Archive for April, 2009

This is a form of bodywork derived from the yoga technique Pranayama, which uses controlled rhythmic breathing to raise kundalini energy in the body. By breathing in such a way that there is no pause between inhalation and expiration of air, hyperventilation occurs and a cathartic emotional state is induced. The therapist guides the patient through this experience. Some therapists believe that traumatic experiences at birth can lead to psychological problems later in life and that the rebirthing process can release and overcome traumas and associated emotional blockages.

Rebirthing can be undertaken while lying on a mat or table. Sometimes a therapist may get patients to float face down in warm water, using a snorkel to breathe, so that the experience will more closely resemble that of the foetus in the womb.

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If one treats a large number of depressed patients, as I do, the use of anti-depressant combinations is standard operating procedure, as the anti-depressants frequently don’t work when administered individually. If one has to be depressed, the late 20th century is not such a bad time for it as there is an ever-increasing array of available medications that act on different elements of the neurones responsible for transmitting the signals that regulate our moods. The skilful clinician, working in collaboration with an observant patient, can mix and blend these medications in such a way as to maximize their benefits while minimizing their side-effects.

St John’s Wort appears to work very well in combination with all anti-depressants except for the MAOIs, such as Parnate or

Nardil, where adding them can be dangerous. This is not to say that medications should be mindlessly shaken into a cocktail in full dosage. After all, if these medications can interact with one another in positive ways that enhance their anti-depressant effects, they also have the potential to enhance one another’s side-effects. When mixing medications it is important therefore to move more cautiously with dosages and timing. Certainly, such medication combinations should not be tried on one’s own but rather under the supervision of a good doctor.

When properly handled, I have seen people manage to decrease the dosage of anti-depressants that were giving them unpleasant side-effects, and add in St John’s Wort instead. For example, Fred, a 52-year-old computer scientist, wrote to tell me that he had added St John’s Wort to the anti-depressants he was previously using, which had been helpful in removing his feelings of ‘doom and gloom’ but did not completely resolve his problems. According to Fred, St John’s Wort ‘takes the edge off feelings of anxiety and depression and flips the switch from negative to positive’. He was able to reduce his dosage of anti-depressant medication from 450 mg to 300 mg per day and, in addition, noticed that he did not need to be quite so precise as to when he took it. Before starting St John’s Wort he had observed that ‘If I missed a pill by one or two hours, I’d get very tired and the glass started looking half empty instead of half full. By taking 250 mg of St John’s Wort with 150 mg of my usual anti-depressant, I can delay taking the next dose by two to four hours.’

Besides helping Fred get by with less anti-depressant medication and space the pills out at wider intervals, the addition of St John’s Wort also gave him a more sustained feeling of well-being. As he put it, T feel like good things will happen – a feeling that I am OK – not perfect – but me. I sense life is going to get better.’

I have similarly observed in my own patients the highly beneficial interactions between St John’s Wort and other antidepressants, sometimes subtle, sometimes very robust. Although I have read of people who have experienced problems with such combinations, such as jitteriness or increased blood pressure, to date I have not observed them in my own patients, perhaps because of my practice of altering dosages of medications gradually, which enables one to detect potential problems early before they become too unpleasant.

Many of my patients are on complicated combinations of anti-depressants and I have been pleasantly surprised to find that the addition of St John’s Wort may nevertheless provide additional anti-depressant protection even in people with depressions that have been hard to reverse. Sometimes the addition of the herb has been so helpful that it has been possible to decrease the dose of some of the other medications or even to remove one or more of them, thereby simplifying the overall medication regimen. As always, the key to successfully combining medications – and St John’s Wort is no exception in this regard – is to change dosages slowly and observe carefully for any untoward effects.

Remember: If you are on a MAOI such as Parnate or Nardil, do not take St John’s Wort. Also, if you have discontinued an MAOI, wait at least two weeks before starting St John’s Wort.

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Joan Kowan was one of my earliest and most difficult headache patients. She had been a student nurse until she was expelled from the nurses’ training program for poor attendance. Her constant, severe headaches had prevented her from being able to keep up with her classmates. So severe were these attacks that, in desperation, she had consented to two brain operations. They were complete failures, and the surgeons could find nothing organically wrong.

