How Important Are Risk Factors?To say which risk factors are the greatest predictors of coronary artery disease for a particular person is fraught with assumptions. However, most doctors would probably agree that the most important risk factors are smoking, elevated lipids (cholesterol) in the blood, high blood pressure, excess weight, diabetes, and sedentary life-style. Obviously, many of these are not independent factors. For example, many overweight people are relatively inactive and have high cholesterol levels.Working to reduce one risk factor may have benefits for others. If you change your diet to lose weight, you may also lower your cholesterol level and blood pressure. You may also decide to start an exercise program.Is Prevention Worth the Effort?The whole purpose of identifying and controlling your cardiovascular risk factors is to prevent a heart attack, early disability, and death. Millions of Americans have learned about these risk factors and have tried to modify them with help from health professionals. You can control high blood pressure, stop smoking, and lower your cholesterol level. As a matter of fact, the average cholesterol level of the population has decreased during the past 20 years, most likely because many people have changed their diets and some people are getting more physical activity. These changes have probably contributed to the declining death rate from heart disease in the United States.Most people agree that a more healthful life-style is worth the effort, but they need a little help. It is not easy to change habits that you have lived with for many years. *227\252\8*
July 26, 2011
MODIFIABLE RISK FACTORS OF CORONARY ARTERY DISEASE: UNDERSTANDING YOUR RISK – HOW IMPORTANT ARE RISK FACTORS? IS PREVENTION WORTH THE EFFORT?
July 19, 2011
Symptoms usually develop gradually with atherosclerosis. As the arteries become increasingly blocked, progressive symptoms frequently develop. The specific symptoms depend on which artery or arteries are obstructed. If the leg arteries are affected, then the symptoms are usually numbness, fatigue, or pain in the leg (claudication). Atherosclerotic obstruction of the coronary arteries may lead to symptoms of angina or even a heart attack. Other commonly—affected arteries include the carotid arteries in the neck (a situation that predisposes to stroke) and the abdominal aorta (which may become partially obstructed and cause claudication or become weekend and lead to aneurysm).Symptoms caused by progressive atherosclerotic narrowing of an artery are more likely to occur during exercise than at rest, at least initially. Early symptoms may occur only after great exertion, but as the narrowing worsens, less and less activity required. The symptoms develop during exertion because your arteries cannot supply your muscles with enough oxygen and nutrients. The more severe the blockage, the less exertion it takes to surpass the ability of the artery to supply adequate-’blood. When you stop and rest, the discomfort resolves in a few minutes. However, blockages can be so severe that even resting muscle does not get enough blood flow, and you may experience symptoms, such as claudication or angina, even when sitting still.Indeed, it is the symptoms caused by inadequate blood flow to a part of the body that may bring you to a physician, who then attempts to discover the cause. Atherosclerosis is the of chronic obstruction of the a in 95 percent of cases, but other causes are important to know about.*192\52\8*
July 8, 2011
When people begin to look at ways they may have participated in their development of cancer, it is a good idea to seek the aid and support of a trained counselor or therapist. Many times, just asking for help is the first step in breaking a “rule” one learned in early childhood and establishing a more healthy way of responding to stress. Unfortunately, many of us grew up with a culturally induced reluctance to seek help for emotional problems. Yet if we are diagnosed with a severe illness, we do not feel embarrassed or ashamed to seek the help of a physician who has spent many years learning about the body. Neither should we feel embarrassed about enlisting the help of a professional to learn the ways in which stress has played a role in our illness.Most of our patients who go through this process of self-examination see important links between their emotional states and the onset of their disease, as well as the ways they participated in these emotional states. But, having seen how their beliefs and behaviors in response to stress may have contributed, some begin to feel guilty about their actions in the past. You may have similar feelings, so we would like to give you the same advice we give our patients.First, it is not our intent, nor is it desirable, for you to feel guilty for having recognized that you’ve participated in your disease. There is a difference between being “to blame” for something and having “participated” in it. It makes no sense to blame persons living in this society for becoming ill in light of the rules they were taught for dealing with their emotions and feelings. (Few individuals in our culture have been taught how to deal with emotions and feelings appropriately.) Further, blame suggests a person consciously knew better and yet decided to respond or act in a self-damaging way. That is certainly not true of people who respond to stress by developing a physical illness. Like most people in our culture, you were probably not even aware of a link between emotional states and illness. Thus, the ways in which you did participate are almost certain to have been a result of unconscious beliefs and habitual behavior.It is a particularly sad course of events, that many times those people who most steadfastly and responsibly attempt to live up to cultural rules develop the most serious illnesses. The literature describing the emotional aspects of cancer is replete with examples characterizing cancer patients in general as “too good to be true”—people who are kind, considerate, unselfish, and pleasant in the face of all adversity.Individuals who begin to accept responsibility for influencing the state of their health deserve the greatest of congratulations. Not only are they willing to begin the process of exploring their own attitudes, emotions, and feelings—and the ways these contribute to their response to stressful situations—but they are also finding the courage to stand up to the cultural rules they were taught and to reject those that are not conducive to health.The real point of a self-examination is to turn up clues on how you can participate in health through a process of recognizing and changing self-destructive beliefs. If you have participated in the onset of the disease, you also have the power to participate in your recovery.*35\347\2*
