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CHARLIE’S STORY – PART 2

July 23rd, 2011

The morning following his birth, Charlie was flown by elicopter to a specialized hospital where he underwent a full-day operation. A staff of doctors cut his pelvic bones, re-inserted his bladder and stitched up his abdominal wall. Charlie and his mom and dad lived at this distant hospital for forty days.This was to be just the beginning of eight nightmarish years of continual surgery to repair the extensive problems to his uro-genital track. Not to mention, the many side-effects from all the surgeries and drugs, including a life changing, life threatening toxic allergy to anything made of latex.His mom has lost count of the number of surgeries he has had. She thinks it’s between twenty and thirty. It is not uncommon for kids with this problem to have this many surgeries or more during their lifetime. And there will be many more.These procedures and treatments have totaled close to a million dollars, probably more. While Liz and her husband have some insurance, it certainly hasn’t covered all costs. It was also necessary for Liz to quit her lucrative job as a paralegal to take care of Charlie full time. “He would be in and out of the hospital every five weeks because so many things kept going wrong. His hip came out of its socket. He had epispadias repair. He had a double strangulated hernia. He, also, suffered for several years with such painful bladder spasms that he had to take heavy narcotics to keep the pain at bay. He is has been on ongoing antibiotics to deal with recurrence of bladder infections and will have to stay on them for the rest of his life.”*37/165/1*

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THE SELF-POISONER: PATTERNS OF SELF-INDUCED TOXICITY – PSYCHOLOLGICAL DIARRHEA

July 15th, 2011

This pattern although the opposite of emotional constipation, is equally toxic. The afflicted person behaves as if he couldn’t hold anything back. He has little tolerance for frustration and must discharge any kind of tension as quickly as possible. In men, this may take the form of premature ejaculation. Verbal diarrhea is seen in people who must talk incessantly to reduce their inner tensions. Silence, even for a minute or two, generates an unbearable pressure.In effect, these people short-circuit a great deal of potential nourishment. Deeply gratifying experiences often require a healthy build-up of tension to a full peak followed by an intense discharge and more complete gratification.T people are characteristically phobic about pain and have little tolerance for the tension of unfulfilled needs. Because they expect that their needs will not be gratified, it is difficult for them to consider any feeling of tension as a pleasurable experience. They are unable to enjoy the delights of anticipating forth-corning gratification and usually have a compulsive need to discharge any tension as soon as they become aware of it.*61\350\8*

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TREATING MIGRAINE WITHOUT DRUGS: EXERCISE

July 8th, 2011

Exercise can bring on headaches in some people, but the reverse also obtains in that physical training can be of benefit in preventing headaches, possibly by ‘toning up’ the body and thereby the blood vessels. The effect of training on performance is well recognized: the heart and lungs work more efficiently so that we do not get out of breath so easily, the blood flow to muscles increases, and the muscles themselves become larger so that we do not get tired as readily. In the trained person, the heart beats more slowly at rest, and, during exercise, it does not beat as fast as before training nor does the blood pressure rise as high. A greater efficiency is achieved due to increased parasympathetic activity. The amount of noradrenalin and adrenalin released for a given amount of exertion decreases; in addition, supplies of energy become more readily available, which also helps to avoid fatigue.When an untrained subject first starts exercising, the level of blood glucose drops, releasing hormones which break down stored supplies of sugar to raise the blood level. (In trained subjects, the blood sugar level shows an immediate rise on commencement of exercise.) Because training makes the body more efficient, it is more able to resist the effects of stress and the subject becomes able to do more during the day without getting tired.Studies of the effects of exercise training on the frequency of headaches in migraine sufferers are producing encouraging results, possibly because the blood vessels alter their tone. Jogging, an activity becoming increasingly popular in both sexes is the best sort of exercise for this purpose because it moves the greatest bulk of muscle and speeds up the heart rate. The distance and speed should be measured each time, the minimum number of runs being three times weekly. It is important to run fast enough to raise the pulse rate above 150 per minute and for long enough to make one slightly tired.
*47/152/5*

