Saturday, April 12, 2014

MIND BODY TEMPLE: HOW I LOOK AND HOW I FEEL

Life is a spectrum. It is a flow of interconnected existence from inside out and outside in. There is a famous saying that how I look affects how I feel. When I was younger and fresh out of school I could never understand this and it even sounded silly to me. I was trained to be an intellectual equipped with science and practice of medicine. The only real values to me were higher intellectual values and they had nothing to do with the way one would look. This belief of mine was enforced by seeing the most influential minds of our history of mankind having the most possible simple lives and looks. To me there was a total disjoint between the higher brain functions and intellectual values with superficial materialistic issue of how one may look.
 It took me many seasons in life with much more lessons to learn from university of real life to realize that there is much more into our spectrum of life than what I was thought at our conventional school. It was through many tragic life experiences and encountering tens of thousands of patients over the past 25 years that it finally started to make sense. It has always been there to see for the one who really looks.
Human's history of life is filled with the expression of art in different forms and shapes. It has been through creating beauty, order and harmony that we have tried to connect to nature. Even more than that is our attempts to compensate for the imperfections through creating arts and beauty. By creating better looks of self and others we get closer to the perceived perfection and that makes us feel better. Once we feel better, it is like we are closer to our life source and feel stronger.
Now it makes sense. This is why cancer patients who have lost hair to chemotherapy wear beautiful wigs or scarfs and that gives them more strength to fight.
HOW I LOOK AFFECTS HOW I FEEL AND HOW I FEEL AFFECTS MY PERCEPTION OF EVERYTHING. MY BODY SENSATIONS AFFECTS MY FEELINGS AND MY FEELINGS AFFECTS MY THOUGHTS. MY THOUGHTS AFFECTS MY FEELINGS AND MY FEELINGS AFFECTS MY BODY SENSATIONS. IT IS A SPECTRUM OF LIFE, A CONTINUOUS BOND FROM INSIDE OUT AND OUTSIDE IN. AN INTERCONNECTED TEMPLE OF MIND AND BODY.
To understand it better, one has to look at the whole picture and take care of the whole person. Being focused on only the pieces would never give us the whole picture.

Saturday, February 8, 2014

ALL MY TESTS ARE NORMAL, SO HOW CAN I HAVE SO MUCH PAIN?

We often face this confusing picture when a patient searches through their test results to find the reason for their severe pain. When we have a medical condition, it is a natural reaction to ask for all the latest possible tests for that condition to find the reason behind it. We go through so many painful, long or expensive tests to find out why we have so much pain. When it comes to trying to get rid off sever pain, nothing seems too remote and we want to get to the bottom of the issue.
It becomes so frustrating for pain patients when they go through all the possible tests hoping they can find the source of their pain and the test results come back normal. It becomes a very personally and emotionally taxing issue. Pain patients already have to fight the world around them to prove their pain to them. As the pain cannot be seen and can only be felt by the affected patient, people tend to have difficulty understanding it and even worse, having difficulty believing it. Now imagine how hard it is for someone who has difficulty with others who don't believe their pain, facing normal test results of their thorough investigations.
If the pain is real, why the source can't be found in test results?
The answer lies behind the actual nature of chronic pain. In many instances, the chronic pain is not a result of any structural damage to the tissues we examine. In many cases it is a state of malfunction in the nervous system and most of our tests are designed to check the structure of tissues and not their function. So having a negative test results is helpful to rule out many different structural problems. It can help to rule out things like cancer, ligament -bone -tendon -cartilage damages or nerve tissue degeneration. Basically the negative test result can help you to know what you don't have and not always helpful in knowing what you have.
It certainly is not an indication of invalidity of your pain. Your chronic pain is real even if all your test results are normal. It can happen.
That is why we should always treat the patient and not the test results!

Wednesday, December 18, 2013

CHANGE YOUR MIND, CHANGE YOUR WORLD, WHAT DOES IT MEAN?

If it is true that the way we perceive the world around us shapes our reality, then our mind determines our position towards the world around us. The reality that we seem to be so sure of is in fact a very relative matter. A single piece of reality may be perceived as three different forms of interpretation by three different observers. So if  the reality is so relative, then the way our mind looks at each event, would shape our understanding or experience of that moment. It is like our mind shapes our understanding of our realty. Once we accept this, then we can understand that if my mind shapes my experience of reality, then by changing my mind I should be able to experience a different version of the same reality. So by changing our mind we can have a changed experience of our world.
It may be difficult to imagine any change in reality when we deal with severe debilitating chronic pain. But the fact is that we are able to handle the same debilitating pain better when we are in a better mood. We may be less irritable and more tolerable at the same life circumstances in different times or moods. The way we think affects the way we feel and our feelings affect our body sensations. So pain sensations can be intensified by negative thinking. This is the basis of cognitive therapy. In cognitive therapy the therapist tries to change the way one thinks about an event. Once the outlook of patient to an event changes, the feelings would change as well. The changed feelings would affect the body sensations. That is how one would change the experience of their world by changing the way they think.

