Posts Tagged ‘Medical Research’

August newsletter

| August 20th, 2012 | No Comments »

Modalities Massage Therapy

August Newsletter

 

Dear clients, This Thursday, August 23rd, is the deadline for aromatherapy orders.  Check out the webpage on direct orders for the short list of products and pricing.  Contact me by phone or email to place your order. As always, orders should be in within a week and I will contact you regarding pick-up. Beginning in September there will be some small changes in my work schedule.  I will be teaching infant massage at Mothering Touch again but on Wednesday mornings and I will no longer be working at Achieve Health Monday and Wednesday mornings.  In terms of hours here at Modalities there will be only small changes and a continuation of the ‘temporary’ addition of Tuesday mornings.  New hours as of September 1/2012 will be:

Monday: 10am to 6pm Tuesdays: 10am to 4:30pm; one 7 pm appointment Wednesdays: 12:30pm to 4:30pm Thursdays: 9am to 4:30pm; one 7 pm appointment Friday: 10am to 6pm

I have been doing some blogging lately and wanted to share those thoughts with you. The following links will take you to them: food and drug efficacy and DNR and final wishes.

As we move into the fall I hope that we all have the opportunity to enjoy some more warm weather and sunshine. For those of you coming under the influence of school I hope your return to classes goes smoothly.

Best wishes,

Sheila Hobbs, RMT

250-361-5246

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Food and drug administration…

| August 15th, 2012 | No Comments »

I am not talking about the FDA (Food and Drug Administration – the entity in the US that approves food and drug sales) in this blog, or at least not directly, but the title just called out to me.  What I am talking about is how the food you eat and the drink you drink impact the drugs you might take.  I got inspired by a couple of tweets I checked out and re-tweeted that I found really interesting.

The question of food and pharmaceuticals, for most, likely brings to mind the little stickers you find on your prescriptions bottles or warnings on the labels of over the counter drugs that mainly circle around whether or not to have with food or alcohol and the safety of heavy machinery operation while using.  I recently was put on doxycycline, a fairly potent antibiotic, and for the first time had a warning about dairy food specifically.  Why do we receive these warnings?  We get instruction of food and drink consumption – both specific types and generally – because of  the risk of over or under-dosing.  Some drugs have greater impact with food, some less; certain minerals can alter how drugs work for all of these reasons we get little stickers and warnings.  This website has very complete information on drug interactions including foods.

How exactly do food and drink influence how drugs are absorbed and broken down in the body?  There are a few answers to that question but one of the main ones is – enzymes.  Enzymes are complex protein molecules that bring about cellular reactions within the body.  Enzymes are how we digest food and are used to speed up, slow down, allow or disallow various chemical reactions to occur.  Enzymes are produced by living cells and found in our bodies and in the things we eat and drink.  Some enzymes also are able to block each other from acting – they shut down other enzymes.  How drugs are processed by the body – especially how long they take to be broken down and absorbed impact how effective they are and how often and how much we need to take.

Alteration in drug processing in the body has profound ripple effects in terms of side-effects, efficacy and costs.  The more of a drug you take the more likely you are to have side effects so if the dose can be lowered you have fewer side effects.  The reason we often have to tolerate side effects is to ensure we receive enough of a drug to actually have it do the job it is supposed to do.  The longer a drug stays at an effective level in our body the more of an impact it can have on our system, slowing down the bodies natural breakdown of a drug into its components can allow a drug to do more.  Cost obviously ends up going down if we use less of a drug making lower doses desirable both medically and fiscally, especially in an era of rising medical budgets.  

The particular article I read was speaking of grapefruit juice and the cancer drug, sirolimus.  When ingested with grapefruit juice a one-third dose of sirolimus had the same effect.  This represents a huge cost savings and a potential reduction in side effects as the lower does was accompanied by fewer side effect.  Here is the interesting bit.  Some dosing is lowered and ordered with a particular accompaniment; in other case, like sirolimus at this time, you take more and are told to avoid the food/beverage that increases the effectiveness of the drug to avoid overdose.  I personally hope that current research will lead to increases the incidence of the former and reduces the latter.

