Author: noorali

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Religion and Illness

Should physicians prescribe religious activities to treat medical ailments – just like they prescribe antibiotics? Why not! In an era of complementary medicine and alternative therapies, why not add religious activities to a long list of non-traditional therapies?

But the answer is not simple. There are people who think this is not a good idea. A group of 7 chaplains, representing a wide range of religions, and two biomedical researchers, have written an article in the New England Journal of Medicine expressing their concerns.

Polls do suggest that the U.S. population is highly religious, that most people believe in heaven and hell, the healing power of prayer, and the capacity of faith to aid in the recovery from disease. About 77 percent of hospitalized patients want physicians to consider their spiritual needs in the management of their problems.

Surveys of family physicians in U.S. strongly support the notion that religious beliefs can promote healing. Nearly 30 U.S. medical schools now offer courses on religion, spirituality, and health. Some physicians believe that going to church promotes good health.

But the authors of the article are troubled by the uncritical enthusiasm shown by the general public, individual physicians, and American medical schools in promoting religious activities as part of medical treatment. The authors feel that there is very little scientific evidence to show religious activities promotes good health. Their argument is summarised here:

1. Is there evidence of a link between religion and health?

Yes. Some studies have shown that regular church attendance, listening to religious television programs, praying, and reading the bible may be associated with improved health. But the authors believe that the evidence is generally weak and unconvincing, since most studies are poorly conducted. A prospective double blind trial would be most difficult to conduct.

2. Should physicians recommend religious activity as a way of providing comfort?

The authors quote a study that says: “The primary task of the physician is to cure sometimes, to relieve often, and to comfort always.” We know that many people do get comfort from religious activities. But is it ethical for a physician to prescribe religious activities to a patient without infringing on patient’s freedom of choice?

The authors feel that religious practices can be disruptive as well as healing. That physicians are not trained to engage in in-depth conversations with their patients about their spiritual concerns. And the physician and the patient may not have the same religious beliefs. Therefore, it may not be a good idea for physicians to get into prescribing religious activities to their patients.

3. Do patients want religious matters to be incorporated into their medical care?

Studies have shown that 40 to 50 percent of patients want physicians to attend to their spiritual needs. But these numbers do not emphasise the views of 50 to 60 percent of the patients who think otherwise. Most of these surveys are on inpatients. This may not be relevant to office and outpatient work.

What do you think? Do you agree with the arguments? Would you like your doctor to prescribe religious activities to you as part of medical treatment? Write to me at: 821A – 5th Street SW, Medicine Hat, AB T1A 4H7 or use my e-mail address.

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Stuttering

Dear Dr. B: Can you please tell me about stuttering? Why do people stutter and can it be cured? Yours, Mr. H.

Dear Mr. H: According to Webster’s dictionary, to stutter means to speak or utter with spasmodic repetition as a result of excitement or impediment.

Stuttering is a disturbance in the normal fluency and time patterning of speech that is inappropriate for the person’s age. The speech disruptions may be accompanied by rapid eye blinks, tremors of the lips and/or jaw or other struggle behaviours of the face or upper body that a person who stutters may use in an attempt to speak. Stutters can predict 95 percent of the words over which they will stutter.

An article in the Canadian Medical Association Journal (CMAJ) quotes a study involving 1879 university students showing prevalence of self-reported stuttering of 2 percent. Information picked up from Encyclopaedia Britannica suggests that over three million Americans stutter.

Stuttering affects individuals of all ages but occurs most frequently in young children between the ages of 2 and 6 who are developing language. Boys are three times more likely to stutter than girls. Most children, however, outgrow their stuttering, and it is estimated that less than 1 percent of adults stutter.

Some successful famous stutters are: Winston Churchill, actress Marilyn Monroe, actors James Earl Jones, Bruce Willis and Jimmy Stewart. But in some, stuttering can interfere with academic and professional development and social communication and interaction.

What causes stuttering?

There are varieties of possible causes of stuttering but the precise mechanisms causing stuttering are not understood. Stuttering can be developmental or acquired.

Developmental stuttering is by far the commonest and may or may not be associated with psychiatric illness. Developmental stuttering occurs in children who are in the process of developing speech and language. Acquired stuttering in previously fluent individuals may be as a result of brain damage due to variety of causes including head injury and stroke.

Some stuttering may be hereditary but no gene or genes for stuttering has yet been found.

Speech-language pathologist, a professional who is specially trained to test and treat individuals with voice, speech and language disorders, makes a diagnosis of stuttering. If you suspect your child to have speech problems then the best thing is to consult your family doctor or your paediatrician and get a referral to a speech-language pathologist.

What is the treatment for stuttering?

In Roman times, stutteres were thought to be possessed by evil spirits that had to be exorcised. In the Middle Ages the tongue, thought to be the source of the problem, was tortured with hot irons and spices, says the article in Encyclopaedia Britannica.

The CMAJ article says that between 50 and 80 percent of children with developmental stuttering will recover with or without professional treatment, generally before puberty.

To prevent developmental stuttering from becoming a life-long problem, speech evaluation is recommended for children who stutter for longer than six months or for those whose stuttering is accompanied by struggle behaviours. Developmental stuttering is often treated by educating parents about restructuring the child’s speaking environment to reduce the episodes of stuttering.

Stuttering is something people do not want to talk about. I knew very little about the subject myself! So, thank you Mr. H for asking the question. And you can obtain more information from the National Institute on Deafness and Other Communication Disorders (National Institutes of Health) web site (www.nih.gov/nidcd).

