Color Therapy And Mood

Ever wonder why you can automatically associate a color to a certain feeling from just looking at it? This is because colors do actually give off a certain “feeling”. They are associated with different mental, physical, and emotional effects on people. Red, for example, can increase heart rate and adrenaline. While some colors have been psychologically proven to influence a change in affect, some may be subjective and can be opened to interpretation and perception between different populations or cultures.  

There are three categories of colors: primary, secondary, and tertiary. Primary colors are basic hues that cannot be mixed together to form and all other colors are created from them like red, blue, and yellow. Secondary colors are mixtures of two primary colors such as green, orange, and violet. Tertiary colors are mixtures of both primary and secondary colors, sometimes resulting in two word names like blue-green.

Color symbolism is the use of color as a representation  of something specific to a particular culture or society. While there is a general meaning behind every color, some colors can represent something totally different from its general meaning based on a culture. For example, the color white gives a sense of purity, innocence, cleanliness, neutrality and space. However in some cultures, like in hinduism, white also means mourning and is typically worn during cremation and mourning period of a loved one. The color black gives a sense of power, authority, strength and intelligence. But again, it can also mean evil or death and is also worn during a funeral. Yellow provides a positive energy representing happiness and optimism. Sometimes  it can also represent hunger and frustration. Green is a natural color that symbolizes growth, prosperity, good health, fertility and harmony but it can also represent envy. The color grey is a neutral color that means practicality and timeless. The color red gives off many emotions. It represents love and roman, but also energy, excitement, intensity and agitation. Orange always gives off an energetic feeling with excitement, warmth, change and prosperity. Blue gives of a calm and serene feeling whose color usually represents cold, wisdom, truth, and focus.

In color therapy, colors are associated with a person’s emotions. It is a holistic healing method that uses light and color to alter a person’s mood or health usually for people with brain disorders or emotional troubles. For example, since the color blue has a calming effect, looking at it can help reduce blood pressure; opposite of the color red. Our auras are represented by different color and intensity, and presenting colors to our environment can help with cleansing and balancing. It is believed that it is the specific frequency and vibration of colors that affect our bodily energies. We know that light enters through our eyes to create images of our physical environment, but it also gets absorbed through our skin. Certain wavelength absorption of light can activate hormones or enzymes in our body to make us feel a certain way. For example, shades of red give off a loving sexual vibration which may activate parasympathetic nervous system and result in increased state of arousal.

The psychological effects of colors are separated into two categories: warm colors which spark emotions ranging from comfort to hostility, and cool colors that spark emotions ranging from calmness to sadness. Some companies even take into consideration color schemes for their interior decoration to give off a sense that will make people need their product. For example, McDonald’s uses yellow because the color yellow increases hunger, making people buy their food.

So maybe next time you decide to repaint your home, it may be of importance to you to consider the mood you want to provide. If you want to create a state of two different moods, you can use secondary colors. For example, purple is a mix of red and blue and can provide a steady balance between stimulation and serenity. Intensity of colors should also be taken into consideration. A light purple, which includes the mixture of color white, can create a more peaceful surrounding, reducing the tension or intensity that can be created by mixing two prominent primary colors.

Walida Ali
What are neurotransmitters and what do they do?

Imagine sitting down in the doctor’s office for your yearly check-up and the doctor says

she is going to check your reflexes. She taps a reflex hammer to the bottom of your knee, causing

your leg to jerk upwards in reflex. “All good,” she says. But what exactly was she looking for

when she examined your reflexes? Was it to make sure your bottom half isn’t paralyzed? Or

perhaps to test how fast you can move in case of emergencies? Neither. In checking your

reflexes, the doctor is checking for a working peripheral and central nervous system. Essentially,

how well the signals travel through your peripheral nervous system (PNS) into your central

nervous system (CNS) from the point your leg is hit with the hammer to when you react.

The nervous system is upheld by chemical and electrical signals that transport messages

from one part of the body to another. Neurons are nerve cells that take on the job of transporting

the electric signals between each other. A neuron is composed of a cell body will small

projections called dendrites and a long projection called an axon. Dendrites, being close to the

cell body, are used for receiving signals from other nerve cells. The axon is used to sending

messages to other cells. At the end of the axon, where it approaches another cell, is the synaptic

terminal. It is called a terminal because it is the end of the electrical charge that passes through

the neuron to produce the signal. Electrical signals are sent within the neuron and chemical

signals are used between neurons and cells.

At the synaptic terminal, little chemical messengers called neurotransmitters enable

neurotransmission. An axon is often connected to a dendrite from another neuron in order to pass

the signal forward. That dendrite will then be called the postsynaptic area containing the synaptic

cleft. Here, receptors are found on the cell’s surface to receive the chemical signals coming out

of the axon terminal. Neurotransmitters are released when an action potential comes to the end of

the cell. These neurotransmitters are transported within a synaptic vesicle to the end of the cell

and out the cell membrane.

Once outside the cell, it is close enough to quickly bind to the receptors in the

postsynaptic cell membrane. The release of neurotransmitters into the next cell is completely

random, leading to multiple failures the smaller the synapse, such as those in the central nervous

system. Large synapses like the ones found between neurons and muscles (called neuromuscular

junction) are able to take more of the neurotransmitters. If the postsynaptic cell is a neuron, the

receptor opens ion channels within the membrane of the cell that changes the transmembrane

potential for a change in voltage. The receptor can inhibit (calm) or excite (stimulate) a response

in the next cell. The neurotransmitter does not stay in the postsynaptic cell, and only touches the

receptors for a bit, enough to pass on the signal. It is then released back into the synaptic

terminal, where it can do three things. 1) It can be taken by enzymes and metabolized back into

the presynaptic cell or 2) taken back up by the presynaptic cell through active transport in the

cell membrane or 3) diffuse to other parts outside the cells.

Neurotransmitters are the reason why our bodily processes occur so efficiently, and why

we never have to worry about not feeling a bug on our hand and process it quickly enough to

move our hands away (unless you don’t mind). They are the way signals are transmitted through

our bodies between neurons and work resourcefully to not miss its function. Neurons mostly give

off thousands of synapses, with some exceptions. Each of these synapses are sending

neurotransmitters back and forth. Now if you can imagine how many neurons and

neurotransmitters are at work while you are simply moving your eyes back and forth on this

page. Oh, what a world we live in!

References:

  1. “Neurogistics.” What are Neurotransmitters? - Neurogistics,

www.neurogistics.com/the-science/what-are-neurotransmitters.

2. “Integrative Psychiatry.” The Four Major Neurotransmitters and the Neurotransmitter

Imbalances, www.integrativepsychiatry.net/neurotransmitter.html.

Naile Ruiz
Barriers To Healthcare in NYC

With the fall season in full flow, we can expect runny noses and pesky colds, meaning more trips to the doctor. Living in in a large metropolis like New York City, it is always important to address health concerns, considering the small and cramped spaces us New Yorkers find ourselves in. Many of us are lucky enough to afford healthcare, but how do we acknowledge and support those who can not? Unfortunately, certain barriers to healthcare prevent many New Yorkers from being healthy and it’s time to talk about how and why this is such a problem. On a larger scale, it is estimated that 28.2 million Americans do not have healthcare.(1) Considering the nuanced advancements in technology and medicine, it is unimaginable that millions of people can not access the help they need. It is expected that class, social identity, and education are three huge components of why health disparities impact millions of Americans.

One broad barrier to healthcare that we often overlook is class. Unfortunately, having money often means having better chances of being healthy. According to a 2015 report by the Centers of Disease Control (CDC), 11.3% of Americans making less than $35,000 delayed seeking medical care due to the cost (CDC, 2015).(2) Wealthier Americans, on the other hand, are more likely to seek and receive medical attention. Consider the process of going to the doctor; health insurance as well as copays and medicine bills certainly add up. Combined with the cost of eating healthy and maintaining physical fitness, it is not surprising that poorer Americans struggle to maintain their health.  

Another key player that impacts health is one we can often physically see–social identity and status. Race, gender identity and sexual orientation are groups of identities which uniquely impact healthcare barriers and access to medical attention. For example, there has been a growing trend of oral diseases negatively affecting minority groups. According to a 2011 study on dental hygiene, non-Hispanic White Americans report better dental health than ethnic minorities such as Chinese Americans and African Americans.(3) Gender identity and sexual orientation additionally impact health. According to Dr. Nadav Antebi, social identity plays a huge role in health outcomes in general. Dr. Antebi focuses his research mainly on the role of stigma in relation to health outcomes and positive psychology. When asked about the role of discrimination and bias against HIV-positive individuals, for example, Dr. Antebi says, “HIV stigma may make HIV-positive people experience shame and guilt, which in turn can make them stay "in the closet" about their HIV status. Such feelings are linked to being at risk for a myriad of mental health concerns, including depression, anxiety, and lower well-being.” Therefore, stigma and societal shaming of certain identities complicates the relationship between health and health outcomes. If people of certain races, genders, or sexual orientations are more likely to experience poor health due to discrimination and shame, health proves itself more complicated than we often think.

In addition to wealth and social status, education and access to information also play a critical role in the nature of healthcare. Simply knowing how to afford healthy food or how to prevent conditions such as sexually transmitted diseases and pregnancy can save lives. The statistics do not work in the favor of the uneducated, however. Those with a college degree are nearly twice as likely to seek medical attention than those without (CDC, 2015).(4) Sex education, especially, is a critical method of preventing illness and poor health. Certain sexually transmitted diseases, for instance, may be prevented with the use of a condom. Using effective and safe methods of birth control promote health. However, millions of Americans do not have sexual education in school or at home and consequently demonstrate higher rates of unwanted pregnancy, HIV, and STDS. Educating both children and adults about affordable health management may be an effective way to improve health outcomes and maintain a healthy lifestyle.

Although changing the infrastructure of the American healthcare system may seem overwhelming, it is possible to take initiative. Changing healthcare can happen at a variety of levels, ranging from government policy to actions of the individual.  Certain initiatives have been implemented in New York City to spread health education and prevent a multitude of health conditions. Just last September, New York City Mayor Bill de Blasio announced a program titled “Building Healthy Communities” which aims to ameliorate living conditions and health outcomes in low socioeconomic areas of New York City. At a more individual level, New Yorkers have the ability to improve living conditions for all by taking part in the community emphasizing collective action as well as community empowerment. Consider supporting organizations which help underprivileged groups, such as New Immigrant Community Empowerment, Planned Parenthood, and Coalition for the Homeless.

References:

  1. Early release of selected estimates based on data from the 2016 National Health Interview Survey, tables 1.1a, 1.1b

  2. "Summary Health Statistics: National Health Interview Survey,2015.” Ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2015_SHS_Table_P-9.pdf. Centers for Disease Control, 2015.

