Positive Affirmations

Strategies for De-Stressing
If you’re like most people, you’ve learned to bottle up "unacceptable" emotions, such as anger, fear, frustration, and grief. Sometimes, of course, the cap slips off. Then these emotions are let loose at high intensity, though not necessarily in the right direction. One safe way to decant any emotions—even the most hurtful, terrifying, or sad feelings—is journal writing. A blank sheet of paper and a pen can offer enormous release and, possibly, insight into hidden conflicts. Writing about traumatic events can have physical benefits, too, according to psychologist James W. Pennebaker, who began studying this issue in the late 1970s. A series of studies required one group of people to write down their deepest thoughts and feelings about the most traumatic event they recalled. A control group wrote only about trivial events. Both groups wrote for 15 minutes a day for four days. In one study, the group that expressed deep emotions reported feeling better and also had significantly fewer doctors’ visits and symptoms of illness for nearly half a year afterward. After a similar experiment, the group that revealed deep emotions had livelier immune system defenders called T cells for the next six weeks. Research shows people with asthma and arthritis benefit from journal writing, too. Why does writing about emotional issues make a difference in physical and emotional health? Pennebaker theorizes that confiding bottled-up feelings can relieve stress, which ratchets up blood pressure, heart rate, and muscle tension.
Writing It Out
Clinicians at the Mind/Body Medical Institute have found that the following journal exercise helps relieve ongoing sources of stress. A single attempt is not enough, though. When you first sit down to write about a problem, you may feel more anxious. The wound, once exposed, may initially hurt more than it did while hidden. But continuing to write about the same problem over the course of several days often enables you to work through difficult emotions and reach resolution or acceptance. Here’s some advice before you begin:
Deeply troubling events and situations, such as domestic violence, rape, or direct exposure to acts of terrorism or war, are best explored with an experienced therapist. For other situations, you can proceed on your own and seek professional help only if you feel you need assistance.
If you’re physically healthy, choose the most stressful event or problem you currently face. It’s usually one that you frequently dwell upon. Or, if you think your current problems stem from past circumstance, write about traumatic events in your past.
Truly let go. Write down what you feel and why you feel that way.
Write for yourself, not others. Don’t worry about grammar or sentence structure. If you run out of things to say in the time allotted, feel free to repeat yourself.
Do this exercise for 15–20 minutes a day for three to four days or as long as a week if you feel writing continues to be helpful.
Mini-Relaxations
The best-written book on stress control is no help to you if you can’t find time to read it. If you only have a short while to spare, dip into the stress-busting suggestions described in this section. Whether you have one minute or half an hour, you’ll find ways to ease your day.
Mini-relaxations can help allay fear and reduce pain while you sit in the dentist’s chair or lie on an examining table. They’re equally helpful in thwarting stress before an important meeting, while stuck in traffic, or when faced with people or situations that annoy you. Here are a few quick relaxation techniques to try.
When you’ve got 1 minutePlace your hand just beneath your navel so you can feel the gentle rise and fall of your belly as you breathe. Breathe in slowly. Pause for a count of three. Breathe out. Pause for a count of three. Continue to breathe deeply for one minute, pausing for a count of three after each inhalation and exhalation.
Or alternatively, while sitting comfortably, take a few slow deep breaths and quietly repeat to yourself “I am” as you breathe in and “at peace” as you breathe out. Repeat slowly two or three times. Then feel your entire body relax into the support of the chair.
When you’ve got 2 minutesCount down slowly from 10 to zero. With each number, take one complete breath, inhaling and exhaling. For example, breathe in deeply saying “10” to yourself. Breathe out slowly. On your next breath, say “nine,” and so on. If you feel lightheaded, count down more slowly to space your breaths further apart. When you reach zero, you should feel more relaxed. If not, go through the exercise again.
When you’ve got 3 minutesWhile sitting down, take a break from whatever you’re doing and check your body for tension. Relax your facial muscles and allow your jaw to fall open slightly. Let your shoulders drop. Let your arms fall to your sides. Allow your hands to loosen so that there are spaces between your fingers. Uncross your legs or ankles. Feel your thighs sink into your chair, letting your legs fall comfortably apart. Feel your shins and calves become heavier and your feet grow roots into the floor. Now breathe in slowly and breathe out slowly. Each time you breathe out, try to relax even more.
