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Mindfulness and Anxiety

Mindfulness practice, at its core, is the opposite of an anxious mind.

What Is Mindfulness?

“There have been many tragedies in my life, but most of them have not happened.” —Mark Twain

Anxiety lives in fears of the future that haven’t happened yet. How often does what you worry about actually happen? Take a second to reflect on the last spiral of worry that took over you. While bad things do happen, the odds are that it was much worse in your mind than what happened or what may happen.

The truth is, most of what we worry about never happens. We’re hardwired to be perceiving and responding to threats. It’s what has kept us alive evolutionarily; other mammals can fight with fangs and claws, but we are “thinking mammals.” We can hardly spend a few moments without thinking. This makes sense, as it’s what has kept us alive. This often causes an emergency response, despite the veracity of the actual threat.

Fear (the core of anxiety, really) is our body’s ancient response to perceived peril, no matter how negligible it actually is. It can present itself as a stress-related physical symptom, making us desperate to get rid of it. This constant state of worry and threat-scanning and detection can wear us down. This can make us avoid any danger signs, even when they often are just signs.

Unfortunately, this is often a trap. What we constantly avoid, we strengthen (i.e., the confrontational conversation or passing by the area where you were robbed), reinforcing its danger, no matter how harmless it may be and usually is.

Our propensity to plan, especially when it stems from anxiety, can also easily become excessive and counterproductive, taking us away from the pleasure and richness of the moment, the only time we can actually feel joy, happiness, pleasure, and peace. We’re also conditioned by capitalism to look for the next thing, taking us away from the now, and everything is usually OK right now unless it’s an emergency or crisis. This is where mindfulness comes in.

Mindfulness practices rewire the brain toward savoring the present moment, instead of dwelling on anxiety, which is often living the state of perceived fears. In mindfulness practice, we learn the wisdom in prioritizing. Things that we’re worrying about often aren’t urgent.

It’s easy to forget you have time to deal with many of the stressors you chronically worry about, and you’ve dealt with them well your whole life! In fact, thinking about bad things happening is worse than just dealing with them! Showing up 20 minutes late to the event wasn’t that bad after all, right?

Worry can also, covertly, feel enjoyable; it’s easy to worry even when everything is OK now. I’m personally an expert at this. The mind can think that worry is what prevented something bad from happening, which can mistakenly reinforce it, despite its factual falseness. Worry often tricks us into thinking we’re “taking action” to prevent danger, when we may actually be reinforcing it.

Mindfulness practice helps you see and prevent these mental pitfalls from decreasing your unnecessary suffering and worrying. What can be better than that? When stuck in traffic, do you want to be fuming like everyone else, or kicking back, relaxing, at ease, savoring life’s blessings? Mindfulness reveals this choice for you, no matter how elusive it felt prior.

Jason Linder, MA, LMFT, is a licensed bilingual (Spanish-speaking) therapist and doctoral (PsyD) candidate at the California School of Professional Psychology in San Diego.

Feb 08, 2020
Mindfulness-Definition-Square

Mindfulness

What is mindfulness?
The modern mindfulness is the brainchild of Dr. Jon Kabat-Zinn, an American professor emeritus of medicine. He defines it as “the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment.”

In simpler terms, mindfulness helps sustain attention to feelings, emotions and thoughts in the present moment without getting carried away by them. Mindfulness has its roots in Buddhism, and from an ancient tradition, it has evolved into a modern mind training. It is a quality that some people possess naturally, but it can also be trained and improved. Mindfulness is the bridge in between our mind and present moment that helps us understand and better react to stressful, overwhelming situations.

Benefits of mindfulness
Mindfulness is a powerful practice that can help with improving wellbeing in terms of physical and mental health. From the physical point of view, mindfulness training can help with stress relief, lowering blood pressure, reducing pain and improving sleep. Mindfulness gives people a larger perspective on life, clear thinking and patience. Our minds don’t have switch off buttons for unwanted thoughts; however, it is possible to train yourself to control them. Systematic training improves focus attention and concentration. It results in having more energy to become fully engaged in important activities of everyday life instead of getting carried away by worries and intrusive thoughts. Mindfulness meditation helps develop better resilience and can help people recover faster from tension and stress.

Scientific foundation
Research on mindfulness has been expanding rapidly in the last decades. The evidence for the benefits of mindfulness is promising and proven in several trials with clinical and social applications.

People have their mind wandering almost 50 percent of the time they are awake. That means their mind is not where their body is; instead, they’re thinking about things that happened in the past, could happen in the future or might never happen at all – all while being involved in many other daily tasks. Evidence suggests that a wandering mind leads to unhappiness.

However, the brain can be trained to sustain focus and attention in the present moment. Introducing mindfulness training in daily routines has the potential to improve mental and overall health treatment outcomes.

Clinical applications of the mindfulness-based cognitive therapy (MBCT) have proven to be effective in several studies and trials. Researchers report that MBCT can decrease the severity of depression symptoms of currently depressed patients in just eight weeks. A number of trials show a positive effect of mindfulness on brain changes and immune responsivity, and even influence the healing process of skin diseases related to psychological stress.  In the context of mental health, mindfulness encourages people to develop a more compassionate and accepting relationship with their own thoughts and feelings.

Approach
There are many mindfulness techniques, but all of them focus on the same: paying attention and accepting your thoughts on purpose, without judgement. You can practice mindfulness where and when you want; it doesn’t necessarily need to be a lengthy process and can take a couple of minutes – on your break from work, for example.

Mindfulness starts with posture. You can choose whether you want to sit comfortably, lay down or even walk, but you need to have your back straight. You continue with breathing exercises and scanning your body. By focusing on your physical sensations, you can switch to focusing on sensory aspects as sounds, smells and touches. It’s important to observe the feelings and thoughts you’re having without judgement and let them go.

