Plant Spirit Shamanism – Planta Maestras – The Shaman’s Teachers – Part 2


One of the qualities of this plant is its ability to boost one’s psychological and emotional strength. For this reason it is regarded as a ‘great balancer’, restoring connection and equilibrium between our rational mind and feelings. For example, it is good at countering shyness and can enhance one’s sense of personal value and authority by helping to overcome painful memories (of past embarrassments and ‘failures’, etc).

Mocura is also used in floral baths to both cleanse and protect against malevolent forces such as sorcery and envidia (envy). Its medicinal properties include relief from asthma, bronchitis, and the reduction of fat and cholesterol.

In the West, there are a number of plants that have similar effects and bring calm and balance to the soul. These include lavender – which Pliny regarded as so powerful that even looking upon it brings peace – meadowsweet, pine, and rosemary.

Burning pine needles will purify the atmosphere of a house and a pine branch hung over the front door will bring harmony and joy to the home. Rosemary, especially when burned, is cleansing and centring, and it is said that if you concentrate on the smoke with a question in mind, rosemary will also provide the answer. There is a European belief that carrying rosemary leaves will protect you from sadness. It is also quite pleasant to drink with honey as a weak tea.

In terms of body energetics and magical uses, moss, orange, and strawberry leaves are effective at removing bad luck, and loosestrife, myrtle, and violet leaves help to overcome fear.


This plant is often used to heal children who are suffering from mal aire (‘bad air’), a malady which can occur when a family member dies and leaves the child unhappy and sleepless. The spirit of the dead person lingers, it is said, because it is sad to go and aware of the grief around it, so it stays in the house and tries to comfort its family. This proximity to death, however, can make children sick.

Rosa sisa is also used to bring good luck and harmony in general. One of the ways that bad luck can result is through the magical force of envidia. A jealous neighbour might, for instance, throw a handful of graveyard dirt into your house to spread sadness and heavy feelings. Those in the house become bored, agitated, or restless as a consequence. The solution is to take a bucket of water and crushed rosa sisa flowers and thoroughly wash the floors to dispel the evil magic.

Many Peruvians also grow rosa sisa near the front door of their houses to absorb the negativity of people who pass by and look in enviously to see what possessions they have. The flowers turn black when this happens, but go back to their normal colour when the negative energy is dispersed through their roots to the Earth.

Rosa sisa is also used for making dreams come true, by blowing on the petals with a wish in mind, like we do with dandelions. It can make these wishes happen because it is bright like the sun and contains the energy of good fortune.

Marigolds have similar magical uses in the West. Aemilius Macer, as long ago as the 13th century, wrote that merely gazing at the flowers will draw “wicked humours out of the head”, “comfort the heart” and make “the sight bright and clean”. In Europe, just as in Peru, marigolds are often grown beside the front door or hung in garlands to protect those inside from magical attacks. For the same reason, and to empower the spirit, marigold petals can be scattered beneath the bed (where they will also ensure good – and often prophetic – dreams) or added to bath water to bring calm and refreshment to the body and soul.

As well as drinking marigold tea, the petals can be used in salads or added to rice and pulses as another way of dieting them. Physically, the tea is good for bringing down fevers (especially in children), for gastritis, gallbladder problems, and tonsillitis. Rubbed on the skin, marigold petals will heal skin diseases, cuts, bruises, and rashes.

Alternatives, to create harmony in the self and home, include gardenia, meadowsweet, and passion flower.


Native people cultivate numerous varieties of medicinal sedges to treat a wide range of health problems. Sedge roots, for example, are used to treat headaches, fevers, cramps, dysentery and wounds, as well easing childbirth and protecting babies from illness.

Special sedge varieties are cultivated by Shipibo women to improve their skills in weaving magical tapestries that embody the spiritual universe, and it is customary when a girl is very young for her mother to squeeze a few drops of sap from the piri piri seed into her eyes to give her the ability to have visions of the designs she will make when she is older. The men cultivate sedges to improve their hunting skills.

Since the plant is used for such a wide range of conditions, its powers were once dismissed as superstition. Pharmacological research, however, has now revealed the presence of ergot alkaloids within these plants, which are known to have diverse effects on the body – from stimulation of the nervous system to the constriction of blood vessels. These alkaloids are responsible for the wide range of sedge uses, but come, not from the plant itself, but from a fungus that infects it.

There are a number of Western plants that are also said to produce visions – i.e. communion with the greater spirit of the world. The leaves of coltsfoot and angelica, when smoked, for example, will induce such visions, and damiana, when burned, will also produce these effects.

Angelica has long been regarded as a spiritual plant with almost supernatural powers. It is linked to the archangel Raphael, who appeared in the dreams of a medieval monk and revealed the plant as a cure for plague. Native Americans used it in compresses to cure painful swellings and believed it sucked the spirit of pain out of the body before casting it to the four winds. It has also been heralded as an aid to overcoming alcohol addiction as its regular usage creates a dislike for the taste of alcohol. Recent research suggests that it can also help the body fight the spread of cancer. Its leaves can be added to salads and this is another way to diet this plant.

Coltsfoot is another plant with wide-ranging properties but is most highly regarded for its soothing effects on respiratory and bronchial problems. One way of dieting it, paradoxically, is to use it in herbal cigarettes. These can be made by adding a larger part of coltsfoot to other aromatic and soothing herbs such as skullcap or chamomile. Cut the herbs to small lengths and mix them thoroughly with a little honey dissolved in water, then spread the mix out and let it to dry for a few days. It can then be rolled to make cigarettes or smoked in a pipe.


Una de Gato (‘cat’s claw’) is a tropical vine that grows in the rainforests. It gets its name from the small thorns at the base of the leaves, which look like a cat’s claw and enable the vine to wind itself around trees, climbing to a height of up to 150 feet. The inner bark of the vine has been used for generations to treat inflammations, colds, viral infections, arthritis, and tumors. It also has anti-inflammatory and blood-cleansing properties, and will clean out the entire intestinal tract to treat a wide array of digestive problems such as gastric ulcers, parasites, and dysentery.

Its most famous quality, however, is its powerful ability to boost the body’s immune system, and it is considered by many shamans to be a ‘balancer’, returning the body’s functions to a healthy equilibrium.

From a psycho-spiritual or shamanic perspective, disease usually arises from a spiritual imbalance within the patient causing him to become de-spirited or to lose heart (in the West we would call this depression). Interestingly, Thomas Bartram, in his Encyclopedia of Herbal Medicine, writes that in the West “some psychiatrists believe [problems of the immune system, where the body attacks itself] to be a self-produced phenomenon due to an unresolved sense of guilt or dislike of self… People who are happy at their home and work usually enjoy a robust immune system”. The psychiatric perspective, in this sense, is not so different from the shamanic view. Cat’s claw is believed to heal illness by restoring the peace of the spirit as well as the balance between spirit and body.

The medicinal properties of this plant are officially recognized by the Peruvian government and it is a protected (for export) plant. It is, however, widely available in the West in capsule form and this is one way of dieting it, although its spiritual affects will be less strong, since, once a plant has been processed in this way, much of its spirit is lost.

Echinacea can also be used as a substitute for cat’s claw and will stimulate the immune system and prove effective against depression and exhaustion. As an alternative, you might try a mixture of borage, cinnamon, and blackberry, all of which are regarded as lifting the spirits and good healers in general.


The resin of the chullachaqui caspi tree, extracted from the trunk in the same way as rubber from the rubber tree, can be used as a poultice or smeared directly onto wounds to heal deep cuts and stop haemorrhages. For skin problems, such as psoriasis, the bark can be grated and boiled in water while the patient sits before it, covered with a blanket, to receive a steam bath. It is important to remove the bark without killing the tree, however, which can otherwise have serious spiritual consequences. Oil can also be extracted by boiling the bark, and this can be made into capsules.

The deeper, more spiritual, purpose of this tree is to help the shaman or his patient get close to the spirit of the forest and in touch with the vibration and rhythm of the Earth. Through this reconnection with nature, it will strengthen an unsettled mind and help to ground a person who is disturbed. It will also guide and protect the apprentice shaman and show him how to recognise which plants can heal.

The tree has large buttress roots as it grows in sandy soil where roots cannot go deep (chulla in Quechua means ‘twisted foot’ and chaqui is the plant). This forms part of Amazonian mythology, in stories of the jungle ‘dwarf’, the chullachaqui, which is said to have a human appearance, with one exception: his twisted foot. The chullachaqui is the protector of the animals, and lives in places where the tree also grows. The legend is that if you are lost in the forest and meet a friend or family member, it is most likely the chullachaqui who has taken their form. He will be friendly and suggest going for a walk so he can guide you or show you something of interest. If you go, however, he will lead you deep into the rainforest until you are lost, and you will then suffer madness or become a chullachaqui yourself.

Ross has speculated that the reference is to the initiation of the plant shaman, who must go deep into the jungle to pursue his craft by getting to know the plants and the forest. Such trials can, indeed, lead to madness or even death for the unwary, but for those who succeed, they will become great healers, in touch with the spirits of nature, like the chullachaqui himself. For those who are not ready to meet these challenges, the advice of the jungle shamans is simple: when out walking in the forest, should you encounter a friend or a family member, always look at his feet, as the chullachaqui will try to keep his twisted foot away from you. Do not go with him – turn back and run away!

The chullachaqui, symbolically, is a tree and the motif of the ‘world tree’ – the spiritual centre of the universe which connects the material and immaterial planes – occurs in many cultures and is often to do with initiation. In Haiti, it is Papa Loko (a variant of the word iroco, which is the name of an African tree) who meets the shaman-to-be in the dark woods at night to initiate him into the Vodou religion. In Siberia, too, there is a tradition that the shaman-elect must climb a silver birch while in a state of trance and make secret, spirit-given, markings on one of its topmost branches.

