real issue behind the epidemic of cancer overdiagnoses:

The most widely accepted definition of ”overdiagnosis” is ”diagnosing a person without symptoms with a disease that will (ultimately) never cause symptoms or death during the person’s lifetime” (2). It should not be confused with misdiagnosis or false-positive findings, which are completely different entities and outside the scope of this commentary. As the generally accepted definition encapsulates downstream effects (ie, ”would otherwise not go on to cause symptoms or death”, the real issue lies with ”overtreatment” of these accurate diagnoses rather than overdiagnosis itself.

Overtreament does not happen in a vacuum. The very industries that produce the treatments also create and supports the “awareness campaigns” that not only use fear to corral the population into screening, but also “pinkwash” away their true causes, i.e. breast cancer awareness month talks about needing a cure but not the causes right under our noses (i.e. carcinogens). Therefore, the more diagnoses that are generated, the more treatments will be “recommended,” resulting in greater revenue and profit – an economic growth model that itself can only be described as a malignant process at least as violent, if not more, than the disease it is claiming to treat and manage.

The editorial concluded:

“The effects of treating inconsequential lesions, rather than their diagnosis per se, result in increased morbidity and cost without added benefit. Society as a whole should strive to treat individuals who should be treated and not those who would not benefit. The 13th law of Shem, true in 1978, remains true today.”

Essentially, modern medicine has become our most Orwellian institution, with “detecting cancer early” the biomedical equivalent of the Thought Police detecting crime before it happens. The prognosticating itself,  is a highly toxic process (nocebo: e.g., “You have cancer and 6 months to live.”) that can contribute to evoking cancer-promoting physiological reactions, as well as inflicting real psychospiritual wounds that have been determined to dramatically increase the risk of heart-related deaths and suicides. Medicine has also adopted the metaphorics of another powerful global force: the military industrial complex, with the cancer “prevention” being equated to “striking first,” eerily similar to the Bush doctrine of preemptive war to secure peace. Here, the precautionary principle is co-opted and inverted from its true meaning. Instead of “doing no harm,” unnecessary medical intervention is considered the only non-violent solution even when the collateral damage is so great that the patient often dies from the violence of “treatment” with weapons-of-mass-destruction grade radioisotopes and chemicals and not the condition.

We need to completely rethink medicine’s role in healing. What happens when we return to the fundamentals of an entity – the human, soul and body together — whose self-healing capabilities are so powerful that even the suggestion through sugar pill or kind word of a health practitioner that a disease can attenuate or disappear actually causes significant improvement? What if given the right conditions – clean air, water, food and a healthy environment, physically and emotionally – the conditions for disease were suddenly removed, and replaced with an opposite environs promoting health? If medicine makes it through the birth process of its own existential crises, these principles will invoke an entirely new medical model where the placebo effect is not to be “controlled for,” but liberated and expanded by educating the patient to the fact that they can and do heal themselves, mainly by avoiding medical treatment and doing the right amount of nothing.

Is Functional Medicine Here to Stay?

Not only is Functional Medicine here to stay, it is poised to be the centerpiece in one of the most significant shifts in the health and medical paradigm in the past one hundred years.  For anyone who has been paying attention, there has been a virtual war going on between Conventional/Allopathic Medicine and Functional/Natural Medicine since the early 1900s.  In fact, this virtual war often became a real war when the medical establishment would attack and try to discredit chiropractors, naturopaths, homeopathy practitioners and those who made or distributed nutritional supplements. 1

The main weapons in this war were the contentions by the medical establishment that they had scientific evidence to support what they were doing, and that the proponents of Functional Medicine did not, and thus were putting people’s health at risk.  The naturalpractitioners were often branded as “quacks” and threatened with the loss of privileges to treat anyone, large fines, the seizure of products or equipment, or even jail time. 2

