Topic: Paralyzed woman sues chiropractic for half billion - installment #4
Sat, 2008-06-21 10:32
#1
Topic: Paralyzed woman sues chiropractic for half billion - installment #4
Sat, 2008-06-21 10:32
#2
[url=http://www.rabble.ca/babble/ultimatebb.php?ubb=get_topic&f=31&t=000703]C... from here.[/url]
quote:
Originally posted by jas:What studies are you citing here, Trevor?
Oh, for crying out loud. Wayne has listed them, so take your pick. Even the chiropractic studies admit as much for instance the article in the Journal of the Canadian Chiropractic Association called "A report on the occurrence of cerebral vascular accidents in chiropractic practice" from 1993 says that a "reasonable estimate of risk was one serious neurological complication per 3 million neck adjustments."
And from "Managing Risk in Your Chiropractic Practice 2001" which appeared in the Journal of the Canadian Chiropractic Association, it states: "Mason v. Forgie and Leung v. Campbell [b]established[/b] that stroke was a material risk associated with cervical adjustment. Chiropractors resent the fact that they are required to inform patients of these risks." and "If you are performing cervical adjustments the risk of stroke is a reality, albeit remote."
Those are both chiropractic journals.
In "Neurologic complications following chiropractic manipulation" (1995)found in the journal "Neurology" they estimated the incidence of strokes to be one in every 500,000 manipulations.
In "Safety in Chiropractic Practice" (1996) in the Journal of Manipulative and Physiological Therapeutics they estimated the incidence of irreversible CVA at one in 1,320,000 neck adjustments.
In "Sudden neck movement and cervical artery dissection" in the Canadian Medical Association Journal (2000) they record that in the previous year the Canadian Stroke Consortium was made aware of 21 strokes with carotid artery dissections from neck manipulation.
In "Chiropractic Manipulation and Stroke: A Population-Based Case-Control Study: (2001) in the journal "stroke" their case-control study found that for those less than 45 years of age the risk of vertebrobasilar accidents in Ontario was 5 times more likely than controls to have visited a chiropractor within 1 week of the VBA.
The truth is we have no idea how often stokes occur as a result of neck manipulation, but we do know it is occuring. Some people will say that correlation does not equal causation and that would be a valid argument if these strokes that are occuring in young patients post neck manipulation were not consistently caused by dissections of the cervical arteries (something that is very rare and generally only related to sudden - most often violent - neck movements). The correlation does not equal causation argument would also be valid if it could not be shown how neck manipulation could damage the arteries in question, but as the scientific american frontiers video posted above shows the cervical arteries can be damaged by the strain of movement that neck manipulation placces on them. The evidence fits. However, the only ways to prove it through testing would be for instance to have patients have an MRI pre-neck manipulation, have their necks manipulated by a chiropractor and then have another MRI post neck manipulation. If any damage to the cervical arteries is shown in any patient then the risk of stroke is proven. However, that would be unethical in my opinion, especially as we have stastistical evidence which while incomplete, and undoubtably extremely under-reported, still shows a link.
[ 21 June 2008: Message edited by: Trevormkidd ]
Sat, 2008-06-21 11:01
#3
On another thread Snuckles posted this article from the National Post today:
[url=http://www.nationalpost.com/related/links/story.html?id=602815]Chiroprac... called to court[/url]
quote:
Victims of neck-adjustment mishaps sue
Kevin Libin, National Post
Published: Saturday, June 21, 2008CALGARY -At more than 80 pages, it is already an unusual statement of claim; the longest Edmonton lawyer Daryl Wilson has ever seen. "It's quite something, isn't it," beams the lawyer behind a massive class-action lawsuit filed last week against Alberta's chiropractors and government.
Also, the pages virtually seethe, accusing the chiropractic business of "masquerading in the white smock of science [to] perpetuate [the] unregulated indiscriminate use" of "dangerous" neck manipulations. Rails the claim: "It has got to be stopped."
The outrage is fuelled by the case of lead plaintiff Sandra Nette. Until last September, she was a fit 41-year-old land administrator with a love for singing and classical piano. Today she is tetrapalegic.
She "cannot move or communicate due to complete paralysis of nearly all voluntary muscles in her body," the claim explains. Sandra, her husband David says, "lives in a prison."
What happened, according to David Nette, is that Ms. Nette visited a chiropractor for a routine neck adjustment. Afterward she felt dizzy and nauseous. Soon, she was pulling her car to the side of the highway, calling for help. Hours later, Mr. Nette said, doctors told him his wife's vertebral arteries were torn; she had suffered a massive stroke.
This has happened before: cervical spine manipulations producing brain trauma or death. Lawsuits have followed. Even public inquiries, as in the chiropractic-related deaths of Saskatchewan's Laurie Jean Mathiason and Ontario's Lana Dale Lewis. But the Nettes' suit is a first in that it targets not only practitioners, but regulators, and argues that spinal manipulation, a chiropractic staple, is illegitimate, and that in sanctioning it, the government and the Alberta College and Association of Chiropractors are not only advancing a useless treatment, but putting lives at risk.
Sat, 2008-06-21 11:04
#4
Of interest from the above linked NP article:
quote:
Alberta offers a particularly vulnerable initial target. Prominent neurologists here have spoken out for years against the practice of vertebral manipulations, which are funded by provincial medicare; a group representing Alberta's pediatricians called on provincial officials a decade ago to end spinal adjustments on children and infants; and Saskatchewan's inquiry into Laurie Jean Mathiason's chiropractic-related death recommended to all "ministries of health in Canada" that chiropractors implement more careful procedures, including warning patients of risks, better patient screening and further testing of the links between neck manipulations and stroke.Alberta's government evidently entrusted the provincial chiropractic association to look after those things. Sharon Mathiason, Laurie Jean's mother, wrote Alberta's health and wellness minister in 2005 concerned that those recommendations were being ignored.
"That's why you do an inquest," Ms. Mathiason says. "So that this doesn't hap pen again. That's the whole purpose of it."
