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Archive for May 29th, 2010

For those of you who understand and support the idea of evolution, worry has probably been one of the key survival characteristics. Imagine what life must have been like as a hunter gatherer, living on the plains, surrounded by large animals that would prefer you not to eat them for lunch. In such circumstances, the fight or flight instinct is to the fore. More importantly, the early humans probably worried about where the next meal was coming from and all the different ways in which they might die. The ability to remember what has happened and use that as a basis for predicting the future is a key feature of genuine intelligence. The ability to plan for survival gives humans the edge over their environment. The other side of the coin is that the laid-back guys who found it difficult to get out of their caves in the morning had little to eat come the evening. Hunger sharpens the mind and encourages survival.

Translating this to the present, we have some new research out of the atmospherically named Black Dog Institute, one of Australia’s leading centers dealing with the spectrum of mental disorders. One of the persistent dilemmas for doctors is how to relate to patients who have had a heart attack. Obviously, any event affecting the heart comes as a severe shock to the individual. It shakes physical self-confidence. Not unnaturally, some people get depressed. Many worry about the risk of a second attack. Although there is a natural sympathy with heart attack survivors, most doctors want to encourage people to work their way back to a positive outlook. While avoiding the, “snap out of it” school of practical psychology, people have been encouraged not to worry. This latest study followed some five hundred patients, all of whom had a serious heart attack. Those who were diagnosed with general anxiety disorder (GAD) were monitored but given no specific therapy or counseling. These patients have had a better survival record than those who were naturally less worried.

It is always difficult to identify cause and effect in studies of this nature. But the research team speculates that the GAD encourages people to be more protective of their health. They worry more and so prove more diligent in following instructions on lifestyle changes. They want to survive. So far, this research stands on its own, but it has proved provocative in challenging the assumption that anxiety is a risk factor for a second heart attack. New studies are being set up in different countries around the world. It is not a new idea that, in the right conditions, a little anxiety is helpful. What surprising is that the more advanced GAD is also helpful. So, if you have recently had a heart attack, think twice before you buy xanax online. No matter what your doctors may be telling you, this study suggests you may live longer if you continue anxious. Only if the anxiety is growing more severe should you agree to use an antidepressant. Generic xanax is the cheapest and most effective remedy at this stage. But do not take it too long. Some residual anxiety may be a good thing.

News stories can strike you in so many different ways. Some will seem stupid, others heart-warming. In some cases, there’s just an overwhelming sense of sadness. You just ask yourself, “How could things have been allowed to get so bad?” So it is with the death of Michael Jackson. Millions of people seem to have liked his music and been prepared to forgive his more obvious eccentricities. Perhaps no-one can live so much in the glare of publicity and not end up a little strange. But his life continued and, with the world fascinated by the thought of seeing the 50 year old on stage again, he went back into full-time rehearsal. It was at this point that Dr. Conrad Murray enters the picture. The quality of the singer’s health is somewhat cloudy before this time. It seems likely he had suffered insomnia for some years but, the combination of additional stress and muscle pain from starting to dance again probably made the problem worse. In any event, the good doctor was paid some $150,000 a month to minister to the singer. In practical terms, this meant the doctor administered a nightly cocktail of drugs to knock his patient out. The basic combination was propofol and lidocaine through an intravenous drip. Not to put too fine a point on it, this combination would have rendered an elephant unconscious. Under normal circumstances, propofol is only used in carefully supervised hospital environments. The doctor was not licensed to administer it.