This situation has been changing gradually over the past 60 years, as Functional Medicine, and its natural allies, have been gathering information from in-office surveys of patients, clinical trials, and other academic and scientific studies.  Linus Pauling was one of the early pioneers in this movement, along with Eric Hoffer, Roger Williams, Carl Pfeiffer, and others who began to examine the impact of food and supplements on brain-related conditions.  This early study of depressionanxietybipolar disorder, and schizophrenia was labeled “Orthomolecular Psychiatry,” which eventually transitioned to become “Orthomolecular Medicine.”  Yes, even the two-time Nobel Prize winner Linus Pauling was often labeled a “quack” by the medical establishment. 3

As it turns out, Linus Pauling and his fellow Functional Medicine pioneers are on the brink of having the last laugh.  In a cover story from Business Week magazine, May 29th, 2006, entitled “Medical Guesswork,” a medical researcher, Dr. David Eddy, examined everything that Conventional Medicine did and could only find scientific evidence for 20-25% of conventional medical practices, products, and procedures. 4   In an even more condemning study in the British medical journal The Journal of Clinical Evidence, it was found that only 11% of conventional medicine treatments produced a beneficial result or outcome. 5

At the same time, Functional/Natural Medicine has been gaining increasing scientific credibility, according to this sample of recent studies:

  • A study by the British medical journal Lancet Oncology found that Functional Medicine was able to stop and reverse hypertensionobesity, heart disease, and prostate cancer. 6
  • A study by the Institute of Medicine found that scientifically proven conventional treatments, combined with meditationyogaacupuncture, and herbal medicine, proved to be both medically and cost-effective. 7
  • The National Institutes of Health conducted a meta-analysis entitled “Health Cost Effectiveness of Natural Health Products: A Systematic Review of Randomized Clinic Trials” and found positive health outcomes with cost savings up to 73% for natural products, compared to conventional treatments. 8

Why Is Functional Medicine Outperforming Allopathic Medicine?

The answer to this question is well known to those in the Functional Medicine community, but below is a quick summary for those who may not be following this subject closely.

Allopathic Medicine Shortcomings

  • Diagnoses and treatments are segregated according to various organs and systems without regard to their interconnected relationship within the whole body.
  • Some diagnostic procedures are actually harmful, such as radioactive mammograms, CT scans, and premature biopsies.
  • Many diagnostic tests can only identify illness or disease after it has already advanced to a dangerous level.  Mammograms are the best example, as tumors do not show up on a scan unless at least four billion cells are present, and these scans still are only 65% accurate.  This size tumor usually indicates Stage 2 or Stage 3 for breast cancer patients, and dangerous radiation exposure occurs with each scan. 9
  • Many treatments, especially prescription medications, are designed to interrupt and alter biochemical functions, instead of working with the body to use its natural disease-fighting capabilities.
  • The side effects of many prescription medications often create more health problems than they resolve, and this can include life-threatening situations.
  • The efficacy of many approved prescription medications is less than 1%.  For example, in the case of statin drugs for the lowering of cholesterol, 150 people need to take this drug before the life of one person is extended.10
  • Allopathic doctors receive virtually no training in nutrition or other natural medicine disciplines, which seriously limits their ability to fully understand the root causes of most diseases.  This forces them to treat the symptoms, which can be the same for many different conditions, leading to misdiagnosis and inappropriate treatment.
  • Operations are often undertaken, even though they often produce limited benefit, or could have been avoided altogether by using an effective natural treatment.  A good example is angioplasty, which consistently produces a meager 3% positive result, whereas EDTA Chelation Therapy could often produce much better outcomes. 11

In addition to these medical practice shortcomings, the entire health-care system is based on the treatment of symptoms, even though 80% of all disease is both preventable and reversible.  There are very few incentives for getting people healthy, and until this is changed, it will be very difficult to change the way most doctors practice medicine.

