Archive for April 2009
THE SELF-MANAGEMENT OF DIFFERENT KINDS OF PAIN:
Wednesday, April 29, 2009 | 4:35 amTHE SELF-MANAGEMENT OF SUDDEN UNEXPECTED PAIN
This is a different clinical problem again. The difficulty with sudden unexpected pain is that the pain is likely to get out of hand and overwhelm us. It is then easy to be overcome with distress before we can compose ourselves. It happens in the case of an unexpected blow, a broken bone, a burn, or even a severe sprain.
Our studies in the self-management of pain help in two ways. If we have learned something of the approach and have had some experience in the mental exercises, we do not react so drastically to sudden pain. This has been my own experience, and a number of patients have volunteered a similar observation. In the second place, if we should find that we are suddenly threatened with loss of control in this way, we now have the means to bring ourselves quickly under control and restore our composure.
As in each of the other aspects of pain and anxiety, we work to bring our principles of
self-management more and more into our everyday life. So when we experience some sudden and unexpected pain, even if it is only of minor degree, we immediately restore our composure by momentary mental relaxation instead of giving vent to our feelings as we have done in the past. Be warned that there is a good deal of false teaching by psychiatrists and those who should know better that it is good to give vent to our emotions and feelings. If we give vent to our feeling of pain, we too easily become distressed, and the intensity of the pain is increased.
Four years ago a dentist came to me. He has a degenerative condition of his backbone so that the nerves are pinched as they come from the spinal cord between the bones. He suffered sudden unexpected twinges of acute pain as well as quite severe chronic pain. His work as a dentist with the long hours on his feet and the necessity of leaning forward over the patient made him very vulnerable to this condition.
He has learned to control the pain. He is still working full-time. Between patients he occasionally lies down in a side room for a few minutes to re-establish his mental and physical relaxation.
A seventy-two-year-old single woman was referred to me in the hope that I might be able to help her with the pain in her tic douloureux. This is a shockingly painful condition characterized by sudden jabs of acute pain in the side of the face. The first attack had come on eleven years previously, but this had settled down. She was now subject to continual jabs of pain when she was talking or eating. On occasions the pain was excruciating. Three years previously she had developed trigger points on the face and tongue, and if these were touched, it would precipitate excruciating pain. At night if she moved in her sleep and the bedclothes brushed her face, pain would be precipitated in this way.
She was a very courageous, stoic woman, and I have no doubt that at times she experienced really terrible pain. However, she wanted to avoid the orthodox treatment by injection or the operation of cutting the nerve, both of which leave that part of the face without feeling and so open to injury.
She was a particularly good patient, as are many people who are in extreme pain. I only saw her on four occasions. She then claimed that she could reduce the pain to quite bearable proportions; and she did in fact allow me to touch the trigger spots, which previously had been so exquisitely tender.
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(posted in Anti Depressants-Sleeping Aid)
PIGMENT DEPOSITS IN THE IRIS: LIPOFUSCIN: THE ‘WEAR AND TEAR’ PIGMENT
Wednesday, April 29, 2009 | 3:35 amThis Fe-free pigment can appear in the iris in a range of colours varying from light yellow to black-brown. It is formed within the ganglion cells of the Nucleus niger and Locus ceruleus, and appears mostly as ‘wear and tear’ pigment in old age. However, it can also originate from protein metabolism without such regressive changes.
Lipofuscin (never melanin) is a constituent of the extra-pyramidal system. In the Zona reticularis of the suprarenal body, lipofuscin can be recognised microscopically as a dark brown colouring in conditions of old age. Although lipofuscin is described as a product of old age, it can also exist as a degeneration product in young people and as a sign of exhaustion of particular organs, hence the terms: liver-, renal- and pancreas-pigment.
At this point, I would like to include the group of rheumatic-gouty deposits. In my view, the duration of the condition can be assessed from the colour of the signs. The longer the disease has been present, the darker is the colour of the pigment.
