Acupuncture for a medical question? January 9, 2011 7:16 PM   Subscribe

Medical question gets placebo answer.

In this comment, an answer to an AxeMe question recommends acupuncture for fibroids. There's a fine line here, and I am probably whacking the hornet's nest, but I think the site would be much better served by avoiding recommendations for unproven (impossible?) cures for genuine physical problems. I haven't seen this discussed before in searching.

(NB-- I really don't have a particular problem with acupuncture for psychological problems, as I understand it has a very powerful placebo/focusing effect; a question asking for smoking cessation advice could very well have a legitimate acupuncture recommendation. But acupuncture for tumors? This seems way over the line.)
posted by norm to Etiquette/Policy at 7:16 PM (90 comments total) 8 users marked this as a favorite

People are more than welcome to question the efficacy of acupuncture in the thread, though we'd appreciate it if they could do it without calling other people names. Something short and to the post as you just write "I really don't have a particular problem with acupuncture for psychological problems, as I understand it has a very powerful placebo/focusing effect. But acupuncture for tumors?"

The trick is to basically give your suggestion and step away and don't stick around to fight with people about it. There's not really a useful way for us as mods to delete "incorrect" information from AskMe without basically reading and approving every comment which is just a flat out non-starter. People should feel free to add better information if they think what's there isn't helpful.
posted by jessamyn (staff) at 7:21 PM on January 9, 2011 [2 favorites]


I really think this is something you should bring up (politely) in-thread. You think it's a bad answer: say so and explain why. I'm not sure what you expect to result from this MeTa.
posted by hattifattener at 7:21 PM on January 9, 2011


Hm, I don't see a comment in the thread from you saying "Acupuncture won't work because of XYZ, you should try ABC instead."

I think that is the best route to go, if you can't FIAMO.
posted by desjardins at 7:22 PM on January 9, 2011


Hm, I don't see a comment in the thread from you saying "Acupuncture won't work because of XYZ, you should try ABC instead."

I think that is the best route to go, if you can't FIAMO.


FIAMO is fine if there is an obvious consensus against the behavior being spoken of, but there isn't one, and my posting of this thread is an attempt to develop such a consensus. Also, the Ask-er specifically asked for the experience of other women with fibroids, and I do not qualify.

Ask isn't the appropriate forum for debating the efficacy of competing answers, as I understand it. MeTa is a much better place to do so; I am fully comfortable with the community discussing the question here and won't feel bad about asking to do so.
posted by norm at 7:27 PM on January 9, 2011 [2 favorites]


Ask isn't the appropriate forum for debating the efficacy of competing answers, as I understand it.

I don't know jack shit about fibroids or the efficacy of acupuncture, but if you believe that the advice someone gives is objectively wrong, it is perfectly reasonable of you to say so in-thread. If someone wanted to know how to fix their laptop and someone replied "just smack it against the side a few times like the Fonz," I'm pretty sure replying "that will do nothing at best" is completely warranted.
posted by griphus at 7:40 PM on January 9, 2011 [19 favorites]


I get what you are saying and agree with you. I'm not a big fan of alternative medicine and was surprised to see this one suggested in that thread. But on the other hand, I'm not sure where the line would be drawn. I see treatment suggestions here fairly regularly that make me roll my eyes but I understand that I'm a pretty pro-conventional medicine person. So I keep the criticism to myself and assume that the poster is going to have to be responsible about the comments they choose to heed and those they discard, and that everyone wouldn't necessarily agree with my assessment of those suggestions. Since all of these comments are prefaced by the idea (explicitly or implicitly) that "IANAD," the OP has to make judgment calls. I'm not sure where the community would draw the line in coming up with a consensus-people like me who are pro-intervention, pro-hospital, pro-traditional medicine would draw it in a very different place than those who are in favor of less traditional approaches.

I appreciate that you didn't want to jump into the thread just to fight with another answerer when you had no answer really, even though you thought that commenter was flat wrong. It's a tough spot to be in. But I'm not sure that a consensus is possible.
posted by supercapitalist at 7:43 PM on January 9, 2011


I did as suggested. Here's my question, though: where do we draw the line? Homeopathy? Scientology? Faith healing? I assume that there is some answer so insane that it be deemed to be breaking the guidelines.
posted by norm at 7:45 PM on January 9, 2011


Norm, are you a physician?
posted by HuronBob at 7:55 PM on January 9, 2011 [5 favorites]


The "insane" answer probably wouldn't be covered by health insurance.
posted by griphus at 8:00 PM on January 9, 2011


I assume that there is some answer so insane that it be deemed to be breaking the guidelines.

I get what you're getting at but really people can suggest whatever snake oil suggestions they want to with the understanding that other people are likely to respond with "that's not going to work, that answer is total nonsense" and that fighting about it beyond that is going to be removed as a derail. We have people asking questions about astrology and about religion and about dowsing and about philosophy and some of them are crazy and some are less crazy but generally speaking there are ways to answer those questions that are appropriate to the spirit of the asker and that's fine.

I know it is frustraing to be a rational person and see people asking questions about how to find a good palm reader but as soon as we put some sort of mod/community seal of approval on the answers that are provided [the sort of opposite end of removing some answers as "wrong"] we're making assertions abotu all the other non-removed answers that we're not okay with. People make homeopathic suggestions, other people say they're nonsense and not supported by research. To my mind, that's how things should work.
posted by jessamyn (staff) at 8:01 PM on January 9, 2011 [13 favorites]


norm: “I did as suggested. Here's my question, though: where do we draw the line? Homeopathy? Scientology? Faith healing? I assume that there is some answer so insane that it be deemed to be breaking the guidelines.”

