Paul Hood : Healthy Lifestyle

Doctors make a general distinction between acute pain from an injury that’s going to heal or disease that’s going to be cured, and chronic pain where you will be forced to deal with pain over a long period of time. So, for acute pain, all you need is a few pills and patience while the pain slowly fades away. Chronic pain should have a different approach but, for the following reasons, doctors prefer the pill bottle. If you look at the way the US healthcare service is organized, the basic motivation is making a profit. Because most patients carry some insurance, the strategy for doctors is to see as many patients in the day as possible so they can maximize the bill presented to the insurers for payment. In the good old days, a caring physician would take the time to get to know the patient and understand his or her needs. Now it’s straight to the business of writing out a prescription and calling for the next patient. Very few doctors ever take the time to investigate the underlying causes of the pain and find the best treatments because this takes time and time is money. Of course, the patients with the top-of-the-line insurance plans are covered. And the wealthy can afford to pay their own way to the best treatment. But the average citizen is on a conveyor belt to the fastest and easiest treatment which, by some strange coincidence, just happens to be a drug.

Why a coincidence? Because all the ads you see on television and in the newspapers and magazines, are paid for by the pharmaceutical industry. The corporations making the drugs are using hard-selling techniques to reinforce your dependence on pills as the primary form of treatment. That way, you go into your doctor’s clinic with the brand names of the relevant drugs on your lips. You are brainwashed into thinking the use of drugs should be the first response to all your problems. Why is this a problem? Because it’s turning the US into a country of addicts. Worse, as people continue to use many of the drugs, their tolerance increases and the effectiveness of the drugs declines. According to the National Centers for Health Statistics, approximately 75 million people in the US suffer some degree of chronic pain, i.e. pain giving them a poor quality of life. Agreeing, the American Pain Foundation offers a simple comparison. If you count up all the people who have cancer, strokes and heart disease every year, only a million or so die every year, but the pharmaceutical industry, hospitals and clinics devote vast amounts of time and money to offering treatments. Because there’s not the same amount of money to be made out of people suffering chronic pain, you are offered second-best service.

This is a political problem and, so far, there’s no sign the reform bills going through the House and Congress will deal with this. It all comes down to the priorities of how limited money is to be spent. On the one hand, you can be offered painkillers on a take-it-or-leave it basis. This is not so bad. Tramadol is an excellent drug and gives consistent relief from moderate to severe pain. Or you can be offered access to proper diagnosis and treatment. While we wait for a revolution, buy tramadol and find some relief from the pain of your condition.

Medicalization is a wonderful word. It means the process of taking a natural condition and convincing people that it’s a disease to be treated and cured by the medical profession. Once a condition is medicalized, the pharmaceutical industry can sell drugs, doctors and hospitals can charge fees. The cash registers just keep on ringing up the profits. Once this happens, there’s a kind of bandwagon effect. The condition suddenly becomes a lot more serious. It’s now a disorder or disease. For health insurance companies, it’s a pre-existing condition.

Now there’s a funny thing about health insurance companies. They are never shy about coming forward with new reasons for not paying out on their policies. One of their classic excuses is the “disclosure” rule. The law sounds quite reasonable. If you are sitting in your office and never get to meet the person applying for a health plan, you have to rely on the honesty of what the person says when you decide whether to write the policy. It’s a sad fact that some people are less than honest when they apply for policies. They forget the heart problem and declare themselves fit and healthy. Insurance companies therefore need the right to rescind the policy – to cancel it if the applicant failed to disclose information needed to assess the risk.

So now we come to the case of Otto Raddatz who, courtesy of his sister, became a famous victim after his death. She testified to a Senate committee about what happened and the story, in suitably dramatic form, was later picked up by President Obama in support of his campaign for healthcare reform. The facts are easy to state. Here was a man lining up to get surgery for cancer. The hospital appointment was booked when, surprise, the insurance company decided to rescind the policy. Why? Because Otto had failed to disclose the fact he had acne as a teen! This was a serious pre-existing condition and likely an indicator he would get cancer later in his life. His failure to disclose it justified rescission. Well, fortunately, his sister was an attorney and she got the state attorney general on the job. Six weeks later, the insurer reinstated the policy and Otto got his operation. This gave him six more years of life.

