Karuparthy Column

Management of Chronic Pain

(Continued from last month)
Chronic pain can initially start with injury or surgical insult like the most common low back surgery. As time progresses the chronic pain will not have clear organic cause that can be measured and fixed by modern medicine. This leads to a vicious cycle of chronic pain affecting the mind and daily life. At this stage, the depression in chronic pain patients fuels further pain. That means chronic pain causes depression and depression causes the perception of pain worse. In many more instances there may not be any initial injury at all, e.g., Fibromyalgia.

The ancient text called “Yoga Vasishta” expounds the concept of disease differently than the modern medicine. According to this text, adhi means the imbalances originating in manomaya kosa and when this imbalance shows up in physical body as symptoms and signs, is called adhija vyadhi (stress born diseases). Simply vyadhi or anadhija vyadhi means any imbalance in the annamaya kosa showing the physical symptoms and signs.  Except for the diseases of infectious origin and degenerative disorders and injuries which originate in physical body (annamaya kosa) many of the disesase imbalances arise in manomaya kosa (mind) and roll over into the body later if left untreated. Even infectious diseases do not affect a physical body, which is in perfect balance in the mind and other levels providing the immunity at its best. This is the reason why everybody who gets exposed to a virus or bacteria does not get the disease symptoms.  Diseases like Asthma, diabetes, hypertension and anxiety disorders are called adhija vyadhi originating in manomaya kosa- the astral layer of our existence. Stress has major role in aggravating and continuing the chronic pain state.

Adhija vyadhis are multifactorial and usually modern medicine can only treat the symptoms and usually the treatment is life long. Here comes the holistic integrative treatment methodology to really make any difference in the long term and eventually wean all the supportive symptomatic treatments, be it a drug for hypertension or chronic pain.

The integration starts with full supportive symptomatic therapy of highly technological modern medicine followed by passive participation therapies of Ayurveda. This is followed by active participation program of Yoga techniques and complete behavioral and life style modification. (continued)
KV, May 2003

Baby Formula
According to a study appearing in the May issue of Pediatrics, infants fed different infant formulas can develop significantly different levels of bone mineral content and bone mineral density.  Babies develop significantly greater, more favorable levels of bone mineral content and density when fed an infant formula without palm olein oil than when fed a formula containing that oil.

Music Affects Your Mood
According to the findings, appearing in the May issue of the Journal of Personality and Social Psychology, songs with violent lyrics increase aggression related thoughts and emotions and this effect is directly related to the violence in the lyrics. The violent-songs increase in aggressive thoughts and feelings have implications for real world violence.  The violent songs increased feelings of hostility without provocation or threat.

Walking
According to new research reported in the rapid access issue of Circulation: Journal of the American Heart Association, men with type 2 diabetes can save their lives by walking, and the faster they walk the less likely they are to have a heart attack or stroke.  In the study, diabetic men who were in the third highest of four categories of total physical activity reduced their risk of cardiovascular disease by 36 percent and their risk of death by 43 percent compared to those in the lowest quintile of physical activity. There was no further improvement in the fourth and fifth quintiles. Men in the highest quintile of walking expended more than 16MET-hours/week (equivalent to four hours of brisk walking in a week) and reduced their risk of death by 43 percent. Men who walked at a brisk or very brisk pace had a significantly lower risk of cardiovascular disease as compared to men who walked at a casual pace. Walking appears to reduce risk when performed regularly and at a fast pace.

Heart Disease and Oral Symptoms
Heart disease will claim half a million lives this year.  Research shows over 90 percent of all systemic diseases-including heart disease-have oral symptoms. A sore or painful jaw could indicate an impending heart attack or heart disease, making bi-annual visits to the dentist an important investment in one's oral as well as overall health. Careful dental examinations of patients with a history of heart disease for any signs of oral pain, infection or inflammation paired with proper treatment is crucial to overall health, reports the Academy of General Dentistry (AGD).   Gum disease, often called gingivitis in its early stages, is caused by plaque buildup and affects 75 percent of American adults. New studies suggest that people who have gum disease are at a higher risk for heart attack. If bacteria in the infected gums dislodge, they can enter the bloodstream, attach to blood vessels and increase clot formation. Clots decrease the blood supply flow to the heart and can increase chances of a heart attack and aggravate higher blood pressure. Signs of gum disease include bleeding or puffy gums, bad breath, sores in the mouth, receding gums, pus or infection between gums and teeth and/or gums that pull away from the teeth. Preventing plaque buildup by brushing and flossing regularly helps minimize the chance for getting gum disease. Seeing the dentist every six months can help identify gum disease as well as overall health problems in their earliest stages. The Academy of General Dentistry is a non-profit organization of more than 37,000 general dentists dedicated to staying up-to-date in the profession through continuing education. For additional information on heart disease and oral health, please visit the Academy of General Dentistry's Web site @  www.agd.org. 

Killers of American Women
Many of the leading causes of death among women can be successfully prevented or treated if the warning signs are caught early enough. For example:

• Heart disease is the number one killer of American women. Often thought of as a man's disease, more women die of heart disease each year than do men.
• Cancer is the second leading cause of death of American women. Lung cancer is the top cancer killer among American women, with an estimated 65,000 deaths in 2002, followed by breast cancer and colorectal cancer.
• Stroke is the number three killer of American women. Each year, 30,000 more women than men have strokes.
• Diabetes is the fifth leading cause of death in women. An estimated 17 million Americans have diabetes (8.1 million women), of which an estimated 6 million are undiagnosed.
• HIV and sexually transmitted diseases: There are an estimated 40,000 new HIV infections each year in the United States, with about 30 percent of reported infections occurring in women.

