Nutrition: Health Benefits of Yogurt. Food Science: How to Make Yogurt

 

Milk and eggs contain proteins that have the highest biological values nutritionists would tell you.

Milk for instance is the only food for human babies for at least 6 months and supplementary feeding needs to be given after that period for at least 2 years or longer. Milk can support the growth of not only human babies, but also calves, clubs, kits, pups, or whelps, of all mammalian carnivorous or omnivorous species of animals because nutritionally it is a complete food by itself. The main nutrient in milk that supports this growth is its very high-quality protein complete with all the amino acids.  

So is hen’s egg on which the entire unhatched chick depends inside its shell until it hatches 20 -21 days later or up to 30 days for other poultry. Eggs are also an excellent source of high-quality protein known as its biological value (BV) which is a measure of how efficiently the body utilizes protein from food. Eggs and milk BV are close to 100.

Foods with high biological values typically contain all the essential amino acids in proportions similar to those required by humans. They contain all the essential amino acids needed by the body.

Like eggs, milk is also a nutritionally good supplementary food even for adults. Besides milk and eggs here's a list of foods with high biological value

Whey Protein: Derived from milk, whey protein is considered one of the highest BV proteins available. It's quickly absorbed by the body and rich in essential amino acids.

1. Fish: Particularly oily fish like salmon, tuna, and mackerel are rich in protein and have high BV. They also provide omega-3 fatty acids, which are beneficial for heart health.
2. Lean Meats: Lean cuts of beef, pork, and poultry are rich in protein and have high BV. Choose lean cuts to minimize saturated fat content.
3. Dairy Products: Milk, yogurt, and cheese are good sources of protein with relatively high BV. They also provide calcium and other essential nutrients.
4. Soy Products: Soybeans and soy products like tofu and tempeh are plant-based sources of protein with high BV. They are also suitable alternatives for vegetarians and vegans.
5. Quinoa: Among grains, quinoa stands out for its high protein content and balanced amino acid profile, resulting in a relatively high BV for a plant-based food.
6. Cottage Cheese: Cottage cheese is a dairy product that's rich in protein and has a high BV. Milk is a popular choice for athletes and those looking to increase protein intake and to build up their strength and body mass.

These foods with high protein content and high BV provide the body with essential amino acids in proportions that closely match human requirements, making them highly effective for supporting muscle growth and preventing loss of body weight.

However, I also mentioned in a separate article milk may not be well tolerated by adult Asians.  Drinking milk in adults may cause diarrhoea due to the presence of milk sugar (lactose) inside. See my explanation here published on 

 Tuesday, June 20, 2023

Why Most People Cannot Tolerate Drinking Milk

https://scientificlogic.blogspot.com/search?q=lactose+intolerance+

We can solve this problem by converting the milk into yogurt by introducing milk bacteria such as Lactobacillus bulgaricus and Streptococcus thermophilus to ferment the lactose (milk sugar) into lactic acid. This process not only thickens the milk but also changes its flavour and nutritional composition slightly. Once the milk sugar lactose is converted into lactic acid and is no longer there, the yogurt is very well tolerated and should no longer cause diarrhoea.  If milk is converted into yogurt, will it retain its high protein biological values? We shall answer that later.

When milk is converted into yogurt, it undergoes a fermentation process where beneficial bacteria will be very useful for gut health. These bacteria called the probiotics found in yogurt are also found in the gut. There are several other types of probiotics that contribute to gut health. Some common ones include:

Lactobacillus: This is a type of bacteria commonly found in yogurt and other fermented foods. It helps in the breakdown of lactose and supports overall digestive health.

Bifidobacterium: Another group of bacteria found in the intestines, Bifidobacteria are also commonly included in probiotic supplements. They help in breaking down complex carbohydrates and promoting a healthy balance of gut flora.

Saccharomyces boulardii: This is a yeast probiotic that can help maintain a healthy balance of bacteria in the gut. It's often used to prevent or treat diarrhoea caused by antibiotics or infections.

Streptococcus thermophilus: Like Lactobacillus, this bacterium is often found in yogurt and helps support digestion and gut health.

While probiotics have been studied for their potential benefits in preventing various diseases, including colon cancer, the evidence is still emerging and not definitive. However, probiotics do play a crucial role in maintaining overall gut health and can contribute to the prevention of certain gastrointestinal issues such as diarrhoea, irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD).

The mechanisms by which probiotics contribute to health are multifaceted. They can help by:

Maintaining gut flora balance: Probiotics help maintain a healthy balance of bacteria in the gut, which is essential for proper digestion and nutrient absorption.

Strengthening the gut barrier: Probiotics can enhance the integrity of the gut barrier, preventing harmful substances from crossing into the bloodstream and reducing inflammation.

Modulating the immune system: Probiotics interact with the immune system in the gut, helping to regulate immune responses and reduce inflammation.

Producing beneficial compounds: Some probiotics produce short-chain fatty acids and other compounds that support gut health and may have anti-inflammatory effects.

While more research is needed to fully understand the role of probiotics in preventing specific diseases like colon cancer, maintaining a diverse and balanced gut microbiome through a combination of probiotic-rich foods and a healthy diet is generally considered beneficial for overall health.

Having explained the above about microbiome and gut bacteria let us now go from nutrition into food science.  

We can now use our knowledge in simple food science to make our own yogurt at home. We can of course buy ready made yogurt from the food shop or supermarket. But they are very expensive. So we shall make our own. 

First we need to buy a cup of ready-made yogurt with at least two types of milk bacteria inside, namely, Lactobacillus bulgaricus and Streptococcus thermophilus. 

This is how to make our own yogurt.

Bring the fresh milk home and gently boil the milk in a pot for about 1 – 2 minutes under low fire. 

Next, let the milk cool to almost room temperature. Once cooled, use a clean spoon to add 1 - 2 tablespoons of the fresh yogurt into the cooled milk and stir.