Monday, December 16, 2013

WHY CORTISONE SHOT?

Cortisone is the general name we give to a group of medications called corticosteroids. Our body naturally makes corticosteroids from our adrenal glands. It is called cortisol and our body uses it to deal with stressful situations. When we face a stress the levels of serum cortisol increases. It gives our body a boost by series of effects like increasing the blood sugar level and increasing the energy to fight the situation.
In Medicine we use Cortisone for reducing inflammation. In fact cortisone family is one of the best anti-inflammatory family of medications we have. We divide arthritic diseases into two big classes of inflammatory and degenerative.  Cortisone is used in inflammatory types of arthritis to reduce inflammation. Inflammatory elements that are released by inflamed tissues cause pain and tissue destructions. That is why the use of cortisone reduces pain in these patients. Many non arthritic conditions like bulging discs or plantar faciitis also may respond well to cortisone.
This family of medications comes in different forms like pills, creams, sprays and injections. We use cortisone injection to deliver this medication exactly to the area of inflammation. Recently by use of image guidance through X-Ray, ultrasound or CT scan the use of cortisone has improved as the precision of injection has increased.
Cortisone has side effects as well. It can weaken ligaments an tendons. It can also increase blood sugar in diabetic patients. Some patients gain weight, grow facial hairs, have skin color changes at the site of injection, develop osteoporosis or sometimes bone necrosis in hip due to this medication.
It is very important that this medication be used appropriately for proper indication and the right amount.
Cortisone can be a miracle maker, only if used appropriately.

Saturday, December 14, 2013

ULTRASOUND GUIDED INJECTIONS

Ultrasound can be used to help physicians to perform image guided injections. It means that the treating physician would use ultrasound to look at the anatomy of the area to be injected and use the guidance of image for performing the injection more precisely.
Benefits: Performing more precise injections by seeing where the needle is going to. Observing real time injection procedure while it happens to now when to start and when to end. To make sure the needle is not in blood vessel. To differentiate different types of tissues under the ultrasound image. To be able to diagnose some issues with tissues before starting treatments. It helps to get to the exact desired point of injection.
Limitations: The deeper the lesions, the lower the image resolution under ultrasound would be. The ultrasound's benefits are dependent to the operator's techniques. Physician needs to know about the local anatomy and understand the sonoanatomy. Ultrasound cant penetrate the bones and creates shadows when it reaches the bones. If bones are to be evaluated, X-Ray needs to be used.
In summary, it is a good tool in hand for when anatomical landmarks alone cannot be trusted for precision or safety of an injection.

Tuesday, November 19, 2013

THE HEALING EFFECT OF LIVING THE PRESENT MOMENT

It is hard to describe something that is so hard to do. It is not easy to be present at the moment and truly live at this moment, not the past or the future. It becomes more complicated if we think about the healing effect of being present at the moment because: How can we be present at this moment if we are focused on its effect in future? If HEALING is something we seek and we are looking forward to it's happening, then we are focused on future and can't be fully present at this moment.
It is hard to do something for the simple sake of doing it without thinking about the effects that action would have and what we would like to happen as a result of doing that. It is such a paradox, it is hard and yet it is so simple. In fact it is our nature's default setting. It is the way we were supposed to be when we were born, before we were programmed to be sad about the past and worried about the future. But it is still hard to explain, yet easy to experience. The difference is between doing and being. If we stop focusing on doing the action of living the present moment and trade it with actually being at the present moment, the way we feel suddenly changes. There is a pleasant feeling of joy and peace that emerges from within. This feeling is the opposite of sadness and worry or one can say Depression and Anxiety. If one gets used to being in this state more often, the mind gets used to being in this mode. Joy and peace become the new habit and help healing the mental ailments like depression and anxiety. These consequences happen as a result of our internal changes of brain circuits and chemistry. It is amazing how living the way we are supposed to live and being the way we are supposed to be would make us feel so much better. The good thing about this is that once we learn to be this way, it is a new way of life and it is not only useful for our healing, but it will help us to feel good for the rest of our life, so long we continue to be present at every single moment. It is like being born again into a new life, a life we were designed by nature to live. The magic is that by being present at the present moment, nothing really changes, but at the same time it feels like everything has changed. This is how healing happens.