It’s sometimes odd to see how the world works. The medical profession goes to great trouble to convince everyone that acne is a disease. The pharmaceutical industry sells us accutane which is an almost always effective treatment, clearing the skin and restoring beauty during the first period of treatment. And then insurance companies accept this medicalization and require people applying for policies to disclose acne as a pre-existing condition. This is a logical and predictable progression. If doctors say acne is a disease, it must be a pre-existing condition and everyone should disclose it when they apply for health insurance! Do not be deceived! The Illinois attorney general does not fight for everyone. Otto was lucky that his sister was an attorney with the right political connections. So never lie about having acne! The risk of rescission is real. And while you have acne, rely on accutane, the sure-fire way of solving the problem.

The power of words must never be underestimated. Pick the right word and suddenly your brand name is on everyone’s lips. Pick the wrong word and no-one ever hears of you or, if they do hear the word, the reaction is amusement or rejection. So get into the time machine and let’s go back to the 1990’s. This is before Pfizer launched the famous little blue pill in 1998. A group of people are sitting round a table in a backroom trying to think up the best way of describing this new wonder drug. How were they going to market something of such a sensitive nature.

No-one liked to talk about erections and sexual problems in public. It was just too embarrassing. The culture was way behind the technology to bring a cure. They decided the key problem was the use of the word “impotence”. It had far too many negative vibes attached to it. So, after hours of fruitless labor, they finally decided to describe the medical problem as “erectile dysfunction”. This also had the advantage of being easily contracted to ED which was definitely not threatening. The rest, as they say, is history. The pill was launched with a major fanfare and no-one minded talking about erectile dysfunction.

Welcome back to a modern debate on whether loss of libido in women is a medical problem to be cured. The word most often used to describe the condition is “frigidity”. This insulting word blames women for not finding men sexually attractive. The new manufacturer has decided to use the term “hypoactive sexual desire disorder”. When this was first announced to the world, there was a scathing reply in the British Medical Journal accusing the manufacturer of inventing a disease to convince gullible women they needed to buy medicine. Put another way, this drug is aimed at a US market estimated to be worth more than the erectile dysfunction market.

As it stands, the first results from clinical trials are due to be released soon and this will quickly be followed by an application to the FDA for a license – assuming, of course, the results are positive. This could be a double-edged sword. As it stands, men with ED problems can be allowed some time to put things right when partnering women with low levels of libido. Although loss of sexual activity for short periods may damage the relationship, it will not always kill it stone dead. But if the partner has already been sexually awakened by a desire pill, men had better find cialis sooner rather than later.

There is something faintly alarming about women demanding sex all the time. This puts pressure on men and may well increase the number with performance anxiety. Both varieties – the weekend pill and the once-daily – will keep men going, but the idea of women with increased levels of expectation about sexual satisfaction is somewhat intimidating. The number of men experiencing ED increases with age and though the wise will always buy cialis and keep going, even the most dedicated of men may have to develop headaches from time to time to get a good night’s rest.

It’s very easy to overdo stories about the risks of obesity. Indeed, those who are overweight grow increasingly angry at the growing number of scientific studies telling them how to live their lives. In this, there are parallels with the campaigns to encourage people to quit smoking. For years, the tobacco industry suppressed evidence of the link between nicotine and cancer, and disputed articles that tried to warn people of the risks. Today, even with the Surgeon General’s warning on the packaging, current smokers resist laws that aim to limit smoking in public places. They see this as intrusive. Nevertheless, as with nicotine, so with obesity, there is increasingly clear evidence of the link between excess body weight and disease. For the purposes of this article, the link between erectile dysfunction (ED) and obesity is also clearly made.

The evidence collected from around the US shows that about 35% of all men over the age of 50 are likely to experience ED at some point in their lives. Both obesity and the resulting lack of physical exercise significantly increase the risk. There are three reasons for this. The first is the change in the level of testosterone as the body gains weight. The second stems from the deposit of plaque on the lining of the arteries. The initial condition is called atherosclerosis – a hardening of the arteries and a restriction in the flow of blood. In turn this increases the blood pressure and can lead to heart disease. Finally, the overweight are more likely to become diabetic. As diabetes progresses, there can be nerve damage which first appears as ED.