We do not need to go into the gory details of the death and subsequent investigations. The gossip pages have been full of the story for months. What brings it all back on to the front pages is that the doctor has now been charged with involuntary manslaughter. So, once again, we all get a front-row seat in the theater of Michael Jackson’s life (and death). And the first question is, inevitably, “How were things allowed to get so bad?” Here is a man whose health had reached such a low point that he can only rest when knocked out by industrial strength anesthetics. This is simply extraordinary. This man is worth millions (despite all his best efforts to lose money in his later years). He could have bought the best in counseling and therapy to treat his insomnia. Every scientific journal over the last ten years and more has been carrying the results of clinical trials demonstrating the effectiveness of cognitive behavioral therapy. All he needed was some lose change and he could have bought the best in therapy for a few thousands of dollars. What psychological quirk drove him to embrace oblivion in an intravenous drip?

Celebrities often seem to be their own worst enemies. They are surrounded by weird people who advise them on how to spend their money. You can just hear someone enthusing, “I hear propofol will knock out an elephant and I got this great doctor for $150,000 a month who will give it to you.” If it had been someone “ordinary”, they would have bought some ambien online and gone to sleep like a baby. Or, if it did not work as well as expected, they would have gone to see their regular doctor, explained they tried ambien online, and received some cognitive behaviour therapy. Only celebrities die in such weird ways while the rest of us sleep on.

Texas is one of many states with thousands, possibly millions, of its residents suffering from chronic pain. Overall, chronic pain will affect between 15% and 33% of the U.S. population every year, and cost the nation $70 billion in medical charges, lost working days, and workers’ compensation — more than cancer and heart disease combined.

Chronic pain can be induced by a variety of situations, including work-related injuries, carpal tunnel syndrome, neurological disorders, joint disease, migraines, and autoimmune diseases, such as rheumatoid arthritis. Most chronic pain is located in the back, hip, and/or shoulders. Particularly with the proper health insurance coverage, however, these conditions can be effectively treated and, if not cured, at least managed. Texas is filled with clinics and doctors specializing in pain management — from Austin, to Dallas, to Houston.

While acute pain can be beneficial — warning, or forcing, us to stop an activity before we injurey ourselves further — it is quite different from chronic pain. Acute pain occurs on a temporary basis, such as when spraining an ankle, or even when breaking a bone. Pain is considered chronic when it has occurred either continually, or intermittently, over a period longer than six months.

One of the major frustrations with chronic pain is that so many in Texas, and across the United States, do not respond to treatment. Because many of the cases are work-related injuries, valuable workers in cities like Houston, Dallas, and Austin are being lost. Even the strongest medications don’t always work, and physicians are still not sure why. According to Dr. Zena Quezado, chief of the Department of Anesthesia and Surgical Services at the National Institutes of Health Clinical Center, it could be due to genetic makeup. Different enzymes metabolize these medications, and not everyone has the same enzymes, nor do they work in the same way. Varying levels of pain are also reported after the exact same procedure or injury.

Such conditions of chronic, seemingly untreatable pain can lead to anxiety, fear, depression, lack of activity, and unemployment. Its management, then, is arguably one of the most pressing health issues today throughout Texas and the rest of the United States.

While treating the various aspects of pain, including the psychological aspects, are critical, the following will focus on the major holistic forms of physical (versus psychological) treatment for chronic pain. Many health insurance policies will even cover certain treatments with the right referrals. Much of the information has been adapted from Prescriptions for Natural Healing by James F. Balch, M.D., and Phyllis A Balch, C.N.C. As always, consult a qualified health practitioner before undergoing any treatment.

(1) Acupuncture

Most acupuncture treatments performed in the United States are on victims of chronic pain, many of them back pain sufferers. An ancient Chinese practice, acupuncture is based on the belief that energy (or chi) flows through the body along certain pathways called meridians. When the flow of that energy is disturbed, unbalanced, or otherwise obstructed, pain can result. The focus of acupuncture treatments for pain, then, is to return the normal flow of energy, thereby reducing, or eliminating pain. This treatment has no known side effects, is found to be quite relaxing for most patients, and is often accompanied by herbs based on formulas thousands of years old.