The other interesting point that came up in the article is that not only will what you do or don’t take with drug impact their breakdown and bioavailability to your cells but it can also alter how your cells welcome the drug.  Recent studies have shown that pre-treatment fasting (of 2-3 days) by chemotherapy recipients increases the impact of the treatment on cancer cell, but even more delightfully, it reduces the impact of the same treatments on the healthy cells.  Basically, in healthy cell fasting creates decreased activity, basically the seek to reduce their consumption of fuel, in contrast cancer cells, which are already gluttons become even more ravenous when exposed to fasting causing them to absorb greater quantities of the chemotherapy drugs.

A 2-3 day fast is not a small thing but I suspect this news would be less daunting to the many cancer patients who have appetite loss as part of the symptoms or drug side effects.  The reward of less nausea, headaches, malaise, nerve damage and hair loss – just to name a few – would be a nice reward for a bit of fasting too.  Further, for those cancer patients and their families who face daily struggles to get enough food into themselves or their loved ones a brief respite would not be bad and all the parties could then focus their food efforts on their inter-treatment time.  The volunteers with the trolleys of cookies and juice that wheel through the chemo room though would become a thing of the past.

What I find most interesting about all of these pieces of data is that they can be implemented with minimal hassle, little to no harm and many benefits.  There is no costly drug research, no need for gene therapy the research I am talking about is from human and animal trials and new human trials are moving forward in several places already.  This is exciting as a new drug or therapy can take years and years to even reach human trial stage.  Plus, the cost of all of these options are negligible or well offset by saving.  Not very often is that the case with modern medical innovation.

 

 

The tweets I’m talking about:

fasting and cancer treatment

grapefruit juice and drug efficacy

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International Fascia Research Congress, Vancouver, BC – Day 3

| March 30th, 2012 | No Comments »

Today began with a keynote speech by Carla Stecco who spoke on the nature of fascial anatomy.  One of the most amazing pieces of information I took from this was the fact that the sheaths of the limbs and trunk (aponeurosis of the deep fascia) that are traditionally classified as “disorganized” can actually be dissected into 2-3 layers of highly organized, aligned collagen fibers that are each oriented in discrete directions in each layers whose fibers are shifted 78 degrees from each other throughout the body and are capable of gliding on each other.  The other aspect, which actually came up several times over the last days is that there are penetrating collagen fibers that bind across various levels of fascia to affect sensory organs and allow force transmission across nested fascial layers.

I chose not to attend the discussion of imaging techniques and devices that followed, but from the tweets that I have seen there is a huge desire for a 4D sonograph now.  I have no idea what that is nor why it is so lusted after but I am glad that those that stayed had a good time.  I was not alone in missing some of the events of the day, I think overload was being reached by many of us and I know I enjoyed the time to be quiet with my thoughts and organize myself for the trip home.  

In the afternoon I returned to congress-land and heard some very interesting presentations, one on plantar fasciitis, one on immobilization of rats (which requires metal harnessing and ankle cuffs, those rats are apparently very much not keen on bondage), one on trigger point release using myofascial techniques and finally a study designed to demonstrate the actual force generate with different applications of Swedish massage.  This last one was an amazing demonstration of several important facts.  One, that the Fascial Research Congress model is generating clinically relevant research (the study was conceived after the presenter attended the second congress in Amsterdam.  Two, that there is a lot of very basic research to do on clinical application of manual therapy – after all, we cannot actually say with any scientific certainty the amount of force that we are generating on the tissue of our clients.  Three, that research is a rough go.  The presenter, brave soul that she was, led us through an elegantly designed trial to determine the compressive force generated by Swedish massage technique.  She covered the various challenges she faced and how she managed to overcome many of them.  She showed us some lovely, very tidy printouts of force generation waves generated by the strokes, and then she had to tell us she had no data to share.  All of her data was invalid due to faulty calibration of the testing equipment.  Oh my.  Despite this I would say she did in fact share quite a lot of data, just no outcomes.  I was relieved to hear she hasn’t given up and she may be able to salvage some of the data she had acquired through the magic of algorithms (okay, I think they are magic, some people think of what I do as magic, I think of algorithms as magic, we each have our own perspective).