This focusing exercise is just an example of many meditation techniques. Guided meditations are popular and can be easily accessed on many resources online.

Written by Ana Maria Sedletchi     December 9, 2019
 
time mindfulness

3 Steps to Deepen Your Mindfulness Practice

Let’s imagine that you’re a reasonably healthy adult with all of your basic needs met, people who care about you in your life, and things you enjoy doing available to you … you should be pretty happy, right?

It turns out, even in this incredibly lucky scenario, most of us still struggle — stress, anxiety, frustration, overwhelm, letting ourselves and others down, disappointment, hurt feelings, anger, feeling like you’re always behind … it all creates a sense of unease that is not aligned with our fortunate circumstances.

So how do we go about enjoying life, finding a sense of peace and calm and purposeful focus?

I’ve found mindfulness practices to be the key. They’re not a magical solution to anything, but they do ease the suffering we experience in our lives.

Those of you who who have practiced meditation for awhile know what I’m talking about. Let’s look at a few ways to deepen into the practice, if you’re interested.

Step 1: Drop Into Direct Experience of the Moment
Most of us are caught up in our thoughts about our lives, ourselves, other people, the world around us … most of the time. We’re stuck in a movie in our minds, a storyline or narrative about the situation. This causes all of our trouble — frustration, disappointment, stress, anxiety, overwhelm, unhappiness.

The practice here is to drop into the direct experience of the moment. Not the thoughts about the moment (though those will come up), but the actual sensations happening in the moment.

You might notice the sensations present in different parts of your body, including how your breath feels, but also how your torso feels, seeing what you can notice in your neck and head, in your arms and legs. You might notice the sensation of air on your skin, or ground beneath your feet. You might notice sounds or light or colors or shapes.

Whenever you notice yourself caught up in thoughts or ideas, in a narrative or fantasies … drop back into the direct experience of the present moment. Experience everything with beginner’s mind, as if this were the first time you ever experienced this before.

This is a practice that you can get better at, returning again and again to direct experience. You move from concepts and thoughts and ideas and storylines, to direct experience. Just observe, just notice, just be curious.

If you’re feeling frustrated or stressed, try this and see if it shifts anything for you. See if you’re caught up less and present more.

Practice this for at least a month (though it’s really a lifetime practice).

Step 2: Bring a Sense of Friendliness Towards the Experience
After you’ve practiced dropping into direct experience … you might try a new way of relating to that direct experience.

Instead of just noticing as an impartial observer … see if you can bring a feeling of warmth, friendliness, gentleness, kindness, even love to your relating to this direct experience.

For example, if you see someone on the street, you can just notice that there’s a person there … or you can feel a friendliness towards them. Welcoming them into your experience like you would welcome someone warmly into your house.

In the same way, you can bring a friendliness and warmth and welcoming towards anything you notice in your direct experience. You notice the sensation of air on your skin, and you might feel friendly towards these sensations. The same with anything you hear, see, smell, touch. The same with how you notice nature all around you, or sensations in your body.

It’s a continuation of the practice of direct experience, but with a shift in how you relate — it’s unconditional friendliness to anything you bring your awareness towards.

Practice this for at least a month as well.

Step 3: Drop the Sense of Self, and Motivation from Gain & Loss
Once you’ve practiced the two steps above, you’ll be grounded in a view of reality that is much more free of conceptions and storylines, more open and unconstrained.

The next step is to notice that when you’re in direct experience, there is no self. I mean, there’s a body and brain, but it’s not separate from everything around it — it’s interconnected, not identifiable as something distinct from the world around it. Just as you might pick a drop of water in the ocean and say, “This is a separate drop of water!” … it’s only separate in our minds, in concept. In reality, it’s not separate but a part of everything around it.

This might sound pretty philosophical, but what is very real is noticing whether everything you do is motivated by a desire for gain or desire to avoid a loss. For example, you might want someone’s praise or affection (gain), or you might want to avoid them getting mad at you (loss). You might be scrolling through and posting in social media looking for validation (gain) or worried about missing out (loss). You might buy something because of how you think it will make you look or feel (gain) or because you’re feeling worried or insecure about a situation (loss).

All of these actions motivated by a sense of gain and loss are completely normal — we all do it. But they all come from a sense of separate self — we are trying to gain something for the self, trying to avoid a loss for the self. Helping this separate self get what it wants or avoid what it doesn’t want becomes our biggest activity and goal in life. It is what makes us frustrated or angry when we don’t get what we want, or hurt or sad when we get what we don’t want, or anxious or stressed when we might gain or lose something.

Being motivated by gain or loss is what causes our struggles in life. And that stems from the sense of separate self.

What’s another way? Dropping the sense of separate self. Just being present with direct experience. Feeling a friendliness and even love for everything and everyone around us. And then being motivated by that love — I act from a place of love and compassion for everyone around me (myself included, but not only myself).

Try it! It’s an incredible practice. Be directly with your experience, dropping your sense of self, of separateness from everything around you. Start to appreciate how connected you are to the world — you breathe in air from the world, eat food from the world, drink water and get information and heat and clothes and shelter and love from everything and everyone around you. You’re completely interconnected and interdependent. Dropping the conception of self, like you drop other concepts, return to direct experience.

And then watch your actions and see if they’re motivated by a desire for gain or desire to avoid loss. See if you can come from a place of love and compassion for everyone in the world, every living being. It’s a really powerful place to be moved from.

 
BY LEO BABAUTA
 


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Can Marijuana Be The Answer For Pain?

Like many of her friends, Alexandra Callner, now 58, experimented with recreational marijuana when she was younger.

“I had tried it, and hated it, in my 20s,” Callner says. “When I was around pot smokers, I thought, ‘Ugh, losers.’ ”

But, that was before her knee arthritis became so bad, it robbed her sleep, night after night. She took two over-the-counter pain pills a day, but the pain would wake her up at night. And the drugs were hard on her stomach.