The Benefits of Functional Medicine

  • Functional Medicine considers the whole body both in the diagnosis stage and the treatment stage.
  • Functional Medicine treats the root cause of an illness, not just the symptoms.
  • Functional Medicine uses treatments that are much safer and with fewer negative side effects.
  • Functional Medicine can combine scientifically proven allopathic treatments with functional medicine to produce an integrated medical solution.
  • Functional Medicine often utilizes diagnostic tests that are able to identify cells that are moving toward disease, but are not yet diseased.  This often occurs five to ten years before conventional medicine  diagnoses a problem.
  • Functional Medicine treatments are usually more effective, and are often able to reverse a condition, while Conventional Medicine can only manage an illness. Type 2 diabetesmay be the best example of this.
  • Functional Medicine treatments are far less expensive than Conventional Medicine treatments, and they can benefit individuals, employers, and governments who are overburdened by the expense of Allopathic treatments that often do not work. 12

Examples of Better Diagnostic Tests

Functional Medicine practitioners use many diagnostic tools.  Here are just a few examples that illustrate why Functional Medicine can find illness earlier, and then use less invasive treatments for better outcomes.

  • C-reactive Protein Test – This is a blood test that measures the amount of inflammation in the body.  In many cases, inflammation is a better indicator of risk for heart disease than cholesterol.  Cholesterol is important to our bodies for the repair of the epithelial lining of our arteries and for making vitamin D3, just to mention a few of its many functions.  Over half of people who experience heart attacks have perfect levels of cholesterol, which calls into question its true value as an indicator of risk for heart disease. 13
  • Glucose Tolerance Test – This blood test requires patients to consume 75 grams of glucose and then be tested several times over a three-hour period to see how well their pancreas and the insulin receptors on their cells manage this ingestion of glucose.  This test is far superior to fasting glucose tests, such as the AIC, because it can identify the early deterioration of insulin receptors, or pancreatic weakness, often five to seven years before other glucose tests. This translates into a very high probability that the Functional Medicine doctor can reverse this condition fairly quickly with changes in diet and exercise.  The potential success rates for this reversal can exceed 90%. 14
  • Vitamin D3 Test – This blood test can detect low levels of vitamin D3, which is crucial for the prevention of many illnesses, including cancer.  Vitamin D3 improves communication between cells, and actually kills cancer cells.  Studies have shown a decreased risk of breast cancer of up to 77% and prostate cancer up to 86% for people with vitamin D3 levels between 50 and 90 ng/ml.  Recovery from cancer is also impacted when patients begin taking proven therapeutic levels of this vitamin, with studies showing an increased survival rate of  47% for lung cancer and 50% for lymphoma cancer patients. 15
  • Thermography – Many Functional Medicine doctors utilize this test for more than 200 diseases, including early cellular changes that could lead to breast cancer.  More than 800 studies have proven the value of this infrared heat-sensing test.  When cells begin to move toward disease, they become stressed and/or develop new blood vessel growth.  These changes produce increased heat, and in the case of breast cells, as few as 200 cells can be detected when this begins to happen. This is between eight and ten years before mammograms can see the four billion cells in a tumor, which often represents Stage 2 or Stage 3 cancer.  This early detection of stressed cells allows Functional Medicine to utilize diet, exercise, stress reduction, or plant-based hormones to rebalance cells, causing them to return to normal function. Other benefits of this test include no pain and no radiation exposure.  This test is approved by the FDA as an adjunct diagnostic tool, but most doctors only include mammograms or ultrasound if thermography identifies some cells that are misbehaving. 16
  • Early CTD Lung Test – This blood test identifies lung cells that are in the process of becoming cancerous, or are in the early stages of cancer. In either case, Functional Medicine doctors can utilize treatments that are much less invasive than chemotherapy, radiation, or surgery to encourage these cells to revert back to their normal, healthy status. This test can identify these cellular changes up to five years before CT scans or x-rays can see anything. Their rate of accuracy has been established at 91%, and there are no negative side effects for this test. 17

Examples of Functional Medicine Protocols

Functional Medicine practitioners have hundreds of highly effective treatment protocols available, and most have excellent evidence to support their use. The following examples are more nutritionally based, but it should be stated that there are many impressive treatment protocols from other natural disciplines, such as acupuncture, chiropractic, herbal medicine, and naturopathy, just to mention a few of the other natural medical categories.

