Over the last couple of weeks, I've been discussing How "They" See "Us," which is basically that "they" see "us" as pure evil. Well, maybe not always sheer evil, but certainly not good, and even more certainly as having ulterior motives, the most common of which is filthy pharma lucre. As a result, when a grant deadline approached, I reposted a post about the "pharma shill gambit." However, how do these brave maverick doctors see themselves? Given that I'm traveling (and my plans have been impacted by the big storm heading through Kansas and Missouri now, it seemed appropriate given that I didn't have time to write a new post last night to revive a post about how cranks and their supporters see themselves. So enjoy this bit of Classic Insolence from way back near the beginning of this blog, when I first coined the term "Galileo gambit" to describe a very common gambit used by quacks. At least, I think I was the first to coin this term. I haven't been able to find a reference to the "Galileo Gambit" dating before I wrote the original version of this post way back in 2005. In any case, if there are any really "classic" posts on this blog (which, I'll concede, is debatable, this is one, IMHO, and I haven't reposted it here since 2006; so it's time. Maybe I should do a more substantial revision and update it, as I've noticed some dead links I apologize, as I didn't have the time to go through and either update them, created Archive.org links, or change the text. Oh, well. Finally, this particular post is very appropriate to what I traveled here, now taking the brunt of the storm, to do. Sadly, the storm has interfered, as it would have been a hell of a lot of fun.
The appearance of the Herbinator on my blog last week and his sarcastic invocation of Galileo reminded me of a topic I've wanted to write about almost since the beginning of Respectful Insolence. It's a favorite tactic used by alties (not to mention pseudoscientists, pseudohistorians, and other cranks). Alties frequently invoke Galileo and other scientists like Ignaz Semmelweiss, who were at first rejected by the scientific orthodoxy of the time and had to fight to get their ideas accepted. The implication, of course, is that their ideas, whatever they may be (alternative medicine, intelligent design, Holocaust denial, psychic abilities, etc.), are on the same plane as those of Galileo or Semmelweiss. Frequently, they will add a list of famous scientists or experts who made predictions about the impossibility of something or other and were later found wrong, so much so that the statements sound ridiculous today. For example, here's a famous list that's been making the rounds on Usenet for years. Some of these quotes may in fact be urban legends (and, in fact, I'd be grateful to anyone who points out urban legends in here to me), but let's for the moment assume they are all legitimate quotes:
..so many centuries after the Creation it is unlikely that anyone could find hitherto unknown lands of any value. - Committee advising Ferdinand and Isabella regarding Columbus' proposal, 1486
I would sooner believe that two Yankee professors lied, than that stones fell from the sky. - Thomas Jefferson, 1807 on hearing an eyewitness report of falling meteorites.
Drill for oil? You mean drill into the ground to try and find oil? You're crazy. - Drillers who Edwin L. Drake tried to enlist to his project to drill for oil in 1859.
Louis Pasteur's theory of germs is ridiculous fiction. - Pierre Pachet, Professor of Physiology at Toulouse, 1872
[Orac's note: This one is particularly amusing to me, given that so many alties reject Pasteur's theory in favor of Beauchamps. Here, they seem to want to have it both ways. They reject Pasteur when arguing against antibiotics, claiming that bacteria are not the cause of disease, or attacking vaccines as useless and harmful. However, they have no problem invoking this quote. Of course, they don't seem to realize that their use of this quote implicitly acknowledges that Pasteur's theories, although initially quite controversial, were ultimately proven correct.]
The abdomen, the chest, and the brain will forever be shut from the intrusion of the wise and humane surgeon. - Sir John Eric Ericksen, British surgeon, appointed Surgeon-Extraordinary to Queen Victoria 1873.
[Orac's note: As a surgeon, I have to point out that, at the time, this was not an entirely unreasonable statement. Operating in the abdomen was risky in the extreme, with a high rate of death from peritonitis that could approach 50% in some operations (that is, until the invention of antibiotics). In fact, I sometimes wonder how the great surgeons of 100 years ago managed to operate on anyone's abdomen and have the patient actually survive the procedure. Operating in the chest was also out of the question, given the problem of reinflating the lung afterward, and certainly the brain was completely off-limits. In any case, there was no way Sir Ericksen (or anyone else) could be faulted for failing to forsee the advancements in anaesthesia, antibiotics, surgical technique, and patient care that would ultimately allow such surgery to succeed and even become routine (although one does have to point out that surgeons were already operating in the abdomen reasonably successfully at the time).]
