2002 11 19 I received the following message. It requires to be shared.
Ken Moyer [e-mail address omitted]
Sent: Tue 2002-11-19 07:06
Subject: Bad Information on your web site.
I have noticed on your web site you have reprinted the Hoax
email about surviving a Heart Attack. Please consider removing that information
because you could be doing a disservice to your readers. Please check out the
information I have included below and let me know what you think.
http://www.viahealth.org/rgh/heartattack.htm
http://www.nuketown.com/templates/hoaxes.php?hoax_id=29
http://urbanlegends.about.com/library/blcpr.htm
http://www.snopes.com/toxins/coughcpr.htm
I Hope you will reach the same conclusion I did that this is not legitimate medical
information and should not be spread.
Respectfully,
Ken Moyer, Austin Texas
I looked at all of the information pointed out by Ken Moyer and composed a reply.
Unfortunately, when I sent the response to him, it bounced, and so did two attempts
to re-send it. Therefore I'll post my response to his message on this page, in the
hope that Ken Moyer may find it and decide whether he'll let his concerns stand.
From: Walter H. Schneider [
]
To: Ken Moyer
Sent: Tue 2002-11-19 13:51
Subject: RE: Bad Information on your web site.
Dear Ken,
This is a re-send. I received a somewhat confusing message from my mail server and
am not sure my response reached you.
Thank you for sending the information. Your
message was short, but it linked to a lot of commentaries and much very useful
information. Therefore allow me to respond at length, so as to put my views into the
context of life in general, rather than to evaluate alternatives that obviously apply
only under ideal clinical conditions. In general, the circumstances of life are
conditions that are far from ideal.
Your message provided access to a very good overview of pertinent concerns and a good
collection of leads to available information. However, I would at least replace
the period at the end of your header line with a question mark, but I would prefer it if I
could quote your whole message at my website. Will you give me your permission to do
that?
I'll install a link to the last URL in the list you provided (or use your
whole message, pending your permission). I'll do that in the context of the web
page by means of an explanatory note (perhaps by means of what I state in my response
to you) and by identifying that some doctors don't like the instructions for self-help
'Cough CPR'. That is because simply stating that information is deemed
questionable by some is not sufficient proof that the information one
questions is actually wrong.
There has apparently been insufficient research, so far, providing support for
the criticism, criticism that is somewhat overdone. On the other hand, there has
been some research proving support for the 'Cough CPR'
method. Consider:
The 1992 Guidelines for Cardiopulmonary
Resuscitation and Emergency Cardiac Care and the Guidelines 2000 for
Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - International Consensus
on Science briefly discuss the technique called Cough CPR ¹. Cough CPR is a
self-administered form of cardiopulmonary resuscitation described by CM Criley in 1976 ².
According to Criley, self-initiated CPR is possible; however, its use is limited to
clinical situations in which the patient has a cardiac monitor, the arrest is recognized
before loss of consciousness, and the patient can cough forcefully. To date, there is
insufficient scientific research concerning the efficacy of Cough CPR. Therefore, American
Red Cross cannot advocate teaching the technique until it has been thoroughly tested in
national studies and found to be effective.
_______________
American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency
Cardiac Care. JAMA. 1992; 268(16): 2135-2302. Criley JM, Blaufuss AH, Kissel GL. Cough-induced cardiac
compression. JAMA, 1976; 236:1246-1250.
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Source: American Red Cross
Note the reason why the American Red Cross is not
recommending the 'Cough CPR' procedure. Note especially that the American Red Cross
does not state that 'Cough CPR' is a hoax. The
information in the article of concern to you is therefore not bad information. It is
not even questionable but merely being questioned by some people and organizations.
Those are important gradations. Moreover, if there were to exist any evidence at all
that someone killed himself by doing 'Cough CPR' when better methods were available and
should and could have been used, we would be sure to hear about it.
There is a considerable amount of empirical evidence showing that the recommended
alternatives leave much to be desired. That may not be true to the same extent
in the U.S. as it is in Canada. Nevertheless, from watching and reading coverage of
American health-care news and debates pertaining to current trends and the looming
collapse of our health-care systems, I gained the impression that we are in the same
boat. The willingness of the spirit of health-care workers is
increasingly not matched by their abilities or by the extent of
funding provided to materialize what they wish for.
The advice offered in the text in question, even if its source is vilified as
being obscure (the American Red Cross nevertheless unequivocally identifies the source of the 'Cough CPR' method), is not a hoax,
and I didn't see anyone of repute actually state that it is, other than that some people
distanced themselves from it. I had followed the advice when I needed it, and
it worked. Perhaps it would have worked even better if, in addition, I would
have taken an aspirin as recommended at the last link you identified. Common
sense indicates so, and the next time around I'll certainly do that, too.
Consider that the 'Cough CPR' method is recommended for people who can't reach a phone or
any help when a heart attack hits them, not as an alternative to readily available and readily
accessible cardiac care.
