Thinking Outside The Box

I so often get frustrated at the apparent lack of common sense in the modern medicine.  It would seem that with advanced medical education there would also be ability make educated decisions based on facts.  Although this seems logical, and in a sense, what doctors do, alas, in many causes we usually see just the opposite.   Doctors learn diagnostic paradigms that, for most, lock them into a rigid thinking pattern that prevents them from thinking outside those set paradigms.  In order to play it safe and conform to the patterns that encompass the basic standard of care they rarely deviate from establisheddisgusted doctor paradigms.

Proponents of our medical system would argue that these paradigms are necessary in order to make sure that the most appropriate care is given for each patient. 

So what is the problem with paradigms?  The uniqueness of humans! 

Even though our biological systems are fundamentally the same, the infinite amount of variables involved that influence human physiology is mind boggling.  Treating each patient by rote is always alienates a certain percentage of patients that fall outside the standard paradigms.  Alas, this pattern remains the norm. Physicians through medical school programming and then subsequent reinforcement in clinical practice become programmed to follow dogma, almost like a religion. Because of this, most doctors cannot think outside the box and some cannot even make simple links in logic.  

Trying to Break Through the Paradigms With Logic

Initially let’s look at the fact that Fluoroquinolones can cause delayed adverse events and that these adverse events can manifest themselves days, weeks, months and years post treatment.   Most doctors would reject this notion by arguing that it is not backed up by research and that they have never seen in it practice. I know that it is fact based on several factors:

  • My own experience:  I had a delayed adverse event.
  • The Veracity of anecdotal data:  I have interacted with literally hundreds of individuals over the last thirteen years who have experienced delayed adverse events.
  • Talking with researchers:  Dr. Golomb and Dr. Noble have both laid out plausible mechanisms for the ability of the Fluoroquinolones to cause delayed adverse events
  • Research: As time progresses studies are starting to show delayed onset of symptoms:
    • This study showed delayed tendon problems of up to 4 ½ months (Study 1).
    • This study showed peripheral neuropathy starting up to 6 months after stopping treatment (Study 2).
    • This study showed a 34% percent increase in carpal tunnel up to a year after stopping treatment (Study 3). 
  • Method of Action:  Fluoroquinolones are Topoisomerase Inhibitors.  Topoisomerase inhibitors are chemotherapy and chemotherapy has been documented to cause “late effects” or what we call them ‘delayed adverse events.’

How to Appeal To Doctor’s Logic

1 First, establish the fact that Fluoroquinolones are very powerful antimicrobials. This step should be easy, as no self-respecting doctor would or should deny the powerful ability of these drugs.

2 Second, Fluoroquinolones are chemotherapeutic drugs.  They are chemotherapeutic drugs or agents by definition and, as a matter of fact, they are chemotherapeutic drugs in every sense of the word.  This fact is not hidden away from the clinical medical establishment, its just that doctors don’t refer to Fluoroquinolones in this sense or terms.  However there is plenty of documentation supporting this definition of FQ’s. (1),(2),(3),(4) and more.  If he/she is still not convinced you can tell them that there are existing  cancer (chemotherapy) drugs that have been based on the FQ’s.  One such drug is Vasoroxin (5) found here and is a quinolone based drug (I believe off of Levaquin if my memory serves me).  Additionally FQ’s are given as adjunct therapy with other chemotherapy drugs to help ‘mop up’ cancer cells and to keep them from re-seeding(6).

3Third, one of the complications openly acknowledged by the mainstream medical community is delayed adverse reactions to all forms of chemotherapy or as the medical community refers to it as “late effects”. defines chemotherapy late effects as “a side effect that occurs months or years after cancer treatment.”  The description of late effects aka “delayed adverse events or reactions” encompass the same health problems that FQ sufferers describe and experience.  Here are several links describing “late effects” of chemotherapy: (7), (8), (9)With a little simple Google investigative work a person can uncover many more credible links to bolster these connections.

It seems so simple doesn’t it: 

Fluoroquinolones Chemotherapy Late Effects   

1-2-3A simple three step action that logically links FQ’s to the ability to initiate delayed adverse reactions.  There are no grand leaps of faith or conjecture required to link the steps.  Now I am not guaranteeing that your doctor, or any doctor for that matter, will become a believer, but it’s worth the try, especially if you’ve been trying to explain your delayed or long term problems from the FQ’s.

Ironically, most doctors would understand completely if you told them that you were having long term health problems from a previous round of chemotherapy years earlier. So, just maybe, if you can get him/her to link the two (FQ’s and Chemotherapy) in their mind you may have a shot.   Sadly, and usually the case, if you tell them that you are experiencing long term health effects of a fluoroquinolone antibiotic taken much earlier, maybe even years, your ideas would probably, at best, be politely dismissed, and sometimes rudely dismissed.

So where is the disconnect?

Let’s throw out the argument that most doctors are not taught that routinely used drugs can have long term adverse profiles. Instead, some of m3 docsy friends in the psychology world believe the answer is simple:cognitive dissonance. Cognitive dissonance is a universal human phenomenon and it is based on the assumption that people want consistency between their expectations and reality. Because of this, they contort their thinking into knots to make that happen.

In the case of Fluoroquinolone adverse events, it is to preserve the notion that their efforts help rather than hurt. Their impulse is to attribute the harm to something other than their intervention. Doctors cannot admit that something that they prescribe every day is actually capable of such long term pervasive damage.  Most will admit to a rare occurrence of adverse symptoms but they are usually limited to those who experience immediate reactions.  Admitting broader or long term problems conveys and sense of culpability or liability that they do not want to venture into.  In every sense of the meaning, it is “plausible deniability”. And, they have the ability to hide behind the FDA, who caters to the pharmaceutical companies and offers blanket “plausible deniability.”

You wouldn’t think that three small steps would be so hard to follow.