Many women with breast cancer want to do anything and everything to fight the disease as aggressively as possible. In fact, more and more are choosing preventive mastectomies even when their cancer is the noninvasive kind that hasn’t spread. But sometimes less treatment may be the healthiest decision. For instance, new research pinpoints a group of women who will do just fine and, in fact, far better without adding radiation to their breast cancer treatment program.

Who Needs Radiation Therapy?

The latest research, from The University of Texas M.D. Anderson Cancer Center, shows that most early-stage breast cancer patients do not need radiation after their mastectomies because there is such a low risk for recurrence. But because what one woman sees as “low risk” can seem “too risky” to another, I contacted Henry Kuerer, MD, PhD, professor and training program director in M.D. Anderson’s department of surgical oncology and senior author of the study, to get some perspective.

Researchers reviewed the records of more than 1,000 women (average age 54) whose stage I or II breast cancer had spread to three or fewer lymph nodes. Each woman had had a mastectomy, 77% had also received postoperative chemotherapy and/or hormone therapy, and none had received postoperative radiation. After an average follow-up time of seven-and-a-half years, this group’s rate of recurrence was quite low, just 2.3%.

“Radiation therapy has so many risks, we have to decide if it’s really a benefit when we consider that the risk for recurrence is so low,” Dr. Kuerer told me. The risks of radiation therapy include injury to the cardiopulmonary vessels, the neurological system, the skin and the musculoskeletal system, plus a higher risk for lung cancer, esophageal cancer and leukemia. Meanwhile, he said, surgery and chemotherapy for early-stage breast cancer are better and more effective than they used to be, so there’s less need to add radiation to the mix.

Making a Decision

Of course, some women really do need radiation treatment for their breast cancer. According to Dr. Kuerer, radiation is advised and very effective in decreasing the risk for recurrence. For many breast cancer patients with advanced disease (stage III and IV), because their risk is far higher, between 10% and 15%. Radiation should also be strongly considered for women with tumors of more than 5 centimeters, more than four positive lymph nodes, positive margins (indicating that cancer cells have spread to the edge of the biopsied tissue) and/or extra-capsular extension (a tumor growing from the lymph node into the underarm). Also, it should be considered for breast cancer patients under age 40 (who typically have an aggressive form of the disease), for patients with metastatic breast cancer and for those whose cancers are at borderline stages, such as between stage II and stage III.

Dr. Kuerer advises asking your doctor to assess your risk of recurrence, adding that it’s important to make sure he/she is usingcurrent data. Also, he suggests seeking another doctor’s opinion if you feel uncertain. “You need to feel comfortable with your team of doctors and confident that they understand the true risks and benefits of radiation therapy for you.” In the end, there’s no single “right” answer, just what’s right for you.

Source(s):

Henry M. Kuerer, MD, PhD, professor and director breast surgical oncology training program, The University of Texas M.D. Anderson Cancer Center, Houston.

This month alone I have learned of four colleagues that have had heart issues due to work stress. There was an episode of Seinfeld that showed George’s father shouting “Serenity now!” instead of getting angry. While we laughed at that episode, new research has found a link between suppressing workplace anger and increased risk for heart attack. In other words, holding anger inside at the office could literally kill you.

Though this research began more than a decade ago, it has become particularly relevant in our difficult economic times. Workers may feel uneasy about the consequences of disagreement or having a misunderstanding with a boss or colleague. People may experience more job-related pressures but also feel less appreciated. We’ve heard many disturbing accounts of disgruntled workers reacting violently when things aren’t going the way they want them to, yet as this study makes clear, it’s not healthy to hold in your feelings all the time either.

Mad Men at Work

Working with a group of 2,832 Swedish men, the researchers designed a questionnaire to quantify each participant’s typical style for handling angry feelings toward superiors or colleagues at work. A series of questions measured the likelihood that each participant would react “covertly” by suppressing his anger (walking away and taking some time to calm himself, but not taking up the issue again), holding feelings inside and later developing physical symptoms such as a headache or stomachache, or venting his anger elsewhere. What they found is what makes gulping down your angry thoughts and words at work look very unwise. The more covert a participant’s style of handling workplace anger, the more likely he was to have had a heart attack in the period between 1992 (when the study began) and 2003 (when it ended).

What does this mean for heart health? The researchers found that those who tended to handle conflict with a superior or coworker by suppressing their anger without saying anything (just “letting it pass”) had double the risk for heart attack or cardiac death compared with those who never or seldom behaved this way, and for those who held their anger inside and suffered physical distress later, the risk was triple.

