Insomnia, Blue Light and the Yin of the Yin

This article in Psychology Today entitled "Blue Light and Sleepless Nights" (Insomnia is no match for the sun) by Sarah Korones reinforces a classic teaching in Chinese Medicine. The balance of Yin and Yang. We are in deepest winter, or the Yin of the Yin when it comes to seasons. So to provide balance, we need to receive the Yang of the Yang. The Yang is the day, and when the sun is at its peak, that is the Yang of the Yang. So for better sleep, it is important to get out in the sun, if possible, at midday for maximum benefit. This applies the whole year, but now it's especially important to be mindful since daylight is more limited, so you have to plan. This same principle pertains to people with S.A.D. (Seasonal Depressive Disorder) also. They need to get out in the middle of the day and take in those light rays.This article spells out the science behind this yin and yang balance. Nice.

Insomnia-a common and difficult-to-treat condition-is estimated to cost the American economy $63.2 billion each year in lost productivity. A new body of research suggests that a cure might be as simple as soaking up some sun.
Blue light, a part of the visitble spectrum in solar rays, keeps us perky during th day, by suppresing the release of melatonin, the hormone that causes sleepiness. But when we spend our time cooped up indoors, our eyes fail to take in the proper amount of light, and we never get an internal signal to sleep at night.
"If you don't have a change in melatonin levels during the wr hours of the day, your body doesn't know when to rest and when to stay awake,.."

Suggestions include
-Take your lunch outside or walk to sowrk, when the sun is at its brightes
-Read a book before bedrtime rather than watching TV. The light might turn off your melatonin and impede sleep.
-Take off your sunglasses, at least for awhile during the day to get that blue light

Complexity Science and CAM: More Mental Models

I will divide this topic into two posts since this article touches on more than one meaty subjects.
Applying Principles from Complex Systems to Studying the Efficacy of CAM Therapies
This article was published over a year ago, but I missed it. The lead author, Andrew Ahn, is a fellow I had met at the SAR (Society for Acupuncture Research) meeting in North Carolina in 2010, discussed briefly here. The article is available in its entirety. I will point out a few points that are of interest to me in particular. My research has involved HRV (Heart Rate Variability) analysis in conjunction with acupuncture. It makes sense to do this if you recognize that acupuncture cannot be explained in a linear, mechanistic fashion. I discussed some of these dilemmas here and here. So Dr. Ahn grapples with ways to study these nonlinear phenomena in this article, describing a workshop he had attended. He says,

"This discusses possible benefits and challenges associated with applying complexity science to CAM research...
Complexity theory provides a theoretical framework for evaluating and analyzing complex systems. These systems are “complex,” because they exhibit global properties not made obvious from the properties of the individual components, and they are “systems,” because they are composed of interconnected parts. Historically, complexity theory borrows concepts and tools from a range of disciplines, including chaos theory (physics), control theory (engineering), cybernetics (mathematics), and General Systems Theory (biology). More broadly, these disciplines share a common theme of nonlinearity—a concept maintaining that the size of an output is not proportional to the size of an input.
Terms such as adaptability, robustness, or health were previously considered qualitative terms and thus were quantitatively intractable. Yet, complexity science has identified analytical methods that can help assess these features... Finally, complexity science offers a conceptual framework that reflects reality better. In the real world, small inputs can have large effects, processes are dynamic, interactive effects can span across many temporal and spatial scales, and transformations from one state to another can happen gradually or precipitously...

There is a lot here. As I discussed previously in my "argument" with Dr. Longhurst over whether I was actually giving continuous stimulation with manual acupuncture, clinical outcomes attest that I get results without continuous stimulation. This requires that one sees acupuncture as setting a cascade in motion of self healing or self regulation in response to the tiny injury incurred, rather than a nerve stimulation directly to the spinal canal, brain that needs continuous input.
He also echoes one of my favorite ways of describing acupuncture's effect on the body, that it makes it sturdier, more robust, more resilient (spoke about it in this interview.) As he says "these were qualitative terms and thus were quantitatively intractable." The search for biomarkers of health, or healthy response can be seen in the testing for telomere length, HRV, galvanic skin response, or electrical impedance at acupoints. My own interest is in HRV as a measure of health and stress level or ability to respond. I will discuss this more in the next post using Dr. Ahn's article
More on the practice here.