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Summer Heat

The heat is on! The air conditioners are going crazy! And the people are asking: Hot enough for you?

Many of us have been waiting for this kind of weather. But is it healthy? Is it safe?

Some of you may remember the heat wave of Chicago in 1995. Many people died. About 20 years ago, heat also claimed the lives of 88 people in Memphis, Tenn. Most of these deaths are due to heat stroke. Heat stoke is dangerous and deadly but fortunately, preventable.

The vast majority of people affected by the immense heat are the elderly with medical problems such as mental illness, lung diseases, or heart disease. Social isolation is another factor. People who live alone and /or are confined to bed are at higher risk compared to those who have access to transportation, nurse visitors or social services, Having an air conditioner helps. But not many elderly people can afford it.

Memphis has adopted a protocol to prevent death from dehydration and heat stroke amongst the sick and elderly and the public in general. At the beginning of summer, officials organize surveillance of emergency departments in the area to see if heat-related visits have increased.

Once temperature starts to rise, media print or broadcast general public advice to increase fluid intake, to reduce physical activity, and to seek medical help for heat related problems.

Visiting nurses, Meals on Wheels workers, and letter carriers help out in finding people who live in isolation and are at increased risk of heat stroke.

Our temperatures may not rise to a level of heat waves seen in Chicago or Memphis but the danger is still there for people of any age group who do not maintain adequate fluid intake during summer months. Especially people with medical conditions.

Effective treatment for heat stroke depends on rapid diagnoses and rapid cooling. Otherwise, a chain of events will lead to irreversible injury and death.

The blistering sun is also damaging to our skin if it is exposed to the sun for prolonged periods of time on a regular basis. The damage is cumulative, starting with sunburn and progressing over a period of time to skin cancer.

There are three types of skin cancers: Basal Cell Cancer, Squamous Cell Cancer and Melanoma. First two are very common and can invade local tissues but are not fatal. Melanoma is not that common but can be fatal if not detected early and excised.

Can we prevent skin cancer? Yes! The Canadian Cancer Society recommends the following preventive measures:

1. Avoid prolonged exposure to the sun especially between 11 a.m. and 4 p.m.
2. Wear protective clothings, such as long-sleeved shirts, and wide brimmed hats.
3. Use a sunscreen with a SPF of 15 or higher to absorb ultraviolet rays.
4. Seek prompt treatment of any skin abnormality.

Summer is time for out door activities and fun. Children are out of school. Many adults take holidays during this time to enjoy family life. When we are having fun, it is hard to remember the dos and the don’ts. So let us make it simple by remembering two facts:

1. Skin is the largest organ of our body and has many important functions to protect us from environment.
2. About 60 percent of our body is water. Water and salt is vital to the survival of our cells and tissues.

So let us treat our skin with respect and keep our systems well lubricated with water and have fun!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Smoking

In 1999, many sports writers declared Tiger Woods athlete of the year. Unfortunately, his father, Earl Woods, is battling heart disease and cancer. Tiger Woods does not smoke. But his father continues to smoke inspite of ill health. A father, who is so proud to have raised and trained a complete golfer, is unable to quit smoking! Why?

Earl Woods is not alone hooked on this. Millions of people all over the world are in the same boat. Their pockets and health have been high jacked by the tobacco industry. The advertising technique used by tobacco industry has millions of people on the “weed”. Once they get hold of us, the noose tightens slowly.

But some smokers are fighting back. Over the last 30 years or more, many smokers have realized the damage done to their health by tobacco industry and have sued the tobacco companies for millions of dollars.

On July 15th, a headline in “San Francisco Chronicle” says: Big Tobacco Bashed by Verdict – Jury awards record $145 billion in punitive damages to thousands of sick Florida smokers. The report says that in the largest damage award in U.S. history, a jury in Miami-Dade County ordered the tobacco industry to pay $144.8 billion in punitive damages to 500,000 sick Florida smokers.

The report says the case was history making in other ways as well. Top executives for the tobacco companies, who rarely testify under oath, took the stand to say that their companies have changed, that they are spending millions to discourage underage smoking and are repentant on the way business was done in the past.

Have we noticed any change?

A document produced by Alberta Cancer Board, called: Cancer and Tobacco – The picture in Alberta, March 2000, has interesting statistics on Smoking Behaviour in Canada.

About 21 percent fewer Canadians use tobacco now than did 30 years ago, an encouraging statistic that is unfortunately offset by a grim one – smoking among teens increased by 25 percent over a four-year period in the early 1990s. But, it adds, fortunately, the percentage of teens smoking has decreased since then.

What about Alberta?

Twenty seven percent of Albertans aged 15 years and older were smokers – 2 percent higher than the national average. Twenty seven percent of Alberta males and 28 percent of Alberta females were smokers – the same as national average for males, but 5 percent higher than the national average for females.

Should we rely on the tobacco industry to help us quit smoking and prevent our teens to stay away from cigarettes? Well, that is a ridiculous question!

But the simple answer is – NO, we have to do it ourselves. We cannot even rely on our governments. Governments can pass as many laws as we want. But there are always people who can find loopholes to abuse the system. And we do not have enough money or the manpower to enforce these laws. So, they are no good anyway. What is good is our will power. And we have to search for that within ourselves today, not when our life is threatened.

That is tough. But if it was easy then we would not lose 3,500 Albertans and 45,000 Canadians each year from smoking – more people than killed by heroin, cocaine, alcohol, AIDS, fires, murders, suicides and car crashes combined.

So, be tough and do it today!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!