Newsletter – August 2014

Holistic Pain Relief

Chronic pain is a miserable business.  When there’s no relief in sight from arthritis or injury or chronic back pain, the confusion and worry about what to do about something disabling, unrelenting, and not fixable, can lead to further anxiety, hopelessness, and depression.

In 2011, the Institute of Medicine estimated that more than 100 million Americans suffered from chronic pain, not including children and those in acute pain.  The International Association for the Study of Pain estimated that 20% of adults world-wide suffer from moderate to severe pain.

I had the privilege of meeting Dr. Heather Tick when I was teaching at Hollyhock, British Columbia in June 2014.  Heather is an integrative medicine professor and practitioner at the University of Washington, teaching doctors to draw on both conventional and holistic therapies for pain.  So, rather than having to wait until conventional treatments, particularly medications, help only minimally or not at all, and then turning to something alternative, Dr. Tick’s curriculum integrates alternative or complementary forms of treatment – acupuncture, intramuscular stimulation,  mind-body practices, massage, nutrition, exercise, movement therapy – into conventional treatments right from the beginning. She is also a strong advocate for policy changes among insurers and Medicaid. For example, in 2009 the Office the Surgeon General asked for mandated integrative pain care, so that physicians can use tools of integrative pain care for people in the health care systems of the Departments of Defense and Veterans Affairs.  That’s a lot of people.

Dr Tick’s book Holistic Pain Relief: Breakthrough Strategies to Manage and Eliminate Pain, offers hundreds of practical suggestions  to help readers literally heal and awaken into aliveness and wholeness.  The book, scientifically grounded and based on 30 years of experience in the mechanisms behind people’s pain, is an accessible tool kit for bring health and healing to the whole person, not just one symptom or disorder.

In an age when we experience more chronic stress, thus more chronic pain, than ever, may these tools and reflections be useful to you and yours.

REFLECTIONS ON HOLISTIC PAIN RELIEF

Nearly 50% of all Americans seek care for pain each year.  (So that figure doesn’t include people who are toughing it out at home, hoping pain symptoms go away on their own.)  There are no instruments or scales that can measure pain the way a thermometer measures a fever.  Pain is always subjective and is conveyed by a person’s self-report or behavior.  And with increasing constraints from practice guidelines currently followed in our medical system, patients get to spend 10.7 minutes with their doctor each visit, hardly enough time to deal with the nuances and complexities inherent in treating pain.

Dr. Tick does a beautiful job summarizing some basic philosophical differences between conventional Western (allopathic) medicine and complementary or alternative (holistic) medicine.  (She is well-trained in both and can work with and teach both in an integrative way.)  There are times when the specializations of allopathic medicine are extremely useful – in the immediacy of a heart attack, and other times when the holistic approach to a person’s entire approach to living in a human body is extremely useful – in preventing heart attacks.

The sentence that caught my attention the most was, “A study published by the Journal of the American Medical Association in 2000 concluded that our health care system itself is the third-leading cause of death in the country.”  (Only statistics about the fast-food and cigarette industries are more dire.)  Given that the study was published by the most prestigious journal of the medical profession itself, I sat up and took notice.

Dr. Tick makes the case that our current health care system focuses too much on problems rather than the person – the torn rotator cuff rather than the lifestyle choices that might make a person vulnerable to tearing their rotator cuff. Her metaphor – re-plastering the ceiling every time the roof leaks rather than fixing the roof – is apt.  Focusing on problems – part of the body or procedures on the body – is more profitable than focusing on the person, which takes time and doesn’t always yield simple outcome data.  Physicians don’t get paid when patients stay healthy.

 

Dr. Tick concentrates on offering specific suggestions to shift our focus from illness-management to health-care.  Many of her suggestions will be familiar to people already eating fresh, organic vegetables, practicing gratitude, and exercising regularly.  Still, it’s fascinating to learn the science behind the benefits of intentional healthy living, especially reduced pain.

The reflections below are not meant to be a comprehensive summary of each chapter.  I’ve edited them more to intrigue and invite you to explore the book further. In most of the text below, I’m using   Dr. Tick’s words directly; she’s a brilliantly clear writer.]

NUTRITION AND DIET

“You change your body chemistry every time you eat,” Dr. Tick counsels all of her patients.

Basic Science

Diet is more powerful in preventing the common diseases than either drugs or medical care. There is strong science behind the idea that food promotes health, and we need to make use of it.  Eating habits affect pain because diet can either increase inflammation or decrease it.  Diet can nourish our cells or leave them vulnerable to further damage.

The chemical makeup of our body is like the soil that we grow plants in.  For your body to grow and heal, your chemical makeup needs to be full of balanced nutrients – just as soil has to be full of balanced nutrients for us to raise beautiful and healthy plants.