In my office, she was found to be highly sensitive to milk. By avoiding milk and dairy products in all of their forms, she was able to control her headache problem and return to school. As time went by, however, it became increasingly difficult for her to avoid all forms of milk. She lived in a college dormitory and ate institutional food. While the regular cook had cooperated with her requests, he was not always there. For example, her vegetables were cooked and set aside before butter was added. A substitute cook, however, did not do this, and Joan unknowingly ate the buttered vegetables. Within an hour, she suddenly fell to the floor in the nurse’s station, overcome by violent head pains. The cause of this reaction was traced, in retrospect, to the seemingly insignificant amount of butter on her vegetables. Such inadvertent exposures to milk were fairly common and most troublesome.

To alleviate the pain, she began to take codeine tablets, until she became addicted to them. She also became dependent on other pain-killers to which milk sugar was added as a filler. Thus, while these drugs appeared to give relief, they were actually perpetuating her basic problem.

Miss Kowan was so amazingly susceptible to milk that I thought it would be worth recording some of the features of her case for the medical record. She agreed to take an EEG (electroencephalogram) test, which records brain waves, while drinking a minute amount of milk.

To make the test “blind,” she was given two drops of milk in a glass of water. This, at least, is what she was told she was receiving. Actually, the first sample she chose contained several drops of an inert antacid, aluminum hydroxide (Amphojel), in a glass of water. The water became slightly cloudy, just as if it had had milk added. She drank this with fear and trembling, since she anticipated one of her characteristic headaches. Nothing happened. She was then given two drops of actual milk in a glass of water, but she was told she was receiving more of the previous substance. This time she rapidly went into agonizing pain. In her writhing, she pulled herself free of the EEG machine, ruining that part of the experiment.

Her case made clear, however, the ability of even small amounts of an incriminated substance to cause severe and chronic headaches.

Miss Kowan eventually managed to get her allergy under control and to graduate. Years later I received a letter from her. She had obtained an excellent position with a large manufacturing concern and had a good work record, with few absences. “Since you saw me last,” she wrote, “I have not faltered in my quest for a new future.”

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Most mechanical devices require petroleum-derived oil as a lubricant. As these machines operate, some of the oil escapes into the air. This atmospheric pollutant may pose a problem for certain people. The most common source of such oil in the home is the air conditioner. The air-conditioning unit not only emits a “normal” amount of oil as it runs but generally has an oil-impregnated glass-wool or fiber filter. Some patients who were affected by air conditioners have been able to use the appliance with impunity when unoiled filters were substituted.

Kitchen devices with motors may be another source of indoor air pollution. These time-saving appliances are proliferating, often without a thought being given to their possible drawbacks. If a refrigerator, food processor, electric hand beater, can opener, and air conditioner are all operating in a kitchen, this can represent a considerable source of oil fumes. In addition, it should be noted that such electric motors emit minute amounts of ozone, a rare form of oxygen, which is highly toxic. American and Soviet scientists have found that humans may be endangered by exposure to fifty parts per billion of ozone in the atmosphere. Susceptible persons may be even more likely to incur damage from ozone in a closed environment.

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Encephalitis is an inflammation of the brain. The causes are many, including poisons, bacteria, vaccines, and parasites. Most cases are caused by viruses, many of which cause familiar diseases such as mumps, measles, rubella, chicken pox, herpes, mononucleosis, hepatitis, and influenza. The whooping cough bacterium can cause encephalitis, as can the vaccines used to prevent whooping cough, measles, influenza, yellow fever, and typhoid. The vaccines are far less likely to cause encephalitis, however, than are the illnesses they prevent. Lead, mercury, and other poisons also may cause encephalitis.

Signs and symptoms

Encephalitis may start with the symptoms of a common cold. The child may have no fever or a high fever (40.6°C). The child usually has a headache, vomits, and is disoriented (confused) and sleepy. Occasionally, convulsions and unconsciousness may occur.

A child with encephalitis will usually be unable to flex his or her neck forward to touch the chin to the chest while the mouth is closed. Sometimes the child cannot sit up without supporting the trunk with both hands braced behind (in a tripod fashion). This is a life-threatening situation.

Home care

None. See your doctor immediately if your child shows any symptoms of encephalitis.

