Being a veterinarian for the past 18 years has allowed me to see many things and encounter many challenges when it comes to health care for my patients. It has also created many challenges for my own health but opened many doors for possibilities.
“To take medicine only when you are sick is like
digging a well only when you are thirsty — is it not
already too late?” (Chi Po, c 2500 BC).
I like this quote as it revolves around an approach that I have undertaken for myself and many of my patients. It is also a subject that I have found increasingly important when it comes to health, but unfortunately not shared by many.
The more I explore in my research and the more I discover with my patients, it becomes readily apparent how important preventative medicine is for overall health. The above quote implies the importance of preventative medicine, however, the majority of people fall into the second scenario where they are seeking solutions only once disease has set in.
As a veterinarian, we are presented a multitude of clinical conditions much similar to human maladies, which could often be better managed through lifestyle, dietary changes and herbal therapies rather than medications. Often these problems could have been curtailed initially if only the proper diet or supplements were implemented, which could have enhanced health and potentially minimized future health problems. It is a frustrating problem for a clinician, as the patient (or owner) wants a resolution to the condition but on the same side, often does not want to put much effort forth to aid in that management.
The reality is that many health problems ranging from arthritis to even various forms of cancer could be better managed through preventative therapies, which include lifestyle changes and dietary or supplement modifications. The other reality is that people, as a whole, often don't see the purpose of intervening if there is no problem present. They don't see the value in enhancing health to prevent disease. This is a shame from my perspective as many conditions could be more easily managed or possibly prevented.
In our patients, we use a multitude of herbal formulas to address ongoing inflammation, impaired cellular function and oxidative stress in our patients. Most of them present for obvious clinical problems ranging from ongoing pain, joint deterioration to overt organ damage. Often, we can improve the quality of life for that animal, but I have to step back and wonder what if this patient had assumed this lifestyle years ago? Would we still be contending with this problem now? Would it have been less severe or possibly delayed by years?
We don't know the answers to these questions for a variety of reasons, with the main one being that simply owners rarely take the proper preventative approach. In those patients that do, we often do not contend with major health problems, so it is hard to conclude if we prevented anything but just note good health. We could have a comparison of a specific breed of dog, which may be more predisposed to allergies for instance. One would take a preventative approach, while the other a more traditional line. I can almost be certain that the one on the proper preventative approach would be less likely to develop allergies, but if this was proven to be a fact, the opponents would contend that genetics or other factors played a part.
The whole concept of preventative health is frustrating for me as I see and read the research regarding the impact of various herbs and nutrients on pathways involved in cancer, diabetes, cardiovascular and immune health. To me, the evidence is in black and white and the results are evident in a multitude of my patients. The sad discovery is that despite education to clients, we can implement a course of therapy for a clinically ill pet, which then recovers but they fail to see and make the changes for other pets in the household. Then soon we are presented that pet for health problems and seem to have to have that talk once again.
Maybe it is a problem in transference of information? Maybe it is a lack of my ability to educate? Or maybe it is just a lack of 'want' on behalf of us as people to take the initiative to try to head off clinical health problems? People question the effectiveness of preventative actions, but to me the evidence is in my own pets, myself and my family. Our 12 y.o. female Doberman has been on one of our preventative herbal formulas for the past 7 years, essentially as a guinea pig. She had no health problems but is three legged and of average size. At the time of this writing, she could physically pass for a dog half her age, demonstrating energy of a young dog, no pain, no stiffness and few gray hairs around the muzzle. She runs and enjoys life to the fullest. The last time I saw a 12 y.o Doberman as a veterinarian, he was debilitated, ridden with arthritis and could barely even stand, destined for euthanasia. My family takes the preventative approach too, each day faithfully consuming our herbal shakes. Considering our age and our kid's level of physical activity, we maintain our health pretty well and no medications.
The reality is that we are in charge of our health and can chose to be pro-active or reactive. However, if we chose to be reactive and find that our therapy options are limited, there is ultimately only one to blame.
Take care,
Tom Schell, D.V.M.
Saturday, December 21, 2013
Sunday, December 15, 2013
Medical Technology and Therapy Advances
I just returned from a veterinary convention, focused on horses and athletic injuries. The hope, in attending these meetings is to gain new information, new insights into therapy for our patients. We look to our peers and those at the center of research to give us hope and new options. Given my background over the past few years, being involved in research, I have found myself being more critical of various therapies and actually looking for implementation of new options.