Nutrition research has shown that we can change the chemistry of our bodies to improve metabolism and encourage healing throughout lives.  In fact, every time you eat – every day, at every meal – you change your body’s internal chemistry, for better or for worse.  Food promotes healing or does just the opposite.  This simple principle has not been incorporated into the conventional medical understanding about health and healing.

 

Application

Inflammatory processes are responsible for most of the damaging effects we see as a result of diseases.  These responses are the final common pathway for conditions that include infections, arthritis, diabetes, heart disease, cancer, and muscle pain.  But as it turns out, inflammation is involved in healing us, too. This is where nutrition comes in.  Nutrition is the most powerful way for us to tip the balance of inflammation toward healing. Foods and nutrients can reduce inflammation and the number of free radicals and leave the healing part of the inflammatory process intact.

Specific example

Few of us in the Western world eat much seaweed.  But we should.  The earth’s farmland has been washed almost clean of iodine, and so the foods we grow have little of this important mineral.  Today, we can get good quantities of iodine from fish and seaweed. The seas and oceans contain a lot of iodine, so swimming in the sea also works to replenish iodine.  Iodine is essential for the function of the thyroid and other organs, and a sluggish thyroid can mean muscle pain and delayed healing.

Basic Science

The glycemic index (GI) is a measure of how fast a food turns into sugar once you eat it.  The scale ranges from 0 to 100, where 100 describes how fast blood sugar rises when an individual eats straight glucose.  Glucose is the sugar molecule our cells use to make energy; it is what is measured in a blood sugar test.  Sucrose is table sugar, made of an attached glucose and fructose molecule, and since it requires more time to be broken down than glucose along, it has a GI of about 62.  That means foods with GIs of about 62 or above turn into sugar in your body faster than sugar does.  You might as well eat out of the sugar bowl.  (You can check the GI of the foods you are eating at www.glycemicindex.com )

When you eat a food that is high on the glycemic index, your blood sugar spikes and your body quickly compensates by secreting hormones such as insulin to lower it.  This usually causes your blood sugar level to drop below the optimal range.  This drop usually happens about two hours after you eat, and it makes you feel fatigued, irritable, and hungry for anything that will quickly raise your blood sugar again.  That hunger is called “carb cravings,” and it puts you on a roller coaster of rising and falling blood sugar levels.  Your body chemistry gets into a pro-inflammatory state, which means more pain.  This increases oxidative stress, which causes tissue damage, weight gain, and eventually insulin resistance or pre-diabetes, which means even more pain.

Application

The fastest way to correct the problem is to eat a low-glycemic diet.  This will help you solve the metabolic problem, reduce inflammation, and cut out your cravings for unhealthy foods.  It often helps to eat five small meals a day with some protein – vegetable or animal protein – in each meal.  Once you are no longer craving the foods that spike your blood sugar, you can move to three meals a day with a long fast between dinner and breakfast and five hours between your other meals.

Specific example

The foods we think of most readily as carbs – bread, pasta, rice, potatoes, and cereals – are the ones most likely to spike our blood sugar.  Beans and other legumes, lentils, seeds, nuts, and steamed whole grains are good sources of carbohydrates and are high in fiber, vitamins, minerals, and healthy oils.

Tidbit – Chocolate is a Health Food!

Chocolate contains antidepressant-like compounds and the potent antioxidants called flavanols.  But chocolate is healthy only if it has a high cocoa content (70 percent or higher) and is consumed in moderation. In one study, researchers found that patients suffering from high blood pressure who took a regular dose of dark chocolate over a period of fifteen days saw a reduction in blood pressure, lower total cholesterol, less bad cholesterol, and improved insulin sensitivity.  A small amount – probably an ounce or two – of high-cocoa-content chocolate can be a healthy treat.  Milk, however, deactivates antioxidants in chocolate, so milk chocolate is not recommended.

MIND-BODY MEDICINE:  RESOLVE STRESS AND DISSOLVE PAIN

The main focus of mind-body medicine is stress.  Stress is not always a negative thing – it actually keeps us alive.  But when stress is more than we can handle, it can chip away at our health.

Basic Science

The sympathetic branch of our nervous system and its stress response are necessary for everyday life.  Without them, we would not have enough blood pressure to stand up without fainting.  When we get stressed, we have an acute stress response, which is also called a “fight or flight” reaction.  Your body might have an acute stress response if you wake up in the middle of the night to the sound of a window breaking; your body goes into an emergency mode that quickly decides on the best way to survive the situation.  Your brain and body coordinate and are ready to spring into action.  In this case, an adaptive stress response may help keep you alive.

