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– Hide quoted text — Show quoted text –          Usenet Advanced Search  Usenet Help  Search all groups   Search the Web Click here for information about upcoming improvements to this beta version of Google’s Usenet search. Usenet search result 7 for PSYCHIATRIST group health Search Result 7  conflicts between drug trials and $$$$ Drug Trials Hide Conflicts for Doctors – Part I By KURT EICHENWALD and GINA KOLATA http://wwwlawyer.com/articles/article2321.cfm When Thomas Parham visited his doctor in the summer of 1995, he expected just another routine checkup. But his doctor had something else in mind. The doctor, Peter Arcan, suggested that Parham might want to join a study of a new drug to shrink enlarged prostates, according to records of the encounter. Parham was puzzled — his prostate was fine. But Arcan brushed aside the retired metal worker’s questions, saying the experimental drug might prevent future problems. Satisfied, Parham, a 64-year-old resident of La Habra, Calif., agreed to participate. There was one question Parham did not ask: What was in it for Arcan? The answer was money. The drug’s maker, SmithKline Beecham PLC, was paying $1,610 for each patient that doctors signed up — money that covered study expenses while allowing a portion to end up as profit for Arcan and his associates. Parham had no idea. "Nothing was mentioned about money," he said in an interview. "It’s a situation where you have faith in your doctor." Through his secretary, Arcan declined comment. With his decision, Parham had unwittingly joined hundreds of thousands of other patients recruited by their personal physicians into a booming venture: the business of testing experimental drugs on people. Once clinical research was a staid enterprise primarily administered by academic researchers driven by a desire for knowledge, fame or career advancement. Now, it is a multibillion-dollar industry, with hundreds of testing and drug companies working with thousands of private doctors. In this new industry, patients have become commodities, bought and traded by testing companies and doctors. Almost daily, the industry urges doctors to join the gold rush, bombarding them with faxes and letters blaring such come-ons as "Improve Your Cash Flow" and "Discover the Secret For Obtaining More Funded Studies." In an era of managed care, the pleas are seductive: The number of private doctors in research since 1990 has almost tripled, and top recruiters can earn as much as $500,000 to $1 million a year. This new system is a boon for drug companies because it reaches out to a vast pool of test subjects who have never before been available for experimentation. But it also injects the interests of a giant industry into the delicate doctor-patient relationship, usually without the patient realizing it. These changes have prompted little public debate, mostly because the full scope of what is happening is hidden. The industry treats research agreements as corporate secrets and contractually forbids doctors to disclose them. As a result, few people outside the industry, including government officials, have seen the contracts or know the magnitude of the money involved. But in a 10-month investigation, The New York Times obtained such contracts and thousands of other confidential documents that present a view of the research industry that has never before been available. These records, and interviews with participants, reveal a system fueling a pharmaceutical renaissance, but fraught with conflicts of interest; that places a premium on speed and meeting quotas; that relies on government and private monitoring that can be easily fooled and that some researchers said is inadequate; and that secretly offers a share of the cash to other health professionals who might influence patients to join a study. At bottom, the only thing separating a trusting patient from a study that could be inappropriate or potentially harmful is the judgment of a doctor torn by these unseen conflicts and pressures. The documents, including contracts, protocols or related financial records from more than 300 recent drug studies, were provided by a number of people in the industry concerned about its direction. The Times also conducted a computer analysis of more than 200,000 filings with the government and related data submitted by doctors who want to conduct research, and interviewed doctors, patients, ethicists, industry executives and government officials. These are among the specific findings of The Times’ investigation: — Drug companies and their contractors offer large payments to doctors, nurses and other medical staff to encourage them to recruit patients quickly. And doctors do not even have to conduct trials to get paid: There are finder’s fees for those who refer their patients to other doctors conducting research. — Doctors who recruit the most patients receive additional perquisites, such as the right to claim a coveted authorship of published papers about the studies — even though the true author is a ghostwriter using analysis from the drug company. Those who fail to meet the recruitment goals are usually dropped from future studies. — Testing companies often use doctors as clinical investigators regardless of their specialty, at times leaving patients in the care of doctors who know little about their condition. For example, psychiatrists have conducted Pap smears and asthma specialists have dispensed experimental psychiatric drugs. — A growing number of doctors conducting drug research have limited experience as clinical investigators, raising questions among some experts about the quality of their data. In interviews, industry officials and researchers said the emerging drug-approval system was dedicated to quality and offers significant benefits. Since patients are seeing their own doctors, researchers said, it adds a level of continuity and personal contact to the process — something unavailable from full-time researchers. Moreover, industry officials said, the new pool of test subjects is a resource of incalculable value that is allowing the development of an avalanche of new compounds. Drug tests "can get delayed if the patients aren’t out there and available," said Chris Kuebler, the chairman and chief executive at Covance Inc., a giant testing company. But some experts said patients were being pushed to participate in the studies because of the financial interests of their doctors. Doctors working as researchers "are enticing and cajoling patients who are in no position to resist their blandishments to enter clinical studies," said Dr. David Shimm, a member of the ethics committee at Porter Adventist Hospital in Denver who has written about research conflicts. "What the patients are not seeing is that the clinical investigator is really a dual agent with divided loyalties between the patient and the pharmaceutical company," he said. While patients must sign detailed consent forms to enroll in drug studies, they are often in no position to question their doctor’s suggestion that they join. "The physician has enormous power over you," said Uwe Reinhardt, a health care economist at Princeton University, who himself recently agreed to participate in a clinical trial run by his doctor — in part because he feared annoying him — and who had no idea that money might be involved. "You want to keep his favor. If you say no, you’ll worry that he may not like you." That is what happened with Parham and Arcan. In joining the study, Parham said: "I just followed his advice, just like if he said to take two aspirin instead of one. He’s a doctor and I’m not." In truth, Parham should never have been signed up for the prostate study. According to his medical records, he had been hospitalized the previous year with a chronic slow heart rate, a condition that specifically disqualified him for the study. But, saying that Parham’s heart rate was only mildly slow, an administrator handling the paperwork for Arcan sought an exemption from SmithKline. Based on those representations, the drug company granted the exemption; it was not told about Parham’s earlier hospitalization. Soon after joining, Parham complained of fatigue, a symptom of his slow heart rate. Arcan dismissed the complaints as emotional. Within weeks, Parham asked to be dropped from the study. Days later he was hospitalized and given a pacemaker; Parham never brought legal action and it is impossible to know whether his participation in the study affected his heart condition. His experience underscores a potential danger of the emerging drug- testing system: Doctors with money at stake may persuade patients to take drugs that are inappropriate or even unsafe. Under the current system of monitoring, such actions are almost impossible to catch and no statistics are collected on such events. Within the industry, most of the planning focuses on conducting studies quickly. Patient issues, some researchers said, are often lost in the rush. "You go to the trade meetings on clinical research; you go for two entire days, and patients are not mentioned," said Dr. Robert Califf, the director of the Duke Clinical Research Institute, an academic drug- testing center in Durham, N.C., affiliated with Duke University. "The patient is an object to make money. Having patients is just the dirty price for doing business." A letter sent out last July by

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What a fascinating article..probably the shape of things to come in Europe..I knew that doctors here receive free foreign holidays, childrens school fees and so on ..but the scale here is breathtaking..no wonder they are so keen to shut you up..

– Hide quoted text — Show quoted text –          Usenet Advanced Search  Usenet Help  Search all groups   Search the Web Click here for information about upcoming improvements to this beta version of Google’s Usenet search. Usenet search result 7 for PSYCHIATRIST group health Search Result 7  conflicts between drug trials and $$$$ Drug Trials Hide Conflicts for Doctors – Part I By KURT EICHENWALD and GINA KOLATA http://wwwlawyer.com/articles/article2321.cfm When Thomas Parham visited his doctor in the summer of 1995, he expected just another routine checkup. But his doctor had something else in mind. The doctor, Peter Arcan, suggested that Parham might want to join a study of a new drug to shrink enlarged prostates, according to records of the encounter. Parham was puzzled — his prostate was fine. But Arcan brushed aside the retired metal worker’s questions, saying the experimental drug might prevent future problems. Satisfied, Parham, a 64-year-old resident of La Habra, Calif., agreed to participate. There was one question Parham did not ask: What was in it for Arcan? The answer was money. The drug’s maker, SmithKline Beecham PLC, was paying $1,610 for each patient that doctors signed up — money that covered study expenses while allowing a portion to end up as profit for Arcan and his associates. Parham had no idea. "Nothing was mentioned about money," he said in an interview. "It’s a situation where you have faith in your doctor." Through his secretary, Arcan declined comment. With his decision, Parham had unwittingly joined hundreds of thousands of other patients recruited by their personal physicians into a booming venture: the business of testing experimental drugs on people. Once clinical research was a staid enterprise primarily administered by academic researchers driven by a desire for knowledge, fame or career advancement. Now, it is a multibillion-dollar industry, with hundreds of testing and drug companies working with thousands of private doctors. In this new industry, patients have become commodities, bought and traded by testing companies and doctors. Almost daily, the industry urges doctors to join the gold rush, bombarding them with faxes and letters blaring such come-ons as "Improve Your Cash Flow" and "Discover the Secret For Obtaining More Funded Studies." In an era of managed care, the pleas are seductive: The number of private doctors in research since 1990 has almost tripled, and top recruiters can earn as much as $500,000 to $1 million a year. This new system is a boon for drug companies because it reaches out to a vast pool of test subjects who have never before been available for experimentation. But it also injects the interests of a giant industry into the delicate doctor-patient relationship, usually without the patient realizing it. These changes have prompted little public debate, mostly because the full scope of what is happening is hidden. The industry treats research agreements as corporate secrets and contractually forbids doctors to disclose them. As a result, few people outside the industry, including government officials, have seen the contracts or know the magnitude of the money involved. But in a 10-month investigation, The New York Times obtained such contracts and thousands of other confidential documents that present a view of the research industry that has never before been available. These records, and interviews with participants, reveal a system fueling a pharmaceutical renaissance, but fraught with conflicts of interest; that places a premium on speed and meeting quotas; that relies on government and private monitoring that can be easily fooled and that some researchers said is inadequate; and that secretly offers a share of the cash to other health professionals who might influence patients to join a study. At bottom, the only thing separating a trusting patient from a study that could be inappropriate or potentially harmful is the judgment of a doctor torn by these unseen conflicts and pressures. The documents, including contracts, protocols or related financial records from more than 300 recent drug studies, were provided by a number of people in the industry concerned about its direction. The Times also conducted a computer analysis of more than 200,000 filings with the government and related data submitted by doctors who want to conduct research, and interviewed doctors, patients, ethicists, industry executives and government officials. These are among the specific findings of The Times’ investigation: — Drug companies and their contractors offer large payments to doctors, nurses and other medical staff to encourage them to recruit patients quickly. And doctors do not even have to conduct trials to get paid: There are finder’s fees for those who refer their patients to other doctors conducting research. — Doctors who recruit the most patients receive additional perquisites, such as the right to claim a coveted authorship of published papers about the studies — even though the true author is a ghostwriter using analysis from the drug company. Those who fail to meet the recruitment goals are usually dropped from future studies. — Testing companies often use doctors as clinical investigators regardless of their specialty, at times leaving patients in the care of doctors who know little about their condition. For example, psychiatrists have conducted Pap smears and asthma specialists have dispensed experimental psychiatric drugs. — A growing number of doctors conducting drug research have limited experience as clinical investigators, raising questions among some experts about the quality of their data. In interviews, industry officials and researchers said the emerging drug-approval system was dedicated to quality and offers significant benefits. Since patients are seeing their own doctors, researchers said, it adds a level of continuity and personal contact to the process — something unavailable from full-time researchers. Moreover, industry officials said, the new pool of test subjects is a resource of incalculable value that is allowing the development of an avalanche of new compounds. Drug tests "can get delayed if the patients aren’t out there and available," said Chris Kuebler, the chairman and chief executive at Covance Inc., a giant testing company. But some experts said patients were being pushed to participate in the studies because of the financial interests of their doctors. Doctors working as researchers "are enticing and cajoling patients who are in no position to resist their blandishments to enter clinical studies," said Dr. David Shimm, a member of the ethics committee at Porter Adventist Hospital in Denver who has written about research conflicts. "What the patients are not seeing is that the clinical investigator is really a dual agent with divided loyalties between the patient and the pharmaceutical company," he said. While patients must sign detailed consent forms to enroll in drug studies, they are often in no position to question their doctor’s suggestion that they join. "The physician has enormous power over you," said Uwe Reinhardt, a health care economist at Princeton University, who himself recently agreed to participate in a clinical trial run by his doctor — in part because he feared annoying him — and who had no idea that money might be involved. "You want to keep his favor. If you say no, you’ll worry that he may not like you." That is what happened with Parham and Arcan. In joining the study, Parham said: "I just followed his advice, just like if he said to take two aspirin instead of one. He’s a doctor and I’m not." In truth, Parham should never have been signed up for the prostate study. According to his medical records, he had been hospitalized the previous year with a chronic slow heart rate, a condition that specifically disqualified him for the study. But, saying that Parham’s heart rate was only mildly slow, an administrator handling the paperwork for Arcan sought an exemption from SmithKline. Based on those representations, the drug company granted the exemption; it was not told about Parham’s earlier hospitalization. Soon after joining, Parham complained of fatigue, a symptom of his slow heart rate. Arcan dismissed the complaints as emotional. Within weeks, Parham asked to be dropped from the study. Days later he was hospitalized and given a pacemaker; Parham never brought legal action and it is impossible to know whether his participation in the study affected his heart condition. His experience underscores a potential danger of the emerging drug- testing system: Doctors with money at stake may persuade patients to take drugs that are inappropriate or even unsafe.

