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Doctors Nix Heroic End-of-Life Measures for Themselves by Fran Lowry

Physicians continue to provide high-intensity care for terminally ill patients even though they do not want the same aggressive treatment for themselves at the end of life.

This conclusion comes from a study presented at the recent meeting of the American Geriatrics Society, which was widely reported in the lay press. The study was published onlineMay 28 in PLoS One.

The findings on physician attitudes about end-of-life care are particularly important because of the “silver tsunami” of older adults who will be needing end-of-life care in the United States and around the world, said lead author Vyjeyanthi S. Periyakoil, MD, director of palliative care education and training at Stanford University School of Medicine in California.

“We have seen large advances in modern biomedicine that have increased longevity but have failed to improve, significantly, a person’s health or quality of life in the 2 years prior to death,” she told Medscape Medical News.

“This results in millions of Americans living with a tremendous burden of major chronic diseases at the end of life,” she explained.

There is also a big disparity between what Americans say they want at the end of life and the care they actually receive, Dr. Periyakoil noted.

“The overwhelming majority of patients, at least 80%, wish to avoid extreme measures to prolong their lives, but their wishes are often overridden,” she said.

“Most patients want to die a peaceful death at home without being a burden to their families, emotionally or financially. But what they want and what they get depends not so much on their preferences or advanced directives, but on their local healthcare system and individual doctors’ practice styles,” she added.

Why the Disconnect?

Dr. Periyakoil and her colleagues sought to determine what factors influence whether physicians choose to pursue aggressive end-of-life treatment for their patients when they would not want it for themselves.

They also looked at how physicians’ attitudes about advance directives have changed since 1990, when the Self-Determination Act was passed, giving patients more control over their end-of-life care.

The study involved 2 cohorts. The first comprised 1081 physicians who completed a Web-based advanced directive form and a 14-item advance directive attitude survey at Stanford Hospital & Clinics and the Veterans Affairs Palo Alto Health Care System in 2013.

The second comprised 790 internal medicine and family medicine physicians from Arkansas who were asked the same 14 survey questions in 1989 but who did not complete an advance directive form (JAMA. 1989;262:2415-2419).

Responses from the 2 cohorts were compared.

“We hypothesized that because advance directives are routine and an accepted healthcare practice, current-day doctors’ attitudes would be much more positive toward them than those in the 1989 group,” Dr. Periyakoil said.

Surprisingly, attitudes changed very little over time.

Because the 1989 and 2013 cohorts were different, “you might argue that we were comparing apples and oranges,” she explained.

There were more women in the 2103 cohort than the 1989 cohort (51.4% vs 7.5%). In the 2013 cohort, 48.9% of respondents reported being an ethnic minority; ethnic diversity for the 1989 cohort was not reported.

In 2103, attitudes about advance directives varied significantly by ethnic group. White and black doctors had similar positive attitudes about advance directives; Hispanic/Latino doctors had the least positive attitudes about advanced directives.

Attitudes also differed by subspecialty in 2013. Physicians from emergency medicine, physical medicine and rehabilitation, pediatrics, and obstetrics and gynecology were more positively disposed to advance directives than physicians from radiology and nuclear medicine, surgery, orthopedics, and radiation oncology.

Differences between the emergency medicine and radiation oncology specialties were notable (success rate difference [SRD], 0.305), as were differences between pediatrics and radiation oncology (SRD, 0.304), emergency medicine and orthopedics (SRD, 0.283), and obstetrics and gynecology and radiation oncology (SRD, 0.280).

FDA Chief on the high costs of cancer drugs

HICAGO (Reuters) – By law, Dr. Richard Pazdur, the U.S. Food and Drug Administration’s cancer drug czar, is not allowed to consider the cost of treatments his agency reviews, only whether they are safe and effective.

But Pazdur is not blind to escalating drug prices and the growing debate over how to place an appropriate value on cancer drugs, which can cost $100,000 a year or more.

“It’s very difficult for me to talk about,” Pazdur said in an interview at the American Society of Clinical Oncology meeting in Chicago, where the issue of value has been a consistent theme among the world’s top cancer doctors.

Instead, he recounts a story about buying his first house in Detroit in 1982.

“I was very nervous. I asked the realtor if I was paying the correct price. She said to me, ‘Rick, the price is what anybody is willing to pay for it.'”

In his view, the same applies to cancer drugs.

“Everybody knows that these are expensive drugs,” he said. “Obviously, we can’t just continue going on with escalating prices of drugs. That’s not a regulatory decision or anything profound from the FDA. It’s just the reality of the situation.”

Pazdur said the solution will likely take “a national dialog” involving all stakeholders – insurers, patients, doctors, lawmakers.

At the ASCO meeting this week, that dialog has already begun. In a forum on drug costs, Dr. Ezekiel Emanuel, the architect of President Barack Obama’s healthcare law, said costs can no longer be ignored. Emanuel reminded his well-heeled audience that the median household income in the United States is $52,000.

“It’s not a lot of money, especially compared to almost everything we do for cancer patients,” he said. Just one costly cancer drug “wipes out the median income household.”

And while the FDA may be barred from considering cost, Dr. John Marshall of Georgetown Lombardi Comprehensive Cancer Center, said the agency might reconsider its standards of deciding which drugs offer enough benefit to win approval.

“Is a $30,000-a-month drug that improves survival by 1.4 months effective? By an FDA standard, yes, if it meets the safety and efficacy data bar. But you would never swipe your VISA card for that kind of advantage,” Marshall said.

Pazdur said FDA cannot suddenly raise the bar on drug approvals, but he said the treatments he is seeing now, based on better science, are already far more effective than ever.

