Healthpharmablog. About Health & Medicine

There are three main energy systems that provide fuel for muscle. Two of these are anaerobic (literally, without oxygen), and the third is aerobic (with air or oxygen).

The final product used by each of these three systems is the high-energy molecule adenosine triphosphate (ATP) which, when split, provides energy for the muscles to contract. For those

Studying exercise performance, it’s the outcomes of these energy systems, particularly muscular contraction, and the types of exercises which improve them, which are important.

For those interested in fat loss, however, it is the fuel use, or substrate utilisation, operating within these systems and leading to the end product of ATP, which is most important, because this determines the rate at which energy is utilised and excess fat ‘burned up’.

The energy systems in relation to exercise have been covered in much more detail elsewhere, and so muscle physiology will only be considered in summary form here. We will then look at the metabolic pathways that provide the options for fuel for muscle. The implications of these for exercise planning for fat loss will be considered in detail. These pathways are complicated and much information is still to be learned from research in this area, but the following will provide an introduction for an understanding of the fat-burning process in humans.

Myth-information. Sit-ups to reduce abdominal fatness will result only in a “tight’ fat waist instead of a ‘loose’ fat waist. Sit-ups can tone muscle but will have little effect on the subcutaneous fat overlaying this muscle.

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Chronic pelvic pain is associated with as many as 10% of hysterectomies but its cause is uncertain. Some studies suggest that there may be a link between this type of pain and psychological factors or a history of childhood sexual abuse. Investigation of the underlying cause usually entails a pelvic examination, laparoscopy, and ultrasound or magnetic resonance imaging (MRI) investigations. These can help rule out the presence of fibroids, endometriosis, adenomyosis, disorders of the ovaries and Fallopian tubes, and pelvic inflammatory disease. When no cause is identified for the pain, medical treatments such as nonsteroidal anti-inflammatory agents and the contraceptive Pill are often tried, with hysterectomy being the last resort when pain is so severe that it is disrupting everyday activities and seriously diminishing quality of life.

There are two main types of period pain or dysmenorrhoea (pronounced dis-men-or-eea). Primary dysmenorrhoea usually affects young women who have never been pregnant. It begins when bleeding starts or just beforehand and rarely lasts more than twenty-four hours. The pain is cramp-like and is usually felt in the lower abdomen, lower back or the insides of the thighs. Occasionally it is so severe that it causes fainting, nausea or vomiting. The cause of the pain is linked to an increase in contraction of the uterus. This may be related to excessive secretions of prostaglandin substances by the endometrium or an increased sensitivity of the uterus to them, causing stronger contractions. Secondary dysmenorrhoea is more often experienced by women whose periods have been painless for some years. The pain may last throughout the menstrual bleeding phase and is thought to be a symptom of something amiss in the reproductive system, for example tissue inflammation, endometriosis, pelvic infection or fibroids. Drugs with anti-prostaglandin activity are often used to treat dysmenorrhoea; in severe cases of primary dysmenorrhoea the pain can be stopped by the inhibition of ovulation through hormone treatments such as the contraceptive Pill.

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Let us now explore the psychological influence of how much sleep we think we need on how we actually sleep.

It is an age-old exercise to classify people into different groups; for example, tall and short, intelligent and not intelligent, hardworking and lazy, and so on. When we try to classify people on the basis of different behaviours we are in fact dealing with characteristics that may overlap between groups. There are two common types of sleep pattern:

* The lark type, who wakes up very early in the morning

* The owl type, who goes to sleep late at night but stays in bed all day

Of course, these two represent the extremes and there is a continuum of behaviour in between. In other words, there is a giant lark and a giant owl on opposite ends of the spectrum and many smaller larks and smaller owls in between. Most of us are a bit of a lark and a bit of an owl, depending on the circumstances.

The lark is a North American singing bird that sings very early in the morning. Lark types are normally short sleepers, believing sleep to be a waste of time. Thomas Edison, the great inventor, was certainly a lark. He slept only a few hours each night, so that he could have more time for his study and research. He probably wished that there was no such thing as sleep and that there were 25 hours on the clock.