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What a fascinating article..probably the shape of things to come in Europe..I knew that doctors here receive free foreign holidays, childrens school fees and so on ..but the scale here is breathtaking..no wonder they are so keen to shut you up.. "-<alexplore

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news:97umo2$l37$0@pita.alt.net… – Hide quoted text — Show quoted text -

Locutis <mercedeshmoborgwh…@attachmate.com wrote in message news:A8AC24ABAD327DAE.E2CE8EE860202422.8021497E37FD26BA@lp.airnews.net…          Usenet Advanced Search  Usenet Help  Search all groups   Search the Web Click here for information about upcoming improvements to this beta version of Google’s Usenet search. Usenet search result 7 for PSYCHIATRIST group health Search Result 7 From: free…@yahoo.com (free…@yahoo.com) Subject: New York Times:Trials Fraud Rampant  conflicts between drug trials and $$$$ Drug Trials Hide Conflicts for Doctors – Part I By KURT EICHENWALD and GINA KOLATA http://wwwlawyer.com/articles/article2321.cfm When Thomas Parham visited his doctor in the summer of 1995, he expected just another routine checkup. But his doctor had something else in mind. The doctor, Peter Arcan, suggested that Parham might want to join a study of a new drug to shrink enlarged prostates, according to records of the encounter. Parham was puzzled — his prostate was fine. But Arcan brushed aside the retired metal worker’s questions, saying the experimental drug might prevent future problems. Satisfied, Parham, a 64-year-old resident of La Habra, Calif., agreed to participate. There was one question Parham did not ask: What was in it for Arcan? The answer was money. The drug’s maker, SmithKline Beecham PLC, was paying $1,610 for each patient that doctors signed up — money that covered study expenses while allowing a portion to end up as profit for Arcan and his associates. Parham had no idea. "Nothing was mentioned about money," he said in an interview. "It’s a situation where you have faith in your doctor." Through his secretary, Arcan declined comment. With his decision, Parham had unwittingly joined hundreds of thousands of other patients recruited by their personal physicians into a booming venture: the business of testing experimental drugs on people. Once clinical research was a staid enterprise primarily administered by academic researchers driven by a desire for knowledge, fame or career advancement. Now, it is a multibillion-dollar industry, with hundreds of testing and drug companies working with thousands of private doctors. In this new industry, patients have become commodities, bought and traded by testing companies and doctors. Almost daily, the industry urges doctors to join the gold rush, bombarding them with faxes and letters blaring such come-ons as "Improve Your Cash Flow" and "Discover the Secret For Obtaining More Funded Studies." In an era of managed care, the pleas are seductive: The number of private doctors in research since 1990 has almost tripled, and top recruiters can earn as much as $500,000 to $1 million a year. This new system is a boon for drug companies because it reaches out to a vast pool of test subjects who have never before been available for experimentation. But it also injects the interests of a giant industry into the delicate doctor-patient relationship, usually without the patient realizing it. These changes have prompted little public debate, mostly because the full scope of what is happening is hidden. The industry treats research agreements as corporate secrets and contractually forbids doctors to disclose them. As a result, few people outside the industry, including government officials, have seen the contracts or know the magnitude of the money involved. But in a 10-month investigation, The New York Times obtained such contracts and thousands of other confidential documents that present a view of the research industry that has never before been available. These records, and interviews with participants, reveal a system fueling a pharmaceutical renaissance, but fraught with conflicts of interest; that places a premium on speed and meeting quotas; that relies on government and private monitoring that can be easily fooled and that some researchers said is inadequate; and that secretly offers a share of the cash to other health professionals who might influence patients to join a study. At bottom, the only thing separating a trusting patient from a study that could be inappropriate or potentially harmful is the judgment of a doctor torn by these unseen conflicts and pressures. The documents, including contracts, protocols or related financial records from more than 300 recent drug studies, were provided by a number of people in the industry concerned about its direction. The Times also conducted a computer analysis of more than 200,000 filings with the government and related data submitted by doctors who want to conduct research, and interviewed doctors, patients, ethicists, industry executives and government officials. These are among the specific findings of The Times’ investigation: — Drug companies and their contractors offer large payments to doctors, nurses and other medical staff to encourage them to recruit patients quickly. And doctors do not even have to conduct trials to get paid: There are finder’s fees for those who refer their patients to other doctors conducting research. — Doctors who recruit the most patients receive additional perquisites, such as the right to claim a coveted authorship of published papers about the studies — even though the true author is a ghostwriter using analysis from the drug company. Those who fail to meet the recruitment goals are usually dropped from future studies. — Testing companies often use doctors as clinical investigators regardless of their specialty, at times leaving patients in the care of doctors who know little about their condition. For example, psychiatrists have conducted Pap smears and asthma specialists have dispensed experimental psychiatric drugs. — A growing number of doctors conducting drug research have limited experience as clinical investigators, raising questions among some experts about the quality of their data. In interviews, industry officials and researchers said the emerging drug-approval system was dedicated to quality and offers significant benefits. Since patients are seeing their own doctors, researchers said, it adds a level of continuity and personal contact to the process — something unavailable from full-time researchers. Moreover, industry officials said, the new pool of test subjects is a resource of incalculable value that is allowing the development of an avalanche of new compounds. Drug tests "can get delayed if the patients aren’t out there and available," said Chris Kuebler, the chairman and chief executive at Covance Inc., a giant testing company. But some experts said patients were being pushed to participate in the studies because of the financial interests of their doctors. Doctors working as researchers "are enticing and cajoling patients who are in no position to resist their blandishments to enter clinical studies," said Dr. David Shimm, a member of the ethics committee at Porter Adventist Hospital in Denver who has written about research conflicts. "What the patients are not seeing is that the clinical investigator is really a dual agent with divided loyalties between the patient and the pharmaceutical company," he said. While patients must sign detailed consent forms to enroll in drug studies, they are often in no position to question their doctor’s suggestion that they join. "The physician has enormous power over you," said Uwe Reinhardt, a health care economist at Princeton University, who himself recently agreed to participate in a clinical trial run by his doctor — in part because he feared annoying him — and who had no idea that money might be involved. "You want to keep his favor. If you say no, you’ll worry that he may not like you." That is what happened with Parham and Arcan. In joining the study, Parham said: "I just followed his advice, just like if he said to take two aspirin instead of one. He’s a doctor and I’m not." In truth, Parham should never have been signed up for the prostate study. According to his medical records, he had been hospitalized the previous year with a chronic slow heart rate, a condition that specifically disqualified him for the study. But, saying that Parham’s heart rate was only mildly slow, an administrator handling the paperwork for Arcan sought an exemption from SmithKline. Based on those representations, the drug company granted the exemption; it was not told about Parham’s earlier hospitalization. Soon after joining, Parham complained of fatigue, a symptom of his slow heart rate. Arcan dismissed the complaints as emotional. Within weeks, Parham asked to be dropped from the study. Days later he was hospitalized and given a pacemaker; Parham never brought legal action and it is impossible to know whether his participation in the study affected his heart condition. His experience underscores a potential danger of the emerging drug- testing system: Doctors with money at stake may persuade patients to take drugs that are inappropriate or even unsafe.

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Locutis <mercedeshmoborgwh…@attachmate.com