The area where I live and farm is so remote that not even a cell phone will work
here. It can take a half hour or more to drive the tractor off the field
and to our home (if driving it is still possible) before I can reach a regular
phone. Then we must wait at the very least a half hour before an ambulance
will get to us when we need it. It will most likely be more than two
hours before I am in intensive care in the hospital - long after the narrow window of
opportunity has gone by.
I'm no longer involved in farming to the extent I was, largely because of those
circumstances. Let's face it, anyone living in an area or circumstances such as ours
hasn't got a chance to receive the required treatment within the narrow window of
opportunity when he is afflicted by a heart attack. The method under discussion is
the only reasonable method available for people in our
circumstances.
If you were to have a heart attack under those conditions, would you just sit
and wait? If coughing as instructed would eliminate your pain, would you do that
instead of merely waiting helplessly and hoping that death may be quick or that you pass
out, if for no other reason than that you'll no longer feel the pain?
The advice and comments offered at some of the URLs you identified concentrate on the
source of the method in question and on that there are better alternatives under ideal
conditions. Moreover, it is stated there that the method offered in the message
under discussion could be deadly to someone who is unconscious. That doesn't make
much sense. How can someone who is unconscious still cough deliberately and thereby
risk causing his own death? How would he even be able to dial 911, let alone
ask for help? I would not, would you? However, provided I am still conscious
and able to do so, I would cough as long as I could, even if I would literally cough my
heart out. At least I would die trying to save myself.
Nevertheless, what valid alternatives are there for someone in circumstances such as those
I mentioned or for someone who is hunting in the bush or hiking, perhaps tens or hundreds
of miles away from the nearest phone?
Even in Canadian urban health-care regions
there have been numerous cases of heart-attack victims dying in ambulances that
were carrying them from one hospital to hospital after hospital, trying to
find one that would admit the heart-attack victim for treatment. As
long as I can, I would rather die while trying to help myself than to expire in
transit.
Don't accept everything doctors tell you without critically examining it. I
hope that by saying that I don't offend you if you should happen to be a medical
doctor. However, doctors don't know everything, and they make mistakes, often.
I had an eye doctor try to use a magnet to attempt to remove a sliver of brass stuck
in the centre of the pupil of my eye, even though I told him that non-ferrous metals
have no magnetic properties and that brass is a non-ferrous alloy. He could not be
deterred and said, "Well, it can't hurt to try. It might work. You never
know." There most certainly is an over-abundance of scientific evidence
contradicting what that doctor was unsuccessfully trying to do. That didn't hold him
back from trying anyway. We know that brass is not attracted by magnets and
therefore anyone with only a reasonable level of education would not even try to prove
otherwise. However, we should at least try to use methods that are not completely
proven as long as they are the only practical hope that is accessible for survival.
I have had a doctor prescribe anti-inflammatory medication for me that caused severe
intestinal bleeding because the prescription had me take that medication at a level that
was twice the allowable daily maximum. Not even the pharmacist, who should have,
noticed that I was being put into danger. And the doctor who had made out the
prescription for the wrong dosage merely prescribed something else to alleviate the
painful and damaging symptoms caused by my being overdosed. I had to find
information about the medication I was taking to determine why it was apparently killing
me. Common sense tells me that I'm alive and kicking in spite of my doctor's error
and mainly because I found something that worked much better for treating the cause
of my problem than the doctor-prescribed treatment of a problem symptom.
I no longer need to take anti-inflammatory medication for
the symptoms of my arthritis because I found an effective home remedy that helped me and
many other people whom we told about it. I've been pain-free since 1990
and even stopped taking the home remedy about ten years ago. Besides, the
home remedy (apple-cider vinegar and honey dissolved in water) is less dangerous, by far,
than what the doctor prescribed for me, even if that were taken only at the
recommended levels; and that medication is still a very popular one frequently prescribed
to patients suffering from acute inflammatory pains while it will do absolutely nothing to
treat the root causes of the symptoms it is intended to alleviate What doctors
try to do in that respect is little more than the equivalent of putting a new coat of
paint on a rusty old car or using a teaspoon of finely-ground pepper to stop a
radiator leak.
I could give you a long list of comparable experiences by friends and
relatives. Let's just consider that it is estimated that in Canada alone about
10,000 to 12,000 people annually meet their maker on account of medical misdiagnoses and
maltreatment, surgical errors, wrong prescriptions, wrongly administered medications and
wrongly-filled prescriptions. Therefore a Royal Commission has been launched to
examine that calamity and to determine what needs to be done to address it.
Do you think that the performance record of American medical professionals is better
than that of the Canadian ones? The Canadian Royal Commission will take about two
years to collect and examine data, and to announce its findings and recommendations.