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DIGESTIVE DISORDERS AND AN UNHEALTHY SKIN

June 24th, 2011

We have to take the matter a step further, to show the effect of disorders of the alimentary tract on the tissues of the skin. The direct relationship between the “sea-water,” of the body in which all of the cells live and function, and the digestive system is quite obvious. In the stomach the food is broken down and prepared for assimilation, and it is then taken to the “sea-water” for the final exchange with the cells. In this way the cells are nourished and relieved of their waste products. The blood and the lymph act as carriers between these two important systems, and disturbance of the one is soon felt in the other.Of all the organs in the body the stomach is most open to abuse. It is at the mercy of our appetites, and all the mistakes we may make, in both the quality and the quantity of our daily food, are immediately inflicted upon the stomach. It may be distended by overeating, it may be irritated by the use of spiced foods, it may be upset by taking foods too hot or too cold. In these and many other ways the normal function of the stomach may be disturbed. The result is that digestion is turned into indigestion, and the whole body suffers as a consequence – not least of all the skin, which, as we have pointed out, depends on the integrity of the digestive process.It is inevitable that indigestion should lead to disorders of the bowel function, and further complications are then likely to follow. When the digestion in the stomach is carried on in normal conditions the work that has to be done by the colon is very much simplified; but if there is constant indigestion the acid and undigested foodstuffs which pass into the bowel are likely to cause all kinds of troubles, not the least being an irregular and difficult action of the bowels, i.e. constipation, which has been named the “universal complaint.”When this state of affairs occurs then the other eliminating organs of the body come under greater strain, and the skin is particularly affected. The important balance between the intake of nutriment and the elimination of the waste products has then been disturbed, and the whole system will be under the strain of retaining the toxins of its own activity to a point where it enters the danger zone of disease.
*19/154/5*

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Cold A cold

June 11th, 2011

Cold A cold spray of the type used on athletes produces dramatic but brief relief. It cannot be caused by cooling the deep tissue that is damaged. The provoked impulses arriving in the spinal cord set off a temporary inhibition of the cells transmitting the injury signals.HeatThere is no doubt about the generally comforting, relaxing effect of overall heating, as witnessed in the Roman caldarium and the modern sauna. It is a standard treatment for anyone’s anxiety. A quite different treatment is local heat. In the words of T. S. Eliot:
Here comes the nurse with the red hot poultice, Slaps it on and takes no notice
The nurse may take no notice but the patient certainly does and shifts attention. Attention distraction is the basis of counter-stimulation. A third Cold A cold and quite different intention of heat therapy is to increase circulation and thereby to speed up the end of inflammation. Ultrasound and microwave therapy were invented for this purpose to heat deep tissue. The use of ultrasound will be described in the next chapter as an impressive example of a proven placebo effect.Gentle massage Delightful.Transcutaneous electrical nerve stimulationWhen I had discovered that the input from large, low-threshold sensory afferent nerves reduced the response of animal spinal-cord cells to an input from injury-detecting fibres, Sweet and I tried in Boston in 1967 to produce the same effect, first on ourselves and then on patients. We knew that a small electrical stimulus preferentially excited the large fibres so we superimposed a gentle tingling sensation on top of the painful area. When this can be achieved, it produces considerable relief of the pain. We extended the method to direct stimulation of nerves and of the spinal cord, but the most common use is to try to produce the effect by simple electrodes on the skin. It is no panacea but it works.*60\219\2*

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IBS AND PRESCRIBED DRUGS: BENZODIAZEPINES – DOSE & PRECAUTIONS

June 2nd, 2011

Dose1 The lowest dose which can control the symptoms should be used. It should not be continued beyond four weeks.2 Long-term chronic use is not recommended.3 Treatment should always be tapered off gradually.4 Patients who have taken benzodiazepines for a long time may require a longer period during which doses are reduced.5 When a benzodiazepine is used as a hypnotic, treatment should, if possible, be intermittent.Precautions1 Benzodiazepines should not be used alone to treat depression or anxiety associated with depression. Suicide may be precipitated in such patients.2 They should not be used for phobic or obsessional states.3 They should not be used for the treatment of chronic psychosis.4 In case of loss or bereavement, psychological adjustment may be inhibited by benzodiazepines.5 Disinhibiting effects may be manifested in various ways. Suicide may be precipitated in patients who are depressed, and aggressive behaviour towards self and others may be precipitated. Extreme caution should therefore be used in prescribing benzodiazepines in patients with personality disorders.*89\326\8*

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HEART FAILURE AS A COMPLICATION OF MYOCARDIAL INFARCTION

May 22nd, 2011

One of the potential early complications of the myocardial infarction is heart failure. This term means that the pump is unable to move an adequate amount of blood through the body. When one portion of the heart muscle suddenly dies, the rest of the heart must take on an additional burden. This is similar to one engine of a multiengine airplane suddenly quitting in flight. If the load is not too heavy and if the remaining engines are powerful enough, the plane will continue to be airborne; otherwise the plane will crash. If the pilot has sufficient time to act, he may be able to compensate for his loss of power by throwing cargo or fuel overboard to lighten his load. The burden on the heart muscle is eased by radically reducing the activity that the entire body undertakes. This is another reason for strict rest during the early phases of a heart attack. If the heart is unable to pump an adequate blood volume, the ensuing course of events results in an engorgement of blood in the vessels of the lungs. The increased back pressure eventually results in the water portion of the blood oozing into the air spaces of the lungs, which blocks normal gas exchange. The patient literally drowns in his own fluids. The clinical picture is called pulmonary edema, which is a form of heart failure. The patient experiences this chain of events as a rapidly increasing shortness of breath.*6/309/5*