But the trouble is that drawing lines doesn't help! You're making the same mistake a lot of people make when they say: "well, we all agree in the interest of decency not to talk about x." The sad fact is that, even if they don't hear it from Metafilter, it's entirely within the realm of possibility that anonymous will have acupuncture recommended to them for this by someone else. We should deal with that possibility, not shove it off the table and try to ignore it.

When someone in Ask gives a really terrible answer – something relatively commonplace but either pointless or even disastrous in fact – the issue isn't keeping that answer from the asker. It's already out there; and, given the quality of other ask sites, the asker has probably already seen that awful answer. No – when someone in Ask gives a really terrible answer, what they're doing is challenging you. They're challenging you to give a much, much better answer, one that catches the attention of the asker and, without being combative or maybe without even addressing the crap answerer directly at all, leaves the asker in no doubt whatsoever that there is a better way. In a sense, a crap answer is just a challenge to give the best answer possible to overrule it.
posted by koeselitz at 8:03 PM on January 9, 2011 [7 favorites]


(And, lest it need to be said, the very best way to be persuasive and get your answer noticed is to avoid the temptation to start arguments in threads, and instead directly address the asker. This is one of those cases, I think, where a well-written and balanced answer that repudiates acupuncture and yet clearly has the asker's interests in mind will generally win out in the end.)
posted by koeselitz at 8:06 PM on January 9, 2011


So, I commented in that thread hours and hours ago (the comment just above yours,in fact) and mentioned that acupuncture doesn't work. Thanks for providing sources, but maybe reading the entire thread would be best for the asker and everyone? (I know, impossible!)

That said, I don't think there's anything wrong with trying acupuncture for fibroids, as I did. Just don't expect it to work.

At the time, I was desperate. Plus, mine were somehow impossible for the gyns to see (even though they turned out to be huge and numerous, once they opened me up) so I didn't have too much faith in the standard medical community at that point.
posted by lesli212 at 8:08 PM on January 9, 2011 [3 favorites]


If someone wanted to know how to fix their laptop and someone replied "just smack it against the side a few times like the Fonz," I'm pretty sure replying "that will do nothing at best" is completely warranted.

I'm in IT. This would have been a perfectly acceptable answer.
posted by John Kenneth Fisher at 8:14 PM on January 9, 2011 [10 favorites]


Norm, are you a physician?

I assume your point by this devastating rhetorical device is that I'm not qualified to make such pronouncements (especially since I list my profession in my profile, so you know the answer to your question). My experience, both professionally and personally, is that training for a particular area of expertise is not necessarily a predictor of proficiency in it. Do you have a contrary position to take?

I've been around this site a few times, so I understand the impulse is to make fun of anyone posting to MeTa for "making a big deal of [subject]." I was seeking a discussion/guidance on community ethos in dealing with a type of question. It's what the site is for.
posted by norm at 8:17 PM on January 9, 2011 [25 favorites]


I have a wildly negative knee-jerk reaction to acupuncture (I did it regularly about seven years ago and it was super-effective.... at giving me a blood-borne disease via unsterilized needles) so reading that glib, confident answer promoting made me uncomfortable. Thank you for the links refuting it.
posted by kate blank at 8:19 PM on January 9, 2011 [3 favorites]


I'm in IT. This would have been a perfectly acceptable answer.

...but only if you know what is going wrong.
posted by griphus at 8:25 PM on January 9, 2011 [1 favorite]


Welp, I just did a search in Pubmed and there were 8 results for "fibroids and acupuncture," including a Cochrane review. The Cochrane Review did not find studies that met the inclusion criteria. But it did find the topic worthy of publication, and presumably, discussion. Would you hold Metafilter to a higher standard?
posted by Wordwoman at 8:28 PM on January 9, 2011 [4 favorites]


At some point Meta posts asking things like this just get too "mother may I". Don't they? How hard can it be to say in the thread, "There is zero possibility that acupuncture will do anything helpful at all for fibroids". Do we really need to hash out minutia like this?

It's like there is a possibility jessamyn might ban your account and hate you forever if you just said flat out that acupuncture is a silly idea for this. Is there a sense that AskMe has really gotten that puritanical and gestapo?

You're adult now. If you want to run with scissors, it's okay. Go ahead. Don't be frightened.
posted by y6y6y6 at 8:33 PM on January 9, 2011 [1 favorite]


So are people who don't believe in woo and quackery obligated to keep on the lookout from thread to thread, dumping copypasta full of links whenever somebody decides to recommend homeopathy over chemotherapy?
posted by Pope Guilty at 8:37 PM on January 9, 2011 [1 favorite]


You say that as if dozens of Mefites haven't taken that up as a hobby already.
posted by griphus at 8:41 PM on January 9, 2011 [11 favorites]


So are people who don't believe in woo and quackery obligated to keep on the lookout from thread to thread

Only if it's going to make you insanely angry if someone suggests homeopathy and you're not there to refute the suggestions. In which case I'm sure you have larger problems than woo-fighting on Ask MetaFilter. I generally trust the community to call bullshit on bullshit in AskMe. As I understand bullshit, they usually don't let me down. Which is good, because I am busy and am not always there to call it out myself.

Also: if someone starts dumping anti-quack copypasta into AskMe threads, that's a one way ticket to "quit fucking around town" Seriously, don't do that. I have never seen anyone suggest homeopathy over chemotherapy in AskMe, ever. I have definitely shut down people who were aggressively promoting whatever their fringe ideas were, whether I agreed with them or not. I have told people who were suggesting adoption in a thread asking questions about abortion to STFU and also told people who started making zombie jesus jokes in a thread asking bible questions to, politely, cram it. I also deleted the "Santa isn't real" comment because, while true, it was snarky bullshit in a question about how to deal with holidaytime stuff.

