A case study: mine
I think I'm objective and rational when describing the causes of obesity, diabetes, and heart disease. I lose some of my objectivity, however, when the subject of treatments comes up.
My giant HMO
I'm a retired civil servant and I have to rely on a giant health maintenance organization (HMO) for my health care. I'm not happy with the care I get.
I'm obese and prediabetic. I had a heart attack in 1998. I have persistent atrial fibrillations, congestive heart failure, and chronic obstructive pulmonary disease. I've been hospitalized with pneumonia several times. I'm convinced that all of my health problems can be traced back to a Chlamydophila pneumoniae (CPN) infection.
A few months after my heart attack, I talked doctor X at my HMO into testing me for CPN. To his surprise, my giant HMO did not have the facilities to test for CPN infections. Doctor X sent a blood sample to an outside laboratory, and the results came back positive. He prescribed a 30-day course of clarithromycin.
The results were stunning! I was nearly sixty, but I felt like I was twenty for a couple of months. Then my symptoms began to return. Clarithromycin, it turns out, can knock a CPN infection down for a while, but it cannot eradicate a CPN infection. Four months after my clarithromycin treatment ended, I was just as sick as I had been before.
Doctor X was reprimanded by the managers of my giant HMO testing and treating me for CPN. Then he retired. No one else takes my Chlamydophila pneumoniae theory very seriously, though I did talk a couple of doctors into prescribing long-term courses of antibiotics. They too were criticized by the managers of my giant HMO. One of them quit, and the other one only works there part time.
I've been trying in vain for ten years to get my giant HMO to implement one of the anti-CPN protocols described at www.cpnhelp.org. My giant HMO still does not have the facilities to test patients for CPN, and management doesn't see any need for such tests.
Why are the managers and doctors at my giant HMO so pig-headed? Here are few reasons:
- The managers and most of the doctors adhere to the lifestyle model of disease. The lifestyle model says that obesity, diabetes, and heart disease are caused by the gluttony and sloth of the patients.
- The managers believe I'm killing myself by obstinately eating too much, by eating the wrong things, and by refusing to get enough exercise.
- The lifestyle model comforts the managers of my giant HMO because it absolves them of blame when patients die from diabetes or heart disease.
- Doctors who question the lifestyle model enough to prescribe treatments for CPN are punished by management, somewhat as Dr. Semmelweis was punished for suggesting that physicians should wash their hands before delivering babies.
- Even if a doctor believes that chronic, low-level infections cause obesity, diabetes, and heart disease, there are no easy, safe, effective, and proven treatments for him or her to prescribe.
The last bullet point requires some elaboration. The Vanderbilt and Wheldon protocols described at www.cpnhelp.org are not easy, but they appear to be reasonably safe and effective. There is, however, no proof yet that they are either safe or effective.
I was never tested for CPN again after Dr. X had me tested in 1999. My health has declined steadily for nearly ten years. I've been to the emergency room so many times I've lost count, and I've been hospitalized repeatedly. During those years, my giant HMO has wasted tens of thousands of dollars treating my symptoms, and it has wasted millions of dollars on other patients. God only knows how many of those patients died years before they really needed to.