Thursday, October 28, 2010
Vitamin D3 (from the herbal411 library post)
It was a toss up betwen omega 3 fish oil and Vitamin D3. Because of some of the chronic pain flare ups I have seen in the clinic over the last few weeks, Vitamin D won. Well documented is the lack of ultraviolet stimulation to human skin to any state north of Georgia. Due to the angle the sun's rays hit during winter months, the amount of sun rays that get through is low. It takes 20-30 minutes during summer months from 10-2pm to create up to 10,000IU. That would be about 50 glasses of milk or 20 standard vitamins daily! I suggest taking a blood test first for 25 hydroxvitamin D, supplementing 5000IU daily and retesting in 3 months. With critically low levels less than 10, 50,000IU IV to load then 5000 daily. I frequently use 4000 daily of D3 in my "influenza cocktail" while working the ER. (astragalus, elderberry, mushroom extract throat spray and D3 twice a day for 3-4 days post exposure). There are very limited sources of data that show toxicity with vitamin d, and multiple new sources of literature with benefits of supplements. Many patients have felt improvement with supplementation in 4 weeks. Once levels are restored with pills, food and sunshine should be utlized to maintain a healthy state. Cod Liver Oil, Sockeye Salmon, Tuna, Sardines, Milk, Egg, Dairy Fortified, Mackerel, Yogurt, OJ are a few to consider. Use food as medicine!
Wednesday, October 27, 2010
A pulled hammy (torn hamstring muscle)
No one is bulletproof when it comes to injury or illness. As posted in my "Adventures", Thich Naht Hanh came up with The Five Rememberances:
1 I am of the nature to grow old. There is no way to escape growing old.
2 I am of the nature to have ill health. There is no way to escape having ill health.
3 I am of the nature to die. There is no way to escape death.
4 All that is dear to me and everyone I love are of the nature to change. There is no way to escape being separated from them.
5 My actions are my only true belongings. I cannot escape the consequences of my actions. My actions are the ground on which I stand.
A near and dear yogi, was taking the time to teach students a difficult pose and "pop", an audible tear from about 40 feet occurred. Seemed to be the area of an old injury so hopefully it was just scar tissue. (If a long muscle is torn off its bony insertion, the long end may reattach close to where is came off but theres always a little piece of where it originated from that still remains tight and stuck on fibrous tissue-its useless and can pop but wont affect walking). So the reason for this discussion is to mention my "go to" supplements to aid in a speedy muscular injury repair.
First control the injured area from further damage. No further stretches, runs, jumps. I like ice to the area to decrease blood flow and halt the "seeping" of further lymph and blood to the area of inflammation. Black and blue marks will usually track down the back of leg with gravity in 2-3 days since it bleeds deep at the sit bones and works its way to the surface skin later. I have seen it go black and blue from the buttock to the back of the knee but without pain or discomfort to any place but the hamstring insert. We luckily had a massage therapist who also did Thai Massage and he helped with cutting the spasm back from the muscle. As a muscle tears, the body of the fiber will start to spasm, contract-like a rubber band that has been stretched then cut-the ends flail apart. So the idea is to try and gently relax the spasming muscle and more importantly for the first few nights-keeping the muscle lengthened so you dont wake up after 6-8 hours and the back of the thigh is 2 inches shorter. Ice is therapeutic for about 10-15 minutes only. After that time, the skin can get frostbite and the blood vessels you were trying to choke off will soon spasm and open up to cause more products of inflammation to enter the area. So keep the cold packs on for 10 minutes at the top of every hour for 48 hours. (as best as you can maintain). Lightly massage or gently stretch the muscle body-this would be the other end of the muscle that wasnt in the "tear zone". Alot of the pain comes from the muscle bulk spasming up and shortening. You can actually apply heat or warmth to this part in a hamstring since it is so long. Placing heat to the site of inflammation will cause the blood vessels to open and a flood of more swelling will result.
After the ice, wipe off and get the topicals on. I like essential oils like TEA TREE, HELICRYSIUM, MARJORAM (I used "PANAWAY" by Young Living to get me through the Chi-town Marathon every few miles), I also like TRAUMEEL by Heel- its a German homeopathic oinment that contains many things, one of the most active ingredients is ARNICA. At UCLA Acupuncture they teach us to apply this to the upper back before Gua Sha (skin scraping) to avoid black and blue formation. Great thing is you cant overdose on the topicals....traditional chinese medicine says you can also apply plant essence oils to the opposite extremity in the same approximate area as the injured leg to effect healing. (It has to do with unblocking the matching meridia/energy channel on the opposite extremity to get the body to heal it faster)
And this beings me to external modalities. Hands on-massage and the healing touch of MASSAGE THERAPY, CHIROPRACTIC or REIKI in some cases will help the body pay more attention to the area of inury. (more white blood cells, more proper nutrients, more organized repair/less inflammation). ACUPUNCTURE can help with cutting down muscle spasm to the injured muscle, help the energy meridia start flowing like prior to injury, also release endorphins to help with the sensation of pain. I have also read of MARMA therapy from ancient India (southern?) Finger or hand pressure to special areas on the body that move energy through "nadi's" or the Indian equivalent to meridias in China. (I have to get Vasant Lad to teach me this once I get some of my more immediate schooling out of the way). Modern day physical therapists can also help with deep tissue massage, transverse friction rubbing, ultrasound, infra red heat or ionotophoresis the application of steroid gel through the skin using elecricity. I like TENS units but seems when I write for these to be given by the therapist, always very difficult to attain. (Transcutaneous Electrical Nerve Stimulation-kinda what I do with needles and electricity but tens is just with sticky pads on the skin)-these are great because they can be applied through the whole night so the muscle doesnt shorten and make for a very difficult pogostick walk/hop to the bathroom in the dark. Physical therapy can also help to rehab 2-3 times a week in order to return to sports performance(and work) faster.