Do NOT stir the cup of yogurt into the boiled milk when the milk is still hot. The heat will kill the milk bacteria, and yogurt cannot be formed. Cool it down first to near room temperature before stirring in 1 – 2 tablespoons of the fresh yogurt as a starter.
  

Then cover the pot of milk to prevent other bacteria entering into the milk. Leave overnight in a warm place. Do not put the pot of milk inside the refrigerator as yet. Leave it covered in a warm place in the kitchen so that the live milk bacteria as a starter from the cup of fresh yogurt can ferment the milk. 

Once yogurt has been formed only then you should keep it inside the refrigerator, but not before that, else yogurt will not be formed from the milk if it is too cold inside a refrigerator. After the yogurt is formed, you need to put it inside the refrigerator to prevent other bacteria from entering.

The next morning about 8 – 10 hours later after stirring in the starter yoghurt, all the milk should be converted into yogurt by the bacteria in the yogurt you bought.  If the milk has not turned into yogurt within 8 – 10 hours, leave it for another 4 hours. If the milk still has not turned into yogurt, then the starter yogurt you bought from the supermarket did not contain live bacteria inside.  In that case throw it away and try again using fresh milk and another different cup of yogurt. Make sure the milk and the cultured yogurt you bought have not exceeded their expiry dates else the bacteria were not there.

Now scoop up a bowl of the home-made yogurt and add in 1 -2 spoonfuls of sweetened condensed milk together with some fresh fruits or canned peaches, apricots, and pineapples with its syrup.  The canned fruits with the syrup or freshly cut fruits can be kept cold in a refrigerator beforehand.

Your home-made yogurt will save you a lot of money instead of buying many cups of them from the supermarket. Yogurt eaten with canned fruits and
syrup inside is quite tasty and very nutritious. You can make as many pots of home-made yogurt as you want cheaply by using the Lactobacillus bulgaricus and Streptococcus thermophilus present in the manufactured yogurt to ferment the lactose (milk sugar) into lactic acid.  While the overall protein content remains relatively similar between milk and yogurt, the biological value (BV) of the protein may change slightly due to the fermentation process, but still contains high-quality protein with essential amino acids, similar to milk.

Some studies suggest that the BV of protein in yogurt may be slightly higher than that of milk due to the fermentation process, which can make the protein more easily digestible for some individuals. Additionally, yogurt contains probiotics, which can benefit gut health.

In summary, while there may be minor changes in the biological value, yogurt remains a nutritious source of protein with valuable health benefits.

I hope my recipe as a food scientist and a food quality controller and as a nutritionist helps. But other clinicians with an MD may not know this. 

Chemical Toxins in Foods from Food Producers Plus Toxic Drugs Prescribed by Doctors

 

 

 Here is a video on poisonous chemicals food producers and their suppliers in China added into our food, a friend of ours sent to us via WhatsApp here:  

https://mail.google.com/mail/u/0?ui=2&ik=409b84d771&attid=0.1&permmsgid=msg-a:r-8120967751700461209&th=18f106a0a4fb0685&view=att&disp=safe&realattid=18f1069aa9362f5c6dc1

 (Please note: The above video in Chinese may not be able to open directly by clicking on the link. Please try to open it by copying link and paste it inside Google search engine, and click from the Google search bar. It seems like it is clickable only by using a home PC, but not by using a smart handphone. But can give this a try).  

The video is in Chinese that says that in China it is sad that $$$$$ is the prime motivator in commerce and business that these 5 vegetables that are treated with chemicals are not safe for human consumption. 

When we suffer from chronic diseases due to these harmful toxins added into our food, most people will go to a MD doctor for a cure.

The doctor will prescribe them some medicine to “cure” them of their illness due to some toxic substances they have taken inside their bodies. By adding more toxic drugs to be taken, the doctor only to make the situation worse. They are not addressing the root causes - dietary exposures and accumulative poisons in foods. The doctor merely treats the symptoms by prescribing you more toxins (drugs) to take. How does that help or solve the problem? Masking the symptoms of chronic diseases from harmful dietary exposures and harmful eating makes the problem worse.

 The patient will go spirally down in vicious circles into chronic diseases due to both food and drug toxicities.

 We get into a situation where everything is shut and trapped inside the body by the thousands of food chemicals ingested plus all those drugs being prescribed. 

Most of these drugs do not cure any disease. They merely act as inhibitors that block a pathological chemistry in the body.

These chemical drugs are given under the hidden names as “medicine”. They were introduced by that rocky, rocky fellow by the name of Rockefeller who used his petroleum products to revolutionize the practice of medicine here:

https://dta0yqvfnusiq.cloudfront.net/allnaturalhealingsrq/2019/04/How-Rockefeller-Founded-Big-Pharma-and-Waged-War-on-Natural-Cures-5cb3d7374f337.pdf

In pharmacology, we know there are numerous drugs that work as inhibitors, and they fall into various categories based on what they inhibit. They are inhibitors of enzymes, receptors, or other biological targets such as calcium channel inhibitors, proton pump inhibitors, and some other biological and enzymic inhibitors

A few examples of each will do here,  such as calcium channel inhibitors like nifedipine, verapamil, diltiazem, proton pump inhibitors like Omeprazole, Esomeprazole, Lansoprazole or enzyme inhibitors like acetylcholinesterase inhibitors, examples are Donepezil, Rivastigmine or  monoamine oxidase inhibitors (MAOIs) like  Phenelzine, Selegiline or HMG-CoA Reductase Inhibitors (statins), examples like Atorvastatin, Simvastatin. Other inhibitors include angiotensin-converting enzyme (ACE) inhibitors - Lisinopril, Enalapril, etc, etc.