While it is interesting to speculate about the initiatory symbolism of the chullachaqui, it must also be pointed out that Amazonian shamans regard it as very real being. Javier Aravelo, for example, has a photograph of a chullachaqui’s tambo, which he swears is real. The tambo is a hut that stands about four feet high and is used as a dwelling. Javier discovered this one next to a cultivated garden deep in the otherwise wild rainforest

In the West, we have our own tradition of magical trees. One of these is willow, a tree sacred to the Druids. Ancient British burial mounds and modern day cemeteries are both often lined with willow, symbolising the gateway this tree provides between the living and the dead, spirit and matter. The brooms of witches are also bound with willow, enabling their flight to the otherworld.

To deepen a connection to the Earth and the spirit, willow can be ‘dieted’ in place of chullachaqui caspi by burning crushed bark fragments with white sandalwood or myrrh and bathing in the smoke.


This is another Amazonian tree which forms an important part of the jungle pharmacopoeia. The bark can be chewed as a remedy for stomach ache, fevers, arthritis, circulation, and bronchial problems, but it is rather bitter and so more often it is macerated in aguardiente or boiled in water and honey.

Western alternatives include burdock for arthritis and for ‘fevers’ as they manifest through the skin in the form of eczema, psoriasis, acne, etc, and ginseng for problems of the circulation. Kola is good for stomach complaints (diarrhoea and dysentery, etc) and saw palmetto is a general tonic which is useful for bronchial problems.

Chuchuhuasi is also regarded as a “libido stimulant” and aphrodisiac, giving the person who drinks it a renewed sense of life and vigour. With these properties in mind, chuchuhuasi is the main ingredient in cocktails at many bars and restaurants in Iquitos, on the banks of the Amazon river, the most popular of which is the Chuchuhuasi Sour, where it is mixed with limes, ice, and honey.

In the West, plants with similar aphrodisiac qualities include burdock, ginseng, kola, and saw palmetto berries. These are not just aids to sexual potency, but reconnect the dieter to the joy of living and a love of involvement with others.

Hilot: An Alternative Medicine Treatment

Alternative medicine has risen so quickly in popularity that many forms of alternative medicine treatments have been brought into the spotlight. The alternative medicine massage treatment is among these.

Massage is a great way to relax the body and take away the stress and problems of the day. The more common reasons that people get an alternative medicine massage is to rid their body of kinks and to feel refreshed afterwards.

The History of Hilot

Hilot as an alternative medicine massage originated from the Philippines. There are several varieties of this kind of alternative medicine massage. It has been a useful way of treating so many things from the flu to sprains and even dislocations. It is embedded in the culture of the country and there are, up to this very day, a few people who practice this type of alternative medicine massage.

The mang-hihilot or masseuse tends to guard their secrets methods of kneading and herbs that this is now uncommon to get a person who is skilled at it. Due to the close guarding of the trade secrets of the masseuse, they only teach their close relatives this art of alternative medicine massage in order to keep the family line going. It is uncommon today to actually have a Hilot that is performed by someone with ancient heritage.

Hilot goes as far back as the 5th century in the tribes of the Filipino people. It is unfortunate to note that there are no written facts or documents regarding the exact ways of this alternative medicine massage. What has been handed down from generation to generation of mang-hihilot contains variations added or subtracted by the current masseuse.

Uses Of This Alternative Medicine Massage

The hilot type of massage is often used to alleviate aches and pains due to overwork or stress. It is also common for a hilot masseuse to attend to a pregnant woman during birth or to change the position of the baby.

Other hilot massages also help to ease the pain of a sprain or a dislocation. These massages can be painful therefore the person giving the hilot usually asks the individual to chew on some leaves or to take a brew which can alleviate pain. Although the pain can be very intense to begin with, many claim that the medicinal value in the future fare outweighs the temporary discomfort of the treatment.

This form of alternative medicine massage is very effective especially for the stress related aches and pains. Many of todays clients of hilot massages are doctors, lawyers, stockbrokers, and real estate brokers. These high stress jobs require a release of stress and many have found that massage is the perfect way.

It is typically done with the accompaniment of virgin coconut oil to rub or knead at the muscles. After a hilot session, you are usually warned not to bathe for approximately twenty four hours. This is because the special oils used in the hilot session are rumored to only work if given enough time to soak in though the skin.

The Way Things Used To Be

One cannot help wonder by looking at the events that are occurring around the world today that maybe we would all wish things were back the way they used to be. Long before the Internet and smart phones we managed quite nicely with rotary telephones and remoteless TV’s. We actually had to get up to change the TV channel. There were only three channels so there wasn’t much debate on what channel to turn to. Not like it is today. Many of us can even remember the days before families got their first television set. Back then the radio was the family entertainment. Imagination is a wonderful experience. But, as we look around today there is too much stress, worry, and even with all those technological marvels of modern living today we really aren’t connected like people were those many years ago.

The way things used to be, a fleeting time in memory and yet with fond remembrance many feel we were all better off than we are today. In those years of common pleasantries neighbors kept their doors unlocked and we all felt a true sense of community. Today, home security systems are one of the fastest growing industries along with identity theft protection. It is as though the modern marvels of today can’t equate to the human connection we all had. Take, the computer for example. Sure, the Internet opened up a totally new medium that has captured so much of our attention. And, along with this technology financial institutions have purposely made credit cards the financial tool of necessity. One cannot help wonder when things used to be cash was the financial tool of the day. The dark side of credit cards is that new technology comes with the high risk of identity theft. Today, banks reap huge profits with every swipe of the card but in doing so has made is far too easy for criminals who now have the means at their disposal to tap into personal bank accounts. Risks are far greater now compared to the way things used to be.

One cannot help notice that where ever you turn the cost of living today has soared, the weather is getting hotter, and the world is a tempest, on the verge of calamity. The storm clouds of discontent whether here or abroad continue to bring terror, misery and woe to the global community. The selfishness and the greed man has turned the world black. No longer are the days filled with anticipation and hope of good times ahead. No, the way things used to be are now just memories.

As another summer of the Autumn of my years approaches with fondness I look back to the days when soft summer winds seem to caress the rolling fields of grass. The peace and tranquility of days long since passed are the highlights of my existence now. Today, as the world tumbles its way forward too many times man in their lust for power, control, and wealth has failed to recognize what lies in the past are so helpful in securing the future. All around today it is as though greed and the love of money has seeped into every fabric of our society. No longer are we attuned to realm of reality of simplicity and ease of fellowship and comradery toward our neighbor.

The pace of the world today is fast and furious. The turbulent times have drowned out peaceful remembrances of the way things used to be. The constant plight of so many is a constant reminder that humanity is all consumed with surviving and not living. The questions that nobody is asking or even trying to answer has been evaded for far too long. We have to ask what went wrong? And, how is it that in the United States and around the world even with all the scientific, medical and technological marvels of today there still remains too much inequality, greed, disease, and terror?

In trying to answer these profound questions we have to realize so many of us are just existing trying to make it through one more day. Surviving the best way they can. In every city and town all across America the plight of the impoverished has spread like an uncontrollable fire. Through-out the world mass starvation has remained unchecked putting the world on notice where the greed of man has rendered mankind on the brink of falling back into the caves.

With so much inequality and misery it is no wonder that the once strong and stable family unit that was the backbone of society has disintegrated to the point of almost no return. We always have to remember that when the family unit is splintered the backbone of society is fractured. And, in the United states we are seeing the devastating results of our fractured society. When we factor in today’s great income disparity gab where millions of incomes are never enough to keep pace with the cost of living is like adding another nail to the coffin of a dying democracy. Remembering the days when the family sat around the dinner table every evening. 50 years ago this was the way that things used to be.

Vitamin D – What You DO NOT Know

The benefits of Vitamin D are not much talked about in the press. That could be why most folks are unaware of the major benefits of Vitamin D. But please do not think that Vitamin D is not for you.

Vitamin D is another one of those fat soluble vitamins. Fat soluble means that Vitamin D (along with Vitamin A and E) are stored by your body.

Vitamin D is the only vitamin that your body can manufacture. Your body needs exposure to sunlight (without sunscreen) for this to occur.

Your body can also get benefits of Vitamin D from food sources or from supplements. Food sources of Vitamin D include cod liver oil, fatty fish like sardines, tuna or salmon, milk that is Vitamin D fortified and eggs.

However, most folks do not get the required amount of Vitamin D from their diet or exposure to sunlight.

Can not Get the Benefits of Vitamin D from My Diet Alone

An article in the READER'S DIGEST titled "The Healing Vitamin" states that "Even with a healthy diet, you may be D-ficient (get it? D-ficient?)." The article argues that Vitamin D is not found in many foods and the foods that it is found in, people do not eat enough of.

In addition, folks are using sunscreen to keep the sun from damaging their skin. And even sunscreen with an 8 SPF cuts the UV rays necessary to make your Vitamin D to almost nothing.

An article in the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION titled "Vitamins for Chronic Disease Prevention in Adults" points out the benefits of Vitamin D. It states that "low levels of vitamin D contribute to osteopenia (comes before osteoporosis) and fractures."

This same article goes on to state that "most people do not consume an optimal amount of all vitamins by diet alone" and "pending strong evidence of effectiveness from randomized trials, it appears prudent for all adults to take vitamin supplements."

Benefits of Vitamin D in Preventing Osteoporosis

Another article appearing in the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION titled "Osteoporosis, Prevention, Diagnosis and Therapy" tells us that "adequate calcium and vitamin D intake is critical to develop optimal peak bone mass and to preserve bone mass through life."

The major benefits of Vitamin D is in enabling your body to use calcium and phosphorous. Without Vitamin D, your body can not process the calcium in your diet and starts taking it from your bones.

In adults, these results in the bone disease called osteoporosis. In children, a severe Vitamin D deficiency causes what's called rickets.

Rickets is a softening of bones in children and is rare in the industrialized nations though.

An article in the NATIONAL LIBRARY OF MEDICINE titled "What Was Wrong With Tiny Tim" amusingly argues that Tiny Tim of the Charles Dickens's "A Christmas Carol" fame is thought to have suffered from Rickets.

That's Not Very Funny

Although Rickets is rare in the industrialized world, osteoporosis is not. In the US it is estimated that 10 million people have osteoporosis. 18 million more have low bone mass making it highly likely that they too will often have this crippling disease.