wrote in message

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Google’s Usenet search. Usenet search result 7 for PSYCHIATRIST group health Search Result 7 From: free…@yahoo.com (free…@yahoo.com) Subject: New York Times:Trials Fraud Rampant  conflicts between drug trials and $$$$ Drug Trials Hide Conflicts for Doctors – Part I By KURT EICHENWALD and GINA KOLATA http://wwwlawyer.com/articles/article2321.cfm When Thomas Parham visited his doctor in the summer of 1995, he expected just another routine checkup. But his doctor had something else in mind. The doctor, Peter Arcan, suggested that Parham might want to join a study of a new drug to shrink enlarged prostates, according to records of the encounter. Parham was puzzled — his prostate was fine. But Arcan brushed aside the retired metal worker’s questions, saying the experimental drug might prevent future problems. Satisfied, Parham, a 64-year-old resident of La Habra, Calif., agreed to participate. There was one question Parham did not ask: What was in it for Arcan? The answer was money. The drug’s maker, SmithKline Beecham PLC, was paying $1,610 for each patient that doctors signed up — money that covered study expenses while allowing a portion to end up as profit for Arcan and his associates. Parham had no idea. "Nothing was mentioned about money," he said in an interview. "It’s a situation where you have faith in your doctor." Through his secretary, Arcan declined comment. With his decision, Parham had unwittingly joined hundreds of thousands of other patients recruited by their personal physicians into a booming venture: the business of testing experimental drugs on people. Once clinical research was a staid enterprise primarily administered by academic researchers driven by a desire for knowledge, fame or career advancement. Now, it is a multibillion-dollar industry, with hundreds of testing and drug companies working with thousands of private doctors. In this new industry, patients have become commodities, bought and traded by testing companies and doctors. Almost daily, the industry urges doctors to join the gold rush, bombarding them with faxes and letters blaring such come-ons as "Improve Your Cash Flow" and "Discover the Secret For Obtaining More Funded Studies." In an era of managed care, the pleas are seductive: The number of private doctors in research since 1990 has almost tripled, and top recruiters can earn as much as $500,000 to $1 million a year. This new system is a boon for drug companies because it reaches out to a vast pool of test subjects who have never before been available for experimentation. But it also injects the interests of a giant industry into the delicate doctor-patient relationship, usually without the patient realizing it. These changes have prompted little public debate, mostly because the full scope of what is happening is hidden. The industry treats research agreements as corporate secrets and contractually forbids doctors to disclose them. As a result, few people outside the industry, including government officials, have seen the contracts or know the magnitude of the money involved. But in a 10-month investigation, The New York Times obtained such contracts and thousands of other confidential documents that present a view of the research industry that has never before been available. These records, and interviews with participants, reveal a system fueling a pharmaceutical renaissance, but fraught with conflicts of interest; that places a premium on speed and meeting quotas; that relies on government and private monitoring that can be easily fooled and that some researchers said is inadequate; and that secretly offers a share of the cash to other health professionals who might influence patients to join a study. At bottom, the only thing separating a trusting patient from a study that could be inappropriate or potentially harmful is the judgment of a doctor torn by these unseen conflicts and pressures. The documents, including contracts, protocols or related financial records from more than 300 recent drug studies, were provided by a number of people in the industry concerned about its direction. The Times also conducted a computer analysis of more than 200,000 filings with the government and related data submitted by doctors who want to conduct research, and interviewed doctors, patients, ethicists, industry executives and government officials. These are among the specific findings of The Times’ investigation: — Drug companies and their contractors offer large payments to doctors, nurses and other medical staff to encourage them to recruit patients quickly. And doctors do not even have to conduct trials to get paid: There are finder’s fees for those who refer their patients to other doctors conducting research. — Doctors who recruit the most patients receive additional perquisites, such as the right to claim a coveted authorship of published papers about the studies — even though the true author is a ghostwriter using analysis from the drug company. Those who fail to meet the recruitment goals are usually dropped from future studies. — Testing companies often use doctors as clinical investigators regardless of their specialty, at times leaving patients in the care of doctors who know little about their condition. For example, psychiatrists have conducted Pap smears and asthma specialists have dispensed experimental psychiatric drugs. — A growing number of doctors conducting drug research have limited experience as clinical investigators, raising questions among some experts about the quality of their data. In interviews, industry officials and researchers said the emerging drug-approval system was dedicated to quality and offers significant benefits. Since patients are seeing their own doctors, researchers said, it adds a level of continuity and personal contact to the process — something unavailable from full-time researchers. Moreover, industry officials said, the new pool of test subjects is a resource of incalculable value that is allowing the development of an avalanche of new compounds. Drug tests "can get delayed if the patients aren’t out there and available," said Chris Kuebler, the chairman and chief executive at Covance Inc., a giant testing company. But some experts said patients were being pushed to participate in the studies because of the financial interests of their doctors. Doctors working as researchers "are enticing and cajoling patients who are in no position to resist their blandishments to enter clinical studies," said Dr. David Shimm, a member of the ethics committee at Porter Adventist Hospital in Denver who has written about research conflicts. "What the patients are not seeing is that the clinical investigator is really a dual agent with divided loyalties between the patient and the pharmaceutical company," he said. While patients must sign detailed consent forms to enroll in drug studies, they are often in no position to question their doctor’s suggestion that they join. "The physician has enormous power over you," said Uwe Reinhardt, a health care economist at Princeton University, who himself recently agreed to participate in a clinical trial run by his doctor — in part because he feared annoying him — and who had no idea that money might be involved. "You want to keep his favor. If you say no, you’ll worry that he may not like you." That is what happened with Parham and Arcan. In joining the study, Parham said: "I just followed his advice, just like if he said to take two aspirin instead of one. He’s a doctor and I’m not." In truth, Parham should never have been signed up for the prostate study. According to his medical records, he had been hospitalized the previous year with a chronic slow heart rate, a condition that specifically disqualified him for the study. But, saying that Parham’s heart rate was only mildly slow, an administrator handling the paperwork for Arcan sought an exemption from SmithKline. Based on those representations, the drug company granted the exemption; it was not told about Parham’s earlier hospitalization. Soon after joining, Parham complained of fatigue, a symptom of his slow heart rate. Arcan dismissed the complaints as emotional. Within weeks, Parham asked to be dropped from the study. Days later he was hospitalized and given a pacemaker; Parham never brought legal action and it is impossible to know whether his participation in the study affected his heart condition. His experience underscores a potential danger of the emerging drug- testing system: Doctors with money at stake may persuade patients to take drugs that are inappropriate or even unsafe. Under the current system of monitoring, such actions are almost impossible to catch and no statistics are collected on such events. Within the industry, most of the planning focuses on conducting studies quickly. Patient issues, some researchers said, are often lost in the rush. "You go to the trade meetings on clinical research; you go for two entire days, and patients are not mentioned," said Dr. Robert Califf, the director of the Duke Clinical Research Institute, an academic drug- testing center in Durham, N.C., affiliated with Duke University. "The patient is an object to make money. Having patients is just the dirty price for doing business." A letter sent out last July by

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– Hide quoted text — Show quoted text –          Usenet Advanced Search  Usenet Help  Search all groups   Search the Web Click here for information about upcoming improvements to this beta version of Google’s Usenet search. Usenet search result 7 for PSYCHIATRIST group health Search Result 7  conflicts between drug trials and $$$$ Drug Trials Hide Conflicts for Doctors – Part I By KURT EICHENWALD and GINA KOLATA http://wwwlawyer.com/articles/article2321.cfm When Thomas Parham visited his doctor in the summer of 1995, he expected just another routine checkup. But his doctor had something else in mind. The doctor, Peter Arcan, suggested that Parham might want to join a study of a new drug to shrink enlarged prostates, according to records of the encounter. Parham was puzzled — his prostate was fine. But Arcan brushed aside the retired metal worker’s questions, saying the experimental drug might prevent future problems. Satisfied, Parham, a 64-year-old resident of La Habra, Calif., agreed to participate. There was one question Parham did not ask: What was in it for Arcan? The answer was money. The drug’s maker, SmithKline Beecham PLC, was paying $1,610 for each patient that doctors signed up — money that covered study expenses while allowing a portion to end up as profit for Arcan and his associates. Parham had no idea. "Nothing was mentioned about money," he said in an interview. "It’s a situation where you have faith in your doctor." Through his secretary, Arcan declined comment. With his decision, Parham had unwittingly joined hundreds of thousands of other patients recruited by their personal physicians into a booming venture: the business of testing experimental drugs on people. Once clinical research was a staid enterprise primarily administered by academic researchers driven by a desire for knowledge, fame or career advancement. Now, it is a multibillion-dollar industry, with hundreds of testing and drug companies working with thousands of private doctors. In this new industry, patients have become commodities, bought and traded by testing companies and doctors. Almost daily, the industry urges doctors to join the gold rush, bombarding them with faxes and letters blaring such come-ons as "Improve Your Cash Flow" and "Discover the Secret For Obtaining More Funded Studies." In an era of managed care, the pleas are seductive: The number of private doctors in research since 1990 has almost tripled, and top recruiters can earn as much as $500,000 to $1 million a year. This new system is a boon for drug companies because it reaches out to a vast pool of test subjects who have never before been available for experimentation. But it also injects the interests of a giant industry into the delicate doctor-patient relationship, usually without the patient realizing it. These changes have prompted little public debate, mostly because the full scope of what is happening is hidden. The industry treats research agreements as corporate secrets and contractually forbids doctors to disclose them. As a result, few people outside the industry, including government officials, have seen the contracts or know the magnitude of the money involved. But in a 10-month investigation, The New York Times obtained such contracts and thousands of other confidential documents that present a view of the research industry that has never before been available. These records, and interviews with participants, reveal a system fueling a pharmaceutical renaissance, but fraught with conflicts of interest; that places a premium on speed and meeting quotas; that relies on government and private monitoring that can be easily fooled and that some researchers said is inadequate; and that secretly offers a share of the cash to other health professionals who might influence patients to join a study. At bottom, the only thing separating a trusting patient from a study that could be inappropriate or potentially harmful is the judgment of a doctor torn by these unseen conflicts and pressures. The documents, including contracts, protocols or related financial records from more than 300 recent drug studies, were provided by a number of people in the industry concerned about its direction. The Times also conducted a computer analysis of more than 200,000 filings with the government and related data submitted by doctors who want to conduct research, and interviewed doctors, patients, ethicists, industry executives and government officials. These are among the specific findings of The Times’ investigation: — Drug companies and their contractors offer large payments to doctors, nurses and other medical staff to encourage them to recruit patients quickly. And doctors do not even have to conduct trials to get paid: There are finder’s fees for those who refer their patients to other doctors conducting research. — Doctors who recruit the most patients receive additional perquisites, such as the right to claim a coveted authorship of published papers about the studies — even though the true author is a ghostwriter using analysis from the drug company. Those who fail to meet the recruitment goals are usually dropped from future studies. — Testing companies often use doctors as clinical investigators regardless of their specialty, at times leaving patients in the care of doctors who know little about their condition. For example, psychiatrists have conducted Pap smears and asthma specialists have dispensed experimental psychiatric drugs. — A growing number of doctors conducting drug research have limited experience as clinical investigators, raising questions among some experts about the quality of their data. In interviews, industry officials and researchers said the emerging drug-approval system was dedicated to quality and offers significant benefits. Since patients are seeing their own doctors, researchers said, it adds a level of continuity and personal contact to the process — something unavailable from full-time researchers. Moreover, industry officials said, the new pool of test subjects is a resource of incalculable value that is allowing the development of an avalanche of new compounds. Drug tests "can get delayed if the patients aren’t out there and available," said Chris Kuebler, the chairman and chief executive at Covance Inc., a giant testing company. But some experts said patients were being pushed to participate in the studies because of the financial interests of their doctors. Doctors working as researchers "are enticing and cajoling patients who are in no position to resist their blandishments to enter clinical studies," said Dr. David Shimm, a member of the ethics committee at Porter Adventist Hospital in Denver who has written about research conflicts. "What the patients are not seeing is that the clinical investigator is really a dual agent with divided loyalties between the patient and the pharmaceutical company," he said. While patients must sign detailed consent forms to enroll in drug studies, they are often in no position to question their doctor’s suggestion that they join. "The physician has enormous power over you," said Uwe Reinhardt, a health care economist at Princeton University, who himself recently agreed to participate in a clinical trial run by his doctor — in part because he feared annoying him — and who had no idea that money might be involved. "You want to keep his favor. If you say no, you’ll worry that he may not like you." That is what happened with Parham and Arcan. In joining the study, Parham said: "I just followed his advice, just like if he said to take two aspirin instead of one. He’s a doctor and I’m not." In truth, Parham should never have been signed up for the prostate study. According to his medical records, he had been hospitalized the previous year with a chronic slow heart rate, a condition that specifically disqualified him for the study. But, saying that Parham’s heart rate was only mildly slow, an administrator handling the paperwork for Arcan sought an exemption from SmithKline. Based on those representations, the drug company granted the exemption; it was not told about Parham’s earlier hospitalization. Soon after joining, Parham complained of fatigue, a symptom of his slow heart rate. Arcan dismissed the complaints as emotional. Within weeks, Parham asked to be dropped from the study. Days later he was hospitalized and given a pacemaker; Parham never brought legal action and it is impossible to know whether his participation in the study affected his heart condition. His experience underscores a potential danger of the emerging drug- testing system: Doctors with money at stake may persuade patients to take drugs that are inappropriate or even unsafe. Under the current system of monitoring, such actions are almost impossible to catch and no statistics are collected on such events. Within the industry, most of the planning focuses on conducting studies quickly. Patient issues, some researchers said, are often lost in the rush. "You go to the trade meetings on clinical research; you go for two entire days, and patients are not mentioned," said Dr. Robert Califf, the director of the Duke Clinical Research Institute, an academic drug- testing center in Durham, N.C., affiliated with Duke University. "The patient is an object to make money. Having patients is just the dirty price for doing business." A letter sent out last July by

… read more »

Response:

What a fascinating article..probably the shape of things to come in Europe..I knew that doctors here receive free foreign holidays, childrens school fees and so on ..but the scale here is breathtaking..no wonder they are so keen to shut you up..