These are just a few examples. However, drugs can exert their effects on the body through various mechanisms, beyond just inhibition of cellular processes. Here are some common mechanisms of drug action (pharmacodynamics):

1. Receptor Agonism/Antagonism: Many drugs interact with specific receptors in the body, either activating (agonism) or blocking (antagonism) their activity. This can affect signalling pathways and alter physiological responses. For example, opioid analgesics act as agonists at opioid receptors, while beta-blockers act as antagonists at beta-adrenergic receptors.
2. Enzyme Inhibition/Activation: Drugs can inhibit or activate enzymes, which are proteins that catalyse biochemical reactions in the body. By altering enzyme activity, drugs can modulate metabolic pathways or prevent the breakdown of specific molecules. For instance, statins inhibit HMG-CoA reductase, an enzyme involved in cholesterol synthesis.
3. Ion Channel Modulation: Ion channels are proteins that regulate the flow of ions across cell membranes, thereby influencing membrane potential and cellular excitability. Drugs can modulate ion channel activity, affecting processes such as neuronal signalling and muscle contraction. Examples include calcium channel blockers used to treat hypertension and antiarrhythmic drugs that target cardiac ion channels.
4. Transporter Inhibition/Activation: Transporter proteins regulate the movement of molecules across cell membranes. Drugs can inhibit or activate these transporters, altering the uptake or efflux of various substances. For example, selective serotonin reuptake inhibitors (SSRIs) block the serotonin transporter, increasing serotonin levels in the synaptic cleft.
5. Second Messenger Systems: Some drugs target second messenger systems, which are intracellular signalling molecules involved in transmitting signals from cell surface receptors to cellular responses. By modulating second messenger pathways, drugs can influence processes such as cell growth, differentiation, and neurotransmission. For instance, cyclic AMP (cAMP) is a common second messenger targeted by drugs like beta-adrenergic agonists.
6. Gene Expression Regulation: Certain drugs can influence gene expression by interacting with DNA or modulating the activity of transcription factors. This can lead to changes in protein synthesis and cellular function. Examples include corticosteroids, which bind to glucocorticoid receptors and regulate gene expression involved in immune and inflammatory responses.
7. Allosteric Modulation: Allosteric modulators bind to sites on receptors or enzymes distinct from the active site, altering their conformation and affecting their activity. This can enhance or inhibit the effects of endogenous ligands or other drugs. Benzodiazepines, for example, act as positive allosteric modulators of GABA receptors, enhancing the inhibitory effects of GABA neurotransmission.

These mechanisms represent a diverse array of ways in which drugs can interact with biological systems to produce therapeutic or mostly harmful effects. Each drug's mechanism of action is crucial to understanding its pharmacological properties and clinical applications.

Whichever way we like to describe their actions on the body, we have to admit the body has to bear the brunt of all these chemicals under the hidden name as “medicines” and drugs.

All these drugs are poisons to the body. All drugs have a chemical formula, a chemical structure, a molecular weight and mass, and they all react with each other and interfere with the body's biochemistry whether at cellular or molecular levels. The body chemistry flows continuously like the waters of a river because the body is a living body. None of the drugs mentioned above and their mode of action can stop this continuous flow of biochemistry whether in health or in illness. Their pharmacological actions are only temporarily to inhibit or block the pathological chemistry unless the underlying root causes are treated, blocked and arrested. In short, as doctors we need to treat the patient as a whole person holistically by understanding the causes, his occupation, his exposure, his behaviour and stress levels, his sleep, rest and working patterns, more importantly his nutritional status, dietary habits, lifestyles and not treat the disease with chemicals called ‘medicines’  Merely prescribing chemicals as medicines is not going to address all these root causes and health issues

 All drugs, even the simplest ones are actually chemical agents alien and poisonous to a normal body especially in high doses over a long period that we can do without in health. This is the same as foods with all kinds of food additives, preservatives, chemical flavouring agents and enhancers, and colouring matter added. The body does not need any of them at all.

All food additives like drugs taken in small amounts are accumultative poisons.  The body needs only nutrients that nourishes and supports the normal biochemistry of the body and paramont nutrition 

 Unfortunately, when we are ill with all these chronic diseases we go to the MD doctors who will prescribe all these inhibitors, ion channel modulation, transporter inhibition / Activators, gene expression regulators, allosteric modulators briefly mentioned above and others  too long to list them here to further poison the body over and above all those food toxins already deliberately added into our food by food manufacturers and food suppliers as shown in the video above.  

When I was a small boy, they told me fairy tales that Big Pharma and the doctors who prescribed these products are both practising very noble professions. Not just that alone. They told me medical doctors are also very kind people who not only save lives, but they also help people a lot. They told me if you are poor, they also give you money. Furthermore, if you are hungry, medical doctors also give you free food and free accommodation.  

But they did not tell me where did the doctor who was so noble and charitable get so much money to give away everthing for free - free consultation, free lab tests, free radiological and other investigations, free diagnosis, free medicine and free treatment? That part of the story they did not tell me, or wish to tell me. They only told me because doctors were so generopus and charitable, the practice of medicine is the noblest of all professions. But I kept quiet as I was only a small ignorant and innocent boy listening  to all their fairy tales with an open mouth, eyes rolling staring blankly into the sky above before they managed to lullaby me to sleep into dreamland.  

Unfortunately, despite being so "noble" medical doctors and the Big Pharma Boys have not won the noblest of all prizes in healthcare - the prestigious Nobel Prizes in medicine since 1927 because they have been so noble prescribing their chemical  products to 'cure' all those chronic ills after the food producers put other chemicals inside our food. Almost all the Nobel Prizes in medicine since 1927 went to medical scientists with PhD degrees instead who made breakthrough discoveries for the advancement of medicine. Medical scientists do not give away money or free treatment. Instead, they ask for hundreds of millions of dollars to fund their research, and desipite being given research fundings, they managed to win most of that highly prestigious Nobel Prizes in medicine.  

These food manufacturers are in the same boat as the drug producers who give  doctors their  petroleum products  to poison the public to make money. Both are in the same boat and category

Now you know why I went an extra mile to study nutrition and food quality control, and after post-graduate studies, I went on to conduct medical and food toxicological research and liver diseases at the prestigious Massachusetts Institute of Technology at Cambridge, United States before furthering my research at the Institute for Medical Research in Malaysia. I am glad I have now fully retired from the practice of chemistry, toxicology, applied nutrition and all health-care professions. 