Precaution

• If your child has had a severe reaction to any of the vaccines listed, be sure to tell your doctor before a booster of the vaccine is given.

Medical treatment

Since encephalitis may be a complication of another disease (such as measles, mumps, whooping cough), a child with such a disease and encephalitis symptoms will probably be examined for encephalitis. Knowing that the child has been exposed to poisons may also lead the doctor to suspect encephalitis.

A definite diagnosis is based on the child’s medical history; a blood count; a spinal tap; identification of the infecting organism in the spinal fluid, nose, throat, or stools; and the presence of antibodies (protective substances made by the body to fight the infecting organism) in the patient’s blood.

If encephalitis is diagnosed, hospitalization may be required. There is specific treatment for only a few types of encephalitis, since most viral infections are hard to treat. There is no medication that can kill the invading virus after it has caused the infection. Usually, however, treatment to ease the symptoms and to help the patient withstand the disease until it runs its course leads to recovery.

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The process of hydrogenation converts a liquid vegetable oil into a more solid state. This occurs through forcing hydrogen atoms into a vegetable oil under high pressure and high temperatures (120 to 210 degrees Celsius). A metal catalyst is used; it may be nickel, copper or platinum, and the process takes six to eight hours. Hydrogenation may be complete or partial.

Complete hydrogenation is where this process continues until all the double bonds in the oil are saturated with hydrogen. In effect this creates a fully saturated fat which is now very hard at room temperature. Because there are no more double bonds, there are no trans fatty acids in this type of fat. This means that the fat is not as harmful to health as partially hydrogenated oil; however all essential fatty acids in the oil have been destroyed. Commonly tropical fats such as coconut fat and palm oil undergo this process, to make them more useful to food manufacturers. This is the type of vegetable fat that is often used in chocolate to make sure it melts at mouth temperature.

Partial hydrogenation is where the process is halted before the oil is totally saturated. This means the resulting fat is not as hard; it has a semi solid, spreadable texture. Many trans fatty acids are present in partially hydrogenated vegetable oil. The essential fatty acids in the oil are also damaged. The word “partially hydrogenated vegetable oil” is present on the label of very many processed foods. This type of fat is present in most margarines, vegetable shortening and processed food such as cakes, biscuits, donuts, crisps and hot chips.

Are there any benefits of hydrogenated oils?

These types of fats benefit the food industry greatly, but our health suffers as a consequence. Usually cheap oils are used for this purpose, such as canola, cottonseed, soy or corn oil, which generally do not have health benefits. It is usually too expensive to use olive oil in manufacturing processed food. Hydrogenated fats, being solid give some foods the required consistency; biscuits for instance are usually made from a solid fat like butter or margarine. Butter is more expensive to use than margarine, and it spoils much faster. Basically hydrogenated vegetable oil is used by the food industry because it is cheap, and gives the foods containing it a longer shelf life.

McDonalds replaced beef tallow with partially hydrogenated soybean oil in 1990. In September 2002 McDonalds promised to use healthier oil in its US stores by February 2003. However, nothing has been done so far: there are still six grams îf trans fat in a large serve of fries. In September 2004, McDonalds Australia began using a canola oil blend. This oil is 75 percent lower in saturated fat than their previous oil, but the trans fat content is not mentioned, and there are other potential problems with canola oil. The canola oil blend McDonalds use contains an antifoam agent called dimethyl polysiloxane.

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Your weight is crucial for your fertility. Being very underweight or very overweight can make conception difficult or impossible. So it’s important that your weight is within a certain range in order to give you the best chance of conceiving.

Nature gave women proportionately more body fat for a specific purpose, in order to reproduce and then feed our young. That is why fat accounts for 27 per cent of an average woman’s body weight, while it is only 15 per cent for a man.

Fat is essential to fertility and it is necessary in order to ovulate. Young girls do not begin to menstruate until their bodies are composed of at least 17 per cent fat.

Underweight

If a woman’s body fat drops too low, then her periods can stop. This low level of body fat may be caused by excessive exercise, as sometimes happens with ballet dancers or athletes who have very tough physical regimes.

Infertility can also be caused by excessive dieting. When a woman is anorexic, for instance, her periods stop. With so much publicity about anorexia and an increasing number of young women falling victim to the ‘summer’s disease’, the long-term damage to fertility caused by drastic weight loss is well-known. But not so many people realize that being overweight can also affect fertility.