– Hide quoted text — Show quoted text –          Usenet Advanced Search  Usenet Help  Search all groups   Search the Web Click here for information about upcoming improvements to this beta version of Google’s Usenet search. Usenet search result 7 for PSYCHIATRIST group health Search Result 7  conflicts between drug trials and $$$$ Drug Trials Hide Conflicts for Doctors – Part I By KURT EICHENWALD and GINA KOLATA http://wwwlawyer.com/articles/article2321.cfm When Thomas Parham visited his doctor in the summer of 1995, he expected just another routine checkup. But his doctor had something else in mind. The doctor, Peter Arcan, suggested that Parham might want to join a study of a new drug to shrink enlarged prostates, according to records of the encounter. Parham was puzzled — his prostate was fine. But Arcan brushed aside the retired metal worker’s questions, saying the experimental drug might prevent future problems. Satisfied, Parham, a 64-year-old resident of La Habra, Calif., agreed to participate. There was one question Parham did not ask: What was in it for Arcan? The answer was money. The drug’s maker, SmithKline Beecham PLC, was paying $1,610 for each patient that doctors signed up — money that covered study expenses while allowing a portion to end up as profit for Arcan and his associates. Parham had no idea. "Nothing was mentioned about money," he said in an interview. "It’s a situation where you have faith in your doctor." Through his secretary, Arcan declined comment. With his decision, Parham had unwittingly joined hundreds of thousands of other patients recruited by their personal physicians into a booming venture: the business of testing experimental drugs on people. Once clinical research was a staid enterprise primarily administered by academic researchers driven by a desire for knowledge, fame or career advancement. Now, it is a multibillion-dollar industry, with hundreds of testing and drug companies working with thousands of private doctors. In this new industry, patients have become commodities, bought and traded by testing companies and doctors. Almost daily, the industry urges doctors to join the gold rush, bombarding them with faxes and letters blaring such come-ons as "Improve Your Cash Flow" and "Discover the Secret For Obtaining More Funded Studies." In an era of managed care, the pleas are seductive: The number of private doctors in research since 1990 has almost tripled, and top recruiters can earn as much as $500,000 to $1 million a year. This new system is a boon for drug companies because it reaches out to a vast pool of test subjects who have never before been available for experimentation. But it also injects the interests of a giant industry into the delicate doctor-patient relationship, usually without the patient realizing it. These changes have prompted little public debate, mostly because the full scope of what is happening is hidden. The industry treats research agreements as corporate secrets and contractually forbids doctors to disclose them. As a result, few people outside the industry, including government officials, have seen the contracts or know the magnitude of the money involved. But in a 10-month investigation, The New York Times obtained such contracts and thousands of other confidential documents that present a view of the research industry that has never before been available. These records, and interviews with participants, reveal a system fueling a pharmaceutical renaissance, but fraught with conflicts of interest; that places a premium on speed and meeting quotas; that relies on government and private monitoring that can be easily fooled and that some researchers said is inadequate; and that secretly offers a share of the cash to other health professionals who might influence patients to join a study. At bottom, the only thing separating a trusting patient from a study that could be inappropriate or potentially harmful is the judgment of a doctor torn by these unseen conflicts and pressures. The documents, including contracts, protocols or related financial records from more than 300 recent drug studies, were provided by a number of people in the industry concerned about its direction. The Times also conducted a computer analysis of more than 200,000 filings with the government and related data submitted by doctors who want to conduct research, and interviewed doctors, patients, ethicists, industry executives and government officials. These are among the specific findings of The Times’ investigation: — Drug companies and their contractors offer large payments to doctors, nurses and other medical staff to encourage them to recruit patients quickly. And doctors do not even have to conduct trials to get paid: There are finder’s fees for those who refer their patients to other doctors conducting research. — Doctors who recruit the most patients receive additional perquisites, such as the right to claim a coveted authorship of published papers about the studies — even though the true author is a ghostwriter using analysis from the drug company. Those who fail to meet the recruitment goals are usually dropped from future studies. — Testing companies often use doctors as clinical investigators regardless of their specialty, at times leaving patients in the care of doctors who know little about their condition. For example, psychiatrists have conducted Pap smears and asthma specialists have dispensed experimental psychiatric drugs. — A growing number of doctors conducting drug research have limited experience as clinical investigators, raising questions among some experts about the quality of their data. In interviews, industry officials and researchers said the emerging drug-approval system was dedicated to quality and offers significant benefits. Since patients are seeing their own doctors, researchers said, it adds a level of continuity and personal contact to the process — something unavailable from full-time researchers. Moreover, industry officials said, the new pool of test subjects is a resource of incalculable value that is allowing the development of an avalanche of new compounds. Drug tests "can get delayed if the patients aren’t out there and available," said Chris Kuebler, the chairman and chief executive at Covance Inc., a giant testing company. But some experts said patients were being pushed to participate in the studies because of the financial interests of their doctors. Doctors working as researchers "are enticing and cajoling patients who are in no position to resist their blandishments to enter clinical studies," said Dr. David Shimm, a member of the ethics committee at Porter Adventist Hospital in Denver who has written about research conflicts. "What the patients are not seeing is that the clinical investigator is really a dual agent with divided loyalties between the patient and the pharmaceutical company," he said. While patients must sign detailed consent forms to enroll in drug studies, they are often in no position to question their doctor’s suggestion that they join. "The physician has enormous power over you," said Uwe Reinhardt, a health care economist at Princeton University, who himself recently agreed to participate in a clinical trial run by his doctor — in part because he feared annoying him — and who had no idea that money might be involved. "You want to keep his favor. If you say no, you’ll worry that he may not like you." That is what happened with Parham and Arcan. In joining the study, Parham said: "I just followed his advice, just like if he said to take two aspirin instead of one. He’s a doctor and I’m not." In truth, Parham should never have been signed up for the prostate study. According to his medical records, he had been hospitalized the previous year with a chronic slow heart rate, a condition that specifically disqualified him for the study. But, saying that Parham’s heart rate was only mildly slow, an administrator handling the paperwork for Arcan sought an exemption from SmithKline. Based on those representations, the drug company granted the exemption; it was not told about Parham’s earlier hospitalization. Soon after joining, Parham complained of fatigue, a symptom of his slow heart rate. Arcan dismissed the complaints as emotional. Within weeks, Parham asked to be dropped from the study. Days later he was hospitalized and given a pacemaker; Parham never brought legal action and it is impossible to know whether his participation in the study affected his heart condition. His experience underscores a potential danger of the emerging drug- testing system: Doctors with money at stake may persuade patients to take drugs that are inappropriate or even unsafe.

… read more »

Response:

Question:

1999…@my-deja.com wrote:

  I tried to make a post in this thread earlier today but it looks like it didn’t make it. I also am looking for an ENT (or allergist, or sinus specialist) someone where in my area. I live in Concord NH, but Boston is only 70 miles away.

Can you drive as far as Chelmsford Massachusetts?  (I’m sure you can–drive south on Route 3.) Because that’s where my ENT (sinus specialist) and allergist both are. And they are both good. My ENT:  Dr. Eric Stein ("Mass ENT Associates") My allergist:  Dr. Wilfred Boucher ("Allergy & Asthma Specialists") Each is part of a group of associates.  And they’re all good (just in case either of the above isn’t taking any new patients right now).  Note that there’s a bit of a wait to see them right now, because (as you probably guessed) it’s the sinus season here in Massachusetts.  I saw my ENT two weeks ago, and he’s very busy this time of year. Hope this helps. — Steven D. Litvintchouk                   Email:  s…@mitre.org                 Disclaimer:  As far as I am aware, the opinions expressed herein             are not those of my employer.

Response:

at my web site list of doctors with web sites is Dr Steven Houser in Cleveland. Take a look.  I would recommend him very highly. He gave the course at the academy of ENT in Washington in September. Murray Grossan, M.D. http://www.ent-consult.com

Response:

  I tried to make a post in this thread earlier today but it looks like it didn’t make it. I also am looking for an ENT (or allergist, or sinus specialist) someone where in my area. I live in Concord NH, but Boston is only 70 miles away.   I have had allergies since I was a kid (I’m 53) and have gotten allergy shots on and off since I was a kid. (I have been getting shots for about five years now, with no noticeable benefit.)   A couple of times in the past I’ve had CT scans and have been told that I did not have infections. I was told by a doctor at the Lahey Clinic about five years ago that I have chronic nonspecific sinusitis, most likely resulting from my allergies. (That doctor said that because I do not seem to have chronic infections, he did not think was a good candidate for endoscopic surgery.)   One reason I’d like to find a new doc is that no one has ever suggesting culturing my mucous. Also, I don’t think I’ve ever been on antibiotics for longer than a month. From what I’ve read in the last few days on this news group and related web sites, that may not be long enough, especially if I was on the wrong antibiotic.   While I’m asking questions, is there a consensus pick for a HEPA canister vac? Very little carpet in my house. In article <20001211233710.01975.00012…@ng-ch1.aol.com

,

  entcons…@aol.com (ENTconsult) wrote:

at my web site list of doctors with web sites is Dr Steven Houser in

Cleveland.