Today, I have changed my interest from medicine  after getting my PhD to study evolutionary biology, forensic science and astronomy.

I have been interested in astronomy since I was a small boy after I being cheated listening to fairy tales about studying medicine. That made me wonder if there are more honest alien beings out there among the trillions and trillion of other worlds that do not cheat telling fairy tales.  

This made me also wonder when Jesus came to this world, He healed the sick, deaf, blind, paralyzed and even raised up the dead who died days ago without asking for money, ask for the various types diagnostic tests to be done first, or needing to use drugs made from petrochemicals. 

All Jesus did was just His touch and His voice, and all were instantly healed whatever they suffered from. Of course, Jesus came from another world out there among the myriads of stars.

That’s why I wrote this article wondering if they are Alien Life in the Universe out there?

https://scientificlogic.blogspot.com/2024/

As a clinician, I have no more trust in all these drug-based conventional medicine anymore after struggling with my own leg ulcers for 10 years now using Rockefeller chemical “medicines” followed by two unsuccessful surgeries plus other conventional medical interventions which numerous vascular surgeons and doctors promised they can cure my leg.  

I am a very disappointed and disillusioned doctor myself with my journey with venous stasis leg ulcers here:

https://scientificlogic.blogspot.com/2024/04/my-journey-with-venous-stasis-ulcers.html?m=1

See also death caused by doctors:

 https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html

 

 

 

 

Aliens Out There in Other Worlds

 

On Sunday, April 23, 2023, I wrote an article entitled:

Are There Life Out There in the Universe?

https://scientificlogic.blogspot.com/2023/04/

 Today, precisely one year later, I shall provide further reasons why I believe there may be other worlds than our own earth that harbours life. We shall also provide reasons against this belief.

An extension of this thought is based on the vastness of the universe containing some estimated 100 trillion, trillion other worlds out there. There is a very high statistical probability of other alien life or even advanced civilizations out there in the horrendous vastness of this universe.

There is no reason why other extra-civilizations would ever want to visit or communicate with us. Other far more advanced life and their civilizations may be in communication with each other as neighbours who are much nearer among themselves than with us. We are very remote and isolated foreigners to them with whom they have no dealings. This is one very strong possibility.

Another possibility is that we are yet to be a discovered species of life in a vast cosmic ocean. This is similar to many more undiscovered species of life here on Earth itself to scientists. So far scientists estimate there are around 8 to 10 million species of life here on Earth itself, and many more new species of life are yet to be discovered and named. So are we to other far more advanced civilizations out there who are yet to discover us. I personally think the existence of life in other worlds is so strong we cannot deny this. If we have studied and understand statistics, we would understand the term “chance” and “probabilities”.

I  shall summarize the reasons for easier reading for my gentle readers.

The question of whether life exists elsewhere in the universe is one of the most profound and intriguing mysteries humans have pondered for centuries. To address this question comprehensively, let's explore the possibilities and reasons both for and against the existence of life beyond Earth:

Possibilities:

1. Abundance of Planets: The universe is vast, with an estimated 100 trillion, trillion planets. With such a staggering number of worlds, the probability of at least some of them having conditions suitable for life is quite high.
2. Diversity of Environments: The universe offers an incredibly diverse range of environments, from icy moons to scorching exoplanets. Some of these environments may harbour conditions conducive to life, whether it's based on carbon like life on Earth or potentially other forms of life we haven't even imagined yet.
3. Extremophiles on Earth: Life on Earth has demonstrated remarkable resilience and adaptability, with organisms known as extremophiles thriving in extreme conditions such as deep-sea hydrothermal vents, acidic hot springs, and even within rocks. This suggests that life could potentially exist in a wide range of environments, including those previously considered inhospitable.
4. Discovery of Exoplanets: The discovery of thousands of exoplanets in recent years, some of which are located within their star's habitable zone where conditions may be suitable for liquid water, has fuelled optimism about the possibility of finding extraterrestrial life.
5. Potential for Other Biochemistries: While life on Earth is based on carbon, it's conceivable that alternative forms of life could exist based on different chemistries, such as silicon, nitrogen, or even exotic elements. This broadens the potential range of environments where life could arise.

See this article:

Can Silicon-Based Life Exist in Another World?

 Scientific Logic: Search results for silicon life

Reasons Against:

As I have explained above, the chance is almost zero that earth is the only world that harbours life among some 100 trillion, trillion other worlds spread out into the immensity of the universe. In that case we need to give very slim reasons for our sole existence. Below would be some doubtful excuses.

1. Complexity of Life: While the universe may be teeming with planets, the emergence of life, especially complex life like that found on Earth, is a highly complex process that requires a delicate balance of environmental factors and evolutionary mechanisms. It's possible that the conditions necessary for complex life are rare.
2. Rare Earth Hypothesis: The Rare Earth Hypothesis suggests that Earth-like planets with the right conditions for complex life are exceedingly rare in the universe. Factors such as the stability of the planetary orbit, presence of a large moon, and the existence of plate tectonics may all play crucial roles in making Earth uniquely habitable.
3. Fermi Paradox: The Fermi Paradox raises the question of why, if the universe is so conducive to life, we haven't detected any signs of extraterrestrial civilizations yet. This paradox suggests that either intelligent life is extremely rare, or there are barriers preventing civilizations from communicating or colonizing the galaxy.
4. Challenges of Interstellar Travel: Even if life exists elsewhere in the universe, the vast distances between stars pose significant challenges for communication or travel between civilizations. This may limit our ability to detect or interact with extraterrestrial life.

In conclusion, while the vastness of the universe and the abundance of planets make it highly probable that life exists elsewhere, the emergence of complex life forms like those found on Earth may be rare. However, ongoing scientific exploration and advancements in technology continue to expand our understanding of the cosmos, offering hope that one day we may discover evidence of life beyond our own world.

