Bold Wish

The deep grays of winter
are bursting to green
the soft glow of sunshine
starts warming to spring

That cold winter past
Just sad memories
with jumbled new life
exploding new trees

as seasons progress
so do our souls
hardened cold hearts
to rekindled coals

As old love is lost
where twisted branch grew
a space to be filled
with life that's as new

These cycles of seasons
They go ever on
shining sweet face
replaced sad one gone

Hearts seem as seasons
in our history of years
summer to fall
and joy into tears

Pray grant me partner
that blows hot nor cold
but steady she steers
dare I wish this so bold ?

Lumbar Back Sprains and Strains

Most people will experience back pain during their lifetime. Some patients fear the worst, especially when pain is severe. Although back pain can be caused by fracture, disc disorder, or tumor, the most common cause is sprain or strain.

Sprains and strains often result from excessive physical demands on the back. Lifting something too heavy, a sudden fall, car crash, or sports injury can cause soft tissues (ligaments, muscles, tendons) to stretch too much.

Sprains · Strains
The spine includes vertebrae (bones), discs (cartilaginous pads or shock absorbers), the spinal cord and nerve roots (neurological wiring system), and blood vessels (nourishment). Ligaments link bones together, and tendons connect muscles to bones and discs. The ligaments, muscles, and tendons work together to handle the external forces the spine encounters during movement, such as bending forward and lifting.

Sprains and strains are similar disorders affecting different soft tissues in the spine. Sprains are limited to ligaments whereas strains affect muscles, tendons, or muscle-tendon combinations.

Ligaments are strong flexible bands of fibrous tissue. Although ligaments are resistant to being stretched, they do allow some freedom of movement. Muscle is made up of individual and segmental strands of tissue. When back muscles encounter excessive external force, individual strands can stretch or tear while the rest of the muscle is spared injury.

To illustrate a sprain or strain, consider what happens when lifting something heavy. Initially muscles are recruited to manage the load. When the load or force exceeds the muscles' ability to cope, the force is shared with the ligaments. When a ligament is stressed beyond its strength, it can tear.

Local tissues swell when ligaments, muscles, tendons, or combination's become overstretched, overused, or torn. Swelling causes pain, tenderness, and stiffness; swelling serves to protect the injured back by restricting movement - similar to a splint on a broken leg.

Back pain also known "dorsalgia"

Back pain (also known "dorsalgia") is pain felt in the back that usually originates from the ,muscles, nerves, bones, joints or other structures in the spine.

The pain can often be divided into neck pain, upper back pain, lower back pain or tailbone pain. It may have a sudden onset or can be a chronic pain; it can be constant or intermittent, stay in one place or radiate to other areas. It may be a dull ache, or a sharp or piercing or burning sensation. The pain may be felt in the neck (and might radiate into the arm and hand), in the upper back, or in the low back, (and might radiate into the leg or foot), and may include symptoms other than pain, such as weakness, numbness or tingling.

Back pain is one of humanity's most frequent complaints. In the U.S., acute low back pain (also called lumbago) is the fifth most common reason for physician visits. About nine out of ten adults experience back pain at some point in their life, and five out of ten working adults have back pain every year.

The spine is a complex interconnecting network of nerves, joints, muscles, tendons and ligaments, and all are capable of producing pain. Large nerves that originate in the spine and go to the legs and arms can make pain radiate to the extremities.

Back pain can be divided anatomically:neck pain, upper back pain, lower back pain or tailbone pain.

Associated conditions

Back pain can be a sign of a serious medical problem, although this is not most frequently the underlying cause:

• Typical warning signs of a potentially life-threatening problem are bowel and/or bladder incontinence or progressive weakness in the legs.
• Severe back pain (such as pain that is bad enough to interrupt sleep) that occurs with other signs of severe illness (e.g. fever, unexplained weight loss) may also indicate a serious underlying medical condition.
• Back pain that occurs after a trauma, such as a car accident or fall may indicate a bone fracture or other injury.
• Back pain in individuals with medical conditions that put them at high risk for a spinal fracture, such as osteoporosis or multiple myeloma, also warrants prompt medical attention.
• Back pain in individuals with a history of cancer (especially cancers known to spread to the spine like breast, lung and prostate cancer) should be evaluated to rule out metastatic disease of the spine.

Back pain does not usually require immediate medical intervention. The vast majority of episodes of back pain are self-limiting and non-progressive. Most back pain syndromes are due to inflammation, especially in the acute phase, which typically lasts for two weeks to three months.

