Varicose veins are thought to be ugly, and in a way, they are. But as a doctor, I am less concerned with beauty, more with health problems – and varicose veins are not always as harmless as they seem.
Thrombosis is a clot that blocks a vein, usually in one leg. Thrombosis may lead to pulmonary embolus and, in rare cases, to a stroke; both can be fatal. The symptoms are swelling and pain and warmth of the affected limb. Physicians order a Doppler scan, to make sure the patient does not have the feared clotting situation. If it is a clot, the patient will be admitted to a hospital and a severe thinning of the blood will be administered with heparin, Coumadin and other anti-coagulants, until the clot is gone or at least stabilized.
Often the Doppler test comes back negative – no clot, good news! The patient has “only” phlebitis, an inflammation of the wall of a vein. The symptoms are exactly the same: pain, swelling, warmth. In German phlebitis is generally called “cramping veins” because cramps are also a feature of phlebitis/thrombosis. What can you do against inflamed veins?
Phlebitis and thrombosis can have several causes, sometimes combined: A genetic disposition plays a role. Longtime immobility - like sitting on a long trans-Atlantic flight without getting up, or being bed-ridden, especially after surgery – is known to cause clots. Hormone therapy can lead to clotting. Less well known reasons are cancer and food sensitivities, or even just plain food that is not healthy.
Nutrition that is less than optimal is known to promote inflammation. That inflammation can show up as different diseases in the body; one is phlebitis/thrombosis. Junk foods with high sugar content, white starches, trans-fats and particularly dairy are highly inflammatory for everybody. Food sensitivities, on the other hand, specific for individuals, can also inflame, but the causative foods are sometimes hard to pinpoint. I have seen reactions to banana, avocado, nuts, beef (it might be more what the cattle ate than the cows themselves) and cherries – but there are endless possibilities; a food diary might help in recurrent cases.
Varicose veins frequently occur in people with unrecognized gluten intolerance. Slowly, over the years, the varicosities grow, which is often thought as being just another sign of aging. However, varicosities can be viewed as a sign of chronic inflammation of the body. Pregnancies and much standing can aggravate the condition.
What to do in phlebitis:
1. Eliminate all offending foods.
2. Move moderately every day. Don’t sit for prolonged times. Go for a walk every day.
3. Don’t sit with legs crossed – that clamps down of the veinous blood flow.
4. Elevate legs as often as possible.
5. High-dosed fish oil, three capsules three times a day. Fish oil is a mild blood thinner (and could be contra-advised in some conditions) and a strong anti-inflammatory agent.
6. Cold washings and gushes of the legs, cold sitzbaths and barefoot walking in the ocean all are beneficial.
7. In the acute situation, an icepack (not longer than 16 minutes at a time) might bring relief.
8. Wear support panty hose. It prevents the veins to bulge out bigger and bigger. On very hot days cut out the crotch of the panty hose. Wear the support hose also after you are better.
9. Don’t rush into surgery. Phlebitis is often not just a mechanical problem – think about the food connection first.
10. If symptoms get worse with fish oil therapy, you better return to your physician – soon! Read More
Blog: On Health. On Writing. On Life. On Everything.
Winter Health – Thoughts From the Workshop
January 31, 2011
Introduction:
[These are my notes – they are a refresher for the workshop attendants. But might also be useful to look something up when one needs it]
What happens through the winter: A depletion of reserves leads to increased susceptibility to infections. Decreased movement. Holiday foods – not healthy.
It takes two to get sick: A virus and a run-down immune system.
“Huge outbreak” of Swine flu in Great Britain: 24 deaths as of 1/29/11 – compared to the more than 35,000 deaths annually from “normal” flu in the US (which is nothing).
Cold and flu:
• Prepare: Get your immune system into perfect shape
• Protect: Shield yourself during an actual outbreak
People are less prone to respiratory infections if they have more contact with people, and hug more. Exception: Little kids – they schlep everything home. But in the long run, it might be beneficial. But in a flu outbreak: Stay away from people as much as you can. Wash hands often. Don’t be sneezed at. Avoid public transportation. Don’t hug and kiss. Avoid touching public doorknobs, telephones and similar surfaces with unprotected hands.
• Pull through: Survive even if you come down with it.
• Water
• Cold stimulus – compare to anti-oxidant stimulus – good stress and bad stress
• Warm rooms: More obesity, more colds
• Cold Shower/cold wash/cold dunk for babies older than four months
• Cold sitzbath
• Sauna
• Sleeping with windows open
• Drink enough warm or hot fluids – hot herbal teas are perfect. Juices are not.
• Don’t do cold applications with an acute cold/flu, uncontrolled hypertension, arterial disease (Raynaud’s)
• Movement
The only thing for increasing qi and against cold is movement. But excess is as detrimental as laziness.