When you’ve got 5 minutesTry self-massage. A combination of strokes works well to relieve muscle tension. Try gentle chops with the edge of your hands or tapping with fingers or cupped palms. Put fingertip pressure on muscle knots. Knead across muscles, and try long, light, gliding strokes. You can apply these strokes to any part of the body that falls easily within your reach. For a short session like this, try focusing on your neck and head.
Start by kneading the muscles at the back of your neck and shoulders. Make a loose fist and drum swiftly up and down the sides and back of your neck. Next, use your thumbs to work tiny circles around the base of your skull. Slowly massage the rest of your scalp with your fingertips. Then tap your fingers against your scalp, moving from the front to the back and then over the sides.
Now massage your face. Make a series of tiny circles with your thumbs or fingertips. Pay particular attention to your temples, forehead, and jaw muscles. Use your middle fingers to massage the bridge of your nose and work outward over your eyebrows to your temples.
Finally, close your eyes. Cup your hands loosely over your face and inhale and exhale easily for a short while.When you’ve got 10 minutesTry imagery. Start by sitting comfortably in a quiet room. Breathe deeply for a few minutes. Now picture yourself in a place that conjures up good memories. What do you smell — the heavy scent of roses on a hot day, crisp fall air, the wholesome smell of baking bread? What do you hear? Drink in the colors and shapes that surround you. Focus on sensory pleasures: the swoosh of a gentle wind; soft, cool grass tickling your feet; the salty smell and rhythmic beat of the ocean. Passively observe intrusive thoughts, and then gently disengage from them to return to the world you’ve created.
The Benefits of Massage
A massage at the hands of a skilled practitioner can be rejuvenating. Research shows massage has a physiological impact, too.
A 2005 review of research studies involving massage therapy showed that massage consistently lowered levels of cortisol while increasing activity of pleasure-related brain chemicals in patients with a broad range of physical and psychological conditions. Massage also lowers blood pressure and heart rate and may enhance certain measures of immune function. A 2005 study showed that women with breast cancer who participated in massage therapy three times a week for five weeks showed more immune system activity and reported less depression, anxiety, and fatigue than the women who didn’t receive massages regularly. Some studies have found that massage is also beneficial in boosting the immune systems of people with HIV.
Whether it’s for therapeutic reasons or purely for pleasure, massage offers the comforts of a warm touch and release from muscle tension. There are currently no national licensing requirements or standards for massage therapists. Experienced practitioners can be found through professional organizations, such as the American Massage Therapy Association (888-THE-AMTA) and the National Certification Board for Therapeutic Massage and Bodywork (800-296-0664).
Affirmations
Affirmations are statements that express love, acceptance and, often, a joyous vision for your self and your life. A stream of positive thoughts can drown out more negative ones. Try incorporating simple affirmations, such as "I breathe in healing" or "I breathe out tension," into relaxation techniques. Or paste them to your mirror or another prominent place where you can read them several times a day. The more often you repeat an affirmation, the more likely you are to believe it and act on it. Whether you write your own affirmation or borrow one from a helpful bumper sticker ("One day at a time"), the words should resonate for you. When creating an affirmation, choose a stressful aspect of your life and decide what a positive outcome would be or how you wish you felt about the situation. Try to craft first-person present-tense statements:
"I can do this."
"I am doing my best."
"I am calm."
"I deserve respect."
"Week by week, I am growing healthier and stronger."
"I can relax my body."
"I am a loving, caring person."Imagine these techniques and self-nurturing acts as dry seeds for a garden. Lush growth rewards those who do more than scratch the earth, toss in a few seeds, and step back to see what comes up. Dig deep. Water frequently. Remove choking weeds from the plot when necessary. Combining the richness of your past experiences, a willingness to expand your current boundaries, and a desire to fill your life with courage, love, and joy can make a great deal of difference in what you reap.
Power of Prayer