I'm aware, norm, that you're looking for more community feedback than just "this is what jessamyn says" so I'll shut up myself here, but there is a system in place and it does mostly work, is my take on it.
posted by jessamyn (staff) at 8:47 PM on January 9, 2011 [5 favorites]


When I came down with a severe case of Bell's Palsy, in addition to the standard drugs, my doctor - a respected neurologist - recommended that I try acupuncture as well. I was very skeptical, and still am, but I read a great deal about the use of acupuncture as a treatment for Bell's Palsy and I'm now convinced that there is a legitimate medical question as to whether it might be beneficial as a physical treatment for the condition.

While I stopped going after about three sessions because my mind simply could not believe that it provided enough benefit to justify the time commitment, I now wonder if I should have kept going. Perhaps my recovery would be better than it is. I'm certainly glad my doctor knew enough about Bell's Palsy to be aware of acupuncture as a possible treatment and that he recommended it to me (with qualifications as a possible avenue to pursue) instead of writing it off as pseudoscience. It gave me the chance to make the decision not to pursue it after I had tried it out. That's exactly the type of medical care I prefer.

Prior to that experience, I would have agreed that acupuncture was pseudoscience not worthy of mentioning as a real treatment, as anything other than a placebo. Now I realize that I should keep more of an open mind about these things, particularly knowing that I lack any relevant medical training. Now I think it's obvious that sticking needles in skin and into muscles must cause some physical reaction on the part of the body - why can't that reaction be useful/helpful in certain cases? Still seems unlikely to me, but I try to keep an open mind and I certainly accept that others may have a different view.

There are some ideas and beliefs that I view as beyond the pale, either because they are utterly illogical, downright stupid, or self-evidently morally bankrupt. But even for that group of ideas and beliefs (of which acupuncture was once a member), there is a much smaller group that I believe so deeply that I would want banned from discourse. If you think through what that means, the certainty that should be required to insist on such a ban should be breathtaking.
posted by slide at 9:10 PM on January 9, 2011 [8 favorites]


Here's my question, though: where do we draw the line? Homeopathy? Scientology? Faith healing?

I don't think any of those responses, if offered in apparent good faith, should be deleted by moderator action. Rather, they should be countered by persuasive counter-argument.
posted by grouse at 9:13 PM on January 9, 2011 [5 favorites]


The problem with your question is that you that you expect the mods to be able distinguish between good answers and bad ones and eliminate bad ones. In this case, you want them to be up on medical research about alternative medicine, recognize when somebody's recommending a therapy for something when it's not supported by empirical research and delete the bad answer.

Think about this for a minute. To really do this, the mods would also have to know what types of cuts are safe on table saw for people trying to do do-it-yourself home improvement projects (and delete answers that recommend doing something thing isn't safe), which Linux distros work best on specific models old laptops (and delete answers that recommend distros that are too fat), which Spanish-language children's books a best for eight-year-old English speakers learning Spanish as a foreign language ... and on and on for every topic people ask questions about on AskMe.

Of course they can't do that, because they're not omniscient. What they do in practice is eliminate answers that aren't responsive to the question at all, and answers that are getting fighty with the OP or other commenters rather than answering the question, since it doesn't require any knowledge of the question's topic to spot those types of responses. They also post answers to questions themselves if they know something about the topic, because they are also users of the site as well as moderators.

It's up to us as users to answer questions when we know something about topic the asker is asking about, and it's up to us to counter bad advice when we realize someone is offering bad advice (preferably explaining why, and offering a few links if possible). That's how as AskMe works
posted by nangar at 9:16 PM on January 9, 2011 [4 favorites]


Placebo effects do have effects sometimes, though, on more than just psychological issues. I was talking to a young woman just a couple days ago who told me that acupuncture treatments greatly reduce the pain of her arthritis. Even if all it's doing is make you think it's working, but it works, I fail to see what the problem is.
posted by girih knot at 9:30 PM on January 9, 2011


answer those questions that are appropriate to the spirit of the asker and that's fine.

Meh. I can appreciate just allowing the woo-based thinkers to be wooed by answers. They're not going to take advice they don't want to take.

Otherwise we simply have to utterly exclude certain people. They don't respond well to unemotional rationality. It's a foreign world to them. They're going to do what feels right.

OTOH, it's a bugger to watch them die because they're using acupuncture to fight cancer.
posted by five fresh fish at 9:33 PM on January 9, 2011 [1 favorite]


Well, on the one hand, there is the countering of bad advice with good advice; on the other, there are the guidelines against debate/fighting/chatting in the AxeMe subsite. I'm not asking for the mods to make determinations about what a good answer is and to delete the others; I was asking for a clarification of the site approach to bogus* answers being offered to questions. Like most of Metafilter, the answers are not particularly clear, and my post makes it equally obvious that I'm not asking for a blanket ban on acupuncture answers.

I do see a danger in "debate out the right answer in thread" as the stated policy, because it seems to me to be a license to do exactly that, and I don't like where that would go. But at least we know to do so.

*Yes, this begs the question, of course.
posted by norm at 9:33 PM on January 9, 2011


Are we violating some norm here that I really just don't get?
posted by Night_owl at 9:39 PM on January 9, 2011 [3 favorites]


So are people who don't believe in woo and quackery obligated to keep on the lookout from thread to thread, dumping copypasta full of links whenever somebody decides to recommend homeopathy over chemotherapy?

