Medsarticles. Medical Weblog

As a person becomes older his sleep pattern changes. He has many more awakenings throughout the night. His sleep is much lighter, and he rarely enters stages 3 and 4; instead these are replaced by a lot of awakenings and there is a kind of natural insomnia. However, most older people do not understand that they no longer need so much sleep. They feel distressed lying in bed alone at night, and some still want to recapture the feeling of ’sleeping like a baby’.

My advice to the elderly is that we are becoming wiser and more respected as we grow older. We should be proud of our grey hair and hard-earned senior status in society. We should feel lucky that we have outlived our unfortunate associates. We are no longer babies, and do not need all that sleep anymore. We can relax and rest at night, and should keep ourselves more active both physically and mentally in the daytime. During the day, if we are inactive, we may have a lot of microsleeps. Microsleeps are brief periods of sleep activity which can be recorded on the EEG. These microsleeps last only a few seconds, but, if all these microsleeps during the day are added together, they will replace most of the need to sleep at night.

Many of my older patients regularly sleep three hours a night and have one hour of afternoon nap. They are all healthy and they function perfectly well in the day. They understand that they do not need all that sleep. It is sad to see older people, who biologically need only a few hours of sleep each night, extending their sleep time artificially with sleeping pills.

To summarise, the two different kinds of sleep, REM and NREM, alternate with each other, and we have a few sleep cycles each night. We used to think that sleep is passive and peaceful and mat if we dream a lot we have had a poor sleep. Now, with the help of the sleep laboratories, we know that we have at least four or five dream periods at night and at least one-quarter of our sleep is spent in dreams, although we cannot remember most of them. The other surprise is that it is normal to wake up in the middle of the night. These findings have dispelled the myth that good sleep means no dreams and no awakenings in the night.

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I have found that one of the greatest difficulties in helping people by this approach has been getting them to accept its simplicity. People always want the newest form of medical treatment. The modern trend in medicine is continually toward greater and greater complexity—more complicated instruments, more complicated tests, more potent drugs. We have come to associate complexity of therapy as an advance over more simple treatment. You can see my difficulty.

I am advocating a form of treatment that is simple in the extreme. But I will remind you that it is natural as well as simple, and that is why it is so successful.

A very aggressive young woman, a graduate in psychology, was openly contemptuous when I explained the way in which I proposed to help her. She gave me a superior smile, and said, “It will take more than that.”

I had great difficulty in persuading her to lie down on the couch so that I could show her what I meant. With a shrug of the shoulders, she said, “Oh well, just to please you!” I then spent sufficient time with her to be sure that she would capture a real feeling of relaxation. She did. This was the turning point. She learned to practise the exercises herself and did very well.

A writer of international fame consulted me because he was tense, disgruntled with himself, and had lost his creative ability. After considerable discussion of his difficulties, it seemed clear that the real problem was his inability to work caused by slowly mounting tension over the years. I explained how I could help him to be less tense and more at ease. However, he prided himself on his worldliness and his sophistication and from the outset was sceptical of my approach because of its inherent simplicity. He did the exercises, but he did them reluctantly, with a smirk on his face, as it were. He benefited to some extent, but I am sure his improvement would have been much more complete had he accepted the truth that we can often be helped most by basic methods which are themselves simple.

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Life had been good to Mrs. Kajsa Andersson, from Smalandstenar, Sweden. Five healthy and handsome children-happy family life—thriving small family business. All would have been rosy and sunny, but for one thing. After the last baby was born, Mrs. Andersson didn’t seem to be able to recover her strength. She was always tired and listless. She could hardly lift up her arms. She lost her interest in everything, and just wanted to stay in bed and rest. Then came the pain in her arms and hands. A visit to a doctor and a dreadful diagnosis: rheumatoid arthritis!

The doctor prescribed a drug and ordered her to stay in bed with warm packs around the affected joints. Warm packs seemed to help relieve the pain, or rather to chase it to another joint As soon as the hands felt better, the pain moved to the elbows. From the elbows it moved to the shoulders. Then her legs and feet started to ache, too. The drug relieved her pains somewhat, but only for a short time. As soon as she was without the pills, the pains returned with increased strength.

