ATI Wisdom Booklet: Burning Bones

After a long break, I'm back to reading the absurdities of the ATI/ATIA/IBLP Wisdom Booklets!

This week's exploration is of Wisdom Booklet 7's Medical Resource - "How Does A Lack of Mercy Trouble The Bones?" 

Apparently, the correct answer of "Not a damn bit" was too short.

The first section of medical resource is a bit disorganized, but gives a cursory overview of:

•  bone fusion in infants 
• how the sacrum forms 
• the strength of bone compared to reinforced concrete 
• the tissues within a bone
• the importance of joints
• how joints work
• how joints are stablized
• how synovial fluid works
• how bursae work
• how the spine is cushioned
• bone marrow creates red blood cells

I have some minor quibbles with a few of the explanations - but there are no major factual errors in the first part.  That makes the insanity of the second half all the more stunning.

Presumably, everyone who reads this blog understands the idea of literary forms.  The Bible is a compilation of works by many authors in many languages over a long period of time.   Entire books in the Bible were never meant to be read literally like Psalms and Proverbs; these books attempt to convey ideas about interactions between humans and the divine through poetic forms.

Using Psalms or Proverbs as a reference for how emotions affect bones - that would be bat-shit crazy.

And it is bat-shit crazy.

Here are the examples someone created by combining a superficial and shallow understanding of the human body and isolated Bible snippets:

This Psalm has a straightforward message: When I had unforgiven sin, I felt like shit.  It's not complicated or difficult to understand.

The scientific "explanation" falls apart rapidly under mild scrutiny.

• I've never heard any correlations between stress and coagulation time before but a few minutes on PubMed showed that under acute stress blood coagulates faster.  This makes some sense; severe wounds are extremely stressful and increasing coagulation may lessen blood loss.   Under chronic stress, blood coagulates faster as well - but not as rapidly as during acute stress.
• Yes, coagulation requires calcium and lots of coagulation will use up calcium in the blood - but that is not going on in massive amounts in healthy adults.  Uncontrolled coagulation causes serious, potentially fatal disorders like heart attacks, strokes, pulmonary embolisms and acute kidney failure.  
• The body will mobilize calcium from bones if blood calcium levels fall too far - but if blood calcium has dropped that low due to blood coagulation, the person is screwed since they've coagulated most - if not all - of their blood so they have no way to circulate oxygen from the lungs to major organs.  Plus, muscles need calcium to work including the heart so the person is in cardiac arrest as well.

  

The term "senile" has been removed from osteoporosis because osteoporosis can develop in younger people who suffer extreme malnutrition or have certain genetic disorders. 

When blood circulation slows, the first problem living tissue has is lack of oxygen - not calcium.  Without oxygen, cells cannot produce enough energy to continue vital processes and die.   This can happen in bones and produces avascular necrosis - not osteoporosis.

Living organisms have finely tuned balances on the amounts of certain chemicals in the blood including calcium.  Excess dietary calcium is excreted.  Similarly, if a person is eating enough calcium and vitamin D, the amount of calcium in the blood is generally adequate.  Adding excess blood flow to a region will not improve the amount of calcium in a bone if the area already has normal blood flow and appropriate blood calcium levels.

Why won't the body let us add excess calcium to the bloodstream when it is available? Too much calcium in the blood can cause cardiac arrest so the body prioritizes heart function over bone health.

That last bit on red blood cells (RBCs) is totally wrong.  Cells in the kidneys produce a hormone that controls the production of RBC based on the amount of blood oxygen.  Red blood cells shuttle oxygen through the body - not nutrients.  Waste disposal is handled by the skin, lungs, kidneys and liver, not RBCs.

Here's my (sane) response: Chronically stressed people often do not have the time or energy to take in the daily recommended amount of calcium.   Since calcium is needed for the heart and nervous system to work, the body will remove calcium from bones to keep the person alive at the risk of weakening bones over time.   If you cannot eat properly, take a calcium + Vitamin D supplement daily to protect your bones.

*rolls eyes*

Oh, yeah!  That totally makes sense!  One time, my twin sister scared me in the middle of the night.  I screamed in fear, jumped out of bed and both of my legs absolutely shattered!  Once the doctors fixed up my legs, they realized I had become severely anemic from the fright.   I knew we should have paid attention to the 1980's public service announcement "Scary tricks, broken bones".

Seriously.  We'd all have stories like that if the Wisdom Booklet was right.

Adrenaline acts to prioritize blood flow to the heart, lungs and skeletal muscles to prepare and power a fight-or-flight reaction. The reaction doesn't last forever so there's not permanent damage to the digestive system, skin, bones or any of the other systems that get less nutrients and oxygen until it is over.

Interesting fact: Red blood cells take 7 days to mature in the bone marrow and live for upto 3 months.  This means that an adrenaline rush - or even a theme park week-long trip - is not going to cause a noticeable decrease in the amount of RBCs in the body.  

Psalm 102 is thematically simple: "God, my life is crap because I'm chronically ill right now.  Please help!".

My biggest problem with this section is that it implies that osteomyelitis is much, much more prevalent than it really is.  According to Mayo Clinic, there are less than 1,000 cases of osteomyelitis in the US diagnosed a year - so it's really rare.   

The reason osteomyelitis is so rare isn't because Americans are relaxed and calm; it's because osteomyelitis requires multiple failures of the immune system to become clinically significant.  Bacteria has to pass through the layers of protection of the skin, respiratory system or digestive system, travel through the bloodstream while avoiding immune cells, and finally lodge in a bone without being destroyed by the immune cells there.

People at risk for osteomyelitis have serious chronic diseases that affect the immune system directly like rheumatoid arthritis and HIV/AIDS or reduce blood flow to extremities like sickle cell anemia and diabetes.  Another way osteomyelitis can occur is when bacteria can skip one or more immune system layers like illegal IV drug use, dialysis, compound bone fractures (which means the bone broke through the skin) or bone surgery.

                           

This section messily combines two separate conditions - osteoarthritis and rheumatoid arthritis - into an inchoate mess. 

Rheumatoid arthritis (RA) occurs when the immune system attacks the lining of joints causing severe inflammation and pain. The inflammation process damages cartilage plus the damaged lining doesn't produce enough fluid to lubricate the joint leading to worse damage to the cartilage.  Untreated RA can lead to fused joints.  The first joints attacked are often the small joints of the hands or feet and there is often visible reddening or swelling of the joint externally.  There are around 200,000 cases in the US each year making it a common disorder. 

In the snippet above, the first sentence and the diagram are about rheumatoid arthritis.

Osteoarthritis (often just called arthritis) is the degeneration of cartilage when daily wear-and-tear on joints cannot be fixed by the body.   The joints most affected are large joints that bear weight in the legs - knees and hips - and the shoulder joint.  Visible inflammation of the joint is rare. Over 3 million cases of arthritis occur annually in the US making arthritis extremely common.

The section about using antidepressants to treat arthritis describes the use of Cymbalta to help combat chronic pain due to arthritis.   Medical science is only starting to understand how chronic pain changes a patient's body.  It's clear that long-term pain causes changes in the amount of neurotransmitters in the brain which makes the brain more sensitive to pain.  SSRI's and SNRI's (classed as anti-depressants) cause the brain to slow the destruction of neurotransmitters which "reset" the patient's brain back to levels of neurotransmitters that pain-free people have.


When facing a chronic illness or the chronic illness of a loved one, stress relief is a good idea - but it's not a cure.   People who are facing RA or arthritis need medical and logistical support, not a spiritual intervention.