Alcoholism

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Chronic Fatigue Syndrome (CFS), commonly known as Chornic Fatigue , and also known as Myalgic Encephalomyelitis (ME) is an illness affecting the nervous system characterised by at least 6 months of extreme fatigue that is not relieved by rest[1]. Affecting anyone at any age, CFS is a complex illness and currently the cause of is unknown[2]. 

What we do know is, chronic fatigue may be a by product of a number of other illness such as Lyme disease or an autoimmune condition. Furthermore, it is thought that chronic fatigue is due to the cells in our body being unable to produce enough energy[1]. However, the underlying mechanisms of CFS vary between patients. 

The most prominent symptoms of CFS include[3]: 

• Muscle pain
• Sleep that doesn’t refresh 
• Pain in several joints
• Impaired concentration and deficits in memory 
• An extreme reaction to exertion 
• §nlarged lymph nodes 

Treatment of CFS remains complex as current medications have been shown to show minimal long-term benefit[4]. Other therapies include behavioural, cognitive and rehabilitative approaches. 

Additionally, recent work has highlighted the positive benefit of acupuncture, like Fong Yang Therapy in treating CFS[5].

References

[1] Harvard Medical School (2018, October) Chronic Fatigue Syndrome https://www.health.harvard.edu/a_to_z/chronic-fatigue-syndrome-a-to-z

[2] Better Health Channel (2017, November) Chronic Fatigue syndrome https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chronic-fatigue-syndrome-cfs

[3] Health Direct (2019, January) Chronic Fatigue Syndrome https://www.healthdirect.gov.au/chronic-fatigue-syndrome-cfs

[4] Toulkidis et al (2002) Chronic fatigue syndrome doi: 10.5694/j.1326-5377.2002.tb04499.x

[5] Zhang et al (2019) cupuncture for chronic fatigue syndrome: a systematic review and meta-analysis doi: 10.1136/acupmed-2017-011582

Complex Regional Pain Syndrome (CRPS), previously known as Reflex Sympathetic Dystrophy (RSD) is a painful condition of the arm, hand, leg or foot, which occurs after trauma, such as a fracture. 

Symptoms range from mild to severe, and may last up to a few years. The cause of CRPS from a western medicine point of view is still being researched. Treatment aims to relieve symptoms and restore limb function (movement and activity). 

Usually females are three times more likely to be affected than males. CRPS affects people in different ways and one person’s response to treatment will be different from another.

Symptoms

• burning pain in the arm, hand, leg or foot
• pain that changes in intensity, but often feels much worse than may be expected
• loss of fine motor control
• tremors or spasms
• stiffness
• changes to the skin, hair and nails on the affected limb
• warmth or coldness to the affected limb
• sweatiness and dryness of the limb.

Injuries that may lead to CRPS

Most cases of CRPS occur after an injury to the arm or leg, such as:

• fracture – broken bone
• penetrating injury – such as a deep wound or laceration
• surgery – such as a knee arthroscopy or an operation to treat carpal tunnel syndrome. 

In rarer cases:

• spinal-cord injury, CerebroVascular Accident (CVA) (a stroke) or Myocardial infarction (MI) (a heart attack) develop CRPS.

Cause

CRPS is a pain disorder that can affect different body systems. 

It is believed that different factors contribute to triggering the symptoms:

• Sympathetic nervous system dysfunction – the sympathetic nervous system is the part of your      nervous system that controls many involuntary actions in the body such as      sweat production, blood flow, and hair and nail growth. Not all people      with CRPS have sympathetic nervous system dysfunction.
• Somatic      nervous system dysfunction – the      somatic nervous system passes messages between the brain and limbs through      the spinal cord. Patients with CRPS may experience a sensation known as allodynia-      where even gentle touch, or warmth or cold is interpreted as being      extremely painful Also strange sensations, such as clumsiness or feeling      that their limb doesn’t belong to their body.
• Neurogenic      inflammation – the redness and      swelling of CRPS may be different from the normal redness and swelling that      generally follows an injury. Doctors postulate that the nerves themselves      may release chemicals that cause these changes in the affected limb.
• Hypoxia – CRPS may tighten blood vessels, restricting blood      flow which reduces oxygen in the body’s tissues (hypoxia) resulting in pain.
• Psychological      factors – some doctors think that a person’s reaction to a      stressful life event can trigger CRPS, while others disagree. Current      research suggests that psychological factors do not play a major role in      the onset of CRPS (except in      extreme stress), but does impact in one’s ability to cope with CRPS.