  3. Shelley, D., Russell, S., Parikh, N. S., & Fahs, M. (2011). Ethnic disparities in self-reported oral health status and access to care among older adults in NYC. Journal of Urban Health, 88(4), 651-662.

  4. "Summary Health Statistics: National Health Interview Survey, 2015.” Ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2015_SHS_Table_P-9.pdf. Centers for Disease Control, 2015.




Caitlin Monahan
Stigma On Mental Illness Around The World

Just a year ago, I learned that my great-aunt had passed away. Before that day, I hadn’t even known I had a great-aunt. Allow me to elaborate.

According to the limited information my mother knew and decided to tell me, my great-aunt had been living in a psychiatric hospital for decades. It had been kept a secret, and no one talked about it. But she was there, living and breathing. Nearly fifty years ago, my great-aunt was diagnosed with an undefined mental illness. She was forced to quit her job, and her family, including her brother, my grandfather, made the decision to put her in a hospital. At that time, many people living in Japan were not well-informed about mental illnesses, and there was a general stigma towards individuals with mental illnesses. My grandfather and his conservative Japanese family kept her existence a secret from my grandmother, perhaps out of fear that she wouldn’t marry him if she knew. Only after my grandmother was married to my grandfather did she eventually learn about her sister-in-law in a psychiatric hospital. And still, the entire family kept silent. They kept the secret so well that her grandnephew did not even know she lived until after she died.

Today, people are more accepting and knowledgeable about mental illnesses. However, the social stigma attached to mental illnesses still persists. The World Health Organization (WHO) identifies this stigma towards individuals with mental handicaps as “the single most important barrier to overcome in the community.”

Attitudes towards mental illnesses differ across individuals, ethnicities, and cultures. Oftentimes, religion can be a large influence that shapes a culture’s perception on mental illnesses. A society’s view on mental illnesses has a monumental impact on people with mental illnesses. If an individual with a mental health problem is living in an environment where mental illness is viewed in a negative light, he or she may be unwilling to seek for help.

It is not an exaggeration to say that the stigma societies hold toward mental health issues worsens mental health issues. Such societies inhibit suffering individuals from coming out asking for help, because they fear the response of others to themselves, once they have been labeled “mentally ill.” Because these individuals do not disclose their mental health, societies do not recognize how common mental health problems are. As a result, many individuals fall into a vicious, negative spiral of mental illness, feeling isolated, and afraid of being isolated.

It is believed that one out of every four people will experience mental health problems within their lifespan, and 450 million people worldwide have a mental health problem. With more education on mental health and treatment, societies can eliminate social stigma towards mental illness. A study on patients with mental health problems conducted by the World Mental Health Surveys revealed that 22.1% of participants from developing countries and 11.7% of participants from developed countries experience some form of anxiety or discrimination due to their mental illnesses. However, the authors believe these numbers understate the true level of stigma associated with mental illnesses, as the data collected was evaluated only by mood changes and anxiety levels.

The difference in perceived stigma between developing and developed countries may result from a difference in education in the general population about mental health and mental health problems. However, stigma towards mental illness does not only depend on the society’s economic status. For instance, many Asian countries, Japan included, have a negative view on mental health problems. This may be due to cultural emphasis on “conforming to norms, emotional self-control, [and] family recognition through achievement.” In such societies, mental illness is viewed as a weakness of the mind, as an embarrassment. Because of the strong relationship between individual and family, an individual with mental health problems may be thought to bring shame upon their family, causing him or her to suffer from unwarranted guilt, worsening his or her mental health further. Even within the United States, there are cultural differences in the perception of mental health problems. In 2010, Carpenter-Song et al. conducted a study on 25 severely mentally ill individuals in Hartford, Connecticut. European American patients seemed more eager to seek from experts in mental health care, as they had biomedical perspectives on mental illnesses. However, African American and Latino patients often sought a less-medicinal approach to mental health problems. The latter ethnic groups perceived more stigma towards mental illness, and viewed medical treatment as “potentially very damaging,” and they were less likely to seek help from health care services.

It may be important to note that cultural perspectives on mental health care may be very different from the biomedical perspective. A study was conducted comparing the perspective on mental illnesses that Indian university students had and American university students had. Indian students were more inclined to view depression as a personal issue that could be fixed and confronted not with medication, but with social interaction and relaxation.

Attitudes towards mental illness greatly differ among cultures for various reasons. As a result, it is crucial to create mental health care programs that account for the many different perspectives of mental health among cultures and help individuals with mental illness through culturally-sensitive methods. This starts with helping suffering individuals understand that they are not alone in their struggle with mental health, and improving general understanding about mental illness and treatments.

References:

  • https://www.psychologytoday.com/blog/culture-in-mind/201109/the-culture-mental-health

  • http://www.uniteforsight.org/mental-health/module7#_ftn7

  • https://www.mentalhealth.org.uk/a-to-z/s/stigma-and-discrimination

  • https://www.everydayhealth.com/depression/mental-health-stigma-and-prejudice-strong-around-the-world-8505.aspx

Mary Yoshikawa
Anxiety Reducing Techniques

From a planner inked with an infinite magnitude of undone tasks to misunderstandings with a loved one over a text message, opportunities for anxiety are everywhere. And once anxiety does hit, it has this crafty way of losing its original context, making everything and anything seem as if it’s falling apart.

On a biological level, anxiety emerges from an evolutionary standpoint simply to put you into a mode of full alertness. Thus, there are both mental and physical components to experiencing anxiety, and all involve getting a person ready for the intensity of a fight or flight situation. So what happens when your anxiety fails in its attempt to change perceived threats, and still the anxiety will not go away?

Fortunately, there are legitimate techniques that can be employed, ultimately reducing anxiety and its debilitating impact. They also encourage relaxation, which ultimately leads to deeper breathing, a more stable blood pressure, a slower heart rate, and an increase in overall blood flow and oxygen to the brain.

Proper breathing is the most basic exercise used to reduce anxiety. The practice of deep breathing involves breathing from the diaphragm, which encourages the most and freshest air into the lungs. Sit with your back straight, let air in through your nose, allow your stomach to enlarge while your chest remains relatively still, and then breathe out through your mouth. Repeat for a few minutes, until you feel a sense of ease overtake your body.

The next relaxation technique is known as progressive muscle relaxation, and is often coupled with deep breathing for a more impactful anxiety-reducing workout. The process is meant for anxiety that manifests itself within the body in the form of physical sensations, and involves getting rid of these sources of tension by slowly relaxing each part of the body. The key is to focus on each foot, then each lower leg, then each thigh, then the hips, then the stomach, then the chest, then the back, then each arm, then the shoulders and neck, and finally the face. For each body part, focus on how that body part feels. The sensations within it and surrounding it. When you are ready, tense that area of the body. Imagine it completely overtaking you, as you count to ten with full tension. Then, switch to relaxation. Relax the body part, counting to ten again, and as you do, imagine the negative energy flowing out as the sensation of relaxation takes over.

The key to doing the progressive muscle relaxation technique correctly is realizing that when you are tensing the muscles, you are surrendering to the anxiety within that area of the body. In this case, you enlarge the feelings to then eradicate them, since you have gained control over that area by exaggerating the tension.

Like the progressive muscle relaxation technique is the surrendering technique, which works to reduce the anxiety by allowing you to not resist the anxiety. You are not against the anxiety. You do not have to fight the feelings that come with it. In fact, you can enlarge these feelings. Let them take over you until you realize they hold no true power. They are not as scary as they may depict themselves. There is no need to resist. You will notice the anxiety disappear when you do this, getting weaker with each second. Welcome the anxiety and work on honing in on it to then spread it rather than waging an internal war against it.

Next up is mindfulness, which strives for a calm and peaceful existence. As a philosophy, mindfulness is about living in the present. From each moment to the next. The key to understanding why mindfulness is effective is realizing how temporary everything truly is. No thought, no feeling, no concern, no problem is as permanent, pressing or immediate as it may seem.

The beauty of mindfulness is it can be practiced anywhere. Simply let your breathing anchor you. Focus on its rhythm as you breathe deeply and thoroughly. Let feelings, thoughts, concerns pass. They can come and go as they please. They are not worth any immediate attention to you, and are not worth any response nor judgment. Avoid engaging them. Simply let them come and go as you continue to focus on your breathing. Soon, you will realize you have less going through you mentally and emotionally. Now is the time to increase focus on what surrounds you. Look at everything around you in that second. Study it. Observe it. Be one with it. Your only concern is the present moment, and not any moment before it or after it, or any concerns related to those moments of irrelevance.

The final technique is visualization. Imagine yourself at peace in the most serene place in the world. May it be your favorite beach in a tropical area that you have not yet visited, your childhood treehouse, or simply an imaginary location, such as in the sky with the clouds and birds. Try to experience the imagery of the scene through your senses. Embrace the imagery.

If you are experiencing anxiety, try these relaxation techniques. Find which works best for you and for which situations. And know that there are always licensed mental health counselors available to work with you on finding your technique, as well as changing your thought patterns using a cognitive-behavioral approach and talk therapy. Anxiety disorders exist, and are treatable, so if the extent is beyond manageable by these techniques, know that seeking help will only lead to a more healthy and happy you. We all understand how strong anxiety can be, but relaxation techniques ultimately teach you that they are nothing in strength compared to you and the inner peace that is undeniably within you.

10 Body Parts Grown in Lab: Stem Cell Research Applications

Organ transplants are some of the most dangerous procedures to date. Requiring a long wait time and heavy medication, many are sadly unable to get the treatment they need. Research into the production of artificial organs through the use of stem cells, however, may soon put an end to this problem. By artificially growing organs from a patient’s own stem cells (“blank-slate” cells that can be turned into any type of tissue), the long and deadly wait for replacement organs may soon be over for many.

1. Human Skin

Skin was once of the first organic tissue to be created artificially, in part due to its relatively simple structure. By simply incubating a line of skin cells within cell growth medium, patches of skin can be grown in a manner similar to ordinary bacteria. This artificial skin is vital to treating severe burns and other permanent injuries to one’s skin.

2. Trachea

The trachea is produced by first producing a replica of the patient’s original trachea. This replica is made out of collagen, which is used as a scaffold for the patient’s cells to grow on. Cells from the patient are then harvested and cultivated, before being placed on the scaffold and allowed to grow. As the cells grow, the collagen will break down with negligible effects on the overall structure of the organ.

3. Liver

Researchers at Cedars-Sinai are currently attempting to produce an artificial liver that can be used to treat liver failure. The organ works by taking in blood from the patient’s central venous line, and then filtering it into four foot-long tubes. These tubes are embedded with artificially produced liver cells, which perform the same functions as the normal human liver. The processed blood is then returned to the patient through the central line.

