The Rash to End All Rashes

Today’s topic is eczema. A lot of us have had eczema at one time or another or had a child who had it. The NIH says there are about 15 million people in the United States on a yearly basis affected by eczema. That’s not insignificant. Eczema tends to be more prevalent as a child. The good news is that it usually diminishes as we get older. But, as you know there are some people who have just a terrible time with eczema. My daughter didn’t get it classically as a infant. She was probably 7 or 8 before she got it. Then she had it horribly for a number of years. Some people get it when they get older. In some it doesn’t show up until they are adults.

What is eczema? It’s always interesting to look at some of the really big diseases that affect a whole lot of people. With all the billions of dollars that we do in medical research every year and all we think we know, a lot of times we still don’t know a lot about some diseases. Eczema is one of those that we don’t know why people get it.

Some people think skin allergens. Other people think dust mites. Others think chemicals. Part of it is probably a disordered immune response. It is just not well defined. It usually appears as a rash on kids on forehead, cheeks, forearms and scalp. On adults it’s a more classical case of appearing on the neck, elbows, knees and ankles. It looks a little different in adults and children.

The good news is that it’s not contagious. You don’t have to worry about catching it. The bad news is, if your mom or dad had it and your grandma and grandpa you’ll have some pretty good odds that you’ll have some trouble with it, too. There is certainly a genetic component to it.

Prevention ideas include trying to prevent coming into contact with whatever it is that is stirring you up first. If it’s wool, change to polyester. If there are a lot of dust mites in the home you try to change the environment. If there are chemicals, remove those. In the prevention/treatment arena you can moisturize those areas with lotions and creams to try to keep those physical things from encountering the areas of concern. At the same time moisturizing is believed to help eczema, not just prevent it. I can’t honestly say I’ve seen a lot of results from that when I’ve treated eczema, but that’s the first thing you want to do medically.

It’s interesting that sudden temperature changes seem to stir eczema up. It’s one of those observed phenomena that medicine doesn’t have a clue as to why that would be so. Sweating and overheating is thought to, but I see a lot of it in winter. One thing for sure is that we absolutely know that stress encourages and makes people with eczema get worse or pop out when they haven’t been having any trouble with it lately. Some people believe there are food allergies involved. Again, there is a lot we don’t know.

Next post I’ll talk about what we can do, medically, to treat eczema.

Your Mind Is A Muscle

Continuing our discussion about Alzheimer’s disease, we are going to ask: who does it happen to? The huge majority of victims are over 65 years old. In fact it is considered an age-related dementia. It seems like women are in a preponderance of 16% to 11% over age 71. But you have to remember those are statistics. They may not reveal the whole truth because we know that women live longer than men and this is an age-related disease. If you take out the fact that women may live longer, at a given age the percentages are pretty close to equal.

Again, there are only a few things very definable about this disease. One of those is that we know for a fact that more educated people don’t’ get the disease at the same rate. For instance, if you have 12 years of education or less as opposed to someone with 15 years of education you have a 35% greater risk. That’s huge. It harkens back to the saying, “If you don’t use it, you lose it.” And we also know that staying active with your mind will help delay onset of dementia.

Race also is a factor in that African-Americans tend to have Alzheimer’s more than Caucasians, but when you take out the education factor then it becomes pretty equivalent again. Just about the only statistic that really matters is education and how much you use your brain over the years. That’s the take-home message there if you are still younger.

There are a number of drugs out there to treat Alzheimer’s, and needless to say they are all very, very expensive drugs. None of them have been shown to delay the onset of Alzheimer’s or to change the ultimate outcome, though they may help for a few months. Of all the meta-analysis studies (meta-analysis is when you go back and study all the Alzheimer’s studies and what different people were on and took and tried, whether they were living in the Bahamas or North America, what kind of water they drank or what kind of toothpaste or whatever) the thing that pops out is it seems the people who have taken Advil-type preparations, non-steroidal anti-inflammatories (that’s what we call that group of medicines as a general rule) have delayed onset of dementia as a whole more than those that don’t take non-steroidals. It seems like people who are always taking this for their arthritis or whatever, and take it on a continual basis for a number of years don’t get Alzheimer’s at the same rate as the general population.

If there is a drug that can help you with your Alzheimer’s I would go and put my money on a $2 bottle of generic ibuprofen rather than a $20 - $30 a pill drugs that big Pharma has come out with. More is not better here. New is not better than old.