Note: Though this study examined only men, study coauthor Tores Theorell, MD, PhD, professor emeritus and scientific advisor at the Stress Research Institute at Stockholm University, said that covert coping is actually even more common among women. The study was reported in the November 2009 issue of the Journal of Epidemiology and Community Health.

Fine, You’re Mad, What Can You Do?

The findings suggest that it’s unhealthy to suppress your emotions when you’re treated unfairly, say the researchers. But other research has shown that simply venting, expressing strong anger directly, actually can trigger a heart attack (although rarely), so this is not a healthy option either. I called a workplace-management consultant to ask about the healthiest ways to handle anger at work, both for your well-being and for your career.

“Blowing up or holding in anger can both lead to problems, and people who suppress their anger eventually blow up anyway,” I heard from Emil F. Coccaro, MD, professor of psychiatry and director of the clinical neuroscience and psychopharmacology research unit in the department of psychiatry at The University of Chicago. Dr. Coccaro said that the goal is not just to get through a situation but “to be calm inside and out and to not feel as if the world is out to get you.”

Take a Time-Out

The best and simplest strategy for handling anger at work is one any modern parent will recognize, a “time-out.” “Excuse yourself and go for a walk. After you’ve calmed down, you’re more likely to have a discussion that’s rational and produces a good resolution,” Dr. Coccaro said. “If you try to discuss the situation when you’re angry, you’ll say things you’ll regret and also you won’t get what you want.”

Another cool-down strategy: Do some deep-breathing exercises, or try counting slowly to 10. Then, he suggests, you should mentally review the situation when you’ve calmed down. Consider whether your anger is justified, was what the person said or did really so bad? Could it be that you were just feeling irritable that day? Or perhaps you need to take some responsibility, did your own actions trigger something you hadn’t foreseen? It’s important to try to understand the situation more completely.

Everyone gets angry from time to time and sometimes with good reason. If you’re blowing up a few times a week, you may need to be evaluated for anger-management problems, Dr. Coccaro said. Treatment may involve talking with a therapist and sometimes even medication for a short while to help you learn to reframe your thinking about your interactions with others. Sometimes at least some of the problem lies within.

Source(s):

Tores Theorell, MD, PhD, professor emeritus, Stress Research Institute, Stockholm University, Sweden.

Emil F. Coccaro, MD, E.C. Manning Professor and Chairman, Department of Psychiatry and Behavioral neuroscience, Biological Sciences Division, The University of Chicago

Stress can make any day hard. There are many ways you can avoid having a heart attack and minimizing stress is one of them. Check out our weight loss tips to find out more ways to minimize the risk of having a heart attack.

In the 1970s, the then-famous actor George Sanders shocked the world when he killed himself and left a suicide note that explained, “… I am bored.” Killing yourself is a pretty extreme response to being bored, of course, but several studies of late have found a startling connection between chronic boredom and early death… perhaps a literal demonstration of “bored to death.” In one study, researchers conducted initial interviews in the mid-1980s with 7,500 civil servants in the UK. When they returned to update information about 25 years later, they found that people who had said that they were bored in the original screening were nearly 40% more likely to have died than those who found their lives more interesting. The same study revealed that people living with high levels of tedium were 2.5 times more likely to die of heart disease than those who did not. This is certainly an interesting demonstration of the powerful connection between mind and body.

Many people live with assorted states of boredom, and yes, some parts of life (paying bills, loading the dishwasher) are quite dull. But giving in to living a life that feels tedious can ultimately be very destructive, says life coach Lauren Zander. Boredom is a state of mind, she says, in her view, this truth is very, very powerful.

The destructive part? People who are bored at work start showing up late, making mistakes and otherwise begin to act in ways that may eventually lead to the exit door (or at the very least, keep them stuck doing the same job without much prospect of advancement). Boredom can also destroy relationships, no longer excited about the other person, people quit paying attention to conversations or doing nice things for him/her, and some even use their boredom to justify having an affair. Boredom doesn’t strike only in romantic relationships, by the way, it can also cause you to take friends, siblings, even your children for granted.

Interestingly, boredom can even arise in areas where you have achieved success, precisely because you’ve succeeded. Say you have a wonderful job and you are on top of the career ladder, but you find yourself getting restless and, yes, bored. The reason is simply that you have attained mastery (and kudos to you!) and now it just feels like the same-old, same-old.

Boredom feeds on itself, breeding laziness and yet more dissatisfaction. When you’re bored, you do nothing, which leads to, being bored. If you are sitting on the couch being bored, you are not reading books that suggest new adventures or challenge your old ways of thinking. You aren’t out enjoying events and activities and interactions with others. You aren’t engaging in activities that are creative, fun, stimulating or enriching. Of course you’re bored!