Since 2012, when FDA began implementing its so-called Breakthrough Therapy Designation program, 45% of the drugs that have been granted that designation have been cancer drugs.

“We’re seeing drugs that have higher response rates even in very refractory (drug resistant) populations,” he said. “That is really making us look at how we develop drugs and how we evaluate drugs.”

Better drugs could translate into a shorter regulatory process, cutting the cost of drug development.

“If we can speed approvals, drugs will cost less,” Marshall said.

Omega-3 fatty acids for Parkinson’s Disease

Although the death rate from stroke is declining, it is rising for other neurologic diseases such as Alzheimer disease and Parkinson disease (PD). Unlike in Alzheimer’s, we can pinpoint the abnormality in the brain that leads to PD, a substantial destruction of the dopamine-producing neurons in the substantia nigra. By the time an individual has lost 50%-70% of the dopamine-producing neurons in this region, the symptoms of PD, such as tremor, slowness of movement, rigidity, and impaired balance and coordination, are already apparent. You might think that simply giving dopamine would resolve the symptoms, but any of the initial benefits of dopamine soon erode, leaving the patient trapped in a body that is increasingly less responsive. We also know that PD is associated with neuroinflammation. Therefore, we need a therapy known to both increase dopamine and reduce neuroinflammation. Does any such therapy exist? Yes, and it comes from therapeutic levels of omega-3 fatty acids. I say “therapeutic,” because if you give placebo levels of omega-3 fatty acids to patients with PD, you get placebo effects.

Omega-3 fatty acids have the unique ability to cross the blood-brain barrier that most drugs don’t have. They are also known to increase dopamine levels and reduce neuroinflammation in the brain.[1,2] Furthermore, the omega-3 fatty acid eicosapentaenoic acid (EPA) has been shown to reduce the motor impairments and neuroinflammation in animal models in which the symptoms of PD can be rapidly induced by a drug known as MPTP.[3]

Why don’t we see any clinical trials using high-dose omega-3 fatty acids? Previous trials have all used placebo doses of omega-3 fatty acids — in particular, EPA. I know this because I have published many peer-reviewed articles on the use of high-dose omega-3 fatty acids rich in EPA in the treatment of attention-deficit/hyperactivity disorder (ADHD), major childhood depression, and age-related macular degeneration (AMD).[4-6] Once you give a therapeutic dose of omega-3 fatty acids, especially EPA, you get therapeutic effects. The common reason given for not using high-dose omega-3 fatty acids is the mistaken belief that the patients will bleed to death. That is simply not true, especially if you monitor the ratio of arachidonic acid (AA) to EPA in the blood. As long as the AA/EPA ratio remains above 1.5 (as it is for the Japanese population, whose diet is rich in omega-3 fatty acids through fish consumption), you are not going to have any bleeding problems. But as you get closer to that AA/EPA ratio, you start to see dramatic improvements in neurologic function.

Another problem with human trials is that you have to treat the patients like lab rats. That is, you have to control their entire diet and in particular the levels of omega-6 fatty acids that they are consuming. Whereas omega-3 fatty acids are anti-inflammatory, omega-6 fatty acids are proinflammatory. In fact, increased intake of AA (an omega-6 fatty acid) appears to be correlated with an increased incidence of PD.[7] Another recent study indicated that if you simultaneously reduce omega-6 fatty acids while increasing the omega-3 fatty acids in the diet, the clinical results are significantly improved.[8,9] Maybe that’s asking too much for patients with PD or any patient with a neurologic problem. As a result, we simply continue to look for a “magic drug” that allows patients to eat whatever they want. I don’t think that this is a productive research route for treating PD, let alone other neurologic diseases such as Alzheimer’s, ADHD, AMD, or even chronic headaches.

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Work for your own business as financial service consultant, call Connie 408-854-1883 motherhealth@gmail.com (in 50 US states).

Best diet to prevent Dementia/Alzheimer’s Disease

Medscape: Which foods or dietary patterns were associated with an increased or decreased risk for dementia?

Dr. Isaacson: Although the full results of our work are not yet finalized, we reviewed many dozens of studies, including randomized controlled trials (RCTs) and prospective cohort studies, that evaluated various dietary interventions in normal, nondemented persons; patients with MCI; and patients with AD. The interventions included the Mediterranean diet, omega-3 fatty acids, antioxidants, B vitamins, and low-carbohydrate diets.

On the basis of our preliminary review, a combination of B vitamins (folic acid, B6, and B12) probably improves cognitive impairment in MCI, whereas a Mediterranean diet may improve cognitive function in AD and probably decreases the risk for AD in both MCI patients and nondemented persons.

We also found some promising potential interventions for cognitively normal persons and MCI patients. We found that, for example, specific omega-3 fatty acids are likely to decrease cognitive impairment in MCI, and flavonoids (eg, regular intake of at least 8 oz per week of blueberries and strawberries) may delay symptoms.

On the other hand, there is strong evidence that beta-carotene does not decrease the risk for AD in nondemented patients. There is weak to moderately strong evidence against vitamin E as helpful in nondemented persons and MCI patients; however, a recent RCT found that 2000 IU resulted in slower functional decline and decreased caregiver burden.

Although there is insufficient evidence for a low-carbohydrate diet, one small RCT demonstrated cognitive improvements with a very low-carbohydrate diet, as well as beneficial effect on a number of relevant biomarkers. In addition, preliminary evidence suggests that dietary ketosis may lead to cognitive benefits in a subset of AD patients, although further studies are necessary.

Medscape: On the basis of your findings, what would your take-home message be for clinicians?