Stress, of course, is always a factor in disease. Stress is the cause of disease. Certainly stress causes cortisol release, causes all the growth hormone to go down, all of the good things to go down and all the bad things to go up. So you’ve just got to figure that in here some place, although they really haven’t done any honest studies on that.

Alzheimer’s is intriguing. It’s a little bit fearful and concerning to us, especially as we get older toward that magic number of 65. Take your Advil, stay out of stress and keep studying. Keep learning, keep growing as a person.

Losing the mind to Alzheimer's

Alzheimer’s is fascinating and intriguing and it’s concerning. At any point in time, many of us are starting to get up there in age. I’m certainly one of them.

It’s of great interest because we see it in action. People can, if we can use the vernacular, “lose their minds” and it’s very sad. It’s pretty scary to realize that we are all aging also. We think about it. Especially when we see someone in that state we really think about it. We just have to wonder, “Am I going to lose my mind some day? Is that going to be me?”

Probably 20 years ago we had never heard the term Alzheimer’s. We called it senile dementia or this or that. As we improved imaging technology, mainly CT and MRI we began to see more specific symptoms related to structural changes in the brain. That’s when Alzheimer’s started becoming more of a thing. Today, Alzheimer’s represents 70% of all dementia. So it’s basically what we used to call senile dementia. It seems to be increasing and getting worse.

Let’s define what it looks like and what it is. It’s a loss or decline of memory or other cognitive skills. That can include speech, hearing and understanding speech or reading the written language. It can be failure to recognize or identify object in terms of being able to feel them. You put a cell phone in an Alzheimer sufferer’s hand and they can’t tell you that’s a cell phone. You put a familiar letter opener in their hands and they can’t tell that’s a letter opener or scissors or something like that. Or it can be motor skills that you lose, the ability to walk and function. Or it can even be abstract thought and judgment and the ability to carry out a task.

Those are all different things, from being able to identify something in your hand to being able to carry out a complex, abstract task. That’s because different areas of the brain can be more affected than others, or sooner. It’s all according to what area of the brain is affected, that’s what would show up first, if you would. Eventually the whole brain is involved. It is a whole brain disease. It’s just that it is going to show up some place first. That’s why it appears one of those places before it does the others. It will eventually encompass them all.

The economic impact is almost incomprehensible. Just the loss of income to the nation from the care-givers, someone who has to stay home and take care of this person because they are a danger to themselves and their family, is a staggering $100 billion a year. That doesn’t include people who are hospitalized or in nursing care facilities.

What happens in Alzheimer’s? The truth is, we’re still learning a lot about it. We know a few things and there’s a whole lot we don’t know yet. There are about 100 billion nerve cells in your brain. Each one of those nerves may have millions if not up to a billion other little touch points where it touches on other nerves. If we can borrow a phrase from Saddam Hussein, it’s the mother of all networks. It’s the ultimate network, your brain. It’s just incredible. Each cell will connect millions and millions and millions of times to other nerve cells and axons (the shaft of the nerve, going from one to the other). So this is an extremely complex, intricate, inter-related piece of matter that we’ve got between our ears.

Those little connections are called synapses. We know for a fact that these synapses become damaged and start to disappear as Alzheimer’s progresses. As they disappear, the nerve axons begin to die and then the nerve cells themselves begin to die. These nerves have different signal patterns than healthy nerves. You begin to lose the interconnectedness of all the different synapses: the reason why Alzheimer victims begin to forget things. Then there’s a whole lot of dead debris laying around the brain, if you would, from all these dying cells.

We notice that there’s a substance that we call amyloid there, or specifically beta-amyloid which is a little tiny protein fragment. There’s a huge debate about whether this is the cause or the result. Is it an over production of beta-amyloid? Okay, let’s figure out how to stop the production, or help the body clean it up. We know that the beta-amyloid does jam the synapses, the little connections we were talking about. Ultimately those little pieces of beta-amyloid build up into plaque which we can physically see on MRI.

Another hallmark on the cellular level of Alzheimer’s is there are tangles inside the cells, tangles of proteins inside the nerve cells themselves. They have given those a name: “tau twist”. The other thing we know is there’s a huge amount of inflammation and oxidative damage due to highly reactive oxygen species in the brain. Those are called oxidizers. You neutralize those with anti-oxidants. But there’s a problem because a lot of anti-oxidants don’t cross the blood/brain barrier very well. So your normal, routine anti-oxidants might not be quite as effective. There are a few that do cross the blood/brain barrier. It seems the medical community would do well to best pay attention to those.