After the bittersweet conclusion of the parallel panel presentations we concluded the afternoon with a panel entitled “Art & Science/ Research & Practice”.  Here was our opportunity to hear the thoughts and hopes of a few that I think reflected the hopes and dreams of many of us.  

Maureen Simmonds and Paul Standley both spoke about the importance of clearer, more standardized language and communication between clinicians and researchers to aid in the development of a greater understanding of whether what we do in the clinic is actually doing what we think and if it can create the kinds of impacts in the real world that simulated work in the lab does in petri dishes and research animals.  

Robert Schleip likened himself to Alice in Wonderland as he as a clinician who has entered the world of the scientist and continues to find both worlds “curiouser and curiouser” (I think I have applied the analogy a bit differently than he did, but I think the idea is the same).  He also pointed out the fact that he is not the only person to have shifted their position on the continum of clinician and scientist, nor is there only one direction to go on that voyage.  the rabbit hole goes both way and it is the both the people that switch burrows and those that simply reach a hand into the other hole to give or receive, or perhaps to join with a hand reaching back, that enrich and invigorate the worlds of fascial research and manual therapy.

Geoffrey Bove concluded the panel with an case study of his experience in reaching hands across the divide, and switching rabbit holes both.  Initially a clinical practitioner, he is now the researcher stretching his hand out to the clinician, in the person of Susan Chapelle, to bridge the gap and create new and fascinating (fascia-nating?!?!) discoveries regarding the outcomes of rubbing rat adhesions.  He presented with an interesting combination of practicality and emotionalism as he discussed the challenges of research and collaboration clearly demonstrating the passion that is brought to the work.

I departed prior to the final remarks to catch a ferry but I left feeling full of knowledge and enthusiasm and hopeful for the future of my profession.

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International Fascia Research Congress, Vancouver, BC – Day 2, the night

| March 29th, 2012 | No Comments »

Tonight I watched a prophet perform. Not what I expected to see at a Fascial Congress but I am not sure what other words to use. Gil Hedley was the final act in our multimedia night. After three amazing, room-stilling videos that were highly anticipated, onto the stage came a wiry, kinetically unstable bundle of poetry reading anatomist.

Perhaps I have had too much coffee, not enough sleep or entirely too much mental stimulation but Gil Hedley’s presentation on his new thinking around fascia makes me what to sign up to join whatever cult he’s leading or drink whatever kool-aid he’s pouring. He brings an inspiring combination of respect, enthusiasm, joy and intellect into the world of fascial dissection.

I am someone who loves my words and concepts and rather resent having to give up a perfectly good story for a new idea. Even though Hedley’s whole presentation was a debunking of his own, infamous “fascial fuzz” speech that has become an easy, u-tube click away, introduction to fascia for the uniformed, I loved it. I now have to discover a new story to tell myself about the development of adhesions and what I am doing in my work. Daunting. I am inspired though by the enthusiasm, dance, poetry and joy that was displayed on the stage of the grand ballroom of the Sheraton Wall Centre tonight in Vancouver, BC

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International Fascia Research Congress, Vancouver, BC, Day 2

| March 29th, 2012 | No Comments »

Today is a new day of learning and the overload is starting to set in.  Not in a bad way, but you can see the shiny eagerness beginning to fade, there is more movement during presentations and alternate seating is becoming more popular and the familiar seats begin to feel entirely too familiar to our posteriors.