Osteoporosis is a major health concern and major source of suffering for us older folks. It is estimated that one in two women and one out of every eight men over 50 years of age will have a fracture related to osteoporosis.

300,000 fractures of the hip, 700,000 fractures of the vertebrae, 250,000 fractures of the wrist and over 300,000 other fractures happen every year related to this disease.

Again, the major benefits of Vitamin D is that it enables your small intestine to absorb calcium from the foods you eat. Calcium is required by your muscles and nerves as well as for bone formation.

When your muscles and nerves are not getting enough calcium because of low Vitamin D levels, your body robs it from your bones.

Your bones then become porous and brittle. This does not happen overnight but over the course of your lifetime. That is why prevention of osteoporosis should begin at childhood. And making sure you get the benefits of Vitamin D along with an adequate supply of calcium is one way to do so.

Benefits of Vitamin D in Slowing Progression of Osteoarthritis

Another Osteo you say? Sorry! This time it's osteoarthritis (OA). This disease is a preliminary deterioration of the cartilage in the joints. It is the most common form of arthritis.

Another of the benefits of Vitamin D is that it has been shown to less the severity of the pain and disability of this disease. The Arthritis Foundation has also reported on the link between low levels of Vitamin D and the increased progress of osteoarthritis of the knees.

Also, in an article in the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION titled "Steps Toward Understanding, Alleviating Osteoarthritis Will Help Aging Population," we are advised that "preliminary results appear particularly strongly for vitamin D."

Are There Other Benefits of Vitamin D? What About Vitamin D and Cancer?

More research is needed but preliminary studies have shown benefits of Vitamin D in areas such as high blood pressure, cancer of the colon as well as breast cancer and diabetes.

Can I Get My Benefits of Vitamin D Without Taking Too Much?

Dr Reinhold Vieth, Dept. Of Pathology and Laboratory Medicine at Mount Sinai Hospital in Toronto argues that the Recommended Dietary Allowance (birth to 50 years – 200 IU, 50+ years – 400 IU) may keep you from getting osteomalacia. But he feels more is needed to keep you from getting osteoporosis and secondary hyperparathyroidism.

In an article published in THE AMERICAN JOURNAL OF CLINICAL NUTRITION, titled "Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety," he argues that our ancestors were "naked apes in tropical Africa (his words)." And as such they enjoyed full body exposure to the sun on a daily basis. This, he stated, could give them the equivalent of 10,000 IU every day (and possibly a certain sunburn – my words).

A Tolerable Upper Intake Level (UL) has been set by the Food and Nutrition Board of the Institute of Medicine. This is the level of Vitamin D that they suggest you do not exceed. The UL for infants 0 to 12 months old is 1000 IU. The UL for both children as well as adults is 2000 IU.

Studies done since 1997 suggest that the current UL is conservative and that Vitamin D is safe below levels up to as high as 10,000 IU.

Since multivitamins supply Vitamin D in doses of 400 to 800 IU as do the single supplements, you should feel more than safe getting your benefits of Vitamin D.

Choosing a Gift for Your Autistic Child

Whenever Christmas time or birthdays roll around, I’m often at a cross roads as to what kind of gift to get for our autistic son. Our child is 6 years old and although he is chronologically six, evaluations have indicated that he is operating at about a 2.5 year old level developmentally. This puts me in a conundrum as to what would be the best kind of gift to buy or suggest for him. Sure, he’s six years old and quite interested in what his older brother and sisters play with, but he is also drawn to toys geared toward toddlers and preschoolers. Talking with his therapists, however, has helped me gain a better perspective and some great gift ideas as well!

What my son’s physical therapist shared was incredibly illuminating when we discussed practical gift ideas. Most parents of disabled children want to rush their child along as they are gaining mastery of different skills and behaviors and get on to the next milestone. What we tend to forget the importance of simply letting the child enjoy what they have accomplished with all their hard work! Essentially, it is not only okay, but it is normal and vital for parents to let their children play and have fun with these newly developed skills! We just don’t notice it as much with neurotypical kids. Our special needs kids are simply going at a different pace. This discussion was so eye opening for me and gave me a sense of relief.

Now, with this in mind, we also must consider most families of children with developmental delays or neurodevelopmental problems, are putting a lot of money into therapies for their children. They want their children to progress to the fullest extent possible. They also have to be wise with their budget. With autistic children, like our son, regular therapies like speech, occupational and physical therapies are typically covered by insurance or Medicaid. Alternative therapies are typically not. Additionally, a lot of children are on special diets and these healthy diets are a higher, yet worthwhile, expense. As a result, I, for one, am interested more in toys or gifts that are not only good quality, but provide some sort of therapeutic value and are durable. Having fun is certainly a therapeutic value, but most autistic kids I know, as well as certain children I’m related to, are really hard on their toys! They need to be able to handle the kind of intense treatment a child with poor judgment puts forth.

There are, of course, a huge variety of toys available in any store that can be used in some therapeutic way for an autistic child. It is such a treat to learn from the therapists, different ways in which to play with one’s disabled child that not only are engaging and fun, but satisfying several needs at once. The advantage of having therapists and special educational services for one’s child, certainly can extend to the home. If you think about it, it’s a fact that is true for any child. All kids like to receive fun gifts and items they are interested in. This goes for autistic children like my son, as well as kids with any type of disability. What is important is encouraging an inquisitive mind, mastery of skills, creativity, engagement with others (ie. growth in social skills) and simply having fun.

Some examples of utilizing a toy for therapeutic value is Mr. Potato Head and all the varieties available. What fun it is to work on directions, body parts, fine motor skills regarding manipulating the parts, hand/eye coordination, emotions (turning the mouth upside down to make him “sad”), matching or coordinating outfits, and simply having fun being silly.

Another example is playing with beads. There are, of course, beads of all shapes and sizes, as well as beads that snap together and easier to manipulate. You can work on patterns, fine motor skills, strengthening fingers, and being creative. This type of gift needs to come with the understanding that when using beads, care needs to be involved in only spending about 15 minutes as kids can get frustrated pretty easily. Bring out just a small amount of the beads so they can have a sense of success and completing a project, while building their self esteem through the mastery of difficult tasks.

Of course, there are also the “Wow” gifts of a trampoline (mini or full size), scooters, balls, X-box Kinect games, bicycles or tricycle, indoor bowling sets, indoor swings, puzzles, simple games, etc. Basically, anything affordable that captures the child’s interest and that will keep them interested and engaged, as some of these gifts are done best when someone is playing with the child. There are some toys they can play by themselves, and there is a place for that in a child’s development, but what will excite them the most is having someone to play with them on a consistent basis.

The reality is that regardless of the gift you get for your child, whether at Christmas or their birthday, the best gift you can give is something they will enjoy with the vital ingredient to include being simply the gift of yourself. Spending time with your special needs child, enjoying their mastery and celebrating their achievements while simply having fun and delighting in them, will make lasting memories for both of you and that is the central piece for a healthy and happy childhood!

Neurotransmitters: Chemical Messengers of Nervous System

Human brain is well encapsulated within a thick, bony skull. The choroid plexus secretes the cerebrospinal fluid (CSF) which surrounds the brain. The fluid passes down through the four ventricles with the help of subarachnoid space and finally enters the cerebral veins through the arachnoid villi. Brain lacks lymphatic system so CSF ​​acts as a partial substitute. Dura mater is a tough, protective conductive tissue firmly attached to the skull and includes the subarachnoid space filled with the CSF, arteries and web-like connective tissue known as archanoid mater. The pia mater is a very delicate and permeable membrane composed of collagen, elastin and fibroblasts that rests on the floor of subarachnoid space and allows diffusion between CSF and the interstitial fluid of brain tissue. The pia mater is also interrupted by astrocyte processes. The dura mater, arachnoid mater and the pia mater are collectively known as meninges.

The brain and CSF are separated from each other by the blood-cerebrospinal fluid barrier and the blood-brain barrier (BBB) ​​which protects brain from undesirable blood substances. These barriers are permeable to water, oxygen, carbon dioxide, small lipid soluble molecules, electrolytes and certain essential amino acids. The barriers are formed by the combined action of endothelial cells lining the capillary walls and glial cells (astrocytes) that wrap the capillaries with fibers. The brain has a distinct chemical composition for example, structural lipid accounts for 50% dry weight of brain, a feature which is in contrast with other fatty tissues of the body that are made up of triglycerides and free fatty acids. The blood brain barrier forms a protective chemical environment through which neurotransmitters can easily participate in nerve impulse delivery.

Neurotransmitters and Their Identification

Neurotransmitters are endogenously produced chemicals that actively participate in the transmission of signals from a neuron to the target cell across a synapse. They are tightly packed inside the synaptic vesicles which remain clustered beneath the membrane on the pre-synaptic side of the synapse. Upon activation they are released into the synaptic cleft where they bind to the receptors located on the membrane of the post-synaptic side of the synapse. Release of neurotransmitters is simply an indication that action potential has produced. These chemicals are synthesized from simple precursors, chiefly the amino acids. Amino acids are easily available and only few biosynthetic steps are involved in the formation of neurotransmitters.

Ramón v Cajal discovered synaptic cleft after carefully performing histological examination of neurons. After the discovery of synaptic cleft it was suggested that some chemical messengers are involved in signal transmission. In 1921 a German pharmacologist Otto Loewi confirmed that neurons communicate with each other by releasing chemical messengers. He performed a series of experiments where vagus nerve of frog was involved. He personally controlled the heart rate of frog by controlling the amount of saline solution present around the vagus nerve. When the experiments were over Loewi concluded that sympathetic regulation of heart rate could be mediated through changes in the chemical concentration. He later on discovered the first neurotransmitter known as acetylcholine (Ach). However, some neurons communicate by using electrical synapses through gap junctions that allow specific ions to pass directly from one cell to the other.