Next time I post I’ll talk more about who is more at risk for Alzheimer’s, and what treatments exist for this terrible disease. Stay tuned.

Treating Pneumonia

Before we continue our talk about pnuemonia, first I’ll cover (and re-cover) a few important basics about the disease.

How do you get pneumonia? Well, if it’s community acquired your immune system may be already compromised a little bit. We know what causes that. It’s called stress. I’ve already mentioned in my previous posts that age is a factor. Smoking and drinking are certainly issues there. Heart disease, lung disease such as asthma or chronic obstructive pulmonary disease (COPD) or emphysema can be factors. Finally, poor health, AIDS and chemotherapy, basically people whose immune system is damaged can have a higher risk of pneumonia.

If you’re a hospital patient and you’ve received gaseous anesthesia (which almost all anesthesia has gasses involved with it these days) that just hammers your immune response. It drives your immune response into the ground. Then, you’re probably having a surgical procedure. Remember, the body can’t only fight infection, it’s having to repair all that surgical damage. So the immune system is, by nature of the procedure, compromised when you’ve had a surgery and gaseous anesthesia. That’s probably one of the reasons that we have a problem with pneumonia in the hospitals. Then, of course, the bacteria in the hospitals have all been talking to each other and remember so they can communicate a resistance to an antibiotic. You can begin to see that the problem can really snowball in a hospital setting.

How is it diagnosed? Your history and a stethoscope with trained ears can usually make the diagnosis. If the doctor is not sure or they need to help pay for the X-ray machine or they want to be totally confident for everybody, they can do an X-ray, and certainly blood cultures may be appropriate to check for circulating bacteria in the blood at some point.

For treatment, have plenty of fluids and appropriate pain medicine for the pain. Again, as I mentioned earlier antibiotics are a cornerstone for treatment by standard medicine.

Naturopathically, probably the number one important things are Vitamin C followed closely by fresh garlic. Cayanne pepper is thought to be important as well as vitamin A, and of course some other immune stimulants: echinacea, shitake, beta 1-3 glucan, uva ursa, una de gato (otherwise known as Cats’ claw), jatobá, and alfalfa. These are a number of things that can be beneficial in the natural arena and I would certainly encourage them.

Most importantly: how not to get pneumonia. If it’s hospital pneumonia, don’t go to the hospital if you can help it. As far as community based pneumonia, number 1, get out of stress. So much of what I talk about in terms of disease is so directly linked to stress.

The natural things we mentioned, probably garlic and good doses of vitamin C and zinc are your greatest preventative medicines there. Again, staying out of stress, living life in love and integrity and forgiveness, and a well-rounded diet of supplements will go a long way in preventing most diseases, but especially pneumonia.

Feeling Breatheless?

Pneumonia is a pretty life impacting disease, and when you’ve got it you’ll know it’s serious.  It starts out with a dry cough and progresses to a wet cough, usually a productive, green-yellow, wet cough which can even have an odor to it.  Breathlessness is the big symptom.  Sometimes people don’t seek help until they’re short of breath.  They can’t get enough oxygen because the lung tissues are compromised.  They swell because of all the white blood cells moving in to combat the infection.  The membrane gets thicker in the lung and the oxygen can’t get across the membrane.  There’s one thin cell wall between the oxygen-laden air you breathe in and the red blood cells that pick it up which gets so broad that the oxygen can’t get across there to get picked up by the red blood cells.  The breathlessness is nothing mystical.  It’s just a physical distance that’s created by the swelling.

People lose their appetite during a pneumonia bout because when they don’t have enough oxygen their body knows that they don’t need to be doing anything extra like walking or doing this or that.  At the same time digesting food takes a lot of energy and a lot of blood flow to go down there and take all the enzymes and to carry the food away and to process the food in the liver.  Loss of appetite is a hallmark of pneumonia.

Then, of course, you can get aches and pains all over.  Frequently pleurisy can develop when you get pneumonia – a little fluid between the lung wall and chest wall.  That will be significant pain.  That’s not a little bit of pain, that’s sharp pain.  Usually every breath you take you know about it.  