Dr. Glazer: AD starts in the brain 20-30 years before the first symptoms of memory loss, and several nutritional approaches, as well as other lifestyle interventions, may be among the most appropriate strategies for managing AD risk that we have today. Dietary interventions should be considered in the management of patients at risk for AD, and probably also in the earliest stages. Aside from being low-risk, these strategies may have other health-promoting benefits (eg, prevention of cardiovascular disease and the metabolic syndrome).

Because currently available pharmacologic interventions may have limited efficacy in some patients, it is necessary to take a more comprehensive, multimodal approach toward AD care. Although our conclusions are based on a preliminary review of the evidence, physicians should consider recommending a Mediterranean diet across the spectrum of AD (stages 1-3), specific omega-3 fatty acids for MCI patients, and flavonoids and B vitamins to those with MCI, as well as to those at risk.

There is less robust evidence toward improving clinical outcomes in dementia due to AD, but this may be attributed to use relatively too late to more meaningfully modify the disease process. As such, dietary interventions may be more helpful in normal, preclinical AD and MCI patients, before they begin to develop functional impairment and dementia.

Our group is currently studying the most effective methods to teach people about these brain-healthy dietary strategies in an effort to understand which methods work best. For busy clinicians who do not have the time or who may not be comfortable with nutritional counseling, we would suggest referral to a registered dietitian, or inviting their patients to participate in an online education research study led by investigators at Weill Cornell Medical College (www.AlzU.org), which uses an online AD nutrition tracking system to longitudinally study outcomes.

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Work for your own business as financial service consultant, call Connie 408-854-1883 motherhealth@gmail.com (in 50 US states).

Exercise Linked to More Diverse Intestinal Microbiome by Niel Osterweil

Professional athletes are big winners when it comes to their gut microflora, suggesting a beneficial effect of exercise on gastrointestinal health, investigators report in an articlepublished online June 9 in Gut.

DNA sequencing of fecal samples from players in an international rugby union team showed considerably greater diversity of gut bacteria than samples from people who are more sedentary.

Having a gut populated with myriad species of bacteria is thought by nutritionists and gastroenterologic researchers to be a sign of good health. Conversely, the guts of obese people have consistently been found to contain fewer species of bacteria, note Siobhan F. Clarke, PhD, from the Teagasc Food Research Centre, Moorepark, Fermoy; Alimentary Pharmabiotic Centre, University College Cork; Microbiology Department, University College Cork; and Alimentary Health Ltd, Cork, Ireland, and colleagues.

“Our findings show that a combination of exercise and diet impacts on gut microbial diversity. In particular, the enhanced diversity of the microbiota correlates with exercise and dietary protein consumption in the athlete group,” the authors write.

The investigators used 16S ribosomal RNA amplicon sequencing to evaluate stool and blood samples from 40 male elite professional rugby players (mean age, 29 years) and 46 healthy age-matched control participants. The researchers evenly divided control participants between those with a low body mass index (BMI), defined as a BMI of 25 kg/m2 or less, and those with a high BMI (>28 kg/m2). Participants also filled out food and exercise questionnaires.

Relative to control participants with a high BMI, athletes and control participants with a low BMI had improved metabolic markers. In addition, although athletes had significantly increased levels of creatine kinase, they also had overall lower levels of inflammatory markers than either of the control groups.

Athletes were also found to have more diverse gut microbiota than controls, with organisms in approximately 22 different phyla, 68 families, and 113 genera. Participants with a low BMI were colonized by organisms in just 11 phyla, 33 families, and 65 genera, and participants with a high BMI had even fewer organisms in only 9 phyla, 33 families, and 61 genera.

The professional rugby players, as the investigators expected, had significantly higher levels of total energy intake than the control participants, with protein accounting for 22% of their total intake compared with 16% for control participants with a low BMI and 15% for control participants with a high BMI.

When the authors looked for correlations between health parameters and diet with various microbes or microbial diversity, they found significant positive association between microbial diversity and protein intake, creatine kinase levels, and urea.

“The article is the first report that exercise increases gut microbiota richness/diversity and highlights that exercise is another important factor in the complex relationship among the host, host immunity and the microbiota,” Georgina L. Hold, PhD, from the Institute of Medical Sciences at the University of Aberdeen, Scotland, writes in an accompanying commentary.

“The fact remains though that our gut microbiota is not programmed to keep pace with the demands that modern life throws at us. Research focused on sustaining health rather than restoring health is urgently needed. Understanding the impact of exercise and the nutritional value of foods in terms of relevance to our microbiota is essential,” she concludes.

The study was funded by a Science Foundation Ireland award to the Alimentary Pharmabiotic Centre at University College Cork. Dr. Clarke is supported by a Teagasc Walsh fellowship. Research in the laboratory of a coauthor is supported by a SFI Principal Investigator award. The other authors and Dr. Hold have disclosed no relevant financial relationships.

Gut. Published online June 9, 2014. Article abstract, Comm

Power Phrases to get what you want by Meryl Runion

Stand up, power up and speak strong.

Speak in a way that elevates you and everyone who hears you.

 

Choose me as your retirement planner for the following reasons: I will help you allocate your idle money to give you lifetime retirement tax-free income with health benefits, I will serve you for a lifetime and help you find ways to save and support the lifestyle that you deserve.

I deserve a 15% raise because…Can you do that for me?

I need an additional week for this project. How can we make that happen?

