How many of you know how to change the oil in your car? How many could change your tire, if need be on the side of the interstate? These seem like basic questions and hopefully, the majority of the readers have said "yes, I can" to both of those questions. Now, we move on to something more complicated...
How many of you know the impact of various foods and our diet on overall health? Do you think it is a fad? Do you truly believe that diet and nutrition can improve health? How many of you know basic anatomy of your own body? How your heart and lungs work? The importance of the kidneys and liver? How about cholesterol and the truth behind it? How about the high sugar content to our foods and drinks and how it impacts health?
I don't know how many would respond positively to those questions, but to me they are important. Why? Because without this basic knowledge we become prone to being at the mercy of others with no knowledge to help assist us in decision making.
For instance, if your car was difficult to start and you took it to the repair shop, without knowledge you might end up paying for an new alternator instead of just having the battery replaced. Without knowledge of tires and tread wear, one might end up paying $500 for four new tires, instead of maybe just rotating them for another 10,000 miles of use.
The same applies to our health and to that of our pets and equine companions. I realize that most people would remark that there is not enough time in the day to learn about health and this is why they rely on others to guide them, which is a valid comment. However, the question comes as to which information you are being supplied with is truly 100% accurate?
As a veterinarian, I always made it a point to explain to my clients what was going on with their pet or their horse. It was important to me that they understood as it helped them to make a decision. I never made decisions for them, as that was not my job, but my job was to inform and give options. In some cases, the clients drank in the information, wanting more details, while in others, I could barely maintain the client's interest for more than 30 seconds. In the end, it was up to them to either choose to understand or choose not to understand, but their level of knowledge would dictate the end result no matter what they thought.
Knowledge is a powerful thing and should not be contained within one individual or group of people, it should be shared and explored. This is true for everything, but most importantly, it is true of medicine and surgery. What I observe is that people either just don't care to know about their own health or that of their pets or horses, OR they are just not given the information that they need to become informed. Even if they are not, I think it is important that they still explore and discover information on their own to come to better conclusions and decisions. Point being...don't just rely on information provided to you, check it out, investigate and discover the validity to the claims.
When I practiced actively, we would have elderly clients come into the office with their pets, not so much due to a health problem with the animal, but they would often pull out a sheet of paper with a list of their own personal medications, asking for our help in letting them know what all those pills were for. They had no idea and often, they just took the pills because their doctor told them to. In some cases, they were on the right medications. In others, there were blatant or obvious interactions between medications going on, which is unfortunate and goes unnoticed for various reasons. Often this is because there are several doctors involved and confliction of health goals. In the end, the patient suffers because of a lack of knowledge.
My goal is to help others and to educate. There is much to be said and much to explore. In many cases, there is not a 'fix' or 'cure' for most situations or conditions, but I do believe that with knowledge, many conditions can be better controlled or managed. The end goal with medicine and surgery, no matter the species, is to improve quality of life for what ever period of time that may be. What I see is that even with the current therapy options for most patients, quality of life is actually lowered, more so than improved.
I think this can be changed, but in order to do this, we have to step outside of the box and begin to open our minds in order to learn and understand. If one is willing to do this, then the possibilities are endless!
All my best,
Tom Schell, D.V.M.
Wednesday, June 18, 2014
Monday, January 27, 2014
Handi-Capp Equine Rehabilitation: The Impact of Nutrition
I have practiced veterinary medicine focusing on horses for the past 19 years, but for the past 8, I have seen things differently in respects to preventing, controlling and managing many health conditions in our patients. I have seen the impact of proper nutrition on performance, overall health and recovery. This wasn't always apparent to me and to be honest, I admit that I was blind sided for much of my career falling prey to marketing from nutritional feed companies and pressure from my peers to use pharmaceuticals. The truth always comes out and we have seen this in the countless horses we have helped to recover over the past decade. As a side hobby, we have taken in horses either via rescue or donation, often with injuries that have left their owners financially strapped, but have helped them turn the corner using our formulas along with nutrition. Seeing these results, we wanted to do more.