Such startling announcements as these should be deprecated as being unworthy of science and mischievious to to its true progress. - Sir William Siemens, 1880, on Edison's announcement of a sucessful light bulb.
We are probably nearing the limit of all we can know about astronomy. - Simon Newcomb, astronomer, 1888
Fooling around with alternating current is just a waste of time. Nobody will use it, ever. - Thomas Edison, 1889
[Orac's note: It's well-known that Thomas Edison wanted to promote the use of direct current rather than alternating current. It was a battle of rival technologies (sometimes called the War of Currents), not unlike the war between Betamax and VHS, but on a much larger scale. Edison ultimately lost.]
The more important fundamental laws and facts of physical science have all been discovered, and these are now so firmly established that the possibility of their ever being supplanted in consequence of new discoveries is exceedingly remote.... Our future discoveries must be looked for in the sixth place of decimals. - physicist Albert. A. Michelson, 1894
Heavier-than-air flying machines are impossible. - Lord Kelvin, president, Royal Society, 1895.
It is apparent to me that the possibilities of the aeroplane, which two or three years ago were thought to hold the solution to the [flying machine] problem, have been exhausted, and that we must turn elsewhere. - Thomas Edison, 1895
The demonstration that no possible combination of known substances, known forms of machinery, and known forms of force can be united in a practicable machine by which men shall fly for long distances through the air, seems to the writer as complete as it is possible for the demonstration of any physical fact to be. - astronomer S. Newcomb, 1906
Airplanes are interesting toys but of no military value. - Marechal Ferdinand Foch, Professor of Strategy, Ecole Superieure de Guerre.
Caterpillar landships are idiotic and useless. Those officers and men are wasting their time and are not pulling their proper weight in the war. - Fourth Lord of the British Admiralty, 1915, in regards to use of tanks in war.
Professor Goddard does not know the relation between action and reaction and the need to have something better than a vacuum against which to react. He seems to lack the basic knowledge ladled out daily in high schools. - 1921 New York Times editorial about Robert Goddard's revolutionary rocket work.
[Orac's note: Why the New York Times would be considered an "expert" in rocketry such that it would be of interest to use it as an example of an "expert" making a statement that is later proven wrong, I have no idea. This quote is at best irrelevant.]
The wireless music box has no imaginable commercial value. Who would pay for a message sent to nobody in particular? - David Sarnoff's associates in response to his urgings for investment in the radio in the 1920s.
"All a trick." "A Mere Mountebank." "Absolute swindler." "Doesn't know what he's about." "What's the good of it?" "What useful purpose will it serve?" - Members of Britain's Royal Society, 1926, after a demonstration of television.
This foolish idea of shooting at the moon is an example of the absurd lengths to which vicious specialisation will carry scientists. -A.W. Bickerton, physicist, NZ, 1926
Who the hell wants to hear actors talk? - H.M. Warner, Warner Brothers, 1927.
Stocks have reached what looks like a permanently high plateau. - Irving Fisher, Professor of Economics, Yale University, 1929.
[Orac's note: Of course, we had the same sort of idiotic statements coming from "experts" during the Internet bubble of the 1990's; for example, this book predicting that the Dow would reach 36,000. How many times did we hear that the Internet "changed everything" and that the stock market had no where to go but continually up?]
There is not the slightest indication that nuclear energy will ever be obtainable. It would mean that the atom would have to be shattered at will. -- Albert Einstein, 1932
The energy produced by the atom is a very poor kind of thing. Anyone who expects a source of power from the transformation of these atoms is talking moonshine. - Ernst Rutherford, 1933
The whole procedure [of shooting rockets into space]...presents difficulties of so fundamental a nature, that we are forced to dismiss the notion as essentially impracticable, in spite of the author's insistent appeal to put aside prejudice and to recollect the supposed impossibility of heavier-than-air flight before it was actually accomplished. Richard van der Riet Wooley, British astronomer, reviewing P.E. Cleator's Rockets in Space, Nature, March 14, 1936
Space travel is utter bilge! -Sir Richard Van Der Riet Wolley, astronomer
I think there is a world market for maybe five computers. - Thomas Watson, chairman of IBM, 1943
Computers in the future may weigh no more than 1.5 tons. - Popular Mechanics, forecasting the relentless march of science, 1949
[Orac's note: Heh heh. This statement isn't an incorrect prediction. Think about it. Most computers don't weigh more than 1.5 tons these days, do they?]