The owl is the big eyed, round faced bird that we see sitting on the branches of a tree with the moon behind. Owl types hate to wake up in the morning. They enjoy sleeping and being in bed, even if they are already awake. They like to stay in their beds as long as possible.

Carl Jung (1875-1961), the famous psychologist, identified two types of personality: the extrovert and and introvert. Larks belong to the extroverts. They are ambitious, full of energy, perfectionists, and unable to tolerate laziness. They dislike being alone, and are attracted to the outside world rather than to their immediate surroundings, such as their bedrooms. There is a tendency to superficiality, and their happiness may depend on making a good impression on others. They are absolutely essential to any party.

Owls belong to the introverts. They enjoy being alone in their own world and are lost in large gatherings. They are tolerant and reserved, sensitive and not outspoken. They may be over-conscientious, pessimistic, and critical, always keeping their best quality to themselves. They may often possess unusual knowledge or great talent. They love to stay in their houses and their beds.

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This aggressive element is very deep-rooted; its beginnings can be seen in early infancy. Baby is happy when mother’s milk comes freely and easily, but if it does not come quickly enough or if it comes too quickly, he is frustrated, and in a moment we see anger in his face, and his aggression is vented in crying and generalized movements of his body.

Different children react differently to parental discipline. One child’s aggression may be aroused by a degree of discipline that would be easily tolerated by another. Anything which serves to make the child different from his fellows may arouse his aggression. Forced attendance at Sunday school, for example, or the failure of the parents to interest themselves in the matter, may worry the child and make him tense. When basic cultural or religious factors work to separate the family from others in the district, the child often suffers a smouldering aggressive reaction and his childhood may be marred by chronic anxiety and tension.

The adolescent is striving for adult status. He wants to be a man, and he is angered if he is still treated as a boy. He resents the controls which his parents and society exert over him for his well-being. This arouses aggression. To prove that he is grown-up he becomes defiant, and by his behaviour unconsciously sets about to show the world that no one can tell him what he must do. There may be impulsive and quite unpredictable displays of aggression which may take the form of unnecessary and inappropriate self-assertion. Such behaviour may alternate between the good-humoured and the vicious. The company of young men of his own age with impulsive aggression similar to his own provides an easy milieu for the dissipation of his aggression, and we have the genesis of the teen-age gang.

Sometimes the aggressive behaviour of the adolescent is easily explained. Recently a

long-haired youth of nineteen was brought to see me by his mother and father because he would not have his hair cut. When asked about it quietly, he said that he really did not care if his hair was short or long; but he was simply not going to be told when to have it cut by mother and father. He was merely expressing his right to make his own decisions. Like many youths, this lad was very tense because he felt constantly frustrated by his parents in his attempt to achieve adult status; his aggression was aroused and found expression in his behaviour and his way of wearing his hair. Many such lads lose their tension and come to behave in a more socially acceptable fashion when they realize what has been driving them to behave in this way.

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As I have already mentioned, it is possible to administer St John’s Wort with a variety of other anti-depressants and other medications in general. A survey of European colleagues who have treated collectively several hundred patients with St John’s Wort revealed no drug interactions noted to date except for potential problematic interactions with the MAOIs as noted above. At one point it was thought that St John’s Wort might itself be an MAOI and might exert its anti-depressant effects by that mechanism. If that were the case, it would be potentially dangerous to combine St John’s Wort with other anti-depressants. Fortunately this does not appear to be the case to any significant degree and St John’s Wort can be used freely with other anti-depressants. Furthermore, you need not worry that you will develop the extremely uncomfortable and sometimes dangerous high blood pressure reaction after eating cheese or drinking red wine, as can occur with those who are on an MAOI. There are no dietary restrictions whatsoever when you are on St John’s Wort.