In 2014, we have officially started our Handi-Capp Equine Rehabilitation & Relocation program, in which we take on horses that have sustained what were originally perceived as career ending injuries. Many of these horses come to us fresh off of the track with tendon problems, joint degeneration and even fractures as a result of the increased stress they have sustained. Our hope is to change their level of nutrition and use targeted herbal therapy to combat many cellular pathways that are involved. Our program is quite simple, steering clear of processed equine feeds and focusing on whole grains and high quality hay, in addition to herbal formulas to manage inflammation and provide natural sources of vital nutrients. We are not a rescue but offer help to those horses that are in need or to assist other equine rescues with the recovery of their residents with hopes of finding them new homes. There are so many injured horses out there that deserve a fighting chance, but are often overlooked. The way I see it is that we all have injuries, the question is whether or not they hold us back. Most horses will not pass a pre-purchase examination, but visibly are doing well under saddle, actually better than before, but are pushed to the side as lacking potential. If we think about it, one prime example of potential is Peyton Manning, whom was sidelined from the Colts for recurrent injuries. He'd never pass a pre-purchase exam, but yet, the Broncos gave him a chance. Does he have injuries or damage? Yes, but look at the potential that he clearly demonstrates. The same can be said for these horses.
It is incredible to me, as a veterinarian, to see the daily changes in these horses. In the past, I have only had the luxury of seeing them maybe at monthly intervals for re-checks, but now I see them daily. In some cases, the changes can be almost overnight. Tendon problems seem more manageable and chronic pain more controlled. In many instances, these horses are often back under saddle within 1-2 weeks and on their way to a new career, when in the past they were pasture retired due to injury. It is neat to see for sure, but it goes to show that we have much to learn in terms of disease prevention and condition management not only for horses, but us as well.
Hopefully, in the end, we can help some horses recover and bring some new management techniques to the world of prevention so that just maybe we can keep these conditions from occurring in the first place. There are many options and possibilities out there, we just have to acknowledge and implement them.
Tom Schell, D.V.M.
In 2014, we have officially started our Handi-Capp Equine Rehabilitation & Relocation program, in which we take on horses that have sustained what were originally perceived as career ending injuries. Many of these horses come to us fresh off of the track with tendon problems, joint degeneration and even fractures as a result of the increased stress they have sustained. Our hope is to change their level of nutrition and use targeted herbal therapy to combat many cellular pathways that are involved. Our program is quite simple, steering clear of processed equine feeds and focusing on whole grains and high quality hay, in addition to herbal formulas to manage inflammation and provide natural sources of vital nutrients. We are not a rescue but offer help to those horses that are in need or to assist other equine rescues with the recovery of their residents with hopes of finding them new homes. There are so many injured horses out there that deserve a fighting chance, but are often overlooked. The way I see it is that we all have injuries, the question is whether or not they hold us back. Most horses will not pass a pre-purchase examination, but visibly are doing well under saddle, actually better than before, but are pushed to the side as lacking potential. If we think about it, one prime example of potential is Peyton Manning, whom was sidelined from the Colts for recurrent injuries. He'd never pass a pre-purchase exam, but yet, the Broncos gave him a chance. Does he have injuries or damage? Yes, but look at the potential that he clearly demonstrates. The same can be said for these horses.
It is incredible to me, as a veterinarian, to see the daily changes in these horses. In the past, I have only had the luxury of seeing them maybe at monthly intervals for re-checks, but now I see them daily. In some cases, the changes can be almost overnight. Tendon problems seem more manageable and chronic pain more controlled. In many instances, these horses are often back under saddle within 1-2 weeks and on their way to a new career, when in the past they were pasture retired due to injury. It is neat to see for sure, but it goes to show that we have much to learn in terms of disease prevention and condition management not only for horses, but us as well.
Hopefully, in the end, we can help some horses recover and bring some new management techniques to the world of prevention so that just maybe we can keep these conditions from occurring in the first place. There are many options and possibilities out there, we just have to acknowledge and implement them.
Tom Schell, D.V.M.
Monday, January 20, 2014
Curcumin and Cancer
For years, I have researched and utilized Curcumin for my veterinary patients, taking advantage of the herb's tremendous ability to reduce inflammation and likewise pain. Truth be told, I became interested originally in Curcumin to aid in my own personal recovery from cancer, targeting the inflammation in my condition. I wasn't always into so called 'alternative therapies' but had practiced traditional veterinary medicine for over 15 years as a western minded individual. Funny, though, that when faced with your own mortality or illness who one's mindset can change.