A few observational studies suggest that two conditions to which back pain is often attributed, lumbar disc herniation and degenerative disc disease may not be more prevalent among those in pain than among the general population, and that the mechanisms by which these conditions might cause pain are not known. Other studies suggest that for as many as 85% of cases, no physiological cause can be shown.

A few studies suggest that psychosocial factors such as on-the-job stress and dysfunctional family relationships may correlate more closely with back pain than structural abnormalities revealed in x-rays and other medical imaging scans.

Treatment

The management goals when treating back pain are to achieve maximal reduction in pain intensity as rapidly as possible; to restore the individual's ability to function in everyday activities; to help the patient cope with residual pain; to assess for side-effects of therapy; and to facilitate the patient's passage through the legal and socioeconomic impediments to recovery. For many, the goal is to keep the pain to a manageable level to progress with rehabilitation, which then can lead to long term pain relief. Also, for some people the goal is to use non-surgical therapies to manage the pain and avoid major surgery, while for others surgery may be the quickest way to feel better.

Not all treatments work for all conditions or for all individuals with the same condition, and many find that they need to try several treatment options to determine what works best for them. The present stage of the condition (acute or chronic) is also a determining factor in the choice of treatment. Only a minority of back pain patients (most estimates are 1% - 10%) require surgery.

Short-term relief

• Heat therapy is useful for back spasms or other conditions. A meta-analysis of studies by the Cochrane Collaboration concluded that heat therapy can reduce symptoms of acute and sub-acute low-back pain. Some patients find that moist heat works best (e.g. a hot bath or whirlpool) or continuous low-level heat (e.g. a heat wrap that stays warm for 4 to 6 hours). Cold compression therapy (e.g. ice or cold pack application) may be effective at relieving back pain in some cases.

• Use of medications, such as muscle relaxants, opioids, non-steroidal anti inflammatory drugs (NSAIDs/NSAIAs) or paracetamol (acetaminophen). A meta-analysis of randomize controlled trials by the Cochrane Collaboration found that injection therapy, usually with corticosteroids, does not appear to help regardless of whether the injection is facet joint, epidural or a local injection. Accordingly, a study of intramuscular corticosteroids found no benefit.

• Massage therapy, especially from an experienced therapist, can provide short term relief. Acupressure or pressure point massage may be more beneficial than classic (Swedish) massage.

Conservative treatments

• Exercise can be an effective approach to reducing pain, but should be done under supervision of a licensed health professional. Generally, some form of consistent stretching and exercise is believed to be an essential component of most back treatment programs. However, one study found that exercise is also effective for chronic back pain, but not for acute pain. Another study found that back-mobilizing exercises in acute settings are less effective than continuation of ordinary activities as tolerated.

• Physical therapy consisting of manipulation and exercise, including stretching and strengthening (with specific focus on the muscles which support the spine), often learned with the help of a health professional, such as a physical therapist. Physical therapy may be especially effective when part of a 'work hardening' program, or 'back school'.

• A British edical journa trial found that the The Alexander techniques was shown in to have long term benefits for patients with chronic back pain.. A subsequent review concluded that 'a series of six lessons in Alexander technique combined with an exercise prescription seems the most effective and cost effective option for the treatment of back pain in primary care'.

• Manipulation, as provided by an appropriately trained and qualified chiropractor, osteopath, physical therapist, or a psychiatrist. Studies of the effect of manipulation suggest that this approach has a benefit similar to other therapies and superior to placebo.

• Acupuncture has some proven benefit for back pain; however, a recent randomized controlled trials suggested insignificant difference between real and sham acupuncture

• Education, and attitude adjustment to focus on psychological or emotional causes -respondent-cognitive therapy and progressive relaxation therapy can reduce chronic pain.

Surgery

Surgery may sometimes be appropriate for patients with:

• Lumbar disc herniation or Disgenerative disc disease
  
• Spinal stenosis from Lumbar disc herniation, degenerative joint disease, or spondilolisthesis
  
• Scoliosis
  
• Compression fracture
  

Emerging treatments

• Vertebroplasty involves the percutaneous injection of surgical cement into vertebral bodies that have collapsed due to compression fractures. This new procedure is far less invasive than surgery, but may be complicated by the entry of cement into Batson's plexus with subsequent spread to the lungs or into the spinal canal. Ideally this procedure can result in rapid pain relief.
• The use of specific biologic inhibitors of the inflammatory cytokine tumor necrosis factor-alpha may result in rapid relief of disc-related back pain.