Having explained that, I was often asked what about UFOs then? Aren't they aliens from another worlds? Let me try to answer.

Unidentified Flying Objects (UFOs) are objects or phenomena observed in the sky that defy conventional explanations. While some people speculate that UFOs could be evidence of extraterrestrial visitation, the reality is more complex.

Possible explanations for UFO sightings include:

1. Misidentifications: Many UFO sightings turn out to be misidentifications of natural phenomena, aircraft, weather balloons, drones, or other human-made objects. Human perception can be influenced by factors such as distance, lighting conditions, and psychological biases.
2. Experimental Aircraft: Some UFO sightings may involve secret military aircraft or experimental technology that is not publicly known. Governments often conduct tests of new aircraft in restricted airspace, leading to sightings that are unfamiliar to the public.
3. Atmospheric Phenomena: Natural atmospheric phenomena such as ball lightning, mirages, or unusual cloud formations can sometimes be mistaken for UFOs. Optical illusions caused by atmospheric refraction or temperature inversions can also create unusual visual effects.
4. Hoaxes and Misinformation: Not all reports of UFO sightings are genuine, and hoaxes or deliberate misinformation can contribute to the perception of UFO activity. This can include fabricated photographs or videos, as well as exaggerated or false eyewitness accounts.

While it's possible that some UFO sightings could be attributed to extraterrestrial visitors, there is currently no conclusive evidence to support this hypothesis. Scientists and researchers continue to investigate UFO reports using rigorous methods and evidence-based approaches. Until compelling evidence is presented, UFOs remain unidentified and open to various interpretations.

 

My Journey with Venous Stasis Ulcers

 

My Journey with Venous Stasis Ulcers

 

Several friends of mine have off and on enquired about my leg ulcers. I have already thanked each of them personally through their WhatsApp.  One of them has even offered me a “cure” using Traditional Chinese Medicine.

I cherish all their concern and friendship. Thank you once again to each of them.  Since my history with this ulcer is a very long one, it would not be possible to keep repeating the same story for each of them. Allow me instead to write this common article to explain to each of them although I have already thanked each of them personally without writing lengthy explanation.   

But first, let me quote a study in this link:

 

https://onlinelibrary.wiley.com/doi/full/10.1111/iwj.14272.

 

“Venous leg ulcers (VLU) are a major clinical challenge and the result of chronic venous insufficiency (CVI) and venous hypertension. They manifest on the lower limb and represent between 60% and 80% of all leg ulcerations. Their three-months healing rate is estimated at 40% and once healed up to 80% of patients develop a recurrence within 3 months. The prevalence of VLUs is reported around 1.08%⁶ and the incidence being up to 1.33%. The latter numbers are primarily based on estimates because of the lack of clinical registries for VLU. The prevalence and incidence of VLU increase with age. Age does negatively affect healing and recurrence as well as treatment adherence. People with VLUs often report having reduced health-related quality of life because these wounds can be painful, malodorous, and exuding”.

My first journey with my venous stasis leg ulcers started in early 2017, involving my left leg.

At that time, I tried for some 3 months to manage it myself, but when it persisted, I decided to go to hospital for better care. But the hospital did not do much except gave me regular wound dressing which I have already done on my own at home.

I then decided to go to a private wound care centre in Petaling Jaya on July 9, 2017, to stay there for regular wound care. I stayed there for 35 days till August 13 before I discharged myself when the wound did not get any better.

On the same night on August 13, 2017, I decided to get myself admitted to Kuala Lumpur Hospital where I was hospitalized for 4 months, 3 days (Sunday, August 13, 2017, till December 15, 2017). Fortunately, I was eligible to a one-bedded room all for myself which was much more comfort than in other wards. After more than 4 months in that ward with regular dressing and bed rest my wound finally almost healed. It finally completely healed a month later after I was discharged from hospital. That was my first journey with my left leg. That is now history.  

Then in early 2022, the same venous stasis ulcer affected my right leg. Today this is my second journey with this problem. This time I sought surgical instead of medical treatment. But before we go into this, let us look at what causes this problem by understanding its causes, its pathology and treatment below:

 

Pathophysiology:

Venous stasis ulcers typically develop due to chronic venous insufficiency, a condition where the veins in the legs have difficulty returning blood back to the heart. Here's a breakdown of the pathophysiology:

1. Venous Insufficiency: Venous insufficiency occurs when the valves in the leg veins are damaged or weakened. Normally, these valves prevent blood from flowing backward, ensuring it moves towards the heart. When these valves malfunction, blood can pool or flow backward, causing increased pressure in the veins of the lower legs.
2. Increased Venous Pressure: The increased pressure in the veins leads to venous hypertension, especially in the lower extremities. This pressure buildup compromises the integrity of the venous system, causing further valve damage and stretching of the vein walls.
3. Capillary Perfusion Disturbances: The elevated venous pressure impairs capillary perfusion, the process by which oxygen and nutrients are delivered to tissues. As a result, the surrounding tissues become hypoxic (lack oxygen) and ischemic (lack blood supply).
4. Inflammatory Response: Chronic venous hypertension triggers an inflammatory response in the affected tissues. Inflammation contributes to tissue damage and further compromises wound healing processes.
5. Tissue Hypoxia and Necrosis: Prolonged hypoxia and ischemia lead to tissue damage and necrosis (cell death). The lack of oxygen and nutrients impairs the ability of cells to repair and regenerate, further exacerbating tissue breakdown.
6. Ulcer Formation: Eventually, the combination of tissue hypoxia, inflammation, and impaired healing mechanisms results in the formation of venous stasis ulcers. These ulcers typically occur around the ankles and lower legs, where venous pressure is highest and blood flow is slowest.
7. Chronic Wound Cycle: Venous stasis ulcers often become chronic wounds, as the underlying venous insufficiency persists. The impaired circulation perpetuates the cycle of tissue damage, inflammation, and delayed healing, making it difficult for the ulcers to heal without appropriate intervention.

