A good cure for insomnia is to get plenty of sleep.
~ W.C. Fields
_______________

Scientists in Singapore noted that persons with irritable bowel syndrome (IBS) often experience sleep disturbances. As melatonin is known to regulate sleep patterns in some, they wondered if it might also have favorable effects on bowel function as well.

Forty patients with IBS were invited down to the sleep lab for an investigation of the effects of melatonin on bowels and bedtime. While this gaseous group did not experience any favorable effects on sleep, within 2 weeks of consuming 3 mg. of melatonin each evening, their average abdominal pain scores decreased significantly compared to the placebo group, while their mean rectal pain threshold increased seven-fold.

Don't even ask how they measured that last parameter, just know that these subjects either didn't know what they were getting into, or they were handsomely paid.

I've tried 3 mg. of melatonin, more for its neuroprotective effects (experts believe that this supplement can decrease risk of Alzheimer's disease and Parkinson's) than any bowel benefits. While I noted a great night's sleep and increased dreaming, I felt foggy and hungover most of the following day.

Did you let your subscription to Gut magazine run out? Then you missed the news about melatonin and irritable bowel. I'll fill you in later.

Here's a woman after my own heart. I don't know why I never thought of this myself, and now I've given away all my old towels!

I am okay with donating the good stuff that we no longer need, it is
the tattered things with holes in them I have trouble letting go. I
feel if they can´t be fixed, I should at least cut them up and use
them to make rugs.

Got six minutes?

Got no time to exercise? No bucks for a gym membership? Dr. Martin Gibala, pictured above practicing what he preaches, suggests that a series of 30 second sprints -- four to seven per exercise session for a total of three sessions per week -- can turn your muscles into lean, mean, metabolizing machines.

So here's the catch. Between each sprint, you should sit on your exercise bike and just suck air. So we're talking about a 20 minute commitment three times weekly, each workout made up of six intense bursts of activity separated by a few minutes of recovery. Then poof! sweet, guilt-free release, on to the rest of your day.

At the end of two weeks or 2 1/2 hours total of this on-again off-again stuff, your muscles will show the same increase in citrate synthase --an enzyme that reflects the ability to utilize oxygen-- as a bunch of hooples who actually wasted 10.5 hours in that same time period cycling nowhere. Furthermore, adds Gibala, you'll get the weight loss benefits as well:

People forget that if you do a 30-second hard spurt your body continues to burn calories during recovery; just because you have physically stopped racing doesn't mean the effects of the workout are over.

So now what's your excuse?

Of linen and proteins...

And stressful situations in closets and cells.

I've mentioned before that I suffer a weense from disposophobia or the inability to part ways with stuff. Old towels are no exception. My linen closet bulged (past tense due to recent reform efforts) with tattered towels and sheets too short for current mattresses. As I dug deeper in search of bath accessories with the most residual fluff, the rifled remaining towels took up more and more space, threatening the hinges on the closet doors. I desperately needed an unfolded towel response (UTR).

Enter the towel-like equivalent of body clutter, namely unfolded proteins. Not only do your cells need to string the appropriate sequence of amino acids together to form proteins, but they also must pull a little proteinaceous origami trick to get them into the right spatial configuration for proper functioning. Unfolded proteins are the bane of an aging cell's existence--witness all that rumpled beta-amyloid protein that gums up old neurons in Alzheimer's disease.

Hurrah for evolution! Enter the unfolded protein response (UPR), nature's way of sensing a haphazard pile of proteins on the cellular floor. And if the UPR can't straighten up the protein closet--wadded proteins stacking ever higher--then the UPR just makes some sort of nasty enzyme that explodes that cell and its proteiny mess right then and there.

Alas, as Dr. Dale Bredesen of the Buck Institute for Age Research points out, the UPR is no different than a lot of other body responses to dysequilibrium: "The initial response is protective, but the late response is destructive." He and other neurobiologists are hoping to unlock the secrets of UPR in order to keep this organizing principle on our side.

I am particularly interested in states of mind--anxiety, depression, dementia, face blindness, etc. So I assumed I was just in a fretful aging lady sort of state each morning as I went to work, barely able to contain my visions of disaster when I'd get stuck in traffic directly under the large construction cranes on Colfax or 17th Avenue.

Just now, however, a news spot on the radio announced that a 60 foot section of crane had indeed collapsed at Fitzsimmons! So not anxiety, but reality! That does it; I'm taking 23rd to work.

No time to exercise

Yeah, yeah, yeah, I hear that one all the time. Well, exercise physiologists at McMaster University just blew that one out of the water. Stay tuned for more details.