After four weeks in bed with increasing disability and pain, which became more and more agonizing, she finally was remitted by her doctor to Spenshults Rheumatic Hospital, one of the most modern medical rheumatic clinics in Sweden. She stayed there six weeks. She didn’t receive many treatments, except drugs and rest in bed, plus a typical hospital diet of plenty of meat, desserts, and coffee.

She felt a little better when she returned to her home. But as soon as she started to work around the house the stiffness and pain in the joints reappeared. She felt discouraged and hopeless, being unable to take care of her home and her children. All she had to look forward to was a dreadful future as a helpless invalid.

One day her nurse brought her a magazine with an article on the Brandals Clinic and biological medicine. After she had finished reading, she immediately went to the telephone and made a reservation.

She went to Brandal on October 20, 1957. That day she will never forget. She arrived there very sick and with agonizing pains. She could not get out of the taxi without help. She could not go up the stairs to her room. She could not dress nor undress herself. She was helpless and felt terrible pain with the slightest movement.

The program of treatments at Brandal started with the traditional fasting on vegetable broth and carrot juice. Among the other treatments were an alternating hot and cold shower, a dry brush massage, an enema in the morning and evening, and sleeping with the windows open while the scent of pine-wood aroma filled her bedroom.

“After one week of fasting I felt so much better that I wanted to continue,” she said. “And I continued as long as I felt that fasting was doing me good—for 20 days.”

“After the first week I could go up and down the stairs and take snort walks outside. And every day my outdoor walks became longer and longer. I felt as if life was returning to me-a most wonderful feeling!”

After 20 days of fasting, one more week on the lactovegetarian diet, and other biological therapies at Brandal, Mrs. Andersson returned to her home-completely free from her arthritis, happy and full of hope for her and her family’s healthy future.

This was in 1957. In 1962, five years after her phenomenal arthritis cure, she was interviewed by a correspondent from Tidskrift for Halsa to determine the permanency of her cure.

“During these last five years I have not been sick a single day,” said Mrs. Andersson. “I did not even have a cold or a running nose! The only reminder of arthritis I have is that if I work unusually long days using extremely hard labor, like washing clothes by hand or such, I feel a slight stiffness in my hands. Otherwise I am as healthy as anyone could wish to be. I don’t remember feeling so healthy and so limber and flexible since I was a young girl.”

Now in her fifties she skis regularly in winter, enjoys ocean swimming in summer, and takes long walks in the woods early in the morning before her family gets up. She also follows religiously the routines she learned at Brandal: hot and cold showers, dry brush massage, and exercises. And, naturally, she adheres faithfully to a healthful diet program which she adopted at the clinic: homemade yogurt with figs, prunes and/or raisins, plus nuts and seeds for breakfast; raw vegetable salad of all available vegetables, preferably from her own garden, for lunch; potato porridge with applesauce for dinner. In between meals, fresh unsprayed fruits plus herb teas (peppermint, camomile, or rose hips). Instead of coffee, potato and vegetable broth has become her favorite morning beverage!

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The changes in blood flow that we have considered so far affect all parts of the brain equally. In older people, arteriosclerotic changes take place in the arteries in the neck and head. There may be a temporary blockage of an artery to one part of the brain by a fragment of chalky deposit or thrombus swept downstream from a larger artery by the flow of blood. Neurologists call these blockages ‘transient ischaemic attacks’. In some of these short episodes, muscle weakness or tingling in one or other limb may slightly resemble partial motor or sensory seizures. However, although focal motor seizures may arise in the scarred brain in the territory of a permanently blocked artery after a stroke, transient ischaemic attacks are associated with transient paralysis rather than convulsions.

In younger people, localized (focal) neurological phenomena occur in migraine. In the first stage of a classical migraine attack, arterial spasm occurs, reducing cerebral blood flow focally. It is unclear whether this is primary or secondary to some depression of nerve cell activity. The occipital area is the region most often affected. This results in a hallucination of distorted vision or flashing lights, rather than the formed visual hallucination which may be part of a partial seizure arising in a temporal lob. Occassionally spasm affects the motor or sensory areas of the brain, producing short-lived paralysis or disturbance of sensation, without convulsions, on the opposite side of the body.

