Lifestyle and Neuropathy interview with an expert in the field

Okay, most HIV patients who also have neuropathy, try to change their lifestyle in some way, to try reduce some of the worst effects of the disease. That's normal; it's not obligatory, it's just a normal reaction to try something out if someone advises you that it will help...so how does a bad diet, drinking and recreational drug use affect people's neuropathy? These are just some of the questions in this interview for Aidsmap.com files (see link below) with Dr Hadi Manji, one of only a handful of neurologists in the UK with extensive clinical experience of HIV-related neuropathy.

ATU: How can you tell whether the neuropathy is caused by HIV or by the medicines used to treat it?

Dr Hadi Manji:The presentation of HIV neuropathy is very similar to drug-related neuropathy, but there are some clues to tell whether it is the drugs or not. Sometimes the drug-related neuropathies come on very rapidly, almost explosively.My impression is that drug-related neuropathies may also be more painful. And if there's involvement of the fingers, that, to my mind, would be more drug – than HIV-related.

ATU: How many people have both HIV and drug-related neuropathy together?

HM: In my experience, a lot of people – up to 60% – who develop neuropathy that is attributed to the drugs are still left with neuropathy when they stop the offending drug, despite some improvement. My feeling is that these individuals probably had asymptomatic HIV related neuropathy that was unmasked by the drugs.

ATU:What other factors can make neuropathy worse?

HM:The bottom line is, if you've got nerve -related problems for whatever reason – HIV or antiretrovirals – and you add another factor that damages nerves, you are more likely to cause further damage. For example, when I see patients, I ask about alcohol intake, because alcohol damages nerves, making you more vulnerable to neuropathy.

ATU: How much alcohol is too much?

HM: It would seem reasonable that anyone who drinks more than the recommended 21 units a week for men [14 for women] may be more vulnerable. It's impossible to be categorical about these things because the other factor in alcohol-related neuropathy is vitamin B deficiency due to poor diet.

ATU: Does that also mean that people who use recreational drugs, and have a poor diet, could get neuropathy?

HM:There's no evidence that recreational drugs themselves cause neuropathy. However, the poor nutrition that can accompany drug-taking could certainly be a factor, since it is deficiency of the B vitamins which is important for nerve function.The cause of neuropathy in people who eat badly for any reason is usually thiamine (vitamin B1) deficiency.

ATU:Would you suggest that people whose diet is likely to be poor, for whatever reason, supplement with a vitamin B-complex tablet?

HM: I think that's reasonable, but with a caveat. One of the B-complex vitamins, B6, if taken in excess, causes neuropathy. At one stage in New York, B6 overdose was a common cause of neuropathy, because people were taking too much in their supplements. It's also worth checking B12 levels if you're a vegetarian, or if you have chronic diarrhoea.

ATU:What else do you check for when you see your patients for the first time?

HM: Diabetes is a cause of neuropathy, so I always check my patients' blood sugar. I also check to see if there are any other drugs that could cause neuropathy. For example, isoniazid, which is used to treat TB, can cause neuropathy.

ATU: What about co-infection with hepatitis C?

HM: Although there is a mechanism by which hepatitis C can cause neuropathy, it is very rare. I haven't seen more neuropathy in coinfected patients.

ATU: Are all the d-drugs equally likely to cause neuropathy, and of all the HAART medications, is it only d-drugs that can cause neuropathy?

HM: Of the antiretrovirals, only ddC, ddI and d4T are associated with neuropathy.The others aren't. ddC used to be the worst offender, but use of that drug has reduced significantly. In fact, compared with the early studies, incidence of neuropathy from all of these drugs is reducing for two reasons. First, lower drug doses are being used. Secondly, people aren't quite so immunosuppressed when they start the drugs, so they don't run the risk of this asymptomatic HIV-related neuropathy, as it is less likely to occur in people with higher CD4 counts.

ATU: How do you treat people with neuropathy who have no option but to
remain on d-drugs?

HM: Often, if the person is doing well as far as CD4 count and viral load are concerned, both the patient and HIV doctor are not that keen on stopping the d-drug.You could consider reducing the dose of the offending drug, but then there are concerns about resistance. Otherwise, all we can do then is to control the symptoms by using other drugs to make life a bit more bearable.

ATU: Do you prescribe antidepressants?

HM: I think they have a role to play, so I wouldn't write them off completely. I tend to use one of the tricyclics, amitryptyline.The crucial
thing is to start at the lowest possible dose (10mg), since it causes drowsiness. However,this does work in the patients' favour,particularly if they take it at night, because they can get a decent night's sleep.