I saw some major positive changes in myself and my recovery, enough to make me pursue the use of Curcumin in our patients, specifically horses. My original mindset was that if inflammation was the main target of this herb, why not use it in cases of joint damage or injury in my patients. In the end, we did some small research trials which proved valuable and demonstrated tremendous benefit for the patient, helping to reduce pain, slow progression in some cases and reduce the need for some prescription medications. It was all very interesting as now we had a new option for our patients. However, as time went by, we began to realize that the potential for this herb had yet to be discovered. In many of our equine patients, we began to notice a decrease or reduction in various skin tumors that were present in some of these animals. What was the connection?
That connection is the inflammatory process, which has been demonstrated in human research to be strongly connected not only with cancer development but disease progression as well. Curcumin has been studied for decades noting tremendous potential in cancer management either as a sole therapy itself or in combination with current chemotherapy and radiation protocols. Despite many oncologists refuting the use of herbs and antioxidants during treatment regimens, current research clearly demonstrates the ability of Curcumin to actually sensitize neoplastic or cancerous cells to chemotherapy or radiation. What that means is that Curcumin actually improves the effects of these therapies, enhancing the outcomes, minimizing damage to normal tissue and potentially allowing the use of lowered or less toxic doses of those medications. In some studies, it was suggested that concurrent use of Curcumin in cancer patients could actually extend life and the quality of it for some patients.
One article that I recently became aware of demonstrated the ability of Curcumin to actually work well in conjunction with a chemotherapy agent called 5-FU in cases of resistant colon cancer. The combined use actually improved the cancerous cell death rate or apoptosis, even in highly chemo resistant cell lines, demonstrating the ability to even impact cancer stem cell lines which are often to blame for cancer recurrence. (Shakibaei, 2014)
The reality here is that there is much potential for Curcumin. In my equine world, I often run into the situation where horse owners question the ability of the herb to produce results, thinking that it is a gimmick on some level, despite our research and the research that has been done to date in the human field. When we really begin to look at the logic here, we realize that most herbs such as Curcumin are actually foods, which have medicinal like activity. In fact, most pharmaceutical medications are produced as a direct result of mimicking plant activity on cell lines. If we realize this, we begin to see the impact of diet and nutrition on overall health. We begin to understand that foods not only provide our bodies with various nutrients, vitamins and minerals, but that they can directly impact various processes in the body. Curcumin is just one of many in this category, but appears to be one of the most heavily researched.
So, the question comes as to why Curcumin is not more readily used and recommended, especially in the cancer world? I don't have the answer for this and often, it really frustrates me as I see and read the research that is available. I see the potential to help people and animals, but yet, the research is just tossed aside as if they are hoping for something better. It is my understanding that they (the pharmaceutical industry) have attempted to synthetically copy and enhance Curcumin's activity, but have failed to produce the same level of results that the simple herb yields. There has always been a question regarding Curcumin's absorption and bioavailability, which deters some individuals, but in my eyes with over 7 years worth of clinical experience, this is not a problem. In our equine patients, we have demonstrated very low blood levels of Curcumin, even just 2 hours post ingestion, but somehow, we still have clinical benefits with reduction of inflammatory proteins in the arthritic joints. So, what is going on? I don't know but I have my opinions.
Despite all of this, I am strongly in favor of bringing this knowledge to the public and to those individuals seeking treatment options. We should know about this information as it benefits all of us on one level or another. There are no side effects in any published studies, nor have we encountered any in our patient use. There appears to only be benefits.
We, as the medical and veterinary community, are quick to accept pharmaceuticals that have only been through quick research phases or limited testing as we tend to trust the sources too much. It seems that many of these trusted medications only end up biting us in the rear end a few years down the road due to side effects in our patients. So, if we can accept this information, often blindly, and use it in our patients, then why do we have such as hard time accepting more natural therapies that demonstrate marked potential but no side effects?
Everyone is going to have a reason for this ranging from proven efficacy to lack of substantiated research or concerns over possible side effects. There is always going to be a reason, but the fact is that last time I checked, we became medical professionals to serve the welfare of our patients, which to me includes all options with informed consent. Nutrition and diet includes herbs as they are foods. We shouldn't fear them, but begin to understand the impact that the correct nutritional plane can have on the body in its ability to recover. After all, the body is a machine and requires nutrients to keep it functioning. It just seems to be blind ignorance, in my opinion, to ignore this fact.
Just my opinion.
Tom Schell, D.V.M.