There are many ways through which neurotransmitters can be classified for example, they can be divided into amino acids, peptides and monoamines on the basis of their chemical composition. The amino acids that act as neurotransmitters are glutamate, aspartate, D-serine, gama-aminobutyric acid (GABA) and glycine. Monoamines and other biogenic amines include dopamine (DA), norepinephrine, epinephrine, histamine and serotonin. Other substances acting as neurotransmitters are acetylcholine (Ach), adenosine, nitric oxide and anandamide. More than 50 neuroactive peptides are known that act as neurotransmitters. Many of these peptides are released along with a small transmitter molecule. The well known example of a peptide neurotransmitter is β-endorphin which is associated with the opioid receptors of the central nervous system. Single ions such as the synaptically released zinc, some gaseous molecules like nitric oxide (NO) and carbon monoxide (CO) are also considered as neurotransmitters. Glutamate is the most prevalent neurotransmitter as it is excitatory in 90% of the synapses while GABA is inhibitory in 90% of the synapses.

Excitatory and Inhibitory Neurotransmitters

Neurotransmitters can be excitatory or inhibitory but their major action is activation of one or more receptors. The effect of these chemicals on the post-synaptic side of the cell is totally dependent upon the properties of the receptors. The receptors for most of the neurotransmitters are excitatory as they activate the target cell so that action potential can be produced. On the other hand, for GABA, most of the receptors are inhibitory. However, evidences have shown that GABA acts as an excitatory neurotransmitter during early brain development. For acetylcholine the receptors are both excitatory and inhibitory. The effect of a neurotransmitter system is directly dependent upon the connections of neurons and chemical properties of the receptors. Major neurotransmitter systems are the norepinephrine, dopamine, serotonin and cholinergic systems. Drugs targeting these neurotransmitter systems affect the whole system thus, explaining the complexity of drug action. AMPT prevents the conversion of tyrosine into L-DOPA which forms dopamine. Reserpine prevents accumulation of dopamine in the vesicles. Deprenyl inhibits the activity of monoamine oxidase-B and thus, increases dopamine levels.

Precursors of Neurotransmitters

Different precursors are needed for the synthesis of different neurotransmitters. For example, L-DOPA is the precursor for dopamine synthesis that crosses the blood brain barrier and is used in the treatment of Parkinson's disease. In case of depressed patients the activity of norepinephrine is lowered, so the precursors for this neurotransmitter are administratively externally. The precursors for this neurotransmitter are L-phenylalanine and L-tyrosine. These precursors also participate in the synthesis of dopamine and epinephrine. The synthesis of these neurotransmitters also requires vitamin B6, vitamin C and S-adenosylmethionine. L-tryptophan is the precursor for serotonin synthesis and studies have indicated that its administration results in increased production of serotonin in the brain. The conversion of L-tryptophan requires vitamin C. 5-hydroxytryptophan (5-HT) also acts as a precursor for serotonin.

Degradation and Elimination

Neurotransmitters must be broken down into small molecules before they reach the post-synaptic neuron in order to participate in excitatory or inhibitory signal transduction. For example, acetylcholine (ACh) is an excitatory neurotransmitter which is broken down by acetylcholinesterase (AChE). Choline is recycled by the pre-synaptic neuron to form acetylcholine again. Other neurotransmitters like dopamine are able to diffuse away from their synaptic junctions and are eliminated from the body via kidneys or destroyed in the liver. Each neurotransmitter has a specific degradation pathway.

Important Neurotransmitters

A number of chemicals are known to act as neurotransmitters and they will be treated here separately.

1. Acetylcholine (Ach)

Acetylcholine is a part of the peripheral nervous system and was the first neurotransmitter to be discovered. It is an excitatory neurotransmitter in contrast to the monoamines which are inhibitory. The precursors of acetylcholine are acetyl-CoA produced during the glucose metabolism and choline that are actively transported across the blood brain barrier. Production of this neurotransmitter takes place in the brain. The dietary choline comes from the phosphatidyl choline present in the membranes of plant and animal cells except bacterial cells. Acetyl-CoA and choline are independently synthesized inside the cell body of the neuron. Brain has few acetylcholine receptors but outside the brain it is the principal chemical that governs muscle activity. Body muscles may be either skeletal muscles that are under the voluntary control or smooth muscles of the autonomous nervous system lacking voluntary control. The nervous system can further be subdivided into sympathetic and parasympathetic divisions. Direct innervation of the skeletal muscles is due to acetylcholine while that of the smooth muscles is due to norepinephrine.

Acetylcholine receptors are of two types normally, a fast acting ion channel controlled receptor and a slow acting receptor that requires a G-protein (Guanine nucleotide binding protein) which stimulates second messengers to indirectly open ion channels. Direct ion channel controlling receivers respond within microseconds while indirect second messenger controlling receptors may take milliseconds in order to generate a response. The fast acting receptor is known as nicotinic as it is specifically activated by a toxin present in tobacco. The slow acting receptor is known as muscarinic as it requires a toxin muscarine and acetylcholine for its activation. Parasympathetic nerves may be either cranial or sacral. 75% of all parasympathetic nerve fibers arise from a single cranial nerve known as vagus. These fibers travel towards the ganglia and finally enter smooth muscles. The preganglionic fibers are nicotinic. The neuromuscular junction of skeletal muscles is also nicotinic while that of smooth muscles is muscarinic.

The speed with which the skeletal muscles respond clarifies that they are controlled by fast acting nicotinic receptors. The activity of acetylcholine in both nicotinic and muscarinic synapses is inhibited by acetylcholinesterase. The choline liberated after the hydrolysis of acetylcholine can be transported across the post-synaptic membrane to be used for the resynthesis of acetylcholine. Some snake venoms can block nicotinic receptors causing paralysis. Atropine is known to block muscarinic receptors. Most brain cholinergic receptors are muscarinic as they show synaptic plasticity. Major proportion of acetylcholine synthesis in brain occurs in the interpendunctural nucleus. All the inter-neurons in the striatum and the nucleus accumbens are cholinergic. The primary cholinergic input to the cerebral cortex arises from the basal nucleus of Meynert, a prominent area of ​​substantia innominata. Meynert's nucleus is also known to innervate basolateral amygdala, basal ganglia and reticular nucleus of thalamus.
If muscarinic blocking agents are administrated in normal individuals then memory loss can occur.

2. Dopamine

Dopamine, norepinephrine and serotonin are the primary monoamine neurotransmitters. Dopamine and norepinephrine are catecholamines while serotonin is an indolamine. Tyrosine is not an essential amino acid as its synthesis occurs in the liver from phenylalanine in the presence of phenylalanine hydroxylase. It can not be synthesized in the brain so must be coupled with the large neutral amino acid transporter molecules in order to enter brain. These transporter molecules also transport phenylalanine, tryptophan, methionine and branch-chained amino acids.

When tyrosine enter brain it must be converted into DOPA (Dihydroxyphenylalanine) by tyrosine hydroxylase along with oxygen, iron and Tetrahydrobiopterin (THB) that act as co-factors. DOPA is converted into dopamine by aromatic amino acid decarboxylase with pyridoxa L phosphate (PLP) co-factor. The rate of reaction fluctuates when there is vitamin B6 deficiency. Central nervous system has high proportion of dopaminergic cells than adrenergic cells. Dopamine present in the caudate nucleus of brain is responsible for maintaining post while that present in the nucleus accumbens is associated with animal's speed. Two types of primary dopamine receptors are already known as D1 (stimulatory) and D2 (inhibitory). Both these receptors require G-protein for their activity. D2 receptors are located on the dopaminergic neurons and produce negative feedback. They are also known as auto-receptors as they inhibit the release and synthesis of dopamine.

The binding of dopamine to the D1 receptors stimulates the activity of Adenylyl cyclase (AC) which converts ATP into cyclic AMP (second messenger). The cyclic AMP (cAMP) then binds with the protein kinase A (PKA). PKA participates in modulating the activity of various proteins by adding phosphate to them. Brain has four main dopaminergic tracts namely, the nigrostriatial tract, tuberoinfundibular tract, the mesolimbic tract and the mesocortical tract. Both dopamine and norepinephrine are catabolized by monoamine oxidase (MAO) and catechol-o-methyltransferase (COMT). COMT is active in synapses and uses S-adenosyl methionine (SAM) as methyl group while while MAO is active in the pre-synaptic terminal against the catecholamines. Schizophrenia is thought to occur due to the overstimulation of D2 receptors of the mesolimbic and mesocortical systems. The mesolimbic and mesocortical dopaminergic systems are believed to play active role in motivation. Cocaine is known to increase the dopaminergic activity in the mesolimbic areas of brain by inhibiting dopamine re-uptake in the ventral tegmental area and nucleus accumbens.

3. Serotonin (5-Hydroxytryptamine, 5-HT)

Serotonin was isolated from blood serum as a substance responsible for causing muscle contraction. Only 1-2% of the body's serotonin is present in brain while rest comes from platelets, mast cells etc. Synthesis of serotonin involves two steps along with tryptophan hydroxylase and co-factors naturally oxygen, iron and THB. The highest concentration of serotonin is present in the pineal gland. It is primarily methylated in the synthesis of melatonin. Melatonin is synthesized from serotonin in two steps and the whole process requires an acetyl group from acetyl Co-A and a methyl group from S-adenosyl methionine. Melatonin regulates diurnal activity, seasonal behavior and physiology of animals. In mammals the noradrenergic neurons located near the optic nerve are inhibited by light but in darkness norepinephrine stimulates pineal cells to release cyclic AMP which in turn activates N-acetyl transferase to cause acetylation of serotonin. The suprachiasmatic nucleus (SCN) of the hypothalamus is responsible for regulating the mammalian circadian clock partially in response to light. SCN receives serotonergic supply from dorsal raphe nucleus. Serotonin also reduces responsiveness of SCN to light. Sleep deprivation is responsible for increasing concentration of serotonin in SCN. Low levels of serotonin are associated with high levels of pain sensitivity, locomotion, sexual activity, aggression, depression, Obsessive Compulsive Disorder (OCD) and panic disorders.

4. Glycine

Glycine is the simplest amino acid composed of an amino and a carboxyl group. The role of glycine as a neurotransmitter is very simple. When released into a synapse it binds to the receptors making the membrane permeable to chloride ions. Thus, it is inhibitory in action and can be easily deactivated in the synapse. It is found only in vertebrates and is primarily present in the ventral spinal cord.

