MEDICINE IS MUSIC

Chronic Pain and Your Emotions: Is There A Connection?

Dr. Eric Viegas, ND

www.medicineismusic.ca

@medicineismusic

chronic pain emotions

You’re in pain. You decide to go to your doctor to address it, but you feel like the physical approach used is lacking something specific to how you feel.

 

Pain is a very interesting sensation; it is highly individualized and subjective. The perception of pain can be limited or worsened by stress.

 

When our bodies encounter physical trauma, a damage to nerve fibres can result in physical pain. If you are suffering from depression, your mental health can worsen the physical pain. Social factors like isolation and loneliness can further complicate the picture of your pain.

 

So as you can see, your emotions and how you deal with them can affect how you experience your pain.

 

Fibromyalgia (FM) and Irritable Bowel Syndrome (IBS) are both conditions where people experience a high degree of pain and discomfort without obvious clinical or laboratory evidence to indicate damage to the affected areas. Also, FM and IBS may occur at the same time, further complicating treatment.

 

A recent theory called central sensitivity syndrome (CSS) attempts to explain the persistent pain felt from these conditions. CSS notes a hyper-excitement of the central nervous system (brain and spinal cord) rather than a direct issue with the affected areas. CSS may explain the emotional component of pain and the need for it to be addressed in chronic persistent pain syndromes (1).

 

Now let’s talk about feelings of fear and anxiety, common forms of stress response.

 

Fear is experienced when we encounter a threat, and it motivates defensive behaviours like running away to escape.

 

Anxiety is usually the anticipation of a threat and results in hyper-alertness and defensive responses.

 

Acutely, fear has the ability to decrease pain, while anxiety may increase it. Eventually, repeated experiences with fear may lead to anticipatory anxiety and persistent pain.

 

Positive emotions, on the other hand, are associated with pain relief. Dopamine is a neurotransmitter involved in the brain’s reward center and is triggered by stimulants like food, water, sex, and drugs. Dopamine makes us feel good by reducing anxiety and fear. As a result, addiction to substances that boost dopamine is often seen in people with chronic pain.

 

Interestingly, pleasant music may also trigger the dopamine reward center and suppress pain (2).

 

Pain is complex, and what works for one person’s pain may not work for you.

 

It is important to be able to identify and label your emotions if you deal with chronic pain, because a difficulty in experiencing, expressing, and describing emotional responses has been shown to be elevated in conditions like low back pain, fibromyalgia, and TMJ disorder. This emotional difficulty, called alexithymia, is often elevated in people with high levels of chronic pain (3).

 

So how can you move forward and address your emotional well being? A good way to start is to draw a picture of how you are feeling if labelling your emotions through spoken word or journalling is difficult.

 

Certain MDs, NDs, psychotherapists, counsellors, and other professional therapists use mindfulness based therapies to further help you work through emotional traumas that might be affecting your pain.

 

Expression of your emotions is helpful if done in a healthy way; perhaps writing, painting, yoga, exercise, singing or dancing may allow for a healthy expression of your emotions.

 

Local community support groups may also be helpful if addiction is a main factor numbing you from your emotions.

 

References:

 

  1. Arendt-Nielsen L, Nie H, Laursen MB, Madeleine P, Simonsen OH, Graven-Nielsen T. Sensitization in patients with painful knee osteoarthritis. Pain 2010; 149: 573-581.
  2. Fields HL. Understanding how opioids contribute to reward and analgesia. Regional Anesthesia and Pain Medicine 2007; 32: 242-246.
  3. Lumley MA, Neely LC, Burger AJ. The assessment of alexithymia in medical settings: Implications for understanding and treating health problems. Journal of Personality Assessment 2007; 89: 230-246.

Physical Activity Beneficial for Cancer Patients

Dr. Eric Viegas

www.medicineismusic.ca

@medicineismusic

exercise cancer

People who are physically active before and after a cancer diagnosis are 40% more likely to survive when compared to their sedentary (little to no exercise) counterparts.

 

A recent study from April 2018 found that exercise holds benefit for all types of cancer. The researchers looked at pre- and post diagnosis physical activity in over 5000 cancer patients who received their diagnoses between 2003-2016. There were more women than men in the study, and the average age was around 60 years old.

