Subject: The Great Cholesterol Lie
Summary: Without inflammation, cholesterol would not accumulate in wall of blood vessel and cause heart disease
A Heart Surgeon Admits Huge Mistake!
By Dwight Lundell, MD
Part 1 of a 2-part article (see part 2 below)
We physicians with all our training, knowledge and authority often acquire a rather large ego that tends to make it difficult to admit we are wrong. So, here it is. I freely admit to being wrong.. As a heart surgeon with 25 years experience, having performed over 5,000 open-heart surgeries, today is my day to right the wrong with medical and scientific fact.
I trained for many years with other prominent physicians labeled “opinion makers.” Bombarded with scientific literature, continually attending education seminars, we opinion makers insisted heart disease resulted from the simple fact of elevated blood cholesterol.
The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter of course we insisted would lower cholesterol and heart disease. Deviations from these recommendations were considered heresy and could quite possibly result in malpractice.
It Is Not Working!
These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.
The long-established dietary recommendations have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences.
Despite the fact that 25% of the population takes expensive statins
medications and despite the fact we have reduced the fat content of our diets, more Americans will die this year of heart disease than ever before.
Statistics from the American Heart Association show that 75 million Americans currently suffer from heart disease, 20 million have diabetes and 57 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year.
Simply stated, without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped.
Inflammation is not complicated -- it is quite simply your body's natural defense to a foreign invader such as a bacteria, toxin or virus. The cycle of inflammation is perfect in how it protects your body from these bacterial and viral invaders. However, if we chronically expose the body to injury by toxins or foods the human body was never designed to process, a condition occurs called chronic inflammation. Chronic inflammation is just as harmful as acute inflammation is beneficial.
What thoughtful person would willfully expose himself repeatedly to foods or other substances that are known to cause injury to the body? Well, smokers perhaps, but at least they made that choice willfully.
The rest of us have simply followed the recommended mainstream diet that is low in fat and high in polyunsaturated fats and carbohydrates, not knowing we were causing repeated injury to our blood vessels. This repeated injury creates chronic inflammation leading to heart disease, stroke, diabetes and obesity. Let me repeat that. The injury and inflammation in our blood vessels is caused by the low fat diet that has been recommended for years by mainstream medicine.
What are the biggest culprits of chronic inflammation? Quite simply, they are the overload of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods.
In Part 2 of this two-part article, I'll discuss which foods cause inflammation, how those foods trigger the inflammatory process, and the foods to eat that will cure inflammation.
Part 2
By Dwight Lundell MD 02/06/2009
Take a moment to visualize rubbing a stiff brush repeatedly over soft skin until it becomes quite red and nearly bleeding. Let’s say you kept this up several times a day, every day for five years. If you could tolerate this painful brushing, you would have a bleeding, swollen infected area that became worse with each repeated injury. This is a good way to visualize the inflammatory process that could be going on in your body right now.
Regardless of where the inflammatory process occurs, externally or internally, it is the same. I have peered inside thousands upon thousands of arteries. A diseased artery looks as if someone took a brush and scrubbed repeatedly against its wall. Several times a day, every day, the foods we eat create small injuries compounding into more injuries, causing
the body to respond continuously and appropriately with inflammation.
While we savor the tantalizing taste of a sweet roll, our bodies respond alarmingly as if a foreign invader arrived to declare war. Foods loaded with sugars and simple carbohydrates, or processed with omega-6 oils for long shelf life have been the mainstay of the American diet for six decades. These foods have been slowly poisoning everyone.
How does eating a simple sweet roll create a cascade of inflammation to make you sick?
Imagine spilling syrup on your keyboard and you have a visual of what occurs inside the cell. When we consume simple carbohydrates such as sugar, blood sugar rises rapidly. In response, your pancreas secretes insulin whose primary purpose is to drive sugar into each cell where it is stored for energy. If the cell is full and does not need glucose, it is rejected to avoid extra sugar gumming up the works. When your full cells reject the extra glucose, blood sugar rises producing more insulin and the glucose converts to stored fat.
What does all this have to do with inflammation? Blood sugar is controlled
in a very narrow range. Extra sugar molecules attach to a variety of proteins that in turn injure the blood vessel wall. This repeated injury to the blood vessel wall sets off inflammation. When you spike your blood sugar level several times a day, every day, it is exactly like taking sandpaper to the inside of your delicate blood vessels.
While you may not be able to see it, rest assured it is there. I saw it in over 5,000 surgical patients spanning 25 years who all shared one common denominator — inflammation in their arteries.
