Thursday, April 12, 2007

Taking some control over one's own health

Although I am not a physician or dentist, I am part of the medical/dental establishment. I work in a medical faculty, I lecture to physicians (mainly about bad breath and body odors), and I do medical research.
We teach our medical and dental students to deal with disease, but we never stop to consider whether there is one standard definition for this word. Wikipedia's current definition of disease is:
The term 'disease' refers to any abnormal condition of an organism that impairs function. In human beings, "disease" is often used more broadly to refer to any condition that causes discomfort, dysfunction, distress, social problems, and/or death to the person afflicted, or similar problems for those in contact with the person

I spend considerable time talking with my students about what constitutes a disease? Is having a stuffy nose a disease? According to the definition above, it is an abnormal condition, impairing function, and causes discomfort. What about a 'hangover', a 'blister', a 'beesting', even a 'mosquito bite'. Each of these would fit the above description, although few of us would refer to these abnormal conditions (causing discomfort) as disease.

In extreme cases, of course, such as unfortunate people with terminal types of cancer, heart failure, etc., there would be much consensus. But what about all the physical challenges in between? Do they constitute disease.

Some people cope better with a cold or the flu than others. They get up, go to work, and do not consider themselves as disease-ridden. Others run to their doctor for prescriptions, get into bed and moan for days.

So what constitutes a disease is actually in the eyes of the beholder. A life-threatening disease for one may be just a bad hair day for another.

Which brings me to the topic of today's posting. I think that people today do not seek enough control over their own health. The moment they feel unwell, they run to the doctor. If the doctor prescribes medication, they take it. If the surgeon recommends surgery, they go under the knife (or lapyroscope, these days). If the dentist tells them they need sixteen teeth capped, so be it.

But physicians are only human and they don't always get it right. By the way, not all of what we teach them in med school turns out to be correct in the long term. Medications and procedures come and go. Vitamins are in one year, out the next.

That doesn't mean that you shouldn't go to the doctor, especially if you are feeling extremely bad. But sometimes your body can fix itself and sometimes you can play an active role.

I am inventor, and when I am not feeling well, I sometimes try to find my own ways of feeling better. If I fail, I go see a doctor. But I've succeeded twice, and lived to tell. So here it is:

About twenty years ago, I had terrible rectal pain and bleeding. Defecation was unbearable. Sitting was tortuous.

I made a date to see a proctologist (actually a tremendous fellow, Prof. Wishnitzer, I should write about him someday) who was the Dean of the Medical Faculty and had accepted me as a young lecturer in 1982. I went to his office and entered his waiting room. There were lots of people waiting. All of them were standing. There wasn't a single chair, who could use one? So I stood and waited and thought to myself: "I'm waiting to see a proctologist. He is a surgeon. Surgeons perform surgery. He's going to operate on my tuchus (ass) !"

I hurried home, and the terror of having my rectum restructured prompted me to experiment. To make a long story short, I found that just by sitting in a different position on the toilet seat, I could greatly ease the pain and discomfort. The bleeding disappeared, and I have been fine (at that end of my body) for years. (Again, please don't misunderstand. If the bleeding had continued, I would have gone back within a few days.)

The second story has to do with my esophagus. When I was 40 I started to have terrific reflux pains. I would awake in the middle of the night, choking on regurgitated food coming out of my nose. It turns out that I have something called achalasia. It's a rare problem in which the nerves of the esophagus don't communicate with the muscles telling them to push down the food into the stomach (peristalsis). So the food just hangs around in the esophagus, the sphincter at the entrance to the stomach goes into spasm (like a clenched fist), and food can go up, but not down. That summer of 1993, I flew to a scientific meeting with my wife, and ended up throwing up all over Rhode Island and Boston. Some of you may have noticed. I went from being chubby to emaciated, and had to be rescued by something called "pneumatic dilation". Which means that doctors stick pipes down your throat, and blow up a balloon which rips and tears the muscles of the sphincter. It's an excrutiatingly painful process, and to make it worse, they don't put you under (they need you awake in case they perforate your esophagus, in which case you are in danger and need a quick operation). This procedure eventually allowed me to recover some of my weight and stamina. But after seven or eight years, the troubles returned (the doctors neglected to tell me that this is what usually occurs) and I was back to my old puking self. So I went to see the most prominent surgeon in the country who does these kinds of things. "We'll do a new operation" he suggested (I hate 'new' operations, it makes you feel like such a guinea pig), " called a Heller myotomy where we'll make five incisions in your sphincter, and then do a fundoplication, stapling a part of your stomach around the sphincter. You'll feel like a million bucks".

Yuck! So my resentment of having physicians turn me into a Lego came into play. I tried everything. Yoga, diet, stretching, bending, you name it. And I hit on a solution. I found that just by eating a bit of dark chocolate (at least 70%, better 80% or more) before meals, I could get the food down with (relative) ease. I must admit that my being a scientist helped out here. Chocolate is a drug (a highly benevolent one in my opinion if you use cocoa or extremely bitter chocolate) that affects the nerves in the body. Probably, the same way that it causes other people heartburn (by relaxing the sphincter at the entrance to the stomach) by allowing acid to pass upward, in my case, it allows the food in my esophagus to go downwards. So people with achalasia, wherever you are, take heart. Try cocoa or bitter chocolate right before meals, and let me know. And feel free to e-mail me for more suggestions.

Interestingly, very religious Jews have a different way of doing things. When someone is ill, I mean really life-threateningly ill, they do not go directly to the doctor. What they do is go to the Rabbi. In the Jewish religion, it is the duty of the Rabbi to find the best solution, medical or otherwise. Here in Israel, the greatest maven in grave health problems is Rabbi Fuhrer. Hospitals confer with him. He literally searches the world for the greatest expert for a given problem. I am not advocating that everyone do this, just sharing.

Finally, we have a lot more control over our health than we realize. Do we exercise enough? Do we sleep enough? Do we laugh enough (good medicine for many things)? Do we love enough? Do we eat too much of everything, especially fats, sweets and salt (which are primitive needs of our ancient biology)? Do we smoke too much? All these are factors that we can control, and which have more influence over our health than many medications and interventions.

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