“It was making me kind of nauseous,” she says of the nonsteroidal anti-inflammatories. Plus, she needed to stay active to manage her dog boarding service in Pasadena, CA.

Then came another solution. “A neighbor said, ‘Try this,’ ” Callner says. It was a joint.

Callner got a medical marijuana card, and then she tried it. “I slept through the night.”

That was a year ago, and it’s now her nightly ritual. “Every night, I get into bed, read about an hour, take one or two puffs, and then I am off to sleep,” she says. “The pain is much lighter.”

About 50 million Americans like Callner live with chronic or severe pain. Patients and doctors are seeking treatments besides the potent prescription painkillers like opioids and the nonprescription medicines that Callner found tough to tolerate.

So could marijuana be the next pain reliever of choice?

Lack of Research

Donald Abrams, MD, a professor of clinical medicine at the University of California, San Francisco, helped review research on marijuana for a 2017 report from the U.S. National Academies of Sciences, Engineering, and Medicine.

There is a lack of evidence about the health effects of marijuana, he says.

Adds Angela Bryan, PhD, professor of psychology and neuroscience at the University of Colorado, Boulder: “The evidence we have thus far suggests that cannabis is moderately effective for pain relief.” But most studies haven’t compared marijuana with other ways to relieve pain, she says.

Cannabis is the scientific name for the marijuana plant. Researchers prefer to use “cannabis” instead of “marijuana” because marijuana is associated with recreational use, Abrams says.

Why the lack of evidence from research in the U.S.?

Although medical marijuana in some form is legal in 30 states and Washington, D.C., it’s still illegal on the federal level. It’s classified as a Schedule I drug — putting it in the same category as other drugs of “high potential for abuse” that have ”no currently accepted medical use,” such as heroin and LSD.

That means federal rules put limits on what researchers can do.

“In the state of Colorado [which allows medical and adult private use], I can go to any dispensary and buy whatever I want to treat whatever I want,” says Bryan, who’s also co-director of the CU Change Lab, which explores health and risk behavior. “You would think that means researchers can, too. The problem is, researchers are in a federal institution [at the University of Colorado]. If we do anything in violation of federal law, we could have all federal funding withdrawn.”

Bryan’s team has grants for four research studies on marijuana, including one on lower back pain. Participants come to the university for their initial assessment, but then must go to the dispensary on their own to buy the marijuana, she says. Declassifying marijuana as a Schedule I drug would make her research easier, Bryan says, or at least as easy as alcohol research.

“If I want to do a study on alcohol, I bring someone in, give them wine, get blood [samples], and see what happens when they use alcohol.”

Bryan says she could use marijuana supplied by the government. The Drug Enforcement Administration (DEA) issued a license to the University of Mississippi to cultivate marijuana for research. The marijuana from dispensaries is different and more potent  than that supplied by the National Institute on Drug Abuse farm, she says.

Patient groups, including those for veterans, are among those pushing for more research. Nick Etten, a former Navy SEAL, founded the Veterans Cannabis Project in 2017. “We are bringing stories to the Hill,” he says, ”of veterans who have found relief from their health issues through cannabis.” He reaches out to individual U.S. legislators, he says, to elevate marijuana as a health issue and to persuade them to declassify marijuana.

In 2016, the National Football League Players Association created a pain management committee to study ways to help players deal with injuries and chronic pain, says Brandon Parker, a spokesman. “Marijuana is just one of several alternative pain relievers being studied by the committee,” he says.

Research Scorecard

The National Academies’ report looked at data from 1999 on, reviewing more than 10,000 scientific studies, of which only seven were directly related to pain relief. One of the seven looked at data from 28 studies.

Abrams says the evidence on marijuana and pain is strongest for helping nerve pain (neuropathy) and cancer-related pain. The committee also concluded that certain oral cannabinoids improved muscle spasms in patients with multiple sclerosis.

Cannabinoids are one of more than 60 chemicals in the cannabis plant. Abrams says it makes sense that marijuana may help relieve pain because the body has cannabinoid receptors, or places where the chemical attaches to cells.

Cannabinoid
The above wheel serves as a resource to determine which cannabinoids
may help treat symptoms associated with mood, eating/gastrointestinal disorders,
neurological disorders, pain, sleep disorders, and other medical conditions.

Here is a sampling of research or reviews published in the past year:

  • Israeli researchers found marijuana gave substantial pain relief to more than half of 1,200 cancer patients who used it for 6 months.
  • In a review of 16 published studies including more than 1,700 participants with chronic nerve pain, German researchers found that marijuana-based remedies increased the number of people who reported a 50% or more reduction in pain relief. But they also concluded that the risks may outweigh the benefits. People taking marijuana-based remedies were more likely to have sleepiness, dizziness, and confusion.
  • In a small study of 47 patients with Parkinson’s disease, Israeli researchers found a 27% improvement in pain with marijuana use.
  • Medical marijuana helped to ease pain in 26 patients with fibromyalgia, a condition in which the body has ”tender” points. Half the patients stopped taking any other medicines for fibromyalgia, but 30% did have mild side effects.
  • A study from the European Academy of Neurology found that cannabinoids given at various doses eased pain in migraine patients by 40% or more. It helped cut pain in people with cluster headaches, too, but only if the patient had a history of childhood migraine.
  • Marijuana and cannabinoids may have modest effects on the pain and muscle spasticity that come with multiple sclerosis, according to an Australian review that looked at 32 studies.

Not for Everyone

Experts also saw potential downsides to marijuana. The European Academy report found that marijuana use may:

  • Make you more likely to be involved in a car accident
  • Raise the chance of unintentional marijuana overdose injuries among children, something that has happened in states where marijuana use is legal
  • Lead to more frequent bronchitis if smoked on a regular basis
  • Raise the odds of having schizophrenia and, to a lesser extent, depression

Smoking marijuana is also linked to delivering a lower birth weight baby, although the relationship with other pregnancy and childhood outcomes is not clear, the report says.