5. Aspartic acid (Aspartate)

Aspartate is also present in the ventral spinal cord just like glycine. It also participates in the opening of the ion channels and is soon inactivated by reabsorption into pre-synaptic membrane. It is an excitatory neurotransmitter as it increases depolarization in the post-synaptic membrane.

6. Glutamic acid (Glutamate)

Glutamate is the most common excitatory neurotransmitter present in brain and increases the flow of positive ions by opening ion channels. Its stimulation is terminated by the membrane transport system used for reabsorption of the aspartate and glutamate across the pre-synaptic membrane. NMDA-glutamate receptor is the most complicated receptor. It is the only receptor which is regulated by a ligand and voltage. It has five binding sites for glutamate, glycine, magnesium, zinc and a site that binds a hallucinogenic substance, phencyclidine. NMDA receptors are more densely located in the cerebral cortex, amygdala and basal ganglia. Glutamate is not able to cross the blood brain barrier.

7. Gamma amino butyric acid (GABA)

GABA is the major inhibitory neurotransmitter accounting for 30-40% of all synapses. It is present in high concentration in the substantia nigra and globus pallidus nuclei of basal ganglia, hypothalamus, periaqueductal gray matter and hippocampus. The concentration of GABA in brain is 200-1000 times greater than that of monoamines or acetylcholine. It is somewhat unique as it is rapidly inactivated during its transport into the glial cells. Both GABA and glutamate are synthesized in the brain from alpha-keto glutarate, a molecule produced during Kreb's cycle. Like glycine GABA receptor are coupled with the chloride ion channels.

8. Norepinephrine

Norepinephrine and acetylcholine are the neurotransmitters of the peripheral nervous system. It is synthesized from dopamine in the presence of dopamine beta-hydroxlase along with cofactors namely, oxygen, copper and vitamin C. Dopamine synthesis occurs in the cytoplasm while synthesis of norepinephrine takes place inside the neurotransmitter storage vesicles. Cells utilizing norepinephrine for making epinephrine use S-adenosyl methionine as a methyl group donor. The levels of epinephrine are low as compared to that of norepinephrine. The major proportion of norepinephrine is present in the locus ceruleus of pons while rest is found in neocortex, hippocampus, and cerebellum. Most of the dopaminergic innervations of hypothalamus are derived from lateral tegmental nuclei. It plays a major role in awakenness-arousal cycle.

9. Peptides

Peptides are the most common neurotransmitters located in the hypothalamus. Their complex structure is responsible for their high receptor specificity. Their synthesis takes place in the ribosomes and they are rapidly inactivated at the synapses by hydrolysis. They are more potent than other neurotransmitters as their very small amounts are sufficient enough to produce a response. Opioid peptides comprise endorphins, enkephalins and dynorphins. Opiates and enkephalins cause inhibitory of the neuron firing at the locus ceruleus. The concentration of the opioid receptors is very high in the sensory, limbic and hypothalamic regions of brain. Their concentration is also high in the amygdala and preiaqueductal gray area. Cholecystokinin (CCK) is known to participate in satiety. Injection of small doses of CCK in the paraventricular area can inducing feeding. It is also known to modulate dopamine release. Low doses of the peptide vasopressin are known to enhance learning process in laboratory animals.

10. Endorphins

Solomon Snyder and Candace Pert of Johns Hopkins discovered endorphin in 1973. It resembles opioids in structure and function. It is inhibitory and is involved in pain reduction and pleasure. Opioid drugs work by attaching to the receptor sites of endorphin. It also causes hibernation in bear and other animals.

Show Me, How Big Your Brave Is

Hope can make you crazy. It can make you blind to reality, but it can also save your life. The hope I had for the Humira working for me was a strange feeling. I knew it was my last option and that was terrifying. I also had a small pinch in the pit of my stomach that even though we were trying, I had reached the end of the line.

Unfortunately, Humira was not the answer. My lab work and numbers got worse when I was on the Humira and to the Cleveland Clinic my family and I went. I was less than prepared for what I heard on that Thursday morning. The surgeon asked about my quality of life and I told him that I was sick, but hopeful. He then asked me what I thought we should do. I told him I did not know. "Do not know or you do not want to admit?" He explained that he had a daughter my age and that if this was happening to his family, the choice would be obvious. He told me that he was going out of town until the end of July and we could do the procedure then. "No!" I screamed. That was way too soon.

He interrupted my cries by saying, "or we could do it Monday."

I began hyperventilating and bawling. Begging for more time to consider my options. He then told me that my options were out, if I did not have the procedure done as soon as possible, I was going to perforate and die.

He excused himself from the exam room and I felt like I had been hit with a train. I begged for my colon harder than I had ever asked for anything in my life. My parents became stern, tired of watching their daughter waste away. After what seemed like I had been pushed into my worst hell, I agreed to have the procedure done.

All of the routine steps to prepare for surgery were rushed and I met with an ostomy nurse to learn about my new body. When she marked the dot where it would be, it felt like the sharpest knife stabbing my beautiful stomach. I could not stop crying for the rest of the day. How was this happening to me? This was promised to never happen. Did we even try everything? How can I even begin to mentally prepare myself for this in only 3 days?

I returned home that day and allowed myself to eat foods that I had not been able to eat in months. Even though they made me really sick, I felt like I was preparing to go to prison. I spent the next 3 days telling myself that it was going to be okay, that I was going to make it through and be brave. This surgery meant that the pain and suffering was over and after only 6-8 short months I would be back to new with my j-pouch. Anyone can make it through 6 months, right?

Sunday, the day before my surgery, I went to church with my mom. Upon walking into the church I looked up at the altar and asked God for strength. He had given me this journey for a reason, like my boss always tells me. This is my journey, not my destiny. Through this entire process I of course questioned my faith; Pleading and begging with God daily to make the pain stop and to help me understand why he was doing this to me. Maybe this surgery was His answer.

I went into my surgery day with the most strength and confidence that I could muster. I did not cry or scream and I tried to find peace with what was happening.

My stay at the Cleveland Clinic after my surgery was eye opening. I woke up in a room with a young girl just across a curtain from me. She had the opposite issue from what I had, her bowel had died and she could not go to the bathroom without having to painful procedures she told me were called, "clean outs." She also had an array of other painful problems, including nervous system issues. While my ostomy seemed like the end of the world, hers was the least of her worries. I remember feeling so helpless when I would hear her called to the nurses for her list of what seemed like 20 different medications.

I was determined to show immediate progress in the hospital in order to be discharged as soon as possible. I walked and sat in my chair the required amounts daily. The best news I had heard in literally a year came when food service came into my room, handed me a menu and asked me what I wanted for dinner. I looked down at the menu, containing chicken fingers, pizza and grilled cheese. I looked at the girl and told her that I was not allowed to have any of this. She gave me a puzzled look and explained, "No, your diet has been changed and you can have any of this." I yelled in excitement, not knowing what to pick first! I chose a grilled cheese sandwich, potato chips, chocolate chip cookies and chocolate milk. I told her I could not wait to have my first meal without having to run to the bathroom!

A few minutes later, the same woman returned. In her hand she had a turkey sandwich and potato chips. "I know you are really hungry, so I wanted to bring you something to eat before your dinner came." It was the nicest gesture. The sandwich was bland and probably disgusting on regular terms, but it was the best damn thing I have ever ateen.

Over the next few days I went through a lot emotionally and physically. I sacrificed at the process of my new ostomy and struggled to find positivity. I knew that I was going to have to get used to it and the nurss kept telling me every day that it is only temporary. My mom describes it like a big band aid that is going to come off in just 6 short months. The nurses and my surgeon told me that my recovery was remarkable and I was allowed to go home in just 4 days. Unfortunately, I left my roommate behind who was still really struggling. I have a great appreciation and respect for her, she made me realize that I should be thankful for my healing, for there are others that are not as lucky. That girl is a fighter.

Since being home I have realized a lot. Even though my body is really different for the time being, I am cured! I can eat, I can shop, I can SLEEP! My family can rest and know that I'm not up all night running to the bathroom. I have been to my favorite restaurants and ateen my favorite foods without the absolute fear of the pain that used to follow. I can get in a car and do not have sweaty palms.

I have had a lot of break downs, this is really hard for me mentally. Getting dressed has been a challenge. I'm very swollen and its weird to see my usually small stomach stick out. I'm very self conscious about my ostomy showing, but I need to realize that after the swings goes down and my nifty "swealt belts" come in, I will have nothing to worry about. I have always been a girl who cares a lot about vanity and self image, and this is proving to be a huge challenge for me. But I'm starting to see that it's also there to teach me.

I have decided to pursue my love of makeup and skin care and sign up to get my esthetician license from Aveda starting in the fall. I want to be able to help those who are struggling. I now know what it's like to not feel very pretty, or like yourself. I want to be able to provide support and relief for those who have suffered as I have. I'm going to return to work for my boss, who has been more than inspiring and supportive throughout this entire process. I'm going to go back to my apartment, go to the gym, go out with my friends and be in love with my boyfriend. And I'm going to do all of it without having to run to the bathroom. I have a long journey and 2 more surgeries ahead, but I'm going to try and remember to look to this journey with positivity and remember that the gift of life and health has been given back to me.

The love and support of my family and true friends have been amazing. I face this process with bravery mostly for them. It has been so relieving to not only not be sick, but to see them look at me without sadness or sorrow. This time is going to fly and I'm going to spend it healing, learning and growing. I have my life back.

Failure to Diagnose Stroke

Quick diagnosis and treatment of a stroke can not only save lives, but it critical in preventing permanent disability for survivors. Once a stroke occurs it starts a chain reaction in which brain cell killing chemicals are released, and brain injury begins. Prompt treatment can stop this and in some cases can reverse the damage.

When a stroke goes undiagnosed, treatment is delayed or not given at all and the damage continues often resulting in:
• Another more severe stroke
• Brain injury
• Paralysis, often on one side of the body
• Loss of motor skills
• Memory problems
• Difficulty speaking and/or understanding words
• Difficulty reading and writing
• Difficulty swallowing
• Seizures
• Pain
• Behavioral changes
• Depression
• Death
In fact, stroke is the leading cause of adult disability and the third leading cause of death in the United States.

