Saturday, March 1, 2008

My Back Always Hurts - So Why Exercise?

I mean after all my back hurts - naturally I don't want to hurt it any more. I'm afraid it might make it worse. What's wrong with avoiding exercise?

Nothing for the first couple days after an injury or acute flareup. It's vital to take care of it. It's important to rest an injury - and to have adequate relief of pain. If you don't do that you might not be able to get back to your baseline. While bedrest used to be recommended for longer after an acute injury, becoming active sooner has been found to be the better way. If you can't get up and about or do gentle exercises in a few days or so you need to see your doctor and find out what's going on.

But if you have well established stable chronic back pain, not an acute flareup, you are better off to get in the best shape you can by gradually becoming more active. Be sure to do stretching and strengthening back exercises. Literally if you don't use it you lose it. If you don't exercise your back muscles, they'll just get more out of shape and weaker. And when you need them the most they won't be strong enough to protect you. Don't exercise and you may be setting yourself up for injury and more pain. Exercise, on the other hand may give you endorphins, the body's own painkiller, elevate your mood, boost your confidence, and give you more energy while strengthening your back muscles and helping prevent injury. That in addition to other obvious health benefits. When I began regular exercise I lost weight I had gained while being inactive, and that helped the back pain and my self esteem.

What kind of exercises should you do? It depends on your own particular needs. Since you don't want to hurt yourself, it's wise and a good investment to get professional advice as far as the specific exercises best for you.

I have taken plenty of physical therapy, which helped, and followed instructions for home exercises that I was given. Though I was very motivated and committed to doing them, I continued to have limitations. When a very good exercise physiologist gave me just a couple of pointers, I started making lots more progress. I learned the active-isolated method and started working smarter with another and related weak link, a knee, as well. It made all the difference in the world.

I've learned it's most important to do it consistently, progressing gradually and carefully, paying attention to helping, not injuring yourself in the process. This is not to impress anyone or to win any competitions. This is far more important. This is to make you feel better and stronger and more confident and to be able to do more, function better and have less pain. It works for me. When I miss my exercise I hurt more, and if I don't exercise for several days I can become bedridden that fast. And that leads to more pain too. I enjoy exercising, after I get started that is, and I use Pilates and a semi-recumbent bicycle every day. That way I can get the exercises I need while protecting my back in the process. Before Pilates I could not walk very far outdoors. Now walking outdoors in nature is healing for me too.

I have chronic back pain, but it's not the end of my life. I'm learning from it. It's a pretty good teacher. Life is good and I can do quite a lot as long as I use the tools I've learned. That way I can be in charge rather the pain in charge of me.

To your good health,
Joan Barice, MD, MPH

Information shared here is not intended as medical advice, and cannot substitute for professional medical advice and information. Information provided is general in nature and may be helpful to some people but not others, depending on their personal medical needs. Always consult with your personal physician before changing or undertaking a new exercise program or following advice designed for general audiences only. Never disregard professional medical advice or delay getting care because of something you have read here.

Friday, November 2, 2007

Why are essential oils not yet fully accepted?

There are a small but growing number of physicians and other health professionals who accept and use essential oils . It is particularly difficult for me, having benefited so much from the use of therapeutic essential oils, to accept the resistance of conventional medicine to them. But as a physician I can understand some of the reasons. Here are some of my thoughts, just one person’s thoughts.

The therapeutic use of essential oils is just being rediscovered. It was practiced by ancient cultures such as in China, Egypt and India. There is much documentation in the Scripture and in ancient medical texts of their use. It was only been since the 1940’s that the medical benefits of oils were rediscovered and modern research began. There is research confirming the scientific rationale for many ancient uses.

Our modern science does not accept ancient folk use or ancient science, which does not use the same terminology or methods as ours. Our modern science has made much progress and many amazing discoveries that have helped save lives. The ancient Egyptians and other cultures left us evidence of their intelligent science thousands of years old, but it was different from our modern science which is just hundreds of years old.