ATU: Given the promising pain-reducing qualities of smoked marijuana presented at the recent Retroviruses Conference, would you support its use in the UK?

HM: In terms of other neuropathies, I have had patients who have said that smoking cannabis may be helpful.These results from San Francisco are preliminary, and it's never been trialled in a formal setting. Since there is no definite evidence to its benefit, I currently wouldn't be able to recommend it.

ATU: Before HAART, about one third of people reported HIV-related neuropathy. Why hasn't the incidence of neuropathy decreased in the HAART era?


HM: It's a combination of people living longer, and use of the d-drugs.We may see even more neuropathies appear as people with HIV are living longer.This is because there may well be increased risks for other causes of neuropathy that we currently see in non-HIV peripheral nerve clinics – diabetes, for example. So, when doctors see patients who are ageing with HIV, they will have to consider not just HIV or the drugs they take, but the other causes, too.

http://www.aidsmap.com/files/file1000724.pdf

Calendula at Peak Lavender Distillation and Summer Lush

In 5 days I will be turning a sun's cycle again, and will enter into my 37th year on this glorious, mysterious, wild earth.

It's this time in the year that I feel the best. It's summer, the plants are exploding in joy and fragrance, the bees hum as the bury their little faces into flowers over and over, and the rivers gush and dance along the rocks, glinting reflections of sun and moon and magic. The air is brand new in the morning; cool and dewy and pregnant with promise, yet it rolls like tumbleweed into the day, bringing sultry humidity and fierce heat like a giant sky God pounding his chest in glory.

This is the time of fruition, bounty, heat, and full presence, and I've been feeling it for sure. I've been busy learning, observing, getting dirty, getting hot, dunking in the river to cool off, and working all the in-between times that I'm home.

Here are some highlights from my recent herbal adventures:

Calendula: 

~~~~

Lavender Distillation:

Inner drum, filled with Lavender blossoms

Outer drum, with water being boiled to generate steam

Lavender Essential oil, collecting at the surface

~~~~~

Sage Harvesting

<3 My friend Dena

Sweet feet playing in the Sage

Goldthread students bringing in the harvest. Lemon Balm I think.