• Yoga, of course
• Daily outside walk – importance to get sun light and vitamin D
• Hiking, bicycling, games on weekends
• Snow shoveling:
Break down the task
Take small loads
No abrupt movements
Cherish twisting movements – but they also can be the source of strained muscles.
• Yoga ball (back)
• Small heavy ball (arms)
• Getting to the ground once a day (strength)
• Knee bends (strength)
• Hanging out (back)
• Standing on one leg (pelvic health)
• Food
• Fresh foods – home cooking: Vegetables, legumes, small portions of fish and meat (lamb!), fresh (or dried) herbs. No microwaving.
• Vegetarian/vegan against omnivore
• No dairy, sugars, white starches, sweeteners, artificial molecules: colorings, flavorings, enhancers, preservatives, etc
• Predominantly cooked – more so in the winter
• Fats: More is better – but they have to be vegetal: Olive oil, coconut oil, ??butter
• Organic: Good but fresh is more important
• If you have a cold/flu: You should always force hot liquids on a sick person but never food: Respect if there is no appetite, and respect if there is. Just nothing sugary. Fruit – fresh or as compotes – is probably the best. Or hot elderberry/blueberry soup (also good for acute stomach flu and urinary tract infections). Blueberries are much cheaper.
• Herbs
Herbs have been with us throughout evolution. Their mechanism fit into our ancient physiology like a key into a lock. We always ate herbs from the wild, and now that we have for the most part stopped, a little bitter green, cabbages or strong root might just be what your body needs to find back to balance.
Bacteria and viruses do not easily develop resistance against herbs. That is because a single herb contains hundreds or more of compounds, and many of these compounds work on killing off the germs - not only one. Since point mutations in bacteria can only develop one by one, it is less likely that an herb becomes ineffective against a pathogen because there will be other compounds to destroy the microbes first.
Synergy is the reason why I recommend whole herbs (tinctures or so-called phyto-caps with extracts of the whole plant) instead of “taking the best” from several pants, and making a patented medicine. Patent medicines exist because natural plants can’t be patented, and so firms try to make money by taking single compounds from a plant, combining it with other single compound, thus producing a “new” medicine that allegedly is better. The truth is, mostly it is not better because you cannot improve on nature
• Prepare: During cold and flu season, take tonic herbs like stinging nettle, astragalus, ashwaganda, or eleuthero (formerly named Siberian ginseng) to strengthen your immune system. Rotate them every three weeks.
• Spice up your food with herbs and spices because they kill microbes (the plants developed the strong-tasting compounds to protect themselves against the invasion of bacteria, viruses and fungi). Pregnant and breast-feeding women as well as little children should go easy on herbs and spices.
• When you go out, use an Echinacea spray every hour or two to protect your throat, the entry port of viruses. Again, GAIA makes a good one
• Mushrooms boost your the immune system – eat them often, or take a mushroom preparation; Whole Body Defense by Gaia is one.
• Protect: (if you had exposure, or suspect you had): If there is a bad flu epidemic: Chew a raw garlic clove, several times a day
• Take a lick of unheated honey (Manuka is the best) every hour or so – kills germs (not for children under three years – danger of botulism!)
• Rinse your nose prophylacticly with saltwater to kill germs (carefully rinse mouth afterward with clear water if you have blood pressure issues)
• Prophylactic and curing: Hot elderberry tea, hot blueberry soup
• Importance to wash hands and cover sneezes and coughs, preferably with a sleeve cough – not your hands
• Take as supplements: A probiotic (I like PrimalDefense), fish oil and cod liver oil
• Pull through: In cold and flu: Immediately when you come down with the flu: REST!
• Fever over 104 F in children, and a cold lingering more than a week should be seen by a physician. Also if you have unusual symptoms like stiff neck, enormous headaches, breathing difficulties, and so on.
• Against cold: Easiest, most expensive: GAIA Quick Defense. It contains Anagraphis paniculata – best cold medication I know (hard to find as a single extract)
• Against cold and flu: Echinacea, olive leaf, osha, pau d’arco, licorice – all as extracts in a bottle. Mix together in hot water like a tea.
• Other herbs that have been found beneficial in colds and flu: bayberry, boneset (Eupatorium perfoliatum), calendula, goldenseal, Oregon grape, juniper berry (chew a dried berry every few hours, not more than five a day, and not for longer than a week), umckaloaba (Pelargonium sidoides)
• A ready-made anti-viral concoction is the Chinese Yin Qiao Jie Du Pian, also called Honeysuckle-Forsythia Detoxifier. It might be a good idea to have some of those pills at hand when you get sick (get them from a reputable source).