To be straightforward, the remedy is easy. If you lose weight and increase the amount of physical exercise you do, this is likely to improve your general health and, even more importantly, relieve the ED. So here is another article telling you to modify your lifestyle. Except that, for many men, the ability to get or maintain an erection is a vital part of their self-esteem. If something is interfering with this, some action is called for. In its early stages, the standard ED medications will usually produce results. But, if left untreated by diet and an exercise routine, only levitra will maintain sexual satisfaction. This drug is the most powerful of the three ED medications and it will usually produce sufficient hardness to achieve penetration and ejaculation. But there will come a time when even levitra will not help. When you reach this stage, the choice has become stark. You need to diet, take drugs to reduce your blood pressure and cholesterol levels, and exercise. As your weight begins to fall, levitra will restore erections. If you maintain the weight loss, you can probably return to the weight and level of health where an erection will come without the need for a drug. So, if you are overweight and suffering from ED, buy levitra to restore sexual activity and start losing weight.

Once formed, habits are difficult to break. It always just seems easier to go on as you have before. This can become a serious problem when science gets in the way of the habits. If you look at the world of adverts in print and the media, you will see opioids recommended as the sure-fire drugs to use as painkillers, no matter what the pain. It carries on in the venerable tradition of the slogan, “Beecham’s Pills cure all ills”. The idea of a panacea – one pill to rule them all, as The Dark Lord of Mordor might have said – has been around since the beginning of time. This is fair game for the marketers to use when talking to the public, but the same thinking has entered the training manuals for the medical profession. Sit in lectures for student doctors and you will hear the same story that opioids are the first line of defense when it comes to moderate to severe pain. Once you have the source of the prescriptions in on the group think, the habit is almost impossible to break.

The monitoring and review process put in place after a drug is released into the market is designed to catch any unexpected side effects. If evidence of problems emerges, the FDA can require the manufacturer to change the warnings on the label or, in the worst cases, withdraw the drug from the market. But this monitoring process is not designed to catch the drugs that are ineffective. If no-one has an adverse reaction when taking it, no report is filed with the FDA. It’s safe so who cares whether it works. All this brings us to the Cochrane Collaboration. This is a non-profit group where researchers sift through and analyze existing published medical research to see whether there are any consistent patterns – what might not be apparent in one clinical trial involving two hundred participants might be identified when you compile the results from fifteen different trials, each involving two hundred participants. Two recently published Cochrane Reports have concluded that opioids should not be routinely prescribed to patients even with severe pain from hip and knee osteoarthritis.

In both Reports, the independent conclusions were that the adverse side effects outweighed the benefits and that tramadol, as the leading opioid, was no more effective than the strongest NSAIDs. The first Report consolidated the results from ten trials involving a total of just over 2,250 participants and concluded that there was little pain relief and minimal improvement in mobility. With higher dosages, one in twelve participants experienced adverse side effects. The second Report consolidated the results from eleven trials involving 1,020 participants and found little difference between the effectiveness of tramadol and the placebo. This leads to a somewhat controversial conclusion. That doctors should not routinely prescribe opioids for the treatment of hip and knee osteoarthritis. There should be a careful discussion of treatment options including weight loss, physical therapy and exercise, and a detailed explanation of all the adverse side effects to be expected. This new research does not change the general acceptance of tramadol as an effective painkiller. All it does is confirm that there is no such thing as one pill to cure all ills.

In one sense, this topic is just a matter of common sense. If someone feels badly enough about their body shape and decides to lose weight, failure is going to fail your mood. The motivation to shed pounds comes from a basic feeling of dissatisfaction. Adding another failure to the pile of failures is moving to depression. But if our dieting and exercise program pay off with an improvement in our looks, we feel good about ourselves. But never forget the complexity of the human mind. Emotions are connected with events and our feelings about them. So the actual number of pounds in body weight is unlikely to be the only thing worrying us. There can be a range of connected issues affecting our mood. It can be problems at work. Our sex life may be disappointing. Our wardrobe may need a transfusion of new and bigger clothes – an unwanted expense when family budgets are under pressure. Look at everything together shows just losing weight may not be enough on its own to lift our mood.