While at this convention, the topic of joint disease and tendon injuries in the horse were paramount as this is a common problem especially in the equine athlete. We discussed technology used in making these diagnoses and reviewed some treatment options. In the end, I walked out somewhat disappointed as the end results in the many cases presented were typical of what we have been seeing for the past 10 years with no change for the patient.
When I graduated from veterinary school, the main technology that we had at that time were 'paper' film x-rays. They were the traditional x-ray, on paper or film, that one could take with them and hold up to a view box to read. The technology was good, but details were missing at times. Ultrasound technology was coming to light while I was in school and soon became a part of clinical practice, helping us to see a little deeper in terms of information and providing more information than we had before. Next to come was MRI and CT capabilities, which had been present in the human spectrum for years, but was working its way into the Universities and now into private practices to be used in the horse and companion patients. Personally, I was quite stunned to hear just how many private practices had this technology at their disposal as it is quite expensive and dictates a very affluent client base.
I find this technology very useful and interesting but I made some observations. First, these new capabilities seem to be replacing the personal approach in some instances. By this I mean that it is quite possible that we are relying on these new diagnostic techniques more instead of using our mind or our hands, evaluating the patient on a personal level. Second, in several cases presented during the conference, it was obvious that this new technology was revealing very early stage degenerative changes in the joints and tendons that were causing significant pain for the patient. These early stage changes were not evident by traditional diagnostic methods and prior to this technology, we would have simply shrugged our shoulders suspecting a soft tissue injury on some level, but not being completely sure. This is a good thing, being able to pinpoint the problems, but is the new information being utilized properly?
Prevention of disease is paramount. There is no denying this fact. The earlier that we can detect a problem, the better or at least that is the way it should be. The problem that I observed is that despite being able to find and localize these problems earlier, therapy options for that patient have not changed. The same old standard approaches were used and often led to the same end results for the patient. What was once an early stage lesion had soon progressed to an advanced problem. Why did that happen? Why didn't we take advantage of the situation and step outside the box, implementing other therapies that might just help?
To me, the biggest issue at hand is ongoing inflammation, which contributes to cellular changes and tissue deterioration. This is a fact and supported by research. It is clear that this problem exists in the horse, especially if they are on a competitive level. We understand and see the changes develop, but yet our course of therapy is not altered. There is so much we could do to intervene potentially and it doesn't have to be complicated nor cost a lot of money.
If we understand the research, we see that nature has provided us options in the form of herbs and overall nutrition. Nutrition is the key to cellular health and functioning. If we provide the proper nutrients, in the form of herbs or other sources, then we might be able to counteract the negative forces acting upon the body. We just might be able to slow the degenerative process by managing inflammation more naturally and restoring cellular health. To me, it is not rocket science, but yet is easily dismissed by the medical and veterinary community.
The reasoning for this is usually that science is lacking or efficacy studies have not been conducted. There is fear of interactions with medications, fear of side effects and a general fear of the unknown. The reality is that there is solid science to support this approach, noting marked positive changes in patients and minimal to no side effects. If there are interactions with medications, they are usually due to similar modes of action, indicating a decreased need for that medication or there is an improvement in health, which then dictates a lack of need for that prescription. The irony is that despite this, clinicians deny the connection, deny the research and rely more on pharmaceuticals to create changes for the patient. They are quick to tell someone to stop using a supplement, even if positive changes are evident.
I guess in the end, it is a matter of 'thinking outside of the box' when it comes to healthcare or veterinary care. I will admit that there are many supplements on the market that make incredible claims and most of them are unsubstantiated, creating false hope. I do understand the skepticism on this level, but we need to realize that we shouldn't generalize and put them all into this group.
We need to realize that with today's changing healthcare society, there are new opportunities to intervene at earlier stages for our patients. This may not include pharmaceuticals, but may just be nutritional changes for that patient. We need to get back to the basics and realize the importance of proper nutrients on overall health and recovery. The results can be incredible and cost very little, creating a better outcome and potentially reducing future health demands.
As a doctor, we were trained to look out for the welfare of our patients and improve their health. Sometimes that means stepping outside of the box and exploring options. If we don't do this but simply rely on pharmaceutical companies and our peers to dictate our options, often accepting failure, then we are not doing our jobs. We do have a choice and I think we can do better for our patients, but it can be a hard concept to accept, especially in the face of pressure to use medications.
Just my thoughts,
Tom Schell, D.V.M.