If we see stress as a challenge that we can handle, it energizes us.  But when stress feels overwhelming, it’s called distress, which has a negative effect on our health and our response to pain and illness.  Some interesting research shows that distress can speed up the aging process by affecting little structures in our cells called telomeres.  These structures allow our cells to multiply.  Every time a cell multiplies, its telomeres get a little short.  When telomeres get too short, our cells cannot duplicate, and eventually they die off.  We need our cells to multiply in order to heal ourselves and keep our organs in good working order. It turns out that a person who has distress gets shorter telomeres compared to a person who just has stress.  The two people may have identical stressors in their lives – the only difference is that one of them finds those stressors overwhelming.  This is just one example of the direct health benefits that come from learning to judge our level of stress and ways to manage it.

Application

These days, chronic stress is what we most often mean when we talk about stress.  Everyday sources of this stress could be the workplace, an abusive relationship, economically difficult times, uncertainty in the age of terrorism, living in crowded cities, pollution, improper foods, irregular eating habits, or not enough physical activity, to name just a few.

But just because chronic stress is common doesn’t mean it’s natural.  Chronic stress is actually a modern phenomena, and so we have no appropriate primitive response to it.  Our body’s response to chronic stress is the same as its response to acute stress – our heart rate, blood pressure, and blood sugar go up, our blood flows to our big muscles, our attention focuses so we can respond quickly to possible threats, and sugar and fat are released into the bloodstream so we are ready for action.  Other functions that are not needed for immediate survival shut down, including our digestion, sex hormone production, immune system, and circulation to nonessential areas.

This stress system, which helps us survive acute stress, makes us sick in the case of chronic stress.  Over long periods, the stress response causes inflammation and wear and tear on our system, and it promotes all the chronic diseases that are so common these days – diabetes, heart disease, strokes, and chronic pain.

Specific Example

[See Stories to Learn From]

HABITS

Making good habits can change the wiring of your brain, which can relieve the pain brought on by bad habits.  Our brains get better at whatever we focus on; this is called neuroplasticity, just as our bodies get better at sports when we practice.  We can train our brains to sharped our focus on pain or to lessen that focus.  Good habits can reduce pain and improve our ability to do the activities that are meaningful to us.

HEALTHY HABIT – SLEEP

At least 40 percent of Americans report occasional insomnia, and some studies report that the number is as high as 70 percent.  Twenty-four percent of us have difficulty sleeping every night or almost every night.  There is a higher incidence among women, and the problem gets worse as we age.

Basic science

During sleep we recover from the activities of wakefulness.  Our bodies rebuild stores of molecules by replacing or repairing damaged molecules needed for the next day.  When we are deprived of sleep, the brain makes molecules that are ordinarily associated with stress – proteins that don’t fold properly and that clump together, and heat-shock proteins that are designed to help the body cope with stress.  So if you sleep well, you have a tune-up overnight; and if you don’t sleep well, your system experiences cellular stress.  Sleep also reduces inflammation and improves immune function.  There has been speculation about other “off-line” functions performed by the brain during sleep, such as keeping memory tuned up and fit by exercising it with dreams, and refreshing circuits for new memories.  Consequently, sleep is restorative, and a lack of sleep is associated with fatigue and cognitive impairment.

During sleep we have greater heart rate variability.  A heart rate of sixty beats per minutes does not necessarily mean one beat per second.  The interval between two beats may vary greatly from one beat to another.  This beat-to-beat variability is a sigh of health and a predictor of longevity.  A steady one-beat-per-second rhythm usually suggests heart disease or some other serious condition, and it is a predictor of poor health.

Sleep promote other healthy rhythms as well.  When we are sleeping soundly, some of our biological functions line up their rhythms with each other.  These functions include our respiratory rate, blood pressure, and brain waves. (This same phenomenon happens when we are in a state of meditation, feeling gratitude or appreciation, or “in the zone” that athletes describe when they feel they are functioning at their best.) Scientists call this rhythmic synchrony entrainment, and they agree it is good for our health.

Application

Melatonin, a hormone secreted by the pineal gland in our brain when we are in darkness, entrains our body rhythms with the day-night cycle.  It is a powerful antioxidant, helps in modulating our immune system, and may discourage the growth of certain cancer cells.  Proper melatonin levels affect sexual development and quality of sleep and overall plays a role in slowing down the aging processes.

Studies have shown that when we sleep in total darkness, we secrete more melatonin.  Even a small amount of light hitting our closed eyelids drastically reduces the amount of melatonin released in to our bodies.  When we sleep with light from a nightlight or even a crack through the window shades, our melatonin secretion plummets.

When used as a sleep aid, melatonin is not addictive and does not disturb the natural rtythm of sleep as most sleep drugs do.  Melatonin causes some people to have vivid dreams.