4. Kidney

The “Kidney Project” is a joint-research endeavor by the University of California and the Cleveland Clinic to create a bio-artificial kidney. This kidney works by first drawing waste particles and other molecules through a silicon membrane. The waste then enters a bioreactor, containing live kidney cells which send water and salts from the waste back into the bloodstream. The wastes are then drained directly into the bladder as urine.

5. Heart

Similar to artificial tracheas, artificial heart valves are first crafted out of collagen, which acts as a scaffold on which the patient’s own cells can grow. The patient’s cells are collected, cultivated, and are allowed to grow on the scaffolding, eventually breaking down and replacing the collagen and leaving a new heart valve.

6. Urinary Bladder

A new procedure created by Dr. Joseph A. Smith and Professor William A. Bray is able to create a new bladder from the patient’s own intestines. The procedure involves the removing 35-40 inches of the patient’s small intestine, and shaping this tissue into a sphere. This artificial bladder is then connected to the patient’s kidneys and urethra, allowing it to function as a normal bladder.

7. Ear

Researchers at Cornell University have recently found a way to create an artificial ear from a patient’s own cells using 3D printing. First, a 3D model of the patient’s ear is digitally produced. This model is used to 3D print a mold, which collagen is then injected into. This creates a biological scaffold onto which cells harvested from the patient can grow, eventually taking the shape of a human ear.

8. Cartilage

Research headed by Jennifer Elisseeff has led to the development of a technique which uses engineered cells to replace lost cartilage in a patient’s joints. This treatment involves injecting a light-sensitive polymer solution carrying a payload of engineered cells and nutrients directly under the skin. Exposure to ultraviolet light will cause the polymer to harden into a gel-like scaffold, on which the engineered cells will safely be able to grow.

9. Bone

Researcher Ramille N. Shah has developed substance which stimulates rapid regeneration in bones. This substance is a mixture of hydroxyapatite (a calcium-based mineral found in human bones) and a specially designed biodegradable polymer commonly used in sutures. This mixture is used to 3D print a biological scaffolding, onto which bone tissue will naturally grow.

10. Lungs

Researchers from the University of Michigan Medical School have recently developed a potential way of growing lung tissue in a lab. This was done by first creating a small tube out of a biodegradable material called PLG, filling it with stem cells, and attaching it to a lab mouse for eight weeks. Afterwards, the tube was recovered and was found to have been filled with lung tissue, which appeared to have developed tube-shaped airway structures similar to those found in adult lungs.

Citations:

“Can We Grow Replacement Organs? A Survey of Current Literature.” Can We Grow Replacement Organs? A Survey of Current Literature | The People, Ideas, and Things (PIT) Journal, pitjournal.unc.edu/article/can-we-grow-replacement-organs-survey-current-literature. Office, Anne Trafton MIT News.

“Tissue Engineering: Growing New Organs, and More.” MIT News, 14 Dec. 2012, news.mit.edu/2012/engineering-health-tissue-engineering-growing-organs-1214.

“Understanding the Organ Transplant Waiting List.” Gift of Life Donor Program, www.donors1.org/patient/waitinglist/.

“Custom-Made Body Parts: Advances in Tissue Engineering.” Science in the News, 16 Mar. 2015, sitn.hms.harvard.edu/flash/2012/issue129b/.

“Skin Culture.” Biotech Hobbyist Magazine, www.nyu.edu/projects/xdesign/biotechhobbyist/skin.html. Suzuki , Teruhisa et al. Regeneration of the Trachea Using a Bioengineered Scaffold With Adipose-Derived Stem Cells. Annals Publishing Company, 2008, citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.927.3173&rep=rep1&type=pdf.

“Researchers Testing Artificial Liver as Potential Therapy for Patients with Alcohol-Related Organ Failure.” Cedars-Sinai, www.cedars-sinai.edu/About-Us/News/News-Releases-2014/Researchers-Testing-Artificial-Liver-as-Potential-Therapy-for-Patients-with-Alcohol-Related-Organ-Failure.aspx. Posted 24 Jun 2016 | 12:55 GMT By Eliza Strickland.

“Three Ways to Build an Artificial Kidney.” IEEE Spectrum: Technology, Engineering, and Science News, 24 June 2016, spectrum.ieee.org/biomedical/devices/three-ways-to-build-an-artificial-kidney.

Colleen Walsh, Harvard Staff Writer |, et al. “Stem Cells Make New Heart Valves.” Harvard Gazette, 13 Sept. 2007, news.harvard.edu/gazette/story/2007/09/stem-cells-make-new-heart-valves/.

“Procedure Creates New Bladder from Patients' Own Intestines (04/21/00).” Vanderbilt University Medical Center, 21 Apr. 2000, www.mc.vanderbilt.edu/reporter/index.html?ID=1107.20, 2013 February.

“Cornell Chronicle.” Bioengineers, Physicians 3-D Print Ears That Look, Act Real, news.cornell.edu/stories/2013/02/bioengineers-physicians-3-d-print-ears-look-act-real.

Beaudouin, Dave. “BIOENGINEERING A CURE: One Tissue at a Time.” JHU Engineering Magazine, 15 Dec. 2014, engineering.jhu.edu/magazine/2003/09/bioengineering-cure-one-tissue-time/#.Wc1W6WhSw2x.

“Promising Biomaterial to Build Better Bones with 3-D Printing.” Northwestern Engineering, www.mccormick.northwestern.edu/news/articles/2016/09/promising-biomaterial-to-build-better-bones-with-3d-printing.html.

Gabe Cherry Michigan EngineeringJuly 28, 2017. “Lab-Grown Lung Tissue Could Lead to New Cancer, Asthma Treatments.” Michigan Engineering, news.engin.umich.edu/2017/07/lab-grown-lung-tissue-could-lead-to-new-cancer-asthma-treatments/.

Alcohol: Can it be good for you?

From ancient Babylon to present day, human beings have enjoyed alcohol and other fermented drinks. Only in recent years have people begun to debate whether alcohol is completely bad for health or if it has any added health benefits. Without any research most people can tell you firsthand that drinking every weekend is not going to make you feel great, either mentally or physically. However, there have been limited studies that suggest alcohol in moderation, can provide some health benefits. You probably will no’t be hearing your doctor advise you to drink more, anytime soon, but maybe that glass of wine with dinner is not as bad for you as it seems. Before you take that to heart, there are a few things to understand.

Depending on one’s age and background, one’s idea of “drinking” can range from a beer or two to having multiple drinks per hour. Yet, all the studies that suggest alcohol may have some health benefits agree that the effects are only observed when alcohol is consumed in moderation. So what is “moderate” and what constitutes a “drink”? There are no concrete definitions as of yet, since “moderate” depends largely on an individual’s body makeup and type and “a drink” depends on the type of alcohol and perhaps the region of the world you live in.

Similarly, in some studies, “moderate drinking” may refer to less than one drink per day, while in others it means three to four drinks per day. For the purposes of the studies to be discussed, the definition of “moderate drinking” will be the point at which the health benefits of alcohol clearly outweigh the risks. The latest definition used by the Dietary Guidelines for Americans places this point at no more than one to two drinks per day for men, and no more than one drink per day for women.

The argument you may have heard the most and the one that alcohol enthusiasts like to cite most often, is that alcohol is good for your heart. In specific cases, there is some truth to this. Many studies have shown an inverse relationship between moderate drinking and the risk of heart disease (~40% reduction). Alcohol has been shown to raise levels of high-density lipoprotein, also known as good cholesterol, which in turn is linked to protection against heart disease. Drinking alcohol has also been linked to a range of benefits from producing better sensitivity to insulin as well improving factors that influence blood clotting. So, a glass of wine or beer once in awhile may actually benefit those who are at risk of heart disease.

Additionally, the potential benefits of alcohol extend beyond the heart. Research performed by the Nurses’ Health Study suggest that the risk of gallstones was lower in moderate drinkers than in non-drinkers. Again, the results placed an emphasis on moderate drinking as there was no benefit observed from those that drank more than four drinks a day. Another Dutch study showed that healthy adults who drank one to two glasses per day had a lower chance of developing type 2 diabetes compared to teetotalers. Moderate alcohol consumption has even shown signs of preventing the common cold. In 2002, the New York Times published the results of Spanish researchers which found that drinking eight to fourteen glasses of wine per week (especially red wine) showed around a 60 percent reduction in the risk of developing a cold. The researchers attributed this result to the antioxidant properties of wine.

Furthermore, the way you drink is seemingly more important than what you choose to drink. Drinking heavily one day of the week and not drinking the rest of the week is not the same as having a drink per day. This is not to say that one should strictly adhere to having a drink every night of the week, but if you particularly enjoy having a drink with dinner or at the end of a long day, the emphasis should again be on moderation.

None of this is to say that you should or need to drink and if you currently do not drink, you do not have to start drinking for the possible health benefits. Conclusive evidence about health benefits of alcohol is not certain, and alcohol may not benefit everyone who drinks. In fact, it is possible that those who drink moderate amounts of alcohol have other behavioral tendencies that lead to healthier living than those that abstain completely or drink excessively. That being said, moderate consumption of alcohol may be of most benefit if you have existing risk factors for heart disease. However, there are a plethora of other steps you can take to improve your heart health besides drinking. For instance, eating a healthy diet and exercising have much more robust research behind them and are a much better alternative to hitting the bottle.

Richard Yoon
Staying Hydrated And The Dangers Of Dehydration

“Stay hydrated.” We’ve all heard the advice before, as well as all the promises and complications that come with it. Drink water to lose weight. Drink water for clearer skin. Coffee doesn’t count. It gets difficult to keep track of it all, especially when it is not always easy to distinguish fact from fiction. But proper hydration is nothing to be pushed aside, as it is integral to the body’s proper function. It is a good idea to know the basics of how much water to drink and why, so that everyone can accurately meet their body’s needs.

Eight glasses of water a day. When it comes to the amount of water we’re supposed to drink in a day, this seems to be the cardinal number. But how accurate is it really? The answer may not be as straightforward as it seems. For a long time, health specialists and scientists alike used the 8 ounce-8 glass rule as a guideline for how much to drink. This number originates from the year 1945, when the US Food and Nutrition Board recommended that for every calorie a person consumes, they also consume one milliliter of water. When put into context of the average person’s recommended daily intake, this rule of thumb yields (approximately) 64 oz of water a day, which is where the rule originates. However, this statement was widely misinterpreted, because many failed to note an important distinction; a great deal of this water is taken in through food, anyway. Though this may seem like an obvious mistake, the “8 by 8” rule stayed intact for a very long time, and is even still preached by some today. However, new research has recently been arising to further debunk this myth. For instance, Monash University in Australia conducted an experiment in 2016 which ultimately revealed that the body has a mechanism for controlling our water intake. Essentially, the experiment showed that when one is hydrated enough it becomes physically more difficult to swallow water. This finding called into question the 8x8 rule, as it showed the body is more than capable of knowing how much water to drink. Overall, there has been a shift towards this direction of thinking, and a good deal of experts now use the mantra of “just drink when you’re thirsty.” It is still recommended to drink throughout the day to stay hydrated, but every individual should simply listen to their body to determine what is healthy for themselves.

