Can You Trust Your Doctor? – A Brief Look at Medical Journal Publication Bias

Stethoscope Laying on Stacks of Money
Recently, I have become increasingly a bit of a medical skeptic. Now don’t get me wrong – I am not anti-doctors or anti-medicine. But I have noticed (especially in the realm of breastfeeding, natural birth and especially vaccines) that a lot of medical professionals have no flippin’ clue as to what they are talking about (to put it as kindly as possible).
The more research I do into topics of interest – digging into resources that include, but go above and beyond medical journals – the more it triggers a massive eye twitch and bout of genuine concern when a medical professional simply parrots “conventional knowledge” as found in mainstream medical journals and then condescendingly pooh poohs outside studies, traditional wisdom and global practices.
It also wrankles me when I try to hold an intellectual discussion with friends or fellow mommies using facts, medical science and common sense, just to be given the unthinking, deer-in-the-headlights look followed by, “Well, my doctor says (fill in the blank) and that’s good enough for me.”
In America, doctors enjoy an unprecedented aura of infallibility, with many Americans holding an almost religious-like faith in their every word, decision or verdict on an issue. Many men and women feel there is no need to think, examine or question a doctor’s word, because he or she has done the thinking for you and there is no higher authority, end of story.
My opinion? That’s a BIG MISTAKE. Aside from the fact that medical professionals are men and women prone to all the errors and flaws that the rest of us mere mortals face, the heart of the issue is that the information doctors receive isn’t always the truth, the whole truth and nothing but the truth.

Doctors Rely On Medical Journals for Their Current Information

In a study on how doctors and nurses stay abreast of the ever-evolving information in the world of medical science, the U.S. National Library of Medicine and Institute for Health found that medical professionals reported spending 4.4 hours on average per week reading medical journal articles and reported reading only the abstract for roughly 63% of the articles.
Respondents admitted to a reliance on medical journals as their primary source of medical information, given the limited time available for critical reading.
It is extremely important to realize that your doctor relies heavily on abstracts and prescreening of articles by editors for his or her current medical knowledge and prescription assessments.
The problem with this is that medical journals have become the infomercials of the medical world. While many people place blind and unquestioning faith in anything “scientific”, it’s important to realize that fraud can and does occur anywhere – medical journals are no exception.

Medical Journals Don’t Always Tell the Full Truth (Or Even Half Truths)

Here’s the skinny: There’s big money in medicine. Take a look at the burgeoning vaccine market, which invests staggering amounts of money into partisan research, and has soared from $5.7 billion ten years ago to $27 billion today (an astonishing rise of over $20 billion).
When you have big money backing researchers, who would not otherwise be funded, what you end up with is publication bias – the practice of selectively publishing trial results that serve an agenda. Publication bias isn’t some wild or crazy conspiracy theory, it is a well-established and thoroughly studied fact. After all, the industry doesn’t pay for negative results.
It’s important to understand that our current medical system has been masterfully orchestrated by drug companies to convince the masses to use their product. Across the board, drug makers do an excellent job of publicizing the findings they want you to know, while keeping studies that don’t support their product hidden from you and the medical community. When drug companies invest in “marketing” through medical journals, the sole purpose of their advertising is to benefit the drug company’s pocketbook (not your health).

Examples of Publication Bias in Medical Journals

Publication bias in medical journals has been well studied in recent years, and they all testify to the fact that publication bias is very real, and very serious. Here are just a few examples of publication bias (there are literally hundreds more out there):
  • Researchers looked at all trials submitted to the FDA during the approval process of 12 different antidepressants. They found 38 positive results, and 36 negative ones. That’s just about 50/50 going either way. But guess how many of these studies could be found in the published medical literature after the drugs were approved? 37 of the positive studies were published, and only 3 of those with negative findings.
  • In 2010, researchers identified all the published trials for five major classes of drugs, and then measured two key features: Were they positive, and were they funded by industry? Out of a total of 500 trials, 85 percent of the industry-funded studies were positive, compared to less than 50 percent of independent-funded trials.
  • Former drug company researcher Glenn Begley looked at 53 papers in the world’s top journals, and found that he and a team of scientists could NOT replicate 47 of the 53 published studies — all of which were considered important and valuable for the future of cancer treatments.
  • In 2007, researchers identified all published trials of cholesterol-lowering drugs known as statins. During this study of 192 trials, the researchers found that industry-funded studies were 20 times more likely to favor the test drug, compared to those with independent funding.
  • One study revealed that missing or skewed studies in medical journals helped create the impression that 94 percent of antidepressant trials had produced positive results as published in the New England Journal of Medicine. In reality, all the studies together (published and unpublished) showed just 51 percent positive results.
  • According to a 2011 study in the Journal of Medical Ethics, nearly 32 percent of retracted papers were not noted as having been retracted by the journal in question, leaving medical professionals completely in the dark about the inaccuracies in the studies they accept as current, up to date, and factual.
  • Retraction rates have increased tenfold in the past decade, and a new paper in the Proceedings of the National Academy of Sciences demonstrates that two-thirds of all retractions follow from scientific misconduct: fraud, duplicate publication and plagiarism.

