A study of various people and their different resulting chemical reactions yielded very interesting data. With personal variances in the location and vigor of mu opioid receptors that receive pain, studies indicate that people have different levels of endorphin production, which exactly corresponds to previous pain ratings. Certain subjects with increased manufacture of endorphins experienced a lower degree of pain. In that instance, the natural pain defense of the subjects functioned similarly to tramadol HCL. Other subjects with more minimal endorphin levels claimed to experience higher levels of pain. This is part of the reason that pain tolerance varies from one person to the next.

Does the fact that our natural pain-combating system works on its own accord render the need to buy tramadol invalid? In a nutshell, no. There are some types of pain that are hard to deal with, even for those with a high pain tolerance.

Nevertheless, the study will result in researchers being better able to understand how the natural pain relief system actually works. This should eventually lead to improvement in painkiller drugs, because they will be able to have a greater effect without intruding into the body’s inherent capability of keeping pain under control. One day, medications may be a thing of the past when we understand how the human body truly works. However, for the time being, we will still depend on medications to alleviate pain.

Research indicates that there are definite connections between the feelings people undergo when having painful experiences and the chemical reactions happening in their brains during the same time period. As people gain comprehension of pain itself, it will result in greatly improved pain solutions. Studies indicate that endorphins, or the opioids generated by the body, inhibit the brain’s receptors and prevent pain signals from going to the rest of the body.

The survey was composed of subjects suffering from consistent jaw discomfort for a duration of 20 minutes. Signals in the brain demonstrated increased endorphins at the onset of the pain. A person has lowered sensations of pain when the subject’s brain has received a fair amount of the substance.

The biggest surge in the production of endorphins has been found in parts of the brain that have been identified for their role in emotional and emotive reactions. This offers researchers greater knowledge about the close connection between the chemistry of the brain and emotive conduct.

Similarly to synthetic opioids like tramadol, endorphins prevent pain signals due to being aimed at certain types of mu opioid receptors located inside the brain. Sensations of pain and the result commonly referred to as pain are partly due to brain receptors that have a critical role.

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“I tell my patients if they eat a healthy diet, drink two eight-ounce glasses of milk and take a 1,600-milligram calcium supplement with 200 IU of vitamin D each day, they’ll meet their daily calcium and vitamin D needs,” Cosman says.

Exercise goes hand in hand with diet in the battle against osteoporosis. Calcium builds bones but exercise makes bone stronger and denser. Two specific types of exercise are key in building bone and maintaining bone mass and density: weight-bearing and resistance.

Weight-bearing exercises — such as dancing, jogging, walking, stair climbing and soccer — place weight on your feet and legs. Resistance exercises — such as working out with free weights or weight machines — build up your body’s infrastructure by improving muscle mass and strengthening bone.

Testing and Treatment
Since osteoporosis is a silent disease, the best way to diagnose it prior to a fracture is with a special test called a bone mass measurement, or bone mineral density test.

There are several methods and machines that measure bone mineral density. They’re all safe, painless, noninvasive and becoming more readily available. The tests measure the bone density in your spine, hip and/or wrist. Recently, the Food and Drug Administration approved tests to measure bone density in the middle finger, heel or shinbone.

Your bone density is measured against two standards: “age matched,” or what’s typical in someone your age, sex and size; and “young normal,” or the optimal peak bone density of a healthy young adult of the same sex. Your test results tell you where you stand within the ranges of normal and determine your risk for fracture. Generally, the lower your bone density, the higher your risk for fracture.

Currently, there are four medications approved by the FDA for the treatment of postmenopausal women to either prevent and/or treat osteoporosis.”It’s good news because we can choose a treatment to meet the needs of our patients,” Chestnut says. “In the future, there will be even more and probably better treatments to choose from and we’ll be able to combine therapies to further tailor treatments to women’s needs.”

Estrogen was the treatment of choice for years. It helps eliminate the hot flashes associated with menopause and helps prevent heart disease.

“But there’s a real layer of uncertainty concerning estrogen and breast cancer,” Chestnut says. “So for some women it’s not a good treatment”

Raloxifene is estrogen-like, “but without the breast cancer-risk baggage of estrogen,” Chestnut says. “It works positively on both the heart and on bone. But 1 in 5 still have hot flashes.”