Take a look.  I would recommend him very highly. He gave the course at the academy of ENT in Washington in September. Murray Grossan, M.D. http://www.ent-consult.com

Sent via Deja.com http://www.deja.com/

Response:

- Hide quoted text — Show quoted text -On Sun, 10 Dec 2000 21:07:57 -0500, "joywilli" <joywi…@mindspring.com

wrote: I would like to know how to find the best possible Dr in the area for chronic sinus infections.  What questions do you ask besides, "how many surgeries have you done?"  I’ve had two Drs who’ve performed hundreds of surgeries on others but neither did the job for me with three tries.  I follow this newsgroup, irrigate 2X day, use numerous nasal sprays, take allergy shots, vitamins, and still, antibiotics are the only answer to feeling good day to day.  My brother had insta-track surgery in FL (first time) was treated with Singulair, Gentimicin in saline, oral cortisone and rapid desensitizing shots for allergies.  Bro is doing so well I’m tempted to visit his Dr but don’t know how experienced he is with difficult cases like mine.  How do I find a Dr in Ohio who will be that aggressive.  Does Singulair make sense when recent studies show a cystic fibrosis gene may be responsible for chronic sinusitis?  Couldn’t figure out how to transfer original message for Don Brady to alt. support.sinusitis so hope this covers original question; namely, how does one research to find the leading expert in chronic sinusitis recovery in a geographic area?  Thanks,  Joy

Three surgeries is a lot!   I looked in "Best Doctors in America" (which is a bit out of  date now) and one Sinus and Nasal Surgery doctor is listed for Ohio:  Dr.  Howard Levine in Cleveland, 1-800-24-SINUS.   I have no doubt that this means that an opinion from him would be very worthwhile. I would also consider allergists.    If your sinuses are sufficiently open now, and you still have problems,  then allergists may be better able to help than otolaryngologists (since one would hope that the anatomical problems have been corrected by now).   This is true even if you are not allergic!     If, on the other hand, there is still a particular anatomical problem, then a rhinologist/ sinus specialist would need to deal with that.  I am sure Dr. Levine could recommend some allergists too. You say antibiotics help.   This is a little puzzling.    I wonder if it could be the secondary anti-inflammatory effect of the antibiotic that is doing good? If so, then there may be other drugs that you have not tried that might be even better. Good luck! Don

Response:

I would like to know how to find the best possible Dr in the area for chronic sinus infections.  What questions do you ask besides, "how many surgeries have you done?"  I’ve had two Drs who’ve performed hundreds of surgeries on others but neither did the job for me with three tries.  I follow this newsgroup, irrigate 2X day, use numerous nasal sprays, take allergy shots, vitamins, and still, antibiotics are the only answer to feeling good day to day.  My brother had insta-track surgery in FL (first time) was treated with Singulair, Gentimicin in saline, oral cortisone and rapid desensitizing shots for allergies.  Bro is doing so well I’m tempted to visit his Dr but don’t know how experienced he is with difficult cases like mine.  How do I find a Dr in Ohio who will be that aggressive.  Does Singulair make sense when recent studies show a cystic fibrosis gene may be responsible for chronic sinusitis?  Couldn’t figure out how to transfer original message for Don Brady to alt. support.sinusitis so hope this covers original question; namely, how does one research to find the leading expert in chronic sinusitis recovery in a geographic area?  Thanks,  Joy

Response:

joywilli wrote:

I would like to know how to find the best possible Dr in the area for chronic sinus infections.   How do I find a Dr in Ohio who will be that aggressive.  

Try finding a good teaching hospital with a decent-sized otolaryngology department.  In Boston, we have several good hospitals to choose from: Mass General, Mass Eye & Ear (my ENT’s hospital), and Brigham & Women’s.  The magazine "U.S. News & World Report" does this annual survey rating the top U.S. hospitals; if you find the back issue, see if they list a good hospital in your area. My ENT *teaches* otolaryngology at a couple of our hospitals.   A few states are also starting to set up databases of physician profiles.  The one we have in Massachusetts is beautiful: http://www.docboard.org/ma/ma_home.htm See if you have something like that in your state, either online or hardcopy. — Steven D. Litvintchouk                   Email:  s…@mitre.org                 Disclaimer:  As far as I am aware, the opinions expressed herein             are not those of my employer.

Response:

joywilli wrote:

I would like to know how to find the best possible Dr in the area for chronic sinus infections.  

Hey, try this too: http://www.docboard.org/oh/df/ — Steven D. Litvintchouk                   Email:  s…@mitre.org                 Disclaimer:  As far as I am aware, the opinions expressed herein             are not those of my employer.

Response:

Question:

Buteyko breathing techniques in asthma: a blinded randomised controlled trial Simon D Bowler, Amanda Green and Charles A Mitchell

Are we supposed to find this study credible when the authors lied? "Usenet is like a herd of performing elephants with diarrhea — massive, diffucult to redirect, awe-inspiring, entertaining, and a source of mind boggling amounts of excrement when you least expect it." Gene Spafford 1992

Response:

Yes, yes, you to can watch you doctor speak out an orifice that was not designed for speech if you claim to be ignorant of the facts, it is you own fault

Buteyko breathing techniques in asthma: a blinded randomised controlled trial Simon D Bowler, Amanda Green and Charles A Mitchell http://www.mja.com.au/public/issues/xmas98/bowler/bowler.html LUNGNET NATIONAL NEWS ARCHIVE http://www.lungnet.org.au/faqs_patient_support.html Buteyko breathing as a treatment for asthma has attracted a great deal of attention over the last several years in Australia. A study was conducted at the Mater Adult Hospital in Brisbane to investigate the effectiveness of this treatment. Buteyko breathing is based on a theory that people with asthma "breathe too much" thus blowing off their carbon dioxide resulting in asthma. Exercises in Buteyko breathing seek to reduce the excess breathing. There is no support for this theory in conventional medical science. Nonetheless, the study conducted in 1994 showed that a group of asthmatics performing Buteyko exercises were able to reduce their relieving medication (Ventolin et cetera) by approximately 90%. There was a one third reduction in the use of preventative medication. Only minor changes occurred in the group who were given non-Buteyko dummy exercises. Its likely that taking too much relieving medication (Ventolin, etc.) is deleterious and perhaps Buteyko works by reducing this. It may be that Buteyko is mainly helpful for people who have very high relieving medication requirements. Certainly, nobody undertaking Buteyko exercises should reduce their preventative medication without the advice of their doctor. Modern medicine does not have all the answers for asthma, and it is appropriate that we have an open mind in considering apparently successful "alternative" treatment. Nonetheless, the only way to evaluate these treatments is through rigorous scientific study. Thank you to Dr Simon Bowler, Thoracic Physician, for providing an answer to this question. General Practitioners in Asthma Group Asthma Specialist Panel Dr David Price (Chairman GPIAG Committee) Dr Mark Levy(Editor) Dr David Bellamy Dr Daryl Freeman Dr Kevin Gruffydd-Jones Dr Vincent McGovern Dr Ron Neville Dr Hilary Pinnock Dr Dermot Ryan Dr Roland Clark, Consultant Chest Physician, Kings Cross Hospital, Clepington Road, Dundee DD3 8EA Dr John Winter, Consultant Chest Physician, Kings Cross Hospital, Clepington Road, Dundee DD3 8EA Dr Somnath Mukhopadhyay, Lecturer in Child Health, Department of Child Health, Ninewells Hospital, University of Dundee —- Q30 "What does the Panel think about the BUTEYKO technique?" Answers to Question 30 Answers: "This has received a lot of publicity as intended by the people marketing this technique.  There is as yet no scientific evidence to support the use of this technique.  According to a panel at the National Asthma Campaign, who have looked at the literature in great depth, there is nothing to substantiate the claims made by the proponents of the technique." —- "1.    Scientific evidence is unconvincing. 2.    Might be useful for patients with hyperventilation misdiagnosed as asthma." —- "Interesting technique which I suspect will help patients who have a larger component of hyperventilation alongside their asthma and are inappropriately overtreated. It was notable in the program the patients were encouraged to increase their steroid therapy and reduce their nebuliser use.  Pretty much conventional practice!" —- "Undoubtedly psychological factors are important in many asthmatic patients – a fact clearly recognised in the current BTS guidelines.  The anxiety that undoubtedly will accompany chronic or acute attacks of asthma is understandable and may well lead to hyperventilation and worsening breathlessness. Reassurance remains an important adjunct to 02 and nebulised therapy in the acute attack. Because of this, the Buteyko method may well have a significant role in helping to control hyperventilation and anxiety (as either a primary cause or as a consequence of deteriorating asthma) in many patients. However, I see no physiological reason to explain how control of respiration could improve airways inflammation, which remains the underlying disorder. I was also sceptical to see, in the recent TV documentary, that prior to the "trial" of the method, a huge increase in oral steroid therapy was also used.  As a result patient improvement could not be attributed solely to the method used. In summary I feel that the method could be useful as an adjunct in anxious patients, but it will not in any way change the mainstays of inhaled drug therapy, inhaled corticosteroids in particular, which will remain the cornerstone of our management." Title:  Danger being too tight-lipped Summary:    ASTHMATICS who tape their mouths shut at night are risking death, doctors have warned. People plagued by the breathing disorder have started practising Buteyko – a controversial treatment which involves putting sticky tape vertically over their mouths. Source:  Sunday News Citation Information:  1; Issue: PSA-2254; NEWS Section Author(s):  Vicky TYLER

Response:

Matthew This is the line that gives me the most trouble here "* And very importantly, it has been proven to work by tens of thousands of people, plus the Clinical Trial which left absolutely no doubt." Statistical studies 1) set out to prove the null hypothesis (that there is no difference between two group say). 2) are based on probability. All you can state in a study based on statistical analysis is that your differences between the means are either different or not different at a certain level of confidence. The larger the sample number (n) is the more confident you can be with smaller differences between the means. 3) You and others from the Buteyko crowd appear to ignore this very fundemental principle: That no study under any situation can be 100% confident. Total confidence ignores the principles of chaos and randomness. Two very interesting mathematical principles. 4) In essence what bothers me is this "certainty principle"- adopted by many. I have disproved so many of my own hypothesese in the lab after feeling certain that the results were real, and then experiment x would blow the theory out the window. But what is important here is that I always set out to disprove my theory. Not to prove it. I don’t believe in the proof. I believe more in the absence of disproof. make any sense? 5) I completely sympathize with the suffering that draws people there. 6) Most drugs eventually get tested in several clinical trials around the world. This could help to see if the "statistical significance of the differences between the two means" is repeatable. Chilla

Response:

What we know Mr Pole is that you are selling a scam by means of contradictory statements, misinformation, selective use of statistics and outright bare faced lying stating that "No medical claims are made here" when you make medical claims throughout the rest of the post does not prevent you being charged with practising medicine without a license eric – Hide quoted text — Show quoted text – The Australian Clinical BUTEYKO Trial Showed Average 90% Decrease In Relief Drugs Needed By Asthmatics They Went From Average of 12.3 Puffs to 1.3 Puffs Per Day Symptoms Decreased, Inhaled Steroids Needed Decreased, Quality of Life Improved, Results Were Maintained At 8 months.. and are still going! Success is also being reported in relief of: * Migraine * Hay Fever, Sinus and Allergies * Emphysema and other COAD’s * Severe Snoring and Sleep Apnea What Do We Actually Know About Breathing and Health/Illness? * We know that all of the ancient healing practices, including those from China, India, Egypt and Japan all involve breathing. * We know that sometimes taking up an activity like swimming can change asthma status. It alters your breathing. * We know that there are thousands of stories of people who go on strange diets, or just meditate all day and have been relieved of usually fatal illnesses. Both altering your diet and meditating change your breathing pattern. * We know that "modern" medical science is certain that how you breathe is vital to health. All major hospitals and physiotherapists teach some kind of breathing which is supposed to help a little. * We know that when people are really ill or dying, their breathing is very clearly different from when they were healthy. Buteyko is a clear and simple model of how changing your breathing can change your health. * It explains clearly and simply the direct link between your breathing and symptoms like asthma and migraine and hay fever. * It shows you the most effective way to change your breathing for better health. * And very importantly, it has been proven to work by tens of thousands of people, plus the Clinical Trial which left absolutely no doubt. You know that breathing is a vital part of your health. Buteyko shows why and how people like you have used it for greater vitality and better health. What is Buteyko? * Buteyko is a simple system which proves that a slight change in your breathing can bring dramatic changes to your health. * It is named after the Russian Professor who developed it over 40 years ago. * The system is based on the physiological fact that people suffering from many diseases breathe a greater volume of air per minute than perfectly healthy people. These diseases include asthma, hay fever, classic migraine and many others. * Buteyko offers a gentle, drug free method that has been shown to reduce symptoms and improve overall health in some people. * Learned correctly the method is easy to combine with normal daily activities such as walking, driving or watching TV, and can be used by anyone over the age of 5 years. * It is not a medical treatment. It is a different way of thinking about and learning to breathe. Students should remain under appropriate medical supervision. No medical claims are made here about Buteyko, only statements about the results already achieved. What Is The Theory Behind It? [Asthma/Hay fever] According to Buteyko, the key to asthma and other diseases lies in the gas – carbon dioxide. Consider the following facts: * There is only 0.03% carbon dioxide in the atmosphere today. Millions of years ago there was over 40%. * If you are perfectly healthy you will have about 6.5% carbon dioxide in the alveoli of your lungs. * Therefore your lungs act to trap in some of the carbon dioxide produced by your body. This carbon dioxide is critical for keeping the pH of your body fluids at a safe level. If the carbon dioxide level drops [or rises] too much it can make fatally large changes to your pH. If you adopt a breathing pattern which causes you to release more carbon dioxide than you produce, your level will drop. To prevent the level from dropping to a fatally low level, the body has developed certain defensive mechanisms. These include spasms of the airpipes and bloodpipes, and the increased production of mucus. To use asthma as a simple example, let’s think like a plumber in terms of pipes. Let’s say that your breathing is too great. As you are breathing out air that is rich in carbon dioxide, and breathing in air that has almost no carbon dioxide, the more you breathe – the less you trap in. If the level of carbon dioxide in your lungs gets too low – you really will have a serious problem. As you continue to release more carbon dioxide than you produce, your level gets lower and lower. Now your body does not want you to die, so if it is [genetically] able it will act to restrict the airflow. It will do this by either reducing the size of the opening in your airpipes, or by increasing the production of mucus in the pipes, clogging them up. The first defence will make you feel tight or wheezy, the second will give you a cough. So asthma is simply your body’s way of helping to restrict the amount of air you are breathing, so that more carbon dioxide is trapped in, and a possibly fatal event is avoided. It is just like plumbing – if you want to reduce the flow through a pipe, simply make it smaller or clog it up. Important Point: * Even when you are breathing three or four times more air than you need, it feels like you are breathing normally. * In fact, because of your body’s defence of reducing the airflow, it usually feels like you are not getting enough air! * If you measure your resting "minute volume", it will be far above the normal of around 5 litres. * You are so used to breathing far too much, it feels normal to you. Hay Fever and Sinus If you now use your knowledge that a shortage of carbon dioxide can make pipes become smaller, and mucus production increase, what can you guess about a blocked nose, a runny nose, and sinuses full of mucus? Simple – over breathing causes your CO2 levels to drop, which causes your nasal cavity to swell and block and become extra sensitive. It can also turn on mucus factories in your nose and sinus. According to Buteyko theory, raising your CO2 levels can unblock your nose and turn off the mucus! Blocked or runny nose? You can change it right now by changing your breathing All you have to do is trap a little more carbon dioxide in. An easy way to do this is: * Take a normal, unforced breath in * Let a little bit of air out so you are not full * Then pinch your nose closed, and hold your breath. [Mouth closed!] * Hold only for about 5 seconds after your first desire to take a breath. Do not hold as long as you can, as this will make control of your breathing when you stop holding more difficult. * When you release your nose and start breathing again, breathe as little as possible. Keep very still. This will keep the carbon dioxide you have trapped in, so that it can open your nose. If you are not sure if your nose is clearer, simply repeat this simple exercise a few times with about 20 seconds between each breath hold. Breathing through your nose is a key part to breathing the right amount of air, but only the first part of Buteyko breathing. If you managed to make a change in how blocked your nose is, [or even cleared it completely] then you have just been more successful than years of drugs or surgery can be. If you already breathe mostly through your nose, and still get asthma or migraine or hay fever, then you are ready for the next step in Buteyko. Buteyko is not just breathing through your nose. How You Can Learn Buteyko Breathing The Best Way. The best way to learn Buteyko is with a personal Buteyko Instructor. Someone who understands every aspect of the method, and is experienced at training others to get the best possible response. This is available at Buteyko clinics in Australia. If you have the resources to come to Australia, please contact us for more details. Send E-Mail To James Hooper The Next Best Way. The next best way is to learn from a package that gives you all the information you require, and also offers access to an experienced Buteyko Instructor in case you want extra guidance. The Instep Buteyko Package gives you an audio tape with simple directions on how to do Buteyko breathing, plus a comprehensive manual, plus 5 free e-mail accesses to Leading Australian Buteyko Instructor James Hooper if you need them. This package costs only $89 [Australian dollars], and includes freight anywhere in the world. Available Soon * A manual and audio tape just for children will be available shortly. This will contain simple ways of teaching Buteyko to children, mostly in story and game form. This will be suitable for early and pre-teenage children. * A simple program for athletes who either suffer from mild exercise induced asthma, or who are simply looking for an edge from better breathing. The Australian Buteyko Asthma Trial A semi-blinded, randomized study trial comparing the effects of Buteyko breathing technique with a placebo breathing technique was funded by the Australian Association of Asthma Foundations. It was conducted at the Mater Hospital in Brisbane, and was designed and monitored by some of Australia’s foremost medical asthma specialists. Severe asthma sufferers were randomly allocated into either the Buteyko group, or the Placebo group. This was done in such a way as to result in

… read more »

Response:

funny……I have not seen this "study" presented in any reputable, peer-reviewed medical journal.  Not only that, your description blindly ignores the current known pathogenesis of asthma. Until such time as your "study" is submitted for peer-review and open for the world to view, you really are doing nothing to enhance your own credibility or that of this crap. As for you Mathew……I hope that I don’t find you posting from Australia…..you will be next on my list for complaints to the appropriate authorities.  I am certain you know that promoting Buteyko as a cure is illegal, and I am sure you know that being a "Buteyko practitioner" also means you are NOT licensed to practice any form of medicine within that country…..therefore it is illegal to promote any form of non-recognized medical treatment for asthma…… Scooby RCP, EMT-P Perinatal-Pediatric Respiratory Specialist This mail is a natural product.  The slight variations in spelling and grammar enhance its individual character and beauty and in no way are to be considered flaws or defects.

Response:

The Australian Clinical BUTEYKO Trial Showed Average 90% Decrease In Relief Drugs Needed By Asthmatics

Of course you are omitting the fact that the authors lied about the details of the trial. Kinda says something about buteyko when the only way to get published is to lie. BTW, since buteyko theory has no factual basis and has nothing to do with asthma we can conclude that if you are clueless about the cause, you are clueless about the solution. "Usenet is like a herd of performing elephants with diarrhea — massive, diffucult to redirect, awe-inspiring, entertaining, and a source of mind boggling amounts of excrement when you least expect it." Gene Spafford 1992

Response:

The Australian Clinical BUTEYKO Trial Showed Average 90% Decrease In Relief Drugs Needed By Asthmatics They Went From Average of 12.3 Puffs to 1.3 Puffs Per Day Symptoms Decreased, Inhaled Steroids Needed Decreased, Quality of Life Improved, Results Were Maintained At 8 months.. and are still going! Success is also being reported in relief of: * Migraine * Hay Fever, Sinus and Allergies * Emphysema and other COAD’s * Severe Snoring and Sleep Apnea What Do We Actually Know About Breathing and Health/Illness? * We know that all of the ancient healing practices, including those from China, India, Egypt and Japan all involve breathing. * We know that sometimes taking up an activity like swimming can change asthma status. It alters your breathing. * We know that there are thousands of stories of people who go on strange diets, or just meditate all day and have been relieved of usually fatal illnesses. Both altering your diet and meditating change your breathing pattern. * We know that "modern" medical science is certain that how you breathe is vital to health. All major hospitals and physiotherapists teach some kind of breathing which is supposed to help a little. * We know that when people are really ill or dying, their breathing is very clearly different from when they were healthy. Buteyko is a clear and simple model of how changing your breathing can change your health. * It explains clearly and simply the direct link between your breathing and symptoms like asthma and migraine and hay fever. * It shows you the most effective way to change your breathing for better health. * And very importantly, it has been proven to work by tens of thousands of people, plus the Clinical Trial which left absolutely no doubt. You know that breathing is a vital part of your health. Buteyko shows why and how people like you have used it for greater vitality and better health. What is Buteyko? * Buteyko is a simple system which proves that a slight change in your breathing can bring dramatic changes to your health. * It is named after the Russian Professor who developed it over 40 years ago. * The system is based on the physiological fact that people suffering from many diseases breathe a greater volume of air per minute than perfectly healthy people. These diseases include asthma, hay fever, classic migraine and many others. * Buteyko offers a gentle, drug free method that has been shown to reduce symptoms and improve overall health in some people. * Learned correctly the method is easy to combine with normal daily activities such as walking, driving or watching TV, and can be used by anyone over the age of 5 years. * It is not a medical treatment. It is a different way of thinking about and learning to breathe. Students should remain under appropriate medical supervision. No medical claims are made here about Buteyko, only statements about the results already achieved. What Is The Theory Behind It? [Asthma/Hay fever] According to Buteyko, the key to asthma and other diseases lies in the gas – carbon dioxide. Consider the following facts: * There is only 0.03% carbon dioxide in the atmosphere today. Millions of years ago there was over 40%. * If you are perfectly healthy you will have about 6.5% carbon dioxide in the alveoli of your lungs. * Therefore your lungs act to trap in some of the carbon dioxide produced by your body. This carbon dioxide is critical for keeping the pH of your body fluids at a safe level. If the carbon dioxide level drops [or rises] too much it can make fatally large changes to your pH. If you adopt a breathing pattern which causes you to release more carbon dioxide than you produce, your level will drop. To prevent the level from dropping to a fatally low level, the body has developed certain defensive mechanisms. These include spasms of the airpipes and bloodpipes, and the increased production of mucus. To use asthma as a simple example, let’s think like a plumber in terms of pipes. Let’s say that your breathing is too great. As you are breathing out air that is rich in carbon dioxide, and breathing in air that has almost no carbon dioxide, the more you breathe – the less you trap in. If the level of carbon dioxide in your lungs gets too low – you really will have a serious problem. As you continue to release more carbon dioxide than you produce, your level gets lower and lower. Now your body does not want you to die, so if it is [genetically] able it will act to restrict the airflow. It will do this by either reducing the size of the opening in your airpipes, or by increasing the production of mucus in the pipes, clogging them up. The first defence will make you feel tight or wheezy, the second will give you a cough. So asthma is simply your body’s way of helping to restrict the amount of air you are breathing, so that more carbon dioxide is trapped in, and a possibly fatal event is avoided. It is just like plumbing – if you want to reduce the flow through a pipe, simply make it smaller or clog it up. Important Point: * Even when you are breathing three or four times more air than you need, it feels like you are breathing normally. * In fact, because of your body’s defence of reducing the airflow, it usually feels like you are not getting enough air! * If you measure your resting "minute volume", it will be far above the normal of around 5 litres. * You are so used to breathing far too much, it feels normal to you. Hay Fever and Sinus If you now use your knowledge that a shortage of carbon dioxide can make pipes become smaller, and mucus production increase, what can you guess about a blocked nose, a runny nose, and sinuses full of mucus? Simple – over breathing causes your CO2 levels to drop, which causes your nasal cavity to swell and block and become extra sensitive. It can also turn on mucus factories in your nose and sinus. According to Buteyko theory, raising your CO2 levels can unblock your nose and turn off the mucus! Blocked or runny nose? You can change it right now by changing your breathing All you have to do is trap a little more carbon dioxide in. An easy way to do this is: * Take a normal, unforced breath in * Let a little bit of air out so you are not full * Then pinch your nose closed, and hold your breath. [Mouth closed!] * Hold only for about 5 seconds after your first desire to take a breath. Do not hold as long as you can, as this will make control of your breathing when you stop holding more difficult. * When you release your nose and start breathing again, breathe as little as possible. Keep very still. This will keep the carbon dioxide you have trapped in, so that it can open your nose. If you are not sure if your nose is clearer, simply repeat this simple exercise a few times with about 20 seconds between each breath hold. Breathing through your nose is a key part to breathing the right amount of air, but only the first part of Buteyko breathing. If you managed to make a change in how blocked your nose is, [or even cleared it completely] then you have just been more successful than years of drugs or surgery can be. If you already breathe mostly through your nose, and still get asthma or migraine or hay fever, then you are ready for the next step in Buteyko. Buteyko is not just breathing through your nose. How You Can Learn Buteyko Breathing The Best Way. The best way to learn Buteyko is with a personal Buteyko Instructor. Someone who understands every aspect of the method, and is experienced at training others to get the best possible response. This is available at Buteyko clinics in Australia. If you have the resources to come to Australia, please contact us for more details. Send E-Mail To James Hooper The Next Best Way. The next best way is to learn from a package that gives you all the information you require, and also offers access to an experienced Buteyko Instructor in case you want extra guidance. The Instep Buteyko Package gives you an audio tape with simple directions on how to do Buteyko breathing, plus a comprehensive manual, plus 5 free e-mail accesses to Leading Australian Buteyko Instructor James Hooper if you need them. This package costs only $89 [Australian dollars], and includes freight anywhere in the world. Available Soon * A manual and audio tape just for children will be available shortly. This will contain simple ways of teaching Buteyko to children, mostly in story and game form. This will be suitable for early and pre-teenage children. * A simple program for athletes who either suffer from mild exercise induced asthma, or who are simply looking for an edge from better breathing. The Australian Buteyko Asthma Trial A semi-blinded, randomized study trial comparing the effects of Buteyko breathing technique with a placebo breathing technique was funded by the Australian Association of Asthma Foundations. It was conducted at the Mater Hospital in Brisbane, and was designed and monitored by some of Australia’s foremost medical asthma specialists. Severe asthma sufferers were randomly allocated into either the Buteyko group, or the Placebo group. This was done in such a way as to result in statistically equal groups in terms of asthma severity and drug usage. The Buteyko group [19 people] was taught Buteyko, the placebo group [20 people] was given general asthma education, relaxation exercises, and were taught non-hyperventilation breathing exercises [abdominal breathing]. Patients kept diary cards at home scoring symptoms [3 = maximal symptoms, 0=no symptoms], PEF, and medication usage. Please note that all measurements are statistically significant unless otherwise stated. Results at 6 Weeks Beta Agonist Use: Buteyko Group decreased average agonist use by 90.1%. [From 1235ug to 134ug] Placebo Group decreased average agonist use by 5%. [From 1029ug to 978ug] Inhaled Steroid Use: Buteyko Group average inhaled steroid use fell 12.5% from 1893ug to 1656ug Placebo Group average inhaled steroid … read more »