Treatments with uncertain or doubtful benefit

• Injections, such as epidural steroid injections and facet joint injections, may be effective when the cause of the pain is accurately localized to particular sites. The benefit of prolotherapy has not been well-documented.

• Cold compression therapy is advocated for a strained back or chronic back pain and is postulated to reduce pain and inflammation, especially after strenuous exercise such as golf, gardening, or lifting. However, a meta-analysis of randomized controlled trials by the Cochrane Collaboration concluded "The evidence for the application of cold treatment to low-back pain is even more limited, with only three poor quality studies located. No conclusions can be drawn about the use of cold for low-back pain"

• Bed rest is rarely recommended as it can exacerbate symptoms, and when necessary is usually limited to one or two days. Prolonged bed rest or inactivity is actually counterproductive, as the resulting stiffness leads to more pain.

• Electrotherapy, such as a transcutaneous electrical nerve stimulation (TENS) has been proposed. Two randomized controlled trials found conflicting results. This has led the Cochrane Collaboration to conclude that there is inconsistent evidence to support use of TENS. In addition, spinal cord stimulation, where an electrical device is used to interrupt the pain signals being sent to the brain and has been studied for various underlying causes of back pain.

• Inversion therapy is useful for temporary back relief due to the traction method or spreading of the back vertebres through (in this case) gravity. The patient hangs in an upside down position for a period of time from ankles or knees until this separation occurs. The effect can be achieved without a complete vertical hang ( 90 degree) and noticeable benefits can be observed at angles as low as 10 to 45 degrees.
  

• Body Awareness Therapy such as the Feldenkrais Method has been studied in relation to Fibromyalgia and chronic pain and studies have indicated positive effects. Organized exercise programs using these therapies have been developed.

• Ultrasound has been shown not to be beneficial and has fallen out of favor.

Low-Carb Fruit: Lists of the Best and Worst

Fruit is an area where some of the low-carb diets part company, as some depend more upon glycemic index or glycemic load (South Beach, Zone), while others just look at total carbs (Atkins, Protein Powder). Also, some diets (Atkins, South Beach) don�t allow fruit at all in the first phase. In general, your best bet fruits are the ones near the top of this list, but do check carb counts. These are roughly arranged by sugar content - where the information is available, based on a half-cup serving of fruit.

Good news: the fruits lowest in sugar are some of the highest in nutritional value, including antioxidants and other phytonutrients.

If you are considering using organic vegetables, check out this list of which fruits and vegetables have the most and least pesticides to help you guide your choices.

Fruits Lowest in Sugar

• Small Amounts of Lemon or Lime
  
  
• Rhubarb
  
  
• Raspberries
  
  
• Blackberries
  
  
• Cranberries
  
  

Fruits Low to Medium in Sugar

• Strawberries
  
  
• Casaba Melon
  
  
• Papaya
  
  
• Watermelon
  
  
• Peaches
  
  
• Nectarines
  
  
• Blueberries
  
  
• Cantaloupes
  
  
• Honeydew Melons
  
  
• Apples
  
  
• Guaves - Pineapple Guavas (Feijoa) and Strawberry Guavas are probably similar, but information that directly compares them is not available
  
  
• Apricots
  
  
• Grapefruit
  
  

Fruits Fairly High in Sugar

• Plums
  
  
• Oranges
  
  
• Kiwifruit
  
  
• Pears
  
  
• Pineapple
  
  

Fruits Very High in Sugar

• Tangerines
  
  
• Cherries
  
  
• Grapes
  
  
• Pomegranates
  
  
• Mangos
  
  
• Figs
  
  
• Bananas
  
  
• Dried Fruit, such as
  
  
  
  • Dates
    
    
  • Raisins
    
    
  • Dried Apricots
    
    
  • Prunes
    

How Much Protein Do You Need?

What is protein?

Protein is one of the basic building blocks of the human body, being about 16 percent of our total body weight. Muscle, hair, skin, and connective tissue are mainly made up of protein. However, protein plays a major role in all of the cells and most of the fluids in our bodies. In addition, many of our bodies' important chemicals -- enzymes, hormones, neurotransmitters, and even our DNA -- are at least partially made up of protein. Although our bodies are good at “recycling” protein, we use up protein constantly, so it is important to continually replace it.

Proteins are made up of smaller units called amino acids. Our bodies cannot manufacture nine amino acids, so it is important to include all these amino acids in our diets. Animal proteins such as meat, eggs, and dairy products have all the amino acids, and many plants have some of them.