I saw some major positive changes in myself and my recovery, enough to make me pursue the use of Curcumin in our patients, specifically horses. My original mindset was that if inflammation was the main target of this herb, why not use it in cases of joint damage or injury in my patients. In the end, we did some small research trials which proved valuable and demonstrated tremendous benefit for the patient, helping to reduce pain, slow progression in some cases and reduce the need for some prescription medications. It was all very interesting as now we had a new option for our patients. However, as time went by, we began to realize that the potential for this herb had yet to be discovered. In many of our equine patients, we began to notice a decrease or reduction in various skin tumors that were present in some of these animals. What was the connection?
That connection is the inflammatory process, which has been demonstrated in human research to be strongly connected not only with cancer development but disease progression as well. Curcumin has been studied for decades noting tremendous potential in cancer management either as a sole therapy itself or in combination with current chemotherapy and radiation protocols. Despite many oncologists refuting the use of herbs and antioxidants during treatment regimens, current research clearly demonstrates the ability of Curcumin to actually sensitize neoplastic or cancerous cells to chemotherapy or radiation. What that means is that Curcumin actually improves the effects of these therapies, enhancing the outcomes, minimizing damage to normal tissue and potentially allowing the use of lowered or less toxic doses of those medications. In some studies, it was suggested that concurrent use of Curcumin in cancer patients could actually extend life and the quality of it for some patients.
One article that I recently became aware of demonstrated the ability of Curcumin to actually work well in conjunction with a chemotherapy agent called 5-FU in cases of resistant colon cancer. The combined use actually improved the cancerous cell death rate or apoptosis, even in highly chemo resistant cell lines, demonstrating the ability to even impact cancer stem cell lines which are often to blame for cancer recurrence. (Shakibaei, 2014)
The reality here is that there is much potential for Curcumin. In my equine world, I often run into the situation where horse owners question the ability of the herb to produce results, thinking that it is a gimmick on some level, despite our research and the research that has been done to date in the human field. When we really begin to look at the logic here, we realize that most herbs such as Curcumin are actually foods, which have medicinal like activity. In fact, most pharmaceutical medications are produced as a direct result of mimicking plant activity on cell lines. If we realize this, we begin to see the impact of diet and nutrition on overall health. We begin to understand that foods not only provide our bodies with various nutrients, vitamins and minerals, but that they can directly impact various processes in the body. Curcumin is just one of many in this category, but appears to be one of the most heavily researched.
So, the question comes as to why Curcumin is not more readily used and recommended, especially in the cancer world? I don't have the answer for this and often, it really frustrates me as I see and read the research that is available. I see the potential to help people and animals, but yet, the research is just tossed aside as if they are hoping for something better. It is my understanding that they (the pharmaceutical industry) have attempted to synthetically copy and enhance Curcumin's activity, but have failed to produce the same level of results that the simple herb yields. There has always been a question regarding Curcumin's absorption and bioavailability, which deters some individuals, but in my eyes with over 7 years worth of clinical experience, this is not a problem. In our equine patients, we have demonstrated very low blood levels of Curcumin, even just 2 hours post ingestion, but somehow, we still have clinical benefits with reduction of inflammatory proteins in the arthritic joints. So, what is going on? I don't know but I have my opinions.
Despite all of this, I am strongly in favor of bringing this knowledge to the public and to those individuals seeking treatment options. We should know about this information as it benefits all of us on one level or another. There are no side effects in any published studies, nor have we encountered any in our patient use. There appears to only be benefits.
We, as the medical and veterinary community, are quick to accept pharmaceuticals that have only been through quick research phases or limited testing as we tend to trust the sources too much. It seems that many of these trusted medications only end up biting us in the rear end a few years down the road due to side effects in our patients. So, if we can accept this information, often blindly, and use it in our patients, then why do we have such as hard time accepting more natural therapies that demonstrate marked potential but no side effects?
Everyone is going to have a reason for this ranging from proven efficacy to lack of substantiated research or concerns over possible side effects. There is always going to be a reason, but the fact is that last time I checked, we became medical professionals to serve the welfare of our patients, which to me includes all options with informed consent. Nutrition and diet includes herbs as they are foods. We shouldn't fear them, but begin to understand the impact that the correct nutritional plane can have on the body in its ability to recover. After all, the body is a machine and requires nutrients to keep it functioning. It just seems to be blind ignorance, in my opinion, to ignore this fact.