When you look at the research, the clinical studies have a consistent focus. They start by counting the number of pounds lost, sometimes on their own or to calculate Body Mass Index or a percentage of body weight lost. They monitor the pattern of loss over time. If dieters falter, how quickly do they regain the weight? What is the weight lost over 12 months and longer? The studies treat weight as a measurable factor. Similarly, they routinely take blood pressure, monitor the carbohydrate level in the blood, look for signs of diabetes and heart disease… It’s easier to design scientific experiments that deal only with measurable factors. These are objective studies. They are better. Except people are people. They have feelings. So, in addition to all these scientific measurings, it would be good to ask them how they feel about their weight loss experience. Yes, this will be opinion and, for whatever reason, people may be dishonest. But it would give us a better insight into whether holistic treatment is better, i.e. treating people as individuals, making them the center of attention rather than focussing on a diagnosed medical disorder or disease.

Well, a newly published piece of research out of Australia has reached an interesting conclusion. It compared two groups of overweight people over one year. One was given a low-carb, high fat-diet, the other a high-carb, low-fat diet. The usual measurements were taken but, on four dates through the year, they were all given detailed questionnaires to assess whether they were anxious, depressed, angry, and so on. Both groups lost about the same amount of weight – an average of thirty pounds – and, at first, both showed improvement in mood. But the low-carb group’s mood quickly returned to pre-diet levels, whereas the high-carb group remained happier. Ignoring the scientific explanations of why this might be – something reserved for future research – there’s a further factor. None of the participants used any supportive drugs like phentermine. This might have made a difference because, if the reason for the loss of mood was the difficulty is keeping to the diet, phentermine would have help overcome the problem.

The health story that had everyone’s attention at the beginning of the year was the threat of swine flu (quickly renamed H1N1 flu to avoid damaging the market for the sale of pork products). We all watched as the threat level inched up to pandemic. The number of people dying was like watching the latest lottery numbers to see how many lost. Yet, although millions of people have caught this flu, only a few tens of thousand have died. Our attention shifted elsewhere. But there is still interesting news about the pattern of deaths. The people most likely to die are young and, almost without exception, they are obese. Frankly, if you carry excess weight, this flu is a killer, which raises a more general question for you to chew on. No matter what you might choose to believe, the majority of people are overweight because of their lifestyles. They eat too much and exercise too little. So, the US is a country where individual liberty is the most important quality of life. It’s up to every one of us to take personal responsibility for what we do and the consequences of those actions. So what personal responsibility should we take for our own health? Further, if we are against big government, should people who do not take care of their health just be allowed to die if they do not have enough money to pay for health insurance?

The latest statistics show that, as a nation, we spend about 16% of the gross domestic product on health care. This includes the cost of medications and is double the average in countries around the world. But we are not a healthy nation. Counting the number of prescriptions fulfilled through real world pharmacies, we consume more sleeping pills and antidepressants per head of population than any other nation. That’s before we start guessing how many drugs are purchased on the internet. We are seriously overmedicated. The results are easy to see. Many drugs cause insomnia as an unintended side effect. So we all walk around like zombies and beg our doctors for relief. So now comes the difficult decision. Do you reduce the dosages of the drugs you are taking, or add ambien to the mixture to offset the side effects? The rational answer is to do without the first drug altogether. If it is interfering with your sleep and making you feel worse, you should stop taking it. Adding a second drug to balance out the side effects of the first is more expensive and potentially going to make you dependent on one or both drugs.

When there is very clear scientific evidence showing meditation and relaxation techniques as a completely effective treatment for insomnia, there should never be a need to take sleeping pills. People should go through the simple training program and emerge better able to control their sleep patterns. As a result, their general health will improve. But, as with everything, there are problems. The marketers have managed to convince the majority of us that drugs are the best form of treatment. We are taught to dismiss psychology as a waste of time. Worse, private health insurance often will not pay for the training sessions. At a time of recession, this leaves many with no choice. There is only enough to buy ambien and not enough to pay for training in something we do not trust.

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You have probably heard many times about Sildenafil or as we now know it, the Blue Pill. This drug has been around for over a decade and marked a new area of sexuality, which can easily be compared to the Sexual Revolution of the 20th century. Why is that? Because prior to the Blue Pill there was no effective remedy for erectile dysfunction and men having that condition were left with no possibilities to overcome their problems and had to suffer in silence. But with the advent of the new drug, things have changed drastically. Erectile dysfunction has become the topic for public discussion and was openly spoken about in newspapers, magazines and on national TV. The problem, which people were unaware of before, has surfaced and shown its real proportions, which were really impressive.