But flat as it may make you feel, Lauren doesn’t see boredom as one-dimensional at all, in fact, it has many layers, she says. If you find yourself saying “it is what it is” about your boring life, it’s partly out of laziness, partly indifference, and also likely has elements of fear and depression too. All this is wrapped up tightly in the belief that you cannot do anything to make life better. People blame outside forces for their boredom, their same old job, spouse, house, everything but themselves.

Boredom is a Choice

Boredom may be an inevitable part of life, but it’s not a life sentence, it’s a signal that you need to find something interesting to do! That seemingly enlightened mantra “it is what it is” is, in fact, a clue that you are feeling stuck in your life or behavior, take it as a nudge to start looking to learn something from your boredom. It may mean that you have achieved your goals in one part of your life, so it is time to create change for yourself, perhaps search out new challenges that you could add to your job description or maybe even look for a whole new position. Or if your weekends are empty and dull because they’re no longer filled with your children’s sports and parties, it’s time to schedule new activities of your own.

Here’s the powerful part: Becoming aware of your boredom shows you the parts of life where you are letting things just exist rather than taking action to shape them to your liking. So now you can do something about it. Take an inventory of your current life, look for areas where you have become lazy, slightly depressed, indifferent and feel resigned about facing another day. These are all indicators of boredom and as such they are your signals to step in to start making change.

Note: Lauren cautions that it is important to be careful not to confuse boredom with contentment. Contentment is when you truly are at peace with the way things are, whereas boredom leaves you unhappy with the status quo.

Finding ways to bring some zing into your life isn’t hard. When people consider making changes in their lives, they tend to think globally, as if they have to change everything, start a new career or ditch a spouse right now. Not so, says Lauren. In fact the best way to get going is with very small changes, which may be as simple as adding air to the tires of your bike and going for a ride, getting in the car and heading out for a “field trip” to a town you’ve never visited, or even going food shopping in a very different sort of place, like a farmer’s market or a gourmet supermarket. If your sex life with your partner puts you to sleep, you can change that by taking small steps as well, says Lauren. “Make out in the car, ask for a kiss in the morning, do something new together each week. Slowly inch your way back to where you would like this to be,” she suggests. Try something new or different to engage your imagination and emotions. Start by breaking the boredom of the moment, and then go on to making plans to break the cycle in more important areas where you feel stuck, such as work or your marriage overall.

Boredom is actually a valuable signal that can energize you and put you back in power. Pay attention to your “boredom radar” so that you spot it quickly, before it harms the quality of your life. Take responsibility, urges Lauren. “You’re the driver in your life — and if you have driven yourself into a ditch, admit you put yourself there and accept that you can get yourself out.” That’s a powerful thought indeed!

Source(s):

Lauren Zander, cofounder and chairman, The Handel Group, www.thehandelgroup.com.

Get a little extra amusement in your life easily! Come back tomorrow and read about the Hidden Horror in Your Food, the next instalment into our fast weight loss tips.

If you or someone you know suffers with stubborn migraines that drugs can’t touch, you may find help in, of all things, Botox. Famous for erasing wrinkles, temporarily, anyway, this neurotoxin from the bacteria that causes botulism has been shown in a new study to provide dramatic relief to a very specific subgroup of migraine patients for whom nothing else in conventional medicine seems to work. Alan M. Rapoport, MD, clinical professor of neurology at the UCLA David Geffen School of Medicine and founder and director-emeritus of the New England Center for Headache in Stamford, Connecticut, stated that for some, Botox provides “amazing” relief.

The discovery of Botox for migraine was an accident, incidentally. Back in the 1990s, a California ENT surgeon observed that a number of patients he injected with Botox to remove wrinkles said that they were experiencing fewer headaches. Though doctors initially interpreted that to mean that Botox could reduce tension-type headaches, it turned out that only migraines respond. It’s believed that Botox helps these patients by preventing release of certain inflammatory chemicals in the area that affect the nerves in the head and neck.

Who Feels Better?

Curiously, Botox does not help patients who have occasional migraine, but it can offer relief for 40% to 50% of chronic sufferers of a particular type; ocular migraines (described as crushing, imploding or eye-popping), the kind that are felt in the eyes. It effectively relieves the number, intensity and duration of headaches.