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In Group #1, eleven subjects presenting with mild to moderately severe osteoarthritis and one with reactive psoriatic arthritis were supplied with 16 capsules, two capsules to be taken each morning and evening for four days. Nine reported about 20% to 30% improvement in articulation and inflammation and about 40% to 50% relief of arthritic pain within 36 hours. In these nine subjects improvement continued rapidly for the next 60 hours, reaching a 70% to 80% overall improvement by the end of the four days. Two of the three latter subjects continued to improve over the following week despite the fact that they were no longer taking the capsules.

However, about half of this group experienced the return of some mild arthritic symptoms after about three to five weeks. (Although not included as part of this study, all of the subjects in this group were treated again and their symptoms have not returned.) The patient with reactive psoriatic arthritis also experienced an almost complete reversal of his associated very severe psoriatic skin condition affecting about 20% of his total skin area.

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Symptoms: runny nose, red eyes, cough, fever, rash.

Home care:

Give aspirin for fever and a cough medication for severe cough.

Give the child extra liquids.

Bright light bothers (but does not injure) the eyes; keep the child out of brightly lit areas.

Precautions:

-    A vaccine is available to prevent measles. Be sure that your child receives the proper vaccination.

-    If your child has not been vaccinated, is under the age of three, and has been exposed to the measles virus, call the doctor.

-    When a child has measles, the fever and cough should subside as the rash peaks. If they do not, watch for signs of complications.

-    Earache during measles may indicate a middle ear infection. Consult the doctor.

Measles, which is also known as rubeola, is a highly contagious disease caused by a specific virus. It affects mainly the respiratory system, the eyes, and the skin, and is spread from person to person in airborne droplets of moisture from an infected person’s respiratory system. The incubation period-the time it takes for symptoms to develop once the child has been exposed to the virus – is ten to 12 days. Measles can be passed to other people between the fifth day of the incubation period and the sixth day after the appearance of the rash that is characteristic of this disease.

Measles used to be one of the more dangerous of the childhood diseases, but it is relatively uncommon today because a vaccine is now available to protect against it. Most children are now vaccinated against measles by an injection given at around the age of 15 months. If a mother is immune to measles (because she has either had it or been vaccinated against it), her baby before birth will receive temporary protection against the disease. This protection lasts only three to six months after birth. The reason that vaccination is delayed until the baby is 15 months old (and not given as soon as the temporary immunity acquired from the mother wears off) is that the vaccination is not fully effective in a baby under 15 months. It’s also fairly unlikely that a child under that age will be exposed to measles. It’s important to note, however, that measles is dangerous in a child under three years old, and if an unvaccinated young child is exposed to the virus you should consult the doctor at once. Measles is also likely to be serious in children who have chronic (long-term) diseases.

Measles is considered dangerous mainly because of the complications it can cause, among them pneumonia (infection of the lungs), middle ear infection, and encephalitis (inflammation of the brain). Encephalitis occurs in only one or two out of every 1,000 cases of measles, and today death from measles or its complications is very rare.

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The “Polypill” was an idea proposed by British researchers Wald and Law in 2003. It was to be an all in one drag that combines six drags that act to lower cholesterol, lower blood pressure, aspirin to act as an anti inflammatory, and folic acid to lower homocysteine levels. The researchers claimed that if everyone over the age of 55 took this pill daily, rates of cardiovascular disease could be reduced by more than 80 percent. The Polypill generated a lot of publicity, but it has not been proven to be safe or effective. The biggest problems with it are cost, side effects (especially if the individual already takes other medication), and the fact that one dose cannot possibly suit everyone.

More recently, researcher Oscar Franco and colleagues have come up with the concept of the “Polymeal”. This is a combination of foods that they claim can reduce cardiovascular disease by more than 75 percent if consumed daily. The Polymeal is a much safer alternative with no side effects. The foods it comprises are almonds, dark chocolate, fish, wine, fruits, vegetables and garlic.