June 21, 2011
The fascinating thing about this force is, as I discovered over the years, that it actually determines the wear and tear of all the relevant structures as mentioned above. Thus if a disc degenerates and bulges or ruptures, it is most likely that it does so because of weakness of this vital anti-gravitational force. For the spinal discs and joints, nothing matters more than this force because the lack of it puts strain on them and the abundance of it relieves them from tension, creating flexibility and well-being.Another fascinating aspect is that this anti-gravitational vital force can be increased through specific massages (passive treatment) and yogic exercises (active treatment). These treatments form an integral part of the Ali Technique for Backache. Most people who do spinal or general exercises, increase the general tone of muscles which form a minor part of the anti-gravitational force, indeed might actually increase it like guy ropes. Increase in posture-controlling muscle tone, however, relieves pain and removes some pressure from the affected or damaged discs, giving much needed relief in backache.This force is weakened by a series of factors ranging from bad posture to fatigue to excess body weight with sluggish muscles. The reduction of this force leads to increased pressure on the spinal joints and discs, which in turn lead to inflammation of their surfaces causing pain and discomfort.*56\330\8*
June 12, 2011
Naturally failing immune systems and naturally overactive immune systems have been blamed as noninfectious causes of chronic disease. But does it make sense that evolution would have generated such a complex system of checks and balances if these complexities were only to generate the system’s downfall? Imagine making an extravagant security guard system that self-destructs without provocation. We would not expect people to select the ineffective complex system over a more effective simple system. If an extravagant immunological security system self-destructed, then natural selection similarly would favor the simpler system. The more extravagant system wouldn’t be reproduced. We can expect that natural selection will not favor added complexity to immunological security systems when the increased complexity destroys the body without provocation. The immune system may, however, be driven to self-destructive tendencies through the ever-changing strategies of the burglars it is attempting to deter. Streptococcus pyogenes, for example, may damage the heart because one of the germ’s proteins has evolved camouflage that makes it look so much like a protein on the human heart that the immune response against the bacteria attacks the heart. In the absence of such provocation, though, the immune system is the quintessence of efficiency and flexibility.*22\225\2*
June 2, 2011
QUESTIONS ABOUT DRUGS FOR RHEUMATOID ARTHRITIS TREATMENT: FOLIC ACID, METHOTREXATE AND SULFASALAZINE
What is folic acid?Folic acid is a vitamin that is usually supplemented in those taking methotrexate to reduce the side effects.
Who should not take this drug?People with liver and kidney problems, diabetes, immune system disorders, and high alcohol intakes should not take this drug. Pregnant women, women intending to get pregnant and nursing women should not be started on the drug. Women planning to conceive a child should wait at least one menstrual period after stopping methotrexate before trying. Men planning to father children should not take the drug both because it might affect fertility and because it could be harmful to the baby.
Does methotrexate interact with other drugs?Yes, it does. Evidence exists that the new COX-2 drugs increase the blood levels of methotrexate. In fact, the elderly with decreased kidney function should not take the drug. Almost every NSAID will increase the potential for problems with this agent; however, under the care of your doctor, this should not be a problem. The doctor will test you periodically for potential problems.
What is sulfasalazine?This is a sulfa-containing agent useful for the treatment of arthritis. It is not terribly toxic, but it has greater toxicity than hydroxychloroquine.It is a good drug used in combination or by itself.The usual dose is 2 grams per day by mouth; however, your doctor will start you on a low dose to see how you fare on it. Some doctors will go to 3 grams per day, depending on any side effects experienced and how your arthritis progresses on the drug.Rashes, loss of appetite, and nausea are side effects experienced with this agent. Serious reactions are rare and include hepatitis, a lupus-like disease, and even a decrease of sperm counts. Your doctor should watch for these. Men should notify their doctors if they plan on fathering children so that the drug can be stopped or replaced with something else.*34/141/5*
May 12, 2011
What role does the laboratory play in the diagnosis of RA?The laboratory has a limited role in the diagnosis of RA. Unlike a disease like lupus, where patients make antibodies to several components of the body, the patient with RA has almost none. The only antibody that is common in patients with rheumatoid arthritis is the rheumatoid factor. Other antibodies may be present, but they do not necessarily indicate RA. In addition to the presence of antibodies, there are other laboratory findings that doctors may look for to help them diagnose RA, including anemia (low red blood cell count) and other blood cell count abnormalities. During the course of treatment, doctors often have to monitor the patient’s health with laboratory tests, as several of the drugs used to treat RA can affect the health of many organs.