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BACH FLOWER REMEDIES: CLEMATUS REMEDY

May 11th, 2011

It is said that Clematis has helped married women to conceive when there was no organic reason in the couple for childlessness.It is a pathetic sight when the creative potential of an artist is not brought to fruition; instead a negative Clematis type man with artistic gifts wastes his energy in pedestrian jobs just to earn a living. By the continued use of Clematis Remedy the negative state may be converted to the positive Clematis State. In the positive state, the man takes lively interest in all things; sees and hears with attention, has a sensitive mind receptive to inspiration. He is in full control of his thought-world. He is a practical idealist, who believes in working to reach his cherished goal.Clematis may be used as a long term remedy but can also be found useful with all the passing mental or physical states where joy, sadness, or physical circumstances distract consciousness from the present situation.*93\308\8*

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YOUR FAMILY AND BONE DENSITY: ONE PATIENT’S STORY (NANA, GRANDMA, MOM, ME, AND ROSE)

May 5th, 2011

I watched my grandmother die an awful death. She’d been shrinking for years, and eventually started to hunch forward dramatically. When I was a kid, of course, I was so proud to grow taller than her. But after I stopped growing and still seemed to have to lean over farther and farther to kiss her each time I saw her, it was just sad. She was never officially diagnosed with osteoporosis, but it was obvious what was happening long before she finally broke her hip. Just like her mother before her—my nana—Grandma never even came home from the hospital. She struggled through some painful physical therapy, but died within a few months. I remember her telling me a long time ago that it was a shame that her own mother had to suffer so long in the hospital after breaking her hip before she died, though it had given Grandma a chance to adjust to the loss. It didn’t bring me much comfort now.As my mother went into menopause, she started to worry about following in her mother’s and grandmother’s footsteps. Her doctor recommended hormone replacement—which my grandmother certainly never had—and supplements of calcium, vitamin D, and magnesium. She experiments with hand weights, though she hasn’t found a routine she likes well enough to make it a twice-a-week habit, and otherwise gets most of her exercise walking up and down the stairs to her fifth-floor apartment and occasional sessions on the treadmill in the study. She’s generally careful about what she eats, but as a single person running her own very busy business, her meals are often catch-as-catch-can.Nonetheless, the combination appears to be working. A DEXA scan almost five years into menopause showed her bones to be well within the normal range for the average 30-year-old! Even with “bad genes” (her father’s mother also had a few too-easy fractures in the years just before she died), a few simple measures have saved my mother’s life.My mom has inspired me to take the necessary steps to protect my bones. I’ve seen and heard too much of what happens if you don’t. I know my bones are as dense right now as they ever will be (I’m 30), and I want to keep them that way. Throughout my childhood a milk allergy meant I ate no dairy products, so I worry that I’m starting with a disadvantage. I’ve taken calcium supplements since I graduated from college—and religiously while I was pregnant and breastfeeding. I started doing two circuits a week on the weight machines at the gym after I read about how strength training helps build bone—a whole-body workout that takes about half an hour. I take a once-a-week yoga class, and usually either swim or ride the stationary bike twice. I also walk about two miles a day, taking my daughter to and from school.But the most important changes of all may be the ones I made for my daughter Rose. She’s still small enough that I control most of what she eats, so I make sure she gets a vitamin with extra calcium, some cottage cheese made with extra calcium, and a glass of calcium-fortified orange juice every day. She’s never been much of a milk drinker—aside from on her cereal—and I’ve been known to bribe her by stirring in some chocolate syrup. She does like broccoli and beans, though, and we eat one or the other just about every day. The whole family eats vegetarian about half the time, with chicken or fish a few dinners a week, so Rose gets small amounts of meat protein. I’m hoping these good habits will be well ingrained by the time she makes her own decisions about what to eat. And I’m glad she’ll never have to see her grandmother go through what mine did. Or her mother, either.*21\228\2*

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MANAGEMENT OF CHRONIC HEPATITIS С: ACUTE INFECTION

April 18th, 2011

The incubation period for HCV infection ranges from 2 weeks to 6 months, with an average incubation period of 6 to 7 weeks. Most cases (60 -70%) of acute HCV infection produce no discernible symptoms. In approximately 20% to 30% of cases, patients may develop jaundice accompanied by fatigue, anorexia, and abdominal pain. Acute HCV infection, however, is rarely fulminant. Elevations in serum alanine aminotransferase (ALT) may be identified and reflect he hepatocyte injury. Symptomatic disease usually subsides after several weeks as ALT levels decline. In approximately 15% of cases, acute HCV infection completely resolves, and this appears to be associated with a younger age at infection, female gender, and certain major histocompatibility complex genes. However, most patients (85%) develop chronic infection, which has been primarily attributed to the propensity of HCV to mutate and evade host defenses.*79/348/5*

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