Even though the above-mentioned pigments are topolabile, the presence of the flecks in the different zones of the iris can still be assigned to definite organ systems. If the light reddish pigment, as described in detail in the literature under the term—Nux vomica pigment, appears in the stomach and intestinal zone (first major zone), then it shows that a condition of fermentation affects these organs. If the discolouration extends outwards beyond the iris-wreath, then other organ systems can be affected.
The yellow to brown deposits which extend from the iris -wreath to the outer margin of the iris (Berberis pigment) indicate general disease of the body (Maubach: Reibekuchen-iris). In this case, the condition arises from a gouty disposition of hereditary origin. Indications of the acute phases of gout appear white, and generally lie next to dark signs in the bone area (fifth minor zone).
The pigments described as liver-, renal- and pancreas-pigment are likewise found in the ciliary zone.
Pigment deposits may appear in the iris if an organ is affected. However, since the differences of colour and localisation of pigment-flecks are insufficient for diagnosis, one must look for other signs in the organ areas of the iris in order to reach a definite opinion. Iridologists have been concerned with iris pigment-signs from the first beginnings of irisdiagnosis, commencing with Liljequist and continuing with Attila von Peczely, Schnabel and Angerer. In spite of their extensive works, there still remains a wide field for further research.
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(posted in General health)
TREATMENT FOR THE ACHING MISERIES: PROGESTOGEN
Wednesday, April 29, 2009 | 2:25 amHowever, there are synthetic forms of progesterone, called progestogens, which can be in pill form. The trouble is that you can’t depend on getting the same results with a substitute as you can with the real thing. If you take progestogen, your body will cut back rather than increase the amount of progesterone it will produce. And remember the object of the exercise is to provide you with more progesterone. However, doctors at St Thomas’ Hospital who treat their patients with progestogen, under the trade name ‘Duphaston’ are pleased with their results. They claim that this drug can relieve many of the symptoms for a majority of their patients. Unfortunately, the picture isn’t entirely rosy. I feel it’s only right to warn you that Duphaston can and does have some unpleasant side effects for some of the women who take it. On the other hand, doctors at St Thomas’ Hospital are encouraged by the success of their trials of this drug, which they say helped seventy per cent of their patients.
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(posted in Pain Relief-Muscle Relaxers)
THE ACHING MISERIES (CONGESTIVE DYSMENORRHOEA): FATIGUE-EATING FOR ENERGY
Tuesday, April 28, 2009 | 5:55 amAs soon as you start to feel fatigue, particularly if it makes you snappy or irritable or, worse, if you suddenly have a migraine or you feel terribly tired and dizzy or in a panic, then you really should check to see that you have been eating enough. You may have been skimping meals or missing them altogether, so what you are suffering from is lack of nourishment or a drop in your blood sugar level. We all need sugar in our blood to keep us going, and when stocks run low our bodies send out very clear signals to us. We feel hungry and start looking at the clock, wondering how near it is to elevenses or tea time. We say we would give anything for a bar of chocolate. We think about food.
Perhaps you have been ignoring the signals? Check and see what you have actually eaten during the day—and, just as important, how long it was between one meal and the next. You may have missed breakfast because you woke up feeling so tired that you decided to lie in. If you are a mother at home, you may have cooked something for the children and gone without
yourself. You may have skipped your tea break and even your lunch hour because you were working so slowly you thought you would never catch up if you stopped for something to eat. In fact, you may have felt quite noble sacrificing your food for the sake of greater efficiency. Actually, you were sacrificing your efficiency too. We work slower and slower when we’re hungry and the more hungry we get, the slower we become. Fortunately we get faster and more accurate immediately we’ve eaten sufficient food.
If you are on a controlled diet you will probably find you can work perfectly well and diet in the weeks after your period, but it might be a good idea to ease up before your period is due. That’s when you really need adequate food—an English breakfast if you can face one, elevenses, a proper meal at mid-day, tea at four o’clock and then a good evening meal. This is another occasion when husbands or relations can be such a help. They notice when you are missing meals, even if you don’t. After all, they’re the ones who get snapped at when you are low. Accept their help. You’ll be all the better for it—even if you can’t get into that skin-tight dress.