In her reply, then-health minister Iris Evans wrote: [b]"My department relies on the chiropractic profession's expertise to govern itself."[/b]
The industry, plaintiffs maintain, failed to do so adequately and "consistently disregarded the public interest," perhaps, they charge, because the ACAC is both a regulatory college and the profession's advocacy association.
[ 21 June 2008: Message edited by: Trevormkidd ]
Sat, 2008-06-21 11:37
#5
I injured my right shoulder in 2006 and wnet thru much of 2007 with a shoulder manipulation by a surgeon and loads of physical therapy.
I injured my left shoulder this year by reaching across the back seat of our truck while standing outside to get a diaper bag.I went to a chiropracter who told me after xrays that my left shoulder was slightly out of socket and he could fix that.So I let him -twice. After that I went to the orthopedic surgeon because I couldn't stand the pain of pushing on my shoulder and I knew it wasn't going to get better with the other method.
I wish I hadn't let the chiropracter mess with my shoulder-because my upper arm still feels like someone hit it over and ovewr with a hammer and it's been about 4 months.
I keep asking the surgeon if the chiropracter made it worse-I think doctors kind of want to "stay together and make no waves".I started this week thinking of if I could sue the chiropracter-because is he really that knowledgeable about putting a shoulder in place? I've been through an MRI, a bone scan and shoulder manipulation and Pt 3 times a week since not going back to the chiropracter-and I'm still having loads of pain and can't raise my arm without aid.I just saw the surgeon again-a shot and more PT prescribed.I went to a doctor about the pain-he said this injury must be worse than the right arm.(I hurt the right one throwing Christmas lights over a dogwood tree).
What do I do? Do I have a chance at suing? I am tired of having so little use of my left arm and PT is so painful.
Sat, 2008-06-21 16:32
#6
As I sat toiling away at work yesterday reading through an injured workers' medical records, the term "subluxation" jumped out at me in a report. I had to laugh.
So who was the hysterical quack that authored that report?
A radiologist.
Sat, 2008-06-21 17:57
#7
Thank you Trevor, for pointing out some searchable sources. Gee, that only took four threads. Give the man some balloons. I must say, this information is a little more convincing than anything Wayne or any others of the anti-chiropractic camp had to say. I wonder why you didn't want to just quote from these sources right off the bat. Perhaps because they don't quite fully support your claims.
quote:
Originally posted by Trevormkidd:
Study after study shows an increased incidence of stroke (especially in extremely low risk age groups) after neck manipulations.
quote:
Originally posted by jas:
What studies are you citing here, Trevor?
quote:
"Sudden neck movement and cervical artery dissection" John W. Norris, Vadim Beletsky, Zurab G. Nadareishvili and on behalf of the Canadian Stroke ConsortiumDuring the past year the Canadian Stroke Consortium, a national network of stroke physicians, has been prospectively collecting detailed information on cases of dissection of the cervical arteries. Seventy-four patients have been studied so far: their age range was 16-87 years (mean 44 years), 60% were male, and there was a predominance of vertebrobasilar artery dissections compared with carotid artery dissections (72% v. 28%). Most (81%) of the dissections [b]were associated with sudden neck movement, ranging from therapeutic neck manipulation to a vigorous game of volleyball, but some occurred during mild exertion such as lifting a pet dog or during a bout of coughing[/b].
...
[b]Stroke resulting from neck manipulation occurred in 28% (21/74) of our cases.[jas: I admit, this sounds high][/b] Neck manipulation as a therapeutic strategy for head and neck pain is common and may be effective. In a recent literature review a chiropractic group in the United States estimated that 6% of patients with headache consulted alternative health care providers (mostly chiropractors) following the failure of conventional medical treatment.9 However, neck manipulation should probably be avoided in patients with recent acute neck pain, especially if it follows closely upon an accidental injury, because a fragile clot formed over an otherwise asymptomatic arterial tear is easily dislodged by abrupt head movement, especially rotation. Most patients undergoing therapeutic neck manipulation will have no ill effects, but there is no doubt that chiropractic neck manipulation can result in dissection of the carotid or vertebral arteries leading to stroke. Until a high-risk group can be identified, chiropractors should inform all patients of possible serious complications before neck manipulation. This is already emphasized in their current training programs.
quote:
"Chiropractic Manipulation and Stroke: A Population-Based Case-Control Study" Deanna M. Rothwell, MSc; Susan J. Bondy, PhD J. Ivan Williams, PhDConclusions—While our analysis is consistent with a positive association in young adults, potential sources of bias are also discussed. The rarity of VBAs makes this association difficult to study despite high volumes of chiropractic treatment. Because of the popularity of spinal manipulation, [b]high-quality[/b] research on both its risks and benefits is recommended.
quote:
"Safety in chiropractic practice, Part I; The occurrence of cerebrovascular accidents after manipulation to the neck in Denmark from 1978-1988." Klougart N, Leboeuf-Yde C, Rasmussen LR.MAIN RESULTS: Five cases of CVA were identified; one resulted in death and the others in permanent neurological sequelae of varying severity. One case of CVA appeared for every estimated 1.3 million cervical treatment sessions and 1 for every 0.9 million upper cervical treatment sessions. Rotation techniques were over-represented in relation to their estimated frequency of use. CONCLUSION: Although the incidence of CVA after chiropractic SMT was confirmed to be low, there seems to be sufficient evidence to justify a firm policy statement cautioning against upper cervical rotation as a technique of first choice
I don't dispute (nor did I previously, ftr) that this does occur. What I was asking for was some solid facts/stats around it, and not just some babbler's assertion, whether he's written a book on it or not. Just spit the facts.
It seems though that medical science finds many of these accidents to be not much more sinister than what occurs in standard medical practice. They caution, not condemn. The tone of this research does not match the tone we find in these threads.
[ 21 June 2008: Message edited by: jas ]
Sun, 2008-06-22 17:29
#8
quote:
You can attack those of us who actually understand science all you want. But the last person I am going to take advice from about the measure of real science is from a psychic healer.