Specific example

Here are some habits that can help you get a good night’s sleep.  Adopt a regular sleep time and develop a relaxing bedtime routine.  During the hour or two before bed, do not consume large quantities of food or beverages, exercise vigorously, or focus on aggravating issues.  In addition, avoid using a computer or watching TV; the light from computer screens and TVs excites the brain.  Keep your bedroom cool, dark, and quiet.  Go to bed tired and turn out the lights. Have a comfortable mattress and pillow.  Sleep primarily at night, and limit daytime naps to a maximum of thirty minutes.  Sleep in total darkness or use a sleep mask.  Avoid nicotine, and limit nighttime caffeine, alcohol, and sugar consumption.  All of the chemicals are stimulants.  Nicotine is an outright stimulant, as is caffeine.  Alcohol makes you drowsy at first, but then wakes you up a few hours later.  If you have any trouble sleeping, completely avoid these chemicals to reestablish a healthy sleep pattern.

UNHEALTHY HABIT – SMOKING

Quitting smoking is the factor you can control that most significantly reduces your risk of getting a chronic and life-threatening disease.  Smokers report that cigarettes help relieve their pain, but the downside, including damage to the entire body, greatly outweighs this positive effect.

Basic Science

Cigarette smoke contains chemicals that clog the small blood vessels, called capillaries, that are supposed to keep the spinal bones, called vertebrae, and the cushions between the vertebrae, called discs, healthy.  Without a proper blood supply the discs and the vertebrae break down, causing degenerative disc disease.  Smokers are three times as likely to develop this disease compared to nonsmokers.  In addition, cigarette smokers have poor circulation in general.  This hinders the healing of bones, – smokers with fractures heal slower and fare far worse with many types of surgery, including orthopedic.

Smoking has been shown to cut life expectancy by ten years.  In addition to all the other ways in which smoking damages your health – including causing cancer, emphysema, chronic obstructive pulmonary disease, asthma, and so on – it starves your tissues of oxygen, which makes it difficult for your body to heal.  These negative effects often lead to the long-term aggravation of pain conditions.

Application

If I told you I had a drug that could prevent 93 percents of type 2 diabetes, 81 percent of heart attacks, 50 percent of strokes, and 36 percent of all cancers, would you want that drug?

There is no such drug.  What if I told you, however, that with a few healthy habits you could achieve those results?  Those habits include not smoking; exercising for three and a half hours per week; eating a healthy diet of vegetables, fruits, beans, whole grains, nuts and seeds, while maintaining a low meat intake; and keeping your body mass index (a measure of body fat) below the obese range.

Specific example

Some habits naturally distract from pain.  These distracting habits can be valuable.  When we are distracted, our pain remains but we reduce our suffering by paying it less attention.  For example, one study showed that patients who have a pleasant view from their window after surgery require fewer painkillers.  Some other popular forms of distractions are music, movies, puzzles, and books.  Other good examples are playing sports, walking in nature, and spending time with friends or lovers.  Meditation is a form of conscious distraction that has been shown to reduce both pain and dependence on painkillers.

Tidbit

Caring connections have been shown over and over to enhance health, prolong life, and offer most of us our most meaningful moments.  Cardiologist, researcher, and author Dean Ornish is famous for showing us that a low-fat diet can improve heart health.  He also points out that connection, affection, and love in our lives are even more important than diet and give us the greatest survival benefits.  Love and connection to family and community help people survive difficult times.  UCLA’s Shelley, Taylor, PhD, has studied  human connections and their impact on health.  She describes how oxytocin, a hormone whose level jumps when we are stressed, makes us reach out for caring relationships – something she calls the “tend and befriend” response.  Physical contact like touching and hugging between family, friends or lovers increases the levels of calming oxytocin, which in turn lowers stress-hormone levels. Oxytocin is anti-inflammatory.  Oxytocin is important in mother-infant bonding and has other health benefits, such as decreasing heart disease and increasing lifespan in cancer patients.

DIETARY SUPPLEMENTS

Basic Science

Vitamin D is important for the function of over two hundred genes in the body.  It boosts the immune system, helps it fight infections like the flu, and reduces autoimmunity, a condition in which your immune system attacks its own body.  Vitamin D also plays a role in blood sugar metabolism and preventing diabetes.  Vitamin D helps our bones absorb calcium and improves muscle strength.  Childhood deficiency of vitamin D causes rickets, which in adults, long-term deficiency causes osteopenia and osteoroporosis and raises certain cancer risks.  Vitamin D deficiency is associated with pain.