Just my opinion.
Tom Schell, D.V.M.
Saturday, December 21, 2013
Seeing Things in a Different Light
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.
“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.
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.
Monday, August 20, 2012
My Thoughts
Tonight I sit here going through emails, which include synopses from various medical journals, highlighting medical research. I have to admit that over the past 18 years of being a veterinarian, I have come to the conclusion that in many instances, we are doing things wrong or have our priorities incorrect. We all sit around in front of the TV and hear commercials for various prescription medications and in today's world, it seems like there is a medication for every known condition. The old adage "Just because we can...doesn't mean we should" always comes to mind when I hear about new medications or therapies being offered. In some cases, the therapy/medication makes sense to me as a caregiver, but then again, the majority of them just seem to be a "bandaid" for a common medical condition, doing very little to resolve the problem itself.
Case in point are statin medications, which are commonly used to reduce blood cholesterol levels. I was once prescribed one of these medications for elevated cholesterol, but quickly developed signs of muscular pain or myopathy and discontinued the medications. After a brief recalling of clients that I have talked to over the years, I would have to guess that about 50-60% of these people are on some form of statin to control cholesterol. Myself, I have changed over to a niacin supplement, along with other dietary supplements and dietary alterations. I also exercise routinely every morning. Now, I will admit that I don't eat perfectly but I do exercise and try my best. The last visit I had with my doctor, my total cholesterol was way down as well as triglycerides. Actually, the values were down about 40 points and about 4 points out of the normal level. The crapper, as I will say, is that my physician recommended a statin medication despite my lowering the overall level on my own.
The thing that bothers me in these scenarios is that I feel that these medications are used as a crutch instead of doing what should be done and that is dietary corrections, changes in lifestyle and exercise. Too many people that I know on these medications lead sedentary lifestyles and their diets are severely lacking overall. The statins may be lowering their cholesterol levels, but none of these people have remarked to me that their levels are normal. Why? Simply because they are not the answer in my opinion. The other thing that bothers me about these types of medications are the long term side effects noted as a result of chronic use. First, cholesterol is a major component of various hormones that are present in our bodies, including testosterone and progesterone. It has been noted in a few studies that mid-aged and elderly men are exhibiting low testosterone levels which coincides with their use of statin medications. The low testosterone levels are contributing to poor overall health. It also makes one wonder about the recent commercials regarding "LOW T" in men. Hmmm, wonder if this population is taking statins? Statin use is also connected with a low level of CoQ10, which is a potent antioxidant present in the bloodstream. Higher levels of CoQ10 are associated with improved cardiovascular health....so a lower CoQ10 level is associated with poor cardiac health. So...are those taking statins more predisposed to cardiovascular disease despite having lowered cholesterol levels? I don't know the answer to this, but maybe there is a paper out there somewhere. Tonight, I was reading an abstract discussing that users of statins are 50% more prone to cataracts that those that are not and diabetics taking statins are even more predisposed to cataracts. Why?? It appears that the lens within the eye depends on cholesterol for cellular health and the statins are lowering the available cholesterol. Interesting as I did not know that.
The bottom line is that I think we need a different approach to disease in general, whether if that is impacting our pets, horses or ourselves. Just because a scientist localizes a cellular pathway involved in a disease process, does not mean that we create a medication to block it WITHOUT evaluating the long term potential down the road for other metabolic pathways that might be impacted. That is a tough thing to ask, especially in today's world of the pharmaceutical industry, who is looking at the bottom line dollar in terms of gross product sales versus the actual health of the patient. I think we all need to be our own advocates regarding our health as well as that of our pets and horses. We need to research and use our intuition when it comes to various therapies and not just do it because someone recommends it.
I believe that ultimately nutrition is going to be the key to all of our health problems. The downside is that a proper diet requires work on our end and often requires supplementation to be complete. I don't have all of the answers, but I certainly do have questions.
To you health,
Tom
Case in point are statin medications, which are commonly used to reduce blood cholesterol levels. I was once prescribed one of these medications for elevated cholesterol, but quickly developed signs of muscular pain or myopathy and discontinued the medications. After a brief recalling of clients that I have talked to over the years, I would have to guess that about 50-60% of these people are on some form of statin to control cholesterol. Myself, I have changed over to a niacin supplement, along with other dietary supplements and dietary alterations. I also exercise routinely every morning. Now, I will admit that I don't eat perfectly but I do exercise and try my best. The last visit I had with my doctor, my total cholesterol was way down as well as triglycerides. Actually, the values were down about 40 points and about 4 points out of the normal level. The crapper, as I will say, is that my physician recommended a statin medication despite my lowering the overall level on my own.