Tips:

1. It’s not what you say – it’s how you say it.

2. Sometimes silence is golden.

3. Don’t expect the world to communicate in powerphrases.

4. In some situations, no powerphrase will help.

5. Learn and practice the Runion rules for communication.
a. Pass Up Points at a Price
b. Swear Off Sarcasm.
c. Banish the Beam in your own eyes first.  The way you are communicating might be contributing to the way she speaks.
d. Judge you not. Know the difference between discernment and judgment.
e.Know their needs. When someone else needs to talk, it’s your turn to listen.
f. Balance your power
g. Remember the 24-hour power. Wait for 24 hours before you open your mouth.
h.Use your verbal litmus test

 

Fish-rich Diets May Help Balance Leptin, a hunger hormone

Leptin is small protein that’s gotten a lot of press in the past few years. Because it’s able to act like a hormone, and is connected with fat metabolism, leptin has become a molecule of interest to many researchers – including drug companies – who see leptin as a possible tool in weight management. Results in the drug development area have not been very promising so far. However, during this period of time, we’ve learned some interesting facts about leptin, diet, and health.

First, exceeding low or high levels of leptin in our bloodstream appear to reflect health problems. High levels are associated with obesity, and also with higher percentages of body fat. High levels may also signify a change in the body’s sensitivity to leptin, where the body may have lost some of its responsiveness to this protein. Low levels appear to be associated with increased appetite, and difficulty reaching puberty during development. Most of the research in the above areas has been conducted on animals.

If possible, we would probably want to avoid both of the extremes described above. In terms of diet, one approach to avoiding these extremes may involve the level of fish we include in our meal plan.

Thanks to a study conducted on two African tribes and published in the July 2002 issue of Circulation: Journal of the American Heart Association, we may have gotten one clue about avoiding extremes in our blood leptin levels. In this study, higher levels of leptin, potentially associated with problems regulating fat metabolism, were found in low-fish diets. Fish-rich diets were associated with lower leptin levels and potentially fewer problems in regulating fat metabolism.

Practical Tips

Here are a few quick serving ideas from the World’s Healthiest Foods to help you balance your leptin levels by enjoying fish more often:

  • Combine cod, broth, healthy sautéed onions and garlic, and your favorite vegetables and seasonings in a stock pot to make a delicious fish soup.
  • Make fish tacos by wrapping halibut, salsa and guacamole in a corn tortilla.
  • Marinate snapper in citrus juice and honey, then bake.

To learn more about the many other benefits offered by fish, truly some of the World’s Healthiest Foods, click cod, halibut, or snapper.

For some exceptional recipes featuring these fish, click on the Recipe Assistant, select a fish from the healthy foods list, and click on the Submit button. A list containing links to all the World’s Healthiest Foods’ recipes containing the fish chosen will appear immediately below.

Research Summary

The researchers compared leptin levels in two closely related African tribal populations living in Tanzania. The two groups are essentially the same tribe, but they’re separated geographically. One group lives close to a lake, while the other lives inland. The inland-dwelling tribe eats a diet high in fruits and vegetables, while for the tribe living by the lake, freshwater fish is a main component of the diet.

The researchers studied 279 people on the high fish diet and 329 who ate the vegetarian diet. They compared average daily calorie intake and food consumption, BMI (body mass index, a measure of body fat based on height and weight), body fat content, age and gender. Skin-fold thickness was also used to assess body fat. Leptin, insulin and glucose levels were measured after an overnight fast.

The average BMI among the people in the study, regardless of diet, was 20. A BMI value from 18.5 to 24.9 is considered healthy; BMI from 25.0 to 29.9 is overweight; and a BMI value of 30 or greater is obese.

Average daily calorie intake was similar for both groups—2196 for the fish-rich diet and 2109 for the vegetarian diet. The fish-rich diet consisted of 300-600 grams (or approximately 10-20 ounces) of fish per day, with 60-120 grams (g) of maize (corn), 40-60g of beans, 20-40g of spinach, 40-60g of potatoes and 30-50g of rice. The vegetarian diet included negligible amounts of fish with 150-350g of maize, 70-140g of beans, 60-100g of spinach, 100-200g of potatoes and 80-120g of rice.

Among those on the fish diet, men had average leptin levels of 2.5 nanograms per milliliter (ng/mL), and women had an average of 5.0 ng/mL. In comparison, among the tribe eating primarily vegetables, men had average leptin levels of 11.2 ng/mL, and women had average levels of 11.8 ng/mL.

Leptin, which is secreted by fat tissue, may act as a satiety messenger, which in normal-weight people signals “stop eating,” when they have consumed enough food. As people gain weight, however, the body may stop listening to leptin’s message, so more leptin may be produced to get the message across, explains senior author Virend K. Somers, M.D., D. Phil., professor of medicine in the division of cardiovascular disease and hypertension at the Mayo Clinic, Rochester, Minn.

Among the African populations in this study, however, higher body fat was not clearly associated with increased leptin levels. “Regardless of body fat or body mass index (BMI), leptin levels were substantially lower among the fish-eaters than among vegetarians,” says Somers. “We speculate that a fish diet may change the relationship between leptin and body fat and somehow help make the body more sensitive to the leptin message.”

Leptin’s effects on health are not limited simply its relation role in satiety and fat metabolism, but higher levels also correlate with insulin resistance and other markers of the metabolic syndrome, popularly dubbed “Syndrome X,” in which the body’s ability to effectively utilize glucose lessens. Syndrome X is thought to be an initial warning sign of increasing risk for type 2 diabetes.

An earlier study of more than 1,000 men in Scotland published in Circulation in 2001 found that high leptin levels could be used to identify men at increased risk for a heart attack. For each standard deviation increase in leptin levels, the men’s relative risk for heart attack increased by 125%.