Several large studies suggest that people with an active religious life tend to stay healthier, live longer, and be happier. For example, a review article published in 2000 in the Journal of the American Geriatrics Society cited an international study of nearly 170,000 men and women from 14 countries that found religious affiliation and attendance at services significantly increased the likelihood of happiness and satisfaction. Twelve years of data from 2,800 older adults enrolled in the Yale Health and Aging Study, reported in 1997 in theJournals of Gerontology, showed members of religious congregations had a slower onset of physical disability. Other studies on how religion affects health have noted less hostility and anxiety, lower blood pressure, and better quality of life among people with strong beliefs.
But the power of prayer is not easy to document. A 2002 study in the Annals of Behavioral Medicine sifted through research claiming religion and spirituality have positive effects on cardiovascular disease and hypertension. The investigators disputed these results, citing numerous flawed or irrelevant supporting studies.
But prayer offers solace and comfort to many people. Religious communities can be part of a larger social network that keeps a person afloat with emotional support and outright assistance (see Social Support). By reinforcing positive emotions, religious belief might stimulate healthy physiological responses through complex nervous system pathways much as a constant flood of negative thoughts may set the opposite reaction in motion. And, of course, certain religions encourage better health habits, such as avoiding alcohol and tobacco.
If prayer is meaningful to you, it can enhance the relaxation response and perhaps your health as well. You may want to use your favorite prayer or a phrase from it to help you focus.
Social Support
Just as a ship is protected by the rubber bumpers that separate it from a hard wooden dock, so, too, do people benefit when social buffers soften the inevitable bumps and bruises of life. Studies show that social ties—at least those that represent positive relationships—significantly protect health and well-being. In Sweden, researchers following more than 17,000 men and women for six years found that the group that reported the most isolation and loneliness had almost four times the risk of an early death as those with good social networks. California researchers who tracked roughly 7,000 Alameda County residents for nine years found that a lack of strong community and social bonds multiplied the likelihood of dying by nearly two to three times. Confidants, friends, acquaintances, co-workers, relatives, and spouses or companions weave a life-enhancing social net. Their support may involve outright assistance or may be largely emotional. Studies show that people who have greater social support fare better on measures of immune function when faced with stressors as diverse as caregiving, surgery, exams, and job strain. For example, women with breast cancer who felt they had high-quality emotional support from an intimate relationship, social support from a doctor, and nourishment from other connections had more natural killer cells—capable of destroying virus-laden cells and certain tumor cells—than those who lacked these advantages. Not surprisingly, the quality of relationships counts. Research suggests negative ones—an embattled marriage or a draining caretaking arrangement—can be more harmful than helpful.
Strengthening Your Social Bonds
Given the pleasures and benefits of social ties, why not grasp opportunities to expand your social circle and deepen the ties you’ve already made? Here are some ways to do just that:
If you normally wait for others to reach out, pick up the phone and propose a date.
Explore some of the many volunteer opportunities available, from wielding tools to spruce up affordable housing to mentoring a child or business-person. Check with http://www.volunteermatch.org or http://www.seniorcorps.org or call your local chapter of the United Way for opportunities that fit your talents and interests.
Harness the warmer side of technology. E-mail and telephones extend your reach around the world. Libraries and senior centers may offer free online time and may even help you set up a free e-mail account.
Find like-minded people through intriguing classes, organizations, and your community newspaper.
If it’s hard to get to religious services, ask fellow congregants to escort you. If a significant illness keeps you away, find out if your spiritual leader makes home visits.
Social support is a two-way street. Offer assistance to friends, family, and neighbors and accept it when it’s offered to you.
Share a confidence. Doing so can turn a friendly relationship into an even deeper one.
If depression, low self-esteem, or social phobias affect your ability to make connections, seek help. Start by talking with your doctor. Many people have been aided by therapy, medications, or both.

