Recently I (guest blogger Dennis Ferrill) posted a discussion of my young daughterâ€™s experience with serious asthma (Healing Molly) and how we ultimately found an â€œalternativeâ€ treatment that helped her. The treatment came with a logical theory of onsetâ€”something that does not exist in the standard approachesâ€”as well as a simple array of diagnostic tests and a clear plan for treatment. In short, while our experience represents a data set of one sample, my daughter is entirely well and our avid collection of data about her symptoms, medication, and peak flow readings from the time strongly support the hypothesis that the therapy was directly causal.
This experience raises an interesting question: How important is a theory of onset to the identification of effective treatment pathways? One comment on the posting suggested that â€œâ€™how one gets thereâ€™ is not nearly as important as how one treats the asthmatic/atopic patient.â€ This is certainly true in the sense that symptom treatmentâ€”the only thing allopathic medicine has in its quiver of arrows, is often a necessary life saving response. But determination of a treatment that can result in real healing requires deeper understanding. In my daughterâ€™s case, food sensitivitiesâ€”allergies, reallyâ€”to most of the foods in her diet, mediated by IgG and IgA, not the standard IgE, were likely behind her problems and would probably have persisted. Pharmacotherapy targeted at symptom control alone would have resulted in a long dependence on medications, ongoing illness, and a huge expense to the system. In my daughterâ€™s case there is a chance that she might not have lived. Perhaps most important is the established view that medication is a sufficient response and that adherence to the textbook treatment plan is the best definition of the physicianâ€™s role. In a case such as ours, if the doc is following the book and the pharmaceutical companies donâ€™t see potential for a silver bullet drug with a large revenue stream, who in the system has the job of looking more deeply for new approaches?
In the same comment on my initial posting, a physician defended allergists against my claim that they donâ€™t work with IgA and IgG, but only look at IgE mediated reactions. I hold to my claim. When the allergic process was first documented it was due to the discovery of IgE, which could be found because it leads to fast reactions, unlike the other immunoglobulins which react slowly and are harder to identify. â€œAllergyâ€ became defined by IgE. In our case, armed with clear test results showing serious food sensitivities based on IgA and IgG and with convincing evidence that an elimination diet had resulted almost immediately in symptom reversal we approached our well known pediatric allergy and asthma specialist in Boston for her view, only to be treated to a negative IgE based test and advice to our daughter that she could resume drinking her favorite milk. Of course we did not take that advice.
Every system has built in assumptions that are invisible to those inside it. These assumptions are ultimately the barriers that make new progress difficult. There is nothing surprising about that. The question remains: What has to be done to open up the new territory?August 18, 2005