A great day none the less with some wonderful clinical information and tonight a multimedia presentation of fascial videos that I, along with several others from the look of the bar and cafe here at the hotel, will be late for.  I admit that I have stepped away from a few presentations seeking some quiet retreat time to process some of the information.  After some dinner though I look forward to watching some highly visual presentations that I am betting won’t stress my lack of chemistry knowledge as several of the presentations today did.  

The flip side of the restlessness is an increase in casual interaction between attendees and lots of chatter.  As I sit and type several tables of congress attendees sit together chatting, eating and drinking.  I suspect many a new research project will be hatched over the next several days.

In terms of the learning there was a shift from the mechanical to the fluid as our keynote speakers focused on the issue of fluid dynamics in the interstitium and the wonderous fourth state of water – bound water.  The water talk, given by Gerald Pollack from the University of Seattle, was my third exposure to his theories and seems to have been a bit of a charm as several of the concepts seemed to sink right into my brain rather than flying inches or feet over my head.  Dr. Pollack’s research has focused around the behaviour of water at it’s edges, where it contacts hydrophilic (water lovings) substances and air, and there is the creation of an exclusion zone where the water enters the bound, or fourth state.  In this zone the water is denser, negatively charged, has a viscosity similar to honey and just generally is really different from what he calls bulk water.  Beyond the interesting implications for us manual therapy practitioners whose clients are all largely composed of water there are real world implications.  

 

In the real world the exclusion zone offers explanations for cloud to cloud electric activity (= lightning), why the basilisk lizard really can walk on water, why heavy objects float and offers interesting possibilities for water decontamination, perhaps even desalination, and the ability to harvest electricity from water – all using only the radiant energy of light to accomplish the task.

There is the report for today, stay tuned for the final day’s report where imaging and more anatomy and clinical discussion look to be the highlight.

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International Fascia Research Congress 3 – Vancouver, BC, Day 1

| March 28th, 2012 | No Comments »

***Beware – this post is a total fascia geekfest, if you are not prepared to deal with that, read a different post!  Also, any factual errors are my faulty memory, not faulty presentations.***

 

Today I had the absolute pleasure of beginning my time at the 3rd gathering on scientists and clinicians who have an abiding interest in fascia in all its varied and wonderous forms.  I began the day with a flight to Vancouver and a slightly late arrival – but I got before the real geek-out stuff began, so it is all good.  

After some general introductory speeches we dove right into the first keynote speaker.  A anatomist from Temple University, Mary Barbe spoke to us about her research in duplicating repetitive stress injuries (RSI’s) in rats and the tissue changes that occurred in response to various types (high, low and negligable intensities) of work.  How could this possibly relate to massage therapy you ask? Well the road hasn’t fully been built, but knowing that rest doesn’t always fix the problem and that inflammatory processes have likely come and gone prior to anyone presenting at my office (they peak between week 4 and 8 of performing the task) after months or years of a repetitive task, provides me with insight into what interventions and homecare might best benefit my clients.  simply knowing that there are significant connective tissue changes that occur within weeks of undertaking an repetitive task shouts loud and clear about the importance of the fascial work that I am a huge advocate for.

After a quick break we moved our second speaker, Michael Kjaer, whose topic was the impact of exercise on tendon tissues.  We discovered that exercise (and not a lot, 1x creates 72 hours of increased collagen production which is what builds your tendons) increases the density of tendons.  Interestingly, there seems to be little issue with maladaptive changes in the tissue to repetitive exercise as there is to repetitive work activity (there’s a thinker).  More surprisingly, it turns out men exhibit greater tendon density increase than women, and that within the female population women taking oral contraceptive exhibit even lower levels of tendon response than the general population.  Further interest in gender issues came when it was revealed that in post-menopausal women being on hormone replacement heightened tendon response.  Hmmm, that estrogen, funny stuff.  

 

After a break for lunch we broke into three groups for presentations on specific areas of fascial research.  I chose the “biomechanics” room and got to learn about different means of trying to empirically measure different types of mechanical interventions.  From pressure sensitive pads on fingers to rather medieval looking table devices this part of the afternoon was an interesting insight into the various ways we can try to research the interventions we apply with our hands and their outcomes.  I also gained an interesting insight into the world of research.  Failure, or rather, not proving your hypothesis fully or at all.  Even in those cases it was interesting to see how that research could be used to launch into better studies.