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(posted in Pain Relief-Muscle Relaxers)
CHILDREN’S VISION PROBLEMS: SIGNS, CARE AND TREATMENT
Tuesday, April 28, 2009 | 4:00 amSigns and symptoms
There are clear symptoms that may indicate poor vision. If your child habitually tilts his or her head or looks out of the corners of his or her eyes, if the eyes cross or move away from normal, or if the child squints or is excessively sensitive to bright lights, there could be an eyesight problem. Holding objects close to examine them, failure to recognize familiar people at a distance, headaches following use of the eyes, problems in school, and a dislike of reading may also signify poor vision.
At birth, a baby who has normal eyes can focus on an object and visually follow movement. If an infant’s eyes seem to make random, searching movements, he or she may have defective vision.
Vision can be tested at different ages in a variety of ways. During the first week of life an infant should be able to fix his or her eyes on a bright light. By two months of age, the child’s eyes should follow that light as it moves through a 180-degree arc. By seven or eight months the child should be able to recognize and respond to facial expressions. After age three, a child’s eyes can be tested by having him or her focus on charts that use pictures or the letter E pointed in different directions. Finally, around age five or six, the child’s eyes can be tested using a standard Snellen eye chart.
Home care
Precautions
• A child who cannot see the television screen from a distance or who holds books close to the eyes may be nearsighted.
• A child’s vision should be checked annually, beginning no later than age four.
Medical treatment
At each annual eye checkup, your doctor will examine your child’s eyes inside and out with an ophthalmoscope, and test the child’s vision using a chart of letters in rows of diminishing sizes. If an abnormality is suspected, your doctor will refer your child to an eye specialist for more detailed examination and correction of the problem.
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(posted in General health)
LIVING WITH DIABETES: ISLET CELLS COULD BE USED
Thursday, April 23, 2009 | 2:43 amIt is possible to separate the islet cells (which make insulin) from the gland tissue (which makes digestive juice) in the laboratory. This can be done from adult pancreases but is a difficult procedure and only a very small proportion of the adult pancreas consists of islet cells.
Islet cells can be obtained from the pancreas of fetuses obtained in abortion, or new-born babies who die soon after birth. It has been hoped that these islet cells, which can be cultured in the laboratory, can be placed in the body of persons with diabetes and grow there to produce enough insulin to control the diabetes.
So far work in this field has been somewhat discouraging, though there is some encouragement in that the system works well in experimental animals. It is not known yet whether in the human the islet cells could grow in number and function normally after transplantation.
Tissue rejection remains a problem with islet cells as with transplantation of the whole or part of the pancreas. It is likely that this problem of tissue rejection will be solved eventually. Tissue rejection refers to the process in which the body fights against strange and foreign tissues placed in the body, and thus rejects the transplant which can no longer survive.
The major problems may prove to be in the supply of islet cells and whether they can function properly when they are transplanted. There are problems in obtaining pancreas tissue from aborted fetuses – problems that are moral, ethical and practical – and these problems have not been resolved. It is not known whether islet cells will grow and function adequately when placed in a person with diabetes or whether they themselves may be damaged in the same way as the person’s own pancreas cells were damaged when he developed diabetes.
These questions are the subject of a great deal of active research in several world centers including in Australia. It may be many years before they are answered but the possibilities are very hopeful.
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(posted in Diabetes)
MANAGING OUR STRESS: MEDITATION IN OUR LIFE
Thursday, April 23, 2009 | 2:37 amIn classical meditation it is regarded as important that the meditator should meditate sitting cross-legged in the position known as the lotus posture. In the ashrams of India and the zen-dos of Japan this posture is regarded as essential, and the beginner is told to get his legs as nearly as he can into this position, and to maintain it, no matter how much it hurts, for the duration of the meditation. There is none of this in the meditation that I would advise you to pursue. If we are striving against discomfort and pain, the essential stillness of mind is impossible.
For the type of meditation that I advocate, we must start our meditation in some position of slight discomfort. Then we let our mind run quietly, with as little thought as possible, and we are soon no longer aware of any discomfort. This transcendence of slight discomfort is an essential feature of successful meditation.
