Saturday, June 30, 2012

Commense sense v dieting.

Hands up everyone who remembers the Israeli army diet! Or maybe the cabbage soup diet? Diets come and go and still the average weight seems to be going in the wrong direction -upwards! News recently has cast a shadow over the Atkins diet that has been one of the few long term "survivors" in the competitive world that is Dieting, with a report suggesting a potential increase in the risk of cardiovascular disease in those who use such a low carbohydrate, high protein way of eating. In no way do I endorse the diet, but on reading the report, the only diet history was taken at the beginning of the study and the average follow up was 15 years: as one critic wrote - "Who eats the same food for 15 years?"

But the problem is not Dieting, it's that we tend to eat too much of the wrong sort of food, and we in the so called "first world" are drowning in a sea of food. It appears that no-one can go to the Mall to shop without stopping for a Jumbo Cappuchino and one of those massive muffins: or if you are of Anglo Saxon origins your choice may be chips with gravy washed down with a caramel milkshake! Governments, Nutritionalists, Foodies and Healthy Lifestyle lobbies are all united in promoting the ideal of eating good quality foods in the correct portion size - and that means lots of veggies, salads and fruit. Go easy on the red meat as most people only need to eat it once or twice a week unless your a female of childbearing age, and plump for more fish and chicken.

Here are some helpful tips:

Don't go for the Big Bang weight loss approach - they usually blow up in your face! In fact it'll be  your waistline that will blow up even faster over the longer term!

Fish is fabulous - get it fresh where you can, but tinned tuna, sardines and salmon are great "take-aways".

If it's fried, try and imagine all that fat searching out your coronary arteries and making it's home there!

If you need to reward yourself after a heavy session shopping, then have an Espresso coffee - it's the new health food and no calories!

When thinking of healthy pre-packed food, try oranges, apples or any fruit or nuts in the fresh food section.

If your belt is running out of holes, eat 2 mouthfulls LESS each meal. Over 6 months you will have saved on tens of thousands of calories and you might even need a new, SMALLER belt!

Don't drink sodas, water is cheaper, fresher and no chemical colouring or calories!

Of course if you have current health issues then you will need to discuss your eating plan with your treating Physician.

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Tuesday, June 26, 2012

Screening for Macular Degeneration

Age Related Macular Degeneration  (ARMD) is a common eye problem, and in some cases will progress to legal blindness, so where possible, we should try to nip it in the bud!

There are two types of ARMD, the so called "Dry" variety and the "Wet" type. The good news is that the early stages of ARMD don't usually cause any serious problems, and the other good news is that there are treatments now that can control the more serious "Wet" variety. But the "not so good" news is that there is no current cure for either types and no specific active treatment at all for the "Dry" variety!

The disease is caused by problems with the lining at the back of the eye where light entering the eye is turned into electrical impulses and transmitted to the brain in order to reach "consciousness".  In the direct "Visual Axis" of the eye where we do most of our seeing, there is an area known as the Macular, which is where there is a massive concentration of our light receptors. When these are damaged by ARMD, then we lose vision in that area - leaving a blanked out area smack bang in the middle of our vision!

Early detection is important and one of the tools that are used is the Amsler Grid.

Amsler Grid 

By using this grid areas of distortion to our vision can be detected. If you wear glasses for reading then wear them whilst doing the "test". View the grid by holding it in your normal viewing position and cover one eye and stare at the central spot. In the normal situation the grid should remain a grid with all the lines straight and all of the grid visible. Further investigation may be necessary is

  • Any of the lines look wavy, blurred or distorted.
  • If any areas are missing or there are dark areas in the grid.
  • If you cannot see all corners and sides of the grid.
And remember to test both eyes.
If you do notice a distortion then get a Specialist check up as you might have early stages of ARMD. For those who do test positive, there is a specific combination of Vitamins that you can take that may reduce the risk of progression by 25% - but discuss this with your treating Doctor.

For the more serious Wet ARMD, new generation drugs can control the disease, and can conserve sight - so please don't take any risks, get your eyes checked: they're very precious!
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Saturday, June 23, 2012

Unsolved mysteries of the brain.

During the course of a week I read of lot of medical articles and am amazed at the variety of research that goes on about how our bodies actually work. Also, during the week, the young bride and I take to our bikes and try and see as much as we can of the great outdoors and all the glorious things that are "out there". These two diverse processes are all computed in my brain, and I'm finding it tough to reconcile the two!

During the week I read of how Psychologists at Concordia University report that they have found where the " Love and Desire related areas" are in the brain. They go on to detail the specifics of their studies and then discuss the structural areas of the brain involved - for those interested, they are the Insula and the Striatum.

Part of my early years of medicine involved teaching anatomy and performing human dissection, so I have some insight into what the brain looks like, and it's an odd structure - usually described as grey and white matter - and notable for only all the waves and grooves on the surface. The experts tell us that our emotions and memories are created by Neuro-transmitters and hormones - chemical substances - that have different cause and effects in various parts of the brain.

Now here's my problem: I see the world in glorious colour, I hear music from birds and symphonies, I read great prose and poetry and when I think of love not even words can capture what I am feeling. When I look at a brain - the real thing, not those colour enhanced, 3D images generated by computers from brain scans - I see an amorphous, grey, jelly-like ovoid mass with lots of wrinkles on the surface: no colour, no words, no poetry, no love .... and I wonder how it all got in there and why?

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Wednesday, June 20, 2012

You are more than you think you are!

