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Chronic pain is a wide-spread issue. Addressing pain management issues are complex and often ongoing and many times fraught with continued patient discomfort and dissatisfaction. For example, Vicodin is the #1 most prescribed medication in our country, but this doesn't do anything to treat or help heal the reasons for one's pain. So the more therapies available to treat chronic pain, the better! Chronic pain is defined as pain experienced three months after the original injury is considered healed. Here are the top therapies for chronic pain (both in terms of amount accessed and evidence-based effectiveness): * Anodyne pharmaceuticals (painkillers): Vicodin, Oxycontin, muscle relaxers, etc. * Biofeedback: by observing a bodily rhythm or signaling via computer imaging, the patient impacts their experience. A simple type of this is breathing patterns adjusted by looking at a monitor displaying one's blood pressure. * Meditation: Mindfulness meditation has in particular been shown to decrease one's perception of pain. * Hypnosis: Many methods and styles are available to change one's psychological responses. * Tai chi: Chinese meditative energy movement styles which are often found to help with many chronic disease concerns (such as its effect on patients living with heart failure) . * Awareness, concentration and expectation: patients perceived less pain if told the pain would end soon, were concentrating on a mental task or while concentrating on a picture of a loved one. There are many therapies to address the acute pain one feels after a trauma or surgery. And they work quite well to dull your brain's perception of that pain. But when dealing with chronic, debilitating pain lasting months or years and affecting one's quality of life, there just isn't one "magic bullet" for everyone. The best approach will most likely comprise one or more of the above treatment options, while incorporating one or more healthcare practitioners who deal with pain management and find efficacy in dealing with underlying causes (a few examples might be massage therapy, Chiropractic care, acupuncture, Naturopathy, physical therapy or orthopedics).
Thank you for reading, please email me any time!
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In a recent review of 75 scientific research articles, vitamin D is showing itself to be associated with lower rates of cardiovascular disease (high blood pressure, heart attacks and atherosclerosis) as well as better insulin control (essential for prevention of Type 2 Diabetes). What this shows is a static picture comparing vitamin D levels and the above disease states. What this doesn't show is whether taking vitamin D will prevent these epidemic-level diseases in our communities. So does taking vitamin D supplements help prevent these chronic disease? This particular research cannot answer this question.
The next step towards answering this, however, is already under way. These researchers started a research project last year comparing development of cardiovascular disease and insulin resistance (seen in diabetes and pre-diabetes) in groups taking either vitamin D, fish oil (high in omega-3 fatty acids) or placebo. This study will continue for another five years, but these research findings could shed some light on dosage of these supplements and what disease risk factors doctors will confidently be affecting. I look forward to to resulte they may find, and will pass this information along when it becomes available. So after a few less than positive articles about diabetes (it's a global phenomena and may lead to dementia), here comes one of the more well known solutions. Published this August in the Journal of Nutrition, the research (here) looked at groups following either a vegan diet or that recommended by the American Diabetes Association. The dieters followed specific glycemic index and load diets and were measured in terms of their change in weight and hemoglobin A1C (blood test which tracks diabetes management). What this research found is that following either a low glycemic index diet or a low glycemic load diet will lead to weight loss and improved blood sugar regulation (a lower hemoglobin A1C and presumably better management of one's diabetes). Although the vegan diet showed lower glycemic index levels and the ADA diet showed lower glycemic load levels, both appear to be helpful in controlling the dysglycemic patterns of diabetes.
For more information about these diets, or the difference between GI and GL please contact me. Research just published Sept. 20 in the American Academy of Neurology journal looked at the link between diabetes and the development of Alzheimer's (may be found here). There was over 1,000 research participants of both sex, all age 60. They were measured for the presence of diabetes or pre-diabetes then followed for 15 years. Those who were diabetic were twice as likely to develop Alzheimer's and more likely (1.75x) to develop dementia of any type (Alzheimer's is a specific type which irreversibly forms plaques in brain tissue). So what's the proposed link? Well, in diabetes, glucose remains in the bloodstream for a long time, waiting to be taken into cells but in the meantime floating around the bloodstream. Glucose which remains too long in the bloodstream leads to oxidative damage, hardening of the blood vessels (atherosclerosis) and glycosylation (think candied fruit but with blood vessels instead). All of this directly and indirectly compromises the body's ability to break down proteins, such as the amyloid protein which form the plaques found in Alzheimer's. People with or at risk for diabetes now have one more reason to keep a close eye on their blood sugar levels and do what they can to keep them in healthy ranges. Diabetes is a complex, difficult disease. Bringing about positive change often means significant lifestyle changes and an ever-changing regimen of drugs.