Overweight

If a woman is overweight it can stop her ovulating. Studies have shown that just losing a small amount of weight, 10 per cent, for instance, can be enough to increase fertility by stimulating ovulation, improving hormone balance and making periods more regular.

In another study, on women who previously did not ovulate, 11 out of 12 conceived naturally after exercising and dieting over a period of six months to get their weight down.

Fortunately your dietary intake is fully within your control, and eating the right food may be the single most important thing you can do to achieve a successful pregnancy.

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In a moment we’ll suggest some ways to “inform our lives with spirituality,” as Dr. Kurth puts it. But first, what are the other benefits of integrating spirituality into our daily lives or increasing its presence and effect? People whom Dr. Kurth has studied report:

•     A sense of deeper meaning, purpose, and direction in life.

•     A sense of fulfillment. Maintaining a sense of connectedness and direction is hard work but worth it, says Dr. Kurth, because the process of doing it brings a sense of peace and fulfillment.

•     Renewed energy. “People are so burned out in their work lives and in their lives in general,” says Dr. Kurth. “Somehow when one taps into that sense of connecting with the Divine, there is a renewed sense of energy.”

•     Increased feeling of well-being. Psychologists Anne Colby, Ph.D., director of the Henry A. Murray Research Center at Radcliffe College in Cambridge, Massachusetts, and her husband, William Damon, Ph.D., professor of education and director of the Center on Adolescence at Stanford University, conducted a study of people involved in “spiritual work.”

These were “people who are highly morally committed, people who are devoting their lives to something they really, deeply believe in,” explains Dr. Colby. “Helping the poverty-stricken, fighting for civil rights, things like that.”

Dr. Colby and Dr. Damon found that those who do such work for a long period of time tend to be deeply spiritual and have a very optimistic, resourceful, positive approach to life.

They also found that sometimes people can begin working for others for narrow reasons – perhaps pursuing career or business goals – and end up transforming their outlook. They may end up adopting a broader set of moral goals and a more selfless spiritual perspective simply from the process of doing the work and engaging other people as they do it.

What about the benefits of meditation we mentioned earlier?

We know that many American males associate meditation with short, fat, bearded men who wear orange robes. But it needn’t be that. Meditation can be cool.

As the body and mind relax in meditation, the brain begins pumping calming chemicals and sending soothing signals that cause our bodies to relax even more. These signals also stave off or even repair the ravages of stress, a known life-threatener and life-shortener, says Dr. Larry J. Feldman of the Pain and Stress Rehabilitation Center. Our blood is less likely to get clumpy and sticky and less likely to gum up artery walls. That translates into heart health. More than that, studies have shown that in the long term, people who regularly practice meditation or some other effective relaxation process develop a much greater tolerance to all sorts of stressors, says Dr. Feldman.

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Everywhere you look, the ideal of thinness, especially for women, is promoted as the ultimate goal. We’ve been brainwashed into accepting an artificial, impractical, even unhealthy image of the human form. Those who fail to achieve the ideal are mocked and scorned. People who are especially susceptible to social pressure-those who never developed a healthy sense of self-esteem-will go to extreme lengths to avoid ostracism and rejection. They will sabotage their own bodies for the sake of an artificial, unnatural concept.

But society’s ideals are at war with our bodies’ natural design. The war takes place on a vulnerable battleground: our minds. For some women, these conflicts may be temporary (a bout of crash dieting, perhaps) and will be followed by some kind of acceptable truce (“Okay, I’ll eat normal meals, but no more desserts”). Other people, however, need additional support to resist social pressure. Without such protection, people become victims of a strange syndrome, one whose symptoms are a distorted body image, bizarre eating patterns, illness, and much unnecessary suffering.

How does our culture develop and transmit this deadly message about thinness? Why should thinness be the social currency we value? Let’s look.

Envision the “ideal” female figure. What comes to mind? In this society, many people—men as well as women-probably conjure up an image of Miss America or a Playboy centerfold. Purely in the interest of science, a team of researchers carefully analyzed the body measurements of these icons of feminine beauty over the past few decades. They made a surprising discovery: As a general trend, each year the women chosen as these ideals have been thinner than their predecessors. This is odd when you realize that the average weight of the population has increased over the same time period. Thus there has been a widening gap between the “ideals” of female beauty and most women’s actual weights. These beauty queens’ relative body weights are actually lower than those of 95 percent of the female population!