Predicting a stroke
Alert doctors and emergency room staff can sometimes prevent a stroke from occurring in the first place by:
• Recognizing the warning signs, including a “mini-stroke”
• Carefully reviewing patient history
• Conducting a detailed physical exam
• Performing an ultrasound of the carotid arteries or angiograms (radiology study of the arteries)
• Administering the appropriate treatment, often including blood thinners

A “mini-stroke,” technically called transient ischemic attack (TIA), is a warning sign that a more serious and harmful stroke is on the way. TIA typically resolves on its own, usually lasting no more than 10 or 20 minutes, but should not go untreated. Prompt diagnosis and treatment of a mini-stroke can prevent a damaging and life-threatening stroke from happening later. For those who are treated properly, a mini-stroke is like getting a second chance.

Stroke symptoms
The symptoms of a stroke re the same whether it is a severe, life-threatening stroke or a mini-stroke, and should always be taken seriously, even if you are not a likely candidate for a stroke. These symptoms include:
• Weakness or tingling in a limb
• Sudden loss of strength in the legs
• Weakness, heaviness, numbness, or paralysis (usually on one side of the body)
• Severe headache
• Confusion
• Loss of vision
• Change of vision, such as dimness, blurriness, or double vision
• Dizziness, loss of balance, loss of coordination
• Difficulty speaking or finding words
• Difficulty understanding speech
• Fainting

How strokes go undetected
Doctors and emergency room staff overlook strokes for many reasons, but often because stroke victims do not always fit the profile for a likely candidate. Mistakes leading to misdiagnosed stroke include:
• Errors in recording intake interview
• Failure to consider patient’s medical history
• Failure to consider stroke in younger patients
• Failure to consider stroke in patients that seem healthy
• Failure to order necessary tests
• Laboratory error
• Improper reading of tests

The Wood Shaper

The wood shaper is a very useful machine, whether you have a garage woodshop or a commercial shop. Shaping wood is a much easier process, once you have the right equipment, and some knowledge of how they work. Almost all woodworkers have used a router table at some point. The shaper is pretty much just a larger version, with more power, and the ability to handle much larger cutters, such as those used for raised panels or crown moldings. The variety of cutters is also much greater that for routers. (Plus you can still use all your router bits with them).

Shapers range in size and are identified by the horse power of the motor, and the diameter of the spindle. From less than one HP for bench top shapers, which I think if that's what you need, you might as well stick with a router table. They increase in size to 2 HP, 3 HP, 5 HP and larger for industrial purposes. The shafts, or spindles are threaded on the end and range in size from 1/2 "to 1 1/4". Many machines come with a couple sizes of spindles, as well as having router collets to allow router bits to be used in it.

These machines are much quiter than a router, due mainly to the fact their belt driven, and turn much slower than a router. Typically, the shaper cuter is turning between 7,000 – 10,000 RPM's, changed by relocating the belts on the stepped pulley system, much like a drill press, whereas a router will turn at between 20,000 and 25,000 RPM's, and are direct drive. It's easy to understand the difference in noise levels, and the pitch of the noise. Instead of a high pitched whine of a router, it's a quiet hum of a quality motor. (Hopefully).

Shapers are also able to run in reverse, which is necessary in performing some cuts. It is very important to always check the position of the directional switch, particularly if you work with others. Feeding a board into a shaper that is turning the wrong direction could result in the board leaving the machine like a missile. It could have FATAL if the board were to hit somebody.

The shaper is considered to be the most dangerous machine in the shop, but with proper precautions and careful set-up it does not need to be feared. There are several safety precautions you can, and should use. First thing would be use the plastic guard provided with the shaper. It has a bearing in the center of it which allows it to spin freely, and is installed above the cutter. This alone would stop many of the injuries attributed to the shaper.

Jigs and fixtures are also a big help in reducing injury, and generally result in better cuts. The time spent to make them is well worth the effort. A very small device, but important one is the starter pin supplied with the machines. This is simply a metal rod, threaded on one end which screws into a hole located a few inches away from the cutter. Holding the work piece against the starter pin, and then feeding it into the cutter is the proper way to start a freehand cut.

Probably the best and also most expensive safety device would be a power feeder. As the name suggests, the power feeder is an attachment that feeds the workpiece past the cutter at a steady speed. While these were probably not designed as a safety feature, they certainly are. The benefits to using a power feeder, in addition to keeping your hands far from the cutters, (as if that were not enough), is the fact it will hold both down and in towards the fence with a great deal of force, while Feeding the board steadily past the cutter. Both of these details are critical to nice smooth burn free painting.

Instead of trying to shape narrow pieces, shape wide pieces and then rip them. Use a miter gauge, on end grain with a backer board to prevent tearout as the board leaves the cutter. On panels, such as raised panels for doors, shape the end grain first and then the edges parallel to the grain. This way any tear out on the end grain will be shaped off when you shape the edges. Make several shallow cuts instead of trying to make large moldings in one pass.

With some caution, careful planning, and common sense, injuries from this machine can be avoided. As always, if it does not seem safe, DO NOT DO IT.

Kugel Hernia Patch Lawsuit Facts

Kugel technique is an important step in the treatment of inguinal hernia. It is based on the introduction of the pro-peritoneal approach in the open surgery. Kugel technique consists in the insertion of a prosthetic device in the pro-peritoneal space, of course after reducing and treating the hernia bag. As humans are submitted to mistakes, sometimes this device is not compatible with the patient’s body and the consequence can be Kugel hernia patch lawsuit. In this case, it is recommended to look for a Kugel mesh-patch recall lawyer, who can help and guide such unfortunate patients.

If you are a patient suffering from hernia, it is better to know some facts about it, before contacting a Kugel mesh-patch recall lawyer. Applying the prosthesis on the same part of the abdominal wall, where the intra-abdominal pressure is as well applied, this pressure contributes to keeping the integrity of the abdominal wall repair and it does not act as an enemy, as it happens in the case of previous approaches, like laparoscopy.

Laparoscopy is a surgery procedure that uses a thin tube that is illuminated, called laparoscope, introduced in the abdomen through a small incision, at the level of the abdominal wall that is used especially for the examination of abdominal organs. Kugel hernia patch lawsuit can be avoided if you have an elementary theoretic support on hernia.

The prosthesis has been conceived as a device that can be introduced in the pro-peritoneal space through a minimal incision, then through its properties, it is extended and it is fixed in this intra-abdominal pressure space. It is made of two layers of polypropylene and it has a special shape.

If initially this device has been made by the surgeon of polypropylene mesh, now it is produced industrially of the same material. Between 1994 and 2003, the promoter of this technique (R.D. Kugel) used it in the treatment of many cases of inguinal hernia, both primary and recurrent. There have been recorded several recurrent hernias, when a Kugel mesh-patch recall lawyer had to be involved.

However, in time, surgeons have gained more experience, but several recurrences have been recorded after the treatment of primary inguinal hernias. In this case, Kugel hernia patch lawsuit has been necessary. As there is a quite significant rate of the recurrence, a Kugel mesh-patch recall lawyer must be always ready to assist people who face such complications.

Post operatory suppuration has occurred in the case of several patients and it has needed drainage. There can be cases when because a hematoma has been seriously infected, the mesh has to be taken out after few weeks since the operation. There can be cases of bilateral hernia operation when patients go to the doctor’s after 1-2 years of suppuration in the inguinal area that as well may need the extraction of the prostheses.

Even if apparently this affection is not very serious, it must be treated seriously since its beginning in order to avoid complications, from the point of view of your health and your financial situation, too.

Orthopedic Hospitals Delhi- Affordable Low Cost Orthopedic Hospitals

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India is one of the most reputed medical tourism destinations in the world. It is known in general for heart surgery, hip resurfacing and other areas of advanced medical science. The private hospital groups are committed to the target of making India a world leader in the industry. The industry’s main focus is low cost health services. Many estimates say treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain….

At one private health care center in London a thorough men’s health check-up that includes blood tests, electro-cardiogram tests, chest x-rays, and abdominal ultrasound costs $574. A comparable check-up at a clinic operated by Delhi-based healthcare company costs $84….

The Escorts Heart Institute and Research Center in Delhi, India performs nearly 15,000 heart operations every year, and the post-surgery mortality rate is only 0.8 percent, which is less than half of most major hospitals in the United States. Major medical tourism promoting hospitals in Delhi are Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, Fortis Flt. Lt. Ranjan Dhall Hospital, Vasant Kunj, New Delhi, Fortis Hospital, Noida, Escorts Heart Hospital, Delhi, Artemis Hospital, Gurgaon and Max Hospital, Saket, New Delhi. These hospitals have been accredited by national and international hospital accreditation bodies and are well equipped to take medical and personal care of International Patients…..

Delhi is also well placed for the convenience of medical travelers as being the capital it is well connected to major air hubs, has some of the major shopping places, accommodation outside the hospital is not costly and tourist vehicles are freely available to move about. If interested in excursions, places like Taj Mahal in Agra, dessert cities of Udaipur, Jaipur etc., hill stations like Shimla, Kullu-Manali, Mussouri are located within 4-8 hr driving distance….

Our nation India is best known for heart surgery, hip resurfacing and other areas of latest medicine. The government and private health service centers are committed to the target of making India a leader in the medical tourism industry. The industry’s main focus is least cost treatment. The treatment fees in India start at around one tenth of the price of comparable treatment in the nation like USA and UK…. 

Other points in favor of India are : –

  • A peaceful democracy for last more than 50 years
  • Independent & mature legal system (although the proceedings are very slow)
  • A wide variety of tourism options.
  • Fixed medical treatment package price that is known in advance…..

Our associate hospitals and Joints Replacement Centers are state of the art facilities, equipped with state of art infrastructure and latest technology.

Advanced Diagnostics and Support Infrastructure – 64 slice CT , High end MRI, Neuro-navigation surgical systems, Neuro-physiology and Comprehensive Rehabilitation services Finest quality implants, prosthesis and Consumables of international repute most of them imported from overseas countries are used….