The benefits of the components of the Polymeal are as follows:

Ingredient         % Risk reduction for cardiovascular disease

Wine 150mL/day     32%

Garlic 2.7g/day     25%

Fruit & vegetables 400g/day     21 %

Dark chocolate 100 g/day     21 %

Fish 114g four times a week     14%

Almonds 68g/day     12.5%

These results were obtained from data from the Framingham heart study and the Framingham offspring study.

A modified version of the Polypill, containing four drags (two blood pressure drags, a statin and aspirin) is to be trialed on patients with cardiovascular or cerebrovascular disease in Australia this year. The study will be funded by the National Health and Medicine Research Council (NHMRC). It may prove effective for some, but it is a lot less expensive, safer and tastier to include the above heart protective foods in your diet regularly.

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Couples who smoke have high levels of cadmium, a heavy toxic metal that can stop the utilization of zinc needed for both male and female fertility. Cadmium will not leave the body just because you or your partner stops smoking. It needs to be actively tackled by supplementing your diet with antioxidant supplements. Even if you give up smoking the cadmium already in your body can concentrate in the placenta once you get pregnant. So it’s important to be tested for heavy toxic metals and make sure that your levels are back to normal before you try to conceive.

What if your partner smokes? Research has shown that chemicals in tobacco smoke can damage the DNA in sperm and deplete the amount of vitamin E, which works as an antioxidant, protecting the sperm. But there is a bigger potential problem resulting from your partner smoking. Dramatic findings from an Oxford Survey on Childhood Cancers, published in 1997 in the British Journal of Cancer? found that men who smoke when their partner doesn’t run a higher risk of fathering children who develop cancer. One in seven childhood cancers, including leukemia and brain tumours, could be due to the father’s smoking habits. Just 1-9 cigarettes per day increased the risk by 3 per cent, 10-20 by 31 per cent and 20 or more cigarettes by 42 per cent. The study concluded that the man risks damaging his sperm more, the more he smokes.

So alcohol and smoking clearly affect fertility for both men and women. If you are really serious about getting pregnant they therefore have to be eliminated for at least four months to give you the best possible chance. I cannot say ‘a little bit won’t harm’ because it certainly can if it is at a vital stage of egg or sperm development.

How to Stop Smoking

Acupuncture can be extremely helpful to get over the withdrawal symptoms when you give up smoking, and I have seen many couples who have used hypnotherapy successfully.

You should not use nicotine patches, nicotine gum or any other anti-smoking aids of this kind once you have started the Four-Month Preconception Plan.

Case History

Ann was 30 when she came to see me in summer 1997 after suffering three miscarriages in quick succession. Her mother had had difficulties as well -she had lost one baby at four months old, and had had three miscarriages. She had told Ann that as a result she had been ‘pumped full of hormones’ while she was expecting her, to stop her miscarrying. Ann worked long and stressful hours as a stockbroker and felt exhausted. Her partner also worked long and stressful hours and smoked 20 cigarettes a day with 5 units of alcohol each weekday and 10 each day at the weekend. Ann drank every day but less than her partner. We discussed the effects of all these factors on the risk of miscarriage. They were tested for genito-urinary infections but these were negative.

Their mineral results were very interesting. Her partner had extremely low levels of zinc and unacceptable levels of cadmium, the toxic poison present in tobacco smoke. Cadmium, like alcohol, can be teratogenic which means that it can cause abnormalities in the foetus. The autopsy on the last miscarriage had shown chromosomal abnormalities but both Ann and her partner were tested for genetic problems and both were fine. So the abnormality was not inherited from the parents but was caused by something happening to the developing cells around conception. Ann’s tests also showed that she was low in zinc and manganese.

I explained to them that their best chance of preventing another miscarriage was to stop drinking, which they did, and Ann’s partner also stopped smoking. They also made other changes, by looking at their diet and lifestyle, and waited four months until they were both back to optimum health before trying again. Ann then became pregnant and had a healthy baby boy. She wrote to me later, saying that they were convinced that the preconception plan I suggested they followed, as outlined in this book, not only helped them have the baby and avoid another miscarriage but that people had commented on how healthy and contented he is.

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What are they?