Our next keynote speaker, Albert Banes, was a doozy.  I am pretty sure I learned so interesting things, but they went by so fast I think I might be lucky to catch up with them sometime next week – after reading the paper a few times!  He seemed to be summarizing quite an extensive array of studies in the field of fascia research and had some very interesting things to say – and showed us pictures of some lab grow tendons, but it was a lot in just a little time

The final event of the afternoon, academically, was a panel of  four clinicians presenting of “scars and adhesions”.  One of the exciting bits of us BC RMT’s was having one of our own on the panel – Susan Chapelle of Squamish, BC who talked about the benefits of integretive treatment and the need for increased research that included a manual therapy aspect.  She was preceeded by a surgeon, Dr. Michael Diamond, who discussed post-surgical adhesions (things sticking together that shouldn’t after surgery) which I was surprised to find has a 65-100% incidence rate in abdominal surgeries (though they are not limited to those surgeries).  We were then treated to a new movie by Jean Claude Guimberteau, a French physician, who has now produced several in vivo movies of fascia using endoscopic techniques (his first being “Strolling Under the Skin”, presented at the first fascial congress).  We also had a naturopathic doctor, Hal Brown, present some of his case studies of the impact of the injection of aenasthetic under the skin into scars to improve function in both near and far tissues. 

The day finished with a welcome reception that was very well attended that allowed us all to review and discuss our reactions and thoughts regarding the days flood of knowledge.  I can hardly wait for day two….

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What is Epigenetics?

| November 7th, 2011 | No Comments »

I love CBC radio.  On the weekend I was listening to “Quirks and Quarks” and a discussion of epigenetics caught my ear.  Naturally, I had to find out what this things was and how it works.

For many years the research into autoimmune diseases and chronic conditions like cancer has focused on lifestyle and environmental impacts.  These diseases have a heritable component but they are not absolutely genetic, leading researchers to try to identify why and this has led into the field of epigenetics.  Epigenetics looks at the small markers that attach themselves to our DNA, especially in utero and in early life.  These markers do nothing to change the DNA you are going to pass on to your child, they simple alter how that DNA expresses itself.  Think of them as the controllers – they can turn things on and off or make things louder or quieter.

In this new field evidence is beginning to show how things like childhood poverty, child abuse and mental illness may have physiologically identifiable marks without changing the DNA.  Further, exposure to certain substances can also create epigenetic changes even late in life.  Many of the substances considered carcinogenic act this way.  They do not alter your genes, they turn on, or turn up, genes you already have (‘genetic predisposition) increasing the growth and success of cancer cells.  This brings in the fact that they can not affect genes you do not have and if you have the gene and nothing turns it on, you won’t experience the effects.

I believe that I have seen this in action in my family.  My maternal grandfather and both of his daughters (my Mom and my aunt) have died of very similar, very aggressive lung cancers – but not my uncle.  In the cases of my grandfather and my mother they also died at about the same age (51 and 52), but my aunt survived until she was in her middle 60’s.   Strong genetic evidence – early onset, aggressive, similar patterns of meta – why did my aunt live the extra decade?  I believe the simple answer is – she didn’t smoke.  My grandparents and parent were smokers meaning life long exposure to the carcinogens in cigarettes.  My aunt, though she grew up in a smoking household didn’t smoke herself.  Epigenetically speaking, she didn’t turn up the gene.  With my uncle, he has passed his early fifties, and is a non-smoker, so the question is, did he get the gene at all?  Time shall tell.  To contrast this heritage, my maternal grandmother smoked her entire life, and lived until 80, never getting lung cancer.  No gene?  Seem so.

