Friday, August 3, 2012

At the Core

So far we've explored how treatment effectiveness, our enthusiasm for our treatments and what people have tried. Today, we look at a different angle on treatment options: what do people currently consider to be the core of their protocols.

This is different from what we were looking at in the last couple blogs because it is less about what we've tried out and more about what we are relying on, based on whatever level of experience we (and our doctors) bring to this.

We'll also look at a couple of the specific protocols we surveyed about to see how those are working for people.


Here's the data from the survey:


Now, I could spin these results in a myriad of ways. Here's a few:
  • People who try more things get better at a higher rate (I spun one of my other blogs in just that way, remember? See how the purple line pokes out further on most things?) In other words, integrative medicine is the way to go, and the more angles you hit lyme from, the better off you'll be.
  • People who get well are the ones for whom either antibiotics and/or herbs work well. (Given that there is lots of purple on both of those.)
  • Given that the best outcome patients only rarely ventured outside this list of 6 things as their cores, if you are going to get well, you'll probably find it here. (This analysis is especially suspect: just because I surveyed about them doesn't mean they are all that special. If I'd asked, say, about hyperbaric chambers, they'd probably have a similar response to some of the stuff here.)
  • In general, you are fortunate if you have access to antibiotics (a doctor who will prescribe them) and they work for you. Almost 80% of people doing well have them as a core, while only 62% of the worst outcome people do.
  • The biggest gap between worst and best outcome patients is in the use of herbs. Therefore, herbs must be a key thing for getting well.

(Side note: see how much fun it is, playing with statistics? I could write a whole blog on how tempting it has been to spin data to fit my own preconceived notions biases. As a general media literacy rule, always be wary of how people spin data! Look at the graphs closely and see if you see a different interpretation.)

Unfortunately, I have no way of knowing which of those spins is actually true; or perhaps a better way to say it is that each of those spins is probably true for some people and not true for others.

I do find it interesting, though, that antibiotics are only core for about 70% of us. I regularly hear people on our support lists express surprise that there are non-antibiotic options out there, or that people are trying anything else. And here's some concrete numbers to say, yes there are other options, and not everyone is primarily focused on antibiotics as their core... in fact a significant minority are looking elsewhere for healing, a chunk of whom are doing really well.

Beyond that, this is one of those blogs where I invite you to pick your own spin. You've seen a LOT of data from me, and probably have looked at other people's as well. What do you think is going on?

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Now, I worried a little bit that there might be a built in problem here that related to time. We all know that chronic lyme cases don't resolve overnight, and it seems like the first thing that almost everyone tries is antibiotics. We also know that a lot of folks in this survey are relatively new to the treatment game (just over half of the people in this pool have been treating for 2 years of less).

So maybe people are doing best with higher doses of antibiotics just because they are on them longer? Or maybe people give up on certain protocols, or we put faith in different things depending on the time we've been in treatment?

(I actually fully expected that second thing to be true, that we'd see a drift away from antibiotics and toward more alternative things as people decided the first thing their doctors tried wasn't going to work for them. There's those biases rearing their ugly heads, eh?)

So I ran these numbers about treatments for longer and shorter term patients, and here's what that looks like:



If you can see something here you'd call statistically significant, I'll eat my hat. When you take into account that the sample sizes for rife machines and essential oils are pretty small, I don't see any significant differences here at all. So the differences we see in core protocols don't appear to be because people tend to gravitate toward one end of the antibiotics-alternatives spectrum over time.

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I also wondered if the variations were more about who we see (or don't) than anything else. Here's the breakdown, based on what type of practitioner support we have:


Now this is interesting! Here we do see significant differences (and in the next blog we'll look at lyme treatment success rates among different types of practitioners). The bottom line is that MD's are far more reliant on antibiotics as the core for treatment than ND's and OD's.

And people who are either essentially self-treating or relying on less knowledgeable doctors (which in some cases is functionally the same thing) are more likely to try a variety of options. This is probably in part because most non-LL practitioners won't prescribe antibiotics for the long term, and so they are forced into looking at other things.

However, some people are in this category voluntarily; they are choosing (either based on philosophy or giving up on professionals) to do it alone, in spite of the fact that it reduces their treatment options by eliminating access to long term (or any) prescription drugs.

Most interesting, perhaps, is how many therapies have a high enthusiasm rating (see my "Healing with an Open Mind" blog) and are not being used by lyme literate doctors, and especially MD's. This isn't that surprising  because MD's (like every other group of humans in the world) tend to rely on what they know, and antibiotics are one of their primary tools in their practices in general.

