Preventing Alzheimer’s Disease – A Personal Responsibility

Preventing Alzheimer's by exercising daily
Preventing Alzheimer’s – exercising daily

 

 

When did you last attend a presentation where the speaker was humorous, engaging and an expert in his field?

Prof Yoram Barak was invited by Alzheimers Canterbury to present a talk recently at the South Christchurch Library. I am so glad I went!

His address was titled ‘Your Mind Matters – Here’s How To Stay Sharp… Dementia Beyond Disease’.

From the notes I jotted down, I thought you may find the following insights and recommendations most helpful. Prof Yoram Barak is an expert in the field of Alzheimer’s and has also published a book:

Preventing Alzheimer’s  Disease – A Personal Responsibility: by Prof Yoram Barak

He explained that there are always multiple factors causing any disease – Alzheimer’s is a multifactorial disorder. Prevention plus treatment form an integrative practice.

Preventative Treatment / Medicine is the practice of managing risk vs protective factors. You don’t have to know exactly how to cure something if you can prevent the development of the risk factors.

Known Risk Factors for Alzheimer’s Disease include:

  • Obesity
  • Carotid artery narrowing
  • Low educational achievement
  • Hyper-homocysteine (in food)
  • Depression
  • Hypertension
  • Frailty
  • Current smoking
  • Type 2 diabetes

Protective Factors include:

  • Learning to play a musical instrument
  • Learning a new language
  • Learning how to listen to classical music
  • Hypertensive drugs that cause modulation of renin-angiotensin
  • Nutrition / diet / brain food. Broadly following The Mediterranean Diet with-
  1. Olive Oil 4 Tablespoons/day
  2. Walnuts and hazelnuts 30g on alternate days
  3. 1 glass of RED wine with a meal
  4. NO RED meat, soda or soft drinks
  5. NO commercial baking or potatoes
  • Cognitive Engagement:
  1. Get Zen – meditate for ½ hour daily (refer Gary Kabat Zinn on Mindfulness)
  2. Physical Exercise – daily for 30-45 minutes
  3. Loneliness – volunteer, maintain and cultivate friendships
  4. Purpose In Life – explore, grow.

Prof Barak explained that we don’t know why people develop dementia, and that there is no cure to date. As we do know the main risk factors, prevention becomes a personal responsibility.  The neurones / grey cells in the brain are responsible for executive functioning. All activities that enhance Neurogenesis are encouraged. These include:

Get Quality Rest: It is essential to have uninterrupted sleep for 6-8 hours per night. Short term memory storage occurs during the day, and during sleep these memories are moved into long term memory and consolidated.

Take The Blues Seriously: Depression reduces cognitive functioning, and is experienced by 17-22% of people, or 1 in 5 people. During episodes of depression the hippocampus, which creates memories, atrophies and memory is therefore reduced. It can take 3 years for the Hippocampus to regenerate.

Manage Stress: Increased levels of cortisol which are produced during stress are neurotoxic. This allows increased levels of calcium through the tissue membranes. The neurones become overloaded and fire too rapidly, which kills the neurones. People exposed to prolonged trauma, such as war veterans, have 3x greater risk.

Play: Playfulness and playing enjoyable games increases brain volume in the regions that control memory and spatial thinking.

Drink Your Coffee: Polyphenals in coffee are antioxidants, and protect the hippocampus and brain cortex. Dry brain material contains 70% fat molecules. When oxygen clumps around the fat cells, oxidation occurs, which is detrimental to the tissues – coffee helps prevent this. 3-5 cups a day for women, and 2-3 cups a day for men is recommended.

Brush Up: Dental hygiene has been linked to improved memory, though the exact cause is unknown. It has been found that memory is enhanced in people who still have their natural teeth.

Monitor Your Hearing: Cognitive decline progresses 30-40% faster for people with hearing loss.

Avoid Smoking: The brain cortex thins with age, and smoking hastens the thinning.

Avoid Alcohol/Hard Spirits: Alcohol is known to kill brain cells and thereby reduce memory.