Let’s get back to the sweet roll. That innocent looking goody not only contains sugars, it is baked in one of many omega-6 oils such as soybean. Chips and fries are soaked in soybean oil; processed foods are manufactured with omega-6 oils for longer shelf life. While omega-6’s are essential – they are part of every cell membrane controlling what
goes in and out of the cell — they must be in the correct balance with omega-3’s.
If the balance shifts by consuming excessive omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation. Today’s mainstream American diet has produced an extreme imbalance of these two fats. The ratio of imbalance ranges from 15:1 to as high as 30:1 in favor of omega-6. That’s a tremendous amount of cytokines causing inflammation. In today’s food environment, a 3:1 ratio would be optimal and healthy.
To make matters worse, the excess weight you are carrying from eating these foods creates overloaded fat cells that pour out large quantities of pro-inflammatory chemicals that add to the injury caused by having high blood sugar. The process that began with a sweet roll turns into a vicious cycle over time that creates heart disease, high blood pressure, diabetes and finally, Alzheimer’s disease, as the inflammatory process continues unabated.
There is no escaping the fact that the more we consume prepared and processed foods, the more we trip the inflammation switch little by little each day. The human body cannot process, nor was it designed to consume, foods packed with sugars and soaked in omega-6 oils.
There is but one answer to quieting inflammation, and that is returning to foods closer to their natural state. To build muscle, eat more protein. Choose carbohydrates that are very complex such as colorful fruits and vegetables. Cut down on or eliminate inflammation-causing omega-6 fats like corn and soybean oil and the processed foods that are made from them. One tablespoon of corn oil contains 7,280 mg of omega-6; soybean contains 6,940 mg. Instead, use olive oil or butter from grass-fed beef.
Animal fats contain less than 20% omega-6 and are much less likely to cause inflammation than the supposedly healthy oils labeled polyunsaturated. Forget the “science” that has been drummed into your head for decades. The science that saturated fat alone causes heart disease is non-existent. The science that saturated fat raises blood cholesterol is also very weak. Since we now know that cholesterol is not the cause of heart disease, the concern about saturated fat is even more absurd today.
The cholesterol theory led to the no-fat, low-fat recommendations that in turn created the very foods now causing an epidemic of inflammation. Mainstream medicine made a terrible mistake when it advised people to avoid saturated fat in favor of foods high in omega-6 fats. We now have an epidemic of arterial inflammation leading to heart disease and other silent killers.
What you can do is choose whole foods your grandmother served and not those your mom turned to as grocery store aisles filled with manufactured foods. By eliminating inflammatory foods and adding essential nutrients from fresh unprocessed food, you will reverse years of damage in your arteries and throughout your body from consuming the typical American diet.
[Ed. Note: Dr. Dwight Lundell is the past Chief of Staff and Chief of Surgery at Banner Heart Hospital, Mesa, AZ. His private practice, Cardiac Care Center was in Mesa, AZ. Recently Dr. Lundell left surgery to focus on the nutritional treatment of heart disease. He is the founder of Healthy Humans Foundation that promotes human health with a focus on helping large corporations promote wellness. He is the author of The Cure for Heart Disease and The Great Cholesterol Lie]
Comments by visitors to Dr Lundell’s article ‘The Great Cholesterol Lie’
1. OH no!!!!! no!! This article added on to more confusion regarding the causes of coronary heart diseases!! What about taking the so called OMEGA eggs, soft boiled or sunny side over? What about prawns and crabs?? Scallops and throw in with sotong? Is there anyone out there care enough to provide a more rational and down- to -earth and more localized explanation / suggestions / comments or argument that may be of help?
A worried Perry
Date: Fri, 26 Jun 2009 13:38:42 +0800
Subject: The Great Cholesterol Lie help
2. Hi all,
After reading this it is still better to go easy on the LARD and 'chee yau char’ when you eat Char Kueh Teow though lard is NOT process oil! Hahaha! Carry on eating Bak Kut Teh with ease of mind!
CHM
3. Dear Dr Lim,
Sorry have to consult your expert opinion again. Could I get a copy of your Keynote Address and your presentation on the Definition of Health you presented at the Health and Wellness Seminar of the Malaysian Senior Scientists Association.
I would also like your paper on ‘The Physiological Basis for Weight Management & Stabilization’ you also presented at the seminar. Kindly also seek your expert view on Dr Lundell’s article ‘The Great Cholesterol Lie’
Thank You & Best Regards,
CK Cheong
4. Dear Dr Lim,
We would like you to comment on the above article ‘The Great Cholesterol Lie’ by Heart Surgeon Dr. Dwight Lundell e-mailed to you earlier. We would appreciate your qualified professional opinion on this health issue as all along nutritionists and cardiologists have put the blame on cholesterol as the cause of coronary arterial disease. Your expert comment please!