My heart goes out to today’s woman, whose body may be perfectly normal but who believes that she must compete against this absurdly distorted vision of ideal beauty.

Our culture’s perception that the ideal female form should be abnormally slender is a fairly recent phenomenon. One of my bulimic patients, an eighteen-year-old college student, told me she had watched a Marilyn Monroe film on television. “Marilyn Monroe was such a pig!” she exclaimed. “She was so fat!” Strange to think that what was seen as sexy and attractive thirty years ago is now condemned as “fat.”

Although there are some historical precedents for similar distortions of the feminine ideal, such as the Victorian eighteen-inch waist, never before have they had such an impact on the vast majority of women. Media, such as women’s magazines, very often add to the confusion about body image. For example: The number of articles about dieting appearing in these publications has doubled every decade since World War II. Yet these same magazines present page after page of recipes for “luscious desserts” and “family-pleasing treats” illustrated with glistening, mouth-watering photographs. Mixed signals? You bet.

Since World War II, our food-buying and eating habits have also undergone a radical change. Food is plentiful, and its variety is enormous. Many of today’s foods are very palatable but rich in calories due to their high fat and sugar content. Fast food-from chain restaurants to microwave meals in our own homes-has revolutionized how and what we eat. And in our sedentary society, the only exercise some people get is pressing buttons on their television’s remote control. Given these facts, it actually does make some sense for people to be on their dietary guard.

For some people, however, an irresistible force (social pressure to be thin) meets an everyday temptation (tasty, abundant food) and produces an extreme reaction (an eating disorder). People at special risk include those who:

• have low self-esteem

• are overly sensitive to the opinions of others

• carry the concept of self-control to extremes

• have difficulty separating from their families

• Work in occupations that require a high level of body-awareness, such as modeling, dancing, or acting

When people with these characteristics suffer stress—for example, the death of a relative, a move to a new school or city, or a personal loss such as the breakup of a romance—an eating disorder is sometimes the result.

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It took him 10 years to figure out how, but George Trott found a way to get rid of those stubborn last 5 pounds.

George, a computer consultant from Manalapan, New Jersey, was just about to turn 50 when he found out that he had diabetes and heart disease. “I wasn’t really surprised, since both conditions ran on both sides of my family and I had been overweight for years,” he says. But it was enough to motivate him to trim 40 pounds off his 6-foot-2-inch frame by eating more healthfully and exercising regularly. “I didn’t want a life of excess medications and insulin shots,” he explains.

For years, he was happy about his new 185-pound physique, but he knew he could stand to lose a little more. At age 58, he was still stuck with what he calls “4 or 5 pounds too much George.”

On the suggestion of one of his grown kids, he visited Ann M. Chicchi, a registered dietitian in East Brunswick, New Jersey. She looked at George’s overall diet and exercise plan—which was good— and did some fine-tuning. She gave him a lower-calorie, low-fat eating plan that incorporated all of the nutrients that George needed. The plan also kept his carbohydrate intake at a level that was more appropriate for someone with diabetes and high triglycerides.

George took the food plan and molded it to fit his eating style. Instead of three large meals a day, he created a fourth small meal of whole-grain foods. “The complex-carbohydrate portion that Ann allotted for my breakfast I found more satisfying as a snack of whole-wheat crackers or bread around 9 o’clock at night,” he says. He still had a good-size breakfast each morning, but he also had something low-fat and nutritious to nosh on before bedtime.

The result was that he finally shed those last few nagging o pounds, and his next blood work came back much improved as well.

So now “4 or 5 pounds too much George” can call himself I cr3″ “just-right George.”

WINNING ACTION

When you hit the wall, call in a pro. If you’re having trouble taking off those last few pounds, consider enlisting the help of a registered dietitian. To find one near you, contact your doctor or your local hospital for a referral. If group support is more your style, look in the Yellow Pages under “Weight Control Services” for organizations such as Weight Watchers and TOPS (Take Off Pounds Sensibly).

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