There is a wealth of modern clinical research demonstrating positive results and safety of the oils for many conditions but many studies lack adequate control groups for comparison. Done by well-intentioned people with expertise in oils but not necessarily in modern clinical research, these studies are mostly not acceptable to modern medicine because of the methods used or small numbers of patients. Clearly essential oils have helped patients with MRSA and relentless pain and many other conditions, from first-aid to intensive care to end-of life-care, and have done no harm. They are being used in many hospitals around the world including many in the United States.

An analogy regarding research evidence would be acupuncture, practiced for thousands of years as folk medicine in China. An NIH consensus panel reviewed the vast amount of research and concluded that though studies have shortcomings, there is enough evidence of effectiveness and safety in so many patients to recommend it for treatment of back pain and nausea and other conditions.

Before doctors will accept essential oils for use in patients, most will need large, randomized studies showing effectiveness and safety. There is not much interest on behalf of conventional medicine or drug companies in doing research on essential oils.

In general the medical establishment tends to resist anything new that is not already clearly proven by western research standards. This is nothing new. For example, it took 250 years and many deaths before the medical establishment of that time accepted Vitamin C containing foods as a cure for scurvy.

Funding for research on complementary medicine is limited compared to that available for drug studies. It might be that the oils, which are considerably less costly than drugs are not likely to be as profitable.

Another reason may be the approach to disease is different for oils vs. most drugs. Oils may help the body heal itself, by releasing substances that promote healing while drugs often substitute for those natural substances and shut down their production by the body, but sometimes they are so powerful that they overwhelm the body’s own healing process, and sometimes, too often, drugs do harm.

The most important thing to consider always is what is best for the patient. As a patient, I have experienced tremendous health benefits using essential oils, and I believe they have much to offer. Which is why I am committed, as a physician and researcher, to doing randomized studies to get the objective answers. In the meantime, I believe these God-given natural remedies have the potential to help a wide variety of conditions from MRSA to burns to chronic pain and much more without doing harm. They have a long track-record of effectiveness, safety and they are inexpensive. When we do not have all the answers how to best help our patients, when a patient may suffer or die because we do not have an effective treatment for him or her, when there is a lot of evidence that oils might do good, and do no harm, then I believe it is justified to use them in medicine. And not to wait until it is too late for that patient.

To your health,
Dr Joan

Wednesday, October 17, 2007

Essential Oils - Why I use them. Why I believe doctors should know about them

As a physician and scientist, I was very skeptical about essential oils and their ability to heal. I had tried them before and was unimpressed. As far as I was concerned they smelled good and that was as far as it went. However, when traditional medicines and treatments could not help me, but rather caused many side effects when I had significant health problems, I tried essential oils. The results were amazing, hard to believe but they happened and I could not ignore them.

My first use of oils was for months of postmenopausal bleeding not responsive to all the best gynecologic medical care including hormones and a D&C (uterus scraping), and a hysterectomy had been suggested. Within hours of applying the oils topically and diffusing them in the room, I felt much better, and within 2 days the bleeding stopped. Subsequent checkups confirmed I was fine, and I still have all my parts.

I also suffered severe chronic pain due to a spinal condition, despite surgery. The pain medications left me in a brain fog and made functioning difficult. Using natural remedies including therapeutic essential oils, acupuncture and meditation, I was able to get off the medications, enjoy a clear head again, and experienced significant pain relief. *Read an article about Dr Barice "Dealing with relentless pain" in Fort Myers Florida Weekly September 20, 2007

Because of these results, I began to look for the scientific reasons these oils worked. I found there is a lot of research out there, much of it basic science research but the numbers of clinical studies were increasing. These studies suggest that oils are safe and effective for a wide range of symptoms and conditions, including infections, burns, pain, nausea, insomnia, stress, GI symptoms and many more, and I have found this to be true for myself and for others. In addition essential oils have been used for many hundreds of years as a folk medicine and have a long track record of safety. Nevertheless we physicians need more well done controlled studies on efficacy and safety, in order to comfortably recommend them to our patients. We have much more to learn, and our medical practices require additional evidence based research criteria.