I have traveled the length and breadth of this country and talked with the best people, and I can assure you that data processing is a fad that won't last out the year. - The editor in charge of business books for Prentice Hall, 1957
Space travel is bunk. -Sir Harold Spencer Jones, Astronomer Royal of Britain, 1957, two weeks before the launch of Sputnik
There is practically no chance communications space satellites will be used to provide better telephone, telegraph, television, or radio service inside the United States. -T. Craven, FCC Commissioner, 1961
We don't like their sound, and guitar music is on the way out. - Decca Recording Co. rejecting the Beatles, 1962.
But what... is it good for? - Engineer at the Advanced Computing Systems Division of IBM, 1968, commenting on the microchip.
There is no reason anyone would want a computer in their home. - Ken Olson, President, Chairman and Founder of Digital Equipment Corporation, 1977
The concept is interesting and well-formed, but in order to earn better than a 'C,' the idea must be feasible. - A Yale University management professor in response to Fred Smith's paper proposing reliable overnight delivery service. (Smith went on to found Federal Express Corp.)
I'm just glad it'll be Clark Gable who's falling on his face and not Gary Cooper. - Gary Cooper on his decision not to take the leading role in Gone With The Wind.
A cookie store is a bad idea. Besides, the market research reports say America likes crispy cookies, not soft and chewy cookies like you make. - Response to Debbi Fields' idea of starting Mrs. Fields' Cookies.
If I had thought about it, I wouldn't have done the experiment. The literature was full of examples that said you can't do this. - Spencer Silver on the work that led to the unique adhesives for 3M "Post-It" Notepads.
So we went to Atari and said, 'Hey, we've got this amazing thing, even built with some of your parts, and what do you think about funding us? Or we'll give it to you. We just want to do it. Pay our salary, we'll come work for you.' And they said, 'No.' So then we went to Hewlett-Packard, and they said, 'Hey, we don't need you. You haven't got through college yet.' - Apple Computer Inc. founder Steve Jobs on attempts to get Atari and H-P interested in his and Steve Wozniak's personal computer.
You want to have consistent and uniform muscle development across all of your muscles? It can't be done. It's just a fact of life. You just have to accept inconsistent muscle development as an unalterable condition of weight training. - Response to Arthur Jones, who solved the "unsolvable" problem by inventing Nautilus.
640K ought to be enough for anybody. - Bill Gates, 1981
[Orac's note: Of course, in 1981, Gates was correct. No one really needed more than 640K in a personal computer. There wasn't much you could actually do with more than that in 1981...]
So, again, what's the point of alties or other pseudoscientists invoking Galileo or any of the hideously incorrect prognostications listed above? Again, obviously, this technique seeks to denigrate the experts who reject the altie's claims as not knowing what they're talking about or as close-minded, unable to have the vision that they do. It also deceptively tries to associate the quack, crank, pseudoscientist, or pseudohistorian with the theories and findings of great visionaries that went against conventional wisdom and were thus rejected by the experts of the day--and then later shown to be correct. It's a transparent ploy, about which Michael Shermer once said, "Heresy does not equal correctness."
Some call it the Galileo gambit (although in actuality Galileo is probably a bad example for pseudoscientists to use, given that he was persecuted by the Church, and not by his fellow scientists). History is indeed full of tales of the lone scientist working in spite of his peers and flying in the face of the doctrines of the day in his or her field of study. No doubt there are still a fair number of such scientists today. Unfortunately (or fortunately, depending upon your point of view), the vast majority of them turn out to be utterly wrong. They disappear into the mists of history, leaving not even a footnote in the grand history of science. As Shermer so correctly put it in his book Why People Believe Weird Things (a book I highly recommend to anyone interested in improving his or her critical thinking skills):
For every Galileo shown the instruments of torture for advocating scientific truth, there are a thousand (or ten thousand) unknowns whose 'truths' never pass scientific muster with other scientists. The scientific community cannot be expected to test every fanstastic claim that comes along, especially when so many are logically inconsistent.