That was pretty much a cheap shot. But it's what I expect from these folks. No, what you're not going to do is put the science out there and discuss it, because the science is pretty weak. But you can take cheap shots to demean those who don't think the way you do. Your speculation about what might happen while being a nice proposal for an experiment is nothing but speculation as is 90% of what you write. ANd your pre-judgement of the outcome is just as unscientific. Again, you make the assumption that if you could MRI before and after you would find that chiropractic adjustments cause strokes. The trouble is, that's just speculation. You also might find a that the people who have strokes after visiting a chiropractor had pre-existing conditions that were going to lead to a stroke before they went to the chiropractor. They might even find that the visit to the chiropractor didn't even speed up the process. Real advocates of science don't prejudge results. When you do have data to support your case you continually make assumptions that are not supported by the data. In other words, you're just playing games.
Until we have a person who is not anecdotally healthy but scientifically healthy, ie an MRI or ultrasound that can show a difference, we can only speculate on the relationship of stroke to neck manipulation. We know what it looks like in some people's eyes, but that's not science. And with a suspected rate of one incidence per 1 million treatments that's not likely to happen.
The fact is we don't know if chiropractic adjustments cause those 1 in a million incidents, or if there is a pre-existing condition. If all the strokes of a this nature were caused by chiropractors then you might have a case. Or if you had data suggesting that strokes after a chiropractic adjustment were more common than stroke after a visit to a neurologist, or physiotherapist or anyone else who treats people with pre-stroke symptoms, then you have a case. Citing statistics of cases compiled solely with data from chiropractors offices means there is no valid control group and are pretty much meaningless. But then as men of science, you knew that...didn't you?
I'm not really suspecting answer. I'm expecting you to call me a faith healer. That is the overall level of your contribution to date.
Tue, 2008-06-24 05:38
#9
It seem curious to me that neither Trevor nor any of the anti-chiropractic camp have anything to say about the quotes I've extracted above from sources that Trevor himself provided.
Trevor claimed that "study after study shows an increased incidence of stroke ... after neck manipulations." When I point out to him that the research that he cites doesn't actually bear this out, he apparently has nothing to say. Is scientific research only valid when it supports your outlandish claims?
Or maybe Trevor made a mistake. Maybe those weren't the sources he meant to supply. C'mon folks, you were making tons of noise last week about "quacky" theories that aren't supported by science-based evidence. What do you have to say about your own?
[ 24 June 2008: Message edited by: jas ]
Tue, 2008-06-24 09:06
#10
quote:
Originally posted by jas:
It seem curious to me that neither Trevor nor any of the anti-chiropractic camp have anything to say about
Trevor has been out of town.
quote:
Trevor claimed that "study after study shows an increased incidence of stroke ... after neck manipulations." When I point out to him that the research that he cites doesn't actually bear this out, he apparently has nothing to say. Is scientific research only valid when it supports your outlandish claims?
I disagree. The studies show that the risk of stroke post neck manipulation is still low. But the risk is still elevated. If you pointed out anything that shows that risk is not elevate then I must have missed it. Please point it out again.
quote:
Perhaps because they don't quite fully support your claims.
I disagree. The first one you quote from the Canadian Stroke Consortium. I said in the past year that 21 strokes (that they knew of) had been identified as caused by neck manipulation, they say the same. Yes they said that other dissections were caused by sudden neck movements etc, but you were not asking about that, you were asking about dissections caused by neck manipulation. Plus neck manipulation alone was responsible for 28% of the dissections which is way, way out of proportion compared to any other cause.
In your second quote you bold that high-quality research is recommended. I agree and after several trials over the years and recommendations to chiropractors to do so, and even with chiropractic journals admitting that neck manipulation is associated with a risk of stroke we still have poor quality research especially from the chiropractic side. I find that concerning.
In your third quote they advise a position of upper cervical rotation not being a first choice. Are chiropractors telling their patients that? They should be telling their patients that neck manipulation is unnecessary and useless in almost all cases that they perform it.
quote:
They caution, not condemn. The tone of this research does not match the tone we find in these threads.
Medical journals (indeed science journals) are always of such tone, they are also boring. If babble posts were always of that tone then it would be like the Simpson’s episode where Marge managed to force the makers of Itchy and Scratchy to remove the violence from their cartoons and on the first episode of a violence free Itchy and Scratchy you see all of the kids turn off their TVs and head outside to do things like paint a fence and skip etc.
[ 24 June 2008: Message edited by: Trevormkidd ]
Tue, 2008-06-24 09:14
#11
quote:
Originally posted by retiredguy:That was pretty much a cheap shot. But it's what I expect from these folks.
Perhaps you should go back and read your own posts, or at least what hasn't been removed by the moderators.
quote:
I'm expecting you to call me a faith healer. That is the overall level of your contribution to date.
I didn't call you a psychic healer - you called yourself that. I said that a psychic healer would be the last person I would listen to on the topic of science, which was actually being charitable.
Tue, 2008-06-24 15:00
#12
quote:
Originally posted by Trevormkidd:
The studies show that the risk of stroke post neck manipulation is still low. But the risk is still elevated.
Elevated compared to what? The risk from coughing? Lifting a dog? I don't understand this statement. Where does it say that the risk is still "elevated"?
Tue, 2008-06-24 15:04
#13
Compared to sitting at home and not getting [ahem] "cured".
Tue, 2008-06-24 15:12
#14
Good point, Unionist. I'm sure even stepping out to take out the garbage puts one at an "elevated" risk of CVA rather than staying inside and waiting for a cure.
And I must say, something must be amiss in the anti-chiro argument if a poster like Unionist must resort to catcalls and snidery to try to make some kind of point.
Tue, 2008-06-24 15:43
#15
quote:
Originally posted by jas:
[b]And I must say, something must be amiss in the anti-chiro argument if a poster like Unionist must resort to catcalls and snidery to try to make some kind of point.[/b]
All right, you got me. I retract the snidery. I don't belong in this thread anyway. I should learn to control myself.
Tue, 2008-06-24 15:54
#16
[img]smile.gif" border="0[/img]
Tue, 2008-06-24 18:42
#17
quote:
Originally posted by jas:Elevated compared to what?