• Lingering (more than a week) colds and bacterial infections: GSE extract (but consult your physician to make sure it is not pneumonia)
• Sore throat: Swish a few drops of oregano extract (nips whatever is coming in the bud, if you take it early enough) in your mouth and swallow, or zinc lozenges (science is a bit wobbly on zinc)
• Sore throat: Gargle with saltwater or warm water with one drop of sage, myrrh, oreganol, neem or tea tree oil. Not for children under six.
• Stuffed nose/Sinusitis: Rinsing nose with saltwater – frequently, if necessary
• Stuffed nose/Sinusitis: Eat mustard, horseradish.
• Stuffed nose/Sinusitis: Steam inhalation helps with a running or stuffed nose. You can add chamomile, thyme, eucalyptus or a pea-sized piece of Vick’s. You can also use Vick’s on older children (check the label).
• Cough: Gan Mao Dan Chinese pills (20 per day in divided doses), or make a tea of peppermint, honeysuckle, ginger, cloves and/or horehound, slippery elm, violets, fennel, anis, marshmallow root (the real one!), Iceland moss (Cetraria islandica), ribwort plantain
• Fever is mostly good – it kills the germs. Therefore, no aspirin or Tylenol. In children, do cold wraps or dunk babies in tepid water
• If you get the flu, start Ginkgo biloba will start repair damaged cells
• Also: No decongestants as they tend to dry out mucosa and increase stuffiness in the long run
• Increase hot fluids: hot water, hot broth (chicken soup has been researched – and it really works!), hot herbal teas (linden flowers, elderberry flowers, honeysuckle, fennel or thyme, sage, green or black tea, thyme, ginger, rose hips, mullein, lemon balm, peppermint - in all combinations) are good – but so are many other. Hot lemonade is also beneficial if made with fresh lemons and preferably with unheated honey
• If you use vitamin C, use a low-dose kind – and only in the first few days of a cold
• Don’t use all the herbs at once – get familiar with a few, one after the other.
• There is no such thing as” That herb does not work in me!” There is only “That herb does not work against this or that germ”
• Order
• Cherish the season – don’t fight it
• Preventing: GET ENOUGH SLEEP! In a flu outbreak, be in bed by nine pm every night – no TV, no computer. The body repairs itself during about two hours the time around midnight — if you are asleep then, that is.
• During a bad flu season, consider wearing a mask over nose and mouth
The causes of death in influenza are of two different origins: Older people die of the virus and its consequences like pneumonia; their weakened immune system cannot fight the virus anymore. Young people succumb to an overreaction of their still exuberant immune system – they produce what we call a cytokine storm, and usually die within the first two days. Consequently, both groups should be treated differently. In young people (older teenagers and young adults) I therefore would add an herbal anti-inflammatory, namely Zyflamend as soon as the young person gets sick. Read More
Weighing In
June 21, 2010
How often should you jump on the scale?
For many years, I never recommended to patients to weigh themselves daily (first thing in the morning). The prevailing medical opinion was that weighing oneself triggered anxieties that might end in eating disorders like anorexia and bulimia.
Contrary to what I said to my patients, however, I have weighed myself my whole life (nearly) every morning – and have kept the same weight since age twelve. Except for pregnancies, gaining twenty pounds with my daughter, forty with my son. The difference? In both cases, relentless morning sickness. With my daughter, eating or even thinking of food made me throw up; with my son, eating calmed the sickness. During pregnancy, I did not care what I weighed and how I looked; all I cared was the baby I was expecting. So I followed my body’s whims and cravings. Including the incredible craving for a lobster at a very inconvenient time…
My body feels well only within a very tight margin: Two pounds less, and faintness grips me. Two pounds more, and stuffiness prevents me bending forward.
My personal weight story made me absolutely unacceptable for several overweight patients who stated that I had never been in their shoes and could therefore not advise them. I respect that view. But it would also mean that one can’t be a good doctor for a cancer patient if one didn’t have experience with the dreaded disease. Or could couldn’t treat a heart attack because … you are getting the idea. (On the other hand, the notion that better doctors come from personal experience with serious illness, is worth spinning out. The A+ nerds who populate our medical schools – half of them should be replaced with compassionate, common-sensical young men and women).
A study showed that people who weigh themselves more often also lost more weight. That takes this discussion beyond my personal story – and here it becomes interesting.
French women supposedly don't gain weight as they age. Which means if the scale tells them they have gained a pound or two, they take action. And responsibility. That might be part of the French Paradox - that the French live longer but eat more fat. Might be they eat fat - and then put in a salad day.
A scale is a reality check. If you want to avoid looking the facts in the face – your decision. I like to confront bad situations – weight gain, disease, divorce, death (why do nearly all adverse events start with a "d"?). That led me one time to lie down in a casket and pull the lid shut, just to see how it was. It was surprisingly peaceful. What I found out in the coffin: It was nothing to fear. Read More