We are not what we appear to be, and by that I don't just mean that our "less-than-film-star looks" not correlating with our sparkling personalities. When we look at ourselves in the mirror we see "Me", but that "me" also is host to an incredible array of bacteria, fungi and viruses - we are one living, walking bio-sphere of extraordinary life forms - nearly all of which are working together for the common good .... keeping us healthy and alive!

Researchers are only now discovering the incredible array of bacteria that live in our mouths, our gut, our airways and on our skin. And then there are the fungi that normally live in our gut tube: apparently these self same fungi will "appear" in the vagina of pregnant women because there is a need for them in the soon-to-be-delivered baby who will need these "milk-splitting" organisms to help them absorb the proteins found in maternal milk. In non-pregnant women, these fungi are not found in the vagina.

Then there are bacteria teeming on our skin. These feed on the sebum produced by our skin cells and which then produce a film that helps to "water-proof" it. Meanwhile in the gut there are essential bacteria that help with the absorption of important vitamins and without which we'd all suffer serious deficiency syndromes. As for viruses, the experts are only now looking at what these "friendly" viruses do as they do invade our cells, but for what purpose is still not clear. They might have a role in priming our cell mediated immunity, but much more research needs to be done before the picture becomes clear.

The important point for this evolving field is that when we use "Broad Spectrum" antibiotics we actually destroy huge populations of these friendly bacteria and contrary to the long held assumption that they return after the antibiotics have been withdrawn, that might not actually be the case. Young children who have had repeated courses of antibiotics are at greater risk of developing immune system problems such as Eczema and Asthma - now thought to be associated with the loss of these gut based bacteria.

And in a quirky way of using this information to fight pathological infections, Doctors are already treating a nasty infection of the bowel caused by over use of antibiotics and and resulting in an "overgrowth" by a germ called C Difficile. They have found that the best way to treat this nasty bug is not with stronger antibiotics but to use a "Faecal Implant"! They take a sample of stool from a healthy person and give it via a suppository into the infected person and it "works like a dream". Now they are purifying the process to remove the "Yuk" factor, but the theory and practice are solid and so are the results!

The message here is that we need to think not twice, but long and hard every time we consider using antibiotics and what the collateral damage may be both in the short and in the longer term. We need to consider not only our biosphere, but the global biosphere too. You are more than you think you are!
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Wednesday, June 13, 2012

Back pain - a little patience needed.

Have you ever gotten out of the chair, or a car and been locked into immobility by sudden, unexpected back pain? It's excruciating when it happens and you feel so powerless. Or perhaps you've been doing lots of lifting and then felt a searing pain shoot down a leg and into the foot, again leading to inability move and sure signs of sciatica!

Low back pain is common, and it HURTS. When it happens we want to get out of pain as quickly as we can and get back to "normal" without having to have anything "serious" done. That will often mean a visit to the Doc to get a diagnosis and find out "what's wrong". And here there is often a desire to get an Xray or a scan done ASAP to make sure it's not serious. Well, according to the experts, having that Xray or having that scan will not make the slightest bit of difference to treatment options or outcomes in the vast majority of cases. In fact most Xrays and scans are a real waste of precious Health Dollars.

These experts tell us that in the first 6 weeks after suffering from low back pain, with no "Red Light" symptoms, there is no need to perform any radiological screening as nearly all these cases will settle with appropriate, conservative physical therapy. Red light issues are serious progressive neurological disturbances and fear of serious other underlying conditions such as osteomyelitis.

So if and when you do get a severe back pain, don't pressure your Doc into sending you for "Scans"as in all likelihood it will be wasting not only your time but his time too: and by being patient you will save precious health dollars. Without complications back pain will settle in due time, and while it is, put that time to good use by learning how to care for your back for the rest of your life!
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Sunday, June 10, 2012

Migraines - a real headache to treat!

If you think you've had a migraine headache, you probably haven't because migraine headaches are so bad that you'd never be in any doubt that you've had one. With a Classic Migraine, not only do you get a crashing, one sided headache, but you often get a "visual disturbance" - such as spots before the eyes or partial loss of vision -, you can't bear to be in the light and often you vomit too: so all in all, they're awful!

But not all Migraines are classic and often it will take an expert to determine whether you are a migraine sufferer or not as there are no specific blood tests to say "yes or no" to a diagnosis. It is however, more common to suffer from them if a family member also suffers from them too. For most people when they get a migraine headache, all they want to do is to crawl into a darkened room and lie down until it passes. For most this may be for a few hours, but for some the hell can last a lot longer so it is very important to know that things can be done to help settle them or even better, to prevent them.

But the news here is not that great. For migraine attacks there is a group of medications known as Triptans - but these are not often used/made available to patients in some European countries, hence only 10% (Denmark) to 35% (France) of migraine patients use Triptans. These medications are seen as "rescue" medications that should be an essential tool in helping to stop a Migraine in its tracks. And for those who suffer frequent migraines and who should be using preventative medications, the news is not much better: drugs such as propranolol, valproate, topiramate, where you'd anticipate seeing a response of at least a 50% reduction in migraine frequency, in reality this is more likely to be around a 40-50% reduction. And preventative treatment is further compromised because people often stop these medications because of side effects or just poor compliance.

In view of the fact that about 2% of the adult population are thought to suffer from migraines, there seems to be a huge opening for effective rescue and preventative medications for this crippling condition. I hope there is someone listening ....

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