It does not matter how we induce the slight discomfort. This will depend on age, and on the physical and mental condition of the meditator. At the start, just sitting straight on an upright chair may be enough to produce slight discomfort. As the beginner becomes more experienced, he will soon learn that he quite easily transcends greater degrees of discomfort. He can then lie flat on his back on the floor, or sit cross-legged on a cushion or pillow, or better still on the telephone book. The meditator may prefer to kneel, either kneeling up, as in a posture of prayer, or kneeling back with the buttocks resting on the heels. If this produces too much discomfort, it can be reduced by placing a pillow over the heels.
The important factor is that the discomfort must never be so great that it is not transcended in the first few minutes of meditation. Furthermore, the discomfort needs to be progressively more severe as the meditator becomes more experienced.
Any idea of meditating while lying comfortably in bed is quite useless. In this case the individual may become relaxed. And of course physical relaxation is a good precursor to meditation, but when lying in bed the relaxation comes from nervous impulses to the brain reporting relaxation of the muscles. This is not what we want. We are seeking a form of relaxation which arises in the brain itself.
In classical meditation the meditator is taught to be constantly aware of his breathing. The breath goes in and out, in and out. The awareness of it means that there is continuing activity of the mind, which means that this process produces a type of meditation quite different from that which I advocate. There is another point. The awareness of our breathing gives our mind something to do, and so reduces the intrusion of thoughts. This makes meditation easier. So those learning to meditate easily fall into the habit of stilling their thoughts in this way. But if we are meditating with awareness of our breathing, our brain never achieves the quiet stillness which is so effective in restoring harmonious function and so relieving stress.
These same principles apply to the technique of visualization. In the last few years there has been a great vogue of visualizing in meditation. The idea is not new to me as I described it in a textbook, A System of Medical Hypnosis.
In this procedure the meditator sees in his mind’s eye the desired result being fulfilled. The person who is under stress visualizes himself calm and at ease in the face of various problems. The technique has become quite widely used with patients suffering from cancer. Of course, while the patient visualizes, his brain remains active, and the therapeutic effect of stillness of mind is never attained.
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(posted in Anti Depressants-Sleeping Aid)
INFERIOR PSYCHOLOGICAL REACTIONS TO ESCAPE STRESS: DEPENDENCE
Thursday, April 23, 2009 | 2:34 amThe way in which we manage our dependence reactions is an important part of successful living, and may become intimately bound up with our reaction to stress. In infancy and childhood we are completely dependent on our parents. In adult life we provide dependence for our own children. In old age our children provide dependence for us, and we learn to accept it.
The dependence that we give our children is not constant. It is variable. We instinctively vary it according to the child’s needs. If something has gone wrong for him, or he is having a tough time, we move closer. When things are going well, and his need of dependence on us is less, we move away so that he comes to learn the self-dependence of adult life.
In our adult life, when things go wrong, we tend to fall back on childhood reactions and patterns of behaviour. Some people, when they come under stress, try to cope with the situation by craving for an intense dependent relationship. The businessman, under stress from problems at work, may become intensely dependent on his wife. The intensity of the dependence may progress to real childishness at home although it is never shown at work.
The relationship reactivates feelings of childhood. He feels more secure, and the symptoms of stress are reduced. And because he feels better, he tends to prolong the over-dependent reaction long after the problem causing the stress has been resolved. The result is that the wife comes to find herself burdened with the emotional needs of another child.
We must be clear about this. It is only the intensity of the dependence reaction following stress that makes it pathological. The giving and acceptance of emotional dependence, when the other needs it, is what man and woman is all about.
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(posted in Anti Depressants-Sleeping Aid)
BODILY SYMPTOMS OF STRESS: BUTTERFLIES
Thursday, April 23, 2009 | 2:26 am“It is usually just a light movement in my stomach. Light. Like a flutter of a butterfly. But a butterfly is nice, and this is not a nice feeling. Not pain. Not hurting. But disagreeable. Nasty. Worrying. Yes. The worrying part of it is the worst. The tests were all OK. But it is worrying. You can’t get away from that. Then if you feel it, and it’s worrying, you can’t concentrate on what you should be concentrating on. Keep thinking of my stomach.