Application

Vitamin D is the “sunshine vitamin” and is not found in fruits or vegetable.  There is some in fish.  Some people need only a small dose of 1,000 IU per day, while others need much more.  Many authorities agree that optimal levels are in the higher part of the normal range.

Specific example

It can be overwhelming to look at a long list of potential supplements and wonder how to start. Dr. Tick’s recommendation: Vitamin D, magnesium and omega-3 from fish oil.

EXERCISE

Basic Science

Our muscles were designed for movement.  Thirty to forty-five minutes of aerobic exercise, four or five times per week, helps with weight control, cardiovascular health, energy levels, and mood.  Exercise raises the level of your natural painkillers call endorphins, reduces body inflammation and insulin resistance, and normalizes blood sugar.  The dynamic pumping action of working muscles improves circulation, which promotes oxygen delivery and the removal of toxins from our tissues.  Regular exercise is one of the best prescriptions for people with chronic pain, fibromyalgia, depression, anxiety, insulin resistance, or diabetes.

Application

Movement therapies are gentle exercises meant to curb unhelpful daily movements by retraining our movement patterns.  Many of us have had injuries without realizing how they change our movement patterns.  For example, after an injury we may not swing our arms fully, we may tilt slightly to one side, or we may have contracted muscles that twist or shift our spine.  Sometimes, we develop these patterns through habits or through injuries that don’t fully heal. Movement therapies identify and improve our awareness of unhealthy patterns and restore better ones.  These exercises sometimes involve only very small movements and are so gently that even very injured people can work with them.  Feldenkrais, Alexander, Mitzvah, Trager, and Laba-Bartenieff all reduce pain and restore health.

Specific Example

Aqua jogging is doing running movements in water.  It can be useful for individuals of all fitness levels, even high-level athletes.  In water, buoyancy makes our bodies feel lighter and allows us freer movement.  This is especially helpful for those with joint pain.  When you move in water, you always experience gently resistance.  As a result, water is a great place to begin gentle strengthening.

Tidbit

Hurt does not mean pain.  Hurt is pain that is not causing damage to your tissues.  Harm is pain that signals damage.  If you have a sore back and move around, you may experience additional pain.  But in most cases that pain is not causing damage.  In the long run it will not make you worse, but it will help you heal.

PRESCRIPTION DRUGS

Drugs that have been properly prescribed and properly taken are the fourth-leading cause of death in North America.  This is alarming.  America consumes fifty times more opioids than the rest of the world combined, and prescription opioids kill more Americans that illegal drugs do. Doctors know that drug swill do something to your system, but their effects on an individual can be quite unpredictable.  This is especially the case with chronic pain medications.  The processes by which pain develops in our system, and by which our system heals itself, are very complicated.  If any one part of these processes changes, all process and our whole system are affected.  This can mean more pain and side effects.  Oftentimes, chronic pain patients end up on a long list of drugs that cause bad side effects on their own, cause worse side effects when combined, and leave the patient worse off in the long run.

Basic Science

In 1964, Robert A. Wilson wrote an article about hormone replacement therapy titled “No More Menopause.”  As a result of the article, published in Newsweek, estrogen replacement became very popular.  Some doctors went so far as to recommend estrogen replacement to all menopausal women, whether or not they had troublesome menopausal symptoms.  We have known since the 1930s that estrogen is carcinogenic, but researchers in the decades after Wilson’s article had to prove it all over again before the fad would die.  In the 1990s, a very large study called the Women’s Health Initiative looks at the effects of these estrogen treatments.  The women in the study suffered such a considerable increase in breast cancer that the study was halted early.

Application

In the late 1990s, an anti-inflammatory drug called Vioxx was put on the market to treat pain and arthritis. It became hugely popular and generated sales of $2.5 billion a year.  In 2000, a study was published showing that Vioxx increases the rate of heart attacks and stroke.  The, at a hearing in 2004, it was revealed that the company that produced Vioxx had know, even before it was approved for use, that low doses increase the risk of heart attack by nearly seven-fold.  Despite this, the labeling at the time of FDA approval contained nothing about heart attack risks.  As a result of the 2004 hearings, Vioxx was withdrawn from the market.  By that time Vioxx had already caused an estimated 160,000 unnecessary heart attacks and strokes.

Specific example

Drugs work by changing the chemical reactions in your cells.  When you take a drug, your body metabolizes it into related compounds called metabolites.  Therefore, when you take a drug you may actually be introducing several new chemicals into your body, and not just the one you took in the pill.

For example, statins work by interfering with an enzyme, which then lowers cholesterol.  Oftentimes, however, a drug changes a chemical reactions that has more than one role in the body.  This is a cause of drug side effects.  The enzyme that statins interfere with is responsible not only for cholesterol but also for making an antioxidant called coenzyme Q-10 (CoQ-10) which is needed to keep your muscle and nerve cells healthy.  A deficiency of CoQ-10 causes muscle pain and sometimes muscle breakdown.  It can even cause heart attacks.  Statins have not been studied long enough for us to know the effect of lower CoQ-10 levels on the brain.