Then comes the oral supplements. First off all my athletes are told for 2 weeks. the "ANTIINFLMMATORY DIET" is a must. Andy Weil has this summarized on his website and he even had put together his own food pyramid to show how someone with chronic diease should be eating not just for 2 weeks but forever. (www.drweil.com) When the body is given foods that heal instead of foods that cause inflammation, white blood cells destroy damaged tissue faster, collagen gets placed by fibroblasts to form a matrix/scaffolding to heal the wound quicker, and muscle fibers reattach in an orderly fashion to make for stronger tissue patches instead of just fibrous/scar tissue. Fill up with water as often as possible. Low glycemic foods to treat the white blood cells better and not cause insulin spikes throughout the day- they essentially screw up healing not to mention that after meal sedation/sleepiness that comes on from eating. (www.glycemicindex.com) And my favorite: TURMERIC. This is a fantastic vegetable mostly used by India for food. I have also seen some older patients with sprains and strains coming in with orange powder around the injured joint as a paste. There are studies being performed on high dose turmeric for the ultimate inflammation-cancer. I am hoping to see these released soon. I have found and used NEW CHAPTER (www.newchapter.com/products/turmericforce) and GAIA (www.gaiaherbs.com/products/detail/83/Turmeric-Supreme) brands and usually I take 1 capsule 4 times a day for about 10-14 days with food. Recommended dose is 1 daily. (about 300 to 400 mg of extract) VITAMIN D3 at 2000IU twice a day (www.naturessunshine.com/us/product/vitamin-d3-60-tabs/sku-1155.aspx) for about 10-14 days is my other mandatory go to supplement with new injury. Even if it is summer and you are outside sunning, any city north of Georgia doesn't get enought sunlight (in my opinion) to convert a daily required amount of D. And finally OMEGA 3 FISH OIL at 2000mg daily (www.naturessunshine.com/us/product/super-omega-3-epa-60-softgel-caps/sku-1515.aspx)
So ultimately, we all will go through an injury, it is inevitable. The people who are already healthy when it happens will go through it faster! The folks arent healthy (and havent taken yoga) will go through the injury slower and probably develop another muscle injury from the over-compensation. My yoga instructor had already started to heal just with the THAI MASSAGE, so she is on her way to recovery in the next 10 days or sooner-(especially if we send healing INTENTIONS her way!)
This is not meant for medical advise so please seek out a primary care doctor who is trained in sports medicine, certified in medical acupuncture, studies with Andrew Weil and teaches yoga if you want to heal up fast.
1 I am of the nature to grow old. There is no way to escape growing old.
2 I am of the nature to have ill health. There is no way to escape having ill health.
3 I am of the nature to die. There is no way to escape death.
4 All that is dear to me and everyone I love are of the nature to change. There is no way to escape being separated from them.
5 My actions are my only true belongings. I cannot escape the consequences of my actions. My actions are the ground on which I stand.
A near and dear yogi, was taking the time to teach students a difficult pose and "pop", an audible tear from about 40 feet occurred. Seemed to be the area of an old injury so hopefully it was just scar tissue. (If a long muscle is torn off its bony insertion, the long end may reattach close to where is came off but theres always a little piece of where it originated from that still remains tight and stuck on fibrous tissue-its useless and can pop but wont affect walking). So the reason for this discussion is to mention my "go to" supplements to aid in a speedy muscular injury repair.
First control the injured area from further damage. No further stretches, runs, jumps. I like ice to the area to decrease blood flow and halt the "seeping" of further lymph and blood to the area of inflammation. Black and blue marks will usually track down the back of leg with gravity in 2-3 days since it bleeds deep at the sit bones and works its way to the surface skin later. I have seen it go black and blue from the buttock to the back of the knee but without pain or discomfort to any place but the hamstring insert. We luckily had a massage therapist who also did Thai Massage and he helped with cutting the spasm back from the muscle. As a muscle tears, the body of the fiber will start to spasm, contract-like a rubber band that has been stretched then cut-the ends flail apart. So the idea is to try and gently relax the spasming muscle and more importantly for the first few nights-keeping the muscle lengthened so you dont wake up after 6-8 hours and the back of the thigh is 2 inches shorter. Ice is therapeutic for about 10-15 minutes only. After that time, the skin can get frostbite and the blood vessels you were trying to choke off will soon spasm and open up to cause more products of inflammation to enter the area. So keep the cold packs on for 10 minutes at the top of every hour for 48 hours. (as best as you can maintain). Lightly massage or gently stretch the muscle body-this would be the other end of the muscle that wasnt in the "tear zone". Alot of the pain comes from the muscle bulk spasming up and shortening. You can actually apply heat or warmth to this part in a hamstring since it is so long. Placing heat to the site of inflammation will cause the blood vessels to open and a flood of more swelling will result.