 

Management:

Treatment of venous stasis ulcers involves addressing the underlying venous insufficiency, promoting wound healing, and preventing recurrence. This may include compression therapy, elevation of the legs, wound debridement, topical medications, and lifestyle modifications.

Compression therapy together with leg elevation during sleep is usually a cornerstone in managing venous stasis ulcers, as it helps improve venous blood flow and reduces oedema. While compression stockings are commonly used due to their effectiveness, compression bandages can also be used, especially in cases where stockings are not feasible or tolerated well. Leg elevation during bedtime allows gravity to help drain the flow of blood towards the heart.

I have used both types of compression therapies most of the time even during bedtime, but it does not seem to help.

I then underwent two operations for my right leg venous stasis ulcers. The first one was done using radio frequency ablation (RFA) in September 2022.

The vascular surgeon could only close up two out of three of the affected veins. He could not close up the third one as it was too near a nerve as the heat of RFA can damage the nerve. Hence, I believe this was the reason why it did not heal very well.  

I then underwent the second surgical operation using VenaSeal or clue procedure. This was also done in September, a year later on 18 September 2023. It was performed by two surgeons, one from Malaysia and the other from Singapore who was on an assignment here at a major hospital in Kuala Lumpur.

The VenaSeal technique delivers a small amount of a specially formulated medical adhesive to close the diseased vein, rerouting blood to nearby healthy veins. This is a minimally invasive non thermal treatment for vein disease and varicose veins. The glue they used I believed was cyanoacrylate.

Unfortunately, this second surgical operation made my ulcer larger and worse than the first one causing my feet now to swell with oedema.

The hospital has done Duplex ultrasound scans many times before the operations in 2022, but they did not do it again just before the second one, probably because they already have my records.

Duplex ultrasound involves using high frequency sound waves to look at the speed of blood flow, and structure of the leg veins.  When the ulcers did not heal after the second operation using VenaSeal procedure they did a duplex ultrasound again, and found the veins have closed up completely?  But ulcers are still not healing, and the feet have now developed oedema. Why is it so? Could it possibly be due to overdoing it with radio frequency ablation (RFA) plus the glue method such that all the veins were closed up that there is now very little opening or passage for the blood to return to the heart.

I asked the senior consultant surgeon about this possibility, but he did not think so because if there was no venous return, then according to him, the entire leg would be swollen like elephantiasis (a disease caused by lymphatic filariasis), not just the feet. But he assured me it will finally heal, but it will take some time because he said it has been a chronic condition and some damages have already been done in the vasculature and tissues.

 According to a study after VenaSeal surgery, the median wound healing time was significantly shorter for VenaSeal than for RFA (43 vs 104 days; P = 0. 001). Two RFA patients developed a post procedure infection. The ulcer recurrence rate was 19.3% (22.1% for RFA vs 13.7% for VenaSeal. But mine currently is already over 7 months since the second surgery.

According to several studies published in the medical journals, several botanical medicines such as horse chestnuts, butchers bloom, diosmin and hesperidin, pine bark, Centella asiatica (Indian pennywort) are helpful in managing venous insufficiencies. I have also tried them on my own, and even my last surgeon has also prescribed diosmin and hesperidin (HemoRid tablets) for me together with Celecoxib, a nonsteroidal anti-inflammatory drug (NSAID), plus an antibiotic Unasyn. None works.

 While radiofrequency ablation (RFA) and Venaseal are normally said to be both effective treatments for venous insufficiency, complications can arise.

The closure of veins with these procedures is intended to redirect blood flow to healthier veins and alleviate the symptoms of venous insufficiency, including leg ulcers. However, since the ulcers persist and oedema worsens despite the closure of the veins, there might be some other underlying issues that need to be addressed.

Below are some of my own personal suspicions on other underlying causes as a clinician myself. Unfortunately, none of my 4 – 5 surgeons and other doctors treating me has offered to explain other causative factors to me.

Here are several other causative factors that could contribute to my persistent ulcers and oedema. Here are my views:

1. Deep Vein Thrombosis (DVT): It's possible that you might have developed DVT in deep veins, which can impede blood flow and contribute to oedema and ulceration.
2. Inadequate Venous Drainage: Closure of veins may not always lead to sufficient venous drainage, especially if there are other underlying venous issues or if collateral circulation pathways are insufficient.
3. Lymphatic System Dysfunction: Oedema could also be a result of lymphatic system dysfunction, especially if the ulcers are not responding to treatment as expected.
4. Chronic Inflammation: In some cases, chronic inflammation around the ulcer site can impede the healing process which I currently suffer.

Given the complexity of my situation, it's crucial to consider the reasons I highlight above so that further evaluation and appropriate management can be instituted. This may include:

• Further imaging studies such as CT venography or magnetic resonance venography to assess venous and lymphatic flow.
• Evaluation for underlying conditions such as DVT or lymphatic system dysfunction.
• Specialized wound care techniques such as debridement, dressings, or advanced therapies like negative pressure wound therapy (NPWT) or bioengineered skin substitutes.
• Management of oedema through compression therapy, elevation, and possibly diuretic medications.
• Consideration of other interventions such as angioplasty, stenting, or surgical bypass if indicated.

I need to address these symptoms and to investigate further to ensure a more comprehensive and personalized care if my present ulcer is not yielding the desired results.

What I have mentioned above is based on my trained medical knowledge, and as a former senior medical researcher, but in practice I cannot do the investigations on myself or treat myself. I need some competent endovascular surgeons from outside to help. I hope my journey will end as soon as possible as my body is my best friend and healer

Jb lim

The Mysteries About Dreams

 

A friend of mine by the name of Ir. CK Cheong, a senior civil engineer recently WhatsApp me an article to seek my opinion on the body, mind and dreams. He asked:   

Dear Dr Lim

Where does the mind go when one is sleeping? What are dreams? May I seek your opinion about dreams, and where does the body wander in sleep?

I received this from a Buddhist master would you be kind enough to provide your expert scientific opinion please? Thank you very much.