This is excellent reason for me and my sister – we can’t change our genetic inheritance (and there is not current test for a lung cancer gene, though they do know there is one) but we can choose our lifestyle.  Neither of us has ever smoked, neither of us drink as heavily as our parent or grandparent, we eat healthy diets with lots of fruits and veggies, and my sister (not so much me) has kept her weight low.  We our doing our part to ensure the volume stays down on our genes, only time will tell if we succeed.

On the human level the field of epigenetics brings weight to our life choices adding to the pressure many feel to “live well”.  The weight of a healthy lifestyle becomes a punishing burden as every choice seems to have dire effects not just for themselves but their children.  Women especially receive barrages of information and direction on what to eat, drink, and expose themselves to during pregnancy and breastfeeding.  I have felt that pressure, but ultimately I try to remind myself that I can only do my best and the stress of trying to manage everything carries as many negatives as a lot of the things we try to manage.   I also try to remember that this gives me power, I can impact how my body acts, I am not at the mercy of my genes, how I live, and how I teach my children to live will change what happens to us. 

From the perspective of the medical field epigenetics creates a field of unique, crafted interventions that has never existed.  We can begin to more clearly understand the most profoundly impacting life events and behaviours to allow both early intervention or to create uniquely personal watch lists given our histories.  How intriguing.

 

LINKS: 

 

epigenetics and poverty

nurturing rats and epigenetics

epigenetics of bipolar and schizophrenia

epigenetics of child abuse

 

 

 

 

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BC Generations Project

| October 7th, 2011 | No Comments »

I have signed up to be a human lab rat. The BC Generations Project is a 25 year study hoping to follow 40,000 BC residents between the ages (at the start) of 35-69. The BC Generations Project is part of a greater, Canada-wide project called the Canadian Partnership for Tomorrow that is hoping to reach a total of 300,000 participants in total. I will be chronicalling my progress through this project over the time – I don’t guarantee the whole 25 years, but at least the first few.

The BC Generations project will use the data and biospecimens collected in aa number of studies over the next decades that are all attempting to understand how to prevent cancer and other chronic disease. I love this project. I also feel bad for it. The researchers are looking to capture some of the most elusive data out there. Trying to connect which specific part of your life increases your risk would be difficult. Trying to find out how the different aspects of you life act together to increase or decrease your risk of disease over someone else is even more difficult. They will have to try to tease apart genetic, environmental and behavioural factors and decide which are the lynch pins. With the real possibility that there are no lynch pins – but rather an calculus level equation of factors that add, subtract, multiply and divide to land you with a negativeor a positive.

This is the reality of medicine as we are coming to understand it. No one thing is the answer, all things are the answer – and your answer is different than anyone else’s.

Initially, BC Generations will be collecting asking lifestyle questions, collecting physical data (height, weight and waist/hip ratio) and physical samples (blood, urine, and saliva). This data and the physical samples will be stored together for future use. By entering the BC Generations Project participants also allow researchers access to their health records and they may be contacted in the future for follow-up.

 

By collecting together such a large pool of samples spanning ages, genders, locations and lifestyles the BC Generations Project and the Canadian Partnership for Tomorrow is creating a resource of incalcuable value to both present and future medical researchers. Data can be extracted for fair-haired, healthy eating women across Canada, or 48-year olds with a history of maternal diabetes that live in urban settings, or 69 year-old males with heart disease in their fathers. The options are myriad and when you add in the ability to track progress over time you have a tool for the future that will offer the future a gift of knowledge about how time, behaviour and family history come together.

My first step will be to fill out the intake form (book) prior to my physical assessment. Next I have an appointment to have samples taken. From there? Who knows, but it should be a heck of a ride. I get the opportunity for a free health assessment and a chance to contribute to the evolution of preventative medicine in my province and my country.

If you want to volunteer, or just learn more about the project, go to their website.  Give some thought to what a wonderful legacy this could be.  As an orphan whose parents both died middle-aged of cancer, I consider my participation to be a gift to my son and his future children (should he have any), a gift I may never have another opportunity to give.

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