Abrams says marijuana can raise heart rate and either raise or lower blood pressure. Frail older people with balance issues have a risk of dizziness and falling.

Will Marijuana Replace Opioids?

Some research suggests that marijuana could take the place of opioids. Two recent studies found that states with medical marijuana laws or legalized recreational use may have a decline in opioid prescriptions.

In another study, researchers polled nearly 3,000 medical marijuana patients, including about a third who said they had used opioid pain medicines in the past 6 months. Most said the marijuana provided relief equal to their other medications, but without the side effects. While 97% said they were able to lower the amount of opioids they took if they also took marijuana, 81% said that taking marijuana alone was more effective than using both marijuana and opioids.

That finding makes sense to Alex Jordan, 29, an artist who works at the Green Valley Collective, a marijuana dispensary in the Los Angeles area. She manages her chronic pain with daily use of marijuana joints and products that contain cannabidiol (CBD), a cannabinoid.

Her experience helps her guide her customers, who range from young adults to those over age 80, to an effective remedy. “I would say 60% of our users use [marijuana] to manage some kind of pain, whether it be physical or mental,” she says.

Without it, her pain is severe – usually a 4 to 7 on a 10-point scale, she says. It started after she was in a car accident in 2011. The van she was riding in hit black ice and flipped seven times. The accident left her with a broken sternum (breastbone), six broken ribs, six crushed vertebrae, and collapsed lungs, making breathing difficult. Morphine helped relieve the pain in the hospital. Later, she says, “I could get any pill I wanted” for pain relief. She wore a neck brace for 2 months and a back brace for 6, but the pain persisted.

She wanted off the potent painkillers and had used marijuana recreationally in years past. She experimented with different options until she found her current regimen. And to make access easier, she and her husband moved from New York City to Los Angeles, where recreational marijuana is legal, last year. Before the move, the pain had gotten so bad, she had trouble putting on a shirt. These days, she’s working regularly and branching out as a freelance artist.

“The lack of pain is a wonderful thing,” she says. “It brings me to tears.”

 

By Kathleen Doheny        April 20, 2018
WebMD Article Reviewed by Arefa Cassoobhoy, MD, MPH on April 20, 2018

Sources

Article: Can Marijuana Be The Answer For Pain?
The National Academies of Sciences, Engineering, and Medicine: The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendation’s for Research,” January, 2017.
National Conference of State Legislatures: “State Medical Marijuana Laws.”
National Organization for the Reform of Marijuana Laws (NORML): “Legalization.”
Donald Abrams, MD, oncologist and professor of clinical medicine, University of California, San Francisco.
Angela Bryan, PhD, professor of psychology and neuroscience, University of Colorado, Boulder; co-director, CU Change Lab.
Nick Etten, founder, Veterans Cannabis Project.
Brandon Parker, spokesman, National Football League Players Union.
Alexandra Callner, owner, Spoiled Dog Pet Care, Pasadena, CA.
Alex Jordan, artist; budtender, Green Valley Collective, North Hollywood, CA.
JAMA Internal Medicine: “The Role of Cannabis Legalization in the Opioid Crisis.”
European Journal of Internal Medicine: “Prospective analysis of safety and efficacy of medical cannabis in large unselected population of patients with cancer.”
Cochrane Database System Review: “Cannabis-based medicines for chronic neuropathic pain in adults.”
Clinical Neuropharmacology: “Medical Cannabis in Parkinson Disease: Real-Life Patients’ Experience.”
Journal of Clinical Rheumatology: “Medical Cannabis for the Treatment of Fibromyalgia.”
Current Neurology and Neuroscience Reports: “The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews.”
World Health Organization: “Cannabidiol (CBD) Pre-Review Report,” Expert Committee on Drug Dependence Thirty-ninth Meeting, Geneva, Switzerland, Nov. 6-10, 2017.

 


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Common Painkillers Tied to Kidney Risks for Children: Study

Children taking the common painkillers known as nonsteroidal anti-inflammatory drugs may be at risk for acute kidney damage, particularly when the kids are dehydrated, a new study finds.

Nonsteroidal anti-inflammatory drugs (commonly called NSAIDs), such as ibuprofen (brand names Advil and Motrin), naproxen (Aleve) and ketorolac (Toradol) are used to relieve pain and fever.

“The one thing we did see that seemed to be connected to kidney damage was dehydration,” said lead researcher Dr. Jason Misurac, a nephrologist at Indiana University School of Medicine in Indianapolis.

For the study, which was published in the Jan. 25 online edition of the Journal of Pediatrics, Misurac’s team looked at the medical records of children admitted to Riley Hospital for Children in Indianapolis from 1999 through mid-2010. Over that time, they identified more than 1,000 cases of children being treated for kidney damage.

In nearly 3 percent of the cases, the damage was related to NSAIDs, the study found. Most kids were teens, but four were under 5 years old. All of them had been given NSAIDs before being hospitalized. Since many other cases involved several causes of kidney damage, it is possible some of those also were related to NSAIDs, the researchers said.

Most children who developed kidney damage had been given the recommended dose and had not been taking NSAIDs for more than a week.

In adults, taking NSAIDs regularly for several years has been tied to kidney problems, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. Cases involving children have previously been reported but only rarely.

Misurac noted that most of the children in the study hadn’t been drinking well and also were vomiting and had diarrhea, all of which can lead to dehydration. When someone is dehydrated the kidneys have a way of protecting themselves, which NSAIDs block, resulting in the damage, Misurac explained.

“Certainly in the way NSAIDs affect the kidneys, it’s reasonable to think that dehydration plus an NSAID has more of an effect than just an NSAID by itself,” he said.