In this study, leptin levels were found to correlate with levels of C-reactive protein, a marker of inflammation that is a coronary heart disease risk factor considered even more significant than cholesterol levels. The higher the men’s leptin levels, the higher their C-reactive protein.

In the African tribe study, lead researcher Somers says the low leptin levels among the fish-eating women were particularly noteworthy. Women usually have higher leptin levels than men, but in this study, women who ate the fish-rich diet had lower leptin levels than either the women or the men on the vegetarian diet.

Somers says this finding fits with earlier studies that showed diets high in fish were associated with an improved cardiovascular risk profile, and adds “These results add to the increasing body of evidence pointing to the benefits of fish consumption.”

Fish consumption is very low in most American’s diets, although The American Heart Association recommends at least two servings of fish a week.

References: Somers V, Winnicki M, Phillips B, Accurso V, Puato M, Palatini P, Pauletto P. Fish-rich tribal diet linked with low leptin levels. July 2, 2002 Rapid Access Issue, Circulation. Wallace AM, McMahon AD, Packard CJ, Kelly A, Shepherd J, Gaw A, Sattar N. Plasma leptin and the risk of cardiovascular disease in the west of Scotland coronary prevention study (WOSCOPS). Circulation 2001 Dec 18;104(25):3052-6.

Herbs with Similar Uses as: Ginger

Below is a list of conditions that are treated by this herb and the other herbs that may be used to treat it.

Arthritis

Black Cohosh
Burdock
Cat’s Claw
Cayenne
Celery Seed
Evening Primrose
Feverfew
Flaxseed
Goldenrod
Pau d’Arco
Red Clover
Stinging Nettle
Atherosclerosis

American Ginseng
Arnica
Asian Ginseng
Bilberry
Dong Quai
Evening Primrose
Flaxseed
Garlic
Gotu Kola
Grape Seed
Green Tea
Hawthorn
Licorice
Red Clover
Turmeric
Blood Clots

Turmeric
Bronchitis

Barberry
Ephedra
Eucalyptus
Garlic
Licorice
Lobelia
Marshmallow
Red Clover
Saw Palmetto
Cancer

Aloe
American Ginseng
Asian Ginseng
Bilberry
Cat’s Claw
Celery Seed
Garlic
Grape Seed
Green Tea
Milk Thistle
Pau d’Arco
Red Clover
Rosemary
Turmeric
Chemotherapy Support

Astragalus
Diarrhea

Astragalus
Barberry
Bilberry
Goldenseal
Peppermint
Slippery Elm
Digestive Disorders

Astragalus
Barberry
Celery Seed
Dandelion
German Chamomile
Goldenseal
Green Tea
Jamaica Dogwood
Lemon Balm
Licorice
Peppermint
Roman Chamomile
Saw Palmetto
Slippery Elm
Turmeric
Yarrow
Hypercholesterolemia

American Ginseng
Asian Ginseng
Celery Seed
Dandelion
Evening Primrose
Flaxseed
Garlic
Grape Seed
Green Tea
Hawthorn
Licorice
Milk Thistle
Red Clover
Turmeric
Infantile Colic

German Chamomile
Lemon Balm
Turmeric
Wild yam
Inflammation

Aloe
Barberry
Bilberry
Burdock
Cat’s Claw
Celery Seed
Comfrey
Devil’s Claw
Echinacea
Eucalyptus
Flaxseed
German Chamomile
Goldenrod
Grape Seed
Jamaica Dogwood
Licorice
Marshmallow
Pau d’Arco
Roman Chamomile
Saw Palmetto
Skullcap
Slippery Elm
St. John’s Wort
Stinging Nettle
Turmeric
Uva Ursi
Wild yam
Willow Bark
Yarrow
Nausea

Grape Seed
Peppermint
Roman Chamomile
Wild yam
Osteoarthritis

Black Cohosh
Burdock
Cat’s Claw
Cayenne
Devil’s Claw
Flaxseed
Stinging Nettle
Turmeric
Willow Bark
Stomach Upset

Dandelion
Devil’s Claw
Feverfew
Goldenseal
Lemon Balm
Peppermint
Roman Chamomile
Turmeric
Valerian
Yarrow
Ulcerative Colitis

Evening Primrose
German Chamomile
Green Tea
Marshmallow
Slippery Elm

https://umm.edu/health/medical/altmed/herb-use-links/herbs-with-similar-uses-as-ginger

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Connie Dello Buono

Prevent vascular disease, manage inflammation, get GYV health caps to boost ATP cells performance and speedy repair of your body, email connie to get the caps and join in spreading the benefits with extra income for you at motherhealth@gmail.com and text 408-854-1883

motherhealth@gmail.com (in 50 US states).

Mullein herb for lung and breast health – COPD signs, symptoms and diagnosis

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is the term used to describe chronic lung conditions that cause severe shortness of breath and block the airways in your lungs. Usually it refers to long-lasting bronchitis or emphysema, but can also include asthmatic bronchitis (bronchial asthma). All of these diseases cause the air sacs and tubes in your lungs to become blocked.

In the year 2002, they reported that mullein leaf extracts are potent against some species of bacteriaespecially against klebsiella pneumonia, Escherichia coli, staphylococcus aureus and epidermidis that are commonly found on lungs and skin.

With chronic bronchitis, a constant cough that produces mucus causes bronchial tubes to become inflamed. Eventually, scar tissue forms in the lungs, which don’t allow in as much oxygen as you need. With emphysema, the walls of your lungs lose their elasticity — they can’t constrict to allow you to exhale. People with COPD can have either or both of these diseases.

