The Protection of a Man

 / By Dr. Margaret Aranda

Just a simple rule in life that we need to tell our children. 

Because I have heard too many stories.

We should each strive to be positive and loving at all times. 

~ Let us Shine! ~

Invisible Illnesses: ME/CFS and "Systemic Exertion Intolerance Disease"

#DrMargaretAranda / In dedication to Luminescentfeeling Across the Pond and Still Oh! So Fond! 

Is Myalgic Encephalomyopathy / Chronic Fatigue Syndrome (ME / CFS) a "real" illness? For decades, doctors questioned its existence (See Image 1).

Image 1. The Full Circle of Redefinition. After years of neglect and stigma, we now have come full circle. Some professionals still use "ME / CFS" as a specific term, with a newer term, "SEIDOR" it is being used more generally to include other Diseases such as Lyme's disease  (CFS = chronic fatigue syndrome, ME = myalgic encephalopathy; SEIDOR = exertion intolerance systemic disease). 

The Harm.  Today, some doctors say:

• "I do not Believe in it." 
• ... I have not even "heard of it." 
• Think, "If I have not heard of it, than it must not exist . Therefore, the you are faking it. You are malingering."    
• "You need a psychiatrist."

... And do not feel alone. Millions of additional Hasta with other "Invisible illnesses" hear the same words. 

That's the shriek, shock and shame of some of today's health care.  Imagine yourself going to the Emergency. Envision the doctors en masse that repeatedly apply this phrase we all grow to hate (ie, patients with an Invisible Illness): "it's all in your head " (See Image 2).

Image 2. "It's All in Your Head." But now, guess what, Mrs. Gomez? And guess what you'll be glad to hear, Mr. Lee? It's not  'all in your head.' Luminescentfeeling  was right all along. Image Courtesy Google Search. 

The Diagnosis.  Sure patients present with elusive SYMPTOMS such as fatigue, sleeplessness, "brain fog," dysfunction of the autonomic nervous system, pain and other neurologic signs. These gleefully rampage the human body without warning or token, in a vibrant trading life for one with virtually no quality of life to be found. Now, that is not elusive to the patient. T he human mind is traumatized not only by the illness, but by the manner of disrespect and lack of compassion that is repeatedly inflicted by the medical field ... and than another trigger occurs in an instant, sending shivers and shakes of Post-Traumatic stress Disorder (PTSD), shattering through the mind and body as yet another Emergency Room doctor stares blankly at the patient, assessing that surely she is inordinately insane.     

After a February 10, 2015 multi-institutional effort was convened, the world did not know (and still does not) that 'ME / CFS' was to be  rocked to the core by multiple 'Big Boys' of the Institute of Medicine (IOM ). They were mandated to meet, confer, conclude, and advise on the answers to solve the problems of ME / CFS - after reviewing 65 years of CFS research described in over 9,000 scientific literature Manuscripts. Wow, right?   

- What did this grand Report show?   

• "Between 836 000 and 2.5 million Americans ..." have it
• About 250,000 were Diagnosed with it Britians
• Sigma is attached to the disease

Words of the NIH Director Francis S. Collins, MD, PhD:

"Of the many mysterious human illnesses that science has yet to unravel, ME / CFS has proven to be one of the most challenging"

• Symptoms "... made worse by exertion of any sort " 
• Publication of a 20-page Clinician's Guide
• A new diagnostic algorithm
• A new list of diagnostic criteria
• A Power-Point slide compendium for doctors to use for awareness and knowledge
• The dedication of Increased funding to research into this disease process

The Future.  For example, Stanford Medicine (my alma mater for anesthesiology and critical care, so okay, I may not be strictly objective here) has instituted the Stanford Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME / CSF) Initiative  as a multi-disciplinary effort of grand proportions. Their focus is on leadership, research, and education. Specifically:

"Our primary aim is to study the roles that infection and the immune response play in the Symptoms of Patients suffering from chronic, unexplained Diseases."  (Author's emphasis). See Image 3.     

Stanford's Initiative offers worldwide opportunities.  For patients who live in the San Francisco Bay area, one can  participate in clinical research . Worthwhile reads are both the Stanford ME / CFS Initiative Newsletter  and an incredibly exhaustive list of Patient Resources and information for ME / CFS here.  