Alendronate, a bisphosphonate, only affects skeletal mass and doesn’t do anything for hot flashes. It can cause gastrointestinal problems in some women. Currently, it’s taken on an empty stomach first thing every morning. Patients cannot lie down after taking it and they can’t eat for about an hour. “Some women don’t like it because they have to wait so long to eat,” Chestnut says. Once-a-week doses.

Calcitonin is a nasal spray. It works specifically on the skeleton and preserves bone, but also helps reduce pain. “That’s something the other treatments don’t do,” Chestnut says. The drawback is that some patients experience nasal congestion, drippy noses or nosebleeds.

“We’ve made great strides in the field of osteoporosis in the past decade because women recognized the serious nature of this condition and started demanding some attention,” Chestnut says. “So, we’ve come a long way. But we’ve only scratched the surface.”

But they were right on target. We should have drunk our milk then and, no matter how old we are now, we should be drinking it today — and eating our yogurt, cheese, broccoli and other calcium-rich foods. Calcium is one of our best lines of defense against osteoporosis, a silent bone disease without symptoms or warnings. At this moment, 8 million American women have osteoporosis — and millions more have low bone mass, which places them in the high-risk category for the disease.

“Essentially, we’re dealing with a major public health threat,” says Dr. Charles Chestnut, director of the Osteoporosis Research Group at the University of Washington Medical Center in Seattle. “Osteoporosis isn’t something new. There’s evidence of osteoporosis in the remains of

Egyptian mummies. It’s been a recognized condition for a long time but no one really seemed to care about osteoporosis much.” Until we discovered we could take real action against it.

Bones and Osteoporotic-Related Fractures
Bone is a living tissue made mostly of calcium. Our bodies renew bone regularly — removing the old and replacing it with the new. Until about age 30, new bone is built at a little faster rate than the old bone is removed, so bones grow bigger and stronger. After about age 30, that reverses. The old is removed slightly faster than the new is built.

When we reach menopause — usually somewhere between ages 45 and 55 — we start to lose bone quantity and quality rapidly. That’s because our level of estrogen — the hormone that helps maintain healthy bone — is greatly reduced during menopause. And that’s when we become at greater risk for osteoporotic-related fractures or bone breaks, especially in our hips, spines and wrists. Spine fractures cause stooped posture and backbone deformities.

In fact, the National Osteoporosis Foundation estimates that there are 1.5 million osteoporosis-related fractures each year, mostly among women. In 1995, Americans paid a whopping $13.8 billion in hospital and nursing home bills to treat osteoporotic-related injuries — a dollar figure that continues to mount as America ages and healthcare costs rise.

Prevention
Most medical experts agree osteoporosis is highly preventable. For now, our best lines of defense against osteoporosis are healthy living, exercise and good nutrition.

“If you smoke, quit. If you drink alcohol, drink moderately. And the earlier you start exercising and eating a diet enriched with calcium and vitamin D, the more positive an impact you will have on your body,” says Dr. Felicia Cosman, the clinical director of the National Osteoporosis

Foundation. Cosman is also an associate professor of medicine at Columbia University and an osteoporosis specialist with the Regional Bone Center of Helen Hayes Hospital in West Haverstraw, N.Y. (The late actress, Helen Hayes, suffered from osteoporosis.)

National surveys show that American women are failing themselves at perhaps the easiest measure of prevention: consuming enough calcium each day. In fact, studies indicate we probably only get about half of what our bodies need.

The NOF recommends the following: 1,000 milligrams for women ages 19 to 50; 1,000 milligrams for post-menopausal women taking estrogen and 1,500 milligrams for post-menopausal women not taking estrogen.

He and his two older brothers were placed in an orphanage following his parents’ divorce. Jim was 2 at the time. His father was described as a “vagabond,” and his mother a religious fanatic. He recalled the orphanage as being a terrifying place and reported being locked in closets or being made to lie on the floor for not having taken a nap. He was later placed in a series of foster homes before an older couple adopted him. The adoptive mother was described as “nagging and overbearing,” and his adoptive father gentle but “half-drunk all the time.” As a schoolboy, Jim fell in with a gang known for criminal activity that involved shoplifting and burglarizing.

Jim dropped out of high school and joined the Marines at age 17. He was sent to Korea but had difficulty accepting military authority and was placed in detention several times. While in Korea, Jim began to drink heavily and tried the widely available narcotics. He had many sexual experiences with Korean prostitutes and had his first homosexual relationship with a fellow Marine. After leaving the service, he eventually married and enrolled at a state college. He was unable to continue his schooling, felt close to neither his wife nor their two children, and held insignificant jobs for only short periods of time. He continued to drink heavily.