After the ice, wipe off and get the topicals on. I like essential oils like TEA TREE, HELICRYSIUM, MARJORAM (I used "PANAWAY" by Young Living to get me through the Chi-town Marathon every few miles), I also like TRAUMEEL by Heel- its a German homeopathic oinment that contains many things, one of the most active ingredients is ARNICA. At UCLA Acupuncture they teach us to apply this to the upper back before Gua Sha (skin scraping) to avoid black and blue formation. Great thing is you cant overdose on the topicals....traditional chinese medicine says you can also apply plant essence oils to the opposite extremity in the same approximate area as the injured leg to effect healing. (It has to do with unblocking the matching meridia/energy channel on the opposite extremity to get the body to heal it faster)
And this beings me to external modalities. Hands on-massage and the healing touch of MASSAGE THERAPY, CHIROPRACTIC or REIKI in some cases will help the body pay more attention to the area of inury. (more white blood cells, more proper nutrients, more organized repair/less inflammation). ACUPUNCTURE can help with cutting down muscle spasm to the injured muscle, help the energy meridia start flowing like prior to injury, also release endorphins to help with the sensation of pain. I have also read of MARMA therapy from ancient India (southern?) Finger or hand pressure to special areas on the body that move energy through "nadi's" or the Indian equivalent to meridias in China. (I have to get Vasant Lad to teach me this once I get some of my more immediate schooling out of the way). Modern day physical therapists can also help with deep tissue massage, transverse friction rubbing, ultrasound, infra red heat or ionotophoresis the application of steroid gel through the skin using elecricity. I like TENS units but seems when I write for these to be given by the therapist, always very difficult to attain. (Transcutaneous Electrical Nerve Stimulation-kinda what I do with needles and electricity but tens is just with sticky pads on the skin)-these are great because they can be applied through the whole night so the muscle doesnt shorten and make for a very difficult pogostick walk/hop to the bathroom in the dark. Physical therapy can also help to rehab 2-3 times a week in order to return to sports performance(and work) faster.
Then comes the oral supplements. First off all my athletes are told for 2 weeks. the "ANTIINFLMMATORY DIET" is a must. Andy Weil has this summarized on his website and he even had put together his own food pyramid to show how someone with chronic diease should be eating not just for 2 weeks but forever. (www.drweil.com) When the body is given foods that heal instead of foods that cause inflammation, white blood cells destroy damaged tissue faster, collagen gets placed by fibroblasts to form a matrix/scaffolding to heal the wound quicker, and muscle fibers reattach in an orderly fashion to make for stronger tissue patches instead of just fibrous/scar tissue. Fill up with water as often as possible. Low glycemic foods to treat the white blood cells better and not cause insulin spikes throughout the day- they essentially screw up healing not to mention that after meal sedation/sleepiness that comes on from eating. (www.glycemicindex.com) And my favorite: TURMERIC. This is a fantastic vegetable mostly used by India for food. I have also seen some older patients with sprains and strains coming in with orange powder around the injured joint as a paste. There are studies being performed on high dose turmeric for the ultimate inflammation-cancer. I am hoping to see these released soon. I have found and used NEW CHAPTER (www.newchapter.com/products/turmericforce) and GAIA (www.gaiaherbs.com/products/detail/83/Turmeric-Supreme) brands and usually I take 1 capsule 4 times a day for about 10-14 days with food. Recommended dose is 1 daily. (about 300 to 400 mg of extract) VITAMIN D3 at 2000IU twice a day (www.naturessunshine.com/us/product/vitamin-d3-60-tabs/sku-1155.aspx) for about 10-14 days is my other mandatory go to supplement with new injury. Even if it is summer and you are outside sunning, any city north of Georgia doesn't get enought sunlight (in my opinion) to convert a daily required amount of D. And finally OMEGA 3 FISH OIL at 2000mg daily (www.naturessunshine.com/us/product/super-omega-3-epa-60-softgel-caps/sku-1515.aspx)
So ultimately, we all will go through an injury, it is inevitable. The people who are already healthy when it happens will go through it faster! The folks arent healthy (and havent taken yoga) will go through the injury slower and probably develop another muscle injury from the over-compensation. My yoga instructor had already started to heal just with the THAI MASSAGE, so she is on her way to recovery in the next 10 days or sooner-(especially if we send healing INTENTIONS her way!)
This is not meant for medical advise so please seek out a primary care doctor who is trained in sports medicine, certified in medical acupuncture, studies with Andrew Weil and teaches yoga if you want to heal up fast.
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