 

According to the authors of the study, the greatest increase in survival was observed in people who exercised 3 to 4 days per week both before and after diagnosis. Interestingly, people who chose to exercise everyday did not fare much better, a boon to the weekend warriors among us!

 

Interestingly, people who were sedentary 10 years prior to their diagnosis but who decided to become more active after their diagnosis had a 25% increased chance of survival when compared to people who remained inactive after diagnosis.

 

As the authors stated, “The message is that it’s never too late to start exercising”.

 

Exercise can help people improve strength, heart and lung function, and overall quality of life.

 

So what is stopping you from exercising? It’s probably a complex answer, and that’s okay. Exercise should be fun, and something that you can fit into your schedule without adding a high burden of stress. Even something simple like daily walks and stretching can be beneficial for the most sedentary among us.

 

If injuries are preventing you from meeting your exercise goals, perhaps it’s time for a tune up with your chiropractor or osteopath. If the issue is due to your mood, perhaps it’s time to find ways to address your mental health through diet, lifestyle, and therapy.

 

Our bodies were made to move, so ensuring that you are taking care of your body’s needs will go a long way to improve your energy levels, stress resilience, and exercise capacity!

 

References:

 

Physical Activity Significantly Boosts Survival in Cancer Patients – Medscape – Apr 23, 2018.

Minimizing The Risk of Childhood Food Allergies

Dr. Eric Viegas, ND

Ottawa Holistic Wellness Centre

www.medicineismusic.ca

food allergies child peanut

Q: As a parent of a young child, what steps can I take to reduce the risk of childhood food allergies?

A:

  • Fish Oil consumption during pregnancy may cut the risk of childhood allergies by 30% (1). Researchers in London compiled data from women consuming a daily fish oil capsule from the 20th week of pregnancy until the first 3-4 months of breastfeeding. The consumption of fish oil cut the risk of childhood egg allergy by 30% (1).

 

fish oil food allergies child

 

  • Probiotics: eczema risk was cut by 22% in a group of mothers consuming a daily probiotic supplement between 36-38 weeks of pregnancy and the first 3-6 months of breastfeeding (1). However, probiotic supplementation did not appear to reduce the risk of childhood dairy allergy (1).

 

soap baby food allergies bath

 

  • Hygiene: Avoid overuse of “baby wipes” and make sure that soap is completely washed off of your baby’s skin. A recent study using mice suggests that disruption of our skin’s top lipid (fat) layer by soaps and allergens can contribute to the development of food allergies in young children with altered genetic mutations in their skin (2). Mice with genetic mutations in their skin barrier that were exposed to common food allergens (eg. peanuts) to their skin over 2 weeks were then fed these allergens by mouth. The mice developed allergic reactions in the intestines, on the exposed skin sites, and suffered anaphylaxis. More research is needed in this area to further clarify how these mechanisms affect humans. Unfortunately, skin barrier mutations are not visible in children until later in life, so minimizing your child’s exposure to harsh chemicals and allergens that may disrupt their skin barrier is a factor in reducing the risk of developing childhood food allergies.

 

 

Always consult with your doctor before beginning any new supplement or medication. For more information on the prevention and treatment of childhood allergies, consult with your local naturopathic doctor and/or functional medicine practitioner.

 

References:

 

  1. Garcia-Larsen V, Ierodiakonou D, Jarrold K, Cunha S, Chivinge J, et al. (2018) Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis. PLOS Medicine 15(2): e1002507. https://doi.org/10.1371/journal.pmed.1002507.
  2. Matthew T. Walker, Jeremy E. Green, Ryan P. Ferrie, Ashley M. Queener, Mark H. Kaplan, Joan M. Cook-Mills. Mechanism for initiation of food allergy: dependence on skin barrier mutations and environmental allergen costimulation. Journal of Allergy and Clinical Immunology, 2018, ISSN 0091-6749, https://doi.org/10.1016/j.jaci.2018.02.003.