Response:

Question:

When my son was started on slo-bid, it took about 4 or 5 doses (a couple of days) until I noticed some hyper-activity.  In fact he began biting his fingernails almost immediately upon beginnning to use the drug.  He was very young, maybe 3 or 4 and we had to open the capsules into a bed of "coolwhip" cause he could not swallow a pill. Over the years he was on Slo-bid, his dose had to be increased with his weight, and everytime it was adjusted, he experienced that intial hyper-activity period, until his body became acclimated to the new dose.  I always tried to adjust on a weekend, having sent him one time to school about 4 doses into the increase, and the teacher said he could not sit still.  He is 12 now, and been off Slo-bid about 2 years, but still bites his fingernails, much to my dismay!! He is now on Singulair, having mild to moderate reactive airway disease and uses flonase everyday and ventolin as needed.  I have been lurking here for a month or so, and find the posts very informative. I live in a town with no pediatric asthma specialists, and usually found out the ins and outs after the fact….like the Slo-bid dose adjustment thing!! We now have to decide whether to leave the out of town Allergy/Immunology Doc or go with the doc in a box, 2 days a week pediatrician (who really knows her stuff) or go with the Pulmonary Office Doc that has agreed to take him.  Obviously, a mom’s work is never done, huh!! Sorry to have ranted on like this, Amellia…..hope the experiences about Slo-bid help, if you can find them buried up there in my ramblings!!      Marcia – Hide quoted text — Show quoted text -My son has had asthma for 7 years and since getting stationed in Germany (11 months ago) it has gotten worse, he went from being on Intal with Provential as needed when we were stateside to Azmacort 2 puffs 2x a day. When it wasn’t working like they wanted they finally sent him to an Allergist/Asthma specialist (first time in 7 years) she increased the Azmacort to 3 puffs 3x a day. This worked better but not like she wanted and was concerned about the amount he was on.  So now he is on Slo-bid 1 capsule 2x a day, Azmacort 1 puff 2x aday and provential as needed. What side effects has anyone experienced with Slo-bid? He hasn’t really had a side effect from the Azmacort and he gets a little hyper and jittery if on the Provential for extended periods of time. He just started Slo-bid with tonight’s dose so we haven’t noticed anything yet. Amellia

Response:

My son has had asthma for 7 years and since getting stationed in Germany (11 months ago) it has gotten worse, he went from being on Intal with Provential as needed when we were stateside to Azmacort 2 puffs 2x a day. When it wasn’t working like they wanted they finally sent him to an Allergist/Asthma specialist (first time in 7 years) she increased the Azmacort to 3 puffs 3x a day. This worked better but not like she wanted and was concerned about the amount he was on.  So now he is on Slo-bid 1 capsule 2x a day, Azmacort 1 puff 2x aday and provential as needed. What side effects has anyone experienced with Slo-bid? He hasn’t really had a side effect from the Azmacort and he gets a little hyper and jittery if on the Provential for extended periods of time. He just started Slo-bid with tonight’s dose so we haven’t noticed anything yet. Amellia

Response:

Question:

I discovered this newsgroup a few days ago (after watching the Buteyko TV program) and was rather surprised at all the "discussion" concerning the Buteyko method.  Leaving aside the theory behind the Buteyko method (which I can’t comment on as I have no understanding of phsyiology), it seems to me that a significant number of people find a significant improvement in their asthma after trying the Buteyko method.  Am I right?  If I am right, how are people "wasting their time" if they try it? I don’t understand … Dr J Pearson Cambridge Crystallographic Data Centre 12 Union Road Cambridge CB2 1EZ UK

Response:

I discovered this newsgroup a few days ago (after watching the Buteyko TV program) and was rather surprised at all the "discussion" concerning the Buteyko method.  Leaving aside the theory behind the Buteyko method (which I can’t comment on as I have no understanding of phsyiology), it seems to me that a significant number of people find a significant improvement in their asthma after trying the Buteyko method.  Am I right?  If I am right, how are people "wasting their time" if they try it?

So far no paper on Buteyko has passed peer review.  The only information on it’s possible benefits is therefore annecdotal (unless you are an advocate of B).  The concern is not that people are ‘wasting their time’ but that due to lack of study it might have unfortunate long-term side effects which we don’t know about yet. I would be delighted to see some decent scientific work done on B. Maybe it works *and* the theory is correct.  Maybe it works and the theory is *wrong*.  Maybe it works for some types of asthmatics only. Maybe (as Prof. MacNee hypothesised) more asthmatics overbreathe than he thought do, and B. helps those asthmatics.  All maybes… until some decent work is done. Watch this space – bet Richard Friedel has something to say! — Surfer! http://www.nevis-vieww.demon.co.uk http://www.nevis-vieww.demon.co.uk/flash Hopeful anti-spam: alter double ‘w’ to single ‘w’ to view site & send Email.

Response:

– Hide quoted text — Show quoted text – With a lung function of 30% and profound emphysema I assure you I would/could not hold my breath for more than a few seconds unless you wanted to see me flapping on the floor, turning a delicate shade of blue ) But what kind of shade of blue?  Sky-blue, robin’s egg blue, baby blue…you have to be more specific.  Ah well, I’m sure you’d be cute all blue like that;-) Woodinat

As my first name is Robin it looks as if the colour is pre-ordained Remove the spam from address if replying by email

Response:

Don’t forget to mention the Scottish GP, Dr Spence, who is teaching the unmentionalble technique to some of his patients. His anlge was to combat the ever increasing cost of asthma meds. He said that by using B he could reduce his asthma meds. budget by about 2/3. This is scary.  Is he motivated by his patients best intrests – or by his desire to save money?

In the UK, some practices are "fund holders" and have freedom to spend their budgets as they see fit. As usual, there are pros & cons of this set up bearing in mind that the money can be spent on equipment, patient referrals, drugs, etc. I have sufferred at the hands of one such practice. Fortunately, I am now with a non-fund holding practice and have been treated a lot better. Now, in the Scottish GP instance, I should say that it was from his desire to save money, but I don’t know wether or not he was a fund holder. There is nothing wrong with saving money is provided patient health is not compromised. In any case, if the B technique cuts down the REQUIREMENT for RELIEVER meds., what’s the problem? This is one reason I always recommend against accepting medical advice form somebody with a financial intrest in the product.

Sadly, some Drs. seem to fall into that category. Jo.

Response:

I’ve just watched the program, and there seems to be some fairly compelling anecdotal evidence to support the theory.

happening, usually personal or biographical. Yes really very scientific evidence. feedback on this topic. Thanks.

Your Welcome, Mike C….. – Hide quoted text — Show quoted text – TV programm is on Wednesday not Thursday as I prev posted ..apologies     BBC 1 at 9.30 pm I

Question:

Well folks, the glory of the big city finally caught up to me.  After having asthma for 21 of my 22 years on this great earth, I have managed to avoid an attack since I was 16, but my lungs just can’t handle the air of this town.  I wound up in Women’s College Hospital Monday morning after experiencing a weekend of frustrated breathing.  I know precisely how I breath, so if my patterns change, I notice and can take steps to rectify  the situation.  This time, my breathing became far too "superficial" to use my own description, so I headed off to nebulized, peak flowed, throat swabbed and x-rayed.  Oh the wonders of modern medicine.  Isn’t it great that I can move from clean-air Winnipeg to wrapping my lips around Toronto’s proverbial exhaust pipe?  What really bothers me is that little or nothing is being done to control the situation.  This city should actively encourage commuters to make use of the subway and streetcar routes instead of stopping-and-going from the ‘burbs to Bloor and Yonge.  I guess I am more than a little frustrated. If my school didn’t give out such a damn good piece of paper, I’d take off for Lakehead in Thunder Bay tomorrow. — Eryn H. T. Smit —UofT 9T9—- "the manchild cometh….."   uh oh.