TOXIC STEW

Toxics – harmful chemicals – affect pain by interfering with our metabolism and health.

Basic Science

According to the Environmental Protection Agency, only 7 percent of commonly used chemicals have complete safety data regarding toxicity, and almost half of common chemicals have no safety data at all. Exposure to chemicals still commonly used can cause reproductive damage, cancer, and other serious illness.  These studies take into account only individual chemicals; almost nothing is known about how these chemicals react in combinations to affect our health.  We are a chemistry experiment.

Studies by environmental groups show we all already have toxic chemicals in our bodies.  On study examined toxicity in new born babies by taking blood sample form umbilical cords.  The sample were tested for fewer that 400 chemicals, and they detected up to 232 chemicals in the newborns’ blood.  If each sample had been tested for all 50,000 of the new chemicals introduced between 1979 and 2013, the number would, without doubt, be much greater.

Application – I

Lead and mercury are toxic and do not belong in the human body in any amount.  Studies have shown that children exposed to low levels of lead can grow up to have lower intelligence and altered behavior.  In fact, studies show an inverse correlation between lead exposure in children and brain development.  It seems that children exposed to more lead grow up to have less brain volume.  Other studies suggest a relationship between childhood lead exposure and violent behavior.  A 2006 study shows that a patient’s risk of heart attack and stroke increases in proportion to her level of lead – the higher the lead level, the higher the risk of cardiovascular death.  Importantly, this study examined only cases of lead levels within the so-called normal range approved by the U.S. Department of Health. Additionally, lead has harmful effects on bone healing, normal calcification of our bones, and the function of vitamin D in our bones.  There are also concerns that lead causes brain atrophy and cognitive decline in all age groups.

Application – II

In 2007 a study showed 25 percent of New York city residents had abnormally high levels of mercury.    Mercury causes kidney damage, brain and nerve damage, and damage to insulin-producing cells in the pancreas.  Mercury levels are also associated with infertility – even when levels are within the normal range.  Additionally a recent study shows that mercury causes increased inflammation.

Specific Example

The Environmental Protection Agency regulates the disposal of thimerosal, a mercury-containing preservative used medically.  The solution is considered hazardous and requires disposal as a toxin if there is 0.2 mg of mercury per liter.  In many flu vaccines there is 25 mcg of mercury in each 0.5 ml does.  This is 250 times more concentrated than what the EPA guides define as a toxin.  It would be illegal to throw it in the garbage.

Part III – The Next Steps – provides the reader with cogent descriptions of many modalities of healing, including energy medicine, cognitive behavioral therapy, myofascial therapy, acupuncture, intramuscular stimulation, physical therapy, chiropractic, massage therapy, osteopathy, therapeutic touch, etc.

POETRY AND QUOTES TO INSPIRE

The merest schoolgirl, when she falls in love, has Shakespeare or Keats to speak her mind for her, but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.- Virgina Woolf, On Being Ill

When I tell my pain patients there is a way for them to reduce the inflammation in their bodies, they immediately make the connection between increased inflammation and pain and realize I am giving them a way to lessen their pain.

– Heather Tick, M.D.

Stress changes how we experience pain.  For example, any young child knows that mommy’s kiss on a boo-boo makes it feel better.  The kiss itself may not heal the boo-boo faster, but it soothers the child, which changes his experience of suffering.  The kiss may even help healing by reducing stress that promotes inflammation and interferes with healing.

– Heather Tick, M.D.

Virtually any peptide found anywhere in the body can be found in the respiratory center.  This peptide substrate may provide the scientific rationale for the powerful healing effects of consciously controlled breath patterns.  The ability to change your body and brain chemistry is always just one breath away.

– Candace Pert

A bear,however hard he tries, grows tubby without exercise.

