[LMB] OT: Surgical placebos

Antoine Guillaud antoineperso at gmail.com
Wed Apr 8 19:51:26 BST 2020


3 years ago, I had heavy problems with my left elbow (more or less a tennis elbow painful and debilitating, as I have 3 small kids who love to be carried by daddy , went to see a doctor, who happened to be a surgeon as well!
He told me, he could do three things: operate, do an infiltration in the elbow to get rid of the pain or go old school with some anti-inflammatory medication, a bandage to stabilise the joint and reduce movement to ensure that the tendons didn’t overstretch ...
I then asked him: ok chances of success: he told me: the same for all 3 methods... only difference is: the 3D one costs only much time and nowhere near as much money! 

I choose to go with time and half a year later, was as good as new ...

Found it more than fair from the sturgeon to be that honest 

Antoine

> Am 08.04.2020 um 20:38 schrieb Pouncer via Lois-Bujold <lois-bujold at lists.herald.co.uk>:
> 
> Karen Hunt reminds us: 
> 
>> some recent [studies ] compared statin drugs to artery stents.
>> Both are known treatments, so it's not really wrong to give one or the
>> other, and researchers want to know which treatment is better for what set
>> of circumstances (for what it's worth, statins have been winning over
>> stents for most situations).
> 
> First, disclosing a bias, stents seem to me a good example of the
> general over-deification of surgeons.  Successfully surgery, which
> * IS * a lot more common that it was a century ago,  is so dramatic
> and so immediate that many of us in the general public tend to
> demand dramatic, immediate, miracles regardless of the technique.
> Or cost. Or need.  Reconstructing a breast after cancer is
> mentally therapeutic, and so we have an entire surgical industry
> boosting the self-regard of certain persons. And certain surgeons.
> Stents are so valuable for emergency repairs of heart blockages
> that they've be used by too many as the "go to" procedure for
> milder and more chronic cases.  Or so I say as a layman. YMMV.
> 
> The always reliable US news network NPR ( well, mostly reliable.
> Well, somewhat reliable.  Well,  at least as much as the paid
> media.  Well … )  reported this year on surgeons doing procedures
> on knee cartilage.  All procedures the same, except, after
> incisions, some surgeons opened sealed ordered and found 
> themselves directed to close up, without doing the work on
> the damaged or diseased cartilage.  Interestingly, the results
> after recovery and therapy were comparably good for those that
> had the "real" procedure and those who had what amounts to 
> a placebo surgery. It certainly leads to the question of 
> whether the surgery adds anything to the physical therapy.  Or
> for that matter whether the expense and emotional investment in
> surgery prompts a patient to expect, and experience, better
> results.  Again, speaking only as a layman, I suspect the 
> cartilage work does help many.  But perhaps not AS many as
> the surgeons who believe it helps are expecting. 
> 
> Comparing stents -- surgery -- to statins -- drugs -- is related.
> In any case it is not a matter of taking an option away from 
> patients or doctors.  It should be, though, a continuing process
> of measuring how well a new idea works.  All of us have 
> some bias in favor of the new and dramatic.  That surgeons
> are worse, IMO,  is inescapable given their importance. It will be
> a better system when physical therapists, pharmacists, 
> nutritionists, allergists, and emotional support animals get
> a little more of the regard they're due, even if such regard
> comes at the expense, or sacrifice, of surgeons.  
> 
> -- 
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