Misconceptions about oxygen by alternative medicine practitioners

An article called “Simple ‘4-7-8? breathing trick can induce sleep in 60 seconds” claims that this trick can get you to go to sleep within 60 seconds. All you have to do is the following:

? Exhale completely through your mouth, making a whoosh sound.
? Close your mouth and inhale quietly through your nose to a mental count of four.
? Hold your breath for a count of seven.
? Exhale completely through your mouth, making a whoosh sound to a count of eight.
? This is one breath. Now inhale again and repeat the cycle three more times for a total of four breaths

An integrative medicine expert, Dr. Andrew Weil, said it works because it allows the lungs to become fully charged with air, allowing more oxygen into the body, which promotes a state of calm.

“Promotes a state of calm” is nonsense. Let’s concentrate on the science. Does it allow more oxygen into the body? Ich dont think so.

The air we breathe contains about 21% oxygen. Nearly all oxygen in the blood is carried by hemoglobin. No matter how many deep breaths you take, you cannot get the oxygen saturation of hemoglobin (normally > 92%, closer to 98% in healthy people) above 100%. This is explained in more detail in a previous post of mine about why athletes don’t benefit from breathing pure oxygen after exertion.

This simple trick would be hard to remember but might work through the power of suggestion. It doesn’t cost anything, and unless you hyperventilate and pass out (but youll be in bed anyway), it is harmless.

The next misconception about oxygen is neither inexpensive nor harmless.

Two naturopathic “doctors” have been accused of injecting a woman with oxygen or perhaps purified water that had been taken from an Octozone machine. The oxygen was supposed to destroy any pathogens in the woman’s blood. In the process of trying to kill the pathogens, the injection killed the patient who paid $500 for the treatment.

The naturopathic duo left town and were at large for several months before eventually being caught and charged with homicide.

An autopsy found her death was due to an air embolism.

According to a recent review of the subject, “Traditionally, it has been estimated that more than 5 mL/kg of air displaced into the intravenous space is required for significant injury (shock or cardiac arrest) to occur. However, complications have been reported with as little as 20 mL of air (the length of an unprimed IV infusion tubing) that was injected intravenously.”

Pure water should never be injected IV either because it causes blood cells to die from hemolysis.

How about we just take our oxygen the old-fashioned way—normal breaths and never intravenously?

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In what specialties can a surgeon be autonomous

I am a medical student who is trying to decide on a field. I am not chasing money but rather autonomy; thus I would prefer to work for myself rather than a hospital. So my question is, which fields of surgery are more amenable to private practice, and which fields tend to require the resources of a hospital or dont work as well without a hospital?

The way things are going; future use of the words “autonomous” and “physician” in the same sentence will be rare, if not unheard of.

Here are some figures from a July 2015 American Medical Association report.

• Younger physicians were more likely than older physicians to be employed. About 59% of physicians under the age of 40 were employed, versus 46.0% of physicians aged 40-54 and 33.3% of physicians 55 and above.
• Nearly one-third of physicians are in practices with more than 10 physicians, including 13.5 percent in practices with 50 or more physicians.
• Multi-specialty practice physicians were more likely than single-specialty practice physicians to report that their practices were hospital owned—44.6% compared to 23.0%.

Who knows what the percentage of employed physicians will be by 2020, but it surely will be higher.

I can think of only two surgical specialties that can be mostly independent of hospitals, otolaryngology and plastic surgery. I am not including ophthalmology because it isn’t really a classic surgical specialty.

The only way otolaryngologists and plastic surgeons can be autonomous is by concentrating solely on cosmetic surgery or working only in an ambulatory surgery center.

Otherwise, you would need a complete operating room—staffed by a nurse, an operating room technician and for some cases, an anesthesiologist—in your office.

Very few surgeons are able to limit their practices to cosmetic surgery directly out of residency or fellowship. Unless you join an established cosmetic surgeon in practice, which would of course limit your autonomy, you will need to be on call for trauma and be available for consults involving problems like pressure sores in hospitals to pay the bills.

My observation as a surgical chairman in community hospitals was that it takes years before the average plastic surgeon is able to develop a reputation and focus solely on cosmetic surgery.

You should also be aware that both of those specialties are highly competitive. In this years match, only 1 of 299 ENT positions went unfilled, and 364 US seniors had ranked ENT as their preferred choice. For plastics, there are two ways to obtain a position. The NRMP handles an integrated match which filled 144 of 148 positions. There were 162 US seniors who listed Integrated plastics as their preferred choice. The other match is independent of the NRMP and takes residents who have done varying years of general surgery. For that 2015 match, which placed applicants in positions starting in July 2016, 85 applicants submitted rank lists, and 68 of 70 positions were filled. That left 17 candidates unmatched.

Additional reading: A post on KevinMD entitled “So doctor, who’s your boss?”

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