All in all, these are recommendations that all health practitioners are promoting. How many of them do you take personal responsibility for?

Food for thought – Food for our brains!

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Changes – How Do We Deal With Them?

Dealing With Change Gracefully
Dealing With Change Gracefully

 

How does one navigate life changes gracefully?

I have come to ask myself this question after a particularly challenging 12 months. I had always assumed that my life would tick along quite nicely once I reached my fifties, and I am constantly amazed at how many challenges I continue to face.

Of course, we could be truly optimistic, and call these challenges ‘opportunities’ – opportunities for growth, for learning new things, for overcoming adversity. Forward movement also proves to us that we are alive, that we are capable of thought and action.

Life changes affect us in different ways. At the time, it may seem that we would never recover from the enormity of the event, our thoughts and feelings about what has transpired and how we were affected. With some time and space to reflect, there is always something lost, something gained.

When I left my previous job after 7 ½ years I could not imagine life outside of the confines of that institution. While I missed my close friends there, I soon came to value the diverse and broad thinking business community that makes up ‘the rest of the workers’. I ‘lost’ the security of a permanent position in a dead end job, yet gained the freedom to express myself and be valued for my work and aspirations.

My close relationships have not escaped the change cycles either. Perhaps we are more prepared for ages and stages related changes, yet sometimes those come sooner than expected. Dementia can rob us of years of communication with a close family member – it starts slowly yet transforms your loved one before your eyes. Younger family members may move in their own orbits, and over time those relationships also have the capacity to slide into nothingness if we don’t nurture and value them. People I thought would be with me forever are slipping away, consciously or unconsciously. Do you ever truly ‘lose’ those connections with Dear Ones?

People change. When large life events happen, we respond in our own unique ways. Sometimes this requires that we change perspective, we gain insight, we transform from the inside out. It is no surprise, then, that we may no longer ‘fit’ in our Love Relationships. That also happened to me. My partner and I separated. I ‘lost’ my best friend, my confidante, my lover. In turn, I ‘found’ my Inner Voice. I reconnected to my deepest beliefs and called on my inner reserves. I found that I really like Me.

Which brings me back to my original question – How does one navigate life changes  gracefully – especially when you feel lost, insecure, alone, sad or downright angry?

I realised that I needed to ask for help, something that was so difficult for me to acknowledge. I called on trusted friends for inspiration and guidance. I worked to maintain great physical health. And I worked with a coach to change my mind-set. I am still navigating monumental changes. I am also learning to dance gracefully through all the areas of my life. It is a work in progress, full of changes, and now it feels more expectantly pleasing than daunting.

Do you recognise similar themes happening in your experience?

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Fear of Change

Fear of Change stops Transformation
Fear of Change stops Transformation

Fear: painful emotion caused by impending danger or evil, state of alarm

Change: alteration; substitution of one for another, variety

(The Concise Oxford Dictionary)

During the past week I have seen two very different situations that have brought me to consider the Fear of Change, experienced both by others and myself.

In the first instance, I was visiting a person in the community who had engaged in an exercise program to promote balance and lower limb strength – the aim of which is to improve older peoples’ mobility and confidence so that they can safely live in their own homes independently.

Many of the elderly people I visit still live in the family homes where they raised their children, where they have experienced trials, tribulations, triumphs and great joy. The homes in which they have lived full and rich lives. Some are now alone, their partner having died or separated years ago. Their walls are adorned with family portraits and photos spanning generations, and memorabilia precious to them. Some homes are light and airy, others stuffy with curtains drawn. The homes take on the personalities of their owners and occupants.

Community Health workers may be the only external people to enter some homes, especially if the client does not have family living close by or friends who visit regularly. It is both a responsibility, and a privilege, not to be treated lightly.

This particular person lives alone, has multiple medical conditions and no family living in our city. It was clear to me that she was not managing the considerable upkeep of her large family home and her own health and well being, and I had been wondering how to be of best assistance to her, within the scope of my practice.

Her fear of change intervened.