How much protein do we need?

Our protein needs depend on our age, size, and activity level. The standard method used by nutritionists to estimate our minimum daily protein requirement is to multiply the body weight in kilograms by .8, or weight in pounds by .37. This is the number of grams of protein that should be the daily minimum. According to this method, a person weighing 150 lbs. should eat 55 grams of protein per day, a 200-pound person should get 74 grams, and a 250-pound person, 92 grams.

Do people who exercise need more protein?

Although it is controversial, there is evidence that people engaging in endurance exercise (such as long distance running) or heavy resistive exercise (such as body building) can benefit from additional protein in their diets. One prominent researcher in the field recommends 1.2 to 1.4 grams per kilogram of body weight per day for endurance exercisers and 1.7 to 1.8 grams per kg per day for heavy strength training.

But shouldn’t protein intake be a percentage of total calories?

Quite a few programs and nutritionists quote percentage of calories, usually in the range of 10 percent to 20 percent, as a way to figure out how much protein a person needs to consume daily. This is a rough estimate of a person's minimum protein needs. It works because usually larger and more active people need more calories, so the more calories they need, the more protein they will get.

Where this falls down is when people are eating diets which are lower in calories for any reason, conscious or not. People who are ill or losing weight, for example, do not need less protein just because they are eating fewer calories.

What happens if we don’t eat enough protein?

Unlike fat and glucose, our body has little capacity to store protein. If we were to stop eating protein, our body would start to break down muscle for its needs within a day or so.

Is it OK to eat a lot more protein than the minimum recommendations?

This is the crucial question for people on diets which are higher in protein than usual, as low-carb diets tend to be. In a review of the research, the National Academy of Sciences reported that the only known danger from high protein diets is for individuals with kidney disease. After careful study, they recommend that 10 percent to 35 percent of daily calories come from protein. They point out that increased protein could be helpful in treating obesity. There is also accumulating evidence that extra protein may help prevent osteoporosis.

Extra protein can be broken down into glucose in a process called gluconeogenesis. On low carb diets, this happens continually. One benefit of obtaining glucose from protein is that it is absorbed into the bloodstream very slowly, so it doesn’t cause a rapid blood sugar increase.

What foods have the most protein?

Meat, fish, eggs, dairy products, legumes, and nuts all have substantial amounts of protein.

Migraine

What Makes a Headache a Migraine?

Almost everyone gets headaches. You might feel throbbing in the front of your head during a cold or bout with the flu, for example. Or you might feel pain in your temples or at the back of your head from a tension headache after a busy day. Most regular headaches produce a dull pain around the front, top, and sides of your head, almost like someone stretched a rubber band around it.

A migraine is different. Us doctors define it as a recurrent headache that has additional symptoms. The pain is often throbbing and on one or both sides of the head. People with migraines often feel dizzy or sick to their stomachs. They may be sensitive to light, noise, or smells. Migraines can be disabling, and teens with migraines often need to skip school, sports, work, or other activities until they feel better.

If you have migraines, you are not alone. Experts estimate that up to 10% of teens and young adults in the United States get migraines. Before age 10, an equal number of boys and girls get migraines. But after age 12, during and after puberty, migraines affect girls three times more often than boys.

What Causes a Migraine?

Not all scientists agree about what causes migraines. Many believe that a migraine is caused by narrowing and expanding of the blood vessels in the brain. There are also theories that the level of certain chemicals in the brain may affect the nerve system that regulates pain.

Whatever the cause, experts do agree that different things trigger (set off) migraines in people who have them. For some people, eating certain foods brings on a migraine. Others find that sleeping too long (or too little) provokes a migraine attack.

Some common migraine triggers are:

• stress
• menstruation
  
• skipping meals
• too much caffeine
• certain foods (alcohol, cheese, pizza, chocolate, ice cream, fatty or fried food, lunch meats, hot dogs, yogurt, aspartame, or anything with MSG, a seasoning often used in Asian foods)
• sudden changes in sleep patterns
• changes in hormone levels
• smoking
• weather changes
• travel

Experts believe that the likelihood of getting migraines is inherited. If one of your parents gets migraines, you have a greater chance of having these types of headaches than someone who doesn't have a family history of migraines.

What's a Migraine Attack Like?

Most migraines last from 30 minutes to 6 hours; some can last a couple of days.

Every migraine begins differently. Some people just don't feel right. Light, smell, or sound may bother them or make them feel worse. Sometimes, if they try to continue with their usual routine after the migraine starts, they may become nauseated and vomit. Often the pain begins only on one side of the head. Trying to perform physical activities may worsen the pain.