Bowels don't like to be touched

And believe me, abdominal surgery is a very 'hands-on' sort of experience. As a result, as well you know if you've ever undergone any such procedure, bowel action stops short. In fact, the reawakening of the bowels puts a whole new meaning on the term 'gas pains.'

Research from Japan and California supports a new concept in post-op recovery: "Three sticks a day makes the gas go away." Surgeons on both sides of the Pacific proved in separate studies that gum chewing at regular intervals after bowel surgery can much improve a patient's flatus status.

Working over a piece of gum shaved as much as a day off the time to the first post-surgical passage of gas or any other moving productions. The first feelings of hunger were also accelerated in the gum chewing group, and, best of all, two days were eliminated from the total length of the hospital stay.

The librarian at my elementary school used to recite (as she dispatched us to the principal's office): A gum-chewing girl and a cud-chewing cow, what is the difference? I see it now. It's the intelligent look on the face of the cow. Well take that Miss Marye; gum-chewing is indeed a moo-ving experience!

Health Inspection As Applied to the Individual*

Every individual should be thoroughly inspected from time to time by a physician applying the resources of a complete physical examination, with chemical and microscopic observation of all obtainable secretions, in order to ascertain the standard of health of the individual.

No one would think of running a complicated machine without an annual inspection and overhauling of those slight defects which, if neglected, lead to a serious breakdown.

*A 100 year old case for the annual physical exam from JAMA, September 1, 1906

More D-tales

A new study of thousands and thousands and health professionals showed a 41% decrease in the risk of pancreatic cancer with the consumption of 400 units of D per day. That's the amount found in one multivitamin pill.

If you're not taking daily D, why on earth not?

Vagal triggers*

My son is worried about anatomy lab. As soon as the dead rat shipment arrives, his class will be dissecting these departed rodents. And Mike is NOT looking forward to the opportunity. When he brought it up at dinner the other night, I was all set to regale him with stories of all the critters I've disassembled through the years. My husband, however, asked in a strained little voice if we could change the subject.

Is there anything that makes a doctor weak in the knees? Absolutely yes, and highly likely to happen early on in training. One of my vivid memories from medical school is watching my good friend (who was also a fairly new mother of a baby boy) hit the linoleum as we observed a circumcision.

I'll tell you what gives me a sinking sensation in the pit of my stomach--finger injuries! Did those of you who've come to the office having crushed a finger or ripped off a nail--you know who you are!-- suspect that I would be more comfortable cutting up a dead rat than checking out your injured digit under those yards of gauze?

_______________

*Any intense experience--emotional, visual, visceral, etc.--that stimulates the vagus nerve, causing a slowing of the heart rate and a drop in blood pressure that may result in fainting.

Two interesting items in this morning's news:

1. An analysis from the October 4th issue of JAMA confirms that there's always a price to pay for squashing some undesirable body function like inflammation. While the cardiovascular side effects of the so-called COX inhibitors have been in the news for some time since Vioxx was yanked off the market, older NSAIDs such as Volataren (diclofenac) and Indocin (indomethacin) are also proving risky business for cardiac health.
   
   Interested in analgesia of the COX-inhibiting variety? The study authors found that naproxen--sold over the counter as Aleve--is your safest bet. For more information on the association between these drugs and trouble, see The dangers of knocking your COX off.


2. Michigan's state legistlature took a bold step this week introducing a bill that would require sixth grade girls to be vaccinated with Gardasil, the newly approved vaccine against cervical cancer. Critics are not happy with this infringement on parental rights and the implied endorsement of sexual activity.

Yuck, nasty air over Denver today. As I drove to a health screening in Boulder, I wondered what I was thinking to raise my children under such a blanket of doom. No wonder I've been seeing more of my asthmatic patients in the office lately.

Fortunately, despite years in the Mile High City and a history of smoking in my younger, foolish days, I scored just fine on the single breath screening test for lung disease.

Did you inhale anything in your youth? We now have spirometry screening available in our office. For more information, see Spirometry screening, and ask for the test on your next visit.

I'm sitting here dithering over whether or not to go to step aerobics. On the one hand, I could motor on in my robe, drinking coffee and reading the paper. On the other, I could get dressed and drive over to the gym to spend an hour dancing on and off a step to driving hip hop music.

A medical journal by my computer here is helping me make this Sunday decision. A study presented at the recent meeting of the American Society of Clinical Oncology found that over 36,000 Iowa women lowered their risk of postmenopausal breast cancer by 10% through exercise. And when the investigators considered a breast cancer subtype positive for estrogen receptors and negative for progesterone receptors (a more aggressive tumor), a high level of physical activity slashed the risk 34%!