Herbal Medicine for Anxiety and Depression: New Evidence

Dr. Eric Viegas, ND

March 2018

depression anxiety herbal medicine naturopath ottawa

 

Depression is estimated to affect 5.4% of Canadians aged 15+ (1).  1 in 8 adults will meet the criteria for a mood disorder in their lifetime (1). Women have higher rates of depression than men.

 

Anxiety can also be present with a diagnosis of depression, further impacting a person’s quality of life.

 

People living with depression experience a lack of pleasure in activities that once brought them joy, sleep issues, fatigue, guilt and feelings of worthlessness, memory and concentration issues, and thoughts of suicide.

 

Depression and anxiety also contribute to a high burden of stress in people with cancer.

 

In a survey of 3370 cancer survivors, 20% identified with moderate to severe levels of depression, and 40% were living with moderate to severe anxiety lasting 6 years after diagnosis (2).

 

Due to the large number of adverse effects, and interactions with chemotherapeutics, conventional antidepressant and anti-anxiety medications are not favourable for cancer people (3). It’s no surprise then that this population seems to favour herbal remedies for anxiety and depression.

 

A recent systematic review summarized the evidence from 100 single herb clinical trials for depression and anxiety from 1996-2016 (4).

 

Here are the top herbal remedies for anxiety and depression as identified by this study:

 

Lavender

A fragrant and relaxing plant to grow in your garden, lavender is also used in perfumes and aromatherapy products. Lavender extracts, taken orally, show a stronger anti-anxiety effect than placebo and are comparable in effect to prescription drugs (eg. paroxetine, lorazepam) in human trials. Lavender also has fewer adverse effects than these drugs.

lavender anxiety depression naturopath ottawa

A tea made from lavender buds may improve the effect of citalopram; a commonly prescribed antidepressant medication.

 

Passionflower

Used by Native Americans as a remedy to improve sleep and anxiety, passionflower tea may improve sleep quality. When used with clonidine, passionflower extract was also shown to improve mental-emotional well-being for people undergoing opioid withdrawal.

passionflower depression anxiety sleep naturopath ottawa

Compared to the anti-anxiety medications oxazepam and sertraline, passionflower extract was not more effective in reducing severity of symptoms, but it had much fewer adverse effects.

 

Saffron

A commonly used spice in South Asia and the Middle East.

saffron depression anxiety premenstrual naturopath ottawa

Saffron was found to be most beneficial for people that identified with mild to moderate anxiety. Some studies also showed that saffron was superior to standard antidepressant drugs (fluoxetine and imipramine).

 

Women who have a flare-up of anxiety and/or depression premenstrually also benefited from saffron extract.

Black Cohosh

Commonly found in most herbal preparations for menopausal symptoms, black cohosh may have a positive effect on hot flashes.

black cohosh depression anxiety hormones naturopath ottawa

One study using a patented extract called Remifemin® was shown to be as effective as low dose topical estrogen in reducing hot flashes, anxiety, and depression without the adverse effects of hormone therapy.

Chamomile

Popular in sleep teas, chamomile is an effective anti-anxiety herb for people dealing with mild to moderate anxiety.

chamomile anxiety depression naturopath ottawa

Chamomile was also shown to be effective in the long-term (the study looked at 38 weeks of treatment) but had no effect on relapse rates.

 

Chaste Tree

Another herbal remedy for hormonal issues, chaste tree/vitex is often taken for premenstrual and fertility issues.

chaste tree vitex anxiety depression fertility naturopath ottawa

Chaste tree, when compared to the antidepressant fluoxetine, was shown to be more effective in reducing physical symptoms associated with depression in postmenopausal women.

 

Always check with your doctor before starting any nutritional supplement, herb, or medication.

 

Follow the links for additional information on anxiety, insomnia, and fatigue.

 

References

 

  1. Pearson, Caryn, Teresa Janz and Jennifer Ali. 2013. “Mental and substance use disorders in Canada” Health at a Glance. September. Statistics Canada Catalogue no. 82-624-X.
  2. Inhestern, L., Beierlein, V., Bultmann, J. C., Moller, B., Romer, G., Koch, U., & Bergelt, C. (2017). Anxiety and depression in working‐age cancer survivors: A register‐based study. BMC Cancer, 17(1), 347.
  3. Fajemiroye, J. O., da Silva, D. M., de Oliveira, D. R., & Costa, E. A. (2016). Treatment of anxiety and depression: Medicinal plants in retrospect. Fundamental & Clinical Pharmacology, 30(3), 198–215.
  4. Yeung, K., et al. Herbal medicine for depression and anxiety: a systematic review with assessment of potential psycho-oncologic relevance (2018). Phytotherapy Research, 1-27.