Most Westerners are not accustomed to believing in a medicine that bases its principles on the flow of unseen energy, but, whatever one’s personal beliefs, acupuncture seems to work. Even the National Institutes of Health reported acupuncture as “beneficial” for chronic and acute pain. Further studies have indicated its effectiveness for carpal tunnel syndrome, and that it may increase immune response, as well as stimulate the production of endorphins, a natural pain killer produced by the body. In China, certain surgeries are performed with acupuncture as their primary form of anesthesia.

(2) Chiropractic Care

Spinal manipulation is considered a “proven treatment” for lower back pain by the U.S. Department of Health and Human Services. Though chiropractic care is effective for many conditions, treating disorders of the back and spine are, by far, the most common reason for seeking out such a practitioner.

Chiropractors focus on the spinal cord itself, believing that, if the spinal cord is able to relay unadulterated signals to the brain and other organs, then healthy function can be maintained throughout the body. Through careful adjustment of misplaced vertebrae, the spinal cord can regain its usual impulse signaling. This enables the body to restore normal nerve function — thereby reducing or eliminating pain, and heal itself of other ailments.

(3) Massage therapy

Massage is a specific type of body work, and focuses on the manipulation of muscles and soft body tissues. It works through the promotion of muscle relaxation, by increasing circulation in the lymphatic system (thus reducing inflammation), breaking up scar tissue and adhesions, promoting blood flow and, in the case of sinus problems or certain migraines, by promoting drainage of the sinuses. For back pain sufferers, massage therapy may be instrumental in managing pain without, or with fewer, medications. Strong anecdotal evidence, obtained from thousands of practitioners’ experiences, suggests that massage therapy may also help to realign tissues, tendons, and vertebrae.

Deep tissue massage is designed to release chronic muscular tension, and is generally applied with a fair amount of pressure on the affected area. There are numerous forms of massage, however, and, with so many choices, it may be best to do some research first. Look up a reputable natural health site online, or visit your local library.

(4) Herbs
Herbs are often classified in a separate category from Western medicines, and for good reason. Herbs are plant-based remedies, with no artificial or laboratory ingredients. But herbs and Western medications operate on the same principle: that, through the ingestion or application of certain substances, a desired effect may be achieved. Some herbs are very strong, or should not be taken with certain conditions, such as high blood pressure or allergies. Certain herbs, though with promising research results, are also controversial, such as marijuana. Though believed by many in the medical community to be highly effective in managing pain, it is still illegal in most states. Therefore, treat herbs as medications and never use them without consulting a knowledgeable health practitioner first.

For muscle spasms and cramps, angelica, black haw, cramp bark, kava kava, rosemary and valerian root are excellent choices. Hops, kava kava, passion flower, valerian root, wild lettuce, and wood betony also have muscle relaxing properties.
Relieve tension and nerve pain with blue violet, catnip, chamomile, gotu kola, licorice, rosemary, white willow, or wood betony teas. Use chamomile and licorice on a short-term basis only.
Capsaicin, a primary ingredient in capsicum (or cayenne pepper) can relieve pain through limiting the production of the vaguely named neural pain transmitter “substance P.” Capsaicin can be taken orally, or used topically when mixed with a carrier oil or cream. Studies with capsaicin have been used to treat pain associated with postherpetic neuralgia, diabetic neuropathy, rheumatoid arthritis, osteoarthritis, and cluster headaches.
Essential oils of jasmine, juniper, lavender, peppermint, rose, rosemary, and thyme can be used to relieve pain. Never ingest essential oils, and always apply topically with a carrier oil, such as jojoba or almond.

Chronic pain, though at times beyond frustrating, can be a manageable condition. With proper treatment, sound research, and good decision making, even most of the worst cases can at least be improved. If you suffer from chronic pain, be persistent about pursuing different types of treatment until you find one that helps. After all, you are the one experiencing the pain, and must therefore make the best decision regarding it.

Pat Carpenter writes for Precedent Insurance Company. Precedent puts a new spin on health insurance. Learn more at Precedent.com