The standard treatment with Botox for headache is to inject tiny amounts over the bridge of the nose and above the eyebrows and in the temples in a quick (10 minutes or so) in-office procedure. If you get migraine pain in other areas, injections can be tried in those spots as well. While some patients notice some benefit within a few days, most find it takes up to three weeks to get real relief, says Dr. Rapoport, adding that relief usually lasts for three or four months. These Botox treatments can be given again and again, Dr. Rapoport told me that he has treated one woman this way for eight years with continuing success.

Botox for migraine is an off-label use, although the FDA is currently weighing its approval for chronic migraine. According to Dr. Rapoport, the statistics support its safety, with 95% of patients experiencing no side effects at all. At about $350 to $900 per treatment for the medicine alone (treatment can take one to two vials per visit), relief can be costly, but for chronic sufferers, perhaps well worth it. For some lucky patients, insurance will even lower the cost.

Source(s):

Alan M. Rapoport, MD, clinical professor of neurology at the UCLA David Geffen School of Medicine, Los Angeles and founder and director-emeritus of the New England Center for Headache, Stamford, Connecticut.

More than 300 doctors were encouraged to anonymously confess diagnostic errors that they had made or witnessed. Find out what the most common types of diagnostic mistakes doctors make so as to develop safeguards to minimize or prevent them from happening in the future. You need to learn where doctors are most likely to go wrong so that you can do your best to keep your medical care on the right track and avoid dangerous misdiagnoses, which could prove to be fatal or cripple your way of life.

Why So Many Mistakes?

Just over 10 years ago, a landmark study by the Institute of Medicine indicated that up to 98,000 Americans die each year as a result of medical errors. Since that time, medical professionals have taken steps to streamline and improve patient safety, yet this new study shows that doctors are still dropping too many balls, observes study coauthor Gordon D. Schiff, MD, an expert in patient safety at Harvard Medical School.

Dr. Schiff and his team distributed a written survey to 310 doctors at 22 institutions across the US asking them to share three cases of diagnostic error — defined as any mistake or failure in the diagnostic process that led to a misdiagnosis, missed diagnosis or delayed diagnosis. They learned lots about particular types of errors…

• Major, minor and somewhere in the middle: Doctors reported 583 errors. Of these, 180 (31%) were self-rated as minor, 241 (41%) as moderate and 162 (28%) as major.
• Most likely to be misdiagnosed: Pulmonary embolism (26 cases, 4.5%) was the condition most likely to be misdiagnosed, followed by adverse drug reactions or overdose (26 cases, 4.5%)… lung cancer (23 cases, 3.9%)… colorectal cancer (19 cases, 3.3%)… acute coronary syndrome and/or heart attack (18 cases, 3.1%)… breast cancer (18 cases, 3.1%)… and stroke (15 cases, 2.6%).
• Not asking… and not telling either: Doctors most often made errors related to ordering or following up on lab or radiology tests (44%). Other common errors included over- or under-consideration of competing diagnoses (32%), problems with history taking (10%) or physical examination (10%), and referral or consultation errors or delays (3%).

These results were published in the November 9, 2009, issue of Archives of Internal Medicine.

Personally, I was misdiagnosed with nasal cancer years ago and fortune for me I went to another doctor for verification and I merely had dry membranes. That’s a big difference.

What Can You Do?

The results highlight the need for ultra-reliable mechanisms to catch those “dropped balls” in order to be sure that patients promptly and accurately receive test results and other important information, says Dr. Schiff. He offered an example of one such fail-proof strategy: At his hospital, Brigham and Women’s in Boston, a new system ensures that physicians receive and acknowledge lab and radiology results, which are also automatically communicated (by letter or confidential e-mail) to the patient. He suggests that yet another layer of improvement might be to have automated follow-up calls to see whether patients are improving as expected and if not, start a process to evaluate whether the initial diagnosis may have been incorrect.

But it’s not smart to wait for the medical community to solve this problem. We patients, too, need to take action to protect ourselves from these types of errors. It’s the only way to ensure that we’re getting optimal medical care.

