MJ had Lupus

Even weeks after his untimely death, people have not been able to come to terms that Michael Jackson is actually dead and, as part of the people’s grieving process, new information hitherto unknown keeps surfacing about the king of pop, that might help fans to somewhat understand the bizarre behaviour displayed by MJ in later years
Now spiritual teacher and medical doctor Deepak Chopra has disclosed that his longtime friend Michael Jackson suffered from lupus and his dermatologist told Larry King that MJ had Lupus.

The famous images of Michael Jackson made everyone think he was eccentric and out of control. His face was always obscured with heavy makeup; he was pushed in a wheelchair and carried an umbrella on sunny days. But now it’s coming to light that Jackson was actually camouflaging a serious disease.
One look at him and I said, “you have lupus erythematosus,” Jackson’s dermatologist, Dr. Arnie Klein, told Larry King on the live show.

“He had been diagnosed with lupus and he had vitiligo,” said Deepak Chopra. “There’s some recent research that suggests that if children have experienced either physical or verbal, mental, emotional or sexual abuse, then 20, 30 years later they can develop these autoimmune diseases including lupus”.
He adds, “Michael was never sexually abused, but according to him, he was traumatised verbally and physically in his childhood, and it was a big issue with him.”

What is lupus?

Lupus is an autoimmune disease characterised by acute and chronic inflammation of various tissues of the body. Autoimmune diseases are illnesses that occur when the body’s tissues are attacked by its own immune system. The immune system is a complex system within the body that is designed to fight infectious agents, such as bacteria and other foreign microbes. One of the ways that the immune system fights infections is by producing antibodies that bind to the microbes. Patients with Lupus produce abnormal antibodies in their blood that target tissues within their own body, rather than foreign infectious agents. Because the antibodies and accompanying cells of inflammation can affect tissues anywhere in the body. Lupus has the potential to affect a variety of areas. Sometimes lupus can cause disease of the skin, heart, lungs, kidneys, joints, and or nervous system.
The precise reason for the abnormal autoimmunity that causes Lupus is not known. Inherited genes, viruses, ultraviolet light, and certain medications may all play some role.

Genetic factors increase the tendency of developing autoimmune diseases, and autoimmune diseases such as lupus, rheumatoid arthritis and autoimmune thyroid disorders are more common among relatives of patients with lupus, than the general population. Some scientists believe that the immune system in lupus is more easily stimulated by external factors such as viruses or ultraviolet light. Sometimes, symptoms of lupus can be precipitated or aggravated by only a brief period of sun exposure.
It also is known that some women with SLE can experience worsening of their symptoms prior to their menstrual periods. This phenomenon, together with the female predominance of SLE, suggest that female hormones play an important role in the expression of SLE. This hormonal relationship is an active area of ongoing study by scientists.

Dozens of medications have been reported to trigger SLE. However, more than 90% of this “drug-induced lupus” occurs as a side effect of one of the following six drugs: hydralazine (used for high blood pressure), quinidine and procainamide (used for abnormal heart rhythms), phenytoin (used for epilepsy), isoniazid ([Nydrazid, Laniazid] used for tuberculosis), d-penicillamine (used for rheumatoid arthritis). These drugs are known to stimulate the immune system and cause SLE. Fortunately, drug-induced SLE is infrequent, accounting for less than 5% of all patients with SLE, and usually resolves when the medications are discontinued.

Patients with SLE can develop different combinations of symptoms and organ involvement. Common complaints and symptoms include fatigue, low-grade fever, loss of appetite, muscle aches, arthritis, ulcers of the mouth and nose, facial rash (“butterfly rash”), unusual sensitivity to sunlight, inflammation of the lining that surrounds the lungs and the heart and poor circulation to the fingers and toes with cold exposure. Complications of organ involvement can lead to further symptoms that depend on the organ affected and severity of the disease.

Skin manifestations are frequent in lupus and can sometimes lead to scarring. In discoid lupus, only the skin is typically involved. The skin rash in Discoid Lupus often is found on the face and scalp. It usually is red and may have raised borders. Discoid Lupus rashes are usually painless and do not itch, but scarring can cause permanent hair loss. Over time, 5%-10% of patients with Discoid Lupus may develop SLE.

