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Friday, December 11, 2009

It seems bronchodilator fallacies trump scientific facts

So why do we have science if nobody is going to use it? Why do we have truth when it's easier to believe a fallacy? Why? Why? Why?

Am I the only one to ask questions like this? I doubt it, although I don't think there are many of us.

I have two examples to what I'm questioning here: global warming and bronchodilator usage.

We've been studying weather patters for over 100 years not. If you put that into consideration, that's 100 years in something like 100+ billion years. If you do the math, I bet that's a shorter amount of time that 0.00000000000001% of our history. Yet, based on the numbers we have accumulated, people have come to a conclusion.

I find this funny, because most scientists (as you can see by this post) are still questioning the science. Not even scientists can come to a logical conclusion regarding global warming. Yet you have a majority of politicians willing change our economic landscape based on this theory, and a majority of the world population willing to buy into it.

To be honest here, I am neither a believer nor a disbeliever in the theory of global warming. I think it's best to let science decide. It's best to look at the trends which show constant periods of warming, followed by periods of cooling, and so forth.

Yet some people fail to look at this big picture, and they make political opinions based on the current trend. For example, in the 1970s the trend was toward global cooling, and you had scientists actually proposing melting the polar ice caps to warm the planet. Aren't we glad that never happened?

From the late 1970s to about 1998 the trend trended upward, and you had the global warming scare which is ongoning, despite stagnant global temps since 2000.

You have people like the honorable Al Gore claiming that if we don't clean up our planet it won't exist in 10 years. To me, this is a scare to get people to send more money his way. It's all about money. It's all about selling a political view over science.

Personally, I think it's a good idea to be environmentally conscious. I think it's a good idea to reduce, reuse and recycle. I think it's a good idea to look for alternative energy sources. Yet let's not get drastic and force one view based on a theory.

The same can be said of bronchodilators like Ventolin. You have doctors and nurses believing that Ventolin is needed every time they hear a wheeze or see a short of breath patient. Yet the science proves otherwise.

Still, when you go to correct a nurse or a doctor, when you share the facts and the science about bronchodilators, they say that I am being lazy. A great example of this occurred last night when I was called to do a breathing treatment for a person who was dyspneic due to pneumonia.

I approached the nurse and said, "You know Ventolin does nothing for pneumonia."

She said, "Yes it does. It opens the airways and helps the patient cough up the pneumonia."

"That's a fallacy," I said. "Science has proven that Ventolin is a bronchodilator you are right. But pneumonia does not cause bronchoconstriction, so the air passages in that person's lungs are already dilated. Thus, a bronchodilator will not expand these air passages beyond what they already are. In fact, there is no need to because pneumonia is not in the bronchioles. There are no secretions trapped in the bronchioles."

"Where did you hear that from?" the nurse said angrily.

"Not only that," I said, continuing on with the facts I've learned through my many years of research, "Pneumonia is a disease of inflammation of the alveoli. Bronchodilators don't treat inflammation, that's the job of corticosteroids and perhaps even antibiotics to kill the bacteria down there if it's bacterial, which it usually is.

"Likewise, I added," her face was red as a beat by now, "Ventolin is 0.5 microns, just the perfect size to fit into the air passages to get to the beta one receptors there. The Alveoli are 0.1-0.2 microns wide, so Ventolin doesn't even get down there.

"And to top that off," I said patting the side of the nurses station in my confident rage, "I don't even believe there are beta adrenergic receptors in the alveioli."

"You're just trying to get out of work," she said. She smiled. She's a great person, although she needed the education regardless that it was going to sink in or not.

By this time Dr. Q1 is standing right next to her, and she interjected: "Jill is right. Ventolin relaxes the bronchioles so the patient can cough up that junk."

My point by relaying this conversation is this: why is it that we folks with the facts on our side always have to be on the defense? Why do we have to prove that we are right? Now, I'm not perfect, but I think I have my bronchodilator wisdom down pretty well. I have actually studied it. I've read books. I read every magazine article I can on the topic.

In fact, I even read the package insert once, which states, "This medicine is for asthma and COPD to treat bronchospasm." So, what is bronchospasm? Bronchospasm is the spasming of muscles. Ahem, there are no muscles in the alveioli to spasm.

I know! I know why people like you and me who have the facts on our side have to defend ourselves. I know why we are always on the defense. It's because it's easier to be ignorant. It's easier to believe in fallacies that make us feel good about ourselves, than to think. It actually makes those RNs and DRs feel good about themselves to order a a breathing treatment because it makes them feel they are doing something good for the patient. It's easier to believe in hoax theories and bronchodilator fallacies than to think.

Yet I'm being lazy. All us RTs are being lazy when we question why a bronchodilator is being ordered. We are lazy because we think we RTs with science on our side, two years of studying bronchodilators at school, and 14 years experience should decide who gets breathing treatments and not some a doctor or nurse and their fake science.

It's the same way with the crowd of people that aren't so quick to believe in global warming. They are lazy and refuse to believe in science. Yet they are the ones who look at the same science and see that the facts show inconclusive results. We must not be to quick to judge, and be more open minded to the facts at hand. We must not be sheep caught up in a movement.

Ladies and gentlemen, this is why it's frustrating to be a thinker. This is why it is frustrating to be a person who always reads to learn the facts. This is why there is so much apathy by RTs because we know the facts and yet no one will listen. They choose to believe the fallacies because it's easier to be ignorant than it is to pick up a book or magazine and read.


Anonymous said...

It is hard not to expect doctors to use bronchodilators for pneumonia when articles like these are so easy to obtain.

iVillage is a respected resource for parents.

Then this study for antibiotic use for pneumonia suggested that more bronchodilator use may be needed especially in patients that have a prior history of bronchodilator use. I know that I don't have a medical background and probably don't truly understand this study, but how do we fight against this type of information?

I do agree with you about the bronchodilator fallacies, but there is a lot of literature that sure confuses the rest of us non-medical folks.


Rick Frea said...

Thank you so much for the links. I really appreciate it. So far I only checked out the one above, and it is chock full of lies. There's no other way to explain it. Ventolin does nothing for pneumonia, and it does not thin secretions. I had never heard that facetious claim before.

Yet, you are right, this might the pneumonia for everyone routine. It's based on a bunch of lies.