Future MDs Unprepared to Manage Pain

Chronic pain affects 100 million Americans – that’s more than the number impacted by diabetes, heart disease and cancer combined. Most suffering from pain turn to their family doctors for help, but many leave the office with a prescription for painkillers in hand. Many physicians do not know how to help their patients manage or eliminate chronic pain, and this trend is going to continue for the future unless a radical change occurs. As it stands, most new physicians are learning little about how to treat pain, despite it being one of the most common, and most debilitating conditions around. Just 12 Hours of Pain Education in Six Years of Medical School - The study, which surveyed undergraduate medical schools in Europe, found that even when compulsory pain courses are in place, they represent just 0.2 percent. Most of the schools have no required courses on pain that all students must take. This means that 12 hours of pain study represents a best-case scenario; at 82 percent of medical schools without compulsory pain courses, the students may be receiving even less… or no pain training at all. Also there is no consistency in what topics are covered, and most of the schools included only classroom based teaching, with no practical or hands-on experience. The researchers called for a major overhaul to address the urgent public health need to adequately manage chronic pain. Pain Education in North American Medical Schools ‘Limited’ and ‘Fragmentary’ - Though the study took place in Europe, it echoes a similar trend in the US and Canada by a separate study published in The Journal of Pain. Most of the schools offered pain education as only a part of general education courses. Less than 4 percent of the schools had a required course in pain and many offered no dedicated courses at all. Even at those schools offering pain curriculum, the education amounted to less than five hours. Those researchers similarly concluded: “Significant gaps between recommended pain curricula and documented educational content were identified. In short, pain education [in US and Canadian medical schools] was limited and fragmentary. Innovative and integrated pain education in primary medical education is needed.” This is clearly out of sync with the needs of Americans. So many are suffering daily with pain that surveys show seven in 10 Americans believe pain research and management should be one of the medical community’s top priorities! Instead, it receives barely a passing mention. What Happens When Physicians Don’t Know How to Treat Pain? - MDs resort to the only treatment they know: prescription drugs. And now we’re facing another epidemic on top of chronic pain: prescription drug abuse. The latter has been called the fastest-growing drug problem in the US by the Centers for Disease Control and Prevention (CDC), as the number of deaths from opioid painkillers like hydrocodone and oxycodone rose nearly four-fold between 1999 and 2009. The overdoses now kill more people than cocaine and heroin combined. As USA Today recently reported, more US states are now taking action to try and stop this growing problem: • Alabama has instituted three new laws that give more medical personnel access to the state’s prescription monitoring program database, as well as tighten regulations on pain management clinics and making ‘doctor shopping’ to get multiple prescriptions punishable by jail time • Indiana instituted new oversight powers to the state attorney general on pain management clinics and is considering mandatory annual drug screening of people prescribed opioids • Kentucky now requires pain clinics to be licensed and mandates that physicians check electronic prescription records before writing opioid prescriptions • Washington state has set dosage limits for physicians who prescribe pain medications, and prescriptions over a certain amount must be approved by a pain specialist • New York has a requirement that physicians and pharmacists check the state’s drug-monitoring program database before prescribing opioids Prescription Painkillers Are Addictive and Often Deadly - Painkillers (opioids) like morphine, codeine, oxycodone, hydrocodone and fentanyl are one of the most commonly abused drug classes. These drugs are not only addictive, they can lead to slowed breathing and death if too much is taken, and the risks are compounded if you add alcohol to the equation. Hydrocodone, a prescription opiate, is synthetic heroin. It's indistinguishable from any other heroin as far as your brain and body is concerned. So, if you're hooked on hydrocodone, you are in fact a good-old-fashioned heroin addict. Worse, pain-killing drugs like fentanyl are actually 100 times more potent than natural opioids like morphine, making the addictive potential and side effects associated with prescription drug use much higher. Americans consume 80 percent of the pain pills in the world, and once you start, they set off a cascade of reactions in your body that make it extremely difficult to stop. Dr. Sanjay Gupta, associate