Over half of the patients with SLE develop a characteristic red, flat facial rash over the bridge of their nose. Because of its shape, it is frequently referred to as the “butterfly rash” of SLE. The rash is painless and does not itch. The facial rash, along with inflammation in other organs, can be precipitated or worsened by exposure to sunlight, a condition called photosensitivity. This photosensitivity can be accompanied by worsening of inflammation throughout the body, called a “flare” of the disease.
Typically, this rash can heal without permanent scarring with treatment.

Most patients with SLE will develop Arthritis during the course of their illness. Arthritis in SLE commonly involves swelling, pain, stiffness, and even deformity of the small joints of the hands, wrists, and feet. Sometimes, the Arthritis of SLE can mimic that of Rheumatoid Arthritis.

More serious organ involvement with inflammation occurs in the brain, liver, and kidneys. White blood cells and blood-clotting factors also can be characteristically decreased in SLE, known as leucopenia and thrombocytopenia, respectively. leucopenia can increase the risk of infection and thrombocytopenia can increase the risk of bleeding.

Inflammation of muscles can cause muscle pain and weakness. This can lead to elevations of muscle enzyme levels in the blood.
Inflammation of blood vessels that supply oxygen to tissues can cause isolated injury to a nerve, the skin, or an internal organ. The blood vessels are composed of arteries that pass oxygen-rich blood to the tissues of the body and veins that return oxygen-depleted blood from the tissues to the lungs. It is characterised by inflammation with damage to the walls of various blood vessels. The damage blocks the circulation of blood through the vessels and can cause injury to the tissues that are supplied with oxygen by these vessels.

Inflammation of the lining of the lungs and of the heart can cause sharp chest pain. The chest pain is aggravated by coughing, deep breathing, and certain changes in body position. The heart muscle itself rarely can become inflamed. It has also been shown that young women with SLE have a significantly increased risk of heart attacks from coronary artery disease.
Kidney inflammation in SLE can cause leakage of protein into the urine, fluid retention, high blood pressure, and even kidney failure. This can lead to further fatigue and swelling of the legs and feet. With kidney failure, machines are needed to cleanse the blood of accumulated poisons in a process called dialysis.

Involvement of the brain can cause personality changes, thought disorders (psychosis), seizures and even coma. Damage to nerves can cause numbness, tingling and weakness of the involved body parts or extremities. Brain involvement is referred to as lupus cerebritis.
Many patients with SLE experience hair loss. Often, this occurs simultaneously with an increase in the activity of their disease. The hair loss can be patchy or diffuse, and appear to be more like hair thinning.

There is no permanent cure for SLE. The goal of treatment is to relieve symptoms and protect organs by decreasing inflammation and/or the level of autoimmune activity in the body. Many patients with mild symptoms may need no treatment or only intermittent courses of anti inflammatory medications. Those with more serious illness involving damage to internal organ(s) may require high doses of corticosteroids in combination with other medications that suppress the body’s immune system.

Patients with SLE need more rest during periods of active disease. Researchers have reported that poor sleep quality was a significant factor in developing fatigue in patients with SLE. These reports emphasize the importance for patients and physicians to address sleep quality and the effect of underlying depression, lack of exercise, and self-care coping strategies on overall health. During these periods, carefully prescribed exercise is still important to maintain muscle tone and range of motion in the joints.
Overall, the outlook for patients with systemic lupus is improving each decade with the development of more accurate monitoring tests and treatments.

The role of the immune system in causing diseases is becoming better understood through research. This knowledge will be applied to design safer and more effective treatment methods. For example, completely revising the immune system of patients with extremely aggressive treatments that virtually temporarily wipe out the immune system is being evaluated. Current studies involve immune eradication with or without replacement of cells that can re-establish the immune system with stem cell transplantation.

Patients with SLE are at a somewhat increased risk for developing cancer. The cancer risk is most dramatic for blood cancers, such as leukemia and lymphoma, but is also increased for breast cancer. This risk probably relates, in part, to the altered immune system that is characteristic of SLE.