Sorry to trouble you with such trivia issue. This was what this Buddhist master sent to me in pink. 

“Tan Ajahn: The mind and the body are not really in the same place. The mind has its own place of existence, and the body has its own place of existence. Let me give you an example. The mind is like the controller of the spacecraft. 

You send a spacecraft into space, and the controller is on earth. You communicate through radio waves. 

This is the same way that the mind communicates with the body, we call it viññāṇa. Viññāṇa will receive all the data from the body such as the eyes, ears, nose, tongue and mind. Then the mind will use saṅkhāra, which is thinking to instruct the body what to do. 

So, the mind is in what we call the celestial world or in the spiritual world, while the body is in the physical world. The mind is in contact with the body through the viññāṇa.  

This is like the spacecraft and the controller. The controller stays on earth, while the spacecraft is in space. 

When the body goes to sleep, it means that the mind and the body stop communicating temporarily. 

Sometimes the mind will do whatever it likes. Sometimes it will think of the past, it will go to some places that it might have visited before; it can be quite varied, but you don’t know about it. Sometimes when you dream, you are not sure what you were dreaming about, whether you were dreaming about this life or past lives. 

Sometimes you don’t dream at all, or sometimes the mind just wants to rest. It stops thinking. 

But the mind and the body are never in the same place. Should anything happen to the body, should there be a nuclear bomb and all the bodies are incinerated, the mind will still remain the same. The mind of everybody remains the same. The mind is indestructible, because the mind is not in this world. Even if this world should explode, when this world no longer exists, the mind still exists. If the mind still has desires, it will go look for a new body on a different earth, in a different world. 

Imagine the people in a spacecraft; if they lose this spacecraft, they will build a new one, and then they will send the new spacecraft into space to explore some more. So this is like the body and the mind.

Finally, let me remind you that you are the mind, that you are not the body. Don’t worry about the body, you will lose it one day. Take care of your mind. 

 And the way to take care of the mind is to bhāvanā, to develop mindfulness (sati), samādhi and paññā. That is all you have to do because the mind will be with you all the time. The mind is your real possession. 

But right now, it doesn’t have the right knowledge to look after itself. It doesn’t have the Dhamma necessary to become peaceful, calm, and wise. 

The mind is still deluded. The mind still thinks the mind itself is the body. 

When you bhāvanā, you will eventually get to the state where you see that the mind and the body are two separate things. 

In the meantime, just keep reminding yourself, I am not the body. I am going to lose the body one day, sooner or later. But losing the body is not important because I can always get a new body. I have lost so many bodies before, so I won’t worry about losing them. The only worry is to worry about not having the Dhamma to look after the mind.

~ Ajahn Suchart Abhijāto

www.phrasuchart.com

https://www.youtube.com/channel/UCi_BnRZmNgECsJGS31F495g

Ends.

...................................

Thank you for the above article Ir CK Cheong.

It is very unfortunate I have not much idea about dreams or the body and mind wandering in that manner being interpreted in that way. But let me give you my alternative interpretation.

Some believe dreams are when our soul temporarily leaves our body and wanders around, often to strange places they have never been or seen before.

Personally, I too have been wondering of this possibility independent of what others have been thinking, even though as a scientist I am liable to be laughed at to envisage such a thought.

But let me offer my thoughts in a different way from the cultural, social, religious, philosophical and of course from a scientific viewpoint as a biological, evolutionary and medical scientist.  

Beliefs about dreams involving the soul leaving the body and venturing into unknown realms are rooted in spiritual and mystical traditions rather than scientific understanding. While such beliefs are common in various cultures and may hold personal significance for some individuals like me, even though I am unable to support this by empirical evidence or scientific research.

From a scientific perspective, dreams are understood as products of brain activity during sleep, particularly during the REM (rapid eye movement) stage of sleep when most vivid dreaming occurs. The REM suggests that the soul may still be with the body, or it may not because the eyes have been rolling rapidly wondering where its soul has gone to? But if the soul has left the body, even temporarily, then the body dies because the physical body plus the spirit became the living soul. In short, the soul must not depart from the body whether in the waking stage or in sleep, else once the soul departs from the body we die, unless God was with the dreamer. 

However, there are many written and documented cases of people from different cultures, religions, and belief systems across the world who have no connection with each other who had near death experiences where they saw themselves outside their bodies when they were resuscitated in pre-hospital and hospital environments during accidents or during a medical emergency. They saw and found themselves floating over the ceiling in the emergency room where they could clearly see doctors and other emergency staff desperately attempting to revive them. Some saw themselves floating above the streets or outside buildings where they met with an accident.  Some described themselves travelling through a dark tunnel at the end they could see a very bright light. On emerging they found themselves in a very strange but very beautiful field where they saw their long-dead relatives. One of them who had this near death out of the body experience was my own youngest sister who nearly died during an operation. She told us she could see what was going on in the operation theatre as she floated up to the ceiling. Perhaps these can only occur during those brief moments after death before the body decomposes. But what about Lazarus of Bethany who was brought up from the dead by Jesus four days after his entombment as described in John 11:1–44 in the New Testament, as well as in the secret Gospel of Mark? These phenomena are all beyond science to explain.  

Maybe we can offer other alternative explanations.

Ghost inside a Body:

It is the spirit of God he breathed into a lifeless physical body made up of tens of thousands of different types of biochemical molecules, proteins of all sorts, nucleic acids, DNA....etc, etc .... together with their highly complex metabolic and signalling pathways that controls all of them. Something much, much higher is controlling all the laws of chemistry in our body. Perhaps, this suggest that even for several minutes after clinical death the biochemistry of life still proceed as usual without the need of a soul controlling these body chemistries. The soul may still linger around outside the body. The chemistry of life can still continue for some time even without the soul controlling those chemistries of life in the body. It is just like in working life where a department can continue to function for some time even without the boss around to give orders.