As I mentioned above, you might be best off moving more gradually with dosages if St John’s Wort is used in combination with other anti-depressants or stimulants as these medications all act on the nerve cells in the brain and can enhance one another’s effects. While this is one of the desired goals of the exercise, namely to induce a more powerful anti-depressant effect than would be obtained on any of the medications alone, it is also a reason to increase dosages gradually to avoid the development of exaggerated and unduly unpleasant side-effects.

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SEIZURES-MOOD AND OTHER ILLNESSES

Mothers of young children with epilepsy can sometimes tell from their child’s mood and behaviour that they are ‘building up to a fit’. Adults with epilepsy may experience a peculiar feeling of heaviness or depression on the morning of the days of their seizures. Occasionally elation rather than depression is reported. It is impossible to decide whether these emotional changes cause the seizures, whether both the mood and the seizures are caused by some common factor, or whether the change in mood is in some way produced by a limited paroxysmal discharge that finally erupts into an obvious seizure.

Other illnesses-Any one with epilepsy may have a seizure in relation to a severe other illness such as pneumonia. In children with epilepsy, fever may precipitate seizures, but it is important to retain the distinction between these and febrile convulsions.

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Female. Age 45. Arthritis attack worsened rapidly over a period of only seven months. Required a wheelchair to be moved about. Frequently unable to leave bed in mornings because of debilitating pain. Seeking relief, she worked with a personal trainer. She was incapable of holding a five pound weight, unable to make a fist. Saw immediate improvement with CMO in just three days. Two weeks after the first, she took a second course of CMO. She is now able to perform a full workout, has no difficulty making a fist, wakes in the mornings free of pain, and has resumed a normal active life.

Male. Age 32. Rheumatoid arthritis at age 25. Long family history of arthritis. Seven years of pain in hands, shoulders, legs, and ankles. Although subject saw substantial improvement after taking CMO for three days, he did not experience complete relief and continuing remission for about two weeks. He has subsequently enjoyed skiing holidays and has been able to return to playing golf without the discomfort of any pain.

Female. Age 66. Rheumatoid arthritis rendered hands useless, gnarled, inflexible, agonizingly painful more than six years prior to treatment. Pain was relieved and full use of hands restored after five days of CMO.

Adult male. Life-long athlete. Arthritic pain and stiffness in hands, feet, knees, neck, and shoulders – especially severe with exposure to the cold. With three days of CMO, was totally free of pain with dramatically increased articulation in the joints. Further improved mobility came with a repeat set of CMO three weeks later. Since 1995, he now enjoys skiing and other activities with the vigour and delight he lost so many years ago.

Female, age 54. Suffered since 1940 with arthritis in neck, hands, hips, and feet. She was incredulous about the effects of CMO despite reporting that her arthritis was “not affected by the spell of damp, rainy weather for the last two weeks. There’s no noticeable hip weakness at all. The tingling and clicking in the pelvic joint is not evident. I’m afraid to believe my arthritis is gone.”

Now, in the hope that they will give you a little more insight, here are some very brief extracts from various patients’ reports.

… “As gracious as she was about it, still I knew how much of a burden I was on my daughter. That torment of being helpless and encumbering was often even more difficult for me to bear than the pain of my crippled, bedridden body. CMO, what a miracle! It not only liberated my body and my soul, but my daughter as well.”

… “It’s a miracle! Ten years with arthritis … three in a wheelchair … and now I’ve got a completely normal life again. Just watch me make up for lost time.”

… “Imagine my agony. I was a professional athlete all my life. CMO gave me back my life. Even knee surgery didn’t do that for me. CMO fixed all my joints, all at once.”

… “As crippled as I was, I hadn’t worn out a pair of shoes in seven years. Now I’m out shopping for them again – all by myself. My whole life has made a complete about face.”

… “After nine years of crippling pain, I can’t believe I’m actually skiing again. CMO is truly incredible. I’ve already told four more people about it.”

… “After two years in a wheelchair, I just can’t believe that I’m taking care of myself and my family again.”

… “I couldn’t even put on my own socks. My wife had to do it. Now after seven years of excruciating pain, I’m actually out golfing again.”