Back manipulation. You can get the same useless treatment dreamed up by a nutbar without the risk of stroke. It will probably cost the same too. Win-win.
quote:
The risk from coughing? Lifting a dog?
Let's assume there was two of each of those events (whereas it was most likely one each, and it wouldn't be surprising if there was only one incident of each over a several year period). That is still 10 1/2 times more strokes from neck manipulations, and although I don't have statistics for either dog lifting or coughing I am pretty sure that both events occur many times more frequently than neck manipulations. However, it would not surprise me if dog lifting resulted in more strokes than cat lifting. It would also be interesting to see the age of patients in question.
quote:
I don't understand this statement. Where does it say that the risk is still "elevated"?
When chiropractic journals admit that there is a risk of stroke associated with neck manipulations that does not exist with other chiropractic procedures then they are admitting that the risk is elevated.
Fri, 2008-06-27 07:05
#18
quote:
When chiropractic journals admit that there is a risk of stroke associated with neck manipulations that does not exist with other chiropractic procedures then they are admitting that the risk is elevated.
If you could quote even one of those journals it would increase the strength of your argument.
quote:
Cervical manipulation is not the only mechanism to initiate a vertebral artery injury. The
medical literature contains numerous reports of similar arterial dissections resulting from
common medical procedures such as administering anesthesia during surgery (1-2), or
while extending the neck during dental procedures or taking X-rays (3). Cases of
vertebrobasilar accidents have been reported which apparently occurred during normal
activities such as talking on the telephone, swimming, yoga, stargazing, overhead work,
sexual intercourse, and even during sleep. “Beauty Parlor Stroke,” caused by extending
the neck over a sink while washing the hair, is also well-documented (4-5).Vertebral artery dissections can occur in all ages, although they are relatively more
common in younger people; 70% of cases occur in persons aged 35-50 years. The
female-to-male ratio is 3:1. In the US, the combined incidence of both vertebral artery
dissection and its related condition carotid artery dissection is estimated to be 2.6 per
100,000 persons. Dissections of the carotid arteries are estimated to be 3-5 times more
common than dissections of the vertebral arteries. Despite their rarity, cervical artery
dissections are responsible for as many as 20% of the ischemic strokes in younger
patients (age 30-45) (6).
And further along.
quote:
A recent biomechanical study (9) measured the forces transmitted to the vertebral artery
during vigorous cervical spine manipulation. This study found that the forces transmitted
to the artery during this procedure are less than 1/9th the force necessary to stretch or
otherwise damage a normal vertebral artery. The forces measured during a neck
manipulation were actually less than the forces measured during normal range-of-motion
movements of the neck. Based upon recent evidence, many experts now believe that it is
physically impossible for a competently performed neck adjustment to cause a vertebral
artery dissection unless the artery already has a significant pre-existing weakness.
[url=http://www.acatoday.com/pdf/chiro-risks.pdf]The above quotes came from this reference.[/url]
I would suggest maybe for the rest of the discussion, in the interest of clarity , when quoting research it might be good to quote the relevant parts an a url for the study if available. Or at least list how the study can be obtained. I might note that the references for this study should you choose to check it out include 27 other studies. Unlike the attack ads in the anti-chiro group, none of those sources are newspaper articles or opinion pieces.
But, in any case, I'm beginning to think the whole argument is coming down to acceptable risk. There is an element of society that seeks in it's wisdom to create a sterile environment in which there is no risk. I'm not saying these people are ill intentioned, although I have to say, when people like Mr.s MaPhail and Kidd start taking actions which may affect my ability to find appropriate treatment, I can get a little steamed. Personally I put myself at risk playing a number of sports. But after reading the above statements I have to ask. Are Mr.s McPhail and Kidd going to next start taking on competitive sports, prescription drugs, riding a bike, driving a car? All those thing have risks way higher than anything associated with chiropractic visits. The thing is, in the opinion of Mr.s McPhail and Kidd, in the case of chiropractic adjustment it's not worth it. And I can show documents that suggest the more expert you can become in in hang gliding or kayaking the more likely you are to have a serious accident.
But, bottom line, Mr.s Kidd and McPhail have yet to produce evidence that would suggest chiropractors should stop doing neck adjustments.
This article would seem to sum up a lot of this thread.
[url=http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/1024898605435_203078... news article[/url]
Lots of anecdotal evidence without any science to support it. Remember the fact that a person attributes their stroke to a neck manipulation doesn't make it so.
The typical assertion by neurologists, that there is risk, but they can calculate is without more research, without of course the admission that it's still possible that there is no risk.
Statements like this.
quote:
Until his stroke, Limage had been a healthy active 66-year old. His doctors say he had none of the risk factors for stroke at his age.
Yes, well my uncle had a stroke out of the blue at about the same age. No one else in the family has had a stroke. Both of his parents died at advanced age and were relatively healthy until they died. And if he'd been a patient of a chiropractor we might be hearing his name brought up in these discussions as someone who had his life ruined. Unfortunately everyone dies, peoples lives seem to be randomly ruined all the time. That's why it's o necessary to have a proper study with a control group done. And why you can't assign risk without a control group.
At the end of the article, as is typical in the popular press regardless of the issue you have the story of someone who's life was altered, forever. Very sympathetic. But, these things happen. When you have a murder trial reversed after a second trial, often the victims families never let go of the idea that the first person convicted is somehow still guilty. There are now rape victims that ID'd innocent people who have now been cleared of DNA who still swear they ID'd the right person, even though a similar looking person with a DNA match has been convicted. Articles like this try to use sympathy for the stroke victim to try and back up their largely unsubstantiated claims of blame. The trouble is, it's not science.
Here is the crux of the issue.
quote:
"Most patients who go for headaches have to ask if it helps their headache is it worth the risk of being disabled or even killed even if it's one in 100,000."But the chiropractors challenge the scientific validity of the stroke consortium's data.
"We are on very solid scientific ground for what we are telling patients," says Gorchynski.
The first point made it the old "even if the risk is 1/100,000" is it worth it. DO you ask the same question when you get in your car? Or walk to the corner grocery store? SHould you have to sign a waiver before you step oout the door? Of before getting on your bike. How about the other causes listed of
The second is the ongoing scientific debate. Numerous articles such as the one above have been written that have prejudged the science.