Diagnosis

There is no one diagnostic test for CRPS. Diagnosis is based on a person’s medical history and their symptoms. Professor Yoland Lim Health Care’s doctors may order pathology or imaging tests to outrule other conditions that may present similarly.

Standard Western Medical CRPS Treatment

Professor Yoland Lim Health Care has treated patients referred by medical specialists or GP’s, and you may have tried a range of standard medical treatments, such as prescription medicines (some of which are also used for epilepsy or depression), physical therapy, and interventions like nerve injections, however the results of these significantly vary.

Treatment

Although CRPS has no simple cure, Professor Yoland Lim Health Care uses an integrated medical approach to obtain the most optimal result for you, involving a number of approaches which aims to restore movement and function of the body:

• Fong Yang Therapy- specialised form of Professor Yoland Lim Helath Care’s acupuncture.
• Phytomolecular medicine 
• Pain and Stress management: Using Professor Yoland Lim Health Care’s Meditation CD’s you will learn how to relax and minimise stress to help reduce pain. Identify sources of stress, and make necessary lifestyle changes. 
• Relaxation techniques may include deep breathing

Prognosis of CRPS

Without treatment patients may have significant pain and disability for years.
Relapses can happen for no known reason or can occur after surgery for a separate problem.

We advise you seek medical review if you suspect you have any of the symptoms stated, to further investigate and manage as necessary.

Fatty liver is a condition in which excess fat builds up in the liver cells. The liver, which is the largest internal organ in our body, removes toxins and processes food nutrients. When the health of our liver is compromised, the blood from our digestive system cannot filter properly. This could lead to various complications such as inflammation known as steatohepatitis. Non-alcoholic steatohepatisis (NASH) is the most common cause of liver disease in Australia and is commonly seen in people of older age groups with diabetes, obesity, high blood pressure or high cholesterol[1]. 

Because fatty liver does not cause obvious symptoms, many are unaware of having it until a routine examination. According to Victorian Government Better Health Channel, this condition affects approximately 1 in 10 Australians[2]. While it is normal for the liver to contain some fat, if it makes up more than 10% of the weight of the liver then it is generally determined as ‘fatty liver’. In some serious cases, the liver can become scarred and hardened which in time could cause a condition known as cirrhosis. This often leads to liver failure[3].

Although there is no known cure, there are a number of things we can do to manage this condition. Making changes to our lifestyles, such as following a healthy diet and exercising regularly are believed to be effective. In a study published by the US National Library of Medicine National Institutes of Health Acupuncture treatment was shown to assists in lipid metabolism which reduces abdominal fat accumulation and helps decrease the mass of fatty liver[4].

References

[1]  healthdirect.gov.au/fatty-liver

[2] betterhealth.vic.gov.au/health/conditionsandtreatments/liver-fatty-liver-disease

[3] racgp.org.au/afp/2013/july/fatty-liver-disease/

[4] ncbi.nlm.nih.gov/pubmed/30945501

Mycoses (fungal infections) are characterised by the invasion of tissues by one or more species of fungi. These may be caused by dermatophytes, yeast or molds and typically occur in individuals who are immunocompromised. Furthermore, individuals who are organ transplant recipients, or those with underlying conditions such as diabetes or lung disease are at a greater risk of fungal infections[1]. 