Lavender Flower Hydrosol

~~~~

River & Forest:

Enjoy the beauty of this Earth we call home.

xoxoxo

Ananda

Sciatica and chiropractic treatment does it help

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Paresis and Paralysis

Paresis and Paralysis

NERVOUS SYSTEM – Paresis and paralysis

The brain , spinal cord and nerves seem to be extraordinarily complex and mysterious. Nerves help

us to feel / recognise all types of sensations, i.e., touch, temperature, pressure, position, movements, and all types of pain (stabbing, pricking, lightning, burning, itching, irritating, etc.). With these feelings, the brain can accommodate the environment or situation to comfort our body. With electrical impulses, they communicate, interact, interpret, coordinate and function efficiently in a very fast manner to maintain and perform all body functions and movements. Nerves work even during our sleep – for example breathing, digestion, etc.

In recent years, our mental stress and physical strain, additive habits, sleeplessness, etc., seem to be a precursor for many neurological problems. Problems arising in nerves often disable one’s life in one or the other unless otherwise properly treated.

Paresis is said to be a pre-paralytic condition or mild paralysis, where muscles seem to be veryweak, but work. One should be more cautious in this state and take treatment immediately with proper diagnosis, since paresis could progress to paralysis anytime.

Paralysis means total loss of function(s) in the affected part(s) / nerve(s). It is otherwise called Palsy. Here nerves abruptly quit their functions due to the compression or damage or diseases (polio, stroke, etc). The affected part will become flaccid without any muscle tone or strength. In general, voluntary muscles cannot be used.

Incidences – usually increase with age, blood pressure, cholesterol level and sugar level. Smoking, alcohol and drugs act as a precursor as well as fuel for the tendency. The tendency to clot, arterial diseases, previous incidence of heart attack / stroke / cerebral problems double the risk value of getting paralysis. It c ommonly occurs in legs, hands and face.

Causes – are numerous. It can be due to infection, inflammation, injury (before, during or after birth) / compression / entrapment / disease, degenerative changes, de-myelination, reduced blood supply. Also toxins (foods / drugs / sniffing insectisides or dyes or glues or metal powders / poisons [curare/cyanide/venums] / addictives), exhaution, sleeplessness, habits (alcohol / smoking), malnutrition, exposure to extreme temperatures, etc., can trigger paralyis. Rarely hysteria, panic attack , visual and auditory hallucinations can also cause paralysis (which usually last only for a few seconds – sleep paralysis ).

Types – Paralysis can occur in parts (localised) or as a whole (in a generalised manner). It can occur

in a partial manner or in complete manner. Sometimes, it is reversible and some times not.

• Localised paralysis – is restricted to the parts involved – for example – Bell’s palsy, facial palsy, vocal cord palsy, wrist drop, foot drop, paralysis of one hand, paralysis of one leg, etc.
• Generalised paralysis – Hemiplegia, Paraplegia, Quadriplegia, etc.
• Hemiplegia – weakness and paralysis of one half of the body, i.e. one leg and one hand.
• Paraplegia – weakness and paralysis of lower half of the body i.e. both the legs. Here level of lesion will be in hip.
• Quadriplegia – weakness and paralysis of all the four limbs. Abdomen and chest muscles will also suffer. Here, lesion will be above thoracic vertebra, i.e. in the neck.

The common disease conditions where paralysis occurs a re stroke (cerebrovascular accident –

haemorrhage and ischeamia in brain), p olio, Bell’s palsy, facial palsy, A mylotrophic lateral sclerosis, Multiple sclerosis (partial or complete), Brain abscess / tumour, H ydrocephalus, M yasthenia gravis, Encephalitis, Arachnoiditis, Meningomyelitis, r abies, transient ischaemic attack, leprosy, tetanus, Multiple myeloma, asphyxia, fractures (especially in spinal column or skull), spondylitis / tumours of spines, thrombosis, etc.

Symptoms – usually vary depending upon the place of suffering and intensity of the affection. Intensity of suffering and its persistence also varies depending upon the health status of the person, will power and treatment.

Most often complaint starts all of a sudden i.e. sufferer wakes up with paralysis. Sometimes, some people will have warning symptoms, i.e., transient ischaemic attacks – altered sensations and functions with numbness of limb(s), headache, nausea, blurred vision, black spots, blindness in one eye, etc. for a moment or up to 24 hours. It indicates that paralysis is about to happen. This forewarning signal should be taken seriously and should be treated to escape from paralysis or disability. With onset of paralysis, sufferers commonly have the following symptoms:

• Coma / loss of consciousness
• Loss of memory
• Loss of movement / functions of affected part(s)
• Numbness or altered sensations in affected part(s) in sensing pain, temperature, touch, pressure, etc.
  
• Loss of coordination of movement and joint sensations
• Difficulty in breathing (rarely due to paralysis of chest muscles)
• Difficulty in swallowing
• Difficulty in speech (in case of affection of left side brain especially Broca’s area)
• Bowel and bladder incontinence

Analysis of the complaints in all aspects will provide a clue about the level and extent of lesion. Commonly, t he part above the lesion will have normal functions and sensations. In case of incomplete damage, the loss of functions and sensations often vary depending upon site, position and extent of the injury.

Complications – Paraplegia and quadriplegia patients will often need of wheelchair for movement. Hemiplegia patients can move with walker or walking stick. The