The outpatient evaluation concluded a diagnosis of “sociopathic personality,” and his prognosis was deemed poor. The discharge note described Jim as an unrealistic and selfish man who had not profited from past experiences.

Over the next five years, his antisocial behavior continued, and he had become a chronic alcoholic. His wife eventually left him and he failed to make court-ordered alimony or child support payments. Jim admitted to being a “subtle manipulator,” having been unfaithful to his first wife throughout their marriage and having affairs with both men and women. He had become involved in the antique trade and was known as a hustler because of his unethical trading practices.

Ultimately, Jim was living in a filthy, rundown apartment with his stepbrother. In the nearly 30 years since his initial evaluation, Jim had mainly worked peddling antiques. He received food stamps and was hoping to qualify for veteran’s disability benefits. He had a long rap sheet, including a felony conviction on a drug-related charge that lead to a one-year prison term.

In summary, Jim was clearly disturbed. He had become a chronic alcoholic, had no steady job and no regular source of income. His current goal was to defraud the government by convincing Veterans Affairs that he merited disability payments due to mental illness.

He was socially isolated and he interacted with others only at bars or while peddling antiques. He remained inappropriate, capable of assault and dangerous.

This is not a story with a happy ending. We can only presume from his past history that Jim today remains locked into the life pattern of a person with antisocial personality disorder.

A.Short-term memory loss can be caused by many different things. Depression and anxiety, for instance, often affect attention and concentration, making it difficult to “store” information for later recall.

Sometimes people with medical conditions such as diabetes or menopause will experience memory problems or “fogginess” when their blood sugar or hormone levels are out of whack. And of course, head trauma, brain injury, substance abuse and forms of dementia such as Alzheimer’s can cause memory problems.

If you’re having trouble remembering things, I’d recommend getting a complete physical to rule out (or in) any possible medical condition that could be affecting your memory. If such a condition is diagnosed, your physician can prescribe medication or another type of treatment that can help. If he or she — or you — suspect depression or anxiety is the culprit, I’d recommend consulting with a psychologist or other therapist to see if psychotherapy can help. Antidepressant or antianxiety medication could be an additional treatment if warranted. (I don’t recommend medication alone as the only intervention for depression or anxiety disorders.)

You asked if there is medicine for memory loss, specifically. I’m not aware of any specific prescription medication for memory loss itself, although your physician may know of some. However, many people believe the herb gingko biloba aids memory. There are reports that gingko has had positive effects on alertness and memory in Alzheimer’s patients. (Not as a cure, mind you, but to help alleviate some of the symptoms.) I’m not aware of any research on gingko’s effectiveness with other conditions, including people without brain dysfunction. But if you are interested in possible herbal or “natural” methods to improve memory, you might consult with someone with particular expertise in that area, such as a naturopathic physician (with an N.D., or Doctor of Naturopathy, degree) or an herbalist.

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Whenever my task mistress gears up to full-blown obsession, I have learned to stop the obsessive thinking, take control, and do something constructive to relieve the situation. Identifying and understanding your strengths and weaknesses is constructive, but stagnating in a cyclical process of negativity and self-depreciation is a destructive process that will not resolve the situation. Ask yourself what you can do to ease the tension of the situation and the turmoil within yourself. Get active to rectify, make amends, or make adjustments in yourself, a situation, or a relationship. When you are done, move on to another project and shift your attention to something that is more positive or constructive.

Let your reaction or response have time to do its work. Train yourself to shift focus to other goals in your life as you wait for the outcome. Rely on other personae to “coach” you as you try to give more balance to their voices and to your life. Learn to become your own best friend as well as your own worst critic. This is a more balanced way of living and it can produce a much higher level of health for you.

Our Tackling Tobacco center is designed to give you a variety of help, information and support. You can join our weekly chats no matter what your stage of quitting, or thinking about quitting.

Our goal is to provide you with knowledge and skills to help you become an empowered ex-tobacco user. We will help you tame an overactive internal critic!