While at this convention, the topic of joint disease and tendon injuries in the horse were paramount as this is a common problem especially in the equine athlete. We discussed technology used in making these diagnoses and reviewed some treatment options. In the end, I walked out somewhat disappointed as the end results in the many cases presented were typical of what we have been seeing for the past 10 years with no change for the patient.
When I graduated from veterinary school, the main technology that we had at that time were 'paper' film x-rays. They were the traditional x-ray, on paper or film, that one could take with them and hold up to a view box to read. The technology was good, but details were missing at times. Ultrasound technology was coming to light while I was in school and soon became a part of clinical practice, helping us to see a little deeper in terms of information and providing more information than we had before. Next to come was MRI and CT capabilities, which had been present in the human spectrum for years, but was working its way into the Universities and now into private practices to be used in the horse and companion patients. Personally, I was quite stunned to hear just how many private practices had this technology at their disposal as it is quite expensive and dictates a very affluent client base.
I find this technology very useful and interesting but I made some observations. First, these new capabilities seem to be replacing the personal approach in some instances. By this I mean that it is quite possible that we are relying on these new diagnostic techniques more instead of using our mind or our hands, evaluating the patient on a personal level. Second, in several cases presented during the conference, it was obvious that this new technology was revealing very early stage degenerative changes in the joints and tendons that were causing significant pain for the patient. These early stage changes were not evident by traditional diagnostic methods and prior to this technology, we would have simply shrugged our shoulders suspecting a soft tissue injury on some level, but not being completely sure. This is a good thing, being able to pinpoint the problems, but is the new information being utilized properly?
Prevention of disease is paramount. There is no denying this fact. The earlier that we can detect a problem, the better or at least that is the way it should be. The problem that I observed is that despite being able to find and localize these problems earlier, therapy options for that patient have not changed. The same old standard approaches were used and often led to the same end results for the patient. What was once an early stage lesion had soon progressed to an advanced problem. Why did that happen? Why didn't we take advantage of the situation and step outside the box, implementing other therapies that might just help?
To me, the biggest issue at hand is ongoing inflammation, which contributes to cellular changes and tissue deterioration. This is a fact and supported by research. It is clear that this problem exists in the horse, especially if they are on a competitive level. We understand and see the changes develop, but yet our course of therapy is not altered. There is so much we could do to intervene potentially and it doesn't have to be complicated nor cost a lot of money.
If we understand the research, we see that nature has provided us options in the form of herbs and overall nutrition. Nutrition is the key to cellular health and functioning. If we provide the proper nutrients, in the form of herbs or other sources, then we might be able to counteract the negative forces acting upon the body. We just might be able to slow the degenerative process by managing inflammation more naturally and restoring cellular health. To me, it is not rocket science, but yet is easily dismissed by the medical and veterinary community.
The reasoning for this is usually that science is lacking or efficacy studies have not been conducted. There is fear of interactions with medications, fear of side effects and a general fear of the unknown. The reality is that there is solid science to support this approach, noting marked positive changes in patients and minimal to no side effects. If there are interactions with medications, they are usually due to similar modes of action, indicating a decreased need for that medication or there is an improvement in health, which then dictates a lack of need for that prescription. The irony is that despite this, clinicians deny the connection, deny the research and rely more on pharmaceuticals to create changes for the patient. They are quick to tell someone to stop using a supplement, even if positive changes are evident.
I guess in the end, it is a matter of 'thinking outside of the box' when it comes to healthcare or veterinary care. I will admit that there are many supplements on the market that make incredible claims and most of them are unsubstantiated, creating false hope. I do understand the skepticism on this level, but we need to realize that we shouldn't generalize and put them all into this group.
We need to realize that with today's changing healthcare society, there are new opportunities to intervene at earlier stages for our patients. This may not include pharmaceuticals, but may just be nutritional changes for that patient. We need to get back to the basics and realize the importance of proper nutrients on overall health and recovery. The results can be incredible and cost very little, creating a better outcome and potentially reducing future health demands.
As a doctor, we were trained to look out for the welfare of our patients and improve their health. Sometimes that means stepping outside of the box and exploring options. If we don't do this but simply rely on pharmaceutical companies and our peers to dictate our options, often accepting failure, then we are not doing our jobs. We do have a choice and I think we can do better for our patients, but it can be a hard concept to accept, especially in the face of pressure to use medications.
Just my thoughts,
Tom Schell, D.V.M.
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