Dr. Schiff shared some suggestions…

• Be aware that certain types of diagnoses are harder to make than others. The top error categories (pulmonary embolism, stroke and heart disease, along with colorectal, lung and breast cancer) are often challenging. Not all patients have the same symptoms, and the typical symptoms don’t always indicate the presence of a serious medical condition. If you don’t improve or if you develop unexpected new symptoms, absolutely question your doctor about your diagnosis, perhaps it is incorrect.
• If you are worried or in pain, bring someone with you to your medical appointment or the emergency room. It’s hard to think clearly under these circumstances. It’s helpful to have another listener and an advocate to speak on your behalf if a health-care provider seems dismissive, distracted or is otherwise not providing the care and feedback you need.
• Be proactive in communicating with your primary care physician. You know your doctor has lots of patients and relatively little time, so arrive at each appointment with a written list of your key questions, it’s a good idea to jot down the answers, too.
• Promptly report any new symptoms, and keep written records of all medications, treatments and tests. Especially if you are referred to a specialist, this can help prevent inconvenient, costly and potentially dangerous drug interactions or procedure duplications.
• Don’t agree to have tests you don’t need, which could lead to more opportunities for wrong diagnoses. Research increasingly suggests that computerized tomography (CT) scans and other tests are overused, exposing patients to unnecessary risks and sometimes leading to false positives (or false negatives if the CT isn’t the best test for a particular condition)… further unnecessary testing… and even unnecessary treatment. Before you have any imaging test, make sure you understand why it is necessary. Discuss other possible options, and, as above, keep records to avoid duplicate testing.
• Always follow up with your doctor. Never assume that no news is good news, Dr. Schiff emphasizes. If you have a test and the office doesn’t inform you about results within the expected time frame, call.
• Practice full disclosure. Be honest and upfront. Do not hide anything from your doctor. Be open about even potentially embarrassing habits, such as smoking, alcohol or drug use or unsafe sex, says Dr. Schiff, so doctors have all the information and clues needed to make the right diagnosis. Withholding information can lead your doctor astray in diagnosing your problem.
• It’s better to share too much information than too little. The more information your doctor has, the more accurately he/she can assess your well-being. For instance, a recent trip abroad may explain your upset stomach symptoms. A new medicine might account for sudden problems such as dizziness or disorientation. If a close family member had cancer and you’re worried that you have it, too, share this concern.
• Get second opinions. When you are uneasy about making a major medical decision, it’s wise to seek several opinions. You may feel awkward, but a confident and experienced doctor is not threatened by a second opinion, and getting one may increase your chances of better care.

And, finally, don’t hesitate to stand up for yourself. You should never feel afraid to approach a physician if you don’t agree with his/her advice. You can do this respectfully while also making sure that your concerns are addressed, Dr. Schiff said. And if you can’t, it might be time to diagnose yourself as being in acute need of a different doctor.

Source(s):

Gordon D. Schiff, MD, associate professor of medicine, Harvard Medical School, clinician researcher in the area of patient safety and medical informatics, Brigham and Women’s Hospital, Boston.

Want to give yourself a better chance of avoiding Alzheimer’s disease? Get your eyes checked. New research reveals that treating vision problems can actually reduce the risk for certain types of dementia, including Alzheimer’s disease.

Seeds for this study were planted with information from the Aging, Demographics, and Memory Study, when University of Michigan researchers observed that people with dementia tended to have had fewer eye procedures prior to their diagnoses than those without dementia. This led the team to ask two questions:

1. Does poor vision contribute to the development of dementia?
2. Does treating visual disorders reduce the likelihood of developing dementia?

Can You See Dementia in Your Future?

Using data from Medicare and the nationally representative Health and Retirement Study, the Michigan researchers followed 625 elderly Americans- none of whom had dementia at the outset- for an average of 10 years. Based on a scale that ranked vision from excellent (one) to totally blind (six), they found that the risk for dementia increased by an average of 52% with each step up the scale. Mary A.M. Rogers, PhD, a clinical epidemiologist and the study’s lead author said that the study results suggest the problems with declining vision preceded the dementia. She said that this is the first epidemiologic study, to her knowledge, that points to treatment of vision problems as being protective against the development of late-life dementia.

Some of the connections between poor vision and dementia symptoms seem obvious, while others are not yet understood; for instance, Dr. Rogers pointed out that people with poor vision may be less likely to participate in the kinds of activities, such as reading, playing board games and engaging in physical activities which can be protective against cognitive decline. She said that other research indicates that vision loss can lead to structural changes in the brain, but notes that more studies are needed to understand why.

See Your Doctor

The truly promising news of this study is the notion that dementia might be preventable.  Dr. Rogers points out that when elderly people received appropriate treatment for their visual difficulties,  such as corneal transplant, cataract removal and lens insertion, and treatment for retinal detachment, lesions and other eye disorders, their probability of developing dementia decreased. Even one visit to an ophthalmologist was associated with a lower risk.

The bad news, however, is that at this point Medicare coverage of vision problems is spotty. While only about 13% of the Medicare population has Alzheimer’s disease, this group accounts for 34% of Medicare spending; and the diagnosis of Alzheimer’s is increasing. Dr. Rogers believes it would be very worthwhile to investigate whether expanding vision screenings and treatment to more elderly Americans would in fact save money for Medicare.