The main risk factor for COPD is smoking. There is no cure for COPD, and while treatments may help control symptoms, they can’t undo the damage to the lungs. The most important thing you can do to prevent COPD or to stop the damage from getting worse if you have it is to not smoke.

Signs and Symptoms

Ongoing cough, often with phlegm that may be hard to “bring up”

  • Shortness of breath, especially during exercise
  • Production of increased mucus
  • Difficulty exhaling
  • Wheezing
  • Frequent respiratory infections

Causes

Smoking is the primary cause of COPD. It can also be caused by exposure to pollutants or toxic chemicals. One rare form of COPD is inherited (see Risk Factors).

Risk Factors

  • Smoking — the longer you smoke and the more packs of cigarettes you smoke, the higher your risk. People who smoke pipes and cigars, and those who are exposed to large amounts of secondhand smoke, also have greater risk.
  • Genetics — people with a rare hereditary disorder called alpha-1 anti-trypsin deficiency lack an enzyme that helps protect the lungs from damage
  • Being over age 50
  • Exposure to toxic chemicals such as silica or cadmium
  • Working around industrial smoke, excessive dust, or other air pollutants (for example, miners, furnace workers, and grain farmers)

Diagnosis

Your doctor will listen to your chest for wheezes and decreased breath sounds. He or she will also look for signs that you are having trouble breathing, like flaring of your nostrils and contracting of the muscles between your ribs. Your respiratory rate — number of breaths per minute — may be high.

Your doctor may order tests to determine your lung function. The most common test is spirometery, where you’ll be asked to blow into a tube connected to a machine called a spirometer. The spirometer measures how much air you have in your lungs, and can help detect COPD before your symptoms become obvious.

Your doctor may also order a chest x-ray will to look for over-expanded areas in the lungs; a CT scan to check the severity of your COPD; an examination of your sputum; or a blood test to measure the levels of oxygen and carbon dioxide in your blood.

Preventive Care

  • If you smoke, quit.
  • If you have COPD, avoiding respiratory infections is very important. Your doctor will recommend that you receive an influenza vaccine (flu shot) each year and a pneumococcal vaccine to protect you from pneumonia.
  • Eating foods rich in antioxidants, magnesium and other minerals, and omega-3 fatty acids (including fruits, vegetables, and fish) may help lower your risk for COPD.

Treatment Approach

Not smoking is the key to preventing COPD or stopping it from getting worse. Treatment varies depending on the severity of the disease. Your doctor may talk with you about lifestyle changes you can make to help relieve the symptoms of COPD, such as exercising and eating a healthy diet. Support groups or therapy (see Mind/Body Medicine) can help make it easier to live with the condition.

Lifestyle

Quitting smoking is crucial. Other lifestyle measures you can take include dietary changes and exercise as described below.

Diet

People with COPD often lack essential nutrients in their bodies. Low levels of antioxidants and certain minerals including vitamins A, C, and E, potassium, magnesium, selenium, and zinc are associated with having COPD and may contribute to poor lung function. Eating lots of fruits, vegetables, and whole grains is recommended to get the nutrients you need.

Exercise

Although it may seem strange to recommend exercise when you have trouble breathing, exercise does help many people with COPD. By strengthening your legs and arms and improving endurance, you may be able to breathe better. Walking is a good exercise to build endurance. Talk to your doctor and respiratory therapist about how to build up slowly and safely. Participating in pulmonary rehabilitation is the best way to learn exercise and safe breathing techniques (see below).

Breathing

There are breathing exercises — for example, a pursed lip technique, breathing from the diaphragm, or using a breathing device called a spirometer twice a day — that may help improve lung function. You can also learn which breathing and relaxation techniques work best when you are short of breath. Talk to your doctor about working with a respiratory therapist in order to learn such exercises.

Medications

None of the current medications for COPD has been shown to stop the long-term decline in lung function. However, there are several types of medications used to control symptoms.

  • Bronchodilators — increase airflow by opening airways and making it easier to breathe
  • Corticosteroids — reduce inflammation; either inhaled with an inhaler or taken by mouth, they are usually used to treat moderate to severe COPD
  • Leukotriene modifiers — help prevent inflammation and swelling in airways, and reduce mucus
  • Antibiotics — used to treat respiratory infections
  • Combination therapy — taking inhaled corticosteroids and bronchodilators together is an effective treatment in stable COPD

Surgery and Other Procedures

When flare ups are severe, requiring hospitalization, you may need supplemental oxygen. At later stages of the disease, many people with COPD need continuous oxygen at home.

Lung reduction surgery is a procedure where a surgeon removes damaged parts of your lung to create more space for your lung to work better. A lung transplant is sometimes done for severe cases of COPD.

Nutrition and Dietary Supplements

Because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable health care provider. Be sure to talk to your physician about any supplements you are taking or considering taking.

  • N-acetylecysteine (NAC, 400 – 1,200 mg per day)
    NAC is a modified form of a dietary amino acid that works as an antioxidant in the body. Several studies using it to treat COPD suggest that it may help relieve symptoms by acting as an antioxidant in the lungs. Although not all the studies agree, some suggest that taking NAC can reduce the number of attacks of severe bronchitis. NAC also helps to thin mucus and lessen symptoms. Some doctors think NAC may be absorbed into the mucus in the lungs and make the lungs more resistant to bacterial infections. Do not take NAC if you take nitroglycerin.
  • Magnesium
    People with COPD often have low levels of magnesium. Lack of magnesium may be associated with poor nutrition — often a problem for people with COPD — or it may be caused by drugs taken to manage COPD. Magnesium is important for normal lung function. One study found that giving intravenous (IV) magnesium to people who were having a flare-up of COPD helped them breathe easier and reduce the number of days they spent in the hospital. Scientists don’t know whether taking magnesium orally would have the same effect. Your doctor may recommend checking your magnesium level through a simple blood test if you have COPD and taking magnesium supplements if your levels are low. Magnesium can lower blood pressure and cause diarrhea, and it interacts with a number of medications. Talk to your doctor before taking magnesium supplements.
  • L-carnitine
    A few studies suggest that L-carnitine may help people with COPD increase the amount they can exercise. People with hypothyroidism or a history of seizures should not take l-carnitine. Taking l-carnitine may increase the effects of the blood-thinner warfarin (Coumadin) and possibly other blood-thinners.

