Thursday, 1 June 2017

June 2017: painkillers: risks and alternatives





Painkillers may seem a blessing, but we should never use them indiscriminately, and it's well worth checking whether there are other ways to face your pain.
There are basically three kinds of painkillers: paracetamol, opioids, and NSAIDs. They all have their downsides. Here are the reasons why we should try to avoid them as much as we can. 

Paracetamol or acetaminophen is an effective painkiller, but taxes the liver. It is extremely dangerous if combined with alcohol. For children, there is very poor evidence of fever relief. Giving kids calpol or similar, is not a good idea anyway - see [1].

Opioid painkillers, like codeine, are addictive, and hard to get off. Only one week of continual use can leave you enslaved.

Anti-inflammatories or NSAIDs (Non-Steroidal Anti-inflammatory Drugs) like aspirin and ibuprofen, damage the gut. Taking too many for too long, can lead to internal bleeding. If you have an ulcer, or any signs of digestive discomfort, the consequences could be serious [2]. 
Only recently, in March 2017, a Danish study led to calls for restrictions on the sale of ibuprofen, after they found it heightened the risk of cardiac arrest by 31%, with other NSAIDs presenting an even higher risk [3].
And did you know that aspirin and other fever-reducing medications actually suppress the production of antibodies, so that the infection lasts for up to 50% longer than it should? They inhibit the release of pyrogen, a substance that causes fever. And fever actually helps the body fight infections [4]. 

So we have to be very careful with painkillers. For 6 reasons, see [5].
For more detail about PARACETAMOL see [6].
More detail about OPIOIDS, and CODEINE more specifically, see [7]. 
For more detail about NSAIDs, see [8].

ALTERNATIVES
There is a marvellous general site about pain, well worth looking at for a start: [9].
You'll find plenty of non-drug therapies such as heat or cold, acupuncture, (breathing) exercise, yoga, massage etc: see [10]. For a herbal pain approach, see [11].
And did you know that 20 minutes of aerobic exercise is enough to stimulate the body to produce more endorphins - natural painkillers? And that our spit contains a painkiller more powerful than morphine: opiorphin? We have it only in minute quantities, so that we’re not off our heads all the time. Eating, though, releases more of the chemical and this may be a factor in comfort eating.



See also the New Scientist article 'Treating Chronic Pain' - click on the right hand side of this page. 




LAST but not LEAST: when it hurts, there is a reason. If all we can think of is to dull the hurt, we’ll never find the cause and it will persist and get worse. To deal with the cause, preferably in an early stage, we have to feel the pain. We have to respond to the feedback our bodies give us: when does it get better, when does it get worse? Does my food, my posture, stress or things I do, affect it? 

~~~

“People who view pain as the enemy instinctively respond with vengeance or bitterness–Why me? I don’t deserve this! It’s not fair! – which has the vicious-circle effect of making their pain even worse. “Think of the pain as a speech your body is delivering about a subject of vital importance to you,” I tell my patients. “From the very first twinge, pause and listen to the pain and, yes, try to be grateful. The body is using the language of pain because that’s the most effective way to get your attention.” I call this approach “befriending” pain: to take what is ordinarily seen as an enemy, and to disarm it, and then welcome it." (Pain: The Gift Nobody Wants’, Dr. Paul Brand)


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EAT
veg: broad beans, beet, cabbage, carrots, lettuce, new potatoes, artichokes, asparagus, broccoli, mangetout, peas, cauliflower, radish, spinach, spring onions, spring greens, watercress, kohlrabi, turnips, rhubarb, redcurrants, strawberries, gooseberries.
meat: lamb, wood pigeon [9].
fish: grey mullet, black bream, gurnard, pollock, whiting, mackerel, lobster, whelks, clams, cockles, coley, crabs, crayfish, flounder, grouper, gurnards, herring, megrim, scallops.

SOW:
beetroot, calabrese, lettuce, french beans, kale, carrots, cauliflower (mini only), salad onions, (sugar) peas, radish, kohlrabi, mooli, turnip, chicory, Florence fennel, courgettes and pumpkins.
Sow swede and sweetcorn in early June. If the soil is above 25°C, sow crisphead, cos or little Gem only.
Plant out: courgettes, cabbage, sprouting broccoli, sprouts, celery, celeriac, ridge cucumbers, runner/french beans, pumpkins, tomatoes, sweet corn.


RECIPES



BRAISED LETTUCE and PEAS for 1 or 2. 
2 tblsp butter, shallot thinly sliced, half a head of (cos) lettuce, ab. 150ml stock, 100g (frozen) peas
Chop lettuce into small pieces. Sauté shallot for a minute, add lettuce, sauté for another minute. Add stock, bring to a simmer.  Add peas, cook covered for a short while. Season if necessary. Garnish with for instance heavy cream, mint, grated carrots or lemon juice.

MARINATED LAMB'S HEART
A lovely cheap and easy dish, as long as you do some preparation   beforehand. Every lamb has a heart, so if you ask your butcher he may well come up with one, if only from the freezer.
450g lamb or beef hearts. For the marinade: 2 tblsp balsamic vinegar, 1 tsp salt, 1/2 tsp ground black pepper and 1tsp thyme.
Trim the heart(s) and cut in 1.5 - 2cm cubes. Marinate for at for least 8 hrs. Grill, spreading out into a single layer, and let brown for a minute or two. Toss and brown on the other sides for another minute; remove. Delicious!

CRAB CAKES
2 slices firm bread, 225g crabmeat, 1.5 tblsp oil, 1 tsp lemon juice and some wedges, 1/2 tsp Worcestershire or soy sauce, 1 large egg, beaten, 2 tblsp butter.
Tear bread into small pieces into a bowl with crab. Add oil, Worcestershire/soy, egg, a pinch of salt. Mix gently but thoroughly, then form into 4 patties. Heat butter until the foam subsides, then cook the cakes, turning once, until golden brown.

MACKEREL with BROCCOLI and SPICY ANCHOVY SAUCE
Mackerel and broccoli for 2; 3 anchovy fillets, 2 garlic cloves, 1 chilli (or powder), olive oil, (rosemary).
Chop three anchovy fillets, two cloves of garlic and one red chilli. Mash to a near-paste. Melt the paste in a small frying pan with 2 tblsp of butter. Meanwhile, grill or sauté the mackerel in oil. Top with rosemary if you have it. Don’t add salt, because the sauce will supply that. Steam the broccoli, drain, then stir it into the anchovy sauce. Serve next to the mackerel.
Best with plain cooked potatoes, methinks.



For more recipes see June issues from former years - click on June 2017 on the right hand side. 


The old days were not always better .....

Next issue: the immune system. To see this now, go to https://thoughtforfoodaw.wordpress.com/2017/05/10/july-2017-the-immune-system/.
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[4] 
[7]
OPIOIDS in general:
One of which is CODEINE : 
Though just because it’s herbal, that doesn’t mean it’s safe: see https://www.theguardian.com/society/2016/jul/11/heart-failure-patients-warned-off-over-the-counter-medications.