Some people get auras, a kind of warning that a migraine is on the way. The most common auras include blurred vision and seeing spots, colored balls, jagged lines, or bright or flashing lights or smelling a certain odor. The auras may only be seen in one eye. An aura usually starts about 10 to 30 minutes before the start of a migraine. Some individuals experience a migraine premonition hours to days prior to the actual headache. This is slightly different from auras and may cause cravings for different foods, thirst, irritability, or feelings of intense energy.

Some people with migraines also have muscle weakness, lose their sense of coordination, stumble, or even have trouble talking either just before or while they have a headache.

How Do Doctors Diagnose and Treat Migraines?

Because migraine headaches are different in different people — in some people, for example, they are triggered by hormones; in others, stress and lifestyle influence headaches — how doctors treat someone depends on the type of migraine that person gets.

A doctor may ask someone having migraines to keep a headache diary to help figure out what triggers the headaches. If your doctor has asked you to keep such a diary, the information you record will help the doctor figure out the best treatment. A doctor may also take blood tests or imaging tests, such as a CAT scan or MRI of the brain, to rule out medical problems that might cause a person's migraines.

Part of treatment may involve making certain changes in your lifestyle — like changing your sleep patterns or dietary habits or avoiding certain stress that trigger your migraines. Your doctor may also start you on a pain relief medication or also prescribe medicines that help with nausea and vomiting. Some people need preventive medicines that are taken every day to reduce the number and severity of the migraines.

Some doctors teach a technique called biofeedback to their patients with migraines. This technique helps a person learn to relax and use the brain to gain control over certain body functions (like heart rate and muscle stress) that cause tension and pain. If a migraine begins slowly, many people can use biofeedback to remain calm and stop the attack.

There have also been studies indicating that some alternative methods, such as acupuncture and the use of certain herbs, can help some people. However, it is important to ask your physician about alternative medicines before trying them for yourself. This is especially true of herbal treatments because they can interfere with more traditional methods of treatment.

List of High-Protein Foods and Amount of Protein in Each

Shortcut: An ounce of meat or fish has approximately 7 grams of protein.

Beef

• Hamburger patty, 4 oz – 28 grams protein
• Steak, 6 oz – 42 grams
• Most cuts of beef – 7 grams of protein per ounce

Chicken

• Chicken breast, 3.5 oz - 30 grams protein
• Chicken thigh – 10 grams (for average size)
• Drumstick – 11 grams
• Wing – 6 grams
• Chicken meat, cooked, 4 oz – 35 grams

Fish

• Most fish fillets or steaks are about 22 grams of protein for 3 ½ oz (100 grams) of cooked fish, or 6 grams per ounce
• Tuna, 6 oz can - 40 grams of protein

Pork

• Pork chop, average - 22 grams protein
• Pork loin or tenderloin, 4 oz – 29 grams
• Ham, 3 oz serving – 19 grams
• Ground pork, 1 oz raw – 5 grams; 3 oz cooked – 22 grams
• Bacon, 1 slice – 3 grams
• Canadian-style bacon (back bacon), slice – 5 – 6 grams

Eggs and Dairy

• Egg, large - 6 grams protein
• Milk, 1 cup - 8 grams
• Cottage cheese, ½ cup - 15 grams
• Yogurt, 1 cup – usually 8-12 grams, check label
• Soft cheeses (Mozzarella, Brie, Camembert) – 6 grams per oz
• Medium cheeses (Cheddar, Swiss) – 7 or 8 grams per oz
• Hard cheeses (Parmesan) – 10 grams per oz

Beans (including soy)

• Tofu, ½ cup 20 grams protein
• Tofu, 1 oz, 2.3 grams
• Soy milk, 1 cup - 6 -10 grams
• Most beans (black, pinto, lentils, etc) about 7-10 grams protein per half cup of cooked beans
• Soy beans, ½ cup cooked – 14 grams protein
• Split peas, ½ cup cooked – 8 grams

Nuts and Seeds

• Peanut butter, 2 Tablespoons - 8 grams protein
• Almonds, ¼ cup – 8 grams
• Peanuts, ¼ cup – 9 grams
• Cashews, ¼ cup – 5 grams
• Pecans, ¼ cup – 2.5 grams
• Sunflower seeds, ¼ cup – 6 grams
• Pumpkin seeds, ¼ cup – 19 grams
• Flax seeds – ¼ cup – 8 grams