At my most recent appointment she met me at the door, and told me she would not be inviting me inside, as she believed I had criticized her home – the home that her husband built for her and where she had lived all her married life.

She elaborated that she would live in her home for the rest of her life and that no-one would be able to force her out so long as she was coping.

I had not criticized her home. I had agreed with her when she had mentioned that there were mice in her lounge which she could not be rid of. She took my agreement as criticism, and must have then felt fear that I would set some actions in motion that could force her to accept help, or worse, present her with the notion that she would need to consider more manageable living arrangements.

Her Fear of Change caused her to reject beneficial action: the exercise program to help her stay in her own home!

The other circumstance is that of a friend going through a relationship break up. Raw emotions of grief and disbelief, if-only scenarios, wishing it were different. The shared home lovingly transformed over the years has now been sold. The garden is coming into its full summer glory, almost making a mockery of the hours spent visioning and planting. A new house has been bought, and awaits some loving attention. A new future beckons, with new opportunities for joy, for self-expression. Yet still there is the tug, the pulling backwards into what was. “I am scared of change. I want what is familiar”.

The Fear of Change holds us back, yet again.

“The events that transform us are usually not the things we would choose. As someone said, we never want to go through what we need to go through to become what we want to become.” Andrew Matthews – Follow Your Heart.

Reflecting on these two situations I am left pondering where I am allowing the Fear of Change to influence my own decision making. Only by letting go of the shore will my boat have the freedom to sail!

What Fear is holding you back from Change?

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Lessons from Live Love Laugh

Live Love Laugh through Life Lessons
Live Love Laugh through Life Lessons

Dayle Hunt is a Life Mechanic and he aims to tune your internal Ferrari to reach peak performance. I attended his inaugural one-man show Live Love Laugh, where he combines personal stories of life lessons with humour and humility.

He maintains that we have six basic Human Needs which need to be fulfilled for us to live a meaningful life. He combined stories and anecdotes to illustrate how we go about meeting our individual needs to have certainty, variety, significance, love and connection, growth and contribution in our lives.

It seemed that one hour was way too short a time to settle in and fully engage with his three personas who occupied the stage in their turn.

Interestingly, for me I guess, my own enjoyment of the evening was marred by the disruptive presence of the young person who sat in the seat behind me. She repeatedly kicked the back of my chair violently, causing the whole row of seats to reverberate, and the man seated in front of me to cast annoyed looks in my direction. Then she explosively crushed her empty plastic cup in my ear. Then she sat with her feet dangling over the back of the empty seat next to me, and proceeded to kick that too.

I had accepted an invitation to Live Love Laugh, and I found myself then pondering whether this young person was actually displaying the effects of NOT having her basic needs met.

  • Certainty. Had her parents explained that they were attending a public performance where she would be required to sit peacefully for an hour during the performance. Had they outlined the expected format of the evening and told her more or less what she could expect to happen? Were there boundaries in place, should she not behave in an acceptable manner? Are her parents consistent with their discipline? How was her need for Certainty met?
  • Variety. If the young person in question was attending a live theatre event, no doubt she has attended many other social outings. School, friends’ parties, family gatherings. Perhaps she was just not enamoured with her current set of circumstances – perhaps she had wanted to be somewhere else, doing something of her own choosing.
  • Significance. Her presence behind me became significant, for all the wrong reasons! I was annoyed, distracted and then heart sore – because I did not want to be frustrated by a child. Her disruptive behaviour made her significant to others that were distracted, and perhaps also to her parents who may have felt annoyed or embarrassed that they needed to ask her to desist. How did her behaviour make her feel significant?
  • Love and Connection. If she had been my own child or grandchild, how could I have strengthened her feeling of being loved and connected? Perhaps I could have invited her to sit in my lap.
  • Growth. Perhaps this was a first ever attendance of a live event for our young person. I am hoping there would be many other opportunities for her to have wonderful experiences – and that she will grow into a sociable and friendly young woman.
  • Contribution. By just being herself, she has contributed to my learning, to my experience. It is up to me to determine the value of the contribution.