bedridden patients i.e., severe paralytic sufferers, may need to use bed pan and urine can (sometimes catheter too for passing urine) with the help of others. Dependency on others and using of wheelchair, walking stick, walker, bed pan, urine can, etc., will make the suffer more depressed than the suffering by itself. Restricted movements will create lack of social activities and depression. Also sitting and lying most of the time will cause bed sores on pressure points.

Diagnosis – Nerve functions and the extent of paralysis are usually analysed with parts involved, weakness, coordination of movement(s), reflexes, muscle thickness / wasting, spasticity, alteration in sensations, etc. Doctors usually go for elicitation of reflexes, nerve conduction tests and electromyography (EMG) to diagnose the complaint and to plan for treatment. The common tests required to detect, manage / treat paralytic complaints and torule out complications are:

• Routine blood tests and urine tests
• X-ray chest and skull (in AP view and lateral view)
• Spinal radiographs (plain and contrast)
• CT / MRI scan
• Electroencephalography (EEG)

General treatment – Reassurance is the first line of treatment in all paralysis irrespective of any system of medicines. Regarding treatment, it depends upon the causative factor, symptoms and intensity of sufferings. Wait and watch approach with supplements will be the answer in most of the cases. Anyhow, one will be provided an anti-inflammatory course of medicines followed by antioxidants, vitamins and mineral supplements. In extreme cases, steroidal drugs and anti-depressants will also be prescribed to manage the situation. Also, after critical care, for rehabilitation , one will be advised / asked to depend on massage and exercises / physiotherapy for good recovery. In case of massive clots or tumour-induced paralysis, surgical option is often sought and this will provide instant and good recovery. If the paralysis is maltreated or left untreated for quite a long time, then hope of getting betterment is very little.

Homeopathic approach – In Homeopathy , if sufferers happen to take care of all the warning signs in the start-up itself, then the start on of paralysis can be halted and prevented. In all systems of medicines, early intervention and treatment always provide good prognosis and good recovery. In Homeopathy also, appropriate and early treatment provides miraculous regain of functions. Delay in treatment usually ends in muscular wasting which is difficult to revive later.

Homeopathy usually supports (stimulates) our body / immune mechanism to maintain good health by tackling any sort of disease force / agent, i.e., it improves withstanding capacity, vitality to avoid disease and its recurrences. Homeopathy can terminate paralysis in its initial stage itself, if treatment is given properly at the right time with the right medicine. With the onset of symptoms, it can also stimulate the nerve to regain its normal functions.

In contrast to all other systems that approach the disease from outside, i.e. with massage, oil applications, physiotherapy, electric stimulation and surgical repair, Homeopathy is the only system which gives importance to internal treatment.Homeopathy also cares for the patient’s feelings and

sensations. The well-selected medicine prescribed for the patients to the core of the disease will certainly stimulate the suffering nerve(s) to regain normalcy and remain in endurance. Homeopathy can ensure better relief / cure from paralysis without any side-effects. Any how, unlike other complaints, paresis and paralytic cases are very difficult to treat and also take a longer time to attain the state of cure, i.e., one needs to wait even to feel the marked improvement for at least a week, most often 20-40 days: patient needs patience to feel its healing touch.

Homeopathic medicines commonly used in cases of paresis and paralysis cases are Aconite, Agaricus, Arg nit, Ars alb, Belladonna, Bryonia, Calc carb, Cannabis indica, Causticum, Chamomilla, Colocynthis, Cuprum met, Curare, Dioscorea, Gelsemium, Glonine, Gnanphalium, Hypericum, Lachesis, Lathyrus, Lycopodium, Natrum mur, Nux vom, Opium, Phytolacco, Plumbum met, Pulsatilla, Rhus tox, Sangunaria, Secale cor, Spigelia, Stramonium, Zinc met, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.

for new hope

Dr. S. Chidambaranathan, BHMS, MD (Homeo)

Laxmi Homeo Clinic

24 E. New Mahalipatti Road

Madurai, TN 625 001

India

Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob)

Fax: +91-452-233-0196

E-mail:  drcheena@yahoo.com

www.drcheena.com  / www.drcheena.in

(Disclaimer - The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)

Guts and Sass

Maybe life just takes some guts and sass

To rub blindly up against the rough bark of a dream and laugh

at the furrowed trunk of growth and the rings

of years sustained amidst the pains of sins

pulling so hard on those reigns of belief, chaffed with will

power, your muscle of dreaming still

holds fast

without fail

without steering you

wrong

Maybe the chains of life's confinements

are glass and foil.

My dagger dreams come sharp

committed, mapped

like yours do

not trapped - they are wild, enraptured

entranced.

In this life we need guts

and sass

to run towards those mirrors of glass: they are lies

and trash. Run buffered by animal tallow and run

fierce

like Buffalo. Pierce

the shadows of crumpled foil and run

wild with dreams of your own

Recklessly owning your

own vision.

Blue Moon Potions and wildcrafting moments

This past few weeks

I was reminded that I am not really spending the summer 

learning how to cultivate plants.

I'm learning how to continue to let the plants 

cultivate me. 

~~

Magic potions are a blessing of a byproduct. 

~~~~~~~~

Under the Tulsi Moon, Woman's Collection

"Chandra" Tulsi - Jasmine Aromatherapy Perfume

Blue Vervain

Play

Purple Loostrife

Wildcrafting accompaniment 

Pickerel Weed

Beauty

Bounty

Skullcap Love

Wild Waters

Bugleweed

Gingko

Ma Huang

Grasshopper on Astragalus

Licorice

Herb pups

Bhringraj

Fennel

xoxo