This information can be particularly helpful if you are in the process of choosing a lyme literate practitioner (and are either fortunate enough to live somewhere that gives you options, or are going to have to travel no matter what). Considering what your own preferred approach would be to healing, it is a good idea to choose a practitioner who is going to support hat basic mode.

As a very general statement, here's what I mean. Fan of antibiotics? Look for an MD. Interested in herbs and other alternatives? Look to the DO and ND doctors for that. Of course, you always want to ask about how that specific doctor approaches it, and these are generalities. Still, they look pretty significant to me, and knowledge, as they say, is power.

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OK, I want to go down a side street before we close today. I had asked survey questions about two particular protocols (and of course since starting this process a couple months ago, have come into awareness about many others I could have asked about... next time!)

I had meant to include this with the last blog, but spaced it out. (You know how that goes). Here's the info about those two protocols.



 I've included the info about antibiotics and herbals next to these specific protocols because these are basically subsets of the larger categories: Marshall uses antibiotics as the main bug killer (in conjunction with other things) and Cowden is an herbal protocol.

It looks like both protocols perform as well as their larger categories, but they don't generate more enthusiasm. It isn't surprising to see them tried less, as there are any number of variations on the theme of antibiotic and herbal protocols.

I don't think this reflects the same kind of belief biases I was discussing in the last blog so much as there being a plethora of choices within each other larger categories.


2 comments:

  1. Fast comment on that last graph about the protocols. Few people, relatively, in your survey used the Marshall protocol (half the % compared to Cowden) so comparing the views of performance isn't too meaningful. And did those who tried these protocols and who rate them high use other measures first? I have issues about this kind of data because it is similar to saying "you always find what you are looking for in the last place you look".

    I really appreciate all the work you are doing with this, tho and don't mean to snipe. Is that horizontal axis on the graph % of respondents or actual #s? I think it is %. So having the total number of responses you received for each subject shown on a graph would be helpful. Is that 5% who tried Marshall Protocol 10 people? 100? Knowing the raw number of subjects helps me assess the responses.

    Also - I think most Naturopaths and DOs are not going to prescribe antibiotics. IDK if Naturopaths are even legally allowed to prescribe Rx drugs. And DOs are not allowed to practice in all states. Some states don't license them as MDs so their treatment options are more limited.

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  2. Hi there, and thanks for the comment. One of the big frustrations I'm bumping into is constantly feeling like the numbers are too low. I'm starting to see this as the "preliminary" study, and all conclusions being tentative, and try to say that pretty regularly. So I feel like I am really with you on that one!

    I was trying to impart in my first couple blog the sense that I want people to take what I am doing as if you are getting a collection of perspectives from friends. This wasn't a massive study with all the advantages that come with that... but I think it is better than taking 1 or 2 friends' stories as the truth about lyme. It is somewhere in between-- it is all basically personal experience and anecdotal, but it is a good deal more of it than most of us have access to.

    Yes, the numbers are in percentages. I have two programs I'm using the make graphs, and with this one, it won't let me put the data label right on the bar, so I have to say it in words (look to the right where it gives you the key: it says percentages there.) There were 18 Marshall people and 35 Cowden people in this survey. (So, again, read it like: "I talked to 18 people about the Marshall protocol and this is what they said" and give this whatever weight you'd give that.)

    I don't know about naturopaths, but my DO has prescribed antibitoics for us. She's in Illinois and I think you are probably right about it varying by state. I think the central point for consumers still holds though-- going to different types of practitioners is likely to yield different protocols, and I want folks to be aware of that when they choose who they want to see.

    My personal experience with my DO is that I have more options with her than I've ever had with any MD I've worked with--she knows a lot more options and doesn't seem to be limited in what she can do. (Now, that said, I don't have traditional insurance--which I think is actually the biggest limiting factor for treatment.)

    Here's the breakdown on the current core protocols for antibiotics between the two categories we are talking about: 70.8% of DO patients and 69.5% of ND patients. It is possible though that an ND needs an MD to actually write that scrip... another question I didn't ask... but it seems like there's a way the NDs are getting their patients the goods.

    Let me know if this sparks other thoughts...

    Cheers! Ma'ikwe

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Hey all! I have set this blog so that anyone can post, and posts are unmoderated. In order to keep it that way, I request that people be kind in your disagreements, open to other viewpoints and come from a spirit of genuinely wanting to help each other on our shared journey. Thanks! Ma'ikwe