Thanks.
Dr KM Tan and colleagues
Dr JB Lim replies below:
Thank you to all of you for your questions and e-mails.
It is very difficult for me to explain why eating high cholesterol foods like brain, liver, eggs, prawns DO NOT cause your blood cholesterol to be elevated permanently. The explanation is very lengthy, and requires a technical understanding of liver biochemistry, and I don’t intend to start on this. This belief that high cholesterol foods cause high blood cholesterol and heart disease was very popular in the 1940’s – 1950’s but it is now out of fashion to talk about it. Advances in nutritional science have debunked this myth.
Nevertheless very briefly, high cholesterol foods may cause a mild and temporary rise in blood cholesterol lasting for only a few hours post digestion stage. This effect will go away a few hours later, only to rise again at night.
But this nocturnal rise in blood cholesterol has nothing to do with any high cholesterol foods you have taken earlier. It is due to your own liver producing them in high amounts at night when you are asleep. In fact the liver can produce its own cholesterol to meet your body’s need 10 times better than all the cholesterol you can eat through foods during the day.
Hence it is no longer a fashion to say that eating foods high in cholesterol causes high cholesterol in the blood or heart disease. It is the type or nature of the oil you consume or use them for cooking that is far more important. By this I mean saturated oils from animal fats such as lard or tallow, or trans-fatty acids from hydrogenated margarine, or saturated oil from coconut oil that you need to avoid, but not eggs, liver etc.
Furthermore, even if you manage to eat a lot of cholesterol, say 10 eggs a day which is about 3,500 mg of cholesterol, the liver is able to throw out at least half of it everyday through the bile. The liver will compensate by balancing its body output (endogenous) of cholesterol with the amount you have taken through food (exogenous), to stabilize the level in the blood. That is why unlike blood sugars, blood cholesterol do not rise up and down sharply after a meal. The liver keeps this in check.
Yes, fish oil containing omega 3 fatty acids do lower your blood cholesterol. Eating a lot of fatty fish, especially the belly part is healthy as it is cardio-protective. Again, the chemistry why this is so, is highly technical in any attempt to explain. But you may find the explanation given in advanced textbook of nutrition, biochemistry or nutrition biochemistry. Check them out.
This is my very brief answer to your question. Full explanation involves complex and lengthy biochemistry, and it is not necessary to go into that for education purposes for the housewives and lay public
Regards
JB Lim
Thank, CK Cheong, for consulting the expert advice of Doctor and Nutritionist JB Lim. I really valued reading that controversial coronary / food articles on the net can actually lead to tremendous stress!
And thanks Dr Lim, for taking the trouble and valuable time to explain in the simplest of terms and avoiding all the medical jargons...!!
For your info, I have undergone angioplasty with a 22mm stenting done but two years later, its was completely occluded. The cardiologists advised an immediate off-pump CABG with a double artery graft taken from my wrist - 4 yrs ago)
I am under regular medication of aspirin, irbesarstan SR & atorvastatin, plus many self -administered food supplements like omega fish oil, milk thistle, vit.E and even glucosamine and a few others!
After the CABG, my nutritionist put me on a strict diet and i missed all the high cholesterol food esp. sea food and my favorite soft boiled eggs for yrs.. The unbelievable thing is I immediately gave up smoking 100% after being a heavy chained smoker for 30 yrs!! -- haha, ck, now you know why i gave up smoking!!!
If according to that article, and yr invaluable explanation, I can occasionally deserve a sumptuous meal of crabs and what not!!
So, CK, the next time I visit you in KL, lets go for sea food instead of roti canai!! Invite Dr Lim along!
*Dr. Lim, one more worried question? Do the drugs I take, esp. atorvastatin, does it cause harmful side effect like affecting libido?
** by the way, any one in my situation is sure to be gullible to all sorts of 'professional advice' from the "street doctors" esp. direct sales people on their miracle health food/products.... and i am a regular victim!!
Thanks again,
Still worried, but lesser!
Perry
Monday, May 24, 2010
Sunday, May 23, 2010
Coconut or Rice Water for Diarrhoea
This article was written by Dr JB Lim in response to an article sent by Dr Chan Boon Lye to Dr Lim for advice and comment about the use of ordinary rice water for children who frequently have diarrhoea.
Subsequently this subject was also brought up for discussion by a group of other doctors at a banquet Dr Lim and other medical doctors and scientists attended at the KLCC Convention Ballroom in Kuala Lumpur.