I am left pondering the evening. Dayle Hunt and Live Love Laugh will take you to many places. The familiar, the funny, the unexpected, the unexplored corners in your heart. Which brings me to ask:

How have you dealt with the disruptive seat-kicker? Please share your comments with me, so that I can keep learning!

 

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Wanting to Live – Wanting to Die

quality of life helps reinforce wanting to live
Wanting to Live

Quality of Life is often taken for granted.

In the past few weeks I have had cause to stop and reflect on what it means to live, and die, well. Three separate recent instances have given me ample opportunity to ponder both wanting to live and wanting to die.

A younger friend triumphed at her third attempt to take her own life. I had not known her for very long, but in the short while that I did, she touched my life deeply and beautifully. We shared exchanges and experiences during a Spiritual Seminar and I remember looking deeply into her eyes and seeing her pure and beautiful essence looking back at me. I can’t imagine the inner turmoil that took her to the edges of her endurance, such that she could not see any other way out of her personal anguish – leaving her wanting to die.

How sad for those left behind: her husband, her family, her friends and work colleagues. Do they blame themselves for not being able to save her from herself? I hope not. They need love and support to celebrate and remember her beautiful soul and the love she brought during the time she was here with us. She was living life, yet choosing the peace of death for herself.

While working in a rest home, I had the real pleasure of meeting a middle aged man who was terminally ill. He told me of his recent exploits, his ‘bucket list’. He had admitted himself into the facility for palliative care, not in the city where he had lived for many years, as he did not want to burden his friends and acquaintances when he died. His estranged family lived overseas and he was matter of fact that they would not be visiting him. He told me about his spiritual beliefs, and that he was not afraid to die. He set about wanting to live his last days with the same enthusiasm that had brought him a very full and interesting life.

A colleague and I were the first two people to enter his room after he had ‘left’ his body. He was lying head propped on one hand, looking up to the ceiling with the clearest blue eyes. While my colleague went to report his ‘passing’ I had the opportunity to Bless him, thank him for allowing me to share some part of his Journey, and to wish him well on his continued Journey.

He had lived life at full tilt, and if he had any regrets he was philosophical that what had been was laid to rest. He died alone, yet touched the lives of each person who had a part in his final days. He lived fully in his body that was dying.

The third person is still living, yet wanting to die. He is elderly, had been a very fit and healthy husband and father – then suffered a severe stroke which left his body ‘half useless’. He says if the results of the stroke can’t be cured, he wants to die. He sees no way forwards if he can’t do all the things he used to do and has to rely on his wife and son to help him with the most basic life skills.

He is living death. He wakes every morning, hating the fact that he has woken. He goes to sleep at night wishing he would not wake. His family are at a loss – what to do? Why won’t he help himself?

In the end, quality of life seems to be the common thread. No matter what our circumstances are, when we feel nurtured and fulfilled we believe that life is truly worth living.

Do you agree? Please share and comment – I value your thoughts about wanting to live and wanting to die.

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New Thinking – New Experience

New Thinking brings New Experience for www.selfmanagechronicpain.com
New Thinking brings New Experience

 

Have you recently changed your thinking about something, and noticed how your world opened up? New Thinking results in New Experience.

Last weekend I was one of the many people promoting a service and health based product at our local Mind Body Spirit Festival, which is held every six months at a multi-storied venue in the city. Stalls or cubicles are set up on the first two floors, with talks and workshops taking place on the third floor.

Regulars to the Festival feel a sense of familiarity with the layout and recognise many of the stall holders as they return each time, often to their same ‘space’. For a newcomer, the experience can be totally overwhelming! Imagine how much new thinking is stimulated, which results in new experience.

First, there is the sense of excitement, the hub-bub of sounds – conversation, music, general activity. The visual stimulation is intense. Posters, wall hangings, tables laden with enticing objects, the vibrant clothing and jewellery people are wearing. Your sense of smell is awakened, by the aroma of foods in the food area, fragrances of massage oils, soaps and other products.