Maybe a stock set of community developed FDQCs. Then everyone can chime in in shorthand. "FDQC 13.2."
posted by five fresh fish at 9:40 PM on January 9, 2011


norm: I think the mods do delete answers that are seen as outright harmful.
posted by girih knot at 9:40 PM on January 9, 2011


Pubmed finding the topic worthy of publication isn't enough, if what's published amounts to "acupuncture is useless for dealing with fibroids". It's not a game where having more reports gains more points, it's about the quality of the info. Same with AskMe - more answers and debate isn't necessarily better than one accurate answer.
posted by harriet vane at 9:47 PM on January 9, 2011 [2 favorites]


Are we violating some norm here that I really just don't get?

I suppose that depends if you buy me a drink first, right?

*waggles eyebrows*
posted by norm at 9:49 PM on January 9, 2011 [15 favorites]


My experience, both professionally and personally, is that training for a particular area of expertise is not necessarily a predictor of proficiency in it. Do you have a contrary position to take?

Actually, yes, I do have a contrary position to take. Training for expertise in medicine is a substantially better predictor of proficiency in medicine it than is not training for it. To think otherwise is frankly unhinged.
posted by dersins at 10:12 PM on January 9, 2011 [2 favorites]


My experience, both professionally and personally, is that training for a particular area of expertise is not necessarily a predictor of proficiency in it.

Problem sorted, then. I'm sure the person who recommended acupuncture has even less medical training than even you, and so should be much more proficient.
posted by empath at 10:43 PM on January 9, 2011


Training for expertise in medicine is a substantially better predictor of proficiency in medicine it than is not training for it. To think otherwise is frankly unhinged.

Fair enough, but not what you really want. You want to argue that physician-level is a necessary prerequisite for making reliable judgments about whether acupuncture, homeopathy, reiki, and so on are effective treatments for non-psychological illnesses.

If you don't have that, then it doesn't matter that norm isn't a physician. Even if training as a physician would make norm even better at comparing these treatments, norm might be good enough at it already.
posted by Marty Marx at 10:44 PM on January 9, 2011


*physician-level training. Why do I never see these on preview?
posted by Marty Marx at 10:44 PM on January 9, 2011


I do see a danger in "debate out the right answer in thread" as the stated policy, because it seems to me to be a license to do exactly that, and I don't like where that would go

Just keep your tone civil. It's not a difficult problem.
posted by mediareport at 11:04 PM on January 9, 2011 [1 favorite]


My experience has been that reasoned, mildly stated dissent on Ask is almost always allowed and it is usually not controversial, particularly if you keep it brief, narrow, factual, and avoid making it personal about whoever gave the advice you disagree about.

Along with flagging I think these are the only tools AskMe needs to deal with controversial answers. At the end of the day if we are not going to allow people the responsibility of making their own hopefully considered and informed opinions then there's really no justification for allowing AskMe to exist.
posted by nanojath at 11:09 PM on January 9, 2011 [1 favorite]


I study Traditional Chinese Medicine, and even I think acupuncture is not the way to go for fibroids. That said, the thread is full of women giving great comments from personal experience, so it seemed unnecessary to waste energy or take up space as a man with no experience working with fibroids in bothering to talk about it.

In general, though, I don't talk about TCM very often here on Metafilter because a) getting something I know works called "woo" pretty much closes the conversation before it begins, and b) the amount of wackos and flakes who jumped under the TCM banner in the US, at least, means most people would probably need 300-500 hours of training themselves to sort out the bullshit from the useful practitioners.

The very simple part of it is this: if anyone tells you one type of treatment works for everything, doesn't require a lot of hassle and work on your part, no weird side effects, or works because of a lot of fucking complex annoying particulars that work -just so-? They're giving you bullshit.
posted by yeloson at 11:32 PM on January 9, 2011 [7 favorites]


So are people who don't believe in woo and quackery obligated to keep on the lookout from thread to thread

Earlier last year I disabled my account for a while while I finished my PhD thesis. I looked occasionally but couldn't post and didn't get so sucked in. What I learned is that when someone posts a pseudoscience-laden question or answer about something I know a lot about, because I was busy writing a PhD thesis about it, if I go away and did other stuff for a few days someone else will come along and post an answer refuting the crap, and generally much more politely and intelligently than I would have. It was hella frustrating the first time but actually quite freeing once I saw it in action a few times. Now I'll answer if I'm feeling coherent and not too grrar-y, or walk away if my eyes are rolling too hard to be nice.

Acupuncture is actually kind of interesting because it's one of the very few alternative medicine methods which can be properly tested in double blind placebo trials (using "sham" needles which don't pierce the skin). And it fails every single time, never has any therapeutic effect at all (beyond the placebo effect, but you get that just as strong if I sit in the room and talk nicely to you so even that's not the needles). But apparently disproving something over and over is meaningless, desperate people will still try it, well meaning idiots will still recommend it, and "practitioners" will still make money off it.
posted by shelleycat at 11:56 PM on January 9, 2011 [11 favorites]


if I go away and did other stuff for a few days someone else will come along

My thesis was full of weird mixed tense sentences too btw (sigh).
posted by shelleycat at 12:02 AM on January 10, 2011 [2 favorites]


because a) getting something I know works called "woo" pretty much closes the conversation before it begins

You would prefer, "One of the very few alternative medicine methods which can be properly tested in double blind placebo trials, and which fails every single time, never having any therapeutic effect beyond that of placebo" maybe?
posted by Marty Marx at 12:32 AM on January 10, 2011 [5 favorites]


As far as I know TCM is not acupuncture. I actually read a fair number of articles related to some aspects of TCM as I work with food extracts, and quite a lot of work in my area is basically testing and possibly validating treatments used in those kinds of "alternative" arenas. That doesn't mean I'd use that particular form of treatment as it stands, but making out like I'm slamming something I didn't even comment on is pretty rude.
posted by shelleycat at 1:19 AM on January 10, 2011 [1 favorite]


Had I seen that, I would probably have said something like "Ï advise you to treat the suggestion of using acupuncture for something like this with extreme caution, and to look to treatments with substantially better scientific backing and clinical proving."

