clinic

Human health and filling in the gaps

There are seemingly no clear boundaries between health and disease of humans. From one side the judgement of one’s health may be subjective, and from the other side the feeling of being healthy or sick may be intermingled in the different parts of the same day. One of the most impactful insights in medical sciences is to find the appropriate definition of health and disease statuses. The definition of health laid by the World Health Organization states health as “the state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity.” Apparently and in practical terms no one on Earth would fit to the WHO definition as being a healthy human.
The human health, being the sum of several biological components or entities, should not be regarded apart from its inherent dynamic nature. It can, therefore, be considered and expressed in hand of mathematical probability estimation. The human health may be, accordingly, defined as the state of satisfactory physical, mental and social showing in average life conditions with or without auxiliary means in terms of lifestyle and/or medical treatment. Therefore, in light of this definition while health state judgment may be individually tailored and appreciated, the presence or absence of certain physical or psychological disease state would be regarded as a constitutional health element for every individual. For the delineation of such constitutional health elements, physicians and other health scientists may succeed in writing down all known conditions (or diseases) with their different possible classifications.
Such dynamic nature of human health should give a red alarm to physicians not to make statements on one’s health based only on some data in limited clinical sessions or visits. In many cases, closer observation and more rigorous data collection may be needed before the health state of an individual can be judged.
On handling certain health condition, the natural body resources and compensatory reserves (so-called natural healing power) should not be overseen, but rather boosted and encouraged. In other words, the medicines; if they are clearly indicated, should be given prudently so that such natural resources and reserves would still be desirably in action. The benefits of such prudent medical conduct include: 1) preservation and boosting of natural healing would ensure permanent or durable cure and reflect positively on longevity, 2) giving less medicines with less chances for side-effects and with lower cost, and 3) deliberate ‘undertreatment’, i.e. prudent treatment, would allow easy-to-follow life style and help avoid iatrogenic (of doctor origin) and accidental overdosing.

Advertisements
clinic

Psychology phenomena ladder

Basically, psychological diseases such as anxiety/depression and phobias/manias may not be regarded as diseases but rather merely as psychological phenomena. This is because of two reasons: 1) they can be experienced by almost all people (then it is quite embarrassing to find all people psychologically ill) and 2) they can happen in varying degrees and in different time lapses.

The origin of psychological disease/phenomenon seems to be the specific set of characters that the person builds up from the very beginning of life and throughout life especially during the first few years. This argument may be supported by the assumption/observation that certain psychological conditions would be experienced by some persons in some life stages but not by others in the same life stages. For examples, anxiety would me more in young adults with little experiences who tend to be sensitive (good-spirited and ambitious) and righteous, while depression may be more experienced by materialistic (intellectual and chance chasing) and self-centred persons.

Such naturalizing of psychological diseases/ phenomena would, from one side, reduce the emotional burden given by those experiences, and revise the significance/role of medical treatment of psychological conditions, from the other side. Indeed, nonmedical or conservative treatment would be the general rule while the medical treatment may be needed only on occasional basis. However, every psychological case should be considered individually and the treatment plan should be, hence, very specific for that person.

As the extent of psychological experiences varies in terms of obviousness/picture, duration and pattern, those experiences may be ordered in a ladder of ascending phenomenal grades. Although that view would implicitly mean a mode of diseases/condition evolution, neither the relay between stages nor the completion of the whole track may be strict.

This scheme sheds light on the importance of the insight of the person as a determinant for favourable/unfavourable psychological path. It implies also the role of the person’s will, i.e. choice – to a certain degree – as to where to direct his/her emotional and spiritual investment.

clinic

Factor 10 disease

factor 10 disease

1- Disease classification: a kind of psychosomatic disease (review disease classification here).
2- Disease description:
Type of patient: young adults and middle age, male > female
Symptoms and signs
The person may c/o usually unrelated symptoms that my include
– unjustified mood change, e.g. depression
– laziness, fatigue, drowsiness, malaise
– defective concentration, haziness
– muscle cramps, pain, heaviness
– intolerance to drink enough water, waterphobia
– intolerance to cold or hot weather
– emotional instability
– maybe some degree of lack of judgment, hesitation
Vital signs
body temperature: may be slightly decreased
pulse: can be slightly increased, high normal
blood pressure: tends to be lower average range
Disease onset: gradual or insidious
Disease course: intermittent or chronic
Prognosis: variable, according to person’s attitude
Investigations: usually normal
Treatment and prevention: according to disease chart
3- Disease chart
Elements:
Movement —> 50%
Emotion —> 50%
Agent —> 0%
Factors:
Work engagement —> 33%
Food and drink —> 33%
Hygiene —> 33%
4- Pathophysiology
The person would be of the melancholic type of personality (see the four human temperaments: https://en.wikipedia.org/wiki/Four_temperaments). The factor 10 disease may be rationalized as a perturbed equilibrium of the body energy balance (see the four-element view of body components: https://en.wikipedia.org/wiki/Classical_element).

clinic

The clinical medicine logic

The physician works in a large frame of 3 pillars: the preventive medicine, the diagnostic medicine and the curative medicine. From a broad practical view the physician’s job is mainly in the curative medicine pillar.