The internal critic usually has some very important insights into any situation or relationship, and these are worth considering. I always let my task mistress have her say at least once, even if I flinch at what she says. We human beings learn from our mistakes as well as from our successes, and I prefer to make my life an evolving, learning process so I can do better in the future. No matter what we do, we tend to analyze it as being good or bad, acceptable or unacceptable, worthy or unworthy. It is what the human brain likes to do: name and define. Therefore, the internal task master always carries an important seed of truth. Listen for it, learn from it, and change the things that you can change.

If you have been giving your internal critic lots of “air time,” then you may find it hard to even know when she or he is or is not speaking. In this case, it is good to give this persona a name, one that will draw your attention and help to differentiate the voice from other parts of yourself. People often select names from their childhood, like “Debora Joan” (the name my mother called me when she was angry or frustrated at me), or names that seem to spontaneously come to mind when you think about your critic, like “Captain Critic” or “Enid.” What might you call yours?

You will find that some other personae within you have more reasonable, compassionate and positive expectations than the critic. There is a part of you that knows and recognizes wisdom, health and goodness.

This persona deserves some “air time” as well. There needs to be more positive and democratic rule within you to allow other personae to have their input as well. Setting limits on the amount of time the internal critic can invade your thoughts will provide openings for these other personae to speak.

Smokers and dippers alike have used tobacco to tame an overactive critic. Nicotine is an effective stimulant drug that can also work like a depressant in heavy doses. It produces a state of “alert-relaxation” that reduces depression, anxiety, and stress, and it helps relieve the inner turmoil that the task master can generate. This is one of the ways that your tobacco habit can be so psychologically addicting.

If your internal critic is very active, and you are experiencing a relapse cycle and frequent strong cravings for tobacco, it can weaken your motivation and determination to quit. This voice can make you believe that quitting is just too hard, that you cannot handle the stress without a cigarette, or that you do not have the strength of character to quit. The result is that you start to feel bad, hopeless and tired of the battle.

This can start a cyclical type of inner conversation that not only makes you feel bad, but can even make you feel bad about feeling bad (the double whammy).

The result is increasing craving for a cigarette to ease the pain or reduce the stress, and the triple whammy comes if you use again. Ironically, your smoking only gives more the critic more material to nag you about. And so it goes.

Now that you have identified your internal critic, begin to assess its level of positive or negative influence on your moods and health. Research has shown that stress and negativity have a destructive effect on the human body, and that cultivating an optimistic and positive outlook is an important health-enhancer. Next week, we will explore ways to tame an overactive internal critic

Some of your roles may “fit” you comfortably, and some may be harder to do because they are new or because you are uncomfortable with them. Dr. Carl Jung, one of the fathers of modern psychology, called these roles “personae,” after the masks of the dramatis personae used by ancient

Greek actors.
Our numerous personae are the functional disguises that we use to show ourselves to others. They are often a compromise between what we really wish to be and what the world will allow us to be.

During your childhood, you learned to model your personae from the people and things you loved, or the people and things that were close to you. As you grew in experience and understanding, you added you own unique qualities to these roles. One of the personae that you both learned and created was your “internal critic” or “task master.” This persona is one of the leading causes of relapse when you try to change or quit your tobacco habit!

Everyone has an internal critic. That nagging, pessimistic voice inside your head that takes merciless moral and performance evaluations of everything you think, do or say is the voice of your internal critic. The function of your internal critic is similar to that of being a parent, but this critic is not the “nurturing persona” of parenthood.

The task of the internal critic is to attain perfection, and to find and correct what is imperfect — a noble cause. The internal critic uncovers your fears, your pessimism, your weaknesses, and your mistakes; and the internal critic alerts you to potential problems.

Often clothed with a self-righteous attitude, the internal critic speaks with authority, as if it knows what is best for us to think, say or do in any given moment.

The hindsight of the internal critic is very sharp, and it may take repeated opportunities to tell you what you (meaning “I”) should have thought, done or said.

Your internal critic is often created from your parents’ internal critics, your genealogy and your own expectations of human excellence or perfection. Family mottoes, such as “if you are going to do it, do it right,” “get it right the first time,” and “don’t make mistakes,” feed into unrealistic expectations of how human beings typically grow, learn and behave. The result is a persona who knows uour weaknesses and fears all too well, and who can use your failings and mistakes to make you feel very bad about who you are. It usually has an opinion, often critical and brutally honest. As the cartoon “Pogo” once said, “We have met the enemy, and it is us.”