With medical AskMes I generally just roll my eyes, stay my hand, and think "Get to the bloody doctor, duh", although I do recognise that there can sometimes be a reassurance value to be gleaned. Nevertheless, I feel that recommending quack treatments for something potentially major moves into the realms of the downright irresponsible, and should be called out.
posted by Decani at 1:29 AM on January 10, 2011


I did as suggested. Here's my question, though: where do we draw the line? Homeopathy? Scientology? Faith healing? I assume that there is some answer so insane that it be deemed to be breaking the guidelines.

I have a lot of sympathy with norm on this one, although I perhaps wouldn't have chosen accupuncture as my fighting ground. It's a fine and murky line, but I would try and draw a distinction between advice that (subjectively) has no benefit, and that which could actively do harm. Accupuncture for fybroids? Is this instead of or alongside conventional treatment? Maybe let it pass? But homeopathy for a stomach ulcer? Maybe I'd step in there. But even this borders on thread shitting. Something even more outlandish could easily ruin the thread. So I'd say I think there is a point at which an answer becomes so batshit insane that a poilite rebuttal is just not enough. MMS? Gay cures? Pyramid schemes? Scientology? Flag flag flag.

A vote up/down feature might help with issues like this perhaps, but I'd still rather see any advice that could cause the questioner harm deleted.
posted by londonmark at 3:24 AM on January 10, 2011


This needle in my eye is not giving me the placebo effect. Is it brokenzorzed? HOPE ME
posted by Joseph Gurl at 3:58 AM on January 10, 2011


woo and quackery

Attorneys at Law.
posted by jonmc at 5:20 AM on January 10, 2011 [5 favorites]


Once I saw Mercury was in retrograde, I knew this call out would happen.
posted by Brandon Blatcher at 5:34 AM on January 10, 2011 [2 favorites]


Now, I realize that my story is not about fibroids, and this is totally anecdotal, but it's the anecdote of a cynical bastard. I've had severe back problems since 2003, which only kick in during the winter months. Back problems so bad that every night I used to have to get out of bed around 2am and stand vertically for an hour just to relieve the pressure on what seemed to be my lungs. I tried everything - from regular massages and a chiropractor, to prescribed medications to relieve the pain. I was vigilant about doing all the exercises recommended to me. I purchased an Obus Forme pillow which made it easier to sleep on my back, rather than my front. I tried it all.

This year, I decided to not be lazy and attempt to preempt the pain before the winter set in. A good friend suggested a Chinese medicine practitioner and so I decided to give it a try. Let me tell you, I went into the acupuncture appointment with huge doubts and I left the session with compete and total skepticism. I was like, "yeah, that didn't really feel very good, and it's fuckin' quackery." I called up my friend and told her just that. Although my major pain hadn't yet set in for the winter, there was some pain there, albeit bearable. I woke up the next day after the appointment, sat down to eat my breakfast and realized that my back felt like jelly. I felt like a kid again. Zero pain. I've now seen Dr. Wang for two months on a weekly basis and I have not had one incidence of back, neck, or head pain. Not one. Placebo or not, it worked for me, and it did the job better than anything else I've tried.

I haven't read any of studies which ave been linked to, but I have been a lab rat for a few long term clinical studies at what used to be called Ventana. The results of the studies I was in were falsified in more ways than one would like to imagine, in order to please Ventana's customers, the pharmaceutical companies who commissioned them. I'm in no way saying the studies above aren't valid. I just know that the Western medical community has a vested interest in proving alternative medicine to be full of shit.
posted by gman at 5:39 AM on January 10, 2011 [8 favorites]


Time for pie yet?
posted by fixedgear at 5:50 AM on January 10, 2011


Brandon, Mercury is not in Retrograde.
posted by aristan at 5:57 AM on January 10, 2011 [3 favorites]


I'm in IT. This would have been a perfectly acceptable answer.

Yes, but it's not the best answer. As any good help-desk veteran knows, the cure all for any laptop of desktop problem is: magnets.
posted by steambadger at 5:59 AM on January 10, 2011 [2 favorites]

With medical AskMes I generally just roll my eyes, stay my hand, and think "Get to the bloody doctor, duh"
posted by Decani at 3:29 AM on January 10 [+] [!]
Please remember that many users here are from the USA where getting to the doctor is often non-trivial and sometimes nigh-impossible, even for people with computers and internet etc. As eye-rolling as it seems, sometimes a question to the Green is the best thing someone can do for their health at the time.
OTOH, it's a bugger to watch them die because they're using acupuncture to fight cancer.
posted by five fresh fish at 11:33 PM on January 9 [1 favorite +]
Having been by my father's side as he died in part because he used Ayurveda to treat what turned out to be stomach cancer, I agree with this part entirely
posted by jtron at 7:05 AM on January 10, 2011 [2 favorites]


> *Yes, this begs the question, of course.