Broadly, there are two categories in which fungal infections can be divided: 

1. Superficial, or 

2. Invasive infections

Superficial infections may be caused by both yeast and molds and typically occur on the skin, nail, hair and mucous membranes. In many cases, fungal infections are limited to the mouth, genital area or skin but in individuals with a weakened immune system, there is an increased risk of experiencing a more serious internal infection[2]. The symptoms of a fungal infection depend on what part of the body is being affected[3]. For example, symptoms of a fungal infection on the skin may cause itching, swelling and redness whereas symptoms of a fungal infection in the lungs may cause chest pain, muscle aches and coughing. Commonly, fungal infections are treated with anti-fungal medication in a cream, ointment, suppository, pill or intravenous form[1]. 

Onychomycosis (fungal nail infections) may also occur in individuals, and may cause unsightly, green or yellow nails. This can spread to other toe nails, and finger nails, and patients may be troubled by the appearance of these.

References

[1] Lab Tests Online (2019, October) What are Fungal Infections labtestsonline.org/conditions/fungal-infections

[2] Harvard Medical School (2019, January) Candidiasis health.harvard.edu/a_to_z/candidiasis-a-to-z

[3] Sepsis (2017, December) Fungal Infections sepsis.org/sepsisand/fungal-infections/

Hepatitis is a condition defined by the inflammation of the liver. The liver is an important organ for regulating metabolism, storing vitamins, removing toxins and making proteins. Hepatitis may be caused by alcohol and drug abuse or certain medical conditions but commonly, hepatitis is caused by a viral infection[1]. 

In Australia, the three most common hepatitis caused by viral infection are hepatitis A, B and C[2]. Depending on the type of hepatitis depends on the symptoms and cause. Hepatitis A is commonly acquired overseas and is spread by direct contact with an infected person or by consuming contaminated foods[3]. 

Symptoms may include fever, nausea and yellow skin and eyes. Hepatitis B is the most common hepatitis and is spread through infected blood or body fluids[4]. Hepatitis C is a blood borne virus and is spread through contact with infected blood[5]. Symptoms include and are not limited to flu like symptoms, pain in the liver region, nausea, night sweats, diarrhoea and poor concentration and forgetfulness.

Furthermore, treatment for hepatitis varies depending on the type of hepatitis. For instance, there are effective treatments available for hepatitis B to reduce the risk of consequential diseases such as liver cancer[4]. In the case with hepatitis A, unfortunately there are no current medical treatments available with medical professionals recommending supportive therapy in plenty of rest and fluids[1]. 

References

[1] Health Direct (2018, May) Hepatitis. healthdirect.gov.au/hepatitis

[2] Better Health Channel (2018, August) Hepatitis betterhealth.vic.gov.au/health/conditionsandtreatments/hepatitis

[3] Hepatitis Australia (2019, July) Hepatitis A. hepatitisaustralia.com/hepatitis-a

[4] Hepatitis Australia (2019, August) Hepatitis B. hepatitisaustralia.com/what-is-hepatitis-b

[5] Hepatitis Australia (2019, August) Hepatitis C. hepatitisaustralia.com/what-is-hepatitis-c

Insomnia is a common sleep disorder defined as the difficulty of getting to sleep and staying asleep ultimately resulting in disruptions in sleep quality affecting daytime functioning[1]. These disruptions can include:

• poor concentration
• forgetfulness
• grumpy mood and 
• fatigue. 
• 
  

There are two main types of insomnia: 

1. Acute insomnia- which occurs for less than 4 weeks, and 

2. Chronic insomnia- occurring more than 4 weeks[2] 

Insomnia can affect anyone at any point in their lives with a higher prevalence in females, shift workers and older people with poor health[3]. There are multiple factors which can cause insomnia such as: 

• some medications
• depression
• stress
• chronic pain
• anxiety[4]

In order to treat insomnia it is crucial the underlying causes are taken into account. However there is strong evidence and support to suggest the first-line treatment to be cognitive behavioural therapy[5]. Unlike the more traditional western approach in treating insomnia using sleeping pills, cognitive behavioural therapy aims to overcome the underlying causes through engaging in a series of sleep assessments, completing a sleep diary and weekly visits to a sleep clinician[6].