A heart attack occurs when the muscle of the heart cannot get sufficient oxygen-containing blood for it to function. Angina pectoris (a tight chest pain that comes on exertion am goes) is often the earliest sign that something is wrong. In this condition there is insufficient blood getting to the heart muscles, especially on exertion, and the person complains of tightness in the chest as the heart muscle goes into cramp.

A heart attack is like a very severe bout of angina. Sometimes the loss of blood supply is sufficiently severe to kill off a part of the heart’s muscle, and less commonly the damage from a shortage of blood is so severe that it causes almost instant death.

The heart finds itself in this lethal condition as a result of a lifetime’s abuse which causes a progressive narrowing of the arteries (atherosclerosis) that supply the heart with oxygen. Blood clots may obstruct the arteries further.

Heart disease is now the prime killer in the western world; although in the US death rates have fallen by a quarter over the last fifteen years. Given that much of this improvement is caused by lifestyle changes it makes sense to look at heart attacks as substantially preventable. Historic evidence and evidence from populations who migrate from one country to another also strongly suggest that mankind doesn’t have to suffer from coronary artery disease and heart attacks.

There are compelling reasons for rejecting a fatalistic view that heart attacks cannot be prevented. We still have a lot to learn about heart disease, but it does seem clear that it is affected by lifestyle. We have seen that the coronary-artery death rates in the US and Australia have fallen dramatically over the last fifteen years. This improvement pre-dates the widespread use of coronary care units and coronary bypass surgery and even the widespread use of drugs for combating high blood pressure. The fall in heart disease has, however, coincided with a considerable reduction in both cigarette consumption and consumption of saturated fats. However, things are not quite as simple as this suggests, because heart-attack rates are still high in Sweden despite their wealth of medical technology and falling cigarette and fat consumption, and rates in American women are falling despite their rise in cigarette consumption.

What causes them?

No one knows exactly what ultimately causes heart attacks but several fairly clear-cut ‘risk factors’ have been established after vast and complicated studies worldwide.

• Smoking. Several studies have shown the link between smoking and heart disease. A study of particular interest looked at British doctors who stopped smoking between 34 and 55 years of age. It found that their coronary death rate fell by half over five years compared with doctors who continued to smoke. Stopping after 55 appeared to make much less difference. The degree of risk with smoking is related to the number of cigarettes smoked. Filter cigarettes are probably not protective. Cigarettes act along with the contraceptive pill to increase the risk of heart disease in young women twenty fold.

• High blood pressure. Many studies have found that reducing raised blood pressure, provided the treatment is begun in middle age, reduces mortality from strokes, heart failure and kidney failure. There is some evidence that anti-hypertensive drugs reduce mortality from heart attacks.

• High blood fats. The fats in the blood are many and take different forms. They all come originally from the digestion of dietary fat. The fractions of fats that seem to be of greatest significance in heart disease are the lipoproteins. High density lipoproteins (HDLs) appear to protect against heart disease, whereas low density lipoproteins (LDLs) seem to be harmful in this respect. The balance of these two types of lipoproteins can be altered by what we eat.

• Exercise. Studies show that those who take regular, vigorous exercise tend to have fewer heart attacks, though the evidence is not so clear-cut as is that on smoking, high blood pressure and dietary fats.

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Group therapy is tailor-made to address some of the problems eating disorders cause—loneliness, isolation, hopelessness. As someone found, just seeing other patients in the room shows a patient she is not alone and bolsters her confidence that therapy will be worthwhile. Patients gain hope by meeting others who have gotten better. Hearing other patient express feelings gives her the strength to speak out for herself. If two heads are better than one, imagine having half a dozen heads all working on the same problem!

After group sessions, patients lose the attitude that “nobody understands me,” because they’ve just encountered a lot of people who do understand. Another benefit is a rise in self-esteem. Patients begin to feel useful to other people. Their experience is respected, their advice is welcome. They sense they are helping one another, and thus begin to feel more effective and worthwhile as human beings.

In group therapy, a patient sees that others who are ñ about her health and who challenge her self-destructive behavior aren’t enemies. What a discovery! Ideally, she comes to realize that friends, loved ones, and other patients can be her allies in the struggle to get better.

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