We thought this health issue will be of interest to people as diarrhoea is a very common problem affecting most people especially children. Dr Lim thought he should share his reply and comments to Dr Chan and to other doctors. Here’s what Dr JB Lim wrote to Dr BL Chan
Dear Dr Chan,
Thanks for your advice on the treatment of diarrhea. This is not something new to me. Even way back in the 1960’s as a postgraduate student in Nutrition at the University of London we were already taught the procedure on how to manage cases of infantile diarrhoea in developing countries like those in Africa where medical facilities were so basic and minimal.
We wanted to introduce this approach to all Government Clinics:
When I returned to Malaysia I worked at various Divisions of Rural Health, Community Medicine, Human Nutrition, etc at the Institute for Medical Research (IMR). We conducted health surveys among villages throughout the length and breadth of the country, and we found that diarrhoea was very prevalent in both urban and rural communities. So we thought we should recommend to the Ministry of Health to introduce this simple and extremely effective method of using rice water to treat all diarrhoea in all the villages and government rural clinics all over Malaysia where access to health facilities were at times difficult especially in the remote interiors of Sarawak and Sabah. Our objective was to educate doctors and nurses manning the clinics the use of rice water in managing cases of common diarrhoeas as part of our public health education to the villages.
Surprise response from the medical staff:
But before we did that, we need to conduct a survey to find out the status of how diarrhoeas were managed in government clinics. So we asked the doctors, health and medical team. We expected the doctors to tell us they use diarrhoeal agents - Loperamide (Beamodium), 400 mg of Berberine sulfate, Diphenoxylate HCl 2.5 mg + atropine sulfate 25 mcg (Dhamotil), plus various antibiotics etc, etc.
To our pleasant surprise, the doctors both in the Kuala Lumpur General Hospital (as it was called then) and the government clinics told us that they simply advised the rural folks to drink rice water or take light watery porridge with 2-3 teaspoonful of table salt added. We really didn’t expect them to give us this reply. We expected them to name us the list of anti-diarrhoeal drugs in use then. That was in the 1980’s. Later we found they already learnt of this method before they were posted to the rural clinics.
So this was not new to them nor was it to us. Even Medical Assistants and Rural Health Nurses working in some rural areas were taught this simple method on how to prevent dehydration and reduce infantile mortality in areas where diarrhoeas, malnutrition, and poor hygiene were common. The heath team has already done this even before we could even recommend to the Ministry of Health to introduce them.
Common pathogenic causes:
We know that most of these diarrhoeas in tropical countries like Malaysia are caused mainly by rotavirus, adenoviruses, parvoviruses, astroviruses, and gastroenteritis from bacterial E. coli O157:H7, Salmonella, Shigella, Campylobacter infections, as well as from protozoal infections such as from various types of pathogenic protozoa like amoebasis from amoebas such as Entamoeba histolytica, Gardia (giardiasis), etc, etc…down the list.
Infantile Diarrhoea:
We were aware that in infants persistent diarrhoeas from gastroenteritis can be fatal especially if the child is already suffering from malnutrition. We see children in some of these communities dying unnecessary due to diarrhoeas where dehydration can easily be corrected by merely what we now call it ‘rice water treatment’ There is no need even for so called ‘intravenous drips’ or oral rehydration salts (ORS) as done in a modern hospital. All that is required is to correct for fluid loss and establish electrolyte (potassium, sodium) balance. That is all that is needed.
In fact it is not just rice water or water from rice porridge which is just as good as the intravenous drip, but even any fruit or vegetable juice will do. Even coconut water is excellent.
Coconut water as IV drip:
Just to let you know that even the World Health Organization recommends the use of sterile coconut water to be used as an intravenous drip for fluid replacement and electrolyte imbalance in rural areas of poor countries where modern health facilities are hard to come by. Coconut water inside an unopened coconut is completely sterile, of the right biological electrolyte constituency with near equivalent osmotic tonicity as saline.
Imagine the entire baby coconut tree has to feed and thrive on this water which is exactly like mother’s natural milk for the baby coconut tree. So Mother Nature has prescribed the right fluid, nutrient and salts for the baby coconut inside the nut before it is washed away into the oceans to land ashore by harsh salty sea water to another place to start a new independent tree and life at another place.
So this fluid (coconut water) can never be wrong as it is given by God for a young plant to survive. Moreover, coconut water does not have foreign protein in it to trigger an anaphylactic shock even if infused many times (serial infusions) into any animal and human body. There is no built up of antibodies against any antigen (coconut water) if administered intravenously.