Orthopaedic Surgery Procedures at hospitals in Delhi

Facilities at Orthopaedic Hospitals in Delhi

  • Operation Theatre equipped with Laminar Air flow
  • State of art Instrumentataion
  • Image Intensifiers….

Joint replacements at hospitals in Delhi

  • Total hip replacement
  • Total knee replacement
  • Total shoulder replacement…

Arthroscopic surgery

Key hole surgery for disorders of knee, shoulder, elbow and ankle are offered, in the following manner One day admission….

Trauma and Fracture surgery

  • High quality Swiss ‘AO’ systems, help stabilize fractures
  • Image intensifier, confirms perfect fracture fixations….

Ilizarov and External Fixation Device

  • Management of open fractures
  • Infected non-union of long bones
  • Limb lengthening
  • Correction of deformities
  • Fusion of joints….

Spinal Surgery

  • Disc surgery
  • Micro surgery for disc
  • Fixation Systems for fractures…


  • Osteoarthritis
  • Rheumatoid arthritis….

Paediatric Orthopaedics

  • Congenital limb & spinal deformities
  • Bone & Joint infections….

The orthopaedic department at our partner hospital in India is supported by the most elaborate intensive care services, a modern Accident and Emergency department, and state of the art Physiotherapy and rehabilitation department. They have established trauma protocols for the care of the critically injured patients and principles of Advanced Trauma and Life Support System (ATLS) are applied for the prompt and efficient treatment of accident victims…

The list of of Orthopedic hospitals in Delhi is as follows : –

A  ]  Indraprastha Apollo Hospital, Delhi, India

Indraprastha Apollo Hospital New Delhi is one of the largest corporate hospitals in the world. It is the third super specialty tertiary care hospital set by the Apollo Hospitals Group, jointly with the Government of New Delhi, India’s capital.

The hospital started functioning from July 1996, its mission being, “Medical Excellence with a Human Touch.”….

B  ]  Fortis Hospital, Delhi, India

Fortis Healthcare flt. Lt. Rajan Dhall Hospital (FFLRDH), like every other Fortis hospital, is a manifestation of the founder’s vision of “creating a world-class integrated healthcare delivery system in India, entailing the finest medical skills combined with compassionate patient care”…..

C  ]  Artemis Hospital, Gurgaon ( Delhi ) , India

Artemis Health Institute (AHI), at Gurgaon is a 500-bed super-specialty flagship hospital established by Artemis Health Sciences (AHS) – a healthcare venture launched by the promoters of the Apollo Tyres Group. Artemis aims at creating an integrated world-class healthcare system by leveraging the best medical practices backed by cutting-edge technology. The super-specialities chosen by Artemis as its area of focus include Cardiovascular, Oncology, Orthopaedics and Bariatric & minimally Invasive Surgery in addition to other specialties….

D  ]  Max Devki Devi Heart and Vascular hospital, Delhi, India

Max Healthcare state-of-the-art facilities designed in accordance with international norms include 225 critical care beds, 20 operation theatres, 3 cathlabs, 4 MRIs and 4 CTs across an integrated network.

Two of our super speciality hospitals located at Saket, New Delhi have been accredited with NABH certification in patient care. Rest assured – your well being is our responsibility and we give you this healthy commitment to live life on your own terms…..

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We Care Core Values

We have a very simple business model that keeps you as the centre.

Having the industry’s most elaborate and exclusive Patient Care and Clinical Coordination teams stationed at each partner hospital, we provide you the smoothest and seamless care ever imagined. With a ratio of one Patient Care Manager to five patients our patient care standards are unmatched across the sub continent.

The Race

The nervous thoughts began to fill my stomach as I sat in the locker room moments away from the biggest race of my life. I got up and paced back and forth, trying to control my breathing. Cold sweat already formed on the tips of my fingers. It was less than an hour before my event. I dropped my brand new racing suit out of my bag. This was the "LZR Elite" everyone was talking about. It was a $ 260 water-resistant suit, the fastest of its kind. My mom had heard about it and had saved enough money to buy one as a Christmas gift.

Careful not to rip it, I slowly slid the size 26 past my clean-shaven legs and it brushed right past them. As the suit near my waist, I understated the "skin-tight feeling" everyone complained about. The compression suit tightly wrapped around my crotch in an awkward way, making it difficult to walk without flinching. I sprinkled some water onto the suit to test it and was surprised to find that the water bounced right off. I looked into the mirror and shut my eyes as I played out the entire race in my head. I imagined the start, the middle, and the finish. I imagined that I had just won the race. I jumped up and pumped my fists in the air. I smoked and washed to the crowd. But my smile quickly faded. Even then, in my own little world of imagination, doubles filled my mind.

I was racing against Jay Thompson, the fastest freestyler in the state, who also happened to be my longtime teammate and captain. All I ever wanted, all I ever dreamed of was beating Jay in any event. I wanted to prove to him that work beats talent.

Walking out of the locker room, I went and sat down beside my coach.

"Hey coach, how do I swim this race?" I asked even though I already knew the answer.

"You nervous?" He asked.

"Yeah, just a little bit."

"Do not think about it too much. Just do it like we did in practice. Keep your strokes long and strong and remember to keep your breathing pattern steady. Your energy. Just swim your own race. Really kick your legs in the back half and try to get that second place. "

"Okay, thanks coach."

I wanted to ask if there was any possibility I could win, but instead I nodded my head and left for the warm-up pool.

Heading towards the pool, I looked up into the stands. Hundreds, if not thousands, of people were packed into the stands. Parents, friends, teachers, and even a few Division 1 college recruiters had come to watch this state championship meet.

As soon as I entered, I spotted Jay talking with a bunch of swimmers from the other teams.

"Look who's here," he said smirking.

His friends turned around and looked at me. Jay singled me out not because I was the second fastest on the team, but because I was the only one who would have the guts to challenge him. Even the coaches were obedient to him. He would make fun of my name, my skinny body. He loved it since it made him feel superior.

"What's his name again? Jizzy? The one who wants to beat you?" One of his friends asked.

They all started laughing, but I did not find it funny. I knew that I had trained harder than he and deserved that first place more than anyone.

He declared loudly in front of everyone, "You do not have to keep it a secret. We all know you think you can beat me. I know you've been working hard, but I've been working on my talent."

I remembered the night when Jay broke the state record. He said to me, "Work will get you now if you have no talent." But how can you get talent? Can you build talent? He told me only a few athletes are gifted with talent and that I was not one of them. But I would have none of that. I was not the best, but I trained like a champion. I knew that if I trained my hardest, I could swim as fast as him.

I walked away from them without saying a word and jumped in the pool to start my warm-up. During the 500 yards of easy swimming, I practiced the smooth long strokes that coach wanted. Breathe, pull, reach … Breathe, pull, reach. Simple right? I had practiced the same stroke day after day for years. But now my strokes felt foreign to me. The anxiety began to overwhelm me. My head spun. My body tensed. How much more pressure could I end?

The meeting had already started and there were only a couple more races ahead of me. I finished my warm-up and headed to the waiting room early. There were eight seats for the eight finalists for the event. Seeded with the 8th fastest time, I had barely qualified, which meant I would be swimming in the farthest lane. The fastest swimmers swim in the middle lanes, giving them a clear view of the competitors during the race. As usual, Jay was the number one seed in this event.

The television screen in the room was tuned to a sports network, with two analysts giving a preview of the race.

"… This really is not much of a race. It's not IF Thompson wins, it's how much he wins by."

"That's right. He is a three-time defending state champion and is looking to not only break his own state record that he set last year, but to also break the decision-long national record."

"Folks, this is an event you will not want to miss. We'll be back to deliver you live coverage of the men's fifty yard freestyle …"

"Pretty cool huh?" Jay said behind me.

"Yeah, sure I guess," I acknowledged.

"You guess? I'm gonna break the record and it'll be nationally televised! Oh, and by the way, good luck. You're gonna need it," he said and walked away.

The pump-up music started booming from the natatorium speakers, as the PA announcer signaled us to walk out.

"… And nowww, the men's … fifty yard freeestyyle …"

We walked in a single file line to the pool deck and lined up behind our blocks as the announcer introduced us.

"In lane 1, swimming for West Central … In lane 2 …"

I strapped on my goggles and put on my cap. Extended my arms, I stretched shoulder to shoulder and took ten deep breaths.

"… And in lane 3, a high school All-American from Rock Valley …"

My lips quivered and my throat dried. I told myself to keep breathing and that everything was okay. But my heart was throbbing uncontrollably. I tried shaking my arms and legs to loosen my stiff body.

"… In lane 4, your top seed in this event, is a 3-time defending state champion and state record holder … swimming for Mission Viejo High School … Jayyy Thompsonnn …"

The roaring crowd drowned my thoughts. I picked nervously at my fingernails; And readjusted my goggles and cap, worried they might fall off during my dive.

"… And in lane 5, who was runner-up in this event last year …"

I looked into the stands trying to find my parents so I could wave to them like I always did before my race. I wanted to thank them for everything, for all the support, for all the effort that they put in for me. I kept looking, but I could not pick them out from the hundreds of onlookers.

"… In lane 6, from Lincoln High … And in lane 7 …"

This was it. This was my time to shine. All those sleepless nights I spent dreaming of this race; All those hours I spent training day after day, were not for a second place finish. I poured my heart out to prepare for this last race of my high school career. I trained like a champion and now I was ready to win like one.

"… And finally in lane 8, also swimming for Mission Viejo, is Jizzy MacGibsonn …"

The whistle blew and the official signaled the swimmers to take their marks. It was dead silent … and then whoosh, off we dove into the water.

My hands entered first, in a streamline position. I glided for a few yards and took seven dolphin kicks before I surfaced. Holding my breath, I swam the length of the pool and charged into the wall for my flip turn. My feet positioned perfectly as I hit the wall and carried my momentum into the final length. By now, the crowd's cheers were deafening. I took another five dolphin kicks and swam the rest of the race with my head down.

I finished to the wall and took a few seconds to catch my breath. Gasping for air, I lifted my head up and looked at the scoreboard. Out-touching Jay and the others by less than a tenth of a second, I had claimed my first victory.