For every Galileo, Ignaz Semmelweis, Nicolaus Copernicus, Charles Darwin, Louis Pasteur, etc., whose scientific ideas were either ignored, rejected, or vigorously attacked by the scientific community of his time and then later accepted, there are untold numbers of others whose ideas were either ignored or rejected initially and then were never accepted--and never will be accepted. Why? Because they were wrong! The reason the ideas of Galileo, Semmelweis, Copernicus, Darwin, Pasteur, et al, were ultimately accepted as correct by the scientific community is because they turned out to be correct! Their observations and ideas stood up to repeated observation and scientific experimentation by many scientists in many places over many years. The weight of data supporting their ideas was so overwhelming that eventually even the biggest skeptics could no longer stand. That's the way science works. It may be messy, and it may take longer, occasionally even decades or even longer, than we in the business might like to admit, but eventually in science the truth wins out. In fact, the best way for a scientist to become famous and successful in his or her field is to come up with evidence that strongly challenges established theories and concepts and then weave that evidence into a new theory. Albert Einstein didn't end up in the history books by simply reconfirming and recapitulating Newton's Laws. Semmelweis and Pasteur didn't wind up in the history books by confirming the concept that disease was caused by an "imbalance of humours" (although Semmelweis probably did hurt himself by refusing to publish his results for many years; his data was so compelling it remains puzzling why he did not do so). I daresay that none of the Nobel Prize winners won that prestigious award by demonstrating something that the scientific establishment already believed. No! They won it by discovering something new and important!
Unfortunately, to most lay people who don't have a strong background in science, the scientific method, or the history of science, such trickery can sound convincing on the surface. For example, you have a quack like Hulda Clark claiming she has a cure for cancer and AIDS and then claiming that the scientific establishment can't accept it. Add a dash of paranoia about big medicine and big pharma "suppressing" her "cure," and it's a potent brew of deception. This ploy is particularly appealing to Americans, because our whole national psyche has in its core a tendency to root for the outsider, the underdog. Alties, pseudoscientists, and cranks tap into that deep-seated sympathy we tend to have for the persecuted outsider and use it to their advantage. It's the same with creationists, who use every well-deserved debunking they get as evidence that they are a "threat" to the established scientific order. The only way to combat such deceptive comparisons is to point out again and again Shermer's dictum that "heresy does not equal correctness" and try to keep the discussion on the hard evidence.
I think it's appropriate to finish with another Michael Shermer quote: They laughed at Copernicus. They laughed at the Wright brothers. Yes, well, they also laughed at the Marx Brothers. Being laughed at does not mean you are right.
Use it the next time an altie tries to imply that the fact that the scientific establishment mocks their ideas means that they must be on to something. Except do what I do and use the Three Stooges instead of the Marx Brothers.
Especially Curly. Nyuck, nyuck, nyck.
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Another layer of irony, of course, is that frequently defenders of quackery are themselves supporting what used to be the establishment form of medical care - e.g. traditional healing practices (whether genuinely traditional or some modern variant) - before being supplanted by more scientific medicine.
It would be equivalent to someone arguing today that heavier-than-air flight or space travel is bunk or that this Internet thing is a passing fad.
A small and pedantic point:
Sir John Eric Ericksen should not be referred to as "Sir Ericksen". Once his full name has been used in a text, he would be referred to as "Sir John", and he would be addressed in the same way. The full name is used to establish which Sir John is being referred to. And so you have Sir Lancelot, Sir Gawain, Brave Sir Robin, etc.
Another small pedantic point...
This was not an original Shermer quote.
It was Carl Sagan.
Well that was a paraphrase of Sagan anyhow... on looking it up I see Sagan originally said:
I've heard this expresed was "They may have laughed at Galileo and Einstein, but that doesn't argue they were wrong to laugh at Bozo the Clown."
There is not the slightest indication that nuclear energy will ever be obtainable. It would mean that the atom would have to be shattered at will. — Albert Einstein, 1932
Einstein was not entirely wrong here. As he correctly notes, nuclear energy depends on the fission of heavy atoms (uranium or thorium; some nuclear weapons use plutonium), and this statement was made several years before fission was discovered. It's also well known that in 1939 Einstein, a well-known pacifist, signed a letter to the President pointing out the military applications of uranium fission, which had just been discovered in Germany, and the fact that Germany had recently stopped exporting uranium. That letter led directly to the creation of the Manhattan Project.