You put that as an afterthought footnote, but it's actually a full and complete refutation of your idea. No, there is no class of solutions which is labeled "clearly bogus" and forbidden, nor could there be. Refute it or forget it, and reread what shelleycat said if you want to feel better about the situation.
posted by languagehat at 7:11 AM on January 10, 2011


aristan, I'm picking up a strong desire to fix things and I think this is your month to do it!
posted by Brandon Blatcher at 7:40 AM on January 10, 2011 [1 favorite]


I have not found much medical relief from alternative medicines, including acupuncture. However, some credentialed experts recommend it. Feel free to offer respectful, thoughtful comments in the thread.
posted by theora55 at 7:41 AM on January 10, 2011


This has nothing to do with anything, but as far as traditional Chinese medicine goes, I have this friend who spent a year in China, and she was sick for ten months of the time. The mere mention of "traditional Chinese medicine" in her presence makes her very, very angry; she says if there's anything in TCM that works, it sure as hell isn't Chinese or traditional. But then, that's totally anecdotal. And she's from Kentucky, and I always wondered why she wanted to go to China in the first place; I was pretty sure it wasn't gonna suit her from the beginning.

For whatever it's worth.
posted by koeselitz at 7:55 AM on January 10, 2011


It's pretty clear that there's a big difference between using acupuncture as a means of pain management, where it has been shown to be effective, and using it to try to cure observable maladies such as tumors.
posted by Burhanistan at 8:51 AM on January 10, 2011 [4 favorites]


The best response to speech you don't like is not to ban the speech; the best response is more speech.

The best response to AskMe answers you don't like is not to ban the answers; the best response is provide better answers.
posted by DWRoelands at 9:20 AM on January 10, 2011 [2 favorites]


using acupuncture as a means of pain management, where it has been shown to be effective

No better than placebo.
posted by Pope Guilty at 9:22 AM on January 10, 2011 [1 favorite]


You put that as an afterthought footnote, but it's actually a full and complete refutation of your idea. No, there is no class of solutions which is labeled "clearly bogus" and forbidden, nor could there be.

My footnote was simply to acknowledge that I was asking a more broad question than the original subject of the post, which you have grasped. That being said, I utterly disagree with your argument. There are definitely "clearly bogus" solutions, and there are ones that are clearly forbidden. Jessamyn listed off a few examples, whether unhelpful or fighty or otherwise, but I can think of another class of forbidden solutions to the question: the astroturf sales recommendation. Snake oil may well work fine for heartburn, but a post from a snake oil salesman is not likely to survive the day, correct?

You may argue with me that sales jobs on Ask Me is not what you were talking about, but then I wasn't the one that put forth the claim that there are "no class of solutions" which could be forbidden.

In any event, I got what I wanted from the post, have my answer, and am happy that the issue has some clarity now.
posted by norm at 9:41 AM on January 10, 2011


But if acupuncture relies entirely on the placebo effect, then surely refuting the benefits of acupuncture is worse than simply ignoring the comment. If the person is inclined toward acupuncture before reading the refutation, then you've hurt the person's chances of getting meaningful help. If the person is disinclined toward acupuncture, the person will ignore all comments relating to it. It's a conundrum.
posted by MarkAnd at 9:43 AM on January 10, 2011 [1 favorite]


This is basically a religious issue. You're not going to get a consensus on it.
posted by ErikaB at 9:56 AM on January 10, 2011 [3 favorites]


Metafilter mods have a thing for allowing woo-woo answers. I nearly got banned a couple of years back fighting over a question regarding 'finding good astrologers in the Denver area' or something like that.
posted by unixrat at 10:52 AM on January 10, 2011


I nearly got banned a couple of years back fighting over a question

Can anyone pull out the salient word from that sentence?

Usually I see stuff in AskMe that goes like this

Question: Something vague that might attract quirky alternative answers.
Answer 1: doctor something something
Answer 2: exercise something something
Answer 3: restatement of exercise with some caveats
Answer 4: homeopathy
Answer 5: homeopathy not so good because
Answer 6: additional support for homeopathy by same poster

We start deleting at answer 6, generally. You are welcome to make your suggestion, however odd it is. You are not welcome to make the thread into an argument about your suggestion. You are not allowed to be jerks to other people with different ideas [yes, even if those ideas are totally off the wall and wrong for most definitions of wrong].

Takeaway from this: if you are giving Answer 5, be accurate, be dispassionate, be accurate and then walk away. Trust the community generally. If you can't trust it, respect it and don't fuck up a thread because you personally have an axe to grind on a topic, even if your particular axe is supported by science/math.

We don't have a "thing" for woo-woo answers, we just don't think that allowing people to make them is threatening to the idea that there is such a thing as scientific method and most people find those arguments quite compelling.
posted by jessamyn (staff) at 11:06 AM on January 10, 2011 [2 favorites]


Pope Guilty: "No better than placebo."

I've been trying to find efficacy rates, but the problem with saying that something is no better than placebo is that what if the placebo is really effective? (The seems to be precisely the case with things like back pain, where your treatment options are all kind of a crapshoot?) If the placebo is better at relieving symptoms than traditional treatments, then fuck yeah, sign me up.

And haven't we had a bunch of discussions about how many modern pharmaceuticals aren't actually that much more effective than placebos?
posted by danny the boy at 11:21 AM on January 10, 2011 [4 favorites]


Can anyone pull out the salient word from that sentence?

Thanks for that.

Only in these woo-woo areas are obviously incorrect answers allowed to live next to factually correct answers (I have an axe to grind supported by science and math, no doubt) under the idea that we should "trust the community" or something.

I've seen harmful and incorrect 'answers' get deleted from other questions, but if they reference acupuncture or astronomy or any number of other wacky con games y'all have a strangely "We can't decide what's right" attitude all of a sudden.