From the Harvard Health Publications Special Health Report, Stress Control: Techniques for Preventing and Easing Stress. Copyright 2002 by the President and Fellows of Harvard College. Illustrations by Scott Leighton and Marcia Williams. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell. Use of Content Disclaimer Last Full Review May 2006

Stretch Away the Pain of Plantar Fasciitis

Stretch Away the Pain of Plantar Fasciitis
Published: 11/25/06
SATURDAY, Nov. 25 (HealthDay News) -- Something as simple as a stretch could ease the pain of plantar fasciitis, a condition that causes heel pain and difficulty walking.
The newly developed stretch targets the plantar fascia, the flat band of tissue that connects the heel bone to the toes. Plantar fasciitis occurs when the plantar fascia is strained, resulting in weakness, inflammation and irritation.
A study published in the Journal of Bone and Joint Surgery found that the stretch was 75 percent successful in relieving pain and enabling patients to return to full activity within three to six months. After doing the exercise, about 75 percent of patients needed no further treatment, the study said.
The stretch was developed by Dr. Benedict DiGiovanni, associate professor of orthopedic surgery at the University of Rochester, and Deborah Nawoczenski, professor of physical therapy at Ithaca College.
Here's how it works: Patients sit with one leg crossed over the other and stretch the arch of the foot by taking one hand and pulling the toes back toward the shin for a count of 10. The stretch needs to be repeated 10 times, and patients need to do at least three stretching sessions a day.
"Plantar fasciitis is everywhere, but we really haven't had a good handle on it. The condition often causes chronic symptoms and typically takes about nine to 10 months to burn itself out, and for people experiencing this pain, that's way too long to suffer through it," DiGiovanni said in a prepared statement.
The condition is common in middle-aged people and young people who spend a lot of time on their feet.
More information
The American Academy of Family Physicians has more about plantar fasciitis.Last reviewed: 11/25/2006 Last updated: 11/25/2006