I suspect the Columbus entry of being apocryphal, but don't have proof of that. In every version of the story I have heard, Columbus claimed that one could reach Asia from Europe by sailing west, and according to one version, the issue was that Columbus was using a lowball estimate of the circumference of the Earth (he claimed it was about 30,000 km; Eratosthenes had measured its value to be about 40,000 km, which is close to the correct value). The flat versus round earth stories told about Columbus are apocryphal. It's also not clear that Columbus was the first European of his generation to reach the Americas; there is evidence that Portuguese fisherman were working along the coast of Newfoundland by 1480.
"Only missed by a moment--fell a little off the pace..."
The alleged Bill Gates quotation is a recognised fabrication -- there is no source, and Gates has denied ever saying anything along those lines. The Watson quote again is certainly spurious.
Many of the other claims are listed in the "Attributed" section of the Wikiquote page on "Incorrect predictions". No-one's been able to track down an original source for the attributions, but no-one's proved them to be spurious either.
People make up these claims, and attach a famous expert's name to each one, and they join in a process of accretion to the lists of "Experts Being Wrong" that circulate by e-mail or are copied from website to website.
John Sladek :
They laughed at Galileo, they laughed at Darwin, they laughed at Edison … and they laughed at Punch and Judy.
[The New Apocrypha, p.155 -- see me sourcing my citations!]
Notice that Sagan's line is from 1979, so Advantage: John Sladek.
"The problem with quotes on the internet is that many are not genuine" Abraham Lincoln
I'm pretty sure that it was actually Santayana who said that.
First they ignore you. Then they laugh at you. Then they keep laughing at you because your idea is complete nonsense.
Actually, I believe that was Nostradamus. It's right after the section where he predicted WWII and 9/11.
More recently, Dr Melba Ketchum, author of a paper claiming Bigfoot is related to humans invoked the 'Galileo Effect' to justify her creation of a scientific journal to publish her paper.
Very much like Jasper Fforde's* Retro Deficit Engineering Principle: why not use a technology now if you're almost certain it'll be invented/proven in the future anyway?
Unfortunately, in his novel "The Woman who Died a Lot", it didn't quite work out for time travel. Someone traveled to the end of time and discovered that it was never invented, so all current time travel had to be stopped.
*If you like Pratchett, Chabon, Gaiman, you'd probably like Fforde.
That's amazing! What sort of scientist would create a scientific journal just to publish that person's paper?
Oh, wait, I know. Didn't Andrew Wakefield do that?
I understand how Gates feels at having his name attached to such drivel. Anyone seems to be able to say whatever libelous dreck they wish and pretend to be whomever they like on the internet.
I, for instance, never uttered the worlds "V'mech sshatvt chaak v'monkay greetz chaakva yachneh." Your species is most certainly not getting smarter. Honestly, it's transparently false.
Lord Draconis Zeneca, VH7ihL
Forward Mavoon of the Great Fleet, Grand Vitara of Cucamonga, Bravo's™ Real Overlords of the Sol System, Season 4
Glaxxon PharmaCOM Orbital
The Jefferson quote is not verifiable, and is merely an observation anyway and not a conclusion. But there is documentation that he said this about meteors:
" We certainly are not to deny whatever we
cannot account for. A thousand
phenomena present themselves daily which
we cannot explain, but where facts are
suggested, bearing no analogy with the
laws of nature as yet known to us, their
verity needs proofs proportioned to their
Sorry CAM skanks, you lose on that one big time.
Also, the full quote ends with,
" The actual fact
however is the thing to be established, and
this I hope will be done by those whose
situations and qualifications enable them
to do it. I salute you with respect."
OT, but of interest in terms of quack vs non-quack billing:
Today's CNN.com led off with a long evaluation of hospital billing in the United States.
The overall conclusion is that Medicare works pretty well, that the billing rates that hospitals use are entirely bogus and an order of magnitude high for the most part, and that people suffer horrible financial pain as a result of being patients in our system. If you read through the whole article, you will see case after case in which people followed the standard advice, went to an emergency room or had an outpatient procedure done at a regular hospital, and ended up tens or hundreds of thousands of dollars in debt.
Perhaps this is one of the reasons that the alties and quacks get away with so much -- the system is unavailable to a lot of people, and is daunting to many of the rest of us.
The story opens with a man in his early forties diagnosed with non-Hodgkins lymphoma, and who wishes to be treated at MD Anderson. The down payment for him to be seen was just under fifty thousand dollars (a relative had to write a check before he would be admitted) and quickly mounted to nearly eighty-four thousand dollars.