So much to see, so many services and products on offer, so many people searching for who knows what? If you came with a particular purpose in mind, it is easy to fulfill your mission and leave feeling satisfied. But what if you had no idea what you were ultimately looking for? A vague sense of wanting something, hoping you would know what it was once it was in front of you.

I met people for whom all of these situations were true.

On the first day I was stationed at our stall, waiting for people to pass by, hoping to interest them in what we had to offer. Many times, these people had a dazed look about them, not wanting to be ‘accosted again’ by a zealous stall holder determined to bend their ear about the “next best thing”. They looked harried, overstimulated, tired, in need of a reassuring hug and a still quiet place to recover their equilibrium. Perhaps new thinking was too active resulting in too many new experiences.

I did not particularly enjoy the hours ‘attached’ to the stall. I did not feel that I created enough opportunities to serve, to offer anything of value to these people who were obviously searching for ‘something’, yet trying to escape from feeling cornered.

Overnight, I realised that my experience would change when my attitude and actions changed. I welcomed new thinking and new experiences. I decided to ‘be the change’, and spent the morning as a Roving Ambassador of Goodwill. I set out to meet each stall holder, to find out who they were, where they came from, what they were offering, and how I could meet any of their needs with what I was offering.

Guess what? I met so many interesting and lovely people! I handed out small samples as an energy exchange. I practiced the art of receiving too, accepting compliments and any snippets of advice or information. The experience was priceless.

Someone suggested to me that I could host my own stall next time – as a Roving Ambassador of Goodwill. It is a thought! Meanwhile, I shall keep practicing the technique: New Thinking leads to New Experiences.

If you enjoyed reading this post, and if you have had similar experiences, please share and re-post, especially if re-posting is a new experience for you!

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Are Spiritual People Always Happy?

David Karchere

 

DAVID KARCHERE is a speaker and workshop leader who assists people to renew their Primal Spirituality—an experience that virtually all human beings know at birth, and that ideally grows as they mature.

I recently attended a Seminar co-presented by David – at Riverdell, in July! I receive the weekly emailing – The Pulse of Spirit, and in this most recent one (August 23, 2015) David shares his wonderful insights about living a full and joyful life – despite the current level of physical pain he was enduring! 

With great respect, I share his words:

 

When I began to think about the topic of our first live online public course, a good friend suggested the theme of happiness. It is a subject of growing interest for people.

Dr. Jane Anetrini had introduced me to Dr. Dan Baker’s book What Happy People Know. And I’ve noticed the growing focus on the positive side of psychology – moving away from a study of mental disease to a study of what well-being looks like.

In July, I visited Riverdell, the Emissary Spiritual Center in South Australia. Dr. Andrew Horwood arranged for me to give a public talk in downtown Gawler on the topic 7 Simple Steps to a Happy, Fulfilling Life. Gawler is not a large town. But 60 people turned out in a packed room at the Prince Albert Hotel. They were fascinated and delighted.

Clearly, the topic was of intense interest. Just as important to me, I found that the subject of happiness gave me an opportunity to speak about the most pivotal areas of our human experience. It was an opportunity to explore the primal bond – our connection with all people, all of nature, and with the creative spirit within us.

Returning home to Sunrise Ranch, the team of people working on the course got very focused on the content. What would be important to people? How could we really make a difference in people’s lives?

The first issue to address was the very nature of happiness. Surely, it must go beyond a momentary feeling of elation, even though that’s delightful.

So the first of the three modules is on The True Nature of Joy. I had just written a chapter for Joyce Graham’s upcoming book, Accessing Joy. I entitled it The Joy of Creation. The truth I wanted to explore was fresh in my mind.

Life contains such poetry and irony.

As I developed the material for the first module of the course, I was recovering from a back spasm, aggravated by my travel. At times, it really hurt!

There I was, writing about joy. And my lower back was killing me!

And then I GOT it.

How perfect!  Joy isn’t just about feeling good. Happiness isn’t just a momentary sensation. I was in some pain. But I knew deep joy and fulfillment in my life. I am a happy man!