Herbs

The use of herbs is a time honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care and only under the supervision of a practitioner knowledgeable in the field of herbal medicine. Also, be sure to talk to your physician about any herbs that you are taking or considering taking.

  • Eucalyptus (Eucalyptus globulus) — is frequently used in cough drops and acts as an expectorant, which means that it loosens phlegm in your lungs. A combination of eucalyptus, a kind of citrus oil, and an extract from pine called essential oil monoterpenes has been studied for respiratory problems. In one study, essential oil monoterpenes appeared to help prevent acute flare ups of chronic bronchitis. Breathing in strong concentrations of eucalyptus oil may be irritating. Do not take eucalyptus oil by mouth.
  • Ginseng (Panax ginseng, 100 mg per day) — One study suggested that taking ginseng helped people with COPD improve their exercise tolerance and lung function, but more studies are needed to see if there is any real benefit. Ginseng may lower blood sugar levels, so people with diabetes should ask their doctor before taking it. Ginseng increases the risk of bleeding, especially if you already take blood-thinners such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin. Ginseng can also interact with a number of other medications, so it’s best to talk to your doctor to see if ginseng is safe for you. Some people may find ginseng to be stimulating and that it makes insomnia worse. Do not take ginseng if you are pregnant or breastfeeding, or if you have a history of or are at risk for hormone-related cancers such as breast cancer, uterine cancer, or ovarian cancer.
  • Lobelia (Lobelia inflata)
    Also called Indian tobacco, lobelia has a long history of use as an herbal remedy for respiratory problems including bronchitis. It is an effective expectorant, meaning that it helps clear mucus from your lungs. However, lobelia can be toxic and should not be used except under a doctor’s supervision. Lobelia can interact with lithium and other medications.
  • Mullein (Verbascum densiflorum, 3 g per day)
    Mullein is an expectorant, meaning it helps clear your lungs of mucus. Traditionally, it has been used to treat respiratory illnesses and coughs with lung congestion. However, it has not been studied for COPD.

Acupuncture

Preliminary studies suggest that acupuncture may help relieve shortness of breath in those with COPD. More research is needed.

If you are trying to quit smoking, acupuncture can help you break the habit.

Mind/Body Medicine

  • COPD is a difficult disease to live with, and joining a support group where members share common experiences and problems can help relieve stress of the disease.
  • Yoga and tai chi use deep breathing techniques and meditation, and may be helpful for someone with COPD. Ask your doctor whether these practices are right for you.
  • Relaxation techniques may help reduce anxiety and shortness of breath associated with COPD.

Diets and relationship with parasites

See anti-parasitic and anti-gout diet in this site and volume 1 ebook on curated cancer-free healing ways.

Supporting Research

Ambrosino N, Palmiero G, Strambi SK. New approaches in pulmonary rehabilitation. Clin Chest Med. 2007 Sep;28(3):629-38, vii. Review.

Bartolome R. Update on the management of COPD. Chest. 2008;133(6).

Booker R. Chronic obstructive pulmonary disease. Part two–management. Nurs Times. 2007 May 1-7;103(18):28-9.

Bourjeily G, Rochester CL. Exercise training in chronic obstructive pulmonary disease. Clin Chest Med. 2000;21(4):763-781.

Cahalin LP, Braga M, Matsuo Y, Hernandez ED. Efficacy of diaphragmatic breathing in persons with chronic obstructive pulmonary disease: a review of the literature. J Caridopulm Rehabil. 2002;22(1):7-21.

Chuck A, Jacobs P, Mayers I, Marciniuk D. Cost-effectiveness of combination therapy for chronic obstructive pulmonary disease. Can Respir J. 2008;15(8):437-43.

Collins EG, Langbein WE, Fehr L, Maloney C. Breathing pattern retraining and exercise in persons with chronic obstructive pulmonary disease. AACN Clin Issues. 2001;12(2):202-209.

Davis CL, Lewith GT, Broomfield J, Prescott P. A pilot project to assess the methodological issues involved in evaluating acupuncture as a treatment for disabling breathlessness. J Altern Complement Med. 2001;7(6):633-639.

Ferri F. Ferri’s Clinical Advisor 2009, 1st ed. Philadelphia, PA: Mosby Elsevier. 2009.

Gigliotti F, Romagnoli I, Scano G. Breathing retraining and exercise conditioning in patients with chronic obstructive pulmonary disease (COPD): a physiological approach. Respir Med. 2003;97(3):197-204.

Gross D, Shenkman Z, Bleiberg B, Dayan M, Gittelson M, Efrat R. Monaldi Arch Chest Dis. 2002 Oct-Dec;57(5-6):242-6. Ginseng improves pulmonary functions and exercise capacity in patients with COPD.

Guell R, Casan P, Belda J, et al. Long-term effects of outpatient rehabilitation of COPD: A randomized trial. Chest. 2000;117(4):976-983.