That does it, I'm stepping out of the robe and stepping up to the music.

Cough season resumes

Sometimes I think it never really stops here in Denver where we all cough, clear our throats, and paw through our purses for Kleenex on a regular basis due to the dry air and dust. Now, of course, we're also hacking from colds brought home by school-aged children aggravated by all the residue in the air from raging forest fires nearby and a big-time ragweed crop.

Short of moving to Portland, is there any relief from all this upper respiratory aggravation? Some hackers of the pulmonary variety may benefit from inhaled steroids if their coughs are due to airway irritation from undiagnosed asthma. Doctors from the Mayo Clinic just reported that a simple breath test may easily identify which sleep-deprived coughers are likely candiates for this therapy.

They measured exhaled nitric oxide (NO) in patients, noting that increased NO in exhaled air is a good marker for bronchial inflammation. Of 41 patients with elevations in exhaled NO, 36 reported improvement in cough after use of inhaled steroids such as Flovent. On the other hand, only 2 of 23 patients with normal NO levels responded favorably to the treatment.

As always, the researchers called for more research prior to implementing this test as a routine screen in chronic coughers.

'Cancer without disease'

Chances are, if you're over 50, you've got it. Consider these statistics from autopsy studies:

--More than a third of women between 40 and 50 have small in situ breast cancers. Only 1 percent of women this age are diagnosed with clinical breast cancer.

--Virtually all persons between 50 and 70 have small in situ thyroid cancers. Far less than 1 percent are diagnosed with clinical thyroid cancer.

Check out the upcoming edition of Vintagefemail for more information.

A comforting thought from Dr. William Woodhouse of Pocatello, Idaho:

...loss is made whole not by joy, but by life, ordinary life.

Ketamine: Out of the clubs and into mainstream medicine

Are you a fan of the TV show House? If so, we're both eagerly awaiting the first show of the new season this coming Tuesday. House requested a shot of Ketamine on his way into surgery during last season's finale, seeking relief from his chronic pain and narcotic addiction. So what's the scoop on Ketamine?

This drug was originally developed as a veterinary anesthetic and subsequently gained favor as a 'club drug' similar to PCP or phencyclidine. Its use for chronic pain-- including cancer-related pain unresponsive to standard narcotic analgesics --is under investigation. Participants in one study experienced pain relief lasting up to 8 weeks after a 3-5 day infusion of the drug.

A study in the August issue of Archives of General Psychiatry found that a single injection of Ketamine in a group of depressed volunteers improved mood in 12 out of 17 of them. Whereas antidepressants such as Prozac can take up to 2 months to kick in, Ketamine's effects were noted in just 2 hours! This finding, therefore, has generated excitement in the possibility of a fast-acting therapy to alleviate depression and suicide risk during the crucial first days of standard therapy.

Ketamine targets receptors in the brain that respond to an excitatory neurotransmitter called glutamine. This represents a new approach to alleviating depression prompting one psychopharmacologist to declare "The glutamate stoary as it has emerged is very promising."

Your acne will go away after you get your first period."
--Dr. R, my pediatrician, 1962

Hah! Dr. R, perhaps my memory is shot (well...no perhaps about that) because maybe you actually told me that my acne would finally go away when my periods stopped. Which it did.

You also told me to stop drinking milk. To heck with the state of my skeleton in the decades to come, stop drinking milk you said. So I did. At least in that respect, you were correct, and over 48,000 female nurses have proven you so.

The Nurses Health Study II did a retrospective study correlating severe acne with consumption of dairy products during the high school years. Investigators found that total milk intake, specifically skim, was associated with an increased incidence of zits. They theorize that this may be the result of hormones and other 'bioactive' molecules in milk.

Bioactive. Great.

Brainstorms

At a purely chemical level, every experience humans find enjoyable - whether listening to music, embracing a lover, or savoring chocolate - amounts to little more than an explosion of dopamine in the nucleus accumbens as exhilarating and ephemeral as a firecracker.

--J Madelaine Nash


While music, love, and chocolate are more or less harmless, nicotine is another pleasure of sorts that results in a burst of dopamine from the nucleus accumbens (NA) deep in the brain. The new anti-smoking drug Chantix is designed to occupy nicotinic receptors in the NA, stimulating the release of a little dopamine but not a big surge. As a result, ex-smokers get a smooth dopamine lift but no cigarette-charged rush, thus allowing them to kick the habit without seeking out other big-time dopamine dischargers such as chocolate and ice cream.