10 Common Childhood Rashes and What You Should Know About Them

Dr. Eric Viegas, ND

rash child ottawa naturopath

There are many different types of rashes that children and their parents will encounter throughout their lives.

The following is a list of common rashes, their causes and symptoms, a description of their appearance, and what you can do about them.

 

 

  • Contact Dermatitis

 

Many causes including certain foods, body products, latex, jewelry and poison ivy.

 

Most incidents of contact dermatitis are mild, start around 48 hours after skin exposure, and resolve when the specific substance is prevented from contacting the skin. A mild reaction will usually result in small red bumps, while a more serious reaction can result in swelling and blisters.

 

  • Measles

 

A red, but not itchy, viral rash that is located over most of the child’s body. Children will usually complain of common cold symptoms: fever, sneezing, irritated throat, coughing, swollen glands, red eyes, and loss of appetite. Although preventable with the MMR (measles, mumps, rubella) vaccine, those who choose to forego immunization are at a higher risk of infection. If you believe your child has been infected with measles, please seek medical care immediately.

 

 

  • Scarlet Fever

 

Most common in children ages 2-10 (but infection can occur at any age). A scarlet fever rash is coarse to the touch, and red. It typically presents on the torso first, then spreads to other areas of the body over the course of a couple of days.

 

Children will typically present with a high fever followed by the rash 24 hours later.

Other symptoms include sore throat, difficulty swallowing, and white or yellow spots at the back of the throat; all related to a strep throat infection. If you suspect that your child has scarlet fever, seek medical attention immediately.

 

 

  • Chickenpox

 

Caused by the varicella zoster virus, this is a contagious and very itchy rash that affects the whole body. It may appear as red spots and/or blisters (pox). Each chickenpox red spot has a life cycle of 1-2 days; blistering, bursting, drying out, and crusting. New spots will appear daily for up to one week. This infection will stay dormant in nerves, and may result in an outbreak of shingles later in life.

 

An easy way to combat the itchiness of chickenpox is an oatmeal bath:

  • Using a mesh bag or cheesecloth, add 1 cup of uncooked oats and tie off one end.
  • Secure the oatmeal bag under your tub’s faucet and run under warm water, periodically squeezing the bag as the tub fills.
  • Once the bath is full, you can remove the bag from the faucet, letting it float in the bathwater. Continue to periodically squeeze the bag into the water.
  • Submerge affected areas in the bath for 20 mins.
  • You can also add calendula and lavender flowers to help soothe irritated skin.

 

 

  • Roseola

 

Appears around 3 days after a high fever caused by the roseola virus. This infection is usually mild, starting with a sudden high fever for 2-3 days and developing into a pink rash appearing on the torso, neck and arms once the fever begins to drop. Some children may experience seizures due to the sudden intensity of the fever, and the rash will last 1-2 days. This rash typically affects children aged 6 months to 2 years. Seek medical care if you suspect your child has roseola.

 

 

  • Fifth Disease

 

A “slapped cheek” facial rash that also has a lacy appearance on the torso, arms, legs, and buttocks.

This rash will follow sudden flu-like symptoms (fever, fatigue, aches, etc.), and children are most contagious 7 days before the onset of the rash.

 

Once the rash has appeared, children are no longer contagious. Hot temperatures and sunlight exposure may cause the rash to wax and wane over several weeks.

 

While the infection is mild for children, developing fetuses are at an increased risk when exposed to fifth disease. If you are pregnant and develop some of the signs and symptoms of fifth disease, seek medical attention immediately.

 

 

  • Heat Rash

 

Can happen to any baby exposed to hot weather or dressed too warmly. The rash looks like red or pink dots on the child’s head, neck, and/or shoulders.