The thing that bothers me in these scenarios is that I feel that these medications are used as a crutch instead of doing what should be done and that is dietary corrections, changes in lifestyle and exercise. Too many people that I know on these medications lead sedentary lifestyles and their diets are severely lacking overall. The statins may be lowering their cholesterol levels, but none of these people have remarked to me that their levels are normal. Why? Simply because they are not the answer in my opinion. The other thing that bothers me about these types of medications are the long term side effects noted as a result of chronic use. First, cholesterol is a major component of various hormones that are present in our bodies, including testosterone and progesterone. It has been noted in a few studies that mid-aged and elderly men are exhibiting low testosterone levels which coincides with their use of statin medications. The low testosterone levels are contributing to poor overall health. It also makes one wonder about the recent commercials regarding "LOW T" in men. Hmmm, wonder if this population is taking statins? Statin use is also connected with a low level of CoQ10, which is a potent antioxidant present in the bloodstream. Higher levels of CoQ10 are associated with improved cardiovascular health....so a lower CoQ10 level is associated with poor cardiac health. So...are those taking statins more predisposed to cardiovascular disease despite having lowered cholesterol levels? I don't know the answer to this, but maybe there is a paper out there somewhere. Tonight, I was reading an abstract discussing that users of statins are 50% more prone to cataracts that those that are not and diabetics taking statins are even more predisposed to cataracts. Why?? It appears that the lens within the eye depends on cholesterol for cellular health and the statins are lowering the available cholesterol. Interesting as I did not know that.
The bottom line is that I think we need a different approach to disease in general, whether if that is impacting our pets, horses or ourselves. Just because a scientist localizes a cellular pathway involved in a disease process, does not mean that we create a medication to block it WITHOUT evaluating the long term potential down the road for other metabolic pathways that might be impacted. That is a tough thing to ask, especially in today's world of the pharmaceutical industry, who is looking at the bottom line dollar in terms of gross product sales versus the actual health of the patient. I think we all need to be our own advocates regarding our health as well as that of our pets and horses. We need to research and use our intuition when it comes to various therapies and not just do it because someone recommends it.
I believe that ultimately nutrition is going to be the key to all of our health problems. The downside is that a proper diet requires work on our end and often requires supplementation to be complete. I don't have all of the answers, but I certainly do have questions.
To you health,
Tom
Sunday, August 12, 2012
Cancer and Inflammation
Being an avid follower of various medical research information, I get emails continuously from various journals spotlighting new research information. Just this past week, I received an email highlighting a published paper reviewing the possibility of a decreased mortality in patients that received aspirin therapy. In the article, one researcher was noted to have stated that in their analysis they found upwards of a 37% reduction in cancer mortality in those patients taking aspirin on a routine basis, information cited in The Lancet 2012 as well as the Journal of National Cancer Institute. The overall conclusions to the studies were that there was a noted reduction in overall mortality in cancer patients, but it was too early to determine which dose would be recommended, how often and whether or not the benefits would outweigh the risks.
I have followed cancer research with an open eye and mind over the past 6 years after my own personal diagnosis in 2006. One of the concluding factors that I can see is that there is a strong correlation between ongoing inflammation in our bodies and the development of cancer. The topic is too in depth for a blog setting, but the overall idea is that various inflammatory proteins are involved in the development and progression of cancer. This, I believe, is where the aspirin therapy comes into play in terms of affecting the outcomes in some cancer patients. Aspirin belongs to the category of medications termed non-steroidal anti-inflammatories or NSAIDS, which inhibits the production of COX-1 and COX-2, resulting in the decreased formation of prostagladins as well as thromboxane from arachidonic acid. This new information also correlates well with the knowledge that we have had for years demonstrating that various tumors exhibit a high level of COX expression. In veterinary medicine, for years we have utilized an NSAID medication called Piroxicam to help us manage Transitional Cell Carcinoma bladder cancer in dogs. In some cases, the medication would help to control further progression, while in others not so much. We have also seen over the past decades the research behind various anti-inflammatory herbs such as Curcumin or Turmeric and how these herbs can inhibit inflammatory pathways associated with various cancers at a much higher level than aspirin. The end results, mainly in-vitro, of these research trials demonstrated various cancer cell line inhibition as a result of the herb activity. In addition to these published studies, I have several years of clinical use of these herbs in our veterinary cancer patients with some surprising results.