A Tribute to my Professors
We learnt of this from 3 of our professors even as students in England – 2 of them at London University and 1 at Cambridge. Later we found this has been in practice already for a number of years on the recommendation by the World Health Organization for poor tropical countries where young coconuts are readily available, and modern medical facilities are not readily available.
Clean, sterile and biologically just right composition:
Coconut water is absolutely clean and completely sterile, and do not have offensive proteins inside to trigger off increasing titres of antibodies against foreign protein antigen that could lead to anaphylactic events and shocks. Not only purer, cleaner and more sterile than pharmaceutical grade saline-dextrose infusion fluids for IV administration, but the electrolytes therein are of the right biological composition. We can’t beat Nature.
Simple, yet so safe and effective:
So this ‘rice water treatment’ may be used instead of using ORS. The use of coconut water as a direct IV infusion is also not something new to me. Even way back in the late 1960s we already knew about this. Both methods are simple, cheap, readily available, and extremely cost-effective.
We are light years ahead of the Internet:
I thought what you sent to me from the Internet would be something from the 21st Century which we are unaware of. I have always thought the Internet is a very powerful IT tool available only in this 21st Century where we can get lots of the latest information. But it looks like what you tell me only now in 2009 was what we already knew when we were students in the 1960’s.
As far as this piece of medical information is concerned, I think we are light years ahead of even the Internet. Thanks to my professors at London and Cambridge Universities who taught us this traditional and simple method half a century ago. No thanks to the Internet of the 21st Century. It is stale information for me.
Natural therapeutics with rice water is best:
My professional advice is, if you have diarrhoea, whether adult or children, just drink rice water, coconut water, or any fruit juice. There are a lot of water, salts, sugars, various vitamins from all these natural juices. Why go for synthetic ORS, or intravenous drips of crystalloids and colloids, dextrose, saline, Ringer’s lactate, etc as used in big hospitals?
Antibiotics therapeutic regime:
Worse still is for patients to take antibiotics for diarrhoeas which are mainly caused by rotavirus and protozoal infections in tropical countries. The problem is when we get rid of all the bacteria in the intestinal gut – beneficial as well as pathogenic forms and strains with antibiotics only make matter worse by giving opportunistic infections to antibiotic-resistant strains of pathogens to colonize there.
More medical problems than it solves:
This can cause another medical problem called dysbiosis (dysbacteriosis) which is the condition of having microbial imbalances on or within the body due to antibiotics. This is jumping from the frying pan into the fire. Instead of getting rid of all the bacteria (friendly and pathogenic) by random slaughter of all of them with antibiotics, it would be much better to flood the entire GI tract with friendly and beneficial Lactobacilli strains from yoghurt and allow them to colonize in the intestine.
The flood of friendly bacteria in the GIT naturally will outgrow and crowd out all the pathogenic strains. Many friendly strains are very useful in synthesizing many vitamins like vitamin K which are needed for normal blood clotting. Why destroy them with haphazard use of antibiotics? Unfortunately a lot of doctors prescribe unnecessary medication.
A lot of diseases are caused by doctors (iatrogenic diseases) by the unnecessary use of drugs, surgery and other invasive modalities. One example is nosocomial infections in hospitals, and the dangerous rise of MRSA (Methicillin-resistant Staphylococcus aureus) superbugs which are resistant to even the most powerful antibiotics. These are all induced by doctors using unnecessary drugs and over-prescription. Because of this random and wide-spread use of antibiotics, we just do not know how to deal with this MRSA problem anymore
What do I recommend to my patients?
Personally, I always prescribe to my patients who came to me with common diarrhoeas to take yoghurt (cultured milk) which they can easily buy in any supermarket or make their own in their kitchen. Not only yoghurt containing natural intestine-friendly bacteria like Lactobacillus acidophilus, L. bulgaricus, Bifidobacterium, etc, gets rid of all the invading harmful pathogens that caused the diarrhoeas, but they also ferment and breakdown the milk sugar (lactose) for patients who are intolerant to drinking milk (lactose-intolerant). The lack of lactase among Asian adults prevents the breakdown of lactose causing the lactose to ferment in the intestines, giving rise to gas, bloating, and causing them to have diarrhoea. This is yet another cause of having diarrhoea from lactose intolerance not just from all those viruses, bacteria, protozoa and pathogens I earlier listed above.
Even for Candidiasis:
I have also in the past suggested consumption of yoghurt and other probiotics as a prescription to my women patients suffering from vulvovaginal candidiasis (yeast candida infection of vagina) where antifungal agents and drugs like imidazole, miconazole and clotrimazole given previously by their gynecologists and doctors have failed to stopped recurrent infections.
A natural ‘drug’ like yoghurt solved all their recurrent problems. I should have complied all my