High Fiber and Colon Cancer
The contemporary theory that fiber wards off colon cancer began in the 1970s, when a British doctor, Denis Burkitt, noted that poor people in Africa produce more feces than Westerners and get much less colon cancer. One obvious difference between the two groups was that Africans consumed more fiber.   As a result high-fiber diets were recommended.  Long-standing recommendations for high-fiber diets have taken a hit over the last few years after a handful of studies failed to find a benefit.  Two major new studies published in the Lancet medical journal, one on Americans and the other on Europeans, indicate that previous research may not have examined a broad enough range of fiber consumption or a wide enough variety of fiber sources to show an effect.  One major difference between the former and current studies is that the new ones examine more diverse populations who eat different types of fiber from each other and in hugely varying amounts.  Fiber is found in fruits, vegetables and whole grains. Americans eat about 16 grams a day, while Europeans eat about 22 grams. The new studies indicate fiber intake needs to be about 30 grams a day to protect against colon cancer.   In the American study, people who ate the most fiber had a 27 percent lower risk of precancerous growths than those who ate the least.  In European study,  those who ate the most fiber, about 35 grams a day, had about a 40 percent lower risk of colorectal cancer compared with those who ate the least, about 15 grams a day.  

Garlic is Good
Researchers say garlic may have a variety of health benefits, including possible protective effects against cancer, Alzheimer's and cardiovascular disease. Study results, presented at the Experimental Biology Meeting in San Diego, indicate aged garlic extract may reduce or inhibit plaque formation in the heart's arteries and lower homocysteine levels in the blood, said Dr. Matthew Budoff, cardiologist at the Research and Education Institute at Harbor-UCLA Medical Center.

Smoking and Drinking and Cancer
A new study that appears in the May 21 issue of the Journal of the National Cancer Institute suggests that cigarette smoking and alcohol intake may reverse potential benefits that the vitamin A precursor beta-carotene has on reducing the risk of colorectal polyp recurrence. Colorectal polyps, or adenomas, are benign tumors that may develop into colorectal cancer.

Fetal Alcohol Syndrome
According to CDC maternal prenatal alcohol use is one of the leading preventable causes of birth defects and developmental disabilities. One of the most severe outcomes of prenatal alcohol use is Fetal Alcohol Syndrome (FAS), which includes abnormalities in three domains at the same time - disorders of the brain, growth retardation, and facial malformations. FAS and other alcohol-related conditions can be prevented by avoiding alcohol use during pregnancy. Preventing FAS requires intervening not only with pregnant women but also with women prior to conception to help reduce risk drinking and/or postpone pregnancy until risk drinking is resolved. Accordingly, decreasing alcohol consumption among pregnant women is an important objective of the U.S. Department of Health and Human Service's Healthy People 2010 initiatives.

Poly Unsaturated Fatty Acids (PUFAs)
Eating PUFA containing foods at least twice a week can prevent sudden cardiac death because PUFAs block dangerous irregular heart rhythms, experts say in a review article in Circulation: Journal of the American Heart Association.  The first clinical suggestion that n-3 PUFAs significantly benefited the heart came from a 1989 study in which 2,033 men with heart disease were given dietary advice on fat, fiber or PUFA. After two years the men who were told to eat PUFA containg foods (fish - in this study) at least twice a week had a 29 percent reduction in death. There was no benefit in either the fiber or fat groups.  In early animal experiments, researchers demonstrated that animals fed a diet in which 12 percent of the calories came from saturated fat died of sustained ventricular fibrillation, but animals that were also fed n-3 PUFAs did not develop these dangerous arrhythmias when their coronary arteries were tied off.  According to a recent American Heart Association scientific statement a dietary approach to increasing omega-3 fatty acid intake is preferable. Still, for patients with coronary artery disease, the dose of omega-3 (about one gram per day) may be greater than what can readily be achieved through diet alone. These individuals, in consultation with their physician, could consider supplements for CHD risk reduction.

In a new study of 11,721 British women, released on May 21st at the annual meeting of the American Psychiatric Association, researchers found that the more omega-3 fatty acids a woman consumed during the third trimester, the less likely she was to show signs of major depression at that time and for up to eight months after the birth.   Pregnant women could be particularly vulnerable to low levels of omega-3 fatty acids because the developing fetus draws on supplies stored in the mother's body.  The rate of depression in the women with the highest intakes was only about half that of women with the lowest intakes.  Eating fish two or three times a week was typical of the highest-intake group.

PUFAs are long-chain fatty acids containing two or more double bonds. Interest in them arises from their potential in therapeutic applications, and food & nutritional applications. They occur throughout animal, plant, algae, fungi and bacteria. Found widely in many lipid compounds such as membranes, storage oils, glycolipids, phospholipids, sphingolipids and lipoproteins. They are produced commercially from selected seed plants, and some marine sources, e.g., PUFAs can  be found in flax seed and fish.  The federal government has warned pregnant women to avoid eating shark, swordfish, king mackerel and tilefish because they can contain high levels of mercury, which might harm the developing nervous system of the fetus.

Paraoxonase
An oxidation-fighting enzyme called paraoxonase (PON1) can significantly reduce the risk of heart attacks, according to research reported in the rapid access issue of Circulation: Journal of the American Heart Association. The enzyme attaches itself to high-density lipoprotein (HDL), which is known as “good” cholesterol. When PON1 is highly active, the risk for heart attack is cut by 43 percent.  Taking antioxidant vitamins, eating foods high in antioxidants, and exercise all increase PON1 activity.

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