You're doing harm.
posted by unixrat at 11:33 AM on January 10, 2011 [1 favorite]


but if they reference acupuncture or astronomy or any number of other wacky con games

You one of them earth-circles-the-sun types, ain't ya boy?
posted by Brandon Blatcher at 11:38 AM on January 10, 2011 [7 favorites]


You one of them earth-circles-the-sun types, ain't ya boy?

Too dependent upon my spellchecker, oops!
posted by unixrat at 11:41 AM on January 10, 2011


I've seen harmful and incorrect 'answers' get deleted from other questions, but if they reference acupuncture or astronomy or any number of other wacky con games y'all have a strangely "We can't decide what's right" attitude all of a sudden.

We'll delete answers that make lulzy jokes about mixing bleach and ammonia. We'll delete answers telling someone to beat their kids, kill their parents or hit their girlfriend. Otherwise we expect people to talk it out in the thread. I don't know what things you think we delete while leaving astrology answers alone. If someone wants to ask a question about palmistry there are ways to answer that are consistent with the practice as it's understood, that don't require you to believe that someone reading your palm is actually prognosticating. But some people want us to actually not allow questions about numerology, psychics or colon cleansing and we're just not going to do that. So, people knowing that can make a choice about how they interact on the site, but they're still bound by the same guidelines as everyone else.

I'm not sure what you're asserting about what we believe. I think astrologers are hucksters. I think acupuncture has a mostly placebo effect, if it does anything. I think dowsing doesn't work and has been proven not to work. I have a fairly jaded opinion of all religions. At the same time if someone shows up in a thread asking about good bible verses for a wedding and someone shows up being all "LOL ZOMBIE JESUS" I'll delete that.

Thanks for that.

People, including me, offer all sorts of contrary-to-OPs-understanding opinions in AskMe every day. The mods didn't talk to you about this because you were offering contrary opinions but because you were continually fighting with people in AskMe about it. If you want to bring up your own history, let's talk about it. If you think we should make an exception to the AskMe guidelines so you can fight with people, let's talk about that.
posted by jessamyn (staff) at 11:48 AM on January 10, 2011 [1 favorite]


LOL ZOMBIE JESUS

This always bothers me. Technically, he more of a mutant, since one of his parents was superhuman. Interesting question: was it this superhuman linage that enabled him to survive or did God use his power to bring him back? Maybe a mixture of the two, something in his DNA which allowed God's power to work easily and readily with the body.

Or was it just a healing factor and Jesus is the original Wolverine?
posted by Brandon Blatcher at 11:57 AM on January 10, 2011


> I nearly got banned a couple of years back fighting over a question regarding 'finding good astrologers in the Denver area' or something like that.

Your favorite astrologer sucks is why.

More seriously, if someone is asking something that is woo-related then it's up to you to provide an answer within the context of the woo, not tell them that their woo is foo. Now, if someone is asking about something not so woo, and someone replies with some woo, then you can nicely say foo.

Er, yeah.
posted by Burhanistan at 12:06 PM on January 10, 2011 [1 favorite]


I've seen harmful and incorrect 'answers' get deleted from other questions, but if they reference acupuncture or astronomy or any number of other wacky con games y'all have a strangely "We can't decide what's right" attitude all of a sudden.

You are asserting a very specific topical bias here, and that assertion is incorrect bullshit. You do not have to like woo-woo stuff—I don't generally like it either, insofar as I think I understand the domain of stuff you're talking about—but your perception of some position of privilege this stuff has in how we moderate is wholly misguided.
posted by cortex (staff) at 12:08 PM on January 10, 2011 [1 favorite]


Should we really expect the mods to be experts in every subject that comes up on Ask, so that they can delete any answer that falls below a certain threshold of credibility? I wouldn't think so. I suspect they have lives, after a fashion.
posted by steambadger at 12:12 PM on January 10, 2011


I absolutely don't think the mods should delete a placebo-effect "solution". The placebo effect is fascinating, shown to be somewhat 'reliable', and not thoroughly investigated. With that in mind, how can we be sure that every single placebo -- even if we can reliably categorize it as a complete sham -- is a woo woo for every condition?

Adding to what danny the boy mentioned - There's a mind-body connection that scientists just don't yet understand (I'm thinking of countless studies that show things like people respond more happily when they're physically smiling, even if they're just making the face and not thinking "happy!") I'm glad to see that the placebo effect itself is under greater scrutiny now that it's costing big pharma so much money.

I'm, err, a big "believer" in the placebo effect myself, but not at the cost of my health or safety. For example, I take echinacea to ward off colds; even though many studies have failed to prove benefits and I strongly suspect it's a placebo, it does work for me. I love Dan Ariely's theories on the "why" of placebo effects. In this video, he explains why he had to get a "new" placebo, once it was shown that his go-to placebo is bunk. Studies are even starting to confirm Ariely's and my experience - that it's possible the placebo effect may work even when people are aware that the treatment is a sham [pdf].

Getting back to the original fibroid question there, there is surprising diversity in treatment outcomes for fibroids. Every study has a different conclusion, and all the potential pain and side effects are masked by statistics. I don't blame the OP for asking for anecdotes. I certainly sought anecdotal evidence when I was researching my options, and they did aid in my decision-making. It's one thing to read "30% chance of xyz" and another to hear about what it's like to actually experience the xyz side effects of those 30%. Knowing what you're getting into beyond a list of symptoms and a number is critical very important in deciding whether risks are worth taking, or whether you should also try something less invasive.
posted by lesli212 at 12:24 PM on January 10, 2011 [3 favorites]


There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy. - Shakespeare

I'm Agnostic about more than the existence of God. I have met and talked with many people who swear by things such as acupuncture and acupressure. I have people tell me they have been cured of all pain through acupuncture and others tell me how much weight they've lost through acupressure or hypnosis. Some claim that yoga helps them with their depression and one person recently told me about a man who cured all of his ills by walking like a dog. Am I going to tell them their "cures" didn't work? No, because they believe they did. Am I going to try them? Probably not, though I have tried yoga. I'm skeptical because I've also had people tell me they've tried these things and they *haven't* worked or they made their illnesses worse.