What is the rheumatoid factor?The rheumatoid factor is an antibody directed against another antibody in the blood. It is present in about 60 percent of rheumatoid arthritis patients; however, its presence does not automatically indicate RA, as it is common to other disorders as well. Conversely, the absence of rheumatoid factor does not rule out a diagnosis of RA. When the rheumatoid factor is present in a RA patient, one is said to have sero-positive disease. When there is no rheumatoid factor, an RA patient is said to have sero-negative disease. Generally, sero-positive disease is more aggressive than sero-negative.
What is an ANA?ANA stands for antinuclear antibody. This antibody is directed against the nuclei of certain cells.
Is an ANA present in those with RA?Some RA patients have antinuclear antibodies, though the strength, or titer, of such antibodies is low. They are more common to other autoimmune conditions, though doctors must not overlook the possibility of rheumatoid arthritis when they detect ANAs. Too often doctors hastily make a diagnosis of lupus when they find ANAs without ruling out RA.
What is an ESR?ESR stands for erythrocyte sedimentation rate. The speed at which red blood cells settle to the bottom of a test tube helps doctors check for inflammation. The faster these cells settle, the more inflammation is present. The ESR is the test conducted to determine the rate at which the red blood cells settle.*26/141/5*
May 1, 2011
While the digestive tract and the kidneys are the main organs of excretion, the skin has also a very important part to play; it is a great deal more useful than just a waterproof covering that keeps our bits and pieces together. If it is kept healthy it can be a wonderful waste disposal system. It covers such a large area it is worth getting it to work for you.Sweating it OutA fever is nature’s way of helping us to lose toxins through the skin. You can stimulate sweating with some water therapies.Water TherapyRegular swimming is very beneficial; steam baths, saunas and Jacuzzis also encourage detoxification.Caution: consult your doctor before using water treatments if you have heart trouble, high blood pressure, diabetes, epilepsy or any condition which might be aggravated by extremes of temperature.Salt BathsThese encourage detoxification and greatly help muscle and joint pains. Add 2 lbs of salt or three cupfuls of Epsom salts to a comfortably hot bath and lie in it for twenty minutes; add hot water as it cools. If you drink a pint of hot honey and lemon, or peppermint tea while you soak it will further encourage sweating. A cold flannel on the forehead might make you feel more comfortable. The next step is to wrap up in cotton towels and get into a warm bed. You should perspire freely and sleep well. If you have to bathe during the day finish with a cold shower and rest for half an hour. You could do this three times weekly.Foot BathsFor aching feet and to stimulate circulation use alternating bowls of hot and cold water, staying two minutes in each; carry on for about twenty minutes. If you like you could add one cup of salt or1/2 cup of Epsom salts to the hot water. When you have finished wrap the feet in a towel and lie down for half an hour.Skin BrushingThis stimulates the lymphatic system, and involves brushing all over with a natural bristle brush for about ten minutes before you shower or bath. Start with the soles of the feet and work on all areas except broken skin, the face, neck and breasts. It can be boring but the results are worth it. In addition to elimination toxins, because circulation is increased, it will also improve the texture of your skin. Boots, Higher Nature and the Body Shop have skin brushes or you might have an old hairbrush that would do the job; wash it carefully.*56\326\8*
April 22, 2011
Some patients have tried to convince me that their view is accurate by holding their face at different angles or changing the lighting in the room. “Can’t you see they’re flat?” a young woman asked me about her cheekbones, turning her head and holding it at different angles.Other variations of questioning behavior are asking others how to fix the problem—the best way to curl hair or how to pay for liposuction—or a discussion of the defect and the problems it’s caused. Virtually all one man talked about was his hair—his belief that it was thinning, how his life would be different if it weren’t, and how to fix it. These discussions dominated his conversations with his girlfriend.Reassurance seeking typically causes problems. It can take up a lot of time and be very difficult for family members and friends. Whereas mirror checking, grooming, and picking can be done in private, questioning always involves someone else. If it’s limited to once or twice a day, it’s generally tolerable. But if it’s more frequent, it can dominate and ruin relationships.I’ve been told by many people with BDD that their spouse, girlfriend, or boyfriend left them because they spent so much time talking about, or asking about, their appearance. Other aspects of the disorder—such as avoidance of social situations—often contribute to relationship problems as well. But it’s surprising how often the questioning is considered a major part of the problem.*102\204\8*
April 12, 2011
Skin tests in food allergy are not of much help; it is the history of the patient which is of greatest help. Other procedures that help are elimination diets. The patient is instructed to note in a diary all the food taken and the symptoms produced,if any. By studying these reports for two to three weeks, the doctor can often detect the onset of symptoms after a new type of food, or after repeated intake of a certain food. The elimination of these foods, one at a time, should result in disappearance of the symptoms. This is followed by controlled intentional ingestion to confirm the allergy. The difficulty arises when the offending food is either milk, egg or wheat, which are common ingredients of many other foods and therefore its presence may not be suspected by the patient.Food allergy is more common in children than in adults. Recurrent abdominal upsets, skin rashes and unrelieved cough should be suspected of having an allergic basis. Proper diagnosis can lead to very favourable results.*40\260\8*