– A.A. Milne, Winnie-the-Pooh

STORIES TO LEARN FROM

Storiesfrom Chapter 5: Resolve Stress and Dissolve Pain]Sharon was on her way to work.  She overslept and rushed out without eating, only to find she had forgotten her briefcase and had to run back for it.  This meant she missed the 7:18bus that would get her to the 8:12 train.  She arrived at the office at 9:14 instead of 9:00, where she was greeted by her new supervisor, who lectured her on punctuality.  When she got to her desk, she discovered that the coffee cup she left there last evening was knocked over by the cleaning staff and it had left the report for her top client account (due to be delivered at noon) a sticky mess.  She was due for a 9:30 meeting in the conference room with all the big bosses, but she now had to produce another copy of all the graphs, charts, and analyses that were in the report.  She went into the meeting twenty minutes late…and this was just the start of Sharon’s day.  It was full of stress,  and her periods of recovery were brief.Sharon went to the doctor last week because she was having trouble sleeping and had developed headaches that felt like a band encircling her head.  She had started taking an over-the-counter headache medicine, but it gave her heartburn.  She had also been gaining weight and sometimes had constipation and other times, diarrhea.  Her periods were painful and irregular, and she got sick all the time.  She had a few minutes to describe her symptoms to the doctor, who was writing the prescriptions while she spoke.   He told her that her blood pressure is too high and that he was sending her for a test.  The prescriptions were for a new headache pill, two kinds of stomach pills, and a sleeping pill. She was told to get a blood test for diabetes.  After a brief examination, the doctor left the room – Sharon had been squeezed into his already-packed day.  She stared at the prescriptions, feeling more stressed because she did not understand why she needed the drugs and was unsure what was wrong with her.  She had questions but no one to ask.

All of Sharon’s problems could be caused by chronic stress, and the handful of prescriptions she was given are unlikely to make her feel any better.  Chronic stress is likely causing imbalance in Sharon’s stress and anti-stress hormones, which would lead to muscle tension, which would explain her headaches.  This would also lead to a lack of a hormone called melatonin, which would explain her trouble sleeping.  This hormone imbalance would also cause the heart to pump harder, and the thickening of blood vessels, which would explain her high blood pressure.  All of this would naturally affect her immune system, too, making her more likely to get sick.

She does not have a healthy diet and may be binging on sweets and starches to make up for lost energy, which would cause weight gain.  In addition, she may have a problem with her thyroid gland, which would also cause weight gain.  Chronic stress can affect every system in Sharon’s body, making it difficult for her to feel healthy and happy.  Sharon’s story is not that unusual.  You probably know people who feel very much as she does.

[Please read Holistic Pain Relief to discover ways to give this story a happy ending.]

* * * * *

Juan works for a prominent national newspaper. He is the editor of a weekly section and writes special-interest stories.  Five journalists report to him.  Four years ago, he started to notice pain and stiffness in his wrists. At that time, he would wake some nights with numbness in his hands.  About two years ago, he noticed soreness and tightness in his right shoulder, and the numbness in his right hand came more frequently.  He also developed a bump on the back of his right wrist and two smaller bumps on the palm side of his fingers – one on the right middle finger and one on the left index finger.  The bumps were sore, and he began to literally lose his grip.  The two fingers with bumps would sometimes get stuck in the bent position, and it would be painful to straighten them.  Once, this cause him to drop a glass of water, and he began to have trouble using scissors.

Difficult financial times led Juan’s newspaper to cut staff, including most of Juan’s team.  Now, he needs to work harder to get his assignments done, and his wife is becoming concerned about him.  He constantly wakes at night in pain, his hands look puffy, and he has extreme difficulty moving his right thumb.  Juan’s wife makes a appointment for him to see his doctor.  At the appointment, the doctor prescribes a nerve conduction test and refers him to a surgeon as well.  The results of Juan’s nerve conduction test are normal.  The surgeon checks the bumps on the fronts and backs of his hands and gives them names.  She calls the big bump on the back of right wrist a ganglion, and diagnoses the problem with his index and middle fingers as a trigger finger and the problem with his thumb as de Quervain’s tenosynovitis.  She suggests either steroid injections or surgery.

Juan tells his wife about the visit.  He would have to take a lot of time off work for surgery and even more during the rehabilitation period.  This makes him uncomfortable.  He considers the injections instead and returns to his family doctor to discuss his options.  The doctor has just attend a seminar on repetitive strain injuries, which are work-related injuries commonly affecting the hands.  He has heard of some therapies that may work without surgery.  The doctor looks up the physical therapist who gave the seminar and sends Juan to see him.

When Juan arrives at the physical therapist’s office, he is surprised to see that there are also other practitioners listed on the wall, including a massage therapist, a kinesiologist, a Reiki therapist, a chiropractor and even a regular MD.  The way this clinic works, Juan has to see the doctor first.  She takes a detailed history and examines him.  She starts by looking at the way he walks and his posture.  She then examines how his neck, back, and shoulders move.  Juan wonders why the doctor is examining his neck and back when he is there for writs and hand problems.  The doctor explains that the nerves in the hands begin at the neck, and that to understand what is wrong in the hands it is necessary to start at the source. She also explains that posture affects the neck, and as a result, the hands.  Posture is the alignment of the different parts of the body.