The clinical (curative) medicine logics may be thought of as:
1- Adjunctive medicine
– analgesic, sedative, anxiolytic
– Mood modifiers
– Psychoactive agents
2- Casual medicine
– surgery
– invasive diagnostic and therapeutic interventions
3- Regular medicine
– nutrition
– common nonspecific agents: laxative, purgative, emollient, carminative
– specific medical agents
– antibiotics and antimicrobials
– anticancer agents

clinic

Drastic and devastating

Drastic and devastating

The title of this post presents two important words from the medical dictionary. “drastic” can be first seen in the homeostasis introduction to medical physiology course. It emphasizes the lack of adaptive and accommodative responses to sudden and strong changes in the environment. In such conditions the outcome can be quite damaging or even fatal. The word “devastating” can be found in the pathology essays such as those changes due to severe infections and it usually concerns a local pathological change, e.g. necrosis. Though the two words may originally concern natural events in the environment, they may provide clues to medical care and case evaluation.

In medical practice the care-giver should avoid harsh interventions in terms of course and dose. The treatment may be better doing when it is decent and incremental (opposite to drastic). That view in the medical care – in some situations – entails ‘partial correction’ of the concerned disorder as”rapid*” ‘full correction’ may bring about quite unwanted or even fatal hazard. It is always wise to have an overall vision of the medical case with top-to-bottom estimate so that such extreme flip-flops can be better appreciated and avoided. The treatment should be both problem- and patient-tailored. As the body’s reserves to accommodate changes (temperature, water, food, etc.) is limited and varying from time to time one should be careful not to be too rush or too slow.

By the way, the medical opposite of devastating can be ‘mild’ or ‘trivial’.

Take-home massage:

1- Be decent, systematic, and incremental.

2- Observe well.

3- Be open-minded, generous and evolution-ready.

4- Make your expectations as modest and small as you can.

 ——————–

* Suggested steps of management could be:

1- Reverse the current event.

2- Restore/establish base line.

3- Treat residual illness.

 

clinic

Orthotherapia (orthocura) – an interview –

orthotherapia (orthocura)

Interviewer: Hallo, everybody! Welcome to this episode of “medical views”. Today, we have another very exciting view of medical care, namely “orthotherapia or orthocura”. Let’s greet our guest; Mr. Physician 21, welcome back to our program!

Physician 21: Thank you. I am very happy to be with you today.

Interviewer: Would you explain the core concept of your orthotherapy?

Physician 21: Well. To start with, the idea is not by any means very novel but more it gathers and harmonizes some basic medical principles in a well structured and meaningful medical philosophy.

Interviewer: So, what are the main pillars of your idea?

Physician 21: Orthotherpia or orthocura claims that among all possible medical care regimens there could be only one that best suits a given medical case. While in this regard the conception of a presumed bodily functional hierarchy would be in the centre, some medical peculiarities are also much concerned including patient type, medical remedy type and mode of application.

Interviewer: Very fine Mr. Physician 21. Now, we are about to get that well structured and meaningful medical philosophy of orthotherapy. Would you bring us closer to those very interesting medical presumptions; first, what do you mean by bodily functional hierarchy?

Physician 21: The bodily functional hierarchy would mean that the various physiological functions and their body organs may be ordered in such hierarchical manner so that one function would be prioritized in respect to another. An example could be: lung > stomach > heart > liver and spleen > muscle and bone > gonad and kidney > brain. Such conception of possible hierarchically ordered body organs would help appreciate disease evolution from one side and disease management order from the other side.

Interviewer: How nice! We would perceive a glimpse of ‘alternative medicine’ in that presumption of bodily functional hierarchy, would you say that?

Physician 21: Well, I should say that I am not an expert in alternative medical methods. Anyhow, as I already said in the beginning the idea may not be very novel and it should make use of much of the well known medical arts.

Interviewer: Would you give practical examples to further explain that?

Physician 21: Well. Let’s consider a case of fever with signs of dehydration. The dehydration may be first corrected by giving appropriate fluids and then the body temperature could be assessed and managed accordingly. In such case, prioritizing fever to dehydration would be inappropriate and cost-ineffective. Another example could be the improvement of anxiety which reflects neurologic stress on practicing some suitable kind of sports. Again, in that case over consumption of anxiolytics may be cost-ineffective.

Interviewer: you mean that in handling diseases it makes great sense which disease or organ function to consider first to achieve a rather smooth and nature-coping healing process.

Physician 21: That is it. Thank you.

Interviewer: To summarize, “orthotherpy” or “orthocura” would emphasize the significance of choosing the management regimen with the presumption of natural hierarchical order of body functions and systems. Thank you very much. Mr. Physician 21 for this very interesting information.

Physician 21: Thank you too.