… “Before, I needed two hands just to lift a cup of coffee. Now I find myself rearranging furniture all by myself. Last week I even changed a flat tire on the car.”

… “My arthritis bothered me only when I did heavy work. So I didn’t even realize CMO had worked for me till I found myself moving a bunch of heavy junk out of the garage. The change was so smooth and natural I just took it for granted till it dawned on me that I had no more pain.”

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Home care

In most instances, insect bites can be treated by applying ice for a few minutes and then applying calamine lotion. À non-prescription antihistamine taken by mouth should relieve the itching and reduce the swelling. For a tick, the still-hot tip of a burned-out match touched to the protruding tip of the biting insect will usually cause the tick to fall off the skin without leaving the head in the wound.

Precautions

• Protect children with proper clothing, mosquito netting, and insect repellents.

• Learn to recognize the insects in your locale and to know their characteristics.

• If your child develops hives or difficulty with breathing, speaking, or swallowing after being bitten by a scorpion or spider or stung by a bee, a wasp or a hornet, take the child immediately to the nearest hospital.

Medical treatment

If the child has an allergic reaction to an insect bite or sting, the doctor will probably prescribe epinephrine, antihistamines, or steroids to inhibit the reaction. The doctor may advise that the allergic child be given a series of injections to reduce his or her sensitivity to the insect in question. The doctor may also teach you or the child how to treat a bite or sting at home.

Among diseases transmitted by insect bites in Australia are the following. Mosquito: dengue fever, viral encephalitis, epidemic arthritis. Larval mites: scrub typhus. Bush ticks: Q-fever. Flies: hepatitis, diarrhea, trachoma.

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What are they?

Bile is a fluid produced by the liver and stored in the gall-bladder ready to be squirted into the duodenum (the first part of the intestine) to aid the digestion of fats. After a meal, unused bile is stored in the gall-bladder for some time.

Gall-stones arise when the cholesterol in bile starts to crystallize out. The stones slowly increase in size until eventually they are so large that they can’t escape with the bile into the intestine. They then start to cause infections in the gall-bladder and other symptoms. Most gall-stones are made of cholesterol.

Gall-stones appear to be a disease of western culture and are seen only rarely in traditional-living peoples around the world.

What causes them?

We still don’t know the exact answer to this question but modern research is getting very close to the heart of the matter.

Under normal circumstances nature’s own bile acid, chenodeoxycholic acid, dissolves any stones formed in this way, and synthetic versions of this natural chemical are now used to dissolve gall-stones. Clearly the answer should be to try to raise the level of this normal protective substance. This can be done by eating fewer fats and refined carbohydrates and by increasing the amount of fibre and complex carbohydrates. According to one study, people eating like this and taking chenodeoxycholic acid dissolved their gall-stones in a third of the time taken by a group using the drug alone.

Interestingly, gall-stones are often associated with certain other diseases, especially hiatus hernia and diverticular disease. Obesity is the factor common to all three diseases and obesity is also linked to diabetes and high blood-fat levels. The link between all of these conditions is the overconsumption of refined foods and fats, leading to a surplus of energy.

It is said that gall-stones are commonest in women who are fat, fertile, flatulent, fair and forty, but they can occur in anyone of any age and are increasingly common in children.

Wild animals very rarely have gall-stones but they can be induced to do so if they are fed artificial diets such as we eat in the West. A lack of dietary fibre seems to be especially potent in this respect.

Prevention

• Eat fewer refined foods, less fat, and more dietary fibre. Eat less sugar. A study in Italy comparing 160 gall-stone patients with a group of healthy subjects found that the stone patients ate much less fruit and vegetable fibre and significantly more sugar and refined foods generally. Eating sensibly will tend to reduce your weight which is the best preventive against gall-stones. Even being 20 per cent overweight doubles your chances of having gall-stones. Don’t worry about reducing your cholesterol intake, though, as there is no real evidence that it matters. The important point here is to eat more dietary fibre as this provably reduces the amount of cholesterol in bile and puts out more in the stools. A recent study of French women who skipped breakfast, having only a cup of coffee, found that they had a much greater risk of gall-stones than would be expected.