  • Type 2 Diabetes – Patients are being advised to avoid  processed sugar, processed flour, HFCS, starches, soft drinks, baked goods, fruit juices, artificial sweeteners, molasses, honey, maple syrup, animal and trans fats, wheat products and processed soy.
  • Foods to Include – Vegetables and fruits (especially those low on the glycemic index), beans, organic poultry, omega-3 fish, non-wheat whole grains, non-dairy milk (rice, almond, coconut), nuts, seeds, and sea vegetables.
  • Nutritional Supplements – Chromium, vanadium, magnesiumvitamin Comega-3 oils, gymnema sylvestre, berberine, and alpha lipoic acid.
  • Exercise – At least 45 minutes each day of aerobic and weight-bearing exercise.
  • Weight Management – Doctors can utilize special diets that include balancing brain chemistry in order to reduce cravings for certain foods (i.e., eat foods rich in tryptophan and B vitamins).
  • Stress Management – At least 30 minutes each day for meditation, yoga, tai chi, or deep breathing.

Some patients are able to reverse their Type 2 diabetes in as little as three days using this, or a very similar protocol. 18

Breast Cancer – With the utilization of thermography, a vitamin Dtest, and other early warning tests, a Functional Medicine doctor can often prevent the initial breast cancer or its recurrence after it has been detected and treated.  The following protocol is an example of some of the elements of such a prevention protocol: 19

  • Foods to Avoid – Basically the same foods should be avoided for most diseases (see the previous list for Type 2 diabetes).
  • Foods to Include – The good foods are also basically the same for each chronic illness with emphasis for breast cancer on the following foods: kale, cabbage, garlic, Brussels sprouts, cauliflower, legumes, and fish with the highest levels of omega-3 fats and vitamin D3.
  • Nutritional Supplements – Vitamin D3, omega-3 fish oil, vitamin C, vitamin E, digestive enzymes, CoQ10, pomegranate, B vitamins, and chromium.
  • Detoxification – Utilize a detoxification diet, sauna, steam bath, and special supplements, such as milk thistle.
  • Hormone Balancing – Using saliva or blood tests to determine hormone levels, and then plant-based hormones to achieve balanced hormone levels.

Some Special Examples – The power of Functional Medicine is often illustrated with the use of only one type of treatment or product.  Here are a few examples:

  • Kidney disease – In one study, over half of the patients on dialysis were able to get off of their machines by taking 180 mg of Co-enzyme Q10 for three months. 20
  • Heart disease – Several doctors have reported the complete reversal of blocked arteries and oxygen-starved hearts with the use of intravenous chelation therapy.  Among the many ingredients used in chelation therapy is EDTA, a chelator of heavy metals and, obviously, plaque build-up as well.  21

The Cellular Deterioration Explanation

Previously, some of the early warning diagnostic tests were explained; however, it may still not be clear how these tests are able to identify cells that are moving toward chronic disease.  In many cases, cells go through five sequential stages of deterioration, as shown in the following illustration:

Conventional medical tests usually detect changes in biochemistry at the dysfunction stage, or even later, when cells are mutated or already diseased.  High blood pressure and high cholesterol are examples of  identification at the dysfunctional stage, due to irregularities in blood chemistry or blood pressure.  As previously stated, mammograms cannot detect tumors less than four billion cells in size.  This usually means that most of these cells are either mutated or diseased, which often translates into Stage 2 or 3 cancer.  In the case of liver cancer, it has been reported, in some cases, that the liver can be 70% diseased before liver enzymes are detected in a blood test. 22

Such late detection of disease makes it very difficult to use safe and effective natural treatments, although successful treatment is often still possible.  In many cases of these late-stage diagnostic situations, invasive and less-effective treatments are often used, such as surgery, radiation, chemotherapy, or some other chemical intervention. 23

By contrast, early diagnosis occurs when Functional Medical doctors detect cells that are in the very beginning of deterioration, such as being stressed or weakened.  These cells often exhibit increased heat profiles, the formation of fibrous material, inflammation markers in the blood, or deficiencies of key enzymes, minerals, or vitamins.  At this point, doctors can utilize much safer and more effective treatment protocols to help these cells return to normal.  A good example of this is the previously mentioned study where 50% of patients were able to get off of dialysis after taking 180 mg of CoQ10 for three months.  In the case of these patients, a majority of cells were likely still in the stressed, weakened, or dysfunctional stage of deterioration, and could be rehabilitated enough to allow removal from dialysis.  However, the 50% of patients who were not able to get off of dialysis had too many cells in their kidneys that had already advanced to the mutated or diseased state.  Functional Medicine doctors understand this situation, while most conventional doctors do not.