Women with SLE appear to be at increased risk for heart disease (coronary artery disease) according to recent reports. Women with SLE should be evaluated and counseled to minimise risk factors for heart disease, such as elevated blood cholesterol, quitting smoking, high blood pressure and obesity.
Individuals with SLE can improve their prognosis by learning about the many aspects of the illness as well as closely monitoring their own health with their doctors

Dr. Robert Lahita, a renowned lupus specialist and the author of Women and Autoimmune Disease says Jackson’s signature fashion statement, his glove, may have been a sign of his battle with lupus.
“Walking around with an umbrella, wearing a glove on one hand, or both hands, is more than appropriate, it is the recommended form of behaviour for a patient that has an autoimmune disease like Lupus”, explains Lahita.
He says Jackson’s use of a wheelchair may have been the result of chronic aching of the joints.

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Q: My doctor told me I have cervical spondylosis and that I will have to wear a cervical collar. This is very cumbersome. Please explain how it is caused and what happens if I don’t wear it, and whether there are any drugs to treat this.
W.E. Seneviratne, Angoda
A: Cervical spondylosis is caused by chronic wearing away (degeneration) of the cervical spine, including the cushions between the neck vertebrae (cervical disks) and the joints between the bones of the cervical spine. There may be abnormal growths or “spurs” on the the bones of the spine (vertebrae).
These changes caused by degeneration can, over time, press down on one or more of the nerve roots. In advanced cases, the spinal cord becomes involved

The goal of treatment is to relieve pain and prevent permanent spinal cord and nerve root injury. A cervical collar is worn for a short period of time to restrict motion and so, it is essential that you wear it. Other treatments include steroid drugs given as injections for more severe cases, and has side effects. So in this case, you will have to put up with the temporary discomfort and wear it for a short time.

Q: I crave chocolate everyday. Is this normal or an addiction?
Shyamalie Fernando, 24 years, Katunayaka
A: Chocolate cravings can be driven by the change in balance of hormones in a woman’s monthly cycle. That same flux can contribute to the periodic acne that some women experience. Chocolate and other food cravings are part of a larger serotonin issue and is quite normal

According to research, one reason that people might crave chocolate is that it has some amphetamine-like properties. Also it is said, the cannabinoid-like fatty acids mimic the effects of marijuana, producing euphoria which is not harmful.
Five hundred years ago, Spanish conquistadors called chocolate the “food of the gods”, when they first discovered it in South America. That kind of reverential attitude hasn’t altered much over the centuries.
So when you crave a chocolate don’t feel too guilty, it is your hormornes and not addiction. But just also remember that, even though cocoa powder in itself is intrinsically low in calories, all the added ingredients that help make it so tasty are high in caloric content, fat and cholesterol

Also remember that as humans, we have the willpower to resist our cravings, and that we don’t have to give into them all the time. Try eating a fruit such as a plantain, when you get the craving for chocolate.
NUTRIENTS IN ONE OUNCE OF MILK CHOCOLATE:
147 Calories
2 g Protein
9 g Fat
16 g Carbohydrate
65 mg Calcium
65 mg Phosphorus

Q: My 16-yr-old daughter has what is described as a strawberry nevus on her upper lip. Its growth reached its peak when she was about 7-yrs-old. It has reduced very slowly over the last 9 yrs to about 2/3rds of this size. Is there any treatment other than surgery available today.
A: There are a few laser devices which can be used to treat this type of lesion. Your daughter should see a plastic surgeon who has experience with these lasers, to see if any of them would be appropriate for her “nevus”. I believe the proper term would be strawberry hemangioma, rather than strawberry nevus. Whomever she sees should discuss the potential risks and complications with her.

usha.perera@gmail.com

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Improving Mental Health facilities

News that steps were being taken at last to improve facilities and strengthen services in the area of Mental Health is really heartening. The statement by Director- Mental Healthcare, Ministry of Health, Dr Lakshmi Somatunge, at the recent National Mental Health Forum last week, comes at a time when the number of persons suffering from mental diseases worldwide and in this country is increasing at a frightening pace. This is hardly surprising, considering the immense problems both young and old face today in a world of conflict and violence, compounded by disintegrating families and family values, not forgetting the economic crunch that has mentally traumatised rich and poor alike.