Now that we know how much water to drink, we come to perhaps the most important question: why stay hydrated? The obvious answer is that we cannot survive without water, but the question goes beyond this. Why is it that experts put emphasis on drinking more than enough water, rather than just what we would need to get by? There are a vast number of reasons for this, and far more than can be discussed here, but it is worth it to examine and understand some of the most important ones. For one, because water makes up a large portion of our blood, it is vital for the proper transport of oxygen and various other nutrients around our body. It plays roles in regulating the amount of sodium in the blood, as well as stabilizing blood pressure and heartbeat, to name just a few functions. If one does not drink a sufficient amount of water, these functions become much harder for the body to carry out properly.

For many people, though, staying hydrated is not so easy. And when water deficiency is very great, it is possible to enter the dangerous territory of dehydration. The National Institutes of Health defines dehydration as the state in which the body “doesn’t have enough fluid and electrolytes to work properly.” And while it may seem obvious that dehydration is caused by a lack of sufficient water, there are a variety of different factors that can lead to dehydration’s onset. For instance, people with Type 2 Diabetes are more prone to dehydration than the rest of the population. Their bodies try to flush out excess blood glucose through urine, which in turn leads to a quicker onset to dehydration if not careful. For women on their periods, hormone fluctuations may also lead to a greater required water intake, and for anyone that works out intensely, dehydration can become a danger quickly if water lost through sweat is not adequately replenished.

A variety of symptoms will warn a person if they are reaching the threshold of dehydration. First and foremost, they will experience a very prominent thirst. If one is on the verge of being dehydrated, though, it is important to drink slowly and over a period of time to regain water, as drinking excessively all at once can cause vomiting. A person’s urine can also indicate their level of hydration. Dark colored urine is more concentrated, indicating that a person’s water intake may be too low. Fatigue, headache, dry skin, and dizziness are also all possible side effects of dehydration. If you experience any of these and suspect that you may be dehydrated, it is important to slowly increase water intake, stop any physical activity, and avoid consuming anything that may have a diuretic effect.

Water is one of the of the human body’s greatest needs, but also one that we tend to disregard. Staying properly hydrated is central to our ability to function daily, and without proper water intake we risk dehydration and, in the long run, potentially severe damage to our bodies.

So, let’s raise a glass (of water!) to proper hydration.

What is the healthiest cuisine?

The 2017 World Health Index (1) released earlier this year, which graded 163 countries based on variables such as life expectancy, causes of death and health risks such as high blood pressure, malnutrition, the availability of clean water and tobacco use, resulted in Italy having the highest health index of 93.11. Over a third of the adults in USA are obese and the number is not dropping. This is a stark contrast especially with countries like Japan and India where the obesity rates are below 5% (2) . For a rich nation, Japan has extraordinarily low obesity. Apart from local culture, living environment and lifestyle, is the local diet an important factor to achieving such a high health index? The double-cheese pizza or the gooey lasagna, which are loaded with calories and fat can certainly not lead to the formation of what we can term as “the healthiest cuisine”. What makes a cuisine healthy or unhealthy? It is interesting to note how different cuisines are linked by similar ingredients and how specific ingredients help define certain cuisines, and how foods influence our health.

The Italian tradition of enjoying a leisurely meal is good for digestion. The star ingredients of this cuisine: tomatoes, olive oil, garlic, oregano, parsley and basil are what make it extremely healthy. Lycopene in tomatoes may be a protective agent for breast cancer. Garlic and traditional Italian herbs provide vitamins A and C, and olive oil helps lower cholesterol, fight heart disease and burn belly fat.

The distinctive flavors in Indian food from its array of aromatic spices are actually protective against some cancers. Turmeric and ginger help fight Alzheimer’s disease. The rates of Alzheimer’s in India are four times lower than in America. Turmeric, a main ingredient in curry, has anti-inflammatory and healing properties. Yogurt and lentils, which are commonly used in the Indian cuisine, have significant amounts of folate and magnesium, and may help stabilize blood sugar.

The Thai Tom Yung Gung soup made with shrimp, coriander, lemongrass, ginger, and other herbs and spices, possesses properties 100 times more effective than other antioxidants in inhibiting cancerous-tumor growth. The incidence of digestive tract and other cancers is lower in Thailand than in other countries. Thai spices like ginger aids in digestion, turmeric is an anti-inflammatory and lemongrass has long been used in Asian medicine to help treat colds and ease tummy troubles.

The culinarily diverse South America’s traditional diet of fresh fruits and vegetables (including legumes) along with high-protein grains like quinoa. In fact, a typical South American meal of rice and beans creates a perfect protein.

The Mediterranean diet consisting of traditional Greek foods like dark leafy veggies, fresh fruit, high-fiber beans, lentils, grains, olive oil, and omega-3-rich fish provide lots of immune-boosting and cancer-fighting ingredients that cut the risks of heart disease, diabetes, and other diet-related diseases. A traditional Mediterranean diet is associated with a 25% reduced risk of death from heart disease and cancer, apart from losing more weight and feeling fuller on this type of diet, which is rich in healthy fats, than on a traditional low-fat diet. This cuisine also ranks high in terms of health benefits because of how it is eaten. The Greeks often share small plates of food called ‘meze’. Spanish tradition of eating the ‘tapas’ (small plates of food) is similar. The Spanish cuisine consists of lots of fresh seafood, vegetables and olive oil, all of which aid in better health.

Fresh herbs, lots of vegetables and seafood, and cooking techniques that use water or broth instead of oils, are the standout qualities of traditional Vietnamese food. This cuisine relies more on herbs than on frying or heavy coconut-based sauces for flavor, which makes it lower in calories. Traditional Vietnamese additives including mint, Thai basil, and red chili have long been used as alternative remedies for all sorts of ailments, while cilantro and star anise have actually been shown to aid digestion and fight disease-causing inflammation.

The traditional Japanese cuisine, especially the version eaten on the island of Okinawa where people often live to 100-plus years, is rich in antioxidant-rich yams and green tea, cruciferous and calcium-rich veggies like bok choy, iodine-rich seaweed (good for thyroid), omega-3-rich seafood, shiitake mushrooms (a source of iron, potassium, zinc, copper, and folate) and whole-soy foods. They prepare these in the healthiest way possible, with a light steam or a quick stir-fry. They also practice Hara Hachi Bu (eat until you are eight parts or 80 percent full). These simple diet rules may be why people in Japan are far less likely than Americans to get breast or colon cancer.

Authentic Mexican cuisine’s emphasis on slowly digested foods like beans and fresh ground corn may provide protection from type 2 diabetes apart from being heart-healthy and even slimming. A Mexican diet of beans, soups, and tomato-based sauces helped lower women’s risk of breast cancer, a study from the University of Utah found.

It turns out that countries with big immigrant populations like the US and Australia tend to have the greatest culinary diversity, the greatest number of ingredients and the biggest variation between dishes. This is mainly due to immigrants bringing their native culinary culture with them, which in turn makes the cuisines of their target country richer. It would be only just to conclude that no cuisine ranks above the other in terms of being healthy, but there are common elements across eating patterns that are proven to be beneficial to health. A diet of minimally processed foods closer to nature, predominantly plants, is decisively associated with health promotion and disease prevention. Globalization (3) has played a crucial role to help enjoy global cuisines in their purest state while also consuming meals that are light, nutritious, and incredibly healthy.

References:

1. 2017 healthiest country index. Kelowna Now Web site. https://www.kelownanow.com/news/news/National_News/17/03/20/2017_healthiest_country_index/.

2. Bite" BW, "First. How the japanese diet became associated with a healthy lifestyle. Business Insider Web site. http://www.businessinsider.com/how-the-japanese-diet-became-associated-with-a-healthy-lifestyle-2016-5.

3. Ross AC, Caballero B, Cousins RJ, Tucker KL. Modern nutrition in health and disease. 11th ed. Philadelphia: Wolters Kluwer Health; 2012:1-3.

Sports Related Injuries in Pediatrics

According to the Centers for Disease Control and Prevention, more than 38 million children participate in sports in the United States. Of these children, more than 2.6 million adolescents (aged 19 years or younger) are treated in emergency departments annually from sports related injuries. These types of injuries are the most common cause of musculoskeletal injuries in children treated in emergency departments. While the most frequent types of injuries are strains or sprains, other commonly encountered injuries range from scrapes and bruises to serious brain and spinal cord injuries such as concussions. Sports related injuries among adolescents is an especially important topic that deserves special attention due to the specific risk factors that are associated with their younger age.

Sprains and strains are the most common injuries that are encountered in children who participate in some type of sport. Sprains are a result of an injury to a ligament, the bands of fibrous tissues that connect bones at a joint. These injuries can occur when one lands on the side of their foot or twists their knee when the foot is still planted, or for a variety of other reasons. The other type of common injury is a strain which involves an injury to either a muscle or tendon, which is the tissue that connects muscle to bone. Strained muscles might occur when one returns to a sport after having taken a long time off or can be caused by injuries such as twisting one’s ankle for example. While sprains and strains are by far the most common types of injuries seen among young athletes, they are in most cases the simplest to treat.

On the other hand, growth plate injuries as a result of sports accidents are considered more serious and are a unique risk factor that is specifically associated with younger athletes. Growth plates are areas of developing tissues at the end of long bones that are present in growing children and adolescents. As children age, the growth plate is gradually replaced by solid bone.  If any of these associated areas become injured, it can lead to misshapen bones or limbs in the most extreme cases. Fortunately, these are rare and in most cases with the right attention and treatment, growth plate injuries can be treated with no permanent damage. Still, before growth is complete, the growth plates are at risk of fractures which pose a larger risk to children than to adults, whose bones have finished growing.