References    

[1] Diagnostic and statistical manual of mental disorders (DSM-5)

[2] Cunnington, D et al (2013, October) Insomnia: prevalence, consequences and effective treatment. The Medical Journal of Australia Vol 199 (8) 36-40. doi: 10.5694/mja13.10718

[3] Sleep Health Foundation Australia (2019, June) Insomnia. sleephealthfoundation.org.au/insomnia.html

[4] Health Direct (2019, June) Insomnia. healthdirect.gov.au/insomnia

[5] Royal Australian College of General Practitioners (2019, April) Insomnia management. Australian Journal of General Practice Vol 48 (4). racgp.org.au/ajgp/2019/april/insomnia-management

[6] Trauer, J et al (2015, August) Cognitive Behavioural Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Annals of Internal Medicine. doi: 10.7326/M14-2841

Pain in the jaw? Trouble chewing? Jaw aching?Difficulty opening your mouth? Stuck or locked jaw? Weird noise or clicking of the jaw? 

You may have Temporo Mandibular Joint (TMJ) disorder. This affects up to 60-70% of all people[1], who will have sign of a TMJ disorder at some point in their lives. The TMJ is located where the mandible (lower jaw) attaches to the base of your skull on each side of your head. You can find this by placing your fingers in front of your ears and opening and closing your mouth and you can feel these joints move. Muscles, ligaments and tendons attach across the TMJ to control its movements.

Symptoms

Pain, clicking, locking, facial pain and headache.

Causes

The exact cause of a TMJ disorder is not always known. The majority are due to joint degeneration, trauma or injury to the mouth[2].

Other conditions which can contribute include:

• osteoarthritis and rheumatoid arthritis, which may cause considerable TMJ dysfunction
• sustained emotional or physical stress
• bruxism (Teeth grinding)

TMJ may contribute to emotional tension or depression. Chronic TMJ pain and dysfunction can be difficult to treat.

There are surgical procedures which involves opening into the joint and joint replacement. However as with any medical procedure there are potential risks, including the facial nerve (7th cranial nerve, that provides the nerve signals for facial movement) which may be affected. Permanent nerve damage is rare but could lead to facial palsy on the affected side and some nerve damage may be permanent. 

Professor Yoland Lim Health Care’s clinical examination includes:

• inspecting your face, jaws and mouth for signs of disease 
• evaluating jaw movements 
• gently palpating jaws and chewing muscles 
• listening for TMJ noises during movement 
• may refer you for blood tests (for rheumatoid arthritis or other connective tissue disorders) and X-ray, CT or MRI scans of the jaws and TMJ.

Management Program

Professor Yoland Lim Health Care uses an integrated medical approach which may include:

• Modified diet: to rest the jaw, eat predominantly soft food that requires little or no chewing. When a small amount of chewing is necessary, try to chew evenly on both sides of the mouth.
• Hot or cold packs. Hot packs on painful areas may help to relax muscles and soothe tenderness. Cold packs may help to reduce inflammation in the TMJ or chewing muscles.
• Stress management using binaural therapy, Professor Yoland Lim Health Care's form of Meditation Music (Chanting) may be combined with techniques to relax and minimise stress to help reduce clenching or grinding of teeth. Identify sources of stress, and make necessary lifestyle changes.    
• Relaxation techniques may include deep breathing.
• Specific exercises tailored for your TMJ requirements.
• Avoiding extreme jaw movements: resist chewing hard foods or talking too much.

The holistic patient centred approach aims to promote relaxation, relax muscle tone, and reduce stress.

Prognosis

Although some patients respond very promptly, as TMJ disorders can take years to develop, it may take some time for improvement. 

References

[1]  Jonathan Lomas Et al. Australian Journal Of General Practice. Volume 47, Issue 4, April 2018Temporomandibular dysfunction.

[2] healthdirect.gov.au/temporomandibular-joint-disorder