Don’t get me wrong. I don’t like pain any more than the next person does. Truth be told, I’m a wimp when it comes to things like dentistry and other kinds of physical pain. I avoid pain when I have a chance. And that includes emotional pain too.

But I am a happy man, with or without a back spasm. I have joy in my life even if I am having a bad day. My joy is from something way beyond that. How can I share the key to that understanding?

I had collided with a belief that is in the back of many people’s minds: If I am on a spiritual path, good things will always happen to me, and they’ll make me happy.

Really?

When I think about it, the most spiritual people I have known in my life have dealt with all kinds of illness, heartache and disappointment.

And then I think about the people who are spiritual heroes to me. People like Martin Luther King, John Lennon, the Dalai Lama and Jesus. They each faced huge challenges. And they radiated joy.

No, happiness isn’t just a momentary sensation.

I’ve decided to name the course The Master Key to a Happy and Fulfilling Life. It will be a deep exploration of what happiness and fulfillment really is, and how to embrace it your own life.

Below is the link to the page where you can find out more about the course and register.

http://davidkarchere.com/ps-masterkey-register

I hope you can join me in our first live online course.

Next time I’ll explore the question, “What is the Master Key to Happiness?”

Warm regards,

David
Please share and re-post if you found this inspiring and interesting.

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The Heart in Two Forms – Treating the Real Heart

The Real HeartHow much do we really connect with the people in our worlds?

As a physiotherapist I have been taught to observe, palpate, analyse, correct. In some instances, manual therapy has been obliterated totally and the therapist is required to only observe, record and comment.

There is little satisfaction gained when, intrinsically, you ache to get to the root of an issue and manually massage it out or provide a gentle reassuring technique to feed your patient’s need for ‘something to make me feel better’.

John Mandrola wrote an article posted in Medscape recently, about treating the Real Heart. Although I am not a Cardiologist, I related so much to what was being expressed. He was discussing a plenary session presented by Dr Abraham Verghese (Stanford University, CA) during the American College of Cardiology 2015 Scientific Sessions.

Dr Verghese spoke of the heart in two forms:

 

The hearts that we examine physically that are easy to see and

The Spiritual Heart, the organ that connects us as people.

 

He wanted to know what makes that connection, how do we treat the Real Heart of our patient?

Firstly, we need to harness the power of words, as words are the glue that makes the meeting between us happen.

Then, another way to carry the hearts of our patients requires that we notice the ritual that happens during the encounter between the clinician and patient. The place beyond words is the encounter between clinician and patient – the actual ritual. “They trust us with their secrets, they allow us to touch them”.

Dr Verghese went on to say that when we recognise our own sense of self and of the patient’s being, something profound and magical happens.

But, if we shorten this ritual, when we don’t hear or touch our patient, we miss the transformation.

If we connect with the Real Heart of our patient we approach the magic of poetry – a place where the mind and the heart say the same thing.

Have you recently experienced this magic?

It can happen during any encounter during our day, not just between clinician and patient. When did you last greet someone warmly and sincerely, and hug them? Smile a greeting and hold out a hand? Listen to a child’s lament and wipe their tears? You have experienced this magic!

We have the opportunity to truly connect with each others Real Hearts multiple times in our daily interactions, if we could just remember it.

If you resonated with this post, please feel free to share and re-post.

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Immense Relief as Migraine Headache Aborted!

Have you ever had a migraine headache that seems to split your head in two, with sharp searing knife-like stabbing? Just the memory of it makes one shudder!

The migraine has distinct phases – that sinking feeling when you feel it building up. Oh no. Not again. Why now? The progression seems inevitable unless you can nip it in the bud with heavy duty analgesics. Sometimes, you just don’t get to avert it.

Then you have to endure the aching body muscles, the nausea, the floating through no-man’s land while the wretched thing takes on a life of its own. Hunker down, keeping quiet and still, hoping ‘it’ will somehow not take too much notice of you curled like an embryo waiting for the labour contractions to end – to deliver you from this awful state of existance.