The most serious sports related injuries are injuries to the brain or spinal cord and should be paid the closest attention. Concussions are a common example in sports, especially contact sports such as football or even soccer. A concussion is an injury to the brain that changes its functioning, usually temporarily. Symptoms manifest in the athlete showing signs of confusion, dizziness, headaches, unsteadiness, and nausea following the accident. While these injuries are most commonly associated with blows to the head, it can also result from the head and upper body being violently shaken. Furthermore, concussions in kids are different than concussions sustained by adults. While in most cases injuries heal faster in kids than adults, studies show that healing rates for concussions sustained by kids are slower than those of adults. Also, children are at a greater risk of suffering a second, more serious injury if the first concussion isn’t fully allowed to heal and can sustain a second concussion from a lesser impact than is generally required to produce one. Repetitive brain trauma, especially starting from an early age can lead to more serious issues later in life. While most mild concussions should heal on their own over time, the biggest mistake made by young athletes, coaches, or parents is trying to return to activity too soon. Thus, with these types of injuries it is best to be especially cautious and to routinely consult with a medical professional.

Sports related injuries in adolescents is common and luckily younger athletes tend to bounce back from mild injuries more quickly than the average adult. However, preventing sports injuries are just as, if not more, important than treating them. There are many ways children can participate in sports in a safe and exciting environment and perhaps avoid any injury. For one, it is advised that children be in enrolled in organized sports through schools or community clubs that are properly maintained and staffed. In addition, it is important that young athletes make sure to use proper equipment, make a habit of warming-up and cooling-down as well as stay hydrated at all times. Conditioning and strengthening muscles is also a good preventative measure to keep your body ready for intense physical activity. Learning the proper technique and fundamentals for any given sport is also recommended to prevent any injuries. However, at times it might not be possible to prevent an injury from happening as any sport carries some potential for injury. Thus, if an accident does occur, it is imperative that athletes do not try to play through the pain. For soft tissue injuries such as a sprain or strain, athletes may follow the R.I.C.E procedure (Rest, Ice, Compress, Elevate). First, reduce use of the injured area for at least 48 hours. Next, ice the area for 20 minutes at a time about 4 to 8 times a day. Use elastic wraps, casts, or splints that can be used to compress an injured area which will reduce swelling. Finally, keep the area elevated above the level of the heart to decrease swelling. For more severe injuries it may be necessary to seek professional treatment.

The nature of sports makes injuries inevitable at times, but that should not stop you from enrolling your child in sports or encouraging them to pursue an active lifestyle. The effects of exercise range far and wide and have been shown to reduce chances of obesity and diabetes as well as helping children build social skills. It also acts as an early step towards teaching kids how to work in teams and can provide many life skills that they can carry with them into their adult lives. By taking the preventative measures mentioned above and teaching young athletes safe habits prior to, during, and post training, injuries can be kept to a minimum as they enjoy leading an active lifestyle.

Motivation for Headaches

In daily life, it is typical for people to experience facial pain or headaches and come to the immediate conclusion that they are experiencing a headache. They are bothersome and can disturb daily function and impact our attention and focus. However, many of us are experiencing headaches at different locations of the head, with different intensities, and from different causes.  People that experience the common headache feel pain that is dull and located on both sides of the head.

Primary headaches are those that occur independently, coming from structures such as blood vessels, muscles, and nerves or differences in chemical activity in the brain. Secondary headaches, on the other hand, occur due to the patient’s supplementary conditions. The most common primary headache is a tension-type headache which is a squeezing feeling on the head or neck due to the tightening of muscles often caused by stress, anxiety, and fatigue. The mild discomfort is usually on both sides of the head. The duration can vary from minutes to several days but vision, balance, and strength are not affected, which makes tension-type headaches distinct from migraines, another primary headache. Migraines are associated with a throbbing pain on a particular side of the head. They can affect vision, induce light-headedness, and cause nausea. They can last at least a couple hours or a maximum of 2 to 3 days. Another primary headache, the cluster headache, affects one side of the head as well but the pain tends to be sharper. Cluster headaches have more physical attributes such as swelling in eyelid or forehead, drooping eyelids and small pupils, and a runny and stuffy nose. They can occur several times a day.

Secondary headaches on the other hand have a further cause to the pain induced on the nerves of the head. Examples of such causes are alcohol intake, blood clots, concussion, taking pain medication, and panic attacks.

Depending on the severity and recurrence of the headache different approaches may be taken to relieve pain. Professional help may not necessarily be needed as home remedies may be sufficient enough to alleviate the pain.  One can use a heat pack or ice pack for the head or neck. Health meals that do not lead to high blood sugar and regular exercise are encouraged. Because stress is one of the leading causes of primary headache, it is imperative that additional stressors are avoided and that one rests more. To diagnose a headache and prevent further complications, blood tests, sinus x-rays, and brain scans (CT and MRI) are utilized and typically medication is prescribed by the doctor. Different mediation includes abortive (those that target receptors in nerves), rescue medicines (pain relievers), and preventive medicines (help deal with the initial point of headaches.) Typical types of medication to help with pain relief are tricyclic antidepressants, serotonin receptor agonists, anti-epileptic drugs, and beta-blockers.

Not everyone experiences the same kind of headaches – some can become severe, some can become chronic. Although it may be “just a headache,” you needn’t suffer through the pain. It is imperative that a headache-sufferer looks into their options. Once you rid yourself of the pain, you’d be surprised at how much more of your life you can enjoy.


#fightthepain

Rachanne Nabong
Insurance Hardball

Despite all the effort and commotion in Washington, D.C. over the last few months, the Affordable Care Act (ACA) – or “Obamacare” – is still in place. This is not to say, however, that coverage under the ACA will remain the same going forward. In the absence of necessary reform and amidst general uncertainty regarding legislation and budgeting, states and insurers are playing hardball with health insurance. What does that mean for the rest of us? Today, we’ll review some of these recent developments in the ACA marketplace to better prepare for what may lie ahead.

You may have seen headlines here and there: “Major Obamacare insurer pulls out of Ohio,” “From Anthem to Aetna, major health insurers are leaving ObamaCare,” “These 5 places will be hardest hit by those leaving the ACA,” and so on. The reason these companies are leaving state ACA marketplaces is simple. They aren’t making as much money on their investments as they could be elsewhere, and in some cases they aren’t making money at all. One such case can be seen in Alabama, where Blue Cross Blue Shield is spending $1.20 for every $1.00 it collects in premiums. Obviously, this is an unsustainable model. Yet the threats to insurers’ bottom lines continue: cost-sharing reductions (CSRs), a type of federal reimbursement that effectively allows insurance providers to reduce medical expenses for people with lower incomes, are on thin legal ice that the recent presidential administration could break at any time. If funds for CSRs disappear, providers will have even less incentive to insure those with lower incomes. Even providers that profit in the ACA marketplace under the current system would stand to lose a great deal of money due to the importance of CSRs. Faced with this potential scenario, many companies are raising their premiums while others are packing up and abandoning the ACA marketplace in favor of more profitable ventures.

In New York, Governor Andrew Cuomo has made his stance on this type of behavior very clear. In June, he announced that any providers that withdraw from the ACA marketplace will be banned from all other state health programs, such as Child Health Plus and Medicaid. In making this announcement, Governor Cuomo signaled that he was willing to play hardball with insurance providers by speaking their language – money. Banning providers from all programs if they withdraw from one may seem more like a petty swipe than a calculated strategy, but it is important to understand that those other state health programs are generally very profitable for the companies involved. So profitable, in fact, that companies complaining about ACA unsustainability often turn around and beg to service Medicaid in the same breath. By threatening their access to the massive profit to be had in serving New York residents, Governor Cuomo was able to effectively rein in any providers considering leaving the ACA marketplace. In his announcement, he asserted that “the people of New York will not have to worry about losing access to the quality medical care they need and deserve,” and he was correct. Compared to other states, the New York ACA exchange has been more stable and seen fewer insurer dropouts. Note, of course, that he made no such promise about preventing premiums from increasing. Such is the nature of insurance hardball.

So what should we expect going forward? Unfortunately, there are likely to be hefty premium increases across the board in our future. While the ultimate fate of CSRs remains in question, the legal case has been put on hold, effectively maintaining the status quo until the end of the year. Until a reasonable and fiscally sound alternative to the ACA is proposed and passed, uncertainty among providers could leave more counties “bare” (without any insurance plans available on the ACA marketplace) as they withdraw in increasing numbers. For this reason, it is important that you look over your health insurance plan and ensure that you are adequately covered, or begin looking into alternatives immediately if you are in an affected area. Below, you can see a list of companies that are known to be withdrawing or are publicly considering withdrawing from the ACA marketplace in some capacity. As we are currently in the season where providers are announcing whether they plan to participate in the ACA exchange, this list may not be complete or fully up-to-date. Speak with a representative from your provider if you are unsure.

  • Aetna

  • Anthem

  • Humana

  • Medica

  • Minuteman Health

  • Molina Healthcare

  • Harken Health Insurance

  • Wellmark

NYC Pain Specialists offers full out-of-network insurance benefits, and most policies reimburse patients for most of the cost of surgery. Our surgical coordinator will be happy to help you with a quote. Similarly, our patient coordinator can explain our financing plans and help you apply. We offer financing through Advance Care Card, and often can have an answer from the financing company by the time you complete your consultation with our medical staff.


Jonathan Arthur
Rotator Cuff Injuries

Rotator cuff injuries are a common type of shoulder injury, especially among athletes or those with jobs that require physical labor. Chances are, you know someone who has experienced a rotator cuff injury--you may have experienced it yourself to some degree.

If you are a sports fan, you may have heard of your favorite player being taken out of the season due to a rotator cuff injury. While they can certainly be severe in nature, rotator cuff injuries can also be minor and can occur due to a variety of reasons both on and off the field. For instance, one can sustain a rotator cuff injury from playing football for many years or even due to reaching out to break a fall and landing on one’s arm. The major cause for rotator cuff injury, however, is simple wear and tear of over years of use or repetitive movement involving the shoulder. In any case, the first step to the path of recovery is to understand the rotator cuff itself. The next step, not any less important, is to employ the good habits learned in physical therapy as a means to recover and maintain a healthy shoulder.

The rotator cuff is a group of muscles and tendons that surround the shoulder joint. It plays a stabilizing role for the shoulder joint and is responsible for the lifting and rotation of your arms. Oftentimes doctors may tell you to imagine the head of the upper arm bone as a golf ball and the shoulder blade as a golf tee. This should help you visualize the versatility that the shoulder joint is capable of handling. In addition, the rotator cuff acts as a sleeve of sorts, as it can enable the “ball” to spin and roll while remaining attached to the tee.

Two main type of rotator cuff injuries exist: impingements and tears. The main difference is that while a tear is due to an actual tear to the muscle itself, an impingement is due to the rotator cuff muscle swelling and causing pinching between the arm and shoulder bones. These types of injuries can alternatively be classified as acute or chronic. An acute injury is classified as a tear or strain in the rotator cuff that results from a single event such as falling, while a chronic injury is the result of overuse and fatigue, often seen in elderly patients and athletes. Acute injuries are more likely to recover in a shorter time period when given sufficient rest and treatment, though chronic injuries are a bit longer-lasting. Nonetheless, both tears and impingement, acute or chronic, can be treated with a combination of rest, rehabilitation, and physical therapy.