In the meantime, add “preventing dementia” to the list of reasons why having your vision checked is a worthwhile endeavor.

Mary A.M. Rogers, PhD, research assistant professor, department of internal medicine, University of Michigan, and research director of the Patient Safety Enhancement Program, University of Michigan Health System, Ann Arbor.

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Can picking up a broom get a man more va-va-voom? That was the research premise for a recent study by Constance Gager, PhD, a sociologist in the department of family and child studies at Montclair State University in New Jersey.

Dr. Gager started with the well-documented fact that housework is typically shared unevenly between husbands and wives even when both have jobs outside the home. “Given that 77% of women with kids age six and older are in the labor force, we wondered why men aren’t contributing more to housework,” Dr. Gager told me. “So we asked, ’What would encourage them to do so?’ And we came up with the obvious hypothesis — more sex.”

On average, the wives in Gager’s study spent nearly twice as much time on household tasks as did their husbands: About 42 hours a week for the women versus 23 hours for the men.  While the husbands logged more paid working hours, about 34 hours/week versus 20 hours for the women, when the total hours worked (jobs plus housework) were combined, women worked more than the men by about three hours a week.  (Three hours may not sound like much-unless you are suffering from a chronic lack of sex…) Also, the data did not capture all the time women spend organizing, planning and forecasting for the household, tasks with which Dr. Gager’s research shows they want more help.

Dr. Gager then looked more deeply into the study participants’ home lives, and here’s where it gets really interesting:  For both sexes, it appears that the harder you work, the harder you play.  In other words,  more hours spent on household labor, on average, meant more hours of sexual activity.  This surprise finding held true for both husbands and wives in all types of work.

Energy for Everything?

I asked Dr. Gager what explanation she had for her findings, and she told me that the study was not designed to explore the reasons behind the results. But, she said, the research team is willing to speculate. “We don’t think it’s causative, but we do know that the more time is spent on housework, the more time gets spent on sex, so it might be reflective of an underlying trait: Being a go-getter with high energy.” In other words, Dr. Gager said, the hardest workers may be people who attack life with gusto, and it seems they get a lot out of it, if you know what I mean…of course you do.

This intriguing finding bodes well for people who have the energy to take on both work and family chores. “As life gets busier and time gets tighter, there are people who can successfully balance their multiple time commitments,” said Dr. Gager. “They devote their time to paid work and housework while maintaining an active sex life. Rather than compromise their romantic life because of work demands, this group of go-getters makes sex a priority.”

So does that mean that if you start doing more vacuuming you’re more likely to get lucky, regardless of your sex? Maybe.  In the doctor’s words, “It couldn’t hurt!”  Hey, a lot can happen in three extra hours a week.

Source(s):

Constance Gager, PhD, lead researcher, sociologist and assistant professor, department of family and child studies, Montclair State University, New Jersey.

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Life happens, and, as we all know, it often leaves scars. We can see them on our knees, elbows and elsewhere. But did you know that you can get scars inside your body too? These sometimes occur after surgery or an injury such as a broken bone, but other times in response to less obvious insults, including simple inflammation.  Things such as heart attack and stroke often  leave internal scars;  inflammatory conditions, including Asthma, Sinusitis, Alzheimer’s disease, Multiple Sclerosis, Arthritis and others also leave destructive scar tissue in their wake. I recently learned more about these internal scars and some of the surprising ways that they can affect our health — and about a therapy that can speed healing while smoothing scars on both the inside and outside of the body.

The Purpose of Scars

Scars are the body’s visible response to injury, which is to generate healing fibers (called fibrin) where damage has been wrought. These eventually weave together to heal the damage done, but the repair is obviously not seamless. Fortunately, your body’s cells are continually regenerating, and over time such scars usually fade until there’s little, if any, evidence left.

Our bodies accomplish this by producing enzymes (called fibrinolases) that dissolve scar tissue and replace it with healthy tissue. Sometimes, though, our natural healing powers aren’t up to par. This is where an intriguing therapy comes into play: Our body’s natural ability can be bolstered by using an enzyme called serrapeptase which is isolated from the silkworm.  It is the substance that allows the worm to dissolve its carapace so that it can become a butterfly. Since it comes from the same class of enzymes as those produced to heal the human body, supplements have been formulated from it. While the transformative powers of serrapeptase aren’t quite so lyrical for humans, it can enhance our natural ability to heal.