Often the signs of kidney problems aren’t apparent, Misurac said. One sign is a decrease in urine; another is stomach pain. “But most kids who have episodes of acute kidney injury have nonspecific symptoms and there’s no one way to tell,” he said.

“If kids are dehydrated and not drinking well, then parents should think twice about using NSAIDs,” Misurac said. Tylenol (acetaminophen), which acts differently than NSAIDs, might be a better choice for children, he said.

For many of the children in the study, the kidney damage was reversed, Misurac said. The damage, however, was permanent for seven patients and they will probably need ongoing monitoring and treatment for declining kidney function, he said.

All the children under age 5 had to undergo dialysis and were more likely to be treated in an intensive-care unit, the researchers said. They also stayed in the hospital longer.

Although the study showed an association between taking NSAIDs and kidney problems in children, it didn’t establish a cause-and-effect relationship.

One expert agreed that NSAIDs can damage the kidneys.

“This is well known. Unfortunately, it is better known among doctors; the public is not as educated regarding this problem,” said Dr. Felix Ramirez-Seijas, director of pediatric nephrology at Miami Children’s Hospital.

Ramirez-Seijas said NSAIDs are “overused and abused, both by doctors and patients.”

For children, most fevers should not be treated; fever is how the body fights infection, he said. “There is a fear of fever that leads to overtreatment,” Ramirez-Seijas said.

In addition, children who take NSAIDs for aches after vigorous exercise also are at risk, because they may be dehydrated, Ramirez-Seijas said.

His advice to parents is to be sure children are well hydrated if they are going take NSAIDs. In addition, he believes that even these over-the-counter drugs should only be used with the advice of a doctor.

“Most people see taking a couple of Advil like taking a sip of water, but it’s not,” Ramirez-Seijas said.

By Steven Reinberg     HealthDay    Jan. 25
 

 

nsaids

 

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

What are NSAIDs and how do they work?

Prostaglandins are a family of chemicals that are produced by the cells of the body and have several important functions. They promote inflammation that is necessary for healing, but also results in pain, and fever; support the blood clotting function of platelets; and protect the lining of the stomach from the damaging effects of acid.

Prostaglandins are produced within the body’s cells by the enzyme cyclooxygenase (COX). There are two COX enzymes, COX-1 and COX-2. Both enzymes produce prostaglandins that promote inflammation, pain, and fever. However, only COX-1 produces prostaglandins that support platelets and protect the stomach. Nonsteroidal anti-inflammatory drugs (NSAIDs) block the COX enzymes and reduce prostaglandins throughout the body. As a consequence, ongoing inflammation, pain, and fever are reduced. Since the prostaglandins that protect the stomach and support platelets and blood clotting also are reduced, NSAIDs can cause ulcers in the stomach and promote bleeding.

What NSAIDs are approved in the United States?

The following list is an example of NSAIDs available:

  • aspirin
  • celecoxib (Celebrex)
  • diclofenac (Cambia, Cataflam, Voltaren-XR, Zipsor, Zorvolex)
  • diflunisal (Dolobid – discontinued brand)
  • etodolac (Lodine – discontinued brand)
  • ibuprofen (Motrin, Advil)
  • indomethacin (Indocin)
  • ketoprofen (Active-Ketoprofen [Orudis – discontinued brand])
  • ketorolac (Toradol – discontinued brand)
  • nabumetone (Relafen – discontinued brand)
  • naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
  • oxaprozin (Daypro)
  • piroxicam (Feldene)
  • salsalate (Disalsate [Amigesic – discontinued brand])
  • sulindac (Clinoril – discontinued brand)
  • tolmetin (Tolectin – discontinued brand)

What are the side effects of NSAIDs?

NSAIDs are associated with several side effects. The frequency of side effects varies among NSAIDs.

Common side effects are

  • nausea,
  • vomiting,
  • diarrhea,
  • constipation,
  • decreased appetite,
  • rash,
  • dizziness,
  • headache, and
  • drowsiness.

Other important side effects are:

  • kidney failure (primarily with chronic use),
  • liver failure,
  • ulcers, and
  • prolonged bleeding after injury or surgery.

NSAIDs can cause fluid retention which can lead to edema, which is most commonly manifested by swelling of the ankles.

WARNING: Some individuals are allergic to NSAIDs and may develop shortness of breath when an NSAID is taken. People with asthma are at a higher risk for experiencing serious allergic reaction to NSAIDs. Individuals with a serious allergy to one NSAID are likely to experience a similar reaction to a different NSAID.

Use of aspirin in children and teenagers with chickenpox or influenza has been associated with the development of Reye’s syndrome, a serious and sometimes fatal liver disease. Therefore, aspirin and non-aspirin salicylates (for example, salsalate [Amigesic]) should not be used in children and teenagers with suspected or confirmed chickenpox or influenza.

NSAIDs increase the risk of potentially fatal, stomach and intestinal adverse reactions (for example, bleeding, ulcers, and perforation of the stomach or intestines). These events can occur at any time during treatment and without warning symptoms. Elderly patients are at greater risk for these adverse events. NSAIDs (except low dose aspirin) may increase the risk of potentially fatal heart attacks, stroke, and related conditions. This risk may increase with duration of use and in patients who have underlying risk factors for heart and blood vessel disease. Therefore, NSAIDs should not be used for the treatment of pain resulting from coronary artery bypass graft (CABG) surgery.

For what conditions are NSAIDs used?

NSAIDs are used primarily to treat inflammation, mild to moderate pain, and fever.

Specific uses include the treatment of:

  • headaches,
  • arthritis,
  • ankylosing spondylitis,
  • sports injuries, and
  • menstrual cramps.
  • Ketorolac (Toradol) is only used for short-term treatment of moderately severe acute pain that otherwise would be treated with narcotics.