‘Then sometimes it’s worse. Not just light. But heavier. Stomach turning over. They say your stomach can’t turn over. But I can feel it. Sometimes makes me feel as if I want to be sick. I am sure there is something wrong.
‘When it’s very bad it is really heavy. A weight in my stomach. A weight and I can feel a lump. A heavy lump. There must be a tumour. If you can feel it, for certain it must be there. Cancer does not always show in the tests.”
In stress, the activation of the brain cells may spread out so as to involve groups of cells which control various bodily functions. In this case the autonomic nervous system has become activated. This part of our nervous system regulates the movement of our stomach and bowel. Increased rhythmical contractions of the muscle in the walls of the stomach are felt as a fluttering feeling. If the process becomes further aggravated, ‘here may come about a generalized contraction of muscle in the walls of the stomach. This can be felt as something hard, and gives rise to the feeling of a tumour and possibly cancer.
As in the case of palpitation of the heart, the trouble is made worse by the increased perception of sensation, so that we become aware of movements which would normally not be of sufficient significance to be registered in consciousness.
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(posted in Anti Depressants-Sleeping Aid)
PREVENTIVE MEDECINE: WAYS TO LOWER BLOOD CHOLESTEROL LEVELS
Wednesday, April 22, 2009 | 10:34 pm• Eat less cholesterol. This is somewhat contentious because various studies conflict on whether or not it is worth while restricting the intake of such foods. Egg yolks, butter and liver are especially high sources. The NACNE report on healthy eating recommends no curtailing of cholesterol-rich foods but anyone eating a lot of any of these three and who has high blood cholesterol would probably do well to cut them down or out.
• Polyunsaturated oils used for cooking or as spreads also have an effect on blood cholesterol levels. In one study in Minneapolis twenty-four healthy volunteers were put on a high-cholesterol diet. When polyunsaturated fats were added both total cholesterol and the harmful LDL component fell. HDL remained high. Of the oils tested, un-hydrogenated soya oil and corn were best. Other studies have found that corn flour oil has similar effects.
• Yoghurt may be helpful. One researcher believes that the special bacteria used to ferment yoghurt also produce a substance which blocks cholesterol production in the liver. Eating yoghurt has been found to reduce cholesterol in the blood. Milk (even skimmed) raises blood cholesterol, however.
• Chromium has been found to lower cholesterol levels in rabbits fed on a cholesterol-enriched diet. The rabbits fed with chromium also had only half as many plaques on their coronary arteries as did rabbits in the control group. In humans, brewer’s yeast (a rich source of chromium) raised HDL levels in one study.
• Vitamins Ñ and E are valuable too. In a study of forty people with coronary artery disease carried out in India it was found that those whose diets were supplemented with 2 g of vitamin Ñ had an average drop of 12 per cent in their cholesterol levels. In a UK study vitamin Ñ was found to raise the helpful HDL cholesterol fraction. The researchers found that many heart-disease patients had both low vitamin Ñ and low HDL levels. A dose of 1 g vitamin Ñ a day brought both levels up towards normal.
Vitamin E also raises HDLs. A daily dose of 800 Ø increased the HDLs of forty-three volunteers and had the greatest effect in those whose HDLs were lowest to start with.
• Get plenty of exercise. When carrying out the vitamin E study the researchers noticed that joggers and long-distance runners in their sample had very high HDLs before supplementation with the vitamin. Several other studies have found that exercise helps keep cholesterol at normal levels. Even moderate exercise, such as a brisk walk, seems to be effective.
• Stop smoking. A Swedish team found that smokers tended to have low HDL levels. When a group of smokers gave up they all experienced ‘rapid and pronounced increases in HDL concentrations’. The levels rose by an average of 29 per cent within two weeks and remained high throughout the observation period.
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(posted in General health)