How Publication Bias Affects Your Doctors Medical Decisions (And Your Health)

It’s important to realize that all research is NOT published. And once you realize that the majority of research funding comes from for-profit drug companies, it should come as no surprise that drug studies funded by a pharmaceutical company that reaches a negative conclusion will rarely ever see the light of day.
What this means is that even if you scour the medical literature to determine what the consensus is on any given medical topic (vaccines are a great example), what you’ll find is an overwhelming preponderance of data in favor of a specific drug that in no way, shape or form reflects the reality of the scientific investigation that went into that drug. With so much data missing in action, what does the claim “scientifically proven” really amount to? It certainly cannot be construed as a guarantee of safety or effectiveness.
While your doctor may be operating in good faith, it does not change the fact that the source of their information is largely biased and in some cases downright deceitful. And even if your doctor is educating himself beyond reading the article abstracts, the sobering reality is that over 60 percent of related studies for pharmaceuticals remain unpublished on average about five years AFTER the FDA approves the drugs for market. This means that physicians are often prescribing drugs without full knowledge of how well the treatments work – up to and including any potential risks, side effects or long term health concerns.

Soooo… Can Medical Journals (and Your Doctor) Be Trusted??

We would all like to think of the scientific process as being objective, rigorous, and even ruthless in separating out what is true from what is false. But the fact is, it’s easy to manipulate results, especially when there is big money involved.
While your doctor may be operating in good faith and to the best of his ability (and knowledge), he or she is most likely gleaning information where there is a blatant intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded.
It is well established that researchers are frequently manipulating data analyses and chasing career-advancing findings rather than good science. In many instances researchers are even using the peer-review process – in which journals ask researchers to help decide which studies to publish – to suppress opposing views. Just one glimpse at the vaccine industry proves this beyond a doubt, with vaccine manufacturing giants like Merck and GlaxoSmithKline facing lawsuits over research fraud and intimidation tactics toward independent vaccine researchers.
So can medical journals be trusted? In my personal opinion, if you are using medical journals as your sole source of medical news and information – then no, they cannot.
Can your doctor be trusted? Well, that depends on where your doctor is getting all of his or her medical news and information from! If it’s from medical journals, (especially if your doctor displays a faith like trust in medical journals) then see my answer above.
It’s vitally important to talk to your doctor and see where they get their information from. If they prescribe a drug or a treatment, do your own research into the matter. If any questions or concerns arise, bring them (along with the accompanying independent, unbiased studies) to your doctor’s attention.
If they act condescending or uninterested in looking at the BIG picture or the full body of evidence for a given drug or treatment, I say find a new doctor!

So! Were you aware of the prevalence of publication bias in medical journals? Share below!

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Gingi is a photographer, cosplayer, amateur chef, crazy cat lady, anime otaku, bookworm, generic geek, world traveler, conservative Christian, homeschooler, devoted military wife and stay at home new mother of two little girls.

Gingi blogs about anything and everything that is relevant to being a supermom, stay at home wife, homeschooler and geek girl! You can contact her at gingifreeman@gmail.com or via the contact form on her website at www.domesticgeekgirl.com

Gingi Freeman

Gingi is a photographer, cosplayer, amateur chef, crazy cat lady, anime otaku, bookworm, generic geek, world traveler, conservative Christian, homeschooler, devoted military wife and stay at home new mother of two little girls. Gingi blogs about anything and everything that is relevant to being a supermom, stay at home wife, homeschooler and geek girl! You can contact her at gingifreeman@gmail.com or via the contact form on her website at www.domesticgeekgirl.com

44 thoughts on “Can You Trust Your Doctor? – A Brief Look at Medical Journal Publication Bias

  • 22 January, 2015 at 12:39 pm
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    I am less trusting of doctors recently. All of our doctors over here think that the answer to everything is anti-depressants. Even for overweight people they just hand out pills without trying to address to issue.