Aspirin (also an NSAID) is used to inhibit the clotting of blood and prevent strokes and heart attacks in individuals at high risk for strokes and heart attacks.

NSAIDs also are included in many cold and allergy preparations.

Celecoxib (Celebrex) is used for treating familial adenomatous polyposis (FAP) to prevent the formation and growth of colon polyps.

With which drugs do NSAIDs interact?

NSAIDs reduce blood flow to the kidneys and therefore reduce the action of diuretics (“water pills”) and decrease the elimination of lithium (Eskalith, Lithobid) and methotrexate (Rheumatrex, Trexall). As a result, the blood levels of these drugs may increase as may their side effects.

NSAIDs also decrease the ability of the blood to clot and therefore increase bleeding. When used with other drugs that also increase bleeding (for example, warfarin [Coumadin]), there is an increased likelihood of serious bleeding or complications of bleeding. Therefore, individuals who are taking drugs that reduce the ability of blood to clot should avoid prolonged use of NSAIDs.

NSAIDs also may increase blood pressure in patients with hypertension (high blood pressure) and therefore antagonize the action of drugs that are used to treat hypertension.

NSAIDs increase the negative effect of cyclosporine on kidney function.

Persons who have more than three alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking NSAIDs.

 

Medical and Pharmacy Editor: Jay W. Marks, MD  
Pharmacy Author: Omudhome Ogbru, PharmD 


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9 Remarkable Healing Properties Of CBD

Cannabis has been stigmatized for decades, but scientists and society cannot deny that the plant’s active ingredients, known as Cannabinoids, provide a natural remedy to a host of health issues. While CBD, extracted from the cannabis plant, is structurally similar to THC, part of the allure is that it won’t get you high.

“CBD is now the most researched cannabinoid on the market and rightly so because the studies go back to the 1940s proving its effectiveness on the nervous and immune systems, with no toxicity, side effects, nor psycho-activity,” says Jared Berry, CEO of Isodiol, a company that produces hemp-extracted CBD for pharmaceutical, nutraceutical, and cosmetic companies.

Cannabis is known to have 85+ different cannabinoids, many of them potentially having health benefits.

“Cannabinoids promote homeostasis at every level of biological life, from the sub-cellular to the organism, and perhaps to the community and beyond,” writes NORML, a foundation that works to reform marijuana laws.

According to research, cannabinoids synergize and help support humans’ built-in Endocannabinoid System (ECS). It was in 1992 that scientists discovered that the ECS plays a direct role in homeostasis, which regulates every metabolic process in the body, such as pain sensation, appetite, temperature regulation, stress reactivity, immune function, and sleep, as well as other processes. Even more interesting is that muscle and fat tissue also utilize these receptors to control their processes.

So basically, CBD communicates with our body’s main command center to keep things running as they should. Pretty amazing.

While the government has arguably made selling CBD quite difficult, the US Department of Health and Services ironically patented cannabinoids in 2001.

The FDA and DEA refuse to change their stance on cannabis.

“Naturally, this shows a certain amount of hypocrisy that there is ‘no accepted medical use’ for cannabis according to federal law,” Sam Mendez, an intellectual property and public policy lawyer who serves as the executive director of the University of Washington’s Cannabis Law & Policy Project recently told the Denver Post.  “And yet here you have the very same government owning a patent for, ostensibly, a medical use for marijuana.”

Politics aside, let’s look at just nine of the myriad ways CBD can help improve  health.

EPILEPSY
Epilepsy is a neurological disorder caused by unusual nerve cell activity in the brain. Each year, about 150,000 Americans are diagnosed with this condition. Many turn to mind-numbing medications, brain surgeries and invasively implanted electrical stimulation devices, with little to no relief.

Yet, 20 years of research has shown that CBD has anti-seizure activity, and has been used successfully to treat drug-resistant, epileptic children with no side effects.

“CBD oil is also really good option for people with seizures, because you want a method of delivery they can’t choke on. As an oil, it can be rubbed on the gums and under the tongue,” adds Payton Curry, the founder of Flourish Cannabis, and a huge proponent of CBD. Curry views cannabis as a vegetable, and uses everything from the bud to the root stock to maximize its non-psychoactive properties.

DEPRESSION
These days, just thinking of the future of the health care system in this country and the assaults on our environment is enough to get a person down and out.

According to the Anxiety and Depression Association of America, in any given year, persistent depressive disorder PDD, affects approximately 1.5 percent of the U.S. population ages 18 and older. That’s about 3.3 million American adults.

In 2015, an estimated 16.1 million adults aged 18 or older in the United States had at least one major depressive episode in the past year.

CBD has shown to have antidepressant-like actions, enhancing both serotonergic and glutamate cortical signaling through a 5-HT1A receptor-dependent mechanism.

ANXIETY
We live in a Xanax-addled society. Anxiety Disorders today affect 18.1 percent of adults in the United States, which equates to approximately 40 million adults, between the ages of 18 to 54.

One of CBD’s most promising implications is in the realm of anti-anxiety. Studies show that CBD can positively impact behavior and reduce psychological measures of stress and anxiety in conditions such as PTSD, social anxiety disorder and obsessive compulsive disorder.

CBD also significantly reduced cognitive impairment and discomfort in speech performance, and significantly decreased angst surrounding public speaking.

Even some pet owners have reported that using CBD oil on their dogs has calmed them down, writes Gunhee Park, Co-Founder of Ministry of Hemp.

While more research is needed to illustrate optimal dosage for anti-anxiety, consider this an opportunity to experiment and learn what works for you.

OXIDATIVE STRESS
Today, chronic disease is on the rise like never before with oxidative stress playing a significant causative role. Oxidative stress occurs when the body has too many free radicals and can’t counteract the damage. People fall prey when eating a nutrient deficient diet or when they experience an onslaught of toxins and the body can’t keep up and detox, causing more symptoms of dis-ease.