Can Functional Medicine Save Our Healthcare System?

The simple answer to this question is, “Not by itself.”   Functional Medicine can make a big difference, but many other factors  must change before our healthcare system can be truly “saved.”

1. The Medical Establishment – Conventional medical practitioners’ attitudes and financial incentives must change drastically.  The medical establishment will have a very difficult time admitting that they have been very wrong about a lot of things for a long time. The essence of this challenge was captured in the words of Dr. Mark Hyman at a Senate Hearing on Health on February 26, 2009.  Dr. Hyman said:

You will not solve the crisis in health care if you just continue to do the wrong things better.

Coincidently, a few years later, Dr. Hyman met Dr. Elos Cosgrove, the CEO of the Cleveland Clinic, on the way to a medical conference in Paris, France.  Dr. Cosgrove must have been impressed with Dr. Hyman’s explanations about how Functional Medicine was resolving many chronic illnesses with natural treatment protocols, because he asked Dr. Hyman to come to the Cleveland Clinic to help them learn more about it.  Dr. Hyman declined at first, but then, two years later, he said “yes” after Dr. Cosgrove made the decision to move the Cleveland Clinic in the direction of Functional Medicine.  Apparently, his quote at the time of the announcement was: 24

Functional Medicine is the medicine of the future.

If this change at the Cleveland Clinic is successful, it could be the first domino to fall for Conventional Medicine, and it could be one of the most significant changes in medicine in the last one hundred years.

If we could get the financial model to focus more on prevention and less on treatment, this change could be significantly accelerated and save millions of lives, as well as billions or even trillions of dollars in the process.  Boeing is one employer trying to change this system by rewarding health providers for keeping employees healthy instead of just treating their symptoms.25  There certainly will be losers in this change, such as drug companies, insurance companies, and many doctors.  However, the winners will be people who will be healthier and live longer, thus saving future generations from the certain bankruptcy of our entire country.26

2. Doctors’ Education – Doctors will need to learn how to incorporate Functional Medicine with their practices, and how to become educators and facilitators, instead of trying to “treat” everyone in the seven minutes they see the average patient.

3. The public will need to take more personal responsibility for their health by reading more, getting timely and useful health exams, and changing unhealthy lifestyle habits.  Workplace wellness programs can have a big influence on this if employers and their insurance companies jump on the Functional Medicine bandwagon.  Employee and family education, combined with good incentive systems, have been proven to make a big difference in people’s health and the employer’s bottom line. 25

4. Food Producers and Sellers – Our food industry needs to get on board with this change as quickly as possible and stop growing unhealthy foods, over processing them, and selling the unhealthy foods so inexpensively, while keeping healthy food prices too high.  If the farmers, food processers, and retailers don’t make the necessary changes, it may be up to the government to legislate these reforms.  Given the government’s track record in this area, we should be concerned about allowing the problem to get to this point.  We are almost there.  Can anyone say “better leadership” and less lobbying by those with a vested financial interest? 26


Other factors  should be considered in this very important paradigm shift.  No one is suggesting that everything about Conventional Medicine is bad and should be changed without cause.  Acute care in the form of operations is pretty good and saves many lives every year.  Some operations do not have a very good track record, such as angioplasty, and there is scientific evidence to support 20-25% of what Conventional Medicine does.  What we need is a true integration of these two forms of medicine, by taking the best of both and combining them to make a medical system that truly saves lives and prevents as much illness, suffering, and excessive spending as possible.  The direction has been clearly laid out.  All we need is someone like Mahatma Gandhi to step out in front of the change and lead the way.