chief of neurosurgery at Grady Memorial Hospital and CNN's chief medical correspondent, reported: “ … after just a few months of taking the pills...The effectiveness wears off, and patients typically report getting only about 30% pain relief, compared with when they started. Even more concerning, a subgroup of these patients develop a condition known as hyperalgesia, an increased sensitivity to pain…all of this creates a situation where the person starts to take more and more pills. And even though they are no longer providing much pain relief, they can still diminish the body's drive to breathe. If you are awake you may not notice it, but if you fall asleep with too many of these pills in your system, you never wake up. Add alcohol, and the problem is exponentially worse...” Try Natural Options Before Considering Painkillers for Chronic Pain - At the top of this list should be an explanation of why dietary changes are so important for long-term pain relief. If you suffer from chronic pain, there’s a good chance your physician has neglected to tell you this: • Take a high-quality, animal-based omega-3 oil. • Reduce your intake of processed foods, they contain sugar, additives and omega-6 fats, which contribute to inflammation. • Reduce most grains and sugars (especially fructose) from your diet. • Optimize your vitamin D by getting regular appropriate sun exposure. • Chiropractic adjustments on patients with neck pain who used a chiropractor and/or exercise were more than twice as likely to be pain free in 12 weeks compared to those who took medication. • Massage releases endorphins, which help induce relaxation, relieve pain, and reduce levels of stress. • Acupuncture has a definite effect in reducing chronic pain - more so than standard pain treatment. • Icing a painful area for 15 minutes on and 30 minutes off can greatly reduce pain, inflammation and muscle spasms. • Nutritional Supplements that may include: Astaxanthin, Ginger, Curcumin, Boswellia, Bromelain, Cetyl Myristoleate (CMO), Evening Primrose, Black Currant, Borage Oils and Cayenne. *Ask the doctors at Beck -Thibodeau Chiropractor which pain relief options are best for you and your family. Source: mercola.com, 10/30/13, Dr. Dan Thibodeau.

Sugar Substitutes - What’s Safe and What’s Not

With all the dire health effects associated with refined sugar and high fructose corn syrup (HFCS), many wonder what is actually safe to use to sweeten your foods and beverages. It’s certainly a good question. You do have to be cautious when choosing an alternative, as many sweeteners that are widely regarded as "healthy" are, anything but. A previous National Geographic article set out to compare eight different sugar substitutes, which fall into four general categories: Artificial sweeteners, Sugar alcohols, Natural sweeteners and Dietary supplements. Sadly lacking from their review are any notations about adverse health effects of many of the sugar substitutes tested. Despite copious scientific evidence of harm, artificial sweeteners are promoted in general, as safe because they “pass through your body undigested.” Needless to say, safety concerns will be front and center in this article. The Case Against Artificial Sweeteners - Sweetener lesson 101: Avoid artificial sweeteners. While the mechanisms of harm may differ, they’re all harmful in one way or another. This includes aspartame (NutraSweet, Equal), sucralose (Splenda), saccharin (Sweet'N Low), acesulfame potassium, neotame, and others. There's little doubt in my mind that artificial sweeteners can be far worse for you than sugar and fructose, and there is plenty of scientific evidence to back up that conclusion. Aspartame is perhaps the most dangerous of the bunch. It’s one of the most widely used and has the most reports of adverse effects. There are hundreds of scientific studies demonstrating its harmful effects. Be Critical of “All Natural” Sweetener Claims - If artificial sweeteners are out of the picture, let’s look at some all-natural sweeteners, such as honey and agave. They may seem like a healthier choice, but not only are they loaded with fructose, many are also highly processed. In that regard, you’re not gaining a thing. The health effects will be the same, since it’s the fructose that causes the harm. Agave syrup can even be considered worse than HFCS because it has a higher fructose content than any commercial sweetener, ranging from 70 to 97 percent depending on the brand. HFCS averages 55 percent fructose. Most agave "nectar" or agave "syrup" is nothing more than a laboratory generated super condensed fructose syrup, devoid of virtually all nutrient value. Honey is also high in fructose, averaging around 53 percent, but contrary to agave it is completely natural in its raw form, and has many health benefits when used in moderation. Keep in mind you’re not likely to find high quality raw honey in your local grocery store. Most of the commercial Grade A honey is highly processed and of poor quality. What About Sugar Alcohols? - Sugar alcohols can be identified by the commonality of “ol” at the end of their name, such as xylitol, glucitol, sorbitol, maltitol, mannitol, glycerol, and lactitol. They’re not as sweet as sugar, and they do contain fewer calories, but they’re not calorie free. So don’t get confused by the “sugar-free” label on foods containing these sweeteners. As with all foods, you need to carefully read the food labels for calorie and carbohydrate content, regardless of any claims that the food is sugar-free or low-sugar. One reason that sugar alcohols provide fewer calories than sugar is because they’re not completely absorbed into your body. Because of this, eating too many foods containing sugar alcohols can lead to abdominal gas and diarrhea. It’s also worth noting that maltitol, a commonly used sugar alcohol, spikes blood sugar almost as much as a starchy potato. Xylitol, in comparison, does not have a great effect on your blood sugar, so from that perspective may be a better choice. In moderation, some sugar alcohols can be a better choice than highly refined sugar, fructose or artificial sweeteners. Of the various sugar alcohols, xylitol is one of the best. When it is pure, the potential side effects are minimal, and it actually comes with some benefits such as fighting tooth decay. All in all, I would say that xylitol is reasonably safe, and potentially even a mildly beneficial sweetener. (As a side note, xylitol is toxic to dogs and some other animals, so be sure to keep it out of reach of your family pets.) Three of the Safest Sugar Alternatives - Two of the best sugar substitutes are from the plant kingdom: Stevia and Lo Han Guo (also spelled Luo Han Kuo). Stevia, a highly sweet herb derived from the leaf of the South American stevia plant, is sold as a supplement. It’s completely safe in its natural form and can be used to sweeten most dishes and drinks. Keep in mind that the same cannot be said for the sugar substitute Truvia, which makes use of only certain active ingredients and not the entire plant. Rebaudioside A is the agent that provides most of the sweet taste of the plant. Usually it’s the synergistic effect of all the agents in the plant that provide the overall health effect, which oftentimes includes “built-in protection” against potentially damaging effects, but what the FDA has approved as GRAS (generally recognized as safe) are just a couple of the active ingredients, including rebaudioside A used in Truvia. In one toxicology review, the researchers point out that stevioside compounds and rebaudioside A are metabolized at different rates, making it impossible to assess the risk of rebaudioside A from toxicity assessments of stevioside (which has been used as food and medicine in Japan and South America for decades or longer). Additionally, in a human metabolism study, stevioside and rebaudioside A had different pharmacokinetic results. In layman’s terms, that means that your body reacts differently to the two compounds; each compound is metabolized differently and remains in your body for different lengths of time. Truvia may turn out to be a very good substitute to sugar, but I’d have to see more details before giving it an enthusiastic thumbs. A third alternative is to use pure glucose. You can buy pure glucose (dextrose) for about $5-7 per pound. It is only 70 percent as sweet as sucrose, so you'll end up using a bit more of it for the same amount of sweetness, making it slightly more expensive than regular sugar—but still well worth it for your health as it does not contain any fructose whatsoever. Contrary to fructose, glucose can be used directly by every cell in your body and as such is a far safer sugar alternative. Consider Dampening Your Sweet-Tooth... Keep in mind though that if you have insulin issues, high blood pressure, high cholesterol, diabetes, or if you're overweight, you'd be best to avoid or reduce all sweeteners, including Stevia, since any sweetener can decrease your insulin sensitivity. Source: mercola.com, 10/7/13

7 Important Reasons to Properly Chew Your Food

The last time you had something to eat, did you give any thought to how long you chewed? Most likely not, as chewing is done almost as a habit or unconscious reflex. As soon as a piece of food enters your mouth, you chew and swallow, probably far too quickly (especially if you’re in a hurry or eating on the run). The chewing process, also known as mastication, is actually extremely important and serves as the first step in your digestive process. The way you chew, including how long you chew, can significantly impact your health in ways you likely never knew. 1. Absorb More Nutrients and Energy From Your Food - Chewing breaks your food down from large particles into smaller particles that are more easily digested, making it easier for your intestines to absorb nutrients from the food particles as they pass through. This also prevents improperly digested food from entering your blood and causing a wide range of adverse effects to your health. Recent research presented at the 2013 Institute of Food Technologists Annual Meeting and Food Expo in Chicago showed