The most common symptoms of an injury to the rotator cuff present as stiffness, weakness, loss of range of motion, and/or varying levels of shoulder pain. Most patients may mention heightened pain in the shoulder at night and a stiffness in the morning when they get out of bed. In addition, lifting the arm overhead or away from you may be difficult and painful. If you are experiencing any or a combination of these symptoms, it may be time to visit a medical professional. In a typical doctor’s appointment, the doctor will typically take a patient background and perform a physical exam in which they physically examine the rotator cuff with stress maneuvers. Such tests may involve asking the patient to hold their arms out in various degrees and applying a downwards force to isolate the origin of the pain. In more severe cases X-rays, MRIs or ultrasounds may be necessary to pinpoint where the injury or pain is coming from.

Once a medical professional has confirmed that a patient is indeed dealing with a rotator cuff injury and not something else, there are a wide range of potential treatment options. Depending on the severity and cause of the original injury, less severe rotator cuff injuries often respond well to rest and rehabilitation. If these options do not work, injections or surgery may be recommended, although the latter is typically reserved for patients with full tears of the rotator cuff muscle. However, for most patients there is a typical order to which recovery takes place. The first step involves pain control and allowing your muscles to rest, achieved through the use of anti-inflammatory medications and wearing a brace that limits shoulder movement. It may be important to note, however, that extensive immobilization is not generally recommended as it may further complicate the injury. The next step is to restore the strength of the muscles with some sort of physical therapy in which therapists will aim to help return the rotator cuff to its original strength and flexibility, as well as addressing any muscle imbalances that may have occurred as a result. In the last step, the patient gradually returns to his/her normal daily activities while incorporating small changes that aim to prevent further distress. For athletes this might be a different throwing motion or lifting motion with an additional stress on correct form.

Rotator cuff injuries can be long and unpleasant since we use and rotate our shoulders in almost everything we do. Not only is it an uncomfortable process to recovery, but it is also an especially inconvenient one. There are many steps you can take in your daily lives to prevent injury and ensure long-lasting, pain-free shoulders. One approach is to view the rotator cuff and the shoulder as part of a comprehensive, not isolated, system. It may not be the best approach to simply focus on strengthening the shoulders to prevent injury. In fact, overdoing it in training or lifting may be putting you back on the path to injury. Instead, consider that the shoulder, shoulder blade, the back, and the hips are all connected, and isolating one part may cause imbalances in other areas. All in all, do not hesitate to consult a professional if you are feeling discomfort or pain in the shoulder. A physical therapist or an experienced trainer will be able to properly address areas of concern and suggest a healthy exercise program. After all, the shoulder joint is involved in almost everything we do. We should undoubtedly want to ensure the longevity of such an important part of our body.


References:

  1. "Rotator Cuff Injuries | MedlinePlus." MedlinePlus Trusted Health Information for You. MedlinePlus, n.d. Web.

  2. "Rotator Cuff Injury." Mayo Clinic. Mayo Foundation for Medical Education and Research, 12 Aug. 2017. Web.

  3. "Rotator Cuff Tear." Virtual Sports Injury Clinic. Sportsinjuryclinic, n.d. Web.

  4. "What Is a Rotator Cuff Tear?" WebMD. WebMD, n.d. Web.


Richard Yoon
Facial Pain: Unlike Headaches or Migraines

You may wake up one day to a sharp, throbbing pain on your forehead. You try to recall what you did yesterday that might be the cause of the aching, but you can’t find any obvious reason. You go to work, but the nagging pain continues. You may be tempted to shrug it off, dismiss it as some ordinary headache that would heal with time. However, sometimes pain escalates to more than what is “normal.”

Sources of facial pain are often the forehead, nose, cheeks, eyes, and mouth, and it is described by many to be stabbing or aching; such pain is usually caused by headaches or injuries. Oftentimes, it is harmless–a natural feeling of pain following physical trauma. Other frequent causes of facial pain, however, include an oral infection, toothache, or an abscess, which is a swelling of pus that forms under the skin. Rarely does facial pain indicate a more serious condition, as pain felt in the face can radiate from another region of the body, such as the ears and the head. Some more serious causes include shingles, sinusitis or a sinus infection, joint disorders, and nerve disorder. In reality, there is a wide range of facial pains, from dull and throbbing to sharp and stabbing. Whatever the case may be, a persistent, unwarranted facial pain is sufficient reason to visit the doctor.

The cause of facial pain is diagnosed based on the location and intensity of the pain. For example, a dull, throbbing pain near the mouth that gets worse when you eat is usually due t o toothache, and a trip to the dentist may be necessary. An aching pain along the cheekbone and eyes that becomes more intense if you lean forward may be an indication of sinusitis. Abscesses and ulcers are associated with throbbing pain at the site, while headaches and migraines are described as aching and stabbing. Trigeminal neuralgia, caused by a damaged or inflamed nerve, occurs when blood vessels apply excessive force on nerves near the brain. These patients suffer from severe, debilitating pain that prevents them from performing everyday activities like walking and eating. A sudden facial pain that seems to radiate from the left chest and arm could be an indication of a heart attack, and immediate medical attention is necessary.

The treatment of facial pain differs with the cause of the pain. Pain due to dental or sinus issues are treated by eliminating it at the source. A dentist can pull out a tooth with an acute cavity or a physician can provide medication to clear a sinus infection. For viral infections like shingles, doctors may prescribe antiviral medications such as acyclovir. Headaches are often treated with non-steroid anti-inflammatory drugs and other pain killers. For more severe cluster headaches and migraines, patients often receive over-the-counter medication such as opioid pain-relievers and antidepressants. Patients with trigeminal neuralgia are treated with occipital nerve blocks and peripheral nerve stimulation, in addition to drugs similar to those for severe headache treatment.

Muscle and joint pain have a different treatment approach. Patients who wake up with facial pain after waking up may be suffering from teeth grinding, or bruxism, while sleeping. Treatments include nightgards and stress management. Poor posture resulting from sedentary jobs that entail hours of work without moving can cause tightening of neck muscles, causing pain to be radiated in the face. Effective treatments include massages and physical therapy.

Chronic facial pain is very difficult to treat because it is a relatively ill-understood symptom, despite the fact that 10% of the adult population and 50% of the elderly population suffer from self-reported orofacial pain. It is also a multi-faceted condition, as it tends to be associated with psychological problems, predominantly depression. As a result of its complexity, a multidisciplinary approach is the optimum treatment for facial pain. For patients with idiopathic facial pain, the most effective way for doctors to alleviate their condition is to let the patients know that the doctors recognize and believe in their pain. Doctors must work together with their patients to create a feasible and reasonable treatment regime to reduce the pain.

The face is one of the most complex regions of the human body, with an incredible number of nerves, muscles, and bones. As a result, facial pain can have various causes and is difficult to diagnose. At one point or other, everyone undergoes facial pain, at varying intensities. As a result, it is important for people to understand the potential indications of facial pain and to seek medical attention when they see the warning signs, for it is always better to be safe than sorry.


References:

  1. http://jnnp.bmj.com/content/71/6/716

  2. https://paindoctor.com/conditions/face-pain/

  3. http://www.healthline.com/symptom/facial-pain

  4. https://medlineplus.gov/ency/article/003027.htm

  5. http://jnnp.bmj.com/content/72/suppl_2/ii27

  6. http://www.tmjhope.org/a-guide-to-the-most-common-types-of-facial-pain/


Mary Yoshikawa
Stress and Kidney Stones

Breaking off a marriage, having a loved one die, getting sued or recovering from a life threatening accident does more than just hurt your wallet or your brain; it also hurts your body. Studies have shown that stress, whether from everyday problems like work stress or big life changing problems, is linked to the cause of kidney stones.

Kidney Stones disease occur in over 200,000 people a year in the United States. Kidney stones are minerals and acid salts that clump together over time into a small pebble shape in your urinary tract and cause immense pain. Many times kidney stones are formed and do not cause pain until it reaches your kidney or bladder. Other than severe pain, if you encounter other symptoms of kidney stones like pain on the side and back, below the ribs that radiate to your lower abdomen and groin, colored urine or foul smelling urine, nausea and vomiting, fevers or chills, you should go to a doctor right away.

There are many causes to kidney stones but one of the most common reason is dehydration causing lack of water in the kidney to dilute uric acid and other toxins in the body. At the same time, the urine in your body may lack substances to prevent crystallization of minerals causing these small but painful stones to form. Kidney stones form in adults between the age of 30 to 50 years old. However, hereditary kidney stone disease can cause stones at an earlier age.

Causes of kidney stones can be deciphered by the type of kidney stone present, allowing less risk of repeating habits or practices that form them. Calcium stones are crystals made of calcium oxalate which is a substance found in food like some fruits vegetables, nuts and chocolate and is made by your liver. Dietary factors, high doses of vitamin D or metabolic disabilities can increase calcium concentration in urine. Struvite stones form due to infection in the urinary tract (UTI). They grow fast with very little warning. Uric acid stones form when you do not drink enough fluids to dilute urine, those who have high protein diet or those with gout, which is a form of inflammatory arthritis. Cystine stones are formed from a hereditary disorder that causes the kidney to let out too much of an amino acid called cystinuria.

In an experiment to correlate stress to kidney stones completed by Miyaoka, 200 patients with kidney stones took a questionnaire to measure stress on a perceived stress scale -10 (PSS-10). Stone characteristics and stress factors were assessed. Results of the experiment showed that the average score was 15.3, with a error range on 1.1. For woman, recent death of a family member or illness, or psychological trauma proved to be significant factors as the patients were going through symptoms of kidney stone disease throughout the time of their crisis.

Austin Urology Institute states that stress, in fact, is an indirect cause of kidney stones. Since the common reason for stone formation is dehydration and high urine concentration, stress can lead to a bad cycle of poor diet, less exercise, and low sleep quality as well as an increase in caffeine intake. Stress sets off a chain reaction of behaviors that cause harm or is unhealthy to the body. Without correct management of stress, kidney stones and other diseases will form in the body.

To prevent the formation of kidney stones, there are a few measures you can take. By decreasing oxalate in your body, you will remove one of the major causes of the most common stones. Through exercise as a stress reducer, drinking more water, less caffeine intake and living a healthier lifestyle by sleeping well and watching your diet can significantly decrease your chances of forming kidney stones.