Complications include pleurisy as well as breathing difficulties that can become so acute that you need to be hospitalized with oxygen.  Certainly if I could I’d want to do the oxygen at home.  Hey, we know that up to 18% of the people who die in the hospital die of pneumonia.  I don’t want to go there, right?  You might get another infection on top of it such as septicemia, where these bacteria wind up in the bloodstream.  The lungs are extremely thin.  They are one cell thick and a lot of times that’s a very thin cell that’s kind of spread out where there’s no nucleus or anything.  But the cell gets real thin there.  It’s fairly easy for bacteria to get into the bloodstream from the lungs.  When you’ve got bacteria circulating in the blood then you’ve got a serious life-threatening issue right then.  

Of course, I’m not advocating that someone not go to the hospital if they’re in need for medical attention.  But if all you’re doing at the hospital is sitting in a bed receiving oxygen, that could be something you can do at home and not worry about the increased risk of bacterial infections you might find at a hospital. 

We’ll talk about treatments for pneumonia next time.

Drowning Alive

As I normally do when I begin a talk about a particular health concern, I like to begin by talking about how relevant this concern is by listing a number of statistics that show the impact of the subject at hand. In this case I’m going to talk about pneumonia.  Many of us have had pneumonia in our lives.  Over 1% of the population every year has pneumonia.  That’s pretty big for a disease that can impact life pretty harshly.  That’s almost as common as getting a cold.  In the general population a little over one out of 100 people every year gets pneumonia.  It’s the fifth leading cause of death; 65,000 people a year die from pneumonia.  It’s the 8^th cause of death if you are in a hospital.  The economic cost is about $40 billion a year.  

It’s interesting to see how the medical community divides up pneumonia.  You would think they would divide it by bacteria, and viruses.  Instead they divided it up into hospital-acquired pneumonia and community-based pneumonia.  You’ve got to know there’s a problem in our hospitals if they are dividing diseases according to whether you got them in the hospital or you got it at home or out in the community.  That’s just a little reality check there.

There are different types of pneumonia according to the normal categories of bacterial, viral, fungal, and inflammatory pneumonias.  We talked a little last week about bronchitis.  That’s where that type of pneumonia would begin.  

In the viral category you have flu which we’re all familiar with.  There are two categories of people that pneumonia is really dangerous for: infants and folks over 65.  If you look at that, probably the danger for those over 65 is influenza.  If you’re talking about an infant it’s a whole different category.  Respiratory seneschal virus and other childhood viruses, even chickenpox, can become pneumonia and childhood diseases like measles.  But RSV  is certainly the biggest one among children.

Almost always, it’s a standard in medicine that we should not put people on antibiotics who get a viral infection.  However, pneumonia is probably the perennial disease that gets treated, day in and day out, with an antibiotic because if you’ve already got pneumonia your lungs are already significantly compromised.  Even if it did start with a virus, there are hundreds of different kinds of bacteria in our lungs already as part of the normal bacteria.  One of those is soon going to take over because your lungs are immuno-compromised from using up your immune system fighting the viral particles there.  Sooner or later if you have a viral pneumonia you’re probably going to come down with a subsequent bacterial pneumonia.  So it’s pretty standard operating procedure in medicine, certainly if you’re admitted or if you are out-patient, if you get the diagnosis of pneumonia to go ahead and start you on a antibiotic.  

Doctor’s are trying to back off of antibiotics because we’re getting all these MRS’s (methicillin resistant bacteria).  These bacteria are smart little rascals.  They can even transfer knowledge of immunity or resistance toward antibiotics between themselves.  You may have gotten an antibiotic and then you sneeze or kiss or share some of your bacteria with somebody else, and the bacteria you gave to someone else can transfer the knowledge of resistance to that bacteria to your bacteria.  So these are not just dumb little bugs multiplying out there that we’re dealing with.  There is certainly some intelligence and knowledge that they swap among themselves.  

Certainly there are atypical pneumonias like Legionnaires' disease.  Back in 1976 a bunch of people came down with an infection, pneumonia, at the head table right under an air-conditioning vent at a American Legion conference in Philadelphia.  That’s how the bacteria got its name.  Six out of 8 of those people at the head table died.  Other people died and a lot got really sick from pneumonia from that bacteria which was in an air-conditioning system.  Other people have died since that happened.