As Dr Mehta, WHO local representative, pointed out at the forum, that Mental Heath has been a neglected aspect of the Health sector all over the world. This was in spite of the fact that over 450 million people suffer from mental illnesses- 33% of such illnesses being due to disabilities caused by non communicable diseases and 7% alcohol related. A total of one out of four persons are said to be afflicted with some form of mental disorder worldwide.

With thousands of war victims living in camps in this country, and the paucity of good counselling services available to them, as well as troubled youth living with drugs, there is bound to be an upsurge of mental ill health. The fact that we now have only one main institution at Mulleriyawa to look after extreme cases, reiterates the need to train more psychiatrists, and enlist more trained counsellors to help them.

What the Mental Health Director has in mind for improving our Mental Health facilities is a practical solution: Developing Community Support Centres. These will be important milestones to alcohol control, suicide prevention and other Mental Health related social problems.

Bottle-feeding puts babies at risk

New research has found that mothers who bottle-feed their infants put them at risk to a number of infant milk formula errors. These risks include: too high concentrations of formula; changing brands too often and changing time of feeds.
High concentration of feeds can lead to obesity while babies not receiving enough formula milk can risk becoming underweight and malnourished.

The researchers also found that lack of information on formula feeding for infants to new mothers was another drawback.
A Comprehensive Infant Feeding Survey from 2005 conducted in England showed that, while 78% of mothers initiated breastfeeding, only 48% exclusively breastfed their babes, stopping after six months or less. The survey also found that half of the mothers who prepared powdered infant formula, didn’t follow key recommendations aimed at reducing risk of infection, over concentration of feeds and said that mistakes were“ common”.

In addition to short term issues of hygiene and safety, it can later lead to overfeeding and rapid infant weight and later obesity.
Breast milk still is regarded as the best milk for infants and breastfeeding is said to be more regulated, more hygienic, besides forging closer bonding between mother and child. Frequent changes in formula have been cited when babies regurgitate or have colic or are constipated or cry excessively. Mothers who change formula were also cited as doing so on their own without a proper doctor’s recommendation, which further compounded their infant’s health risks.

Fortunately, the number of breastfeeding mothers in Sri Lanka has increased to 80 % or more due to a vigorous awareness programme of the Health Ministry. However, authorities are concerned that the dropout rate is still high as many stop breastfeeding after 6 months, exposing their children to diarrhoeal related illnesses, among others.

Dengue control is public’s duty

Healthcare & Nutrition Minister and the WHO rep recently emphasised the need for the public to step in and curb the spread of Dengue, with over 17,000 cases being reported since January this year. Since the Dengue carrying vector can fly only up to half-a-mile, it is essentially a neighbourhood disease and can be effectively controlled by keeping one’s neighbourhood free of mosquito breeding sites, sources said. Good news is that there seems to be a decline in the number of Dengue deaths, with just one reported last week, Health sources said.

Brain facts

Do you know that a simple habit like missing your breakfast or overeating could lead to brain damage?
Following are habits that could increase risk of brain damage:
1. No breakfast
Recent researchers have found that people who don’t take breakfast will have a lower blood sugar level. This leads to an insufficient supply of nutrients to the brain causing brain degeneration.
2.Overeating
This causes hardening of the brain arteries, leading to a decrease in mental power.
3. Smoking
Causes multiple brain shrinkage and may lead to Alzheimer’s disease.
4. High sugar consumption
Too much sugar will interrupt absorption of proteins and nutrients causing malnutrition, and may interfere with brain development.
5. Air Pollution
The brain is the largest oxygen consumer in the body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.
6. Covering head while sleeping
Sleeping with head covered increases the concentration of carbon dioxide and decreases concentration of oxygen, and may have damaging effects on the brain.
7. Working hard or studying during illness
Working hard or studying with sickness may lead to decrease in effectiveness of the brain and damage it.
8. Lack of stimulating thoughts
Thinking is the best way to train our brain. Lacking in brain stimulation may cause brain shrinkage.

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