Resveratrol

Red Wine Ingredient Increases Endurance, Study Shows

By NICHOLAS WADE
Published: November 17, 2006
A drug already shown to reverse the effects of obesity in mice and make them live longer has now been shown to increase their endurance as well.
Institut Clinique de la Souris
The two mice on treadmills at left have been given resveratrol; the one on the right has not.
Related
Yes, Red Wine Holds Answer. Check Dosage. (November 2, 2006)
Experts say the finding may open up a new field of research on similar drugs that may be relevant to the prevention of diabetes and other diseases.
An ordinary laboratory mouse will run one kilometer on a treadmill before collapsing from exhaustion. But mice given resveratrol, a minor component of red wine and other foods, run twice as far. They also have energy-charged muscles and a reduced heart rate, just as trained athletes do, according to an article published online in Cell by Johan Auwerx and colleagues at the Institute of Genetics and Molecular and Cellular Biology in Illkirch, France.
“Resveratrol makes you look like a trained athlete without the training,” Dr. Auwerx (pronounced OH-wer-ix) said in an interview.
He and his colleagues said the same mechanism seemed likely to operate in humans, based on analysis in a group of Finnish subjects of the gene that is influenced by the drug.
Their rationale for testing resveratrol was evidence obtained three years ago that it could initiate a genetic mechanism known to protect mice against the degenerative diseases of aging and prolong their life spans by 30 percent.
Dr. Auwerx, whose interest is in the genetic control of metabolism, decided to see whether resveratrol would offset the effects of a high-fat diet, specifically the disturbances known as metabolic syndrome that are the precursors of diabetes and obesity. In his report, he and his colleagues say very large doses of resveratrol protected mice from weight gain and developing the syndrome.
Dr. Auwerx attributes this in large part to the significantly increased number of mitochondria he detected in the muscle cells of treated mice.
Mitochondria are the organelles in the body’s cells that generate energy. With extra mitochondria, the treated mice were able to burn more fat and thus avoid weight gain and decreased sensitivity to insulin, Dr. Auwerx said. He found their muscle fibers had been remodeled by the drug into the type more prevalent in trained human athletes.
Dr. Ronald M. Evans, an expert on the hormonal control of metabolism at the Salk Institute, said the report by Dr. Auwerx’s team had “shown very convincingly that resveratrol improves mitochondrial function” and fends off metabolic disease. He described the study as “very important, because it is rare that we identify orally active molecules, especially natural molecules, that have such a broad-based, positive effect on a problem which is as widespread in society as metabolic disease.”
Dr. Ronald Kahn, director of the Joslin Diabetes Center in Boston, said this research would focus more attention on a recently discovered group of enzymes called sirtuins that resveratrol is believed to affect.
Noting that he is a scientific adviser to Sirtris, a company developing drugs that activate sirtuins, Dr. Kahn said that “certainly drugs that act on this class of proteins have the potential to have major effects on human disease.”
Dr. Auwerx’s study complements one published this month by Dr. David Sinclair of the Harvard Medical School, who found that much more moderate doses of resveratrol protected mice from the metabolic effects of a high-calorie diet. Though his mice did not lose weight, they lived far longer than the undosed mice fed the same diet.
The two studies were started and performed independently, Dr. Auwerx said, though he obtained supplies of resveratrol from Sirtris, which was co-founded by Dr. Sinclair, and has become a scientific adviser to it.
A drug that prolongs life, averts degenerative disease and makes one into a champion athlete sounds almost too good to be true, especially if all or even some of its properties should turn out to apply to people.
Dr. Christoph Westphal, Sirtris’s chief executive, replied to this objection with a question, “Is it too good to be true that when you are young you get no disease?”
Dr. Westphal said he believed that the activation of sirtuins was what kept the body healthy in youth, but that these enzymes became less powerful with age. This is the process that is reversed by resveratrol and, he hopes, by the more powerful sirtuin activator drugs that his company has developed, though many years of clinical trials will be needed to prove they work and are safe.
The buzz over sirtuin activators has infected scientists who do research on the aging process, several of whom are already taking resveratrol. Dr. Sinclair has been swallowing resveratrol capsules for three years and has said his parents and half the members of his laboratory do the same. So does Dr. Tomas Prolla at the University of Wisconsin, who said, “The fact that investigators in the field are taking it is a good sign there is something there.”
But many others, including Dr. Leonard Guarente of M.I.T., whose 15-year study of sirtuins has laid the basis for the field, say it is premature to take the drug.
It was after working in his laboratory as a postdoctoral student that Dr. Sinclair found in 2003 that resveratrol was a sirtuin activator. Though resveratrol has long been known to be an ingredient of red wine and other foods, its presence there is minuscule compared with the doses used in experiments.
Dr. Sinclair dosed his mice daily with 22 milligrams of resveratrol per kilogram of weight, and Dr. Auwerx used up to 400 milligrams. No one can drink enough red wine to obtain such doses.
Resveratrol is sold as capsules that contain extracts of red wine and giant knotweed, a plant found in China. The company Longevinex makes capsules containing 40 milligrams of resveratrol that are used by several researchers. Longevinex’s president, Bill Sardi, said demand had increased by a factor of 2,400 since Nov. 1. But even Longevinex’s capsules would have to be taken in almost impossible quantities to attain doses equivalent to those used in the mice.
Whether much lower doses than those used in the experiments would benefit athletic performance is not clear, Dr. Evans of the Salk Institute said. And higher doses may not be as safe as the small amounts found in foods and nutraceuticals, he added.
Scientists’ rule of thumb is to believe nothing until it has been confirmed in at least one other laboratory. The Sinclair and Auwerx experiments, though not the same, both point to powerful beneficial effects of resveratrol. But many of the details remain up in the air, and almost all hopes about resveratrol, especially for people, remain subject to revision.
The science of the field is still in flux, as many central details are unclear. The main theory developed by Dr. Guarente and others is that sirtuins sense the level of energy expenditure in living cells and switch the body’s resources from reproduction to tissue maintenance when food is low.
This is an ancient strategy, Dr. Guarente believes, intended to let an organism live through famines and postpone breeding until good times return. The switch to tissue maintenance involves specific action that would stave off the major degenerative diseases of aging like cancer, diabetes, heart disease and degeneration of brain cells.
One major uncertainty is whether resveratrol in the mice experiments even acts through sirtuins, supporting the theory, or in some other way.
Dr. Auwerx cited new evidence that resveratrol did activate sirtuins, but Dr. Evans said the case was not yet convincing.
Dr. Auwerx theorizes that resveratrol activates sirtuin, which in turn activates a substance known as PGC1-alpha in a manner described last year by Dr. Bruce Spiegelman, an expert on fat metabolism at the Harvard Medical School. Subsequent actions by PGC1-alpha then stimulate cells to produce more mitochondria. In an e-mail message, Dr. Spiegelman described Dr. Auwerx’s paper as “pretty good.”
Increased energy production by mitochondria generates dangerous reactive chemicals that are known to damage cells. So it has long been puzzling that exercise, in which extra energy is expended, is good for health, not bad. The answer, Dr. Auwerx suggested, may have been provided by Dr. Spiegelman, who reported in the journal Cell last month that PGC1-alpha not only increases mitochondria but at the same time also generates extra chemicals that detoxify the energy byproducts.