However, when effective treatments are not available or when treatment may carry significant risks, it is reasonable to consider safe alternative adjunctive treatments. There are some conditions now that do not respond well to conventional medical treatment. In view of the well-known and increasing evidence for the effectiveness of essential oils against MRSA and other drug-resistant organisms, the apparent wide margin of safety and relative low cost of essential oils compared to drugs, and the fact that suffering may be relieved and lives may be saved if treatment is timely, I believe that the time is now for doctors to learn more about the evidence for essential oils and their potential as adjunctive therapy. For one, essential oils may be useful in helping prevent and treat some of these drug-resistant pathogens.

Joan Barice MD

For free tipsheet about dealing with chronic pain please fill out the request on the right.

Sunday, October 7, 2007

Allergies - An Alternative Approach

Is there an alternative to all those allergy medications? Here are my thoughts, my opinion, and my experience on this too frequent problem.

Allergies can make us miserable, or can even be life threatening. Avoiding whatever is causing the allergy is one thing you can do. Allergy shots and medications may relieve our allergy symptoms or at least make them more tolerable, so we can enjoy our life and function better. But we have to realize that they usually come at a price - not just money, but side effects as well. If you'd like to know more about the potential side effects, you might be interested in reading the article in AOL Body titled Allergy Medication: Side Effects: "8 surprising side effects." I'm not against medicine or doctors. I am a doctor. Sometimes we need drugs. But we overdo it. All those drug ads are working. We in the US now use twice as many prescription medicines as any other developed country. I'd rather use prevention and natural remedies whenever possible. I realize it is not always possible for some.

Consider what can happen when you use allergy medicines. Years ago, my allergist friend, Dr Sang Lee, explained it like this: An allergic reaction is our immune system over-reacting because it is weakened. It’s a message, telling us we need to strengthen our t-cells of our immune sytem. T-cells can help protect us against things like cancer and viruses. Cortisone, which is often used for allergic reactions basically kills our t-cells. We keep making t-cells, but the cortisone really weakens our immune system. Other allergy treatments can weaken or paralyze our t-cells. Allergy shots wear them down till they quit and get weaker and then they will be allergic to the next thing that comes along. The best solution of all is to support your immune system with a healthy lifestyle. We need to get plenty of good water too. Histamine is our water regulator. When we are low on water, histamine can cause asthma and hay fever and stuffiness – because it’s trying to prevent further loss of water from the respiratory system.

I believe what Dr Lee said is true. And I believe there is something we can do. There may be things we don't have control over, but our lifestyle is something we can change. It's our choice. A poor diet, alcohol or drug abuse, stress, whether emotional or physical, and our reaction to it, are a few of the lifestyle things that can affect our immune system. Anger and hatred can weaken our immune system and make us more susceptible to serious illness. On the other hand, love has been demonstrated by research to boost our immune system. Our hyper-paced lifestyles can leave us with little time to take care of ourselves, so we skip breakfast, don't get enough rest or leisure time, eat fast food on the run, don't exercise because there's not enough time, drink coffee or sugar-filled energy drinks to keep us going. We may be trying to reduce our stress, but these things are not stress-reducers -- they are stress producers and weaken our immune system.

Cleaning up my lifestyle and using therapeutic essential oils not for allergies specifically, but for chronic pain, not only helped my pain, but I found helped gradually alleviate my allergy symptoms as well, without the side effects of drugs.

If you have any questions or comments or would like more information I'd love to hear from you.