Guo R, Pittler MH, Ernst E. Herbal medicines for the treatment of COPD: a systematic review. Eur Respir J. 2006 Aug;28(2):330-8. Review.

Jaber R. Respiratory and allergic diseases: from upper respiratory tract infections to asthma.Prim Care. 2002;29(2):231-261.

Jones A. Causes and effects of chronic obstructive pulmonary disease. Br J Nurs. 2001;10(13):845-850.

McKeever TM, Scrivener S, Broadfield E, Jones Z, Britton J, Lewis SA. Prospective study of diet and decline in lung function in a general population. Am J Respir Crit Care Med. 2001;165(9):1299-1303.

Qaseem A, et al. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians. Annals of Int Med. 2007;147(9):633-8.

Rahman I, Kilty I. Antioxidant therapeutic targets in COPD. Curr DrugTargets. 2006 Jun;7(6):707-20.

Romieu I, Trenga C. Diet and obstructive lung diseases. Epidemiol Rev. 2001;23(2):268-287.

Seamark DA, Seamark CJ, Halpin DM. Palliative care in chronic obstructive pulmonary disease: a review for clinicians. J R Soc Med. 2007 May;100(5):225-33. Review.

Smit HA. Chronic obstructive pulmonary disease, asthma and protective effects of food intake: from hypothesis to evidence? Respir Res. 2001;2(5):261-264.

Stey C, Steurer J, Bachmann S, Medici TC, Tramer MR. The effect of oral N-acetylcysteine in chronic bronchitis: a quantitative systematic review. Eur Respir J. 2000 Aug;16(2):253-262.

 

How my dad shaped me as a person

He is my role model, working hard and caring for the family.

He told me to find a man who will travel many mountains just to find me.

To be ambitious and not settle for less.

To finish college and help my younger siblings as the eldest in the family of 6.

To support my mother and siblings when I am able to.

To care for my children and instill generosity, love and happiness in them.

To have a sense of humor at all times and to accept failure with grace.

To be compassionate to the older generation and respect them.

To be a woman, mother and sister to those around me.

Happy Father’s day this June 15, 2014.

A toast to all fathers who raised their children well, loved and showed compassion and generosity.

Coconut oil, ground ginger, ground cayenne pepper, ground turmeric, grapeseed oil as anti-arthritis balm for pain relief

Pain relief in a cream

I was searching for an anti-arthritis pain relief in a cream, balm or oil at a drugstore last night and I could not find one with ginger. My mom loves the effect of ginger balm when she massage her aching body at age 78.

DIY anti-arthritis balm

So, here is a DIY anti-arthritis balm t hat works wonder in many pains and aches in your body when applied as massage balm.

Heat 1/2 cup of coconut oil or Grapeseed oil  in the microwave for about 30 seconds or until melted. Combine in large bowl with 1/2 cup of light oil and 1 tablespoon ground cayenne pepper, ginger and turmeric.Place the bowl in the refrigerator for about a half hour.

If you have light or fair skin don’t use the turmeric. If you decide to do ginger and cayenne then you want to replace the tablespoon of cayenne in the recipe with 1 1/2 teaspoons each of ginger and cayenne. If you want to use all three then use 1 teaspoon of each. Remove bowl from refrigerator. Using blender to whip on medium high speed for about 10 minutes or until creamy. Spoon into an airtight container and place it back in the refrigerator until hardened.

Anti-arthritis : Ginger and Turmeric

Ginger and cayenne are powerful pain relief no matter what you choose. All are 100% natural and safe to use. How to use it: Massage a small amount into your skin over the area that hurts for about 30 seconds. You might feel a slight warming sensation. That is the capsaicin in the cayenne pepper (or ginger or turmeric) which is what relieves the pain.

You should start to feel immediate relief but if after 20 or 30 minutes you are still hurting you can apply more. It is safe to apply as much as you like. Make sure to rub it in thoroughly for it to work and to wash your hands before touching your eyes or mouth. The cayenne or cayenne and ginger will not stain your skin in any way. I have the palest ivory skin and haven’t had a problem with the either staining my skin.

The turmeric may discolor your skin temporarily if you have light skin. If this bothers you then skip the turmeric when making the recipe. What you can use it for: Everything that pains you. From migraines to back aches to arthritis, this pain relieving body butter will not only leave you pain free but silky smooth too.

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Connie Dello Buono

Need a caregiver for your homebound parents and get a free ginger massage oil, contact us at motherhealth@gmail.com and text 408-854-1883

Motherhealth LLC, for affordable and compassionate in-home caregiving

Our current health is affected by prolonged sitting at work for 8 hours and doing tasks faster with current technologies

At what costs? Obesity costs American companies $225.8B per year in health-related productivity losses.  The average healthcare cost exceeds $3,000 per person annually. An obese employee costs employer additional $460 to $2,500 in medical costs and sick days per year. Some companies offer healthy foods, ergonomic environment, and a gym.

If you do not have the above at work, try to insert 30 min of exercise before going to work. And companies should get help from health coaches to provide extra service for one-on-one health coaching by phone or in group settings.

We need to be motivated on a daily basis on the right way to a healthy living, at work and outside of work.

We commend those companies who believe that the health of their employees is their priority.

Stress is the biggest factor in losing extra weight and maintaining a healthy body. So let us not pressure our employees to deliver tasks at shorter time and use encouraging words to motivate them.

In the bay area, we can add the long commute as another factor affecting our stressful lifestyles.  And next to that is high cost of housing, making it impossible for one parent to stay home during the early years of their children. What do you think are other factors affecting our health in the bay area? Your feedback is very important.

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