Two positive things have come of this research. One is that those with pre-diabetes did not show as significant a correlation with the development of Alzheimer's, so encourage your friends and family members in this situation to not wait for until pre-diabetes becomes diabetes. The second is that the research authors have already begun follow-up research looking at what Alzheimer's rates they find in diabetics who then control their blood sugar levels and risk factors. I'll keep you posted on the developments. The International Diabetes Federation met two weeks ago to document current cases of diabetes and what unified proposals they agreed upon to recommend to last week's UN meeting. This federation represents associations from 160 countries, all of whom are finding ever more increasing and concerning numbers of diabetics in their healthcare systems (information from their symposium may be found here). So what's the current picture? There are now an estimated 366 million people with diabetes (data combines types 1 and 2). Their total estimated yearly financial impact on healthcare systems is $465 billion. Annually. That's a huge number of people and a huge financial impact- both on larger systems and on a personal level. To put this number into perspective, there are 54 million more diabetics in the world than the entire U.S. population combined. Although this is far from an American problem, many chronic non-communicable diseases rise in countries in proportion to their adoption of industrialized (American) culture and food (diabetes, heart disease and cancer are a few). Type 2 diabetes has been around for some time but has been rapidly growing from the 174 million diabetics estimated worldwide 30 years ago. What was at one time termed "Adult Onset Diabetes" can now be found affecting grade-school children. Type 1 or "Juvenile Onset Diabetes" was a rare disease to my knowledge as a child, and I knew of no children with Type 2. I'm thinking that this is not the case with today's children. So where does this all end? Personal choices, government choices and companies' influence impacts all our lives. Whether it's diabetes, cancer, lung disease, an autoimmune disease or some other chronic non-communicable disease, it's a long and difficult path towards continual improvement of one's health. Our modern medical establishment it not set up to optimally serve people in a preventative and health-supporting manner, so check out what the Naturopathic profession can do for you if you have one of these or a similar concern.
What was your favorite school lunch item? I'll admit mine was the chocolate milk; less than healthy choices such as mine may soon be a thing of the past. School lunches are in the cross-hairs of the current legislative activity aimed at improving children's nutrition. Last year, Obama signed the Healthy, Hunger-free Kids Act, showing how concerning our children's lunchtime food choices are (even the presidents getting involved here!). Today's Washington Post featured an article titled, "School lunch debates heat up," where author Jennifer LaRue Huget asks: "...whose responsibility it is to decide what to feed America’s schoolchildren, who should determine what’s healthful and what’s not, and what role [do] parents play in that decision-making process. We also have to consider whether serving nutritionally sound meals at school is itself part of the curriculum; teaching kids what foods are best for their bodies by offering such foods at lunchtime." So whose responsibility is it that kids eat healthy lunches?
Shouldn't it be everyone's? If healthy meal choices are made at home, then children will (by extension) bring healthy lunches to school. And for those who are provided meals at school (for parental convenience and/or reduced-price), then shouldn't this be where the schools step in with healthy choices? If childhood (and adult) epidemic levels of obesity and diabetes are to be reversed, we need to take what kids eat seriously. When nutrition becomes a value that we as a society act upon, only then will children benefit and chronic disease stats decline. Until that time, Lunchables will continue to be the top lunchtime trading commodity, and our following generations will grow evermore unhealthy and overweight. I love to hear all of your comments, questions, and suggestions for upcoming articles. Feel free to contact me any time! Thanks for reading! -Angela |
I'm Dr. Eloise Cortal, and I want to help you and your joints feel their very best.
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