ANyway for a last word, and I'm doing this as a last word because as far as I can tell this is the best methodlogy, with the least relience on anecdotal evidence. Notice that the determination of health is made by looking a Ohip records for a year before the stoke. Not by someone hoping for financial gain saying "the rotten bastard ruined my life".
Check out
Cassidy et al. Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-Based Case-Control and Case-Crossover Study. Spine. 2008 Feb 15;33(4S), S176-S183.
quote:
The study included patients that had incident vertebrobasilar artery stroke and were admitted to Ontario hospitals between 1993 and 2002. Each case included four controls that were age and gender matched. Health billing records the year prior to the stroke date were used to determine case and control visits to chiropractors and primary care physicians....
Although the risk of a vertebrobasilar artery dissection occurring after a chiropractic neck adjustment is small, it does happen. However, based upon these data, the risk of it happening is not any greater than after a primary care physician visit.
[url=http://www.highlighthealth.com/health-news/chiropractic-adjustments-and-... Study of Stroke Victims with regard to Chiropratic visits.[/url]
I'm sure this won' be the last word. But until someone comes up with some better research, it probably should be.
Fri, 2008-06-27 09:31
#19
quote:
Originally posted by retiredguy:
If you could quote even one of those journals it would increase the strength of your argument.
I did. Seeing as you continually miss those things the assistance that you require is beyond what I or anyone else here can provide.
Fri, 2008-06-27 12:16
#20
quote:
I did. Seeing as you continually miss those things the assistance that you require is beyond what I or anyone else here can provide.
I'm guessing that's because they don't exist. How many bogus studies am I supposed to read and discredit before you realize you don't have the evidence to say what you are saying.
What I need is a double blind trial or a study with controllthat proves your point. You haven't provided one. The study I provided in my last post was
a) done in Ontario.
b) "The study included patients that had incident vertebrobasilar artery stroke and were admitted to Ontario hospitals between 1993 and 2002. Each case included four controls that were age and gender matched. Health billing records the year prior to the stroke date were used to determine case and control visits to chiropractors and primary care physicians."
Do you have something as good? Every quote you provided looked at the risk of a stroke after a chiropractic adjustment, without regards to the risks of people with similar symptoms who do nothing at all. Which part of "you have to have a valid control group to have a good study" is it you find hardest to comprehend. Nothing you quoted above even addresses the idea of a control group. And the fact that even some chiropractors may have been taken in by the unscientific data, doesn't make it any more right. It's still anecdotal. Anyway, I'm interested in seeing if you can even critique the above study. ( Cassidy et al. Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-Based Case-Control and Case-Crossover Study. Spine. 2008 Feb 15;33(4S), S176-S183.) Is there a real scientist over there or have you just been blowing smoke?
Fri, 2008-06-27 18:17
#21
quote:
Originally posted by retiredguy:
The study I provided in my last post was
completely meaningless.
quote:
Do you have something as good?
Something as good as that piece of crap study? Just about anything would be better. Now I realize that you uncritically believe the study you provided to be the cat's ass. But, it is ridiculous and here is why. Let's say a stoke victime visited her GP 10 months before the stroke and lets say that she had said stroke within hours of leaving her chiroprator after he manipulated her neck, causing injury and leading to the stroke. Who would this study assign blame to in this case? Both. This is relevant considering that Laurie Mathiason had seen her doctor within a year of her stroke, but it was the chiropractic neck manipulation that caused her stroke and death - the stroke started right in the chiropractor's office (she came in because of a sore tail bone - nothing to do with her neck). Sandy Nette would likely be treated the exact same by the study. Again her stroke symptoms started before she left the chiropractors office, but if she had seen her doctor within the past year then they would both share the blame from this study.
That is embarrassing, especially considering the percentage of people who see their family doctor once a year. This study was specifically designed to shift the blame off chiropractors and onto family doctors as most people see their doctor once a year. If the study looked into stroke victims with chiropractic and/or GP visits within the past month it would be potentially worth considering - this study isn't. If the study looked into patient charts or tests they received it would be potentially worth considering - this study isn't.
quote:
And the fact that even some chiropractors may have been taken in by the unscientific data, doesn't make it any more right. It's still anecdotal.
Again, as I said earlier you have a grade six view of science. If something is not confirmed with double-blinded studies it can still be science. Some double-blind studies are complete crap, full of bias (as I would argue Cassidy's is especially considering his history) and therefore not science. The scientific method is about collecting data through observation and experimentation. Have I said that the current data available in regards to chiropractic care is great? No, I have made it pretty clear that the data is shit - and I place the blame for that where it belongs - on the chiropractic field.
As you believe that double-blind studies must prove that chiropractic neck manipulation is leading to strokes, then I will have to assume that at the same time you are fighting to ensure that all complementary and alternative medicines provide proof of the effectiveness of their claims in double-blind studies before they are allowed to practice on the unsuspecting public. If that was the case then would be almost no CAM legally practicing in this country.
quote:
How many bogus studies am I supposed to read and discredit before you realize you don't have the evidence to say what you are saying.
The Canadian Stroke Consortium said that in 1999 21 strokes that they new of were caused by neck manipulation, and as I have said above even the chiropractic journals admit that although rare strokes are a complication of neck adjustments. They understand, neurologists understand, anyone with common sense or an understanding of human anatomy understands.
[ 27 June 2008: Message edited by: Trevormkidd ]
Fri, 2008-06-27 19:10
#22
Actually, I was hoping you would comment on the data presented in the study. Not resort to name calling etc. but hey.
You objections to the study are noted, but not understood. Are you saying that the study didn't find any stroke victims that had strokes in emergency, or in a dentist office or in a doctors office? Or that anyone has even looked for that. That seems to be your drift. That strokes only occur in chiroprators offices, and not in other peoples offices. Do you have any documentation to back that up?