Image 3 Stanford University's ME / CFS Initiative: Explaining Invisible illnesses as Infectious Diseases.  Work done by other scientists Frissora and Koch (2) and Chia and Chia (3) have tied stomach enterovirus infection to Celiac disease and Resulting CFS. Lerner et al ( 4) also showed improved outcome in Patients with CFS and individual AntiVirus Biomarkers like herpesvirus who were treated with antivirus medications. (CFS = chronic fatigue syndrome, ME = myalgic encephalomyelitis.)

"The power of the bugs remains to be fully seen."  Dr. Margaret Aranda

And where does all of this leave us now? With hope.  The hope is that ME / CFS can achieve a respectable place in physician and community acceptance, as a valid disease without the stigma of mental distress and / PTSD. And the real hope ? it is always for a cure. Read more about this with Joseph Montoya  who describes the hopeful promises that could lie ahead. 

Have hope. Do not let anyone ever take that away from you.  They do not even ... know who 'you' are.

Dr Margaret Aranda

And anyway, you live in the body. Only you know what it feels like (Image 4).

Image 4. The Power of the #rebelpatient (TM) . The patient can not be treated by a physician who never heard of the "Invisible Illness." She is Empowered to become the Stanford Medicine-X e-Patient . See #medx. 

~~~~~~~~~~~~~~~~~~~~~

* The Autonomic Nervous System (ANS)  controls all of one's Vital Signs: temperature, blood pressure, heart rate, and all the 'automatic' things one does not control such as standing up without fainting, eating food that goes through your stomach, holding urine in the the bladder without spilling it out at will, erecting the penis, holding stool in the rectum, sweating, breathing properly and more. Dysfunction of the ANS, also known as dysautonomia, is associated with syncope or fainting when standing upright.

I believe that Infectious Diseases have a more primary role in causing or worsening invisible illnesses. Since about 80% of our immunity, protection against bacteria and viruses, is located in the gut, I've been a proponent of #Immunonutrition.

We must view each bite of food as either killing or protecting us. 

Let's keep an open mind and continue to saturate our senses with good sense.

Thank you for reading my writings. 

Previously this article was printed on the infant, my Public Profile 
July 10, 2016

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References Cited in Stanford, Image 2.

1    Hickie et al., Post-infective and chronic fatigue Syndromes precipitated by viral and non-viral Pathogens: prospective cohort study.  BMJ. 2006 Sep 16; 333 (7568): 575. Epub 2006 Sep 1. 

2   Frissora CL  Koch KL . Symptom overlap and comorbidiy of irritable bowel syndrome with other conditions.  Curr Gastroenterol Rep. 2005 Aug; 7 (4): 264-71.

3   Chia JK ,  Chia MONTH . Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach.  J Clin Pathol. 2008 Jan; 61 (1): 43-8. Epub 2007 Sep 13.

4   Lerner AM, et al. Herpesvirus Subset-directed antiviral treatment of 142 patients with chronic fatigue syndrome.  Virus Adaptation and Treatment. May 2010: 2 47-57

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Copyright ©  2016, Aranda MD Enterprises. All rights reserved. Not meant as medical advice, treatment or cure. See your health care provider to get individual treatment. 

Stanford's Sean Mackey, MD, PhD, on "What is Pain?"

 / by Dr Margaret Aranda /


 Sean Mackey, MD, PhD gives a nice, concise definition of "Pain."

It is so nice to have #BackPainDay2016 and #StanfordPain and a LIVE Stream on 9/11.
Here's the link, to be aired from 10 am to 4 pm: stan.md/1Wb4cLS


And Thank You, #SeanMackeyMDPhD and #StanfordHealth

Smell Your Breath

 / by Dr Margaret Aranda /



 Yup. Smell your breath. Is it bad? That could be due to boiled eggs, garlic, onions or peridontitis. What is peridontitis?


Well, anytime you see a word with the ending or suffix "-itis," that means there's "inflammation" that could be deadly. The original medical derivation is from the Hebrew or Greek, who coined this medical condition, peridontitis.



Medical Conditions with a Word ending in "-itis:"

• Appendicitis - inflammation of the appendix. This can lead to phlegmon, abscess, diffuse peritonitis, gangrene or death. The Clinical Diagnosis may be made by ultrasound or CT
• Ulcerative Colitis - inflammation of the large intestine leading to ulcers, pus, mucous and diarrhea. Treatment options may include participation in an Inflammatory Bowel Disease (IBD) Management Program like that offered at Stanford Health Care IBD Program
• Retinitis pigmentosa - night blindness