Viewed with this lens, Dr B is a piker, the only difference being that MD Anderson is not engaging in medical fraud. On the other hand, MD Anderson and lots of other hospitals mentioned in the story are doing some amazing gauging.
I support whole-heartedly the concept of science based medicine, but the system we have provides a lot of ammunition to its critics in terms of its greed and heartlessness.
Shorter version: Try dealing with UCLA medical billing some time.
"Well, yes, there's absolutely no evidence which suggests antineoplastons are effective at curing advanced stage cancers, but they do cost less than the conventional science based medicine that has actually been shown to work" isn't much of an argument in woo's favor.
I'm not sure if you are responding to my post or to something else. My view of "antineoplastons" (with the quotes intentional) is that back in the 1960s, there were lots of attempts to find some naturally occurring substance that worked on cancer the way penicillin works on bacteria and aspirin works on fever. It is not evident that Dr B ever really showed anything about his miracle potions, but the search may have been not-unreasonable at the time. But science moved on. Just to mention a few discoveries that post-date the use of human urine as a cancer treatment, we have the discovery of the "nu particle" which was quickly identified as the nucleosome, around which DNA is wound in the nucleus. The nucleosomal structure was itself understandable based on Sally Elgin's discovery (in James Bonner's lab) that the histone proteins are a fairly limited group. All of the work on histone acetylation and deacetylation and how this affects gene expression came later, and are based on these earlier discoveries. The fact that antineoplastons have some modest effect on histone deacetylase, if I understand correctly, is obviously an understanding that post-dates Dr B's original work.
The myriad collection of gene transcription factors came a little later, and the intermediate signaling systems that we hear so much about nowadays were described even later still.
In short, Dr B's discovery, if you want to call it that, is essentially 19th century science at best. More likely, it is weak science, and to the extent that the antineoplastons have any useful effects, they are certainly long since outmoded. Dr B manages to make a living by selling his snake oil to patients whose disease has no effective treatment. As I have pointed out in other comments, the advent of an effective line of therapy for these otherwise untreatable brain tumors will spell the end of the Burzynski era. Perhaps there will be an antineoplaston clinic next door to the last laetril clinic, but that will pretty much be the end of it.
The fact that Dr B is a snake has nothing to do with whether the current medical care system is also a vipers' nest. At the level of billing, I think it is. The politics that underlies this situation is frustrating to us rationalists, but there it is. The fact that the US could offer high quality care at two-thirds the overall cost is becoming more and more obvious, but the right wing opposes any and all reform.
I always thought Peter Gabriel received PharmaComm assistance via that quotation from our Lord Draconis, in writing his famous hit brainwashing song, "Chaak V' Monkay."
You have to watch out with those quotes.
I said "I seem to be having tremendous difficulty with my lifestyle" and got attacked by a swarm of gnats. Well, I thought they were gnats, anyway.
This is not exactly relevant to your post but I'd like your opinion please. My husband has been prescribed tetrazepam by our doctor (for a very painful shoulder and arm). I always look up medication and found this http://lci.tf1.fr/science/sante/attention-au-tetrazepam-dit-l-agence-du…
For anyone not happy with French it is saying that due to the number of adverse side effects (mainly skin related but including 11 deaths) the ANSM (National Agency for Medical Security) are calling for the drug to be re-evaluated. Needless to say i'm worried about my husband taking it.
Have any of you heard of concerns for this medication please?
Seems like an odd first choice as an antispasmodic, but of course IANAD. (English summary here.)
@sablonneuse: given the drug is under re-evaluation from the link posted by Narad, perhaps your doctor would be willing to prescribe an alternative. Speaking from experience, benzodiazapines are very good muscle relaxants - here in the US they use Valium (diazepam) for such problems (I've had it myself).
It is certainly reasonable for you to talk to your doctor about your concerns and ask for an alternative if possible.
Sablonneuse, am I correct in guessing that your husband is suffering residual pain from an acute injury?
Ew, Yeah, I'd ask the doc for a different drug, too.
@ sablonneuse: Wikipedia entry on Tetrazepam:
Thank you all for your help.
I will ask the doc for something different but she won't be on duty again till Monday.