Oxidative stress is associated with a number of ailments including neurodegenerative diseases, heart disease, gene mutations and cancer.

How amazing that CBD is particularly beneficial in the treatment of oxidative stress-associated diseases of the CNS, because cannabinoids’ ability to cross the blood brain barrier and exert their antioxidant effects in the brain.

ANTI-INFLAMMATORY
Chronic low-level inflammation can severely erode your health; the silent lurker contributes to at least seven of the 10 leading causes of mortality in the United States, which include heart disease, cancer, chronic lower respiratory disease, stroke, Alzheimer’s disease, diabetes and nephritis.

While real organic food and proper nutrition should be the base of any anti-inflammatory protocol, CBD has shown to significantly suppress chronic inflammatory and neuropathic pain without causing dependency or tolerance.

CHRONIC PAIN AND NEURO-PROTECTION
Studies also indicate that this magical compound can help reduce chronic pain, which is fantastic considering America is witnessing a serious and deadly opioid epidemic. To put things in perspective, we are now losing more people to opioids than from firearms or car crashes – combined.

Cannabis can regulate immune functions and shows positive effects where neurons have been damaged, which makes it a safe and effective treatment for ALS, Alzheimer’s, Parkinson’s and MS. CBD has also slowed down cell damage in diabetes patients and worked effectively to block progression of arthritis.

WEIGHT MANAGEMENT
As if CBD wasn’t already a home run, CBD also plays a positive role on our metabolism, and body weight regulation.

In a published study in the scientific journal Molecular and Cellular Biochemistry

CBD was found to:

  •       Stimulate genes and proteins that enhance the breakdown and oxidation of fat.
  •       Increase the number and activity of mitochondria, which increases the body’s ability to burn calories).
  •       Decrease the expression of proteins involved in lipogenesis (fat cell generation).
  •       Help induce fat browning.

SLEEP
Not sleeping can wreak havoc on your psyche and physique. According to the American Sleep Association, 50-70 million U.S. adults have a sleep disorder today.

Evidence suggests that CBD oil can improve quality of sleep and reduce anxiety. I can attest. One study found that CBD blocked anxiety-induced REM sleep suppression, resulting in better quality of sleep. Another study found that the oil reduced participants’ cortisol levels, which are linked to anxiety and stress in the body.

When it comes to doses for treatment, Gunhee writes that CBD dosing experiments have shown that small doses of CBD have an “active” effect, meaning it actually helps you stay active and focused while interestingly, large dosages have the opposite effect: sedation.

ADDICTION
How ironic that we can use a compound belonging to a Schedule 1 Drug (marijuana) to stop the addiction of other narcotics.

CBD is thought to modulate various neuronal circuits involved in drug addiction. A limited number of preclinical studies suggest that CBD may have therapeutic properties on opioid, cocaine and psychostimulant addictions. One of the most promising application is using CBD to curb the habits of cigarette smokers.

CBD can even be effective for the treatment of cannabis withdrawal syndrome and certainly helped me kick Xanax for good.

Many of these could replace synthetic drugs that have flooded the market and allow patients and customers to use a natural non addictive plant compound as a remedy.

In the words of Gunhee, co-founder of Populum: “…maybe that’s the exact reason why progress has been so slow; approval of CBD as a legitimate supplement and drug would be a significant blow to big pharmaceutical companies.”

By: Maryam Henein       May 12, 2017       About        Follow at @MaryamHenein


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Fun Fact Friday

  • Simply looking at a photo of someone you love can help relieve pain.

  • Scientists usually omit left-handed people from tests because their brain works differently.

 

  • Pretending you don’t have feelings of anger, sadness, or loneliness can literally destroy you mentally.

  • Chocolate milk was invented in Jamaica.

 

Happy Friday!
source: @Fact


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Does Christmas music turn you into the Grinch?

Does Christmas music put you in the spirit of giving or turn your heart two sizes too small?

If you find yourself relating to a hairy, green, holiday-hating beast known as the Grinch when your ears are filled with the sounds of the season, you’re in good company.

A 2011 Consumer Reports poll found that almost 25% of Americans picked seasonal music as one of the most dreaded aspects of the holiday season, ranking just behind “seeing certain relatives.”

A survey this fall of 2,000 people in the US and Britain by Soundtrack Your Brand, a Spotify-backed company that says it’s on a mission “to kill bad background music,” found that 17% of US shoppers and 25% of British shoppers “actively” dislike Christmas music. Bah! Humbug!

Health benefits of music

When it comes to your health, science says music is good for you. Studies show that music can treat insomnia; lessen the experience of pain (even during dental procedures); reduce your heart rate, blood pressure and anxiety; boost your mood and reduce depression; alter brainwaves and reduce stress; help you slow down and eat less during a meal; help your body recover faster; and engage the areas of the brain involved with paying attention, remembering and making predictions. Many studies say the best type of music for health is classical in nature, full of rich, soothing sounds.

With all those positives, what’s the problem with Christmas tunes?

One reason you might find yourself cringing is oversaturation. Due to “Christmas creep,” music and decorations seem to go up earlier each year, much closer to Halloween than Thanksgiving. That gives you ample time to hear Mariah Carey’s hit “All I Want for Christmas is You” for what seems like the googolplex time before you get far on your shopping list.

It makes sense that too much of anything can cause annoyance, even stress, and put a damper on your holiday spirit, much like a certain famous “nasty, wasty skunk”: “You’re a mean one, Mr. Grinch … you have all the tender sweetness of a seasick crocodile … ”

That’s certainly the case for retail workers who are forced to listen to holiday tunes on a seemingly endless loop in the workplace. Soundtrack Your Brand’s survey found that one in six employees believe Christmas music repetition negatively affects “their emotional well-being,” while a full 25% said they felt less festive.

Or … more Grinchy?