I think that if a practice works for someone then they should be allowed to tell others about it and let those others -- we're all adults here -- make their own decisions.

I take tried and true medications for my bipolar and it only works on a low percentage of the people who have bipolar. They are my miracle cocktail, but I wouldn't recommend them to everyone. And not even ten years ago, two of them never existed -- hell a few decades back bipolar didn't "exist" and only a few short years ago there was no such thing as fibromyalgia (even my spell checker doesn't believe it exists). Even now I have a hard time convincing doctors I have it because they don't accept it as a proper diagnosis.

What I'm saying is, just because someone believes something is a "sham" or a "con" does not make it so. And I, for one, would think less of Metafilter if we did delete comments - simply because science doesn't back up their existence.
posted by patheral at 12:44 PM on January 10, 2011 [2 favorites]


"Santa isn't real"

Damn! Another Jessamyn spoiler.
posted by Neiltupper at 1:17 PM on January 10, 2011


Every time somebody mentions "woo," I picture my great-grandfather calling upon the home of my great-grandmother at teatime for the purpose of courting her.
posted by koeselitz at 1:46 PM on January 10, 2011


That doesn't mean I'd use that particular form of treatment as it stands, but making out like I'm slamming something I didn't even comment on is pretty rude.

Hey, sorry, shelleycat. I didn't mean for that to read like I was pitting you against yeloson and traditional Chinese medicine, but rather substituting an accurate, if unfavorable, account of the evidence against acupuncture instead of 'woo' to show that the problem goes deeper than whether or not people call it 'woo' to shut down conversation (as yeloson said).

I took yeloson to be only talking about acupuncture, but on rereading, I can see that's not necessarily the case, and he may have meant TCM-not-including-acupuncture when talking about what gets called 'woo.' (I took TCM to include acupuncture, as does the National Center for Complementary and Alternative Medicine, but Googling reveals that may not be a universal view.)

So to be clear: I was only talking about acupuncture. I thought yeloson was talking about acupuncture. My paraphrase of your comment about the efficacy of acupuncture was about the lack of evidence of its efficacy and the use of the word 'woo.' I'm not trying to represent your views, and certainly not your views about TCM broadly, but rather to state the current knowledge of the inefficacy of acupuncture and the problem that poses for not shutting down conversations about it, even without calling it 'woo.'
posted by Marty Marx at 1:50 PM on January 10, 2011


Seems to me as though the person was genuinely trying to help, rather than see the op die horribly from an untreated condition.

I think acupuncture is a load of unctious new age bullshit myself, but there's nothing to stop the op having formal medical treatment as well as having Ms Rainbow Suncloud come and stick mystical healing rods on her arse while chanting stairway to heaven backwards. It's probably more interesting than sitting in a doctors waiting room imho.
posted by sgt.serenity at 2:32 PM on January 10, 2011


Hasn't there recently been a study that indicates placebos to be effective, even if the person taking the placebo doesn't believe in them? In that case I'd just ignore the acupuncture answer and give my own answer.

Now, if you believe acupuncture is a dangerous placebo because (say) the risk of infection, there's a good argument against it, as long as you're civil and not attacking the person who suggested it.
posted by IndigoRain at 3:05 PM on January 10, 2011


Every time somebody mentions "woo," I picture either Ric Flair or Curly from the Three Stooges
posted by jtron at 7:45 PM on January 10, 2011 [2 favorites]


Hasn't there recently been a study that indicates placebos to be effective, even if the person taking the placebo doesn't believe in them? In that case I'd just ignore the acupuncture answer and give my own answer.


Um yeah, about that. My general practitioner is a big fan of mixing traditional and alternative medicine. So I've got this cold and despite traditional treatment it doesn't go away, like forever. I demand more/different antibiotics, because after weeks I still feel like shit. She's all let's try something else first and heads for her special cabinet. Oh, no, I think, not the sugar pills again. I roll my eyes take the sugar pills home and ingest them with all the distase a skeptic can muster. Two days later the cold was gone. It's a miracle.
posted by ZeroAmbition at 12:46 AM on January 11, 2011


Might not have been the placebo, even, then; the cold maybe would've stopped bothering you in 48 hours if you'd used acupuncture, visualization, or offered rum and cigars to Jobu.
posted by jtron at 8:45 AM on January 11, 2011


Well yeah, that was pretty obvious to mee too, but I found it hillarious nonetheless.
posted by ZeroAmbition at 2:31 PM on January 11, 2011


A cold. Like, the kind caused by viruses? And you were taking antibiotics. The stuff that kills bacteria?

Hilarious doesn't even describe the face I am palming right now
posted by danny the boy at 6:19 PM on January 12, 2011 [2 favorites]


"HURF DURF PLACEBOS amirite! Now gimmie a z-pack for my flu."
posted by danny the boy at 6:28 PM on January 12, 2011


Would you like some gasoline for your straw man? It burns even easier!
posted by Pope Guilty at 6:34 PM on January 12, 2011


It's been a while, danny the boy. I think she said something about the illness being from a combination of bacteria infection and some virus. I just called it a cold because that's how it felt and IANAD.
posted by ZeroAmbition at 4:30 AM on January 13, 2011


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