Narad: we don't really know what's causing the pain. It hurts from his shoulder blade all the way down to his fingers - but not all the time. If he finds a good position he's relatively painfree but once he moves it's agonizing.
He is 85, has 'renal insufficiency' so can't take anti-inflammatories and is diabetic so can't have cortisone. The doctor prescribes lammaline for his usual pain (he needs a knee replacement but neither he nor the surgeon are keen to do his other knee as it took over a year to get over the left one and the right one would be complicated due to a previous operation for torn quadriceps). She really didn't know what she could prescribe for this latest pain so tried a muscle relaxant.
The only possible cause we can think of is that he was moving logs on Tuesday and it came on after that.
@ sablonneuse: None of us who provided you with info on Tetrazepam are doctors or pharmacists.
My only advice would be to use a warm heating pad. It will not cure your husband, but should provide some relief. And, of course, I would suggest that he and you evaluate for signs that the pain and numbness is abating somewhat...and not worsening.
As Liliady has correctly noted, the vast majority of us are properly considered to be just random Internet people. That said, if analgesia is the main issue, I'm a big fan of tramadol (and I don't mean recreationally), and it kind of looks to be plausible in diabetics. Might be worth asking about. In any event, there are certainly other antispasmodics if that's the source of the pain.
I also forgot to mention that any 85-year-old hauling logs automatically gets my respect.
My qualifications are non-medical, so I am only adding a comment here to apologise for not having anything useful to say.
Have I ever told you about Forthman Murff?
Narad: he was moving small logs - 50cms - and cutting them on the electric log splitter. but even so, not bad at his age, eh!
He does have Tramadol but it makes him dizzy so he's not allowed a big enough dose to kill the pain.
lilady: he has a hot water bottle and says that's as useful as any of the tablets, if not more so.
Thanks again for your interest and help everyone.
For sablonneuse--I am neither a doctor nor a pharmacist, but I have much personal experience with acute shoulder trauma. One of my problems was found to be due to a suddenly entrapped suprascapular nerve that occurred in similar conditions to your husband's injury. Within a week the spinatus and supraspinatus muscles in the shoulder girdle were paralyzed. The problem was eventually diagnosed by traditional electromyelogram, and surgical decompression eventually relieved the acute pain and paralysis. That condition is responsible for only about 0.5% of all cases of acute shoulder/arm pain but may be worth asking your doctor about if your husband seems to be having increasing weakness as well as horrific pain. I recovered very well after the nerve release and much intensive physical therapy. Both of my surgeons believe it is an underdiagnosed source of sudden shoulder/arm pain following certain kinds of injuries. Good luck with finding an answer and relief.
Have I ever told you about Forthman Murff?
The 'Fieries' from Labyrinth are not an appropriate role-model.
Fingers crossed, sablonneuse.
I will leave it to the MDs here, but coming from a non-medical person, have they ruled out shingles? The only part that is strange, and looks more orthopedic, is the fact that the pain goes away when he finds a comfortable position.
Bob G: I'm playing doctor here. :-)
Shingles rash is quite distinctive:
@sablonneuse - Can you give him massages and heat/ice packs throughout the day?
IANAD, but I would suggest rotating heat and ice on the area throughout the day. Don't do any lifting, but do light stretches so as not to allow the muscles to stiffen up. If at all possible, I'd advise a massage of the affected area several times a day, preceded by a heat pack each time. The ice packs should not be so cold as to cause him to tense up his muscles.
Thanks again everyone.
The doc did check for shingles and decided it wasn't.
Sara: did your pain 'come and go' initially? I'm hoping my husband's problem doesn't turn out to be as serious as yours was but am glad you've recovered now.
Oooh, I love the electric heating pad suggestion, especially if hot water bottles are giving him relief. I echo the respect about the log-hauling, even if they're small! My grandfather was one of those tough old birds, too-- he bounced back from double knee surgery at age 88, though many his age wouldv'e never walked again. He was a farmer, and had a lifetime's worth of built-up muscle and bone strength to fall back on when times got tough. Your husband will likely be just fine after a decent period of recuperation-- make sure he does LIGHT and GENTLE exercises, preferably those recommended by a physical therapist. I'm pretty much in agreement with S @ #44 above, although I am a big huge weenie about cold packs and cannot stand any except for the ones used for baby fevers, usually in the shape of a teddy bear or somesuch! :)
A tramadol before bed might give him a good night's rest-- and the dizziness might not matter at that time. IANAD either, so all my advice is just a random internet person poking her nose in. ;)
C'mon, Forthman was awesome. I knew a fellow back in high school who claimed to be his nephew. This lad also had habits reminiscent of Lee Mellon from A Confederate General from Big Sur.