Walida Ali
Obesity and Pain

In 1940 the American fast food chain McDonald's was founded by the brothers Richard and Maurice McDonald. Today it serves roughly 70 million customers daily all around the world, making it of one of the largest fast food chains in the world. The inescapable offer of cheap food and fast service was definitely a success in the modern period as people became more busy and time more limited. The introduction of fast food chains is believed to be one of the major causes why obesity became a frequent condition among the population. Obesity was first recognized as a global epidemic in 1997 when the cases started to escalate rapidly.  Of course it would be unfair to put the blame of a whole epidemic in the creation of fast food. It is important to understand that the food market as a whole contributed as it went through major changes, including the marketing and industrialization of its products. Genetics can also play an important role; once there is a history of obesity in the family, or even a tendency to gain weight easily, one needs to be extra careful not to develop such condition. Moreover, the discouragement of physical activity as a result of new technologies led to a higher rate of sedentarism, also contributing to the increase in obesity. Why walk to the supermarket if you can order everything online? Why play sports if you can play video games with your friends in the comfort of your house? Everything was simplified by technology, but the outcome of that created a problem bigger than expected.

According to the World Health Organization approximately 500 million adults are obese, with higher incidence among women between ages 50 and 60. In the United States, severe obesity is increasing in an alarming rate, exceeding the overall rate worldwide. There are several health issues that can arise as a result of obesity , including life threatening ones as heart attacks and diabetes. Psychological problems can too take place as the patient feels excluded from the society and shuts themselves inside their homes, not being able to overcome that challenge. After all, what characterizes one as obese? Obesity is defined by weight and height, which together are used to calculate the “Body Mass Index” (BMI), where a BMI greater than 30 kg/m2 reflects obesity. In this article I will talk about the connection between obesity and pain, where one can be triggered by the other.

Pain can become a paralyzing condition, limiting physical activity and encouraging sedentarism. This resultant inactivity can lead to weight gain and easily develop into obesity. Individuals that suffer from chronic pain are in even higher risk due to the possibility of depression as a result of its limitations. Depression is strongly linked to both pain and obesity as it is associated with disturbed sleep and emotional eating. The need to ingest high-caloric food is one of the main causes to weight gain as patients try to find comfort in food and lose control over their diet. The lack of motivation, also caused by the condition, not only renders the person inactive but can too act as a barrier for the road to recovery as there is no stimulus to get up and find help. Moreover the poor quality of sleep can play an important role in weight gain. Approximately 53% of patients experiencing chronic pain have high levels of insomnia and sleep apnea which is known to trigger obesity due to increased appetite and insulin resistance caused by sleep deprivation. Medication for pain and depression can also be an enemy as many can lead to side effects that contribute to obesity.  We can explore the connection between chronic pain and obesity better by considering patients that suffer with fibromyalgia. It is estimated that 80% of people with this chronic pain disorder are overweight or obese. Fibromyalgia and obesity are both identified by the impairment of the communication system between glands and therefore can be targeted from the same source.

Conversely, overweight patients have higher risk of developing fibromyalgia and may even present worse symptoms than those in a normal weight range. It has been observed that individuals with a high BMI usually experience higher intensities of pain. It is a combination of factors that contribute to such incidence, including mechanical stress, chemical mediators that cause inflammation, lifestyle issues as well as depression and sleep deprivation. The mechanical stress caused by heavy weight affects mainly joints and the spine. Obesity completely alters the body mechanics, which leads to structural pain, cartilage damage and even increases the risk of developing arthritis as the joint becomes more strained with the weight. The predisposition of obese individuals developing arthritis is also linked to chemical mediators. The fat stored in the body is called adipose tissue and it is an active tissue that produces chemicals as well as discharging it around the body. Some of these chemicals released provoke inflammation which accentuates the perception of pain. Obesity is sometimes recognized as a chronic inflammatory state due to these chemicals.

The comorbidity of pain and obesity becomes clear when we consider how inactivity promotes obesity that in turn highlights pain, creating an even larger barrier for the practice of physical activity; running into a vicious cycle. Treatment should involve the targeting of both conditions, as the presence of one may intensify the other - there is no point in performing a bariatric surgery in an obese individual if they won’t be able to maintain a healthy lifestyle afterwards. In a real case scenario a 11 year old girl was a candidate for a bariatric surgery, but she also had severe pain in her legs causing them to bend due to her weight. After careful consideration it was decided to perform surgery in her legs first so that she would be able to walk normally before undergoing the bariatric surgery. It can be observed that in this situation the pain factor was targeted first so that the outcome of the weight loss through surgical intervention would be successful. Inversely losing weight through behavioral intervention may help in pain rehabilitation and the quality of life of such individual. It is however a demanding task to maintain eating and exercising habits for a long-term and it can become challenging to overcome this condition once you have the history. In order to defeat obesity and the pain related to it you need to be focused and aware of the benefits as well as developing a  long-term strategy with a professional to maintain the accomplishments.






References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508090/

  2. https://www.practicalpainmanagement.com/treatments/pharmacological/obesity-pain-management

  3. https://fibromyalgianewstoday.com/2015/08/05/link-chronic-pain-obesity/

  4. http://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/fat-and-arthritis.php

  5. https://www.livescience.com/18321-obese-pain-inflammation.html

Rachel Rodrigues
AAAASF Accreditation

The American Association for Accreditation of Ambulatory Surgery Facilities, or AAAASF, is an organization founded in 1980 for the purpose of enforcing higher standards in America’s medical facilities. Having accredited thousands of facilities worldwide, AAAASF is considered by many medical experts to be the “golden standard in accreditation.” AAAASF examines every aspect of the medical facility, from the hygiene standards of the operating rooms, to the qualifications of the staff, to the data which they track and review. By ensuring that a hospital has met its high standards of safety and quality, the AAAASF allows patients to know where they can receive the best healthcare possible. Here at the NYC Pain Specialists, we have received such accreditation, confirming our ability to meet the highest standards of modern medicine and provide the best possible services made available to our patients.

In order to qualify for AAAASF accreditation, this facility has to satisfy several basic mandates, meet the required standards for maintaining and using an operating room, and proper maintenance and usage of a recovery room. There are also standards defining the maintenance of general safety within the facility, and the proper utilization of IV fluids, anesthesia, and medications. Furthermore, the facility is required to maintain its medical records appropriately, retain competent personnel, and the means to properly govern said personnel. Finally, the facility must meet several standards regarding the quality of its care towards its patients. At all times, a AAAASF accredited facility is required to adhere to the Life Safety Code and the Health Care Facility Code, both of which are detailed by the AAAASF.

The basic mandates of the AAAASF establish some fundamental rules which the facility must adhere to. They specify information which must be disclosed to the AAAASF, as well as the frequency at which said information is disclosed.

The basic mandates are as follows:

  • Patients receiving anesthesia other than local or topical anesthesia must be supervised by a responsible adult for 12-24 hours after application, depending on the procedure performed and the anesthesia used.

  • Any changes in the ownership of the facility must be reported to the AAAASF within thirty days of the change.

  • Any deaths occurring in the facility, or any deaths occurring within 30 days of an operation performed at this facility, must be reported to the AAAASF within five business days after the facility is notified of said death.

  • All medical professionals within the facility must be certified, or eligible for certification, by a national organization correlating with their profession. Said organizations are as follows: The American Board of Medical Specialties for Medical Doctors (M.D.), the American Osteopathic Association Bureau of Osteopathic Specialists for Doctors of Osteopathy (D.O.), the American Board of Foot and Ankle Surgery for podiatrists, and the American Board of Oral and Maxillofacial Surgery for oral and maxillofacial surgeons.

  • The director of the facility must be responsible in establishing and enforcing policies which protect its patients, in addition to monitoring staff in order to ensure compliance with said policies. Furthermore, the facility must display and encourage adherence to the AAAASF Patient’s Rights, which gives patients the rights to consent to their healthcare, the rights to know about the healthcare they're receiving and the people giving said healthcare, and the general right to doctor-patient confidentiality (these being a very brief summary of the patient rights. The full document can be found on the AAAASF website, as well as any AAAASF accredited facility).

  • All medical professionals must be given unrestricted hospital privileges in their specialty.

  • The AAAASF must be allowed to conduct onsite inspections of the facilities on a regular basis.

The AAAASF also details how operating rooms should be maintained and how operations should be carried out. Numerous regulations ensure that surgery can occur with minimal risk towards the patient. These regulations are as follows:

  • There must be a pre-emptive “time-out” before each operation, in order to verify that the patient is receiving the correct treatment, and that all materials and personnel required for the operation are here and accounted for.

  • The operating room, as well as the waiting rooms and lavatories should all maintain a clean and “professional” appearance.

  • The waiting rooms, operating rooms, and recovery rooms should all be physically segregated from each other, as well as from the general office area.

  • The operating suite of the facility must contain operating rooms (at least one of which is designated solely for operations), a prep/scrub area, a clean area and/or a dirty area, and a recovery room. Furthermore, an exam room must also be able to function as an operating room.

  • Operating rooms must have ample space both for the storage of necessary materials and to accommodate all necessary personnel for each procedure.

  • Operating rooms must be hygienic, well lit, and properly ventilated. Their temperature should always remain between 68 and 72 degrees Fahrenheit, and they should be equipped to deter the entrance of both unwanted persons and any pests or outside germs.

  • All messes must be cleaned with proper germicides, and all operating rooms should have at least one autoclave present in order to sterilize equipment. The floor should be built with smooth, washable tiles that are always free of particulate matter.

  • All ambulatory surgery staff must have knowledge of how to detect and stop infections, and protocols must exist to aid in this endeavor. Reported infections must be logged, and techniques used to prevent infections must be regularly used.

  • Each operating room must be equipped with: an EKG monitor with a pulse readout, a pulse oximeter (both for use in the operating room and the recovery room), blood pressure monitoring equipment, a standard defibrillator or an Automated External Defibrillator Unit (AED Unit), pneumatic boots or a substitute, a source of oxygen and every possible means of delivering that oxygen to a patient, a means of cauterizing wounds, as well as an electrocautery with appropriate grounding plate/disposable pad, and an anesthesia machine with a proper failsafe and the means to deliver said anesthesia equipped. This equipment must be regularly inspected by a biomedical engineer.

  • Each operating room must be equipped with emergency power and emergency supplies.


By following the aforementioned medical standards, AAAASF accredited facilities are able to ensure the highest quality medical care for their patients. Facilities accredited by the AAAASF will be capable of treating a wide variety of different injuries, and will be able to accompany any patient it takes in. By ensuring a professional staff and efficient logistics within the facility, the AAAASF minimizes risks to the patient and ensures that they receive treatment as soon as possible. As an AAAASF accredited facility, the New York City Pain Specialists is able to meet the lofty standards put forth by the AAAASF, and is thus able to provide some of the highest quality medical care in the nation. This is all done to ensure our patients will always receive the treatment they need.