I hope that I don't need the services of too many MDs before the commission finishes its
work. However, I'll keep as watchful an eye on anything and everything any doctor is
trying to do to me as if I were watching any mechanic doing work on any of my machinery or
vehicles. "Keep the doctors away and you might
live to eat an apple a day." :-)
By the way, the recovery rates and record of recovery for heart-attack victims
in France are much better than in North America. That is because intensive
initial cardiac care in France is being administered by paramedics at the homes of
patients and by then providing for home care, rather than merely trying to keep patients
alive during transport to hospitals.
The narrow window of opportunity that was mentioned by some of the commentators at the web
pages you identified is apparently better taken advantage of by doing what the French do
than by what the North American medical services promote as the best possible alternative
for the treatment of heart attacks. That is especially true considering the
inadequate and decreasing levels of services available under Canada's deteriorating
socialist health-care system, where nurses (often) and doctors (sometimes) go on
strike or work to rule, and where more and more hospital beds, even whole hospital
wings are being closed down permanently.
In Canada's rural areas it is not merely hospital beds but large numbers of hospitals
that are being closed. If you are in the market for small hospitals, let me
know. I know some, that were recently renovated at the cost of ten's
of thousands of dollars, that now stand empty and unused, and that you can own –
including the land they stand on – for prices as low as 10,000 Canadian
dollars a piece.
All the best,
Walter
Subsequent to my attempts to send that response to Ken Moyer I did some more
searching on the Internet and found the following:
Statement on Cough CPR
During a sudden arrhythmia, it may be possible for a
conscious/responsive victim to cough forcefully and maintain sufficient blood flow to the
brain to remain conscious for a few seconds until the arrhythmia disappears or is
treated. Blood flow is maintained by an increase in intrathoracic pressure that occurs
during forceful coughs.1-3 The phenomenon has been mislabeled "cough
CPR" although it is not a form of traditional resuscitation.
"Cough CPR" should not be routinely taught as a part of lay rescuer CPR
because it would complicate the teaching of traditional CPR by adding information that is
not generally useful in the prehospital setting. In virtually all lay rescuer CPR courses,
the assessment finding that signals the presence of an emergency is unresponsiveness
on the part of the victim. This signals the rescuer to begin the "A,B,C's" of
CPR. Unresponsive victims will not be able to perform "cough CPR".
Full story and additional references at the website of the
American
Heart Association
One of the references quoted in the information provided by the American
Heart Association is the original paper by Criley JM, Blaufuss JH, and Kissel GL.
Two additional references refer to reports that are dated 1998 and 1996,
respectively. From that it is quite obvious that the 'Cough CPR' method to restore
an individual's heart rhythm is far from being a hoax.
It boggles the mind, that if a laymen could with little effort find
accreditation of the procedure in two articles by prestigious and well renowned
organizations, why supposedly professional health-care providers would label the procedure
as a hoax.
Still, it needs to be stressed that the procedure should be used by an
individual only when he has absolutely no other recourse and only then,
which is a no-brainer, if he is conscious.
___________________
Comments:
Walter,
You are absolutely right.......cough CPR is not a hoax.
Thanks for sharing your response to the message from Ken Moyer and
the (in my opinion) questionable logic of some highly regarded
professional organizations.
A few years back, I had the unfortunate opportunity to personally
need to use the cough CPR procedure. I was driving home from work at
the time when I felt a very erratic rhythm to my heartbeat. There
was absolutely no pain but, almost immediately, I became very dizzy
which was getting progressively worse very quickly.
I was not in a remote area and I did have my cell phone with me but,
let me assure you, there is not enough time to even stop a vehicle
safely, much less flag down a passing motorist or call 911 as
suggested by the American Heart Association. Upon feeling dizzy, you
have 10 to 15 seconds before passing out. You have much less time
than that to do any rational thinking or to take any actions.
I won't go into any details how I knew about cough CPR (by the way,
it wasn't from the email) but I immediately began coughing very
aggressively. This did not make the dizziness go away completely but
it helped and certainly kept it from getting worse. With each cough,
I could feel the dizziness subside slightly but increase somewhat
again between coughs. I didn't try to time the coughs but determined
when I needed to cough by how dizzy I was. I would guess that it was
one every 1 to 2 seconds.
You don't have any sense of time under these circumstances but I
would guess that I kept this up for about 20 seconds when I suddenly
felt my normal heartbeat return. The dizziness went away almost
immediately. I don't know if the coughing had any effect on
restoring normal heart rhythm, as claimed by some, but I am certain
that it kept me from passing out.
It doesn't take a lot of "horse sense" or a "rocket scientist" to
conclude that the logical thing to do is take whatever steps
available to live. As I have just conveyed by email to the AHA, it
just doesn't make sense to sit quietly and wait to die or for help
that may come too late.
I salute you on your courage to publicly disagree with the norm.
G. S.
Another
comment (2009 02 09) by Lisa L.
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