    • 22 January, 2015 at 1:03 pm
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      Yeah, it’s gotten to where for children it’s ADHD pills and for adults it’s antidepressants.. not to mention antibiotics for EVERYTHING from the common cold to a sniffle…

  • 22 January, 2015 at 1:07 pm
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    Great post Gingi! I always think, you have to question everything and everyone these days. We had to switch pediatricians right away, they pushed so hard for vaccines that we don’t really believe in. I know they have to worry about herd immunity, I get that, but my kids are not in daycare and I would never expose them to other kids if they have so much as a slight sniffle, that’s just being considerate. My OBGYN said that I’d never be able to handle the pain from a natural birth and again , he was wrong. You just got to pray and do what you think is best I guess.

    • 22 January, 2015 at 1:26 pm
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      I don’t understand, when doctors were proscribing cigarettes for asthma and cocaine tablets for teething not too long ago, how mothers can just be so unthinking regarding the new multi-billion dollar vaccine fad.. it boggles my brain, especially since the science against vaccines and the countless studies all point to vaccines causing far more HARM than GOOD, especially in young children! Ugh! Anyhoo, you really should read up on “herd immunity” more, it’s a total farce.. here’s a quick article to check out! http://healthimpactnews.com/2013/the-herd-immunity-myth-treating-our-children-like-cattle-2/

  • 22 January, 2015 at 2:36 pm
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    I have to say I am sharing your opinion. After my mom passes and I saw how they were treating here, I really firmly believe that even health you can pay. Ok, maybe not health, but patient care. Amazing post. Mel
    http://www.livingoncloude9.com

    • 22 January, 2015 at 3:21 pm
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      I’m sorry for your loss. *hugs* It’s amazing how many people don’t see the big picture when it comes to the medical realm.. 🙁

  • 22 January, 2015 at 2:48 pm
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    You touch on an important issue here in this piece. One I fully understand. Even besides the big issue of publication bias though, there’s the fact that most medical doctors don’t read any journals outside of their basic practice.

    I bring that point up because, often there’s information that would be pertinent to know that is in say a kidney/liver publication, but doesn’t make it anywhere near a pediatrics publication, for example. That information might be very very pertinent, not just in terms of medications/prescriptions, but for overall health.

    As you said, “…condescendingly pooh poohs outside studies, traditional wisdom and global practices.” This drives me quite a bit batty. Very rarely have I (and we don’t frequent medical establishments) come across a doctor who will A) listen to a genuine question or concern that’s outside mainstream practice or B) engage in discussion surrounding a non-mainstream practice. Again, quite aptly you said “In America, doctors enjoy an unprecedented aura of infallibility, with many Americans holding an almost religious-like faith in their every word, decision or verdict on an issue. Many men and women feel there is no need to think, examine or question a doctor’s word, because he or she has done the thinking for you and there is no higher authority, end of story.” And, I think, that’s the bigger issue!

    • 22 January, 2015 at 3:25 pm
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      You make a great point! It’s virtually impossible for one person to absorb and stay current on ALL aspect of health and wellness at all times.. and when there is an inflexible attitude and unwillingness to listen to outside sources or legitimate questions, that’s a BIG PROBLEM… especially where childresn health is concerned!

      I have gotten to where I avoid doctors for the most part, unless there is an issue that I simply cannot understand or handle on my own. It drives me nuts when I see friends and family urging visits to the doctor for every normal sniffle or fuss, lol. Anyhoo, thanks for your thoughtful and enlightening comment!!

  • 22 January, 2015 at 10:15 pm
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    Thanks for stopping by. This is a very interesting article. One doctor we trust told us that doctors make the most money on “procedures” and I believe her. I find it difficult to find a caring and smart doctor all in one person.
    Sam
    Sam

    • 22 January, 2015 at 10:17 pm
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      They are out there!! But since medicine, like all professions, is a for-profit BUSINESS, it boggles my brain when people just blindly trust any and every “upsell”. I mean.. people question car dealers, car mechanics, pet veterinarians, etc… why not doctors too?! lol

  • 22 January, 2015 at 10:53 pm
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    I think you bring up some good points and I understand publication bias. But what are doctors to do? They can’t possibly stay on top of every unpublished study. I also think that doctors schooling and experience in the field brings them a level of knowledge that I can’t get by researching an area myself. I agree that it’s okay to question doctors and not take one opinion as an absolute answer but I certainly don’t think we should discredit professional advice either.