Clean Up Crew

Dr. Rubman suggests picturing serrapeptase as an internal carpet-cleaning formula. With repeated applications and some scrubbing, a stain or, in this case a scar, scar tissue will begin to dissolve and dissipate.

In the wake of all that activity, however, serrapeptase is apt to leave behind its own mess. This detritus has a tendency to accumulate and can end up thickening your blood. That’s why Dr. Rubman routinely prescribes a second enzyme to be taken along with serrapeptase: Nattokinase. Nattokinase is made from the traditional Japanese fermented soy product, natto. It’s like a vacuum cleaner, he says. Along with plasmin, the body’s own natural anticoagulant or blood thinner, nattokinase serves as a clean-up crew to dissolve errant fibrin and other tissue particles. This completes serrapeptase’s job and encourages good blood flow throughout the body.

Who Needs Enzymes?

At certain times, typically with illness, stress, when you’re eating poorly or just with age, your body’s natural production of enzymes such as serrapeptase and nattokinase may decline, but taking supplements can help pick up the slack. Dr. Rubman and I discussed how these enzymes can be used to improve various health problems:

Respiratory disease: Serrapeptase thins the dense mucus often present in people with chronic asthma, bronchitis, sinusitis and other pulmonary diseases. Studies show that it helps repair damage to the structure and function of delicate mucous linings.

Pain and inflammation: Together, serrapeptase and nattokinase have antiinflammatory properties that serve as natural analgesics. They ease pain by relieving swelling, fluid accumulation and pressure. Serrapeptase also speeds tissue repair and blocks the release of pain-inducing chemicals called amines from inflamed tissue.

Cardiovascular health: Dr. Rubman prescribes a combination of serrapeptase and nattokinase to reduce arterial plaque and break up small blood clots that clog arteries in the cardiovascular system. Together these enzymes thin the blood, promote circulation and bring down levels of LDL cholesterol (the “bad” cholesterol) and C-reactive protein (CRP, a marker of inflammation and heart disease). (Note: When prescribing these two enzymes together for his patients, Dr. Rubman likes a product called Neprinol, available from the manufacturer at www.ArthurAndrew.com and at The Vitamin Shoppe stores.)

Women’s wellness: Some women experience an imbalance between estrogen and progesterone that triggers inflammatory responses such as the development of scar tissue. This abnormal tissue may accumulate in the breasts or uterus, where it can lead to fibrous breasts or uterine fibroids. To control these conditions along with the pain and pressure that many women experience with menstruation, Dr. Rubman prescribes FibroVera (also from www.ArthurAndrew.com and The Vitamin Shoppe), a product he helped create, that combines serrapeptase, nattokinase and the enzymes bromelain (extracted from pineapple) and papain (from papaya).

Use Under Medical Supervision

While serrapeptase and nattokinase are safe and effective supplements for most people, Dr. Rubman says that they should be avoided by those with a bleeding disorder or who are taking blood-thinning drugs such as warfarin(Coumadin). Other interactions are sometimes (though rarely) problematic, including those with aspirin, fish oil and vitamin E.

According to Dr. Rubman, the most effective enzymes are “enteric-coated,” which means that the active ingredients are covered with a protective layer that lets them survive exposure to stomach acid and pass into the intestine intact. Enzymes should be taken 30 minutes before or 90 minutes or so after eating. Supplementation with enzymes can be complicated, Dr. Rubman said, so they should be taken only under the supervision of a trained professional.  That said, these powerful enzymes have the potential to improve your health in a way that you may, indeed, find transformative.

Source(s):

Andrew L. Rubman, ND, founder and director, Southbury Clinic for Traditional Medicines, Southbury, Connecticut. www.southburyclinic.com.

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Many people who are chronically ill, for instance, with diabetes or cancer or who have suffered a traumatic injury, ultimately end up with a condition called neuropathy.  Sufferers experience their nervous systems turning against them, randomly sending out pain signals that can range from merely uncomfortable tingling, to debilitatingly painful, stabbing sensations . Opioids and antidepressants can help, but these drugs have side effects which render them less-than-great choices. Acupuncture can be helpful, too, but generally speaking, chronic pain sufferers have few effective treatment options.

A recent study of a relatively new treatment addresses this concern and has proved promising for a few. The new therapy is called transcutaneous electrical nerve stimulation (TENS) and is recommended for people who have neuropathy resulting from a spinal cord injury. This form of treatment involves placing electrodes (attached to a battery pack) on the skin along both sides of the spine at the level of and just above the spinal cord injury to deliver electrical current. The same technique has been used to treat other forms of chronic pain and muscle spasms.