Again, you are relying on anecdotal evidence. If I want to prove that seat belts save lives, I can do that. If I want to prove that seat belts cause loss of life, I can do that too. There are lots of incidences where people have died because they got trapped in a vehicle by their seat belts. Our legislation is based not on the fact that seat belts are good for everyone. It's that overall, they increase your chances of survival.
SInce you continue to bring up Sandy Nette as if she were a case in point. First, she says she was in perfect health. But that is an assumption after the fact. She could have done all the damage before she went to the chiropractor. She could have possibly had her stroke on the way in the door. It may be just a matter of coincidence that she had her stroke at the chiropractors. No one knows what condition she was in when she went in to that office. She could be a total scam artist out to bilk chiropractors with the help of a lawyer looking for a big payday. You know of course that if she gets her half billion, her lawyer will probably get over 15% of that. That's got to be worth a gamble. Scientifically, we don't know. You think you know, but where is the science?
Now if you go back to the seat belt thing. The stats are pretty clear both ways. You win some, you lose some, but you win more than you lose. Until there is some evidence on neck manipulation that goes beyond anecdotal evidence we don't know if we're winning or losing with the chiropractic thing. Some people could die, but we could still be coming out ahead. Those are the kinds of questions people should be asking.
And as for your thing about observation being part of science, yes, under controlled settings. However making up data after the fact to fit the supposed crime is not observation. That Sandy Nette was completely healthy before she went into the chiropractors is an assumption, not an observation. For it to be an observation we'd need some science, an MRI before and after or something.
Actually I believe that all medicines and procedures have a possibility of doing harm. And I believe that it's up to the individual take responsibility for what they allow themselves to get involved in. If nothing chiropractors did causes some harm, I'd be very surprised. That isn't the issue. The tylenol and ibuprofen I take do harm, as does the codeine I take for my migraines. Everything is a trade off. In your zest to attack chiropractors you seem to be forgetting that. As for people getting neck adjustments and hoping there is absolutely no risk, are we going to start giving people monetary awards because no one told them there wasn't a tooth fairy too? I'd suggest that before you go after chiropractors you go after cosmetic surgeons, fad diet guru's, cosmetologists, perfume manufacturers, the whole food additive industry, the pesticide industry and a host of others who make products that do harm with less benevolent intentions than chiropractors. In Toronto the CMA estimates that 2000 people are year die from the effects of air pollution, and your crying about 21 suspected, not proven but suspected, deaths from chiropractors over more than 10 years.
OK, your turn. Tell me again about my grade 6 science education. That was good. I laughed, my wife laughed, it's party time around here.
Fri, 2008-06-27 20:19
#23
quote:
Originally posted by retiredguy:You objections to the study are noted, but not understood. Are you saying that the study didn't find any stroke victims that had strokes in emergency, or in a dentist office or in a doctors office?
Um no. That was the whole point. The study did not take into account where a stroke occured or what caused it. That is why I said that if the study only looked at for instance the previous month before a stroke instead of the previous year then the data might be worth the paper it was written on. Instead what we have is a study that can say this patient had a stroke directly after spinal manipulation from a chiropractor, but the patient saw a doctor 11 months before for a routine checkup, so equal blame. That is completely ridiculous. The study you posted is beyond worthless.
quote:
If I want to prove that seat belts save lives, I can do that.
Congratulations.
quote:
SInce you continue to bring up Sandy Nette as if she were a case in point.
How dare I bring up the person for whom these four threads is about.
quote:
First, she says she was in perfect health. But that is an assumption after the fact. She could have done all the damage before she went to the chiropractor.
Good point. Let's dismiss her condition based on the fact that she could have damaged herself before hand. She is probably just a liar and faking this whole thing for the sweet payout....
quote:
She could be a total scam artist out to bilk chiropractors with the help of a lawyer looking for a big payday.
Completely pathetic.
quote:
You know of course that if she gets her half billion, her lawyer will probably get over 15% of that.
So fucking what.
quote:
Scientifically, we don't know. You think you know, but where is the science?
Hence why I support this trial.
quote:
Now if you go back to the seat belt thing.
Don't care.
quote:
That Sandy Nette was completely healthy before she went into the chiropractors is an assumption, not an observation. For it to be an observation we'd need some science, an MRI before and after or something.
Baloney. If the damage that she has to her neck is consistent with the damage caused to other patients by chiropractors then it might not be "proof" but it will have to be evaluated as to whether or not the evidence is strong and consistent. The judge might require additional information than can be provided at the moment, he might not. They might decide to run tests with MRIs before and after neck manipulation to see if there is ever damage, they might not.
quote:
Actually I believe that all medicines and procedures have a possibility of doing harm. And I believe that it's up to the individual take responsibility for what they allow themselves to get involved in.
I believe in informed consent and I don't think that the chiropractic field has been interested in finding out if their treatments may be harmful and to what degree, or in passing that information fully to their patients to make informed decisions. Without that the individual can not take responsibility for their own treatment.
quote:
If nothing chiropractors did causes some harm, I'd be very surprised. That isn't the issue. The tylenol and ibuprofen I take do harm, as does the codeine I take for my migraines. Everything is a trade off.
Again those drugs have studies available indicating the potential adverse effects, therefore you can make an informed decision. Chiropractic lacks those studies despite being an industry that has made billions.
quote:
I'd suggest that before you go after chiropractors you go after
Thanks for the suggestion.
quote:
and your crying about 21 suspected, not proven but suspected, deaths from chiropractors over more than 10 years.
It was 21 in a single year. You might dismiss them, but I value you the Canadian Stroke Consortium's view more than yours.
quote:
OK, your turn. Tell me again about my grade 6 science education. That was good. I laughed, my wife laughed, it's party time around here.
"Again, as I said earlier you have a grade six view of science."
[ 27 June 2008: Message edited by: Trevormkidd ]
Sat, 2008-06-28 09:18
#24
You're a sick man Trever the Kidd.
quote:
Um no. That was the whole point. The study did not take into account where a stroke occured or what caused it. That is why I said that if the study only looked at for instance the previous month before a stroke instead of the previous year then the data might be worth the paper it was written on. Instead what we have is a study that can say this patient had a stroke directly after spinal manipulation from a chiropractor, but the patient saw a doctor 11 months before for a routine checkup, so equal blame. That is completely ridiculous. The study you posted is beyond worthless.
