On Friday a long time friend and patient came into the office.  During his visit he shared with me an experience that he had earlier in the day that was to me both unbelievable and yet not surprising, and that I thought would be interesting to share.

Over the last few weeks we had been working with this patient (we will call him AD), for symptoms similar to acid reflux.  Now, as most of you should know, we don’t treat symptoms or conditions, but we had been making good progress removing subluxations at C1, T1, and T5 – all areas with important nervous system connections to the stomach and esophagus, as well as working with him on adding food (and supplements) to his diet designed to increase his stomach acid.

Note:  Acid reflux isn’t caused by too much stomach acid, it’s caused by not enough!  When we don’t have enough stomach acid we are not able to break down food properly, leading to the condition we know as reflux or GERD.  Taking antacids to block acid production, while providing some short-term relief, actually makes the problem worse!

The one symptom that AD had that was persisting was a sensation, when swallowing, of a catch in the throat – like food was caught there and not going down.  I decided to recommend to AD that we have his throat taken a look at by an ENT just to make sure that there wasn’t a growth or other structural reasons for his symptoms.

After a long wait for an appointment, AD went in for his consult for on Friday.  The visit started off poorly as the Dr. was running very late, seemed rushed, and had poor bedside manner [not everyone can have the sunny dispositions that Dr. M and I have I guess ;)].  The good news was that, following the scope, there was no cancer or other blockages in the throat.  The diagnosis was, drumroll please, acid reflux.

Now, all of this is what I expected would happen, even the prescribing of some medication – that is what an ENT does for acid reflux, tries to mask the symptoms.  What happened next is what blew my mind.  After AD explained that he really didn’t want to take the meds (as a great patient of ours he knew that they weren’t the answer), the Dr. reiterated that he should try them and that if they didn’t work he would go ahead and prescribe some anti-depressants!  Apparently a tickle in the throat can be caused by being sad (the impact of the prescription is greatest when you actually know AD – the guy has a great family with a baby on the way, takes great care of himself, and is probably the last person I would think would need an anti-depressant)!

Back in January of 2006, in one of my first ever posts to this blog, two months after I joined the practice here at McKinley Chiro, I wrote a blog article entitled – Anti-Depressants Depress Me.  In it I highlighted a couple of recent (at the time) articles about anti-depressant use:

• A study in the Annuals of General Psychiatry (as described here by NPR) details that more Americans, including children, than ever are being prescribed multiple psychiatric medications.  The authors found that patients are commonly prescribed untested combinations of drugs, where the efficacy and possible side effects of the combos are unknown.  The study did not find an increase in the number of people with severe mental illness, rather more Drs are writing more presciptions.
• A second article, published in JAMA. The authors found that for people with mild to moderate depression, medications was no better in treating these symptoms than placebo.  You’re better off taking a sugar pill than Paxil, you’ll get the same benefits without the risk of serious side effects including suicide.

Is there any wonder that the numbers as reported by NPR in 2006 were skyrocketing (and I doubt that they have slowed down with the economy and all)?  All for drugs that, for the majority of people, don’t work and bring on tons of serious side effects!

In AD’s case we have a ENT prescribing anti-depressants.  According to Wikipedia, ENT is a “branch of medicine and surgery that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders.”  No where in that description does it say “mental and/or emotional” disorders.  Yet he is recommending medication that plays with the very chemistry of the brain.  This is one (or many) areas that I feel the FDA does a poor job of regulating prescription meds in this country.  Any MD, regardless of specialty, is allowed to prescribed (almost) any medication – whether it not it is within their area of expertise.  Would an orthopedic surgeon prescribe medication for use in the eye?  How about a podiatrist prescribing heart medication?  Of course not….yet, for some reason, all sorts of Drs prescribe anti-depressants.

This is where the drug culture in our society has led us astray.  For many diseases we’ve stopped looking for the actual cause – we are so focused on repressing the symptoms, on making ourselves feel good.  And the natural extension of that is to start giving people who have, as in AD’s case, minor pains or inconveniences, drugs that forces them to not have negative emotions.  Why fix it when we can just make you happy instead?

In the end AD’s case illuminates one the difficulties that Dr. M and I have in practice.  We want and need to be able to refer people to medical doctors in order to have things checked out that we can’t do ourselves.  But at the same time I need to be sure that my patient isn’t going to walk out with anti-depressants for a throat tickle.  We are lucky that we have some great MDs that we have great working relationships with (unfortunately ENT wasn’t one of them).  But this is also why we work so hard to educate our patients with Case Reviews, articles on our blog and in our office, dinner parties, etc – so that when you are faced with a situation likes AD’s you will have the knowledge to recognize recommendations that go against how the body actually works and have the courage to do just what AD did – say “I’m getting a second opinion” and walk out.

PS:  Anyone know a good ENT guy?