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How long will I have to wait for an operation to remove a lump from my breast, and will a long wait make a difference to the outcome?

Although most breast cancers are relatively slow growing, and therefore a delay of up to a month or two between the discovery of a lump and its removal should make little, if any, difference to the outcome, efforts are made to avoid a long wait for surgery for the sake of the peace of mind of the woman concerned. The ideal strived for is usually to operate within a couple of weeks of diagnosis of a breast cancer. If you have to wait much longer than this because your consultant has a long waiting list, it may be worth asking your GP if it is possible for your operation to be done by another specialist who can treat you sooner.

I have had a mastectomy and there does not seem to be any sign of spread of my breast cancer to other parts of my body. However, I am constantly anxious about any small ache or pain I have in case it is a sign of cancer in the bones or brain. Can I ask for a total body scan to reassure myself that there is no further cancer in my body?

Unfortunately there is no test available which will confirm the presence or absence of cancer everywhere in the body. If you do develop any symptoms, tell you doctor, as scans can be done of individual parts of the body if necessary. Almost all doctors will be sympathetic and understand your anxiety, and will be quite prepared to put your mind at rest about any particular symptoms.

However, even if it were possible to scan the whole body, microscopic cancer cells would not be visible if they were present, and such a scan would therefore not tell you anything conclusive. The possibility that cancer could have spread to other parts of the body before an operation to remove the breast, or that it could recur in the future, is well understood as a cause of anxiety to women who have had breast cancer, and you should receive all the support you require when trying to come to terms with this.

You will have regular check-ups for many years so that any symptoms or signs can be picked up early, but do talk to your GP, consultant, or breast care nurse if you are worried, and do not be afraid that you are pestering them – they will understand your concerns and should take them seriously. You may want to discuss the possibility of having counseling if your fears continue to cause you distress.

What will the wound look like when I have had a mastectomy? I have a fear of seeing it after the operation, and of being horribly disfigured for the rest of my life.

After your mastectomy there may be a pressure dressing over your wound so that you will not be able to see it. When this is removed – usually about 24 hours after your operation – it will probably be replaced with a clear dressing which will remain until your stitches are removed or for up to 10 days if your wound has been stitched with an absorbable material. Through the clear dressing you will be able to see the cut edges of the wound and either a single ‘running’ stitch or separate stitches across the wound itself. The cut edges may be red and angry looking, and there is likely to be some bruising.

Once your stitches have been removed or the wound has started to heal, it will begin to look much better.

Although many women find the first sight of their wound shocking, most do gradually get used to seeing it as it heals. Within a few months, it will probably have faded to a white or pinkish line, which over the years will fade still further.

As your entire breast will have been removed, you will be left with a flat chest wall on that side, and the wound may be a horizontal or diagonal line. Your nipple will also have been removed during the operation. Sometimes, however, there may still be fat left on the chest which was overlying the breast. If so, you will have some breast contour rather than a dip where your breast used to be. There may be puckering around the wound which may settle after a while.

Following a wide lump excision or lumpectomy, when the nipple is retained, there is usually some nipple distortion, particularly if the operation was to remove a tumour just beneath the nipple. The length of the scar will depend on the size of the lump which was removed. Following a mastectomy, however, there should eventually be only a neat line where the skin was cut.

If I have to have chemotherapy or radiotherapy following my breast operation, what side-effects can I expect to experience?

The drugs used nowadays for chemotherapy are much improved in terms of their side-effects, and you may not experience any at all. It is unlikely that your hair will drop out, and although you may feel tired and nauseated for a while, many women do not even suffer these problems.

Radiotherapy for breast cancer is similarly unlikely to have any seriously debilitating side-effects, although – as with chemotherapy – different women react differently. The skin in the treated area may become sensitive, red and dry, and you will be advised about how to care for it during your treatment.

Do ask your consultant and/or breast care nurse to discuss any possible side-effects of the particular therapy you are to receive.

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