Now as I looked into the stands, I could pick out my parents from the hundreds of spectators. They were screaming and jumping up and down with joy. I smoked and washed to them and they got me a thumbs-up.

As I got out of the pool, a news reporter immediately congratulated me.

"Hey, great job. Do you have a moment to tell us about your race?"

"Uh yeah," I stammered.

I had only dreamed of being interviewed, but reporters never asked me about anything.

"Well, tell me about the race. How did you prepare for it and how did it feel to finally win your first title?"

"I spent months preparing for this race. It took a lot of commitment, but through the pain, through the sweat and tears, I knew that every ounce of effort was worth it."

I had practiced reciting those exact sentences every night for this moment, and now I was finally able to say them.

Treat Panic Disorder With Your Very Own Masterplan

Back when I was trying to treat panic disorder I was a little lost. I did not know where to turn, or what to try. Some things I got a shot, and I made a little progress. Other things I tried and made none. But my biggest problem was that I had no real plan of attack. I did not know what I was trying to achieve.

So when I realized this I started developing something that I'd like to share with you today, and I think if you make use of this idea you'll have a great new way to treat panic disorder.

I called it my "masterplan."

It was a combination of short-term goals, and long-term goals, and a way to track them.

I think it's vital to have a long-term goal that you've like to achieve (your ultimate goal), and many short-term goals (little baby steps you'd like to achieve along the way.). And just as important as those goals is an effective way to track them.

So first of all, decide on your long-term goal and write it down. Then plot out all the baby step goals that will take you from where you are now to your ultimate goal. When you see an entire plan laid out like this ic can be very inspiring, because it makes your long-term goal suddenly seem so easy to reach.

When you've got all your goals written down, start monitoring your progress towards them in a daily journal. You can either do this in a little diary, or maybe even an online blog. Nothing fancy – just a quick note of the progress you made that day, and if you've achieved or got nearer to any of your short-term, or baby step, goals.

Having a masterplan like this can produce incredible results, and I think if you stick with it you will have a great new weapon in your arsenal to treat panic disorder.

Eating Healthy – Bringing Sugar Levels Down

Millions of people are afflicted with diabetes, and the number keeps on increasing. There can be many reasons for that, and not surprisingly, they seem to boil down to lifestyle changes. It looks like everyone is up on their toes all the time, always rushing about, meeting deadlines and the like. This doesn’t give them time to sit down for a proper meal, thus they’d rather order take-outs or eat at fast food restaurants. These can be convenient choices, indeed, but not very healthy at all.

In addition, these people don’t have time to exercise anymore. Perhaps, you may think that rushing into things is exercise, but it’s not. There’s a lot of stress that goes with it, which isn’t healthy either. When you think about these things, you wouldn’t wonder why many people experience spikes in blood sugar levels, resulting to diabetes, more specifically, Type II diabetes.

Type II diabetes may not be as severe as Type I diabetes, but it doesn’t mean that you should just take it for granted. Type II diabetes can still potentially cause long-term damage, thus the need for specific control measures to ensure that they do not spike up abnormally.

When diabetes is not yet advanced, control measures may not necessarily involve medications yet, but may include making wise food choices and exercise. A diet that is low in carbohydrates, sugar and fat and one that is rich in protein and fiber is very suitable. Fruits like apples, avocados, bitter lemons, and grapefruits are blood sugar burners; thus, munching on them helps in the regulation of blood sugar levels. If you are a diabetic, you should also include grains in your diet, and of course limiting intake of sweets is a must.

The importance of exercise should not be discounted. Exercising on a regular basis is a good way of burning excess blood sugar, besides which it gives you a trim, fit, and well-toned appearance.t it’s not. There’s a lot of stress that goes with it, which isn’t healthy either. When you think about these things, you woul

Chronic Myofascial Pain & Fibromyalgia – Often Together But Miles Apart

Many people with fibromyalgia also have chronic myofascial pain or CMP (formally known as Myofascial Pain Syndrome, MPS) and don’t even know it.  It is often missed because it is easy to confuse the pain and it’s origins with that of FM.  As a result, it is missed in the diagnosis.  Both are connected to the musculoskeletal system which makes up almost 50% of our body weight, but should not be confused as being the same.  Understanding FM and CMP and what makes them tick, will empower you to help yourself.  You will be able to figure out some of the contributing factors to your pain, where it originates and what makes it feel better.  It will help you understand treatments and find the one(s) that work for you.

It was recently discovered that MPS is not actually a syndrome at all, but a neuromuscular disease.  This is important news!  The difference?  Diseases have known causes and a well-understood process for producing symptoms.  Myofascial pain due to trigger points is now considered a true disease, rather than a syndrome.  Fibromyalgia is a syndrome like rheumatoid arthritis and lupus and has tender points (not to be confused with trigger points).  Even with these differences, it is believed by many researchers that one can influence the other.

I have mentioned before that I have a few experts that I follow closely and call my “fibro heroes” because they helped me through their studies and publications to understand and validate my pain.  Devin Starlanyl is one of those heroes.  Actually, she was my first.  I read a book she co-authored, Fibromyalgia and Chronic Myofascial Pain: A Survival Manual, and quickly followed that by her book, The Fibromyalgia Advocate: Getting the Support You Need to Cope with Fibromyalgia and Myofascial Pain – she is amazing!  She is a sufferer herself as well as a doctor/researcher.  She set about trying to give doctors perspective from the patient’s point of view and has created diagnostic guidelines, patient resources with an empathy you can’t get anywhere else.  She is at the forefront of all the research, news and information & shares it with FM & CMP sufferers in a way we can understand.  Finding out about her work, was the beginning of my understanding.

What are trigger points?  Trigger points are subtle, but taut bands that constrict the muscle and cause tremendous pain. Trigger points can be in the fascia that surrounds the muscle or in the muscle itself.  They are extremely sensitive to pressure at the site and also cause “referred” pain – meaning pain at another location of the body.  The part of the muscle fiber that actually does the contracting is a miniscule component called a sarcomere which cannot be seen by the naked eye. Contraction occurs in a sarcomere when its two parts come together and interlock like fingers.  Myofascial trigger points are confined in one area and are dying for oxygen, which causes a demand for energy.  There is a chemical reaction in central nervous system which sensitizes nearby nerves.  This triggers the motor,  sensitivity and autonomic (not under voluntary control) reactions of the trigger points.  Muscles with trigger points are in a perpetual state of energy crisis.

Trigger points cause headaches, neck and jaw pain (TMJ), low back pain, tennis elbow, and carpal tunnel syndrome. They can cause pain in the shoulder, wrist, hip, knee, and ankle and are often mistaken for arthritis, tendonitis, bursitis, or ligament injury.

Trigger points can also cause dizziness, earaches, sinusitis, nausea, heartburn, false heart pain, heart arrhythmia, genital pain, and numbness in the hands and feet.  Some experts believe that fibromyalgia may sometimes start as a result of myofascial trigger points.  In CMP trigger points, the pain is more intense with a radiating pattern along the same muscle or muscle group. There is usually some loss of the range of motion, as well as a substantial weakness in the muscles that have active trigger points.  The pain decreases when the muscle is at rest, and the intensity of the pain increases as soon as the that muscle starts to contract.

Proof of myofascial trigger points has been produced by the use of electromyographic imaging (a device that converts the electrical activity associated with functioning skeletal muscle into a visual record or into sound and has been used to diagnose neuromuscular disorders and in biofeedback training).  Researchers have also used ultrasounds of localized twitch responses of trigger points.  They can even do biopsies of myofascial trigger points that show the contraction knots and rounded muscle fibers. In one of Devin Starlanyl’s articles, I read that, as a result of this, The Journal of Musculoskeletal Pain has stated that the trigger points involve the “nerve terminal and the postjunctional muscle fiber” which “identifies myofascial trigger points as a neuromuscular disease”.  Simons DG. 1999. Diagnostic criteria of myofascial pain caused by trigger points. J Musculoskeletal Pain 7(1-2):111-120.

What causes trigger points?  There are many factors that can be attributed to trigger points: poor posture, scoliosis, thyroid deficiency, estrogen deficiency, loss of flexibility, nerve root compression (pinched nerve), emotional stress/anxiety that leads to lack of sleep which can increase muscle tension, fatigue and pain threshold.  Other factors that MAY cause or worsen CMP trigger points are:  nutritional deficiencies, chronic infections, muscle imbalance, inactivity (static posture).

When I injured my left knee, which resulted in surgery, I developed a limp and without even thinking about it, continued to favor (protect) that knee long after surgery.  As a result, my entire left side became weak and I experienced pain that radiated from my lower back all the way to my ankle.  My lower back and hip would tighten up so much to compensate for the muscles in my leg, that I sometimes couldn’t even move.  The pain felt like all my muscles from the waist down on that side had “seized”.  It was so intense, I would have to freeze in that position until it eased.  It still happens today, but the difference is, I know what to do about it.

After a car accident, my FM and CMP were inflamed to a point that I was sent to a therapist for continual treatment.  I had been reading about myofascial release therapy and was really wanting to try it.  I was pleasantly surprised to find a myofacial release therapist that had practiced under John F. Barnes, President and Director of the Myofascial Release Treatment Centers and National Myofascial Release Seminars.  Barnes developed the most incredible, pain-easing therapy that makes your fascia and muscles feel like they are melting like butter and gently releasing and unfolding your muscles!  Of course, that is MY non-clinical way of describing it, BUT that is what it felt like to me.

Being a military family, we eventually had to move to another base and I immediately started searching for a therapist that knew and understood the John Barnes method.  I saw several therapists (covered by my insurance) that claimed to know it, but I was incredibly disappointed and ended up hurting more after a session than when I went in.  So, my recommendation is to make sure these people have actually studied under Barnes or were trained at one of his seminars.  Ask for proof.  You can also find a link to his site on my website where you kind find a list of therapists.

With all of the research and progress being made in understanding and treating chronic myofascial pain, who knows what tomorrow will bring!   I will continue to bring you more information on CMP – from diagnosis to traditional and alternative treatments.  There is a great deal of hope for people like you and me!