The bottom line here to me is that there is emerging proof demonstrating the correlation between inflammation and cancer development. The biggest concern that is being expressed is that there are potential side effects with prolonged aspirin therapy, which are justified. Some individuals may be able to tolerate, while some may have existing health conditions that would increased their risk factors with aspirin therapy. I do think that we all need to be aware of the connection as well as the medical research that is being published and discuss it with our doctors. I personally feel that we are all undergoing a tremendous amount of inflammation on a daily basis as a result of activity, various food being eaten as well as lifestyle influences. This has led to the dramatic rise in various health conditions such as diabetes, obesity, arthritis and cancer development. We need to be proactive and recognize that this problem exists. I feel that aspirin therapy may be a good thing for some individuals, but there is a better opportunity for us to head off this inflammatory pathway by the use of diet and various herbal therapies. The results may be even better in the long term and the side effects much fewer. There are so many herbs that exhibit anti-inflammatory benefits such as Curcumin, Boswellia and Ashwaghanda....the list goes on. Many of these same herbs have supporting data to show benefits against cancer development.
With my cancer diagnosis, it shed new light on natural therapies. I have been a long term user of a product called Cur-OST, which is formulated to target inflammation in the body. I wouldn't go a day without it and honestly, if I miss a day....I know it. Google it and check it out.
Food for thought.
Tom
I have followed cancer research with an open eye and mind over the past 6 years after my own personal diagnosis in 2006. One of the concluding factors that I can see is that there is a strong correlation between ongoing inflammation in our bodies and the development of cancer. The topic is too in depth for a blog setting, but the overall idea is that various inflammatory proteins are involved in the development and progression of cancer. This, I believe, is where the aspirin therapy comes into play in terms of affecting the outcomes in some cancer patients. Aspirin belongs to the category of medications termed non-steroidal anti-inflammatories or NSAIDS, which inhibits the production of COX-1 and COX-2, resulting in the decreased formation of prostagladins as well as thromboxane from arachidonic acid. This new information also correlates well with the knowledge that we have had for years demonstrating that various tumors exhibit a high level of COX expression. In veterinary medicine, for years we have utilized an NSAID medication called Piroxicam to help us manage Transitional Cell Carcinoma bladder cancer in dogs. In some cases, the medication would help to control further progression, while in others not so much. We have also seen over the past decades the research behind various anti-inflammatory herbs such as Curcumin or Turmeric and how these herbs can inhibit inflammatory pathways associated with various cancers at a much higher level than aspirin. The end results, mainly in-vitro, of these research trials demonstrated various cancer cell line inhibition as a result of the herb activity. In addition to these published studies, I have several years of clinical use of these herbs in our veterinary cancer patients with some surprising results.
The bottom line here to me is that there is emerging proof demonstrating the correlation between inflammation and cancer development. The biggest concern that is being expressed is that there are potential side effects with prolonged aspirin therapy, which are justified. Some individuals may be able to tolerate, while some may have existing health conditions that would increased their risk factors with aspirin therapy. I do think that we all need to be aware of the connection as well as the medical research that is being published and discuss it with our doctors. I personally feel that we are all undergoing a tremendous amount of inflammation on a daily basis as a result of activity, various food being eaten as well as lifestyle influences. This has led to the dramatic rise in various health conditions such as diabetes, obesity, arthritis and cancer development. We need to be proactive and recognize that this problem exists. I feel that aspirin therapy may be a good thing for some individuals, but there is a better opportunity for us to head off this inflammatory pathway by the use of diet and various herbal therapies. The results may be even better in the long term and the side effects much fewer. There are so many herbs that exhibit anti-inflammatory benefits such as Curcumin, Boswellia and Ashwaghanda....the list goes on. Many of these same herbs have supporting data to show benefits against cancer development.
With my cancer diagnosis, it shed new light on natural therapies. I have been a long term user of a product called Cur-OST, which is formulated to target inflammation in the body. I wouldn't go a day without it and honestly, if I miss a day....I know it. Google it and check it out.
Food for thought.
Tom
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