• Glossitis -  swelling of the tongue (see Image 1)

Image 1. Glossitis is swelling of the tongue. What is the most common cause of tongue swelling? It is dentures. Does it hurt? The patient's Chief Complaint is tongue soreness. A common medical condition associated with this 'beefy' tongue is Vitamin 12 deficiency. Medical students will enjoy the clinical aspects here, Image Courtesy:  #StanfordMedicine25.

So Let's Talk about Peridontal Disease

Peridontitis is inflammation of the gum area around the teeth, the peridontis. A quick look at the American Academy of Peridontology article entitled, "How to Keep a Healthy Smile for Life" states this:

"What you may not realize is that oral health is not just important for maintaining a nice-looking smile and being able to eat corn on the cob."

Image 2. Quality of Life is a Part of Good Oral Health. A smile is important for giving a great First Impression. It also makes us feel happy inside. People with bad teeth don't usually smile brightly because they are embarrassed by their teeth. Fully 25% of people over age 65 have lost their teeth and put dentures in bubbly stuff every night when they sleep. While this generation looses all their teeth less so than previously, the medical profession is still weighing in to wrap their arms around all the bad diseases that lead to death and can be caused by "bad teeth."




Risks and Complications of Peridontitis in Older Adults:

• Gingivitis - swelling of the gums that can lead to peridontitis and loss of gum attachment, peridontal disease 
• Peridontitis - inflammation of the gum, leading to receeding gums and exposed teeth bases; this leads to tooth and jaw bone loss
• Heart disease - The Number One killer in the world
• Atherosclerosis - hardening of the arteries
• Decreased QoL - unable to actually smile
• Forgetfulness - may inhibit a good preventive dental schedule
• Stroke, or Cerebral Vascular Accident (CVA)
• Diabetes - usually associated with chronic metabolic syndrome and heart disease
• Dry mouth - decreased saliva as a lubricant disrupts the protective barrier to gums:teeth
• Arthritis - may have adverse effects onQoL, hindering: "Activities of Daily Living, Mobility, and Instrumental Activities" (i.e., brushing the teeth) as described in the historic 1983 article by Sidney Katz, MD (1924 - May 4, 2012) in the Journal of the American Geriatrics Society
• Cigarette smoking - toxic chemicals affect more than tooth color: QoL without a smile
• Financial Considerations - reduced income from any source may put dental care to the side
• Medications - may cause decreased saliva, due to unpredictable anticholinergic side effects
• Treatment for decreased saliva - mouth swishes, sugarless gum and even artificial saliva
• Postmenopausal women - increased risk of tooth decay and gum disease due to estrogen deficiency
• Postmenopausal women and osteoporosis - osteoporosis eats away at the bones and probably the teeth, too. Further research may show that taking Hormone Replacement Therapy (HRT) decreases gum and tooth disease

Dental Replacements

• Need - do we really need all the extreme dental work that is being given in America? I think it's time to increase our knowledge, given the voracity of dental hygiene 'un-knowledge.' I mean seriously, who talks about this topic? Doctors? I don't think doctors talk about nutrition or dental care nearly as much as they need to, given the debilitating chronic illnesses we suffer.
• Questioning the System -  For culture change purposes, I'm going to be radical here. Why? Because age management principles teach doctors to guide patients in nutrition, exercise and diet so they are predisposed to less risk of getting heart disease, diabetes, and a stroke. All at once. Every day, someone is going to the Emergency Room to discover, "WoW. I had a heart attack. And I'm diabetic and I didn't even know it." That's not acceptable in American medicine. We're just better at Preventive Medicine and obviously we are still falling short. To change this scenario now, you have to question not only every morsel you put in your mouth: you need to question how meticulous you are with your dental hygiene and gum care.
• Notes on Peridontitis - it's more common in patients with heart disease, diabetes and obesity. What the 'circle dynamics' show is that this is a vicious circle. You can stop it by paying attention to nutrition and meticulous dental care.

"I just don't want you to have a heart attack with bacteria in your teeth that goes up to your brain and throughout your entire body." -Dr Margaret Aranda

• Dentures -  they are less common in the aging population than in previous decades. The denture-wearing group requires high self-maintenance and not all the aging can do ADLs