Response:

Hi Eryn, I too, well know the troubles with Toronto’s smog and pollution. I spent far too many days in the ER at Mount Sinai (just down the street from Woman’s College Hospital!) with very poorly controlled asthma. When all else failed on my own, it was the right decision to head to the ER for more aggressive treatment. Can I suggest you might want to call the Asthma Clinic at the Toronto General–Western Division (399 Bathurst St) and get an appointment with their asthma specialists. You might like WCH, but for serious asthma management in Toronto, you would be remiss if you were not knocking on the door of the Asthma Clinic at the Western. The asthma specialist  there is Dr. Ken Chapman. Give him a call! PS: I am a U of T grad (1996) and a more recent Yale University grad (1998). Go Blues!!! Yalie Hugs, Lori – Hide quoted text — Show quoted text -Eryn H. T. Smit —UofT 9T9—- "the manchild cometh….."  uh oh.

Response:

Question:

Pulmicort is net yet available in the US under any name.  The same drug, Budesonide, is available in a nasal inhaler, called Rhinocort.  It should be coming out in the not too distant future. Aerobid is a very good corticosteroid anti-inflammatory drug for asthma. It should give you good relief if used in the right dosage.  Unfortunately many doctors, not asthma specialists, use it too little.  2 puffs twice a day is just not enough for many folks, at least until the asthma is gotten under good control. Best wishes, Bill

Response:

is there ANY way to get Pulmicort? Like Mexico or

You have e-mail about this. There is a protocol for getting Pulmicort via mail-order from Canada. National Jewish Hospital can fill you and your doctor in on the details. Call them at 1-800-222-LUNG.

Response:

I can sympathize.  It really is tough trying to find the right combination of meds to keep you stable.  I was in a similar situation until I started seeing a pulmonary specialist on a regular basis.  I am currently on Pulmicort and Bricanyl (I am from Canada), and am under VERY good control.  I was on Becloforte, with very good success, which is made by the same company as Beclovent.  I switched to Pulmicort because I wanted to get away from the propellants in the aerosol inhaler.  It is my understanding that Pulmicort and Beclovent/Becloforte are very similar in their make up.  Becloforte is aproximately 6 times stronger than Beclovent.  If you can get Beclovent in the U.S., you should check into the possibility of getting Becloforte.  According to my specialist, if you have severe enough asthma to need a preventative, you should be on Becloforte rather than Beclovent.  Beclovent will probably not be strong enough to control the symptoms.  I have also been on Intal in the past, but had little success.  Take care, and good luck! I have had an on and off relationship w/ drugs…..phases of daily dose prevention ( Theophylline, Prednisone, various steroid inhalers}, etc. interspersed with running bare trying to get away with albuterol overuse….which always got me in the ER a couple of times a year….used Pumlicort in UK with great success… can’t get here though…have tried Aerobid with only aggravation… does anyone have any ideas–I am a 23 year old female—allergies, too. Right now I am taking about 40 mg of Prednisone daily to combat the latest bad spell. Really want to be under good control—-right now I can’t go anywhere I might encounter an allergen for fear of setting off an attack. Have heard about Intal, Beclovent????Appropriate for me??? I had used Serevent in England….not too useful…is there ANY way to get Pulmicort? Like Mexico or

– SJ

Response:

 =20   Aerobid with only aggravation.         I use Aerobid with no problems.  My doc gave me a blue plastic=20 bellows-type inhaler.  I take the metal canister out of the pharmacy box and put it into this special inhaler mechanism.  There are 2 advantages:  1) It has a noisemaker to teach me to breath the Aerobid in slowly, which helps it reach the way-down alveolae, and 2) It has a long mouthpiece that I push all the back into my throat, which means I can inhale it without tasting it. is there ANY way to get Pulmicort?

Call up someone (a friend, doctor, or chemist) in England who can read off the long chemical name for you.   It might be available here under a different name.  You can look up the chemical name in a book called "The PDR" that is in every library branch and find out what its American brand name is, if any. Or, find out what company makes it, and contact an American office of that company and ask them the same  question. Ask your local Asthma doctor. It just might be the same as the American medicine "Asthmacort", which is a sales leader in its field.   Warren         Warren Seltzer

Response:

I have had an on and off relationship w/ drugs…..phases of daily dose prevention ( Theophylline, Prednisone, various steroid inhalers}, etc. interspersed with running bare trying to get away with albuterol overuse….which always got me in the ER a couple of times a year….used Pumlicort in UK with great success… can’t get here though…have tried Aerobid with only aggravation… does anyone have any ideas–I am a 23 year old female—allergies, too. Right now I am taking about 40 mg of Prednisone daily to combat the latest bad spell. Really want to be under good control—-right now I can’t go anywhere I might encounter an allergen for fear of setting off an attack. Have heard about Intal, Beclovent????Appropriate for me??? I had used Serevent in England….not too useful…is there ANY way to get Pulmicort? Like Mexico or

Response:

Question:

DITTO, DITTO, DITTO! (To Gretchen’s response.) You can get yourself into big trouble very quickly if you don’t know how to use Serevent. Better talk this over with your asthma specialists. – Hide quoted text — Show quoted text – Excerpts from netnews.alt.support.asthma: 24-Oct-96 Re: Scary thing Maybe you should talk to your doctor about servent this drug is for exersice induced asthma and you take 30 min. before exersice.  Good luck it can be very scary!!!!! Woooo!  Is this actually a drug called "servent" or is this "serevent"? I’ve never heard of taking the later 30 minutes before  exercising, it’s a long acting, not a quick fix drug. Though my doctor has recommended using my bronchiodialator (i.e. alupent) in that fashion…. toodles, gretchen

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That’s interesting, I have been prescribed the opposite.  I am taking Intal three times per day, long-term, but using Ventolin 20 minutes prior to exercise (daily).  So far…no problems.  Am I being treated appropriately?

If it works, then I’d say it is appropiate.  Remember that what may be the ‘best’ program for me may not be what is ‘best’ for you.

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- Hide quoted text — Show quoted text – Excerpts from netnews.alt.support.asthma: 24-Oct-96 Re: Scary thing Maybe you should talk to your doctor about servent this drug is for exersice induced asthma and you take 30 min. before exersice.  Good luck it can be very scary!!!!! Woooo!  Is this actually a drug called "servent" or is this "serevent"? I’ve never heard of taking the later 30 minutes before  exercising, it’s a long acting, not a quick fix drug. Though my doctor has recommended using my bronchiodialator (i.e. alupent) in that fashion…. I was given ‘Intal’ (cromolyn sodium) and told to take it 15-45 min before excrecise.  However with my asthma under control, I have found I don’t need it very often (now I only use it when my allergies are acting up).That’s interesting, I have been prescribed the opposite.  I am taking

Intal three times per day, long-term, but using Ventolin 20 minutes prior to exercise (daily).  So far…no problems.  Am I being treated appropriately?

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writes: So far…no problems.  Am I being treated appropriately?

If you have no problems, then one would assume you are being treated properly. As they say the proof is in the pudding. …Mike

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Serevent is not for quick fixes.  It is for long term management.  Check with your md’s.  Ventolin or albuteral is more widely used for exercise induced along with intol.  Serevent has been widely misunderstood and misused. Even the company that makes it wants it clear it is not to be used when you are in trouble.  It will not give you the help you need quickly.

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Has this ever happend to you. I was having an exersise induced asthma attack.

Maybe you should talk to your doctor about servent this drug is for exersice induced asthma and you take 30 min. before exersice.  Good luck it can be very scary!!!!! Shauna

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Excerpts from netnews.alt.support.asthma: 24-Oct-96 Re: Scary thing Maybe you should talk to your doctor about servent this drug is for exersice induced asthma and you take 30 min. before exersice.  Good luck it can be very scary!!!!!

Woooo!  Is this actually a drug called "servent" or is this "serevent"? I’ve never heard of taking the later 30 minutes before  exercising, it’s a long acting, not a quick fix drug. Though my doctor has recommended using my bronchiodialator (i.e. alupent) in that fashion…. toodles, gretchen

Response:

Excerpts from netnews.alt.support.asthma: 24-Oct-96 Re: Scary thing Maybe you should talk to your doctor about servent this drug is for exersice induced asthma and you take 30 min. before exersice.  Good luck it can be very scary!!!!! Woooo!  Is this actually a drug called "servent" or is this "serevent"? I’ve never heard of taking the later 30 minutes before  exercising, it’s a long acting, not a quick fix drug. Though my doctor has recommended using my bronchiodialator (i.e. alupent) in that fashion….

I was given ‘Intal’ (cromolyn sodium) and told to take it 15-45 min before excrecise.  However with my asthma under control, I have found I don’t need it very often (now I only use it when my allergies are acting up).

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- Hide quoted text — Show quoted text – Has this ever happened to anyone??  This really scared me. I was having an exercise induced attack and tried to calm myself drink some water and got to the point of no return so I sent a friend to the car for my rescue meds. Well when I inhaled my albuterol, my lungs froze and I could not exhale! I thought my lungs would burst.  My hearing muffled and my body was paralyzed and my head was swimming and my vision kind of watered over.. I have never had this happen before and I was just wondering if that was common thing? Thanks, Suzanne Dear Suzanne. Should this happen again, do not call a friend, but call for an ambulance and go to the nearest emergecy…You were lucky… Yves Dussault

Welcome to the wonderful world of asthma! The reason it is of pocket size is for that reason, and not to be left in the car. It sounds like you waited too long to take a puff. Use it before exercise or make sure you have it with you . Mitch

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Dussault) writes: Has this ever happened to anyone??  This really scared me. I was having an exercise induced attack and tried to calm myself drink some water and got to the point of no return so I sent a friend to the car for my rescue meds.

Maybe you should consider keeping them with you.  I bring mine with me to the gym in a fanny pack, and they are with me on the treadmill, etc. Intal is commonly used to _prevent_ exercise induced asthma.  You may wish to look into this med if you are not already taking it. MP

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Has this ever happened to anyone??  This really scared me. I was having an exercise induced attack and tried to calm myself drink some water and got to the point of no return so I sent a friend to the car for my rescue meds. Well when I inhaled my albuterol, my lungs froze and I could not exhale! I thought my lungs would burst.  My hearing muffled and my body was paralyzed and my head was swimming and my vision kind of watered over..   I have never had this happen before and I was just wondering if that was common thing? Thanks, Suzanne

Dear Suzanne. Should this happen again, do not call a friend, but call for an ambulance and go to the nearest emergecy…You were lucky… Yves Dussault

Response:

Has this ever happened to anyone??  This really scared me. I was having an exercise induced attack and tried to calm myself drink some water and got to the point of no return so I sent a friend to the car for my rescue meds. Well when I inhaled my albuterol, my lungs froze and I could not exhale! I thought my lungs would burst.  My hearing muffled and my body was paralyzed and my head was swimming and my vision kind of watered over..   I have never had this happen before and I was just wondering if that was common thing? Thanks, Suzanne

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