Almost all men experience erection problems every now and then and there’s nothing to worry about. But if the problem persists over a period of time and there are no improvements, this is the case of erectile dysfunction. And research have found that practically all men experience erectile dysfunction at a certain point of their lives, and this doesn’t mean only late adulthood as younger men were also reported to experience the problem. These results were quite shocking as there are millions and millions of men over the world who suffer from a condition that could not be cured before. Of course, there were numerous natural remedies, herbal solutions, drugs that boosted sexual performance and even special surgeries that ensured mechanical erection. But it was never as effective and convenient as just taking one single pill and enjoying the pleasure of intimacy to the max.

Viagra has changed that situation dramatically by being the first orally administered drug that was observed to help in almost all cases of erectile dysfunction, bringing back the joy of sex and lovemaking to men, some of which have already forgot how it should be done. It was approved for treating erectile dysfunction in 1998 and after that it simply exploded the whole pharmaceutical market, creating a niche of its own and bringing its developers (Pfizer) so much money that its competitors can’t even reach today if combined. Men all over the world started to buy Viagra because there were no alternatives and it really helped. Having a global market where you are the single player is a great advantage for any product, and the Blue Pill was just lucky to be that very magical remedy that men across the globe were waiting for ages.

Of course, similar products from different manufacturers followed a few years later, some of them being more advanced than the pioneer of ED treatment. But still, men choose to buy Viagra at numerous online pharmacies because they know it will help them. People already know what the drug is capable of doing and the fact that it’s sold practically all over the world makes it simply the best ED medication on the planet, no matter how hard the competitors try to rival that position.

There’s a standard joke (except among the farmers of produce) that, among all animals, the rabbits are the most enthusiastic of lovers and, with no natural predators to keep down their numbers, they are likely to take over the world (and eat all the produce) through their breeding power. It is therefore somewhat ironic to read of research work carried out in the Institute of Regenerative Medicine at Wake Forest University in New Carolina. Researchers have been practising their techniques to rebuild the muscle walls in the penis of rabbits. Instead of leaving the males to suffer from erectile dysfunction, surgeons have been trying to keep up their breeding reputation. So let’s bring this back to Earth. With today’s technology, if a human male has a serious accident, goes through surgery, say to remove a prostate cancer, or catches the wrong disease, and the penis is damaged, it cannot be repaired. The penis is actually a complicated piece of kit involving sponge-like tissue designed to soak up blood and a complicated system of arteries and veins to carry blood into and out of the penis. There are no quick fixes.

Now, thanks to the rabbit, there’s hope for men with serious damage to their penis. The research is concentrating on growing new tissue in the laboratory. This starts with the collection of endothelial cells and cells from the smooth muscle walls of the penis. These cells are then used to coat a scaffold and allowed to grow. It takes several months but, when complete, the scaffold holds blood vessels and muscles matching those in the penis of the donor. Then it’s just a matter of surgery to implant the scaffold to replace the damaged arteries. Once the surgery is complete and the rabbits recover, they have been able to achieve an erection and penetration 85% of the time. To go from complete impotence to such high levels of success is encouraging for men.

The technology for growing implants in the laboratory is increasingly common for human transplant purposes. Indeed, the same team has been growing bladders for implantation into humans for the last year or so. Applying the same technology to erectile dysfunction offers a remarkable opportunity. No matter how good a drug such as cialis, it cannot rebuild damaged muscles or replace lost nerve endings. Seeding the cell culture on the scaffold with the cells taken directly from the penis of the man awaiting surgery gives the maximum compatibility between the finished artificial organ and the donor. There is little likelihood of rejection. If the same success rate of 85% was experienced by men following surgery, this would be a remarkable recovery of a lost function. As it stands, many men postpone surgery for the removal of growths in the prostate because they fear the common consequences of impotence. Should this technique be proven, it would encourage men to have life-saving surgery earlier. Until the FDA formally approves the process, this will remain a distant prospect. But there is hope for men of all ages who suffer traumatic injuries. If the team gets a license, such men may be able to enjoy a sex life again. Until then, the most they can expect is that they buy cialis and it works some of the time to produce an erection often less than complete hard.