Shock for Migraines NYT

It May Come as a Shock

By AMANDA SCHAFFER
Published: November 7, 2006
In ancient Rome, patients with unbearable head pain were sometimes treated with jolts from the electricity-producing black torpedo fish, or electric ray.
Enlarge This Image
Top, Corbis; Bottom, Tony Cenicola/The New York Times
A.D. 41 In ancient Rome doctors treated the throbbing pain of migraine headaches by applying an electric fish like the black torpedo, top, directly to the head. 2006 It doesn't smell and its shocks are more predictable, but the occipital nerve stimulator, implanted in the head and buttocks, operates on the same principle, bottom.
Multimedia
Graphic
Treating Migraine Without Drugs
Related
Times Topics: Migraine Headaches »

From Top, Lawrence Konig; Kevin Fitzsimons for The New York Times; Richard L. Weiner
One of the two kinds of electrical stimulatory treatment of migraines now in widespread clinical trials is occipital nerve stimulation. (The other uses electromagnetic impulses.) Top, a surgeon implanting an occipital nerve stimulator into a patient. Center, Cheryl Myers shows where hers is implanted. Bottom, an X-ray of an implant.
Scribonius Largus, physician to Emperor Claudius, was a staunch advocate of the remedy. “To immediately remove and permanently cure a headache, however long-lasting and intolerable, a live black torpedo is put on the place which is in pain, until the pain ceases and the part grows numb,” he wrote in the first century.
Electric fish have long disappeared from the medical armamentarium. And patients with headaches are most frequently treated with pharmaceuticals.
But recently, electrical or electromagnetic devices that hark back to the head-zapping torpedo fish have come into vogue among the country’s most prominent migraine researchers. Two different kinds of stimulatory devices are now in large-scale clinical trials for possible use in patients with the most severe migraine cases. Many researchers believe that such devices are likely to play a greater role in migraine treatment in the future.
Roughly 30 million Americans suffer from migraines, an inherited neurological disorder characterized in part by painful, throbbing headaches.
Dr. Richard B. Lipton, a professor of neurology at the Albert Einstein College of Medicine and director of the Montefiore Headache Center, says that while there are many drugs to treat the disorder or ward off the pain of an attack, some people do not respond or cannot tolerate the side effects.
“There is still a lot of unmet need,” Dr. Lipton said. “So the idea of having stimulatory devices that can be used to prevent headaches or to treat them acutely is very attractive to me, and I think very attractive to patients as well.”
The two kinds of stimulatory approaches now in large-scale clinical trials are occipital nerve stimulation, or O.N.S., and transcranial magnetic stimulation, or T.M.S.
In occipital nerve stimulation, a pacemakerlike device is connected to electrodes placed at the back of the head just under the skin. Electrical current is delivered through these electrodes, with the goal of inhibiting or preventing migraine pain.
In transcranial magnetic stimulation, a magnetic device is pressed to the back of the head, and brief pulses are delivered, altering electrical activity inside the brain in hopes of halting the migraine before it progresses. This approach is being studied only for patients whose migraines begin with an aura, or premonitory phase, that is typically characterized by flashing lights or other visual disturbances.
Experts say approaches like these represent a powerful new trend in migraine research.
“Since 1990, there have been well over 100 clinical trials for migraine drugs,” said Dr. Lipton, who added that by comparison virtually every stimulatory-device study that has been started is still going.
Some patients who have undergone the treatments say that they have helped.
Cheryl Myers, a mother of two who lives near Columbus, Ohio, said that for 9 or 10 years she suffered from chronic and disabling migraines that forced her to stop working and often confined her to bed.
“The only thing that helped was narcotics,” said Ms. Myers, 49. “But I couldn’t be taking them three or four times a week.”
In 2004, Ms. Myers enrolled in a clinical trial at the Michigan Head-Pain and Neurological Institute, where she had an occipital nerve stimulator surgically implanted.
The pacemakerlike device was placed in her upper buttocks and connected, by way of wires tunneled under the skin, to electrodes at the base of her neck, on either side.
Soon after the device was turned on, Ms. Myers said, she began having fewer migraines, and those she did have were less severe. Within a few months, she was also able to return to work several days a week. “I am not headache-free,” she said, adding that she still has “one or two headaches a week” and takes Percocet, a pain-relieving narcotic.
“However, I am enjoying a much more normal life,” she said.
Dr. Joel R. Saper, director of the neurological institute, said that in the treatment, electrodes are positioned to stimulate the greater occipital nerve, which runs along the back of the head on either side. The occipital nerve converges in the upper or cervical spinal cord with the trigeminal system, which includes neurons and neural pathways responsible for conveying much of the throbbing pain associated with migraine, he said.
Dr. Saper says it is not clear precisely how occipital nerve stimulation works. But one possibility is that it effectively inhibits activity in the trigeminal system, dampening the patient’s pain.

Speaking in tongues - neuropsych

A Neuroscientific Look at Speaking in Tongues

Evelyn Hockstein/Polaris
Women at a Pentecostal church in the Congo.