that when participants chewed almonds longer, the smaller particles were better and more quickly absorbed by the body. In those who chewed less, the larger particles were passed through the body, while also providing opportunistic bacteria and fungi with a source of fuel during their transit. Purdue University professor Dr. Richard Mattes explained: “Particle size [affects the] bioaccessibility of the energy of the food that is being consumed. The more you chew, the less is lost and more is retained in the body.” 2. Maintain a Healthy Weight - The longer you chew, the more time it will take you to finish a meal, and research shows that eating slowly can help you to eat less and, ultimately, to avoid weight gain or even lose weight. For example, chewing your food twice as long as you normally would will instantly help you control your portion sizes, which naturally decreases calorie consumption. It takes time (generally about 20 minutes) for your brain to signal to your stomach that you’re full, and this may explain why one study found people reported feeling fuller when they ate slowly. They also ended up consuming about 10 percent fewer calories when they ate at a slow pace, and presumably chewed slower, as opposed to when they were rushing. 3. Your Food Gets More Exposure to Your Saliva - Saliva contains digestive enzymes, so the longer you chew, the more time these enzymes have to start breaking down your food, making digestion easier on your stomach and small intestine. One of these enzymes is lingual lipase, an enzyme that helps break down fats, for example. Saliva also helps to lubricate your food so it’s easier on your esophagus. 4. Easier Digestion - The chewing process predigests your food into small pieces and partially liquefies it, making it easier to digest. Digestion is actually a very demanding task for your body, requiring a great deal of energy, especially if forced to digest improperly chewed food. Chewing properly allows your stomach to work more efficiently and break down your food faster. 5. It’s Good for Your Teeth - The bones holding your teeth get a ‘workout’ when you chew, helping to keep them strong. The saliva produced while chewing is also beneficial, helping to clear food particles from your mouth and wash away bacteria so there may be less plaque buildup and tooth decay. 6. Less Excess Bacteria Lingering in Your Intestines - When large particles of improperly chewed food enter your stomach, it may remain undigested when it enters your intestines. There, bacteria will begin to break it down, or in other words it will start to putrefy, potentially leading to gas and bloating, diarrhea, constipation, abdominal pain, cramping and other digestive problems. 7. Enjoy and Taste Your Food - If you rush through your meal with hardly any chewing, you’re also not really tasting or enjoying the food. When you take the time to properly chew your food, it forces you to slow down, savor each morsel and really enjoy all the flavors your food has to offer. How to Chew Your Food Properly The way you chew is unique to you and is probably deeply ingrained by this point in your life. You will likely need to make a conscious effort to change the way you chew, but the good news is you can start with your next meal. There are many theories about how many times you should, ideally, chew each piece of food. The Times of India recently highlighted Horace Fletcher, a late-1800s health-food guru (also known as “The Great Masticator”) who was famous for chewing each bite 100 times before swallowing (and to this he attributed his good health, strength and endurance). You need not be this strict, however, as the amount of chewing a food requires will obviously vary depending on its type and texture. Here’s a guide to ensure that you’re chewing in a way that will support your health. Generally speaking, you’ll want to eat in a relaxed, non-distracted environment; eating on the run or while you’re working or watching TV is not conducive to proper chewing. • Take smaller bites of food to begin with (it’s easier to chew smaller morsels) • Chew slowly and steadily • Chew until your mouthful of food is liquefied or lost all of its texture • Finish chewing and swallowing completely before taking another bite of food • Wait to drink fluids until you’ve swallowed The Dangers of Chewing for No Reason While chewing is essential when you eat, chewing without eating food can be counterproductive. When you chew gum, for instance, you send your body physical signals that food is about to enter your body. The enzymes and acids that are activated when you chew gum are therefore released, but without the food they’re intended to digest. This can cause bloating, an overproduction of stomach acid, and can compromise your ability to produce sufficient digestive secretions when you actually do eat food. Chewing gum can also cause jaw muscle imbalances (if you chew on one side more than the other) and even TMJ or temporomandibular joint disorder in your jaw, which can be a painful chronic condition. Source: mercola.com, 10/2/13.