    • 22 January, 2015 at 11:06 pm
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      I agree, which is why I specified you should ditch your doctor ONLY if they are unwilling to listen to both sides of the coin. Not all doctors are good or bad, in the same way that not all cops are good or bad. We’re all human, and we’re all prone to bias, error and limited knowledge. It’s when someone in the medical profession relies solely on pre-selected medical journal bias, that I think it’s time to find a new doctor. 😉

  • 22 January, 2015 at 11:12 pm
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    You sum it up greatly!!
    I’m very sceptic too, due to a long life of experience and some years working in pharmaceutical industry…. Apart uninterested (or only in money) doctors, there’s simply too much to know now. A general practicer can’t keep up to date, it’s impossible. It’s more the medical service of the country that doesn’t function (can’t speak for your country, though). But here, too, there’s so much progress that has it’s costs, so we can’t pretend the whole service.
    Really a difficult topic, one could discuss for hours and clearly not find solutions.
    So if it’s possible one has to find oneself a doctor whom you an trust as a person – and look up on internet as much as possible if you already have a secure diagnosis….
    By the way, and maybe I shouldn’t say it in print – I detest my general practicer, but since it’s the one of the family and I don’t really need him I just go for prescriptions that I don’t get without for headache-pills and similar. My husband trusts him – I think he’s more reassured like that, so at least it serves a purpose.
    Sorry if I maybe sound confused but my English is not that good that I can discuss difficult topic….

    Love
    Rosa
    Styleyourselfinstyle.blogspot.com

    • 22 January, 2015 at 11:30 pm
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      I never would have guessed English wasn’t your first language.. very impressed! And you make perfect sense!
      I am very lucky to have a pediatrician that I like for my daughter. He knows his stuff, reads both sides of an issue (from what I can tell) and respects my views when I am not comfortable with certain procedures or interventions. It’s rare!! But yes, I agree it’s important to trust your doctor as a person. Glad you liked my post! <3

      • 23 January, 2015 at 10:45 am
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        Thanks 🙂 I have to say I’m happy that my son is grown now, when he was small I was fairly hysteric -really didn’t like the pediatrician of the social services, so went in private – cost me 150 Euro every time, an it was more than ten years ago!! My son is now studying in Switzerland, and some months ago I forced him (on nothing, like usual, but one never knows..) to go to the doctor of the states’ services, but in private, and on Saturday – it was only the equivalent of 50 Euros!!!! That to illustrate that some aspects that you described above are valid everywhere – a little bit less in one of statistic’s best countries to live – puts some questions, to my opinion……….
        :)))

        • 23 January, 2015 at 1:26 pm
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          My husband is in the military so we get great medical coverage… but it almost makes it worse in some ways. When I see a doctor, they know they can suggest multiple forms of medicine and treatment and frequent visits because if I say yes, it all gets billed to the military.. more money for them. With my first pregnancy they had me coming in once a week just to talk to a nurse about what I ate!! It was all so pointless and money grubbing..

    • 23 January, 2015 at 1:19 am
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      Thanks! <3

  • 23 January, 2015 at 12:26 am
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    Wow…a great write up on doctors and the biasing happens in the profession…. I love the way u have written….very clear and to the point….Indeed informative post… 🙂

    • 23 January, 2015 at 1:33 am
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      I’m glad you found it informative! <3

    • 23 January, 2015 at 2:39 am
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      Anytime! I am an information junky!! hehe!

  • 23 January, 2015 at 2:49 am
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    I’ve definitely gotten my skeptical of doctors, because it seems like they’re just in it to make money and prescribe something rather than actually heal you. I’m all for holistic doctors and things like that. (Of course, if it came to a broken limb or something… get me to a hospital! haha)

    • 23 January, 2015 at 3:55 am
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      I was telling my husband, Americans are well aware that when someone is in a BUSINESS, it’s for profit. That doesn’t mean every car mechanic is out to rob you blind – but it doesn’t mean that he ISN’T either. lol.. what we need is a little more common sense, especially in a realm so vital to health!!

  • 23 January, 2015 at 6:17 am
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    Great post! This is really interesting!
    Melanie @ meandmr.com

    • 23 January, 2015 at 1:15 pm
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      <3

    • 23 January, 2015 at 1:20 pm
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      I think doctors are great when used in context. Too many people see doctors when they need to see a nutritionist, or a gym, lol..

    • 23 January, 2015 at 2:22 pm
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      I agree!