And there is good reason for that. The fact that people assign blame after the fact does not mean they are correct. The only thing looked at was the number of stokes. As for the implication you have that there is one type of stroke that is only caused by chiropractors, that is also incorrect. There is one type of stroke for which 28% have been to see a chiropractor. Even in that type of stroke 72% of the victims have never even been to see a chiropractor. What you are in essence asking for is a biased study with no control. Far from believing in science, it is likely you don't actually understand enough about science to design a proper study or interpret the results. The above quoted paragraph is a clear evidence of that. As well, the fact that physicians and chiropractors have the same stroke rate over a long period of time would also suggest that if chiropractors are doing harm, what good they do is enough to compensate for it. Now whether a break even is acceptable is another question, one that could be legitimately explored. You hope that there would be lower stroke rates after primary health treatment, so don't get me wrong, I'm not saying chiropractors should be shouting from the rooftops about these results. But, news flash, neurologists are just as bad. If we are going to level these kinds of complaints against chiropractors we need to be doing the same thing to neurologists and primary care physicians, because their success rates are identical over a year with the same medical histories. In case you didn't notice neurologists and primary health care physicians make billions every year and thus are just as suspect as chiropractors in your warped view of the universe. However, the fact is, we put up with both of them, because they're the best we have at the moment. More stroke work needs to be done by both groups, not just chiropractors. This thread can be interpreted as much as a turf war between medical practitioners, who are sued on a regular basis and quite often are subject to huge payouts. You want to ascribe all kinds of issues to this trial. Yet you let the medical community completely off the hook. Talk about lack of accountability. Physicians don't even have to tell you how many malpractice suits they have had filed against them or what they were filed for. And the CMA covers for them. You have a lot fo nerve coming on here singling out Chiropractors and the Chiropractic association. Fact is, what the Chiropractic Association is doing is accepted practice in the medical community in Canada.
quote:
How dare I bring up the person for whom these four threads is about.
Bring her up as much as you want. But please, start realizing the limitations of your arguments as based on her case.
quote:
Good point. Let's dismiss her condition based on the fact that she could have damaged herself before hand. She is probably just a liar and faking this whole thing for the sweet payout....
Again your words not mine. There is no doubt she's paralyzed. That's not at issue, and I never said that, if you could read, you wouldn't say such inhumane things. But.... she doesn't know what caused her stroke. She's not a medical diagnostician. She could actually believe her chirotpractor did something wrong , but that doesn't make it true. Again , you use science when you find it convenient, but hearsay the rest of the time.
quote:
So fucking what.
Way to go potty mouth. We're starting to see the real you.
I thought it was obvious, if this legal firm can win a 500 million judgement, they will get 75 million for a couple of years work, not bad work if you can get it. Given the precedents set in previous cases their odds of success are low, but given the payout they are asking for, they clearly think it's worth the gamble. But really these guys are the equivalent of ambulance chasers. Hand out your card to anyone who might have a case. Try and raise a public outcry supporting your position. Hope to hoodwink the jury into a large payout based on the kind of science you're quoting here. Walk away with a huge payday. These guys aren't working pro-bono. In your naivety you try to pretend that chiropractors are evil and these lawyers are saints. I hope your getting paid for the propaganda your spreading, because you're helping these guys, and they plan to make a mint.
quote:
Baloney. If the damage that she has to her neck is consistent with the damage caused to other patients by chiropractors then it might not be "proof" but it will have to be evaluated as to whether or not the evidence is strong and consistent. The judge might require additional information than can be provided at the moment, he might not. They might decide to run tests with MRIs before and after neck manipulation to see if there is ever damage, they might not.
You don't mean caused, you mean observed after the fact. The same type of damage has been noticed after trips to the dentist, trips to the hair salon, sex, and all kinds of other places. There is no stroke that is exclusive to chiropractors. If there was, we wouldn't even behaving this conversation. The fact is your whole argument is dependent on an unproved premise.
quote:
Hence why I support this trial.
No you support this trial because you have prejudged the verdict and you are hoping a jury will do what science has not, condemn chiropractors. You are actually hoping the trial will impose an injustice. You're hoping for a "Donald marshall" verdict. Did a chiropractor insult you in front of your girl friend? What?
quote:
I believe in informed consent and I don't think that the chiropractic field has been interested in finding out if their treatments may be harmful and to what degree, or in passing that information fully to their patients to make informed decisions. Without that the individual can not take responsibility for their own treatment.
Really, no one cares about your defamatory statements towards chiropractors. When I went for my arthroscopic knees surgery, no informed me of the success rate of the operation, the complication rate from the anesthetic, the rate of secondary infection in the hospital I was in. If you want to go after informed consent, why are you focusing on chiropractors? No, the evidence would suggest that yours is a personal vendetta against the chiropractic profession that goes way beyond what's healthy given the lack of certainty around the evidence. As for you knowledge of what chiropractors have done and haven't done, I'm not putting a lot of weight on that either.
quote:
It was 21 in a single year. You might dismiss them, but I value you the Canadian Stroke Consortium's view more than yours.
Wow, what a revelation. Unfortunately, if they're biased, that would make you biased. Let me guess, the report of the canadian Stroke Consorium was based on anecdotal evidence. Basicly speculation after the fact. "We are the experts, give all your money to us and stop giving it to those crazy chiropractors." And you can't see anything wrong with that? Does this sound anything like "Chevy Malibu, better mileage than Ford or Chrysler". Dude, you've been seriously duped.
Sat, 2008-06-28 18:24
#25
quote:
Originally posted by retiredguy:As for the implication you have that there is one type of stroke that is only caused by chiropractors, that is also incorrect.
I said no such thing. Actually no one here has said that. You continue make things up.
quote:
Even in that type of stroke 72% of the victims have never even been to see a chiropractor.
So what. 99% of heart attack victims have never been on Vioxx. I guess that means that Vioxx could not have been the cause for anyone’s heart attack.
quote:
As well, the fact that physicians and chiropractors have the same stroke rate over a long period of time would also suggest that if chiropractors are doing harm, what good they do is enough to compensate for it.