The post-drome is equally tiresome. Feeling like you have lost your capacity to think or reason – mind foggy and brain fatigued. Muscles aching as if you had run a marathon, then a triathalon, back to back. This can take a couple of days to pass.

Does this sound familiar?

Imagine my delirious delight when I managed to ABORT a migraine last week, in a completely unexpected way!

Natural Pain Relief
PowerStrips – a patented fusion of Modern Energy and Ancient Herbs

This is my ‘selfie’ of the PowerStrip I placed over my greatest tension area, before I took two regular panadol tablets and went to lie down. After an hour I woke – and the migraine was GONE! No residual headache, no residual muscle tension or brain fog and fatigue. I had to believe it – because I experienced it first hand. I kept the PowerStrip in place for the recommended 48 hours, and felt its comforting warmth as it worked wonders.

If you, or anyone close to you, would benefit from knowing more about the natural pain relief and energy giving properties of PowerStrips (FDA listed Class 1Medical Device), please leave me a comment below with your email address.

comment here
for more information ask us here

 

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What Is The Most Effective Weapon For Fibromyalgia?

Aerobic Exercise !

aerobic exercise is the most effective ‘weapon’ that we have
People with fibromyalgia benefit from continuous physical exercise.

 

A recent article in www.medscape.com by Alice Goodman summarised an overview of research on fibromyalgia treatment that was presented at the Paris 2014 European League Against Rheumatism Congress.

Winfried Häuser MD, from Technische Universität Munchen is an expert in the field of fibromyalgia. He believes that treatment for people with fibromyalgia should be individualised and include non pharmacalogical approaches, as these are often more effective than drugs. He explained that aerobic exercise is the most effective ‘weapon’ that we have and both healthy people and people with fibromyalgia benefit from continuous physical exercise.

He and his colleagues recently published a network meta-analysis which was an indirect comparison of all available therapies for fibromyalgia. They were unable to find any significant differences in effectiveness between drug and non-drug therapies. While the effects of drugs are lost once the patient stops taking them, the effects of aerobic exercise and multicomponent therapy are sustained but declining at 1 or 2 years.

Dr Häuser advocates a graduated approach to treating fibromyalgia.

Mild fibromyalgia: can be managed with reassurance from the doctor and encouragement to engage in regular physical and mental activities.

Moderate fibromyalgia: should be managed with aerobic exercise and the temporary limited use of drugs.

Severe fibromyalgia: can be managed with aerobic exercise, drugs and the psychological and/or psychopharmalogic treatment of mental comorbidities.

Dr Mary-Ann Fitzcharles, a rheumatologist at McGill University in Montreal who treats people with fibromyalgia, agreed with the patient-tailored approach outlined by Dr Häuser. She cautioned about overmedicating people, and keeping them on continued medications which have side effects. Non Pharmalocological therapies have no risks, she explained.

Dr Fitzcharles went on to say that non pharmacologic therapies are probably the most important ones for people with fibromyalgia. In her experience, every person with fibromyalgia should be managed with exercise, promotion of an internal locus of control and education.

Activity pacing is the key, in order to not overdo or avoid exercise.

Non Pharmacological therapies include:

  • Aerobic exercise
  • Acupuncture
  • Psychotherapy

Pharmacologic / drug therapies include:

  • GABA analogues
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Tricyclic antidepressants
  • Serotonin-specific reuptake inhibitors (SSRIs)

References:

  1. Aerobic Exercise ‘Most effective weapon’ for Fibromyalgia. Medscape. June19, 2014. Annals of the Rheumatic Diseasesard.bmj.com
  1. Comparative efficacy of pharmacological and non-pharmacological interventions in fibromyalgia syndrome: network meta-analysis

          Eveline Nüesch, Winfried Häuser, Kathrin Bernardy, Jürgen Barth, Peter Jüni

               Ann Rheum Dis 2013;72:955-962 doi:10.1136/annrheumdis-2011-201249

 

 

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