You probably heard on the news in 2003 about SARS, acute respiratory syndrome.  Again, that’s viral.  Then there are other bugs such as TB.  It is still out there and it’s making a comeback.  Certainly fungi can cause pneumonia.  Funguses are much more important if you consider a person who is getting drugs for cancer treatment or an AIDS patient, someone whose immune system is compromised.  Those are the people you really watch out for with fungal infection.

Then there are physical ways you can get pneumonia.  If you were to breathe in some caustic chemicals with a lot of alkali or acid in it that could burn your lungs. You might also aspirate some food and the bacteria that was in the food or the bacteria in your lungs could begin to grow. The immune system doesn’t just fight bacteria and infection.  It also takes care of damaged tissue and cleans up the debris and lays down new tissue and does repairs. While your immune system is mopping up all the damage from the aspirated food it has to be able to take care of any bacterial infection as well.  The immune system is a multi-tasking genius that our Creator designed in our bodies. 

Next time I’ll talk a little about what pneumonia looks like and then we’ll deal with the treatments. 

Get Rid of Your Allergies

Earlier this week I talked about allergies and their causes.  I wanted to add a note about bronchitis before we talk more about treatments. While allergies certainly cause a good deal of discomfort in the nasal passages, they can also be the cause of many cases of bronchitis.  Everything I said about the nose and nasal passages relates to the lining of the lungs and the bronchi, too.  Even though your nose filters out a lot of those particles of pollen, a lot of them still do get down into the bronchi and lungs and they land there.  The same response is going on in the lungs that is going on in the nose (which you can read about in the last post) except your lungs have all these little hair-like fibers that brush the mucous and pollen up toward the throat when you, for lack of a nicer way to describe it, hock it up and clear your throat to spit it out. 

What are some treatments for allergies? Standard medical treatment relates first of all to making a proper diagnosis of whether it’s an infection or whether it’s allergy.  The common practice is to treat bacterial infections with antibiotics even though that may not always be prudent or wise.  That’s frequently what’s done.  We probably need to reserve antibiotics for more severe conditions, longer-term bronchitis, or even pneumonia and let the body heal itself in most of the other instances.  If the white blood count does show that it is allergic or if the doctor’s clinical examination wisdom along with your history provide that information, that’s good. 

After that, the standard medical treatment are anti-histamines and steroids.  Steroids have gotten a pretty bad name because of the medical steroids that we use, the artificial steroids.  If I’m ever going to put a patient on steroids, I like to use what the human body makes and that is cortisol or hydrocortisone.  That can be used with relative safety and impunity especially for short periods of time as opposed to the artificial steroids.  As long as we can use a very, very identical thing to what the body is making usually we don’t get into a whole lot of trouble.  

There are some good homeopathics for allergies.  You may want to consult a good homeopath because there are some practical homeopathics.  Some beneficial supplements include Vitamin C, which has been known to help allergies and allergy-related issues, as well as bioflavonoids.  If you are having allergic reactions you should probably avoid aspirin and ibuprofen and drugs like that.  Of course you want to avoid cigarette smoke and things like that which are very irritating to the bronchi and sinuses.

You should consider the possibility of keeping your windows closed and using good air filtration.  If you don’t have a central furnace you might want to consider a room HEPA filter.  Frankly, the more you pay for those filters, or the finer particle it filters, probably the better you are.  Live plants in the house can help filter some things.  There is a caveat there.  Sometimes if you are watering them too much you can grow your own mold and mildew and create your own problems.  A word of caution there.

It is interesting to note, medically, that people with a bacteria in their stomach (helicobacter pylori) have a significant association with allergies.  In other words if you take 1000 patients with seasonal allergies (rhinitis, bronchitis, sinusitis) and test them for helicobacter pylori a dramatically more significant percentage of those will have that bacteria than if you just test a random population without any sinus problems.  That bacteria is associated with allergies for whatever reason.  We don’t know that connection.

Other natural things that can be used are echinacea, golden seal, and bromelain.  One very practical thing to do is good old saline nasal spray.  Just washing those allergens off of the membranes in your nasal passages can have a significant benefit.  If you’ve been outside a good thing to do is take a shower before going to bed.  Your hair is a great pollen magnet.  You lay that on your pillow and rub your nose in it as you go along in your sleep.  Those are just some practical things to do.

Finally, as I mentioned last post, stress reduction and stress avoidance is the most significant thing that we can do.  Any overflow of stress can exacerbate allergies and cause them to manifest.