Shocking But Effective

Twenty-four patients were given TENS units and taught to self-administer the treatment three times a day for 30 to 40 minutes at a time. They did this for two weeks at high frequency and then for another two weeks at low frequency.

Results: About one-third of the patients reported that their pain was reduced at least somewhat. 29% were helped by high-frequency stimulation and 38% by low-frequency stimulation. But six patients asked if they could keep their TENS units so they could continue the treatments themselves at home-clearly indicating that they experienced some benefit.

TENS may sound more like torture than treatment; you’d think that stimulating nerves that have already gone haywire would simply cause more pain.  But Cecilia Norrbrink, RPT, PhD, in the department of clinical sciences at the Karolinska Institute in Stockholm, Sweden, where the study was done, had this to say:  ”TENS is not painful and it does work well for some people.” She also said that scientists believe it works by using the body’s own pain-inhibiting systems. She gave a very simplified explanation: High-frequency TENS activates large nerve fibers, which are the ones carrying nonpainful signals such as touch. Stimulating these nerve fibers releases transmitter signals in the spinal cord that can inhibit the pain signals coming from small nerve fibers. Low-frequency TENS, on the other hand, seems to activate neurons in the brain stem (where inhibitory pathways start) by releasing pain-blocking endorphins.

Another option: There’s a form of Japanese acupuncture that incorporates electrical stimulation through needles, according to contributing medical editor Andrew L. Rubman, ND. It is called electro-acupuncture, and it might be a good option to explore with your acupuncturist or naturopathic doctor.

Can You Do This At Home?

Side effects from the treatment are minimal.   Some patients experience muscle spasms and others find the electrodes irritating to their skin. But those are minor complaints compared with the pain relief the treatments sometimes deliver. If you’re interested in exploring TENS treatment for neuropathic pain, discuss it with your doctor as there’s a long list of medical cautions that are considered contraindications for its use. If you are among the lucky ones, this might provide welcome relief from chronic pain.

Source(s):

Cecilia Norrbrink, RPT, PhD, department of clinical sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.

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Couples who talk about their lives, likes and dislikes using the word “we”, as in “we love Thai food”, can seem annoying to a lot of people. Two people who seem to share a brain, sharing all the same opinions can appear, well, brainless. But if you are among the folks who find “we” talk irritating in couples, you may want to reconsider your stance. According to a new study, people who routinely us words such as  ”we” and “our” to describe couple conflicts are better able to resolve those differences than those who tend to say “I” and “my.”

Are “We” Happy?

This study, done at the University of California, Berkeley, built upon earlier research showing that plural pronoun use is a strong indicator of satisfaction in a new marriage. This study asked the following:

-Whether the sense of partnership implied by saying “we” contributes to the emotions couples experience while interacting with each other

-Whether using plural pronouns affected the couples’ physiological measurements of stress or their behavior

-Whether there were any age-related differences in use of these pronouns

There were two groups.  The first comprised couples who were between ages 40 and 50 years who had been married at least 15 years; the second group were between ages 50 and 60, and married 35 or more years. Each couple spent 15 minutes discussing a topic they’d previously identified as being an area of conflict while sensors monitored their skin temperature, pulse, heart rate and physical motions. Transcripts of their conversations were then analyzed by computer to count “we-ness” pronouns versus “separateness” pronouns.

So what did we learn? Use of “we” words did, in fact, correlate positively with other aspects of how affectionately the partners behaved toward each other as well as with lower levels of physiological stress. The tendency to use singular pronouns, on the other hand, was linked with more stress. Also, the older couples were more likely to speak in the “we” voice than the middle-aged ones and, interestingly, in that group the use of singular pronouns was especially indicative of an unhappy marriage.

How This Can Help You

Using lots of singular words during conflict may have a detrimental effect on a relationship, study author Benjamin Seider, a graduate student in psychology, told me. He speculates that use of these words places the spouses in adversarial positions, whereas use of togetherness words “seemed to help couples regulate their interactions better.” Seider believes that when you find yourself using words like “I” and “you” during a heated conversation, it may be a sign that you’re feeling increasingly negative — he suggests pulling back, perhaps taking a time out to get calm. Consciously sticking to plural pronouns, on the other hand, makes resolution easier, Seider said. “The ‘we’ words really were an antidote to help realign the couple and put them back on the same team,” he said.

Realizing that you and your partner are on the same team can help you both escape the trap of selfishness that can fuel any conflict.  So, go ahead and share your partner’s brain-at least during a heated conflict.

Source(s):

Benjamin Seider, graduate student, department of psychology, University of California, Berkeley.

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