Wishing you good health,

Dr Joan

*Read an article about Dr Barice "Dealing with relentless pain" in Fort Myers Florida Weekly September 20, 2007

These statements have not been evaluated by the FDA. Anything mentioned here is not intended to diagnose, treat, cure or prevent any disease. If you have any medical conditions please consult a qualified medical provider

Thursday, October 4, 2007

Caution: Potential hazards to your health

Just Say No to acetaminophen with caffeine.
(or at least be careful-learn the facts)

Just Say No to butter flavored microwave popcorn.
(check it out and decide for yourself)

Maybe you already heard about these health hazards recently in the news. I just want to be sure you don't put your lungs, liver, health at risk, so I'm sharing what I have learned.

I must admit I stopped microwaving food some time ago, and I avoid pills like the plague unless I absolutely need them, but I would have wanted to know about this. So if you or someone you know might be at risk, please read on. I realize jumping out of airplanes might be a little dicey too! I rationalized that it was immunizing me against stress. Besides I stopped after 250 jumps.

#1: Mixing acetaminophen and caffeine may cause liver damage

What's the evidence? It's preliminary and based on tests in the laboratory on bacteria, and huge doses of both acetaminophen and caffeine were studied, but it needs to be taken seriously because of the serious possible adverse effects.

Dr Sid Nelson of the University of Washington in Seattle studied the effects of combining acetaminophen, a popular over-the-counter pain remedy, and caffeine on bacteria in the laboratory, and found that caffeine triples the amount of a toxic by-product produced while breaking down acetaminophen and this can cause liver damage and failure.

Some people could unintentionally take this combination because there are medicines that have caffeine and acetaminophen together - you can get them in prescriptions or over the counter for pain of headaches or menstrual cramps. And we have energy drinks and foods that contain caffeine, sometimes in large amounts that might be risky to take those pills with.

Dr Nelson said "the bottom line is that you don't have to stop taking acetaminophen or stop taking caffeine products but you do need to monitor your intake more carefully when taking them together, especially if you drink alcohol."For more details, see Science Blog

#2 Buttery flavor microwave popcorn might damage your lungs

Since an additive was changed to make popcorn have a more buttery taste at least 7 years ago, a number of workers in popcorn plants have been coming down with a rare, crippling and deadly disease, bronchiolitis obliterans, that is eating away of their lungs and their ability to breathe. Why does that have anything to do with you? Besides the fact we should care about the workers, popcorn lung has now been reported in someone who got it by popping popcorn in his own kitchen. Was not a popcorn worker.

This could be just the tip of the iceberg. A doctor who is an occupational medicine physician and knew about this disease recognized it, made the connection, and reported it to the government in July. Other doctors might be missing the connection because they don't know about it yet.

Diacetyl in the buttery flavoring appears to be the culprit. The government has known about it for at least 5 years, and did essentially nothing to regulate it, protect workers or warn consumers of a possible hazard. Finally, the House passed a temporary standard to protect workers days ago - it still has to go to the Senate. The flavoring and popcorn manufacturers have known about this problem for years . A couple weeks ago one of the popcorn manufacturers said his company has substituted a different flavoring ingredient so the consumer has a choice. Did they recall the the old ones from the shelves? Are there other hazards besides the diacetyl? What happens to the coating inside the bag when it gets hot? I don't think it's worth taking the chance, but you have to decide for yourself. Remember this it not medical advice. Can't give that here. I just want you to be informed so you can make your own decisions. At the very least, if you love microwave popcorn, I would check it out and stay informed. Personally I would make my own popcorn. For more information, visit The Pump Handle blog.

Wishing you the best of health,
Dr Joan

Wednesday, October 3, 2007

Who Am I?