Putting aside the auditory attack on holiday retail workers, there’s another way to look at survey statistics: About 75% of us enjoy listening to Christmas music. And it’s not just baby boomer nostalgia that fuels those facts. According to Nielsen’s 2017 Music 360 report, millennials are the biggest holiday music fans (36%), closely followed by Generation X (31%) and then the baby boomers (25%).

Stores use music against you

Retailers are quite aware of those statistics and have learned how best to use our emotions to tap into our wallets.

Studies show that Christmas music, combined with festive scents, can increase the amount of time shoppers spend in stores, as well as their intentions to purchase. It turns out that the tempo of Christmas music plays a role as well.

Faster-paced pieces like “Jingle Bells” will energize shoppers and move them more quickly through a store than retailers might like. That’s why many rely on slower-tempo tunes, like Nat King Cole’s “The Christmas Song,” to relax shoppers and entice them to spend more time and money.

That makes sense to University of Cambridge music psychologist David Greenberg, who studies the relationship between our cognitive styles and musical preferences. He believes that how you think is an excellent predictor of what music you will like.

According to Greenberg, if you like to analyze rules and patterns in the world, like those that apply to technology, car engines and the weather, you’re probably a “systemizer.” If instead you enjoy focusing on understanding and reacting to the feelings and thoughts of others, you’re likely an “empathizer.”

Want to know your personal thinking/musical style? Take Greenberg’s in-depth quiz 

If you found yourself scoring somewhere in the middle, Greenberg says you’re a “balanced” thinker, and your musical choices will probably contain a mixture of high- and low-energy pieces.

“About a third of us fall into each grouping: systemizer, empathizer and balanced,” Greenberg explained. “But it also depends on gender. Females score higher on empathizing and males on systemizing.”

Just how does that apply to holiday music?

“Empathizers prefer mellow styles of music, soft rock, R&B and soul, music that is slower,” Greenberg said. “It can be sad or nostalgic and certainly has an emotional depth to it. That profile that matches many Christmas songs such as ‘I’m Dreaming of a White Christmas,’ songs with features that get you in the Christmas mood.”

A “systemizer,” he says, will like more complex, high-energy music. Examples include hard rock and heavy metal, such as Metallica, The Sex Pistols and Guns N’ Roses. It’s safe to say that most holiday tunes don’t fit into that category.

It’s possible, says Greenberg, that those of us who don’t like Christmas music from the start of the season might fall into the “systemizer” category. Or that you might prefer listening to the more upbeat hits on Billboard’s Holiday 100, such as this year’s No. 2, “Rockin’ Around the Christmas Tree” by Brenda Lee, or No. 4, “A Holly Jolly Christmas” by Burl Ives.

So the next time the sounds and smells of the holiday season start to overwhelm you at your favorite retail store, relax. Understand that it’s all about personal style. Take a tip from the Grinch and let your heart grow – three sizes, perhaps?

By Sandee LaMotte, CNN     Fri December 15, 2017
source: www.cnn.com


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Poor Sleep Associated With Higher Risk Of Chronic Pain

(Reuters Health) – People who sleep poorly may be more likely to develop a chronic pain condition and have worse physical health, a study from the UK suggests.

A general decline in both the quantity and quality of hours slept led to a two- to three-fold increase in pain problems over time, researchers found.

“Sleep and pain problems are two of the biggest health problems in today’s society,” said lead study author Esther Afolalu of the University of Warwick in Coventry.

Pain is known to interfere with sleep, she told Reuters Health by email. But the new study shows “that the impact of sleep on pain is often bigger than (the impact of) pain on sleep,” she said.

Sleep disturbances, she added, contribute to problems in the ability to process and cope with pain.

Afolalu and colleagues reviewed 16 studies involving more than 60,000 adults from 10 countries. The studies looked at how well people were sleeping at the start, and then evaluated the effects of long-term sleep changes on pain, immune function and physical health. Half the participants were tracked for at least four and a half years.

Overall, sleep reductions led to impaired responses to bacteria, viruses and other foreign substances, more inflammation, higher levels of the stress hormone cortisol and other biomarkers related to pain, fatigue and poor health. Newly developed insomnia doubled the risk of a chronic pain disorder and hip fracture problems, the study authors wrote in the journal Sleep Medicine.

Deterioration in sleep was also associated with worse self-reported physical functioning.

At the same time, researchers didn’t find links between increased sleep and less pain or arthritis, although they did find that improvement in sleep was associated with better physical functioning.

One limitation of the analysis is that the studies relied on participants to recall their own sleep patterns. Also, the studies didn’t all use the same tools to measure sleep quality and quantity.

Future studies should look at sleep patterns for different groups of people and how that affects health, Afolalu said. Her team is now analyzing data from the UK Household Longitudinal Survey to understand sleep, insomnia and health for people with arthritis.

Additional studies should also investigate how sleep deficiency leads to chronic pain disorders, said Dr. Monika Haack, who studies sleep, pain and inflammation at Harvard Medical School’s Human Sleep and Inflammatory Systems Lab in Boston.

Haack, who wasn’t involved with the new research, said in an email, “It is also important to identify whether there is a specific sleep pattern that is most dangerous for pain. For example, does sleep disruption (with frequent, intermittent awakening throughout the night) have a higher impact than a short but consolidated sleep?”

Haack and colleagues recently reported in the journal Pain that restricting sleep on weekdays and catching up on the weekends led to more pain. Furthermore, people who caught up on weekends had a tougher time dealing with pain than those who slept eight hours every night.

“In those already suffering from chronic pain, it is of critical importance to incorporate sleep improvement strategies,” Haack said. “And to have sleep specialists as part of the pain management team.”

SEPTEMBER 19, 2017    Carolyn Crist
SOURCE: bit.ly/2xcwb8b Sleep Medicine, online August 18, 2017.    www.reuters.com