See this:

Existence of Life After Death

https://scientificlogic.blogspot.com/search?q=soul+controlling+biochemistry

Mysteries of Life: An unmeasurable Vital Force

https://scientificlogic.blogspot.com/2010/09/mystery-of-life-unmeasurable-vital.html

 

While dreams can indeed feel otherworldly and may involve unfamiliar or fantastical scenarios, there is no evidence to suggest that they involve the soul leaving the body or traveling to alternate dimensions. Instead, dreams are thought to reflect a combination of internal processes, including memory consolidation, emotional processing, and cognitive activity.

If dreams are not our soul temporarily leaving our body to wander to strange places and to other worlds not our own, what exactly then are dreams?  What causes us to dream. What are the different theories put forward so far to explain why we dream?

 Neuroscientific studies have identified specific brain regions and neurotransmitter systems involved in dream generation, providing insight into the physiological mechanisms underlying dreaming.

However, it's necessary to recognize and respect the diversity of beliefs about dreams and the soul across different cultures and spiritual traditions. While scientific inquiry may provide one perspective on dreams, personal beliefs and cultural interpretations can offer alternative insights and meanings. Ultimately, the understanding of dreams as a purely biological phenomenon or as a spiritual experience is a matter of individual interpretation and perspective.

Dreams are a fascinating aspect of human experience, yet their exact nature and purpose remain somewhat elusive. They are essentially a series of thoughts, images, emotions, and sensations that occur during sleep, often experienced as vivid narratives or scenarios.

The precise cause of dreaming is still debated among scientists and psychologists, but several theories have been proposed to explain why we dream. Some of them being suggested are:

1. Activation-Synthesis Theory: Proposed by Allan Hobson and Robert McCarley in 1977, this theory suggests that dreams are a result of random neural activity in the brainstem during REM (rapid eye movement) sleep. According to this theory, the brain tries to make sense of these random signals by synthesizing them into a narrative, creating the content of dreams.
2. Evolutionary Theory: Some researchers propose that dreaming serves an evolutionary purpose, such as helping us to process emotions, consolidate memories, or simulate threatening situations to prepare us for real-life dangers. Dreaming could have provided an adaptive advantage to our ancestors by aiding in problem-solving or enhancing survival skills.
3. Psychoanalytic Theory: Developed by Sigmund Freud, this theory suggests that dreams are a window into the unconscious mind, where repressed desires, fears, and conflicts are expressed symbolically. Freud believed that dreams served to fulfil unconscious wishes in a disguised form, allowing the individual to safely explore taboo desires or unresolved issues.
4. Information Processing Theory: This theory posits that dreaming is a mechanism for organizing and processing information acquired during wakefulness. Dreams may help to consolidate memories, integrate new information with existing knowledge, and solve problems encountered during the day. This perspective views dreaming as a form of mental housekeeping, essential for cognitive functioning.
5. Neurobiological Theories: These theories focus on the physiological mechanisms underlying dreaming, including the role of neurotransmitters, brain regions, and neural networks involved in dream generation. Research suggests that various neurotransmitters, such as acetylcholine and serotonin, play a crucial role in regulating REM sleep and dream activity.
6. Threat Simulation Theory: Proposed by Antti Revonsuo, this theory suggests that dreaming evolved as a way for organisms to simulate and rehearse threatening situations in a safe environment. By experiencing and processing potential dangers during sleep, individuals may be better prepared to respond effectively to similar situations in waking life.

These theories offer different perspectives on why we dream and the potential functions of dreaming, but none provide a comprehensive explanation. The study of dreams remains a vibrant area of research, with ongoing efforts to unravel the mysteries of the sleeping mind. How far is true is worth exploring.

If we think dreams are not the soul temporarily wandering out of the body, then could it be the opposite of God or a spirit entering the body to dialogue with us while we are sleeping?

Let’s have a look at this verse given in the bible:

"At Gibeon the LORD appeared to Solomon during the night in a dream, and God said, "Ask for whatever you want me to give you."  (1 Kings 3:5). What about this?

Some will believe interpreting religious texts like the Bible can be nuanced and often depends on one's faith tradition and personal beliefs. In the case of the verse from 1 Kings 3:5, it describes an encounter where God appears to Solomon in a dream and engages in dialogue with him.

From a religious perspective, this verse could be seen as evidence of divine communication through dreams. Many believers including myself who strongly believes the existence and presence of God in my life interpret such passages as instances where God communicates with individuals during their sleep, conveying messages, guidance, or insights.

 There were also many stories and accounts by people I have read who told their relatives of very strange, weird and unusual dreams they had a few days before they died as if it was to  foretell or a premotion of their death? 

However, from a psychological or scientific standpoint, interpreting dreams as communication from a divine entity may not be the primary explanation. Instead, dreams are often viewed as products of the subconscious mind, influenced by a variety of factors such as emotions, experiences, and memories.

I think the interpretations of dreams can vary widely across cultures, religions, and individuals as I have already warned earlier in this discussion. Some may see dreams as purely psychological phenomena, while others may interpret them as spiritual or metaphysical experiences.

Ultimately, how one interprets biblical passages like in 1 Kings 3:5 depends on our personal religious beliefs and the interpretative framework they use to understand such texts.

Dreams are indeed fascinating, and there's still so much we're learning about them.

I think it is worthwhile exploring all these possibilities.

In closing, just to reveal to you I have dreamt of God bringing me to the edge of the Universe at three times the speed of light where I saw another universe revolving in the opposite direction. There were two rivers I saw.  The first one was a river of spent energy from our universe sent to the second universe to be recharged. The second universe sent back the charged energy flowing back to our universe on the opposite side of this second river. Both the rivers flowed slowly.

 I have dreamt this same dream twice.  In Einsteinian physics, nothing can travel faster than light let alone me traveling at three times the speed of light unless it has no mass like our souls but in the presence of God carrying me across hundreds of billions of light years beyond our Observable Universe.  Was it just a dream, or  was my massless soul being carried across those dimensions leaving my body temporarily behind even for a few seconds? Give this thought!  

I hope I have answered your question Ir CK Cheong.  

Jb lim