  • 23 January, 2015 at 3:13 pm
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    That’s a very interesting story!
    I agree with you, I’ve came from a country where doctors give you medicine in case if you really need it and not curing flu with antibiotics like I see it some places.
    Canadian medicine is a bit different, we still have good doctors, but also have doctors who get commissions from recommending particular brands. And I don’t trust that year round flu shots, after which people still have flu.
    I think it’s OK to be a little bit sceptical)

    http://www.stripesnvibes.com
    BlogLovin

    • 23 January, 2015 at 3:24 pm
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      Yeah, I think the kickbacks from pharmaceutical companies is just plain wrong.. it should be illegal! If a doc gets a commission with a certain drug, that’s a clear conflict of interest in my opinion! I’m not anti-doctor, but I think being a wise “customer” is always a good idea.. especially where health is concerned!

  • 23 January, 2015 at 3:44 pm
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    I had become cynical of doctor’s after my experience a few years ago, where it became totally obvious that my doctor knew less about what was wrong with me than I did. I recently read Ben Goldacre’s book Bad Pharma, which uncovers just how much publication bias there is and how many of the medical professionals just prescribe the druga manufactured by the companies that a) advertise the most; b) send the doctor freebies and c) sponsor conferences and invite the doctor out for free meals…..

    • 23 January, 2015 at 4:17 pm
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      I’ve heard of that book! And have heard a lot about Goldacre.. I will need to read that book, for sure! The degree of corruption in this business is astounding.. it makes the blind faith of patients that much more dire..

  • 23 January, 2015 at 4:02 pm
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    The worse is going to the dr and them not knowing what the problem is. Spending money to tell me just to rest! That’s why I don’t ever go unless it is something serious effecting me.

    • 23 January, 2015 at 4:19 pm
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      Yeah.. I reserve my visits for true emergencies, lol..

  • 24 January, 2015 at 12:03 am
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    Gingi, I really enjoyed your article! I think we all need to be proactive about taking care of our health and the health of our families. Do your research on any drugs prescribed to you and treatments recommended and don’t just assume that if you doctor says you should do something that it’s the right choice for you and won’t cause any issues with your health.

    • 24 January, 2015 at 12:11 am
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      EXACTLY!!!! I’m so glad other people “get it”!!! ^_^

    • 24 January, 2015 at 11:39 pm
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      LOL, well a DENTIST, now that’s a whole different topic entirely! 😉

  • 27 January, 2015 at 6:18 pm
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    I haven’t entirely lost my faith in doctors but while I find they are able to help tremendously when diagnosing a condition, they don’t seem able to offer alternative healing methods to the pills etc they prescribe. My son was going to be prescribed a whole host of IMO terrible medication for his Crohn’s Disease which has now been totally controlled by diet! I think doctors graduate then follow the line, they seem to be blinkered and unaware that there could possibly be an alternative to the drugs they prescribe or they are unable to, due to the lack of trials. I do think that both ordinary medicine and alternative medicine can live side by side. For example, when my daughter was 3, a sore throat turned to blood poisoning within 6 hours adn without the help of the wonderful doctors at our local hospital, she would have died. Here antibiotics worked their magic and the training of all present saved her. SO there is a place for both, I just think that more can be done to educate the population about less harmful methods of healing!

    • 27 January, 2015 at 6:49 pm
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      I absolutely agree that there is a place for both traditional / mainstream and alternative health medicines.. but many doctors don’t see it that way. And it’s not that doctors are anti-holitic remedies, it’s just that drug companies can’t make money off of, say, garlic.. so they don’t put money into research, and doctors don’t see any mention of it in medical journals and so on and so on.. I think it’s our job as wise consumers to research ALL options ourselves, while still turning to professionals when need be! ^_^

      • 27 January, 2015 at 7:09 pm
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        I totally agree with you, however, sadly, who helps those that can’t help themselves? I think that is a huge problem, For example, I’ve just taken my mother for acupuncture treatment which appears to be working. For years she was prescribed the standard treatment for her condition which has caused memory problems – I am so angry about the situation, but this is the normal route. Without family, what would she have done? It’s such a shame really. Great article BTW!

        • 27 January, 2015 at 7:58 pm
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          Yeah, you’ve got a point… Your mum is very lucky that she has you looking out for her. I hope her treatments continue to be successful.. I know FAR TOO MANY people hurt or wounded or carrying permanent scars from the lunacy of the medical industry.. hence why I feel so strongly on the subject! Anyway, thanks for reading and weighing in! <3

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