Hi! Welcome to my blog. I'm Dr Joan Barice. If you are interested in staying healthy naturally, if you love aromatherapy or natural medicine, if you are interested in acupuncture, or energy healing, or public health or preventive medicine, please stay tuned. If you suffer chronic pain*, want relief, and don't tolerate or like to take drugs or don't want to jeopardize your sobriety this may be a good place for you to visit. I would love to share health tips, my experiences as a doctor and a patient, and medical news which may be important to you. Most of all I would like to hear from you. I'm most interested in helping inform people so they can stay healthy as naturally as possible. I received my MD from Stanford, MPH from Harvard, and honorary doctorate in Humanities from Northwood University. I am board certified in internal medicine, preventive medicine and public health and ASAM certified in addiction medicine. I'm on the adjunct faculty of 3 medical schools. I teach med students and doctors. I believe in prevention first and a healthy lifestyle, and have given many classes to help people make changes which are difficult but worth it. It's never too late to get some benefit from prevention. I cannot give anyone medical advice here. Anything I say here should not be taken as medical advice, and will not substitute for proper medical care. I wrote the Palm Beach Long-Life Diet, published by Simon & Schuster years ago - basically good nutrition under the cover of a popualr diet book. I try to practice what I preach. I set up and ran a chronic pain management program which used integrative medicine, including acupuncture, exercise, meditation,and conventional treatments. I have made 250 skydives, love the outdoors, lived in China where I studied qigong, survived a plane crash in the arctic wilderness, and have otherwise had a wonderful life.

My favorite quote is "Life is either a daring adventure or nothing at all." by Helen Keller.

Wishing you health,

*Read an article about Dr Barice "Dealing with relentless pain" in Fort Myers Florida Weekly September 20, 2007

MRSA - Aromatherapy essential oils an adjunct or alternative treatment for superbugs?

I have been studying and using essential oils for over 5 years. The problem of superbugs such as MRSA is growing. Adequate infection control and prevention are a must. In my opinion, therapeutic essential oils may have something important to offer medicine when it comes to preventing, suppressing or eradicating infections due to resistant microorganisms (Superbugs) including MRSA.

Essential oils (aromatherapy) are considered a complementary therapy.They have been used for centuries by doctors and laypeople alike to treat symptoms. According to Dr Jane Buckle, they are the fastest growing complementary therapy today. There is already a wealth of research that suggests the effectiveness of therapeutic essential oils against superbugs resistant to all antibiotics. We need more controlled clinical studies on effectiveness and safety before oils can be accepted widely for use in medicine, because we need to use research evidence-based treatments whenever possible. Standards are good to have. However, the most recent surveys show that we now use evidence-based treatment only about 30% of the time in conventional medicine, even if there is research evidence available.

As a physician, one concern I have about using essential oils is the lack of standards and quality control in the US. The purity and quality is very important to their effectiveness and safety. This is one of the reasons I use Young Living oils - because I know they use strict quality control and meet AFNOR and ISO standards used in Europe. Most physicians in America don't know much if anything about therapeutic essential oils. Doctors can't recommend a treatment we do not know about. We need to follow the standard of care, and if we have a treatment that’s known to be effective, we must use it, unless the informed patient refuses it. When there is no effective treatment, as can happen with superbugs, when the standard of care does not work, complementary adjunctive treatments may be used if there is justification to do so. Why would we not want to use an available alternative treatment if nothing else works and the alternative offers a relatively safe and possibly effective option?

Essential oils appear to have a long track record of safety. They are inexpensive, and they have been shown to be effective against a number of superbugs in the laboratory, in animals and in some patients. One patient with chronic osteomyelitis who failed all the antibiotic treatments was successfully treated with essential oils and avoided an amputation that had been considered. (Sherry et al, BMC Surgery, 2001, 1:1) There is evidence supporting their use for prevention, such as for hand cleansing, cleaning surfaces and equipment, purifying air, decreasing the indiscriminate use of antibiotics, and for treating drug-resistant infections. They appear to be effective against MRSA (methicillin resistant staph aureus infections), herpes, anthrax, drug resistant TB, toxic mold and more. It has been reported that so far no resistant organism tested has been able to survive exposure to some combination of pure good quality essential oils.

Drs need to learn about essential oils, since drug-resistant infections are sky-rocketing, we are having difficulty preventing, and we cannot now effectively treat some drug-resistant infections with antibiotics. Good quality essential oils used early and appropriately may have the potential to save lives.

Joan Barice MD, MPH