• Dental Implants - don't need to use healthy, neighboring gums support a new implant. An implant is an artificial root to the tooth; it holds an artificial tooth or bridge in a way that leaves them synchronized with the gums and jaw bones. It feels more like a real tooth
• Facial Structure - loss of teeth leaves the jaw muscles and skin many changes in structure that add to aging and adversely affect nutrition, especially in our elders

In the coming weeks, I'll be taking a closer look at common dental practices, with a specific slant: the effects on patients with an Invisible Illness. Because there's just so much more to know. In the meantime, please increase vigilance to keep your mouth free from being a bacteria-Festival.

I mean, care for your mouth even moreso now. 

Try to clean up shop if you could and just see how you can build on improvements.

 - talk to your doctor and dentist about meticulous dental care. 

~ ~ ~ ~ ~ ~ 

Dr Margaret Aranda is a Stanford alumni of anesthesiology and critical care. She and her beautiful daughter were in a tragic 2006 car accident that left Dr Aranda with dysautonomia, vertebral artery dissection, and traumatic brain injury. 🎀Her daughter is just fine. Dr Margaret Aranda is a Public Figure in Patient Advocacy for Invisible Illnesses, Teens and Ethics.

These are her Books - Genre

No More Tears: A Physician Turned Patient Inspires Recovery - Memoir

Stepping from the Edge - Christian Living

Little Missy Two-Shoes Likes a Ladybug - Children's

Little Missy Two-Shoes Likes to Go to School - Children's 

Archives of the Vagina: A Journey through Time - Girl's and Women's Health

"I AM" The Cork of Life

 / By Dr. Margaret Aranda and William C. Ballard II /

# 316 BIG SKY 9-5-16

From the WCBI the GRACE OF PAINTINGS 

"I AM" the cork, in the drain of life that exists today. 

Deny that you., Deny life., God bless. "

~William C Ballard, II

Artist William C. Ballard II StartEd started painting this image after being aware that Dr Aranda is now spending quality time with a dying daughter. The continuing failure of Australian Hospice and Palliative Care delivery to Mother, Warrior and Beautiful 

Mandi Loren

exists as you read this heartfelt article and Dedication. And as William C Ballard, II Dedicates this Original Painting to Dr Margaret Aranda, so too Dr Aranda takes this in kind and in the same lovingkindness and compassionate consideration to bestow it upon 

Mandi Loren, 

also known as 

#MandiPandi

Today, Dr Margaret Aranda is doing what she can to help this precious lady who is not laying down in destitution, but who sits up straight with the Light of Godin her room. 

 #MandiPandi possesses conscious 

of extreme pain 

in her dying process.

Let us first be stimulated to look upon her as a human.

Then let us be aware of our own travesty 

in failing to provide

"Patient Dignity in Dying Alone"

Give us strength and character to fight for others in 

"Palliative Care" 

so this travesty

 should never happen again.

Let this one beautiful baby girl's life 

have purposes and meanings

so much further than our dreams. 

Let Us Pray: 

Let us take responsibility

To learn the meaning: True Charity 

Forgive our being too busy to care

Let us make others aware

that this "ain't the way to die."

~Dr Margaret Aranda

Prayers and supplications go up to God and Our Living Lord, and we ask that you join us 

in asking Our Maker to let us bear the burden of taking #MandiPandi's pain away so we may 

help 

relieve her 

of her sorrows 

in her last days. 

"Let not anyone depart this world 

with consciousness 

that it is a heartless and lonely place 

without compassion.

Don't let people be glad to die 

in order to find PEACE."

#DrMargaretAranda

To William C. Ballard, II and MandiPandi:

Finest shades of blue

Calming soothing hues

 Expression of Love 

Relief Dues above

 The leaks in cold society stare

 Big 'equalizer' of pain 

Natural forces of a drain

Stops us dry freezing pain

Mesmerized blue cork unrestrained

Give Mandi Peace

Garments of Wreaths
Bestow pain relief
Forge our disbelief
Exalt Your praises to greater seas

Calm whispy glitterin'
Glow gifts a flitterin'
Blue seagulls chirp
Mountains exerp 
The breeze of unleashed love from above.

~Dr Margaret Aranda

"Please take away Mandi's pain as she is truly in dire need during our last days. 

God Bless us all. Amen."

Note that artist William C Ballard, II likes to hide the numbers "143" inside. 

#MandiPandiProject    #LymeDisease   #StemCellResearch 
#Australia

Please stop and pray for Mandi now.