After her examination, the doctor tells Juan that he hangs he head forward when he leans forward at his computer, which has changed his everyday posture.  His should are rounded forward and, as a result, some muscles have shortened.  The short muscles are weak, and they sometimes put pressure on the veins, arteries, and nerves that run from his neck to his hands.  She shows him that he has a decreased range of motion in his neck and wrists.  He has tight and sore muscles in his neck, shoulder, upper back, chest, arms, and forearms.

The proposed steroid injections and surgeries would have addressed only the problems in his hands.  The hands, however, are like the tip of the iceberg: they are just the easiest part to see.  Chopping off the top of the iceberg will not solve iceberg problems, the doctor explains; operating on Juan’s hands would not fix his neck, shoulders, and arms.  She explains that there are therapies that treat the root  causes, which are his bad posture and tight muscles.  Addressing the root causes will also improve the ganglion cyst, the trigger finger, and the de Quervain’s

[Juan’s treatment plan included therapies discussed in Chapter 11 of Holistic Pain Relief, including intramuscular stimulation, massage, manual therapies like physical therapy and chiropractic, and stretching exercises.]

EXERCISES TO PRACTICE
Harvard’s Herbert Benson developed his “relaxation response” when he realized that, as a cardiologist, he could sometimes provide better care to his patients by teaching them Tibetan Buddhist meditation techniques than by more drastic cardiac interventions.Chapter 5: Resolve Stress and Dissolve Pain offers many relaxation techniques that will be familiar to readers of the Healing and Awakening into Aliveness and Wholeness newsletter: Breathing exercises to  reduce anxiety, lower blood pressure, relieve pain, improve the quality of sleep, and increase energy and mental clarity. Meditation exercises (mindfulness, walking, eating, gratitude meditations) to lower levels of stress hormones, decrease excessive muscle tension, normalize blood pressure, reduce anxiety, bring body rhythms into sync with one another, and increase pain tolerance.  Humor: Laughter causes some of the same physiciological changes as exercise and helps balnce the sympathetic (activataing)and parasympathetic (de-activating) nervous systems.   Here are three examples:

Alternate-nostril breathing

Sit upright in a comfortable position.  You will use your right thumb and ring finger to close your nostrils alternately.  Put your right ring finger on your left nostril to close the air passage.  Breathe in through your right nostril.  Pause at the end of a deep inhalation.  When you are ready to breathe out, release your index finger and close your right nostril with your thumb and breathe out fully through your left nostril.  Pause.  Inhale through your left nostril.  Press your left nostril closed with your ring finger and release your thumb and breathe out through your right nostril.  Continue for as many minutes as you can spare.  Each exhale should be about twice as long as the inhale.  You might find that this yogic breahing practice calms you, clears your mind, and gives you energy.

Eating meditation

Food tastes better when you don’t eat quickly – when you give your taste buds a chance to really experience the food.  Try to choose one meal each day during which you eat mindfully.

Take your plate of food and sit down comfortable.  Take a moment to look at the colors of the food on your plate.  Then smell the aromas of the food.  Try to distinguish as many different aromas or just enjoy the blend of them.  Take a forkful of food and, before you put it into your mouth, hold it close to your mouth and see if you can already “taste” it.  Then slowly put it in your mouth and feel the texture.  Begin to chew slowly.  You will feel digestive enzymes being released along with saliva to help you digest your good. Chew for twice as long as you ordinarily would.  Then swallow and wait a moment before you decide which morsel of food you will pick up next.  Choose a different part of the meal, if there is more than one type of food on your plate.  Notice the different aromas, textures, and tastes, and continue eating this way until you are full.  Then ask yourself, “How did it feel to eat this way?”  Did it change your attitude to the food?

Autogenic training

Autogenic training reduces the effects of stress in your body by taking you through a series of images and affirmations.  Mostly the statements address the symptoms of stress and aim at helping you achieve relaxation.  Sit or lie down comfortably.  Make sure you are not cold.  Repeat each of the following statements three times and try to feel, in your body, the sensation suggested by the words.

I am completely calm

My arms feel heavy and warm.

My legs feel heavy and warm.

My heartbeat is calm and regular.

My breathing is calm and regular.

My abdomen is warm and comfortable.

My forehead is pleasantly cool.

My neck and shoulders are heavy and warm.

I am at peace.

RESOURCES
Holistic Pain Relief: Dr. Tick’s Breakthrough Strategies to Manage and Eliminate Pain by Heather Tick, M.D. (New World Library, Novato, CA, 2013)The bibliography includes many resources of book, CD’s, DVD’s and websites related to chronic pain, integrative health, nutrition, myofascial disorder, repetitive strain injuries, fibromyalgia, mind-body medicine, exercise, prescription drugs, and toxicity.