Make sure your child is dressed lightly on hot days, covering their head and limbs, and do your best to avoid prolonged sun exposure.

 

 

  • Cradle Cap

 

Oily, yellow, scaly and/or crusting rash on a baby’s scalp. This rash is common and treatable, and its presence certainly does not mean parents are not caring for their baby.

Home treatment for cradle cap:

  • An hour before shampooing, rub your baby’s scalp with baby oil, or vaseline to help lift and loosen the crusts/ scales.
  • Wet your baby’s scalp then gently scrub the scalp with a soft-bristle brush (eg. a soft toothbrush or a fine-toothed comb) for a few minutes to remove the scales.
  • Wash the scalp with baby shampoo, rinse well, and gently towel dry.

 

 

  • Lyme Disease

 

Can be caused by bacteria that are carried by ticks. A Bullseye red rash at the site of the bite will expand, followed by flu-like symptoms, joint pain, and neurological problems.

 

In the case of lyme disease, see a doctor immediately.

 

 

  • Diaper Rash

 

Can be caused by urine/stool bacteria, moisture, heat, friction, or chemicals in a baby’s diaper. The rash has a red (may also appear burned/scalded) appearance, and affects the thighs, buttocks, genitals, or abdomen.

Sometimes, a yeast infection may be responsible for the rash, so always check with your doctor before using any medicated ointments for your child.

 

As with any skin issue, it is best to see your doctor when a rash presents so that you can get an accurate diagnosis and timely treatment. Some rashes require immediate antibiotics, while others tend to resolve on their own. I hope this quick guide to rashes will help ease the stress around skin issues for you and your children.

Male Fertility: Some Background Info

Dr. Eric Viegas, ND

@medicineismusic

www.medicineismusic.ca

 

The term infertility has no agreed upon standard meaning. Generally, if a couple has not conceived after 1 year of sexual intercourse they are labelled as infertile.

 

About 16% of Canadian couples fall into this territory of infertility; a figure that has doubled since the 80s.(1)

 

In about 3 out of every 10 cases, male fertility issues are the sole causative factor in a couples’ fertility problems.

male fertility dr. eric viegas naturopath ottawa

Some factors at play here include: poor sperm quality, low sperm count, sexually transmitted infections, chronic illnesses (eg. diabetes), smoking (both tobacco and marijuana), alcohol, and poor weight control (overweight or underweight).

 

Recently, an article published in TIME magazine highlighted a study on the long-term use of ibuprofen (Advil, Motrin). Researchers found that, after 6 weeks, men taking daily ibuprofen experienced “compensatory hypogonadism” suggestive of male fertility problems.

male fertility dr. eric viegas naturopath ottawa

Basically, increasing ibuprofen levels in the blood also saw a rise in the body’s production of luteinizing hormone (LH). LH functions as a signal for the production of testosterone in the testicles. However, study participants did not see a rise in testosterone production despite LH levels being high.(2)

 

When researchers studied the effects of ibuprofen on testicular function, they found the cells responsible for testosterone production (those that respond to LH) were suppressed.(2)

 

Another possible reason for male infertility is mitochondrial dysfunction.(3)

male fertility dr. eric viegas naturopath ottawa

Mitochondria are the powerhouses or batteries of our cells, and sperm is no different. Mitochondrial DNA mutations that result in poorly functioning mitochondria have been identified in males with fertility concerns.

 

Fortunately, there are diet and lifestyle interventions that show promise in their ability to increase the number of healthy mitochondria, boost sperm function, and help cope with the stress of fertility problems.

 

Speak with your Naturopathic Doctor for more information on how fertility issues can be effectively treated with a holistic approach to wellness.

 

References:

 

  1. Government of Canada. Fertility. Feb 4, 2013. https://www.canada.ca/en/public-health/services/fertility/fertility.html accessed Jan 15, 2018.
  2. Kristensen DM, et al.Ibuprofen alters human testicular physiology to produce a state of compensated hypogonadism. PNAS Jan 2018; doi: 10.1073/pnas.1715035115.
  3. Nakada K., et al. Mitochondria-related male infertility. PNAS 2006; 103(41): 15148-15153.