S @44: thanks for your suggestion. The doc has prescribed a massage cream (containing diclofenac) but at the moment I can only rub very gently when I apply it so think a real massage would hurt too much. Fingers crossed it will not be so sensitive soon.
for sablonneuse--Yes, my pain was a little relieved in the right position but never disappeared entirely. The first week I turned over in my sleep and felt the excruciating pressure on he nerve relieved a little. One problem with diagnosing peripheral nerve injuries is that they often don't cause paralysis right away, and the nature of the pain can change over time with increasing trauma to the affected nerves. It can also be somewhat relieved if mechanical pressure on the nerve is released.
Added to that, these conditions may not show up right away on EMG or MRI studies, which show neuropathy by revealing muscle and nerve conduction abnormalities. EMG was definitive in my situation but had to be done four weeks after the injury because the abnormal signals and pathology can be hard to detect right away. I was misdiagnosed twice by a renowned sports medicine guy at a major teaching hospital. I was eventually diagnosed by a very diligent private ortho guy and a neurosurgeon after many, many tests.
They had a point: if you're hiring actors for silent films, then you can get away with having people that sound like Fran Drescher. If you have talkies, suddenly you have to hire people who actually can talk and sing. Or hire people to dub the voices.
The sum of the list is that hindsight is not the best way to prove that your hypothesis is correct now.
Or that your hypothesis may be valid but not entirely within someone's financial interests to take a risk on, and has nothing to do with being 'correct' at all...
I don't know about that. Here with our universal health care, it doesn't prevent the huge amount of woo being used, and even included on health plans. Sadly I live close to an area which has a lot of Asian immigrants/descendants, and you'd be amazed at how much TCM and homeopathy and etc there is.
I have no doubt that woo being more financially accessible would contribute to the problem, but I highly doubt that it's the main reason.
The thing about some of the big breakthroughs in science is that even when people laugh first laugh at an idea, the person proposing it does research and makes observations and then proves that their idea is a good one. In most cases this is achieved within one or two decades, e.g. Helicobacter pylori causing gastric ulcers.
Some of these "amazing ideas" put forward by alternative medicine pundits have been around for centuries and they have failed to provide evidence to support them.
They fall in the bozo the clown category
Thank you Sara. Thta sounds very conplicated and difficult to diagnose. I really hope my husband isn't suffering from the same condition.
Sablonneuse - My dad had a traumatic shoulder injury that led to constant pain that was only alleviated by some bizarre position.
He was taking gabapentin, diclofenac and tramadol, they were of some help but he still had pain. Then his GP referred him to a gain management clinic, they recommended steroid injections into the shoulder capsule. Within a few days he was sleeping through the night, and only taking paracetamol (acetaminophen) for the pain. He now has them on a regular schedule.
Sorry if your husband's tried that already.
Oh and tramadol - I've used it for various recurring issues since my teens, and it always makes me extremely dizzy for the first few days. Last year I stopped it for five days (after two years) and restarting it was like being on a bloody rollercoaster! I had to start on a tiny dose and ramp my way up. Also, the extended release didn't make me at all dizzy (but it aggravated one of my motor issues), so maybe his doc could furnish him with samples to see if that makes a difference?
Best of luck to you both.
Yah, it is noticeable for a little while. I'm still interested in its structural similarity to venlafaxine (Effexor); it does seem to have SNRI action. Strangely, I've found, in two challenges, Effexor to be completely intolerable even at a mere 37.5 mg. I really should look around to see whether there are any real clinical data on testing tramadol as an antidepressant.
Hope I understand the thread on venlafaxine (browser display problems). I was part of the final clinical trials for it in the late 1980s and found that it aggravated chronic pain, contrary to expectations. Elavil, the old tricyclic, has been used for years to help with chronic pain. When I took it for a few months with little relief, we found that the problem was partly inadequate dosage. I have a friend now who is taking tramadol for chronic pain, and they have had to tweak his dose quite a bit. He believes it is actually helping his depression. The pain itself is depressing. Hard to tease out the two.
Yah, it appears that the extant work on antidepressant effects of tramadol is all in rodents.