Citations:

  1. “What Is Accreditation.” Aaaasf.org, www.aaaasf.org/who-we-are/what-is-accreditation.

  2. “Patient Bill of Rights.” Aaaasf.org, www.aaaasf.org/patients/patient-bill-of-rights.

  3. “AAAASF Releases Latest List of Facilities Receiving Accreditation.” Rehab Managment, www.rehabpub.com/2016/04/aaaasf-releases-latest-list-facilities-receiving-accreditation/.

  4. ASC Standards and Checklist. www.aaaasf.org/docs/default-source/accreditation/standards/standards-manual-and-checklist-v6-7-(asc).pdf?sfvrsn=22.


George Galanis
The Standard American Diet and Chronic Pain

When we think about diets, we typically think about weight and restricting calories. But simply restricting calorie intake may have adverse effects.  When we consume foods, it's important to remember what will really make our bodies healthy, and ultimately happiest. If you are suffering from chronic pain, many studies have been shown that a diet with a focus on plant-based foods can have beneficial effects.

The Standard American Diet (SAD) consists of excessive amounts of meat, refined grain products, and dessert foods. True to popular belief, SAD has a low intake of both fruits and vegetables. Twenty-five percent of Americans eat a single fruit serving in one day, and ten percent eat the minimum recommended amount of vegetables. Also, SAD is profuse in meat, dairy, sugar, fat, and processed foods. Because of such abundance and accessibility of these foods in America, we tend to have excess amounts of these foods. Sixty-three percent of America’s calories come from refined and processed foods, twenty-five percent come from animal-based foods, and a mere twelve percent come from plant based foods. Sadly, six percent of the plant based calories come from French fries. These statistics are almost hard to believe. Although we have been hearing these facts for possibly a decade, the consequences of SAD are often undermined.

Degenerative diseases, inflammation, and chronic pain are all tied to diet, and more specifically SAD. A study from 2002 determined that most degenerative diseases are caused by a diet-induced proinflammatory state. For example obesity and chronic pain are frequently comorbid, and they are both inflammatory issues. Pain is the result of inflammation. When we consume refined sugars, refined flour, and omega-6 oils. Instead of obtaining our essential fatty acids from whole food sources, we are replacing these necessary oils with oils from calorie dense foods with low nutritional value. Many studies indicate this direct link between poor diet quality and increased pain.

Some diseases and conditions that have been found to be linked to SAD are: greater risk of Alzheimer’s disease, atherosclerosis, breast pain, heart disease, and inflammatory bowel disease, greater risk of pancreatic cancer, prostate cancer, and enlarged prostate and heart attack. Inflammation is our immune response to tissue damage and infection. Our immune systems work in response to toxins as part of a healing mechanism and will cause pain.  However, it involves many signaling pathways in our body and is not as simple as it seems. This is why it is important to approach prevention, and possibly cure, inflammation in an interdisciplinary way.

In order to counteract these diseases, the one of the simplest approaches we should try is to change dietary guidelines. When faced with chronic pain, reducing intake of carbohydrates, processed sugars, and meats can reduce inflammation and therefore pain.  Whole foods and plant-based diets have been shown to prevent and even reverse some chronic diseases. A whole food, plant-based diet consists of vegetables, fruits, whole grains, tubers and legumes. It reduces intake of meat, dairy, eggs, bleached flour, refined sugar, and oil. Antioxidants and essential fatty acids are found in a whole food, plant based diet, and an absence or imbalance of these important nutrients can promote inflammation and disease.  The importance of our diets is shocking, but SAD is even more shocking. If we continue to consume these kinds of foods, our bodies will suffer. Most treatment programs for degenerative diseases or diseases that cause inflammation include nutritional protocols.

An anti-inflammatory diet can help relieve pain, even as you age. Vegan diets, or diets with reduced intake of dairy products and meat and increased consumption of vegetables, can control insulin and cholesterol levels and decrease inflammation. When we are in chronic pain, it is important not to underestimate the necessity of a healthy diet. If Americans begin to follow dietary guidelines, perhaps pain and inflammation will be reduced.

Abigail Jawahar
The Most Common Signs of Fatigue

It is extremely common to hear someone say “I’m so tired today” or other phrases. The causes of this temporary tiredness are usually identifiable–perhaps lack of sleep the night before or stress from having to complete a large amount of work. Not surprisingly, they can usually be remedied easily, such as with sleep or relaxation. However, this is significantly different from fatigue, which lasts longer and is not relieved with rest. Fatigue is a state of constant tiredness and weariness to the point where it affects one’s energy levels, concentration, emotional and psychological well-being. The causes are usually more severe and serious than a bad night’s sleep or stress from work, as fatigue develops gradually. Generally, disorders, diseases, or lifestyle habits are the factors behind fatigue.  

Although fatigue is common, it can be a sign of underlying illness. It is important to know that certain conditions such as hypothyroidism, adrenal insufficiency, anemia, diabetes, depression, endocarditis, and sleep apnea can cause fatigue. However, more often than not, the cause of fatigue is less severe. The three main types of fatigue are physical fatigue, emotional fatigue, and psychological fatigue, all of which will be briefly discussed. Physical fatigue can possibly stem from underlying medical condition or physical overexertion, such as in sports. Other sources can be a state of constant busyness or an unhealthy diet. Of course, this is not to say that constantly being busy or having an unhealthy diet will definitely cause fatigue, or that it is the sole reason for fatigue. Emotional fatigue results from dealing with personal life events. Emotions such as grief, confusion, anger, fear, and/or dread can become so intense that they leave the body in a continuously distressed state. When the body is tense and constantly stressed, you can quickly exhaust all of your energy and become overwhelmed by simple tasks. Constant worrying can make it difficult to have a good night’s rest, adding on to one’s fatigue. However, it is important to note that prolonged sleeplessness is a small part of emotional fatigue, and is different from not being able to sleep well one night due to short-term stress. Lastly, there is psychological fatigue, which occurs when there is a significant decrease in the abilities of our skills and output due to emotional and attitudinal factors. Psychological fatigue also has to do with one’s attitude towards life and daily actions, as well as motivation levels.

Since fatigue is usually a symptom or result of something, after determining which type(s) of fatigue is present, it is important to obtain treatment for it, whether through medication or lifestyle changes. For example, if hypothyroidism is the sole cause for fatigue, there is medication that can be taken to treat hypothyroidism, which may in turn decrease or eliminate one’s fatigue. Of course, there may be more complex cases, such as when there are both physical and psychological factors present. Another key point to remember is that there may be a delay between the beginning of treatment and absence of fatigue. For example, depression is not like a common cold in that it can be cured relatively quickly with medication and rest. Those with depression require more time to recover, which would then require more time for fatigue to be reduced or eliminated.

When it comes to fighting fatigue, these tips can be separated into four categories. Dietary suggestions include eating a balanced diet, cutting down on caffeine to rely less on it, not skipping meals, not overeating, staying hydrated, and eating iron-rich food. While these tips seem like general advice given when it comes to diets and eating healthy, they are important in providing one’s body with energy for the day, or even long term. Without proper eating, it is difficult to maintain high energy levels and stay motivated in one’s daily life. Sleeping suggestions involve avoiding naps, sleeping the required hours per night, avoiding sleeping pills, and relaxation (not overthinking) in bed. Lifestyle tips which would help prevent fatigue are to not smoke, not excessively consuming alcohol or drugs, and to exercise. Psychological tips, which is helpful for those suffering from psychological fatigue, include going to therapy, finding someone to talk to, changing up lifestyles, and decreasing stress factors. These tips may seem to be common knowledge or perhaps easier said than done, but without putting in the effort, results would not be seen! It is therefore crucial to figure out what is the cause behind fatigue, and come up with ways to not only treat it, but also to prevent it from reoccurring in the future.

Stephanie Chan
The Autism Spectrum: A Breakdown

           Autism, now known as Autism Spectrum Disorder (ASD), is generally stereotyped to be disability related to a person’s intellect and their ability to interact with others. Along with many other misconceptions, these disabilities tend to be generalized amongst the whole population of people who suffer from it. In truth, symptoms to autism come in a range and its effects are different on different people, which is why its full name respects the range. While it may hurt and hinder some people extremely, symptoms caused by Autism do not affect the lives of others with it. true for the whole population of people with Autism.

       According to the Center of Disease Control and Prevention, almost 1 in 68 children tend to identify as autistic. Autism is diagnosed early in life, usually within two years after birth. Older people tend to raise concern of autism based on their unusual behavior towards others, at school, work or other areas in life. Doctors usually identify and connect behaviors like limited repetitive actions, having intense interest in certain a topic and entertaining oneself in that one thing, or lack of social interactions to ASD. There are also positive effects provided by Autism. Patients with ASD tend to have above average intelligence, excel in mathematics, science or the arts. They are also very detailed people with good memory and have strong visual and auditory learning capabilities. If any of the symptoms mentioned above are present in your child, it is crucial to go to your doctor for an official diagnoses and start thinking of ways to help.

       There are four different disorders that is found under the ASD range. Asperger’s syndrome, which lies on the milder side of the spectrum, tend to cause people to have a harder time socially although does not very much effect their intellect or language. The classic case of ASD is the Autistic Disorder, which is most commonly what people assume Autism is. People with this disorder have significant language delays, intellectual disabilities, communication challenges, social challenges and unusual behaviors, placing it on the more extreme side. Next,  the Pervasive Development Disorder (PDD-NOS), or “atypical autism” whose symptoms are in between the mild and u cases of Autism, putting majority of people diagnosed with Autism under this specific type. The last type of disorder under the ASD umbrella the childhood disintegrative disorder, which is the rarest of them all. This disorder develops in normal children between the ages of 2 and 4 who at some point start to rapidly lose their social, language and mental skills. In addition, with disintegrative disorder, these children also tend to obtain a seizure disorder.

       The struggle of understanding social cues, learning and communicating, it makes life hard for those with Autism. That is why, if you know someone struggling with AST, it is important to know how to help them. To make their lives easier, it is important to make sure the child is safe around their environment and having a safe zone at home—which is a spot at home where they can relax, feel secure and safe. By being consistent in their learning and interactions techniques at school, therapy and even at home, children with ASD have a better chance of learning and understanding. By sticking to a routine, schedule and interaction aids with consistency. Children with this disorder are prone to sensitivity and should be rewarded for good behavior as a positive reinforcement since unhappy feelings may cause them to react in a tantrum. While connecting can be difficult, communication is always key. That is why it’s important to understand where a diagnosed child lies on the Autism spectrum and how to go about taking care of them.

Walida Ali