Good to see that one study establishes that “fact.” You must believe in homeopathy too because I am sure that you can find a study which verifies the “fact” that it can cure everything.
I realize that this is pointless as I am not dealing with a rational person. However, the author of the study designed this study to achieve the results he wanted to achieve. That is beyond obvious to almost everyone except you. How do I know that those were the results that he wanted to achieve? Because of what he has said as a witness at Laurie Mathison’s trial. We have several known cases of people having severe strokes either while in the chiropractors office or within hours of leaving. These strokes are all the same type of stroke. The damage to their arteries is consistent with what would be expected from neck manipulation. There is a big difference between someone having that type within hours of chiropractic neck manipulation and someone having such a stroke 10 months after having seen their doctor. But not according to this study – when it comes across someone who saw their doctor a year before and has a stroke on the drive home after having their neck manipulated it says they are both equally responsible. So I wonder how Diane Rodrigue is classified in this study. She had a stroke in the office of her chiropractor in 1994. If she saw her doctor within the previous year then this study blames both equally. The same goes for Lana Dale Lewis who would also be covered in study you posted. Like I said, we have several incidences of this type of stroke happening at the chiropractors office or within hours of departing. Can you site any incidences of this type of stroke occurring at a GPs office or on the drive home? The study is a piece of crap because of the way it was designed and the bias of the author.
quote:
In case you didn't notice neurologists and primary health care physicians make billions every year and thus are just as suspect as chiropractors in your warped view of the universe.
In case you didn’t notice, neurologists and primary health care physicians have studies to back up their work and procedures, chiropractors have never bothered despite the industry making billions. Why?
quote:
Yet you let the medical community completely off the hook.
My history on this forum shows that I do no such thing.
quote:
But really these guys are the equivalent of ambulance chasers. Hand out your card to anyone who might have a case. Try and raise a public outcry supporting your position. Hope to hoodwink the jury into a large payout
Any evidence that the law firm or firms in question have a history of this “ambulance chasing”, or are you as usual just talking out your ass? You have continually attacked the victim and the law firm(s) calling both unethical money chasers. How about you provide something to back up your attacks pertaining to Nette’s character or to the law firm(s) in question.
quote:
In your naivety you try to pretend that chiropractors are evil and these lawyers are saints.
Again, you just make things up. In no post among these threads have I said anything at all about the lawyers. However you have on several occasions as you are just trying to shift the blame away from chiropractors. If you want to sue lawyers for 500 million dollars then be my guest. But this thread is not about them, it is about chiropractors and people who have suffered strokes after neck manipulation. It is a legal case and thereby requires lawyers – get over it.
quote:
I hope your getting paid for the propaganda your spreading, because you're helping these guys, and they plan to make a mint.
If there is anyone on this board who is working for one side or the other I put my money on it being the person who said this:
“I'll be happy to pass the info on to the Chiropractic Association so they can sue him (referring to Wayne MacPhail).” Who could it have been who said that? It was you! Are you working for the chiropractic industry? Getting paid for trying to intimidate and threaten people into being quiet? I wish you the best of luck. However, if you can not be honest and continue to make things up do not expect me to reply.
[ 28 June 2008: Message edited by: Trevormkidd ]
Sun, 2008-06-29 06:05
#26
Well I have to admit Trevor, I'm retired, but you have more time for this than I do. I'm not conceding even one of the points you made above, either your name calling, putting words in my mouth or any of the rest of it. But, I've made my point, and I have nothing more to add. If people have read what they previously wrote, they'll se how to poke the holes in your position, if they choose to do so, and if people have read yours, they'll se how to poke holes in mine, so maybe it's time to pack it in.
As in any discussion with science this nebulous, the debate always goes like this. Discredit the other guys studies, call the other guy names as civilly as possible, express frustration at his unreasonable nature. Extol your own logic, ridicule the other guy's. I think our work is done here. Good luck in your next endeavor.
Sun, 2008-06-29 07:18
#27
Trevor said:
quote:
Originally posted by Trevormkidd:
Study after study shows an increased incidence of stroke (especially in extremely low risk age groups) after neck manipulations.
I asked Trevor which studies showed this. He provided 4 sources. I quoted (above) from those sources, only [i]one[/i] of them actually citing a figure, based on a single year of study. I pointed out that, in fact, "study after study" does NOT show an increased incidence of stroke after neck manipulation, then Trevor changes his wording from
"increased incidence" to "elevated risk". Bit of a difference in meaning there.
quote:
Originally posted by Trevormkidd:
I disagree. The studies show that the risk of stroke post neck manipulation is still low. But the risk is still elevated. If you pointed out anything that shows that risk is not elevate then I must have missed it. Please point it out again.
Just thought I'd point out this slight little leap in logic, as Trevor seems to want to be acknowledged as the only rational voice in this argument.
Sat, 2008-07-12 21:14
#28
I apologise for not reading the thread completely before posting - but the subject matter is too painful.
I just want to say:
My grandfather left a chiropractor appointment and 1/2 hour later, while attempting to drive home, had a stroke. He ended up in the wrong lane of the TransCanada Highway, and had a head on collision. No one was seriously injured in the accident, amazingly.
When admitted to the hospital, no one thought to mention, nor did anyone ask, if he had recently had his neck manipulated.
So, here is a possible unreported case - as I am sure there are many. It was not until the lawsuit made the news that family began to wonder.
No, we aren't joining the lawsuit - all our energy is going to care for Grandpa. I am trying hard not to find someone/something to blame, as that will only produce anger - which is unproductive.
But I will NEVER to to a chiropractor again, and I will tell people who mention going what I think 'may' have caused Grandpa's stroke.
It may have been a coincidence, but it may not have been.
Wed, 2012-11-14 22:40
#29
Sandra Nette's lawsuit has been settled for an undisclosed sum - a sum that has helped pay for her rehabilitation, equipment and care.
And it looks like the quack who paralyzed her also forged her signature on a consent form after the fact - gosh, what a surprise!