Tragic. High Cost of Failing Artificial Hips

To be filed under "Follow the Money." This has got to be horrendous for patients since you know that the insurance company's costs will be reimbursed first since they can hire more lawyers. And to have to be dealing with these kinds of financial issues and law suits when you're not feeling well. Horrible. Some excerpts follow. I've been following this story for the 6 months and it follows the typical trajectory of the companies ignoring complaints, blaming the physicians and then finally having to cop to the problem. Not good. Not good at all. Recent blog post on topic here.
The High Cost of Failing Artificial Hips
By BARRY MEIER

The most widespread medical implant failure in decades — involving thousands of all-metal artificial hips that need to be replaced prematurely — has entered the money phase.

Medical and legal experts estimate the hip failures may cost taxpayers, insurers, employers and others billions of dollars in coming years, contributing to the soaring cost of health care. The financial fallout is expected to be unusually large and complex because the episode involves a class of products, not a single device or just one company...

The incidents have set off a financial scramble. Recently, lawsuits and complaints against makers of all-metal replacement hips passed the 5,000 mark. Insurers are alerting patients that they plan to recover their expenses from any settlement money that patients receive. Medicare is also expected to try to recover its costs...
Still, some patients are weathering some of the financial impacts on their own. While Charmin McCune, a teacher in Wylie, Tex., is recuperating well from a recent replacement operation, she said that she and her husband, also a teacher, have had more than $12,000 in expenses that have not been covered by insurance.

Information on my practice here.

Story of Stress and Disease: Robert Ader Pioneering Psychologist

This is the story of Robert Ader who first coined the term "psychoneuroimmunology" or PNI. If you're interested in stress and disease, as I am, you probably would like to read the whole article. A few excerpts here.

Robert Ader, Who Linked Stress and Illness, Dies at 79
By PAUL VITELLO

Dr. Robert Ader, an experimental psychologist who was among the first scientists to show how mental processes influence the body’s immune system, a finding that changed modern medicine, died on Tuesday in Pittsford, N.Y. He was 79...

His initial research, in the 1970s, became a touchstone for studies that have since mapped the vast communications network among immune cells, hormones and neurotransmitters. It introduced a field of research that nailed down the science behind notions once considered magical thinking: that meditation helps reduce arterial plaque; that social bonds improve cancer survival; that people under stress catch more colds; and that placebos work not only on the human mind but also on supposedly insentient cells.

At the core of Dr. Ader’s breakthrough research was an insight already obvious to any grandmother who ever said, “Stop worrying or you’ll make yourself sick.” He demonstrated scientifically that stress worsens illness — sometimes even triggering it — and that reducing stress is essential to health care...
“My father used to say, ‘I just didn’t know any better,’ ” she said, recounting how he had described his pioneering research.

He told her, she recalled, “I didn’t know the immune system wasn’t supposed to be connected to the brain.”

Information on my practice here.

New Joint Implants no Better Than Older Ones

Filed under "Follow the Money"
December 22, 2011
New Models of Implants Not Better, Study Finds
By BARRY MEIER

A new study suggests that the recent technology for artificial hips and knees did not perform any better than older, less expensive designs.

The study, which draws on data from Australia’s orthopedic registry, covered implants introduced from 2003 to 2007 and was published this week. The findings are significant for patients in the United States because many of the new designs, like so-called metal-on-metal hips, are widely used here. Those implants, which have both a ball and cup made of metal, are expected to fail prematurely in tens of thousands of patients rather than lasting 15 years or more as artificial joints are supposed to do.
The Australian study showed that not a single new artificial hip or knee introduced over a recent five-year period was any more durable than older ones. In fact, 30 percent of them fared worse...


“Not only has the introduction of this technology been potentially detrimental to patient care, but the current approach may be an important driver of increased health care costs,” the review concluded...

That review, by researchers in Austria (mistake, should be Australia), found that surgeons involved in the original published reports are often involved in its development and may have a financial stake in them. In addition, such reviews tend to be short term...
This month, bipartisan legislation was introduced in the Senate that could force manufacturers to track the performance of implants like artificial hips after they have been approved for sale. Proponents of the bill acknowledge that the measure faces an uphill fight.
Both device producers and their allies in Congress have maintained that any additional F.D.A. regulations would slow the development and marketing of innovative products that benefit patients. For his part, Dr. Graves, the Australian official, said he believed that such arguments were misleading.

Where have we heard that before?? That regulation will somehow damage innovation, or hurt business and job creation? Just about every time any sort of regulation is proposed, that's when.
Info on my practice here.