By BENEDICT CAREY
Published: November 7, 2006
Correction Appended

Graphic
Evidence for a Religious State
Related
Web Link
The Measurement of Regional Cerebral Blood Flow During Glossolalia: A Preliminary SPECT Study (Psychiatry Research: Neuroimaging)
The passionate, sometimes rhythmic, language-like patter that pours forth from religious people who “speak in tongues” reflects a state of mental possession, many of them say. Now they have some neuroscience to back them up.
Researchers at the University of Pennsylvania took brain images of five women while they spoke in tongues and found that their frontal lobes — the thinking, willful part of the brain through which people control what they do — were relatively quiet, as were the language centers. The regions involved in maintaining self-consciousness were active. The women were not in blind trances, and it was unclear which region was driving the behavior.
The images, appearing in the current issue of the journal Psychiatry Research: Neuroimaging, pinpoint the most active areas of the brain. The images are the first of their kind taken during this spoken religious practice, which has roots in the Old and New Testaments and in Pentecostal churches established in the early 1900s. The women in the study were healthy, active churchgoers.
“The amazing thing was how the images supported people’s interpretation of what was happening,” said Dr. Andrew B. Newberg, leader of the study team, which included Donna Morgan, Nancy Wintering and Mark Waldman. “The way they describe it, and what they believe, is that God is talking through them,” he said.
Dr. Newberg is also a co-author of “Why We Believe What We Believe.”
In the study, the researchers used imaging techniques to track changes in blood flow in each woman’s brain in two conditions, once as she sang a gospel song and again while speaking in tongues. By comparing the patterns created by these two emotional, devotional activities, the researchers could pinpoint blood-flow peaks and valleys unique to speaking in tongues.
Ms. Morgan, a co-author of the study, was also a research subject. She is a born-again Christian who says she considers the ability to speak in tongues a gift. “You’re aware of your surroundings,” she said. “You’re not really out of control. But you have no control over what’s happening. You’re just flowing. You’re in a realm of peace and comfort, and it’s a fantastic feeling.”
Contrary to what may be a common perception, studies suggest that people who speak in tongues rarely suffer from mental problems. A recent study of nearly 1,000 evangelical Christians in England found that those who engaged in the practice were more emotionally stable than those who did not. Researchers have identified at least two forms of the practice, one ecstatic and frenzied, the other subdued and nearly silent.
The new findings contrasted sharply with images taken of other spiritually inspired mental states like meditation, which is often a highly focused mental exercise, activating the frontal lobes.
The scans also showed a dip in the activity of a region called the left caudate. “The findings from the frontal lobes are very clear, and make sense, but the caudate is usually active when you have positive affect, pleasure, positive emotions,” said Dr. James A. Coan, a psychologist at the University of Virginia. “So it’s not so clear what that finding says” about speaking in tongues.
The caudate area is also involved in motor and emotional control, Dr. Newberg said, so it may be that practitioners, while mindful of their circumstances, nonetheless cede some control over their bodies and emotions.
Correction: Nov. 11, 2006
An article in Science Times on Tuesday about brain images of people speaking in tongues misstated the origins of the practice in America. It is thought to have begun in Pentecostal churches established in the early 1900s, not in charismatic churches. The charismatic movement began decades later.

Zinc-Copper problem

Diagnosis
The Healing Problem
E-Mail
Print
Save

By LISA SANDERS, M.D.
Published: November 12, 2006
1. Symptoms
Skip to next paragraph

Top, Andrew Syred/Photo Researchers, Inc.; Right, James Cavallini/Photo Researchers, Inc.
Red and white blood cells (close-up, top) are produced in the bone marrow (above). The patient was not producing enough of either.
As Dr. Lisa Pastel, a resident in her second year of training, entered the brightly lighted cubicle, five faces turned to greet her. The patient, a pleasant-faced middle-aged man in a wheelchair, invited her in. His wife sat next to him, and their three children sprawled across the cool linoleum floor with schoolbooks opened before them. For this family, like so many caught up in the care of a chronically ill member, going to the hospital had become just another family routine.
The patient leaned forward to shake the doctor’s hand. His grip was firm and his hand warm, the doctor noted, but not hot or sweaty. He was tired and achy, he told her, and he had a fever he just couldn’t shake. He had been well until a couple of days ago — or at least as well as he could be, considering all his other health problems, he added, smiling through a bushy, gray-streaked beard. Because of this fever, he visited his doctor, who told him he had to go into the hospital. That would be excessive for most of us, but this patient had an impaired immune system, and close observation and strong antibiotics were necessary.
He was 47. Four years earlier, he had gastric bypass surgery. It worked, and he lost more then 100 pounds. Before the surgery, he had diabetes, high cholesterol and sleep apnea, but those diseases melted away along with the excess pounds.
About two years later, he developed a hernia, a common complication of abdominal surgery. He had an operation to fix it, and that’s when the latest round of trouble began. After the operation, he developed a serious infection. He needed weeks of intravenous antibiotics, and he was still living with the consequences: the incision that the doctors made to repair the hernia never healed. It remained an open wound, and no one could figure out why. That wasn’t the only mystery: six months ago, routine blood work showed that he had developed anemia (too few red blood cells) and neutropenia (too few infection-fighting white blood cells). He had a slew of tests, but no one could explain this newest complication either.
2. Investigation
The resident could find no obvious signs of infection when she examined the patient. The large wound on his abdomen was almost the length of her hand. The tissue lining his incision offered no clues about why it had not healed. His blood work showed that he had fewer than 2,000 white cells per microliter of blood — less than half the number he should have had, even without an infection. The neutrophils — the type of white blood cells that serve as the front line of the immune system, our body’s version of the Marine Corps — were below 500 cells per microliter, an inadequate force to fight off even the most insignificant infection.
Pastel admitted the patient to the hospital, ordered a chest X-ray to look for pneumonia and blood and urine cultures to look for other infections and started broad-spectrum antibiotics. She might never find out where the infection was, but the antibiotics would shore up his tiny army of white cells and treat it.
Then the resident turned to examine the patient’s extensive chart. She was particularly curious about his neutropenia. She had taken care of many patients with neutropenic fever, but usually the cause of the white-cell loss was obvious. A person had undergone chemotherapy or taken immune-suppressing medicines for some other reason. But this patient’s neutropenia was described as idiopathic; after an extensive work-up, they still hadn’t found the cause. He had been checked for hidden infections like hepatitis and H.I.V., for autoimmune disorders, for thyroid disease. Nothing stood out. A bone-marrow biopsy showed only that he wasn’t making enough red or white cells. She began reading up on idiopathic neutropenia for some clue about what could be causing his bone marrow to fail. She knew she probably wouldn’t be able to figure this out — more experienced doctors had already been through all this. Still, she was interested and confident enough to try.
After reviewing the studies and his work-up, the resident could come up with only a couple of possible unexplored causes. The patient was on more than a dozen medications. Could any of these be connected to his problems? In addition, in a few cases, nutritional deficiencies after gastric surgery had been linked to neutropenia. But the patient had been tested for most of them: iron, vitamin B12, folate. He had not been tested for copper deficiency, but that was pretty rare. In about a third of all cases of idiopathic neutropenia, she read, no cause was ever found.
That evening, the patient’s wife approached the young doctor. She had gone home to get the list of vitamins he was taking. “Please make sure he gets them,” she said. “He needs them.” The resident looked over the list: iron, calcium and a multivitamin — such a regimen was normal enough after gastric bypass because the removal of parts of the gastrointestinal tract limits the body’s ability to absorb certain nutrients. But then she noticed two supplements that she wasn’t used to seeing: vitamin A and zinc. Could they have anything to do with his neutropenia?.
First she looked into vitamin A. She knew it could be toxic at high doses, and he was taking more than 10 times the recommended amount. A quick search, however, turned up nothing. What about zinc? She didn’t know much about that mineral, but he was taking 15 times the usual dose. She did another search, and — bingo! A half-dozen reports appeared on the screen describing cases in which high zinc intake had caused neutropenia, and sometimes anemia. She read on, fascinated. Zinc itself didn’t cause the problem; it was that zinc and copper were absorbed by the body through the same cellular doorway. If you consumed too much zinc, you absorbed too little copper. And that mineral was essential to making blood and tissue. Maybe he had a copper deficiency after all, she thought triumphantly.
3. Resolution
She directed the patient to stop taking all his vitamins and sent off blood for a copper-level test. Even before the results came back, the effect was visible. Within days, his white-cell count was in the normal range. He was sent home with a prescription for copper and told to take it for the next six months. When the copper test finally came back, it confirmed the deficiency. Over the next couple of months, the anemia resolved too, and the wound finally healed.
Why was the patient on such high doses of vitamins? His surgeons had started them after the hernia surgery to promote wound healing; there is evidence that this can be helpful, especially early on. But the wound hadn’t healed, and the patient continued to take the supplements. He had been in and out of the hospital several times since then. Each time he was admitted, hospital doctors had continued his vitamins — with neither the patient nor the doctors seemingly aware of the possible complications.
It is a truism in medicine that the difficult diagnoses are most likely to be made by the oldest or the newest physicians. The oldest because they have seen so much, know what it’s not and also know, like Sherlock Holmes, that when everything else has been ruled out, what is left, no matter how unlikely, is probably the answer. The newest because they are fresh from the books and can follow the clues without a sense of just how unlikely the destination may be.
“It seems somehow unfair,” Pastel reflected when I spoke with her not long ago. “Here’s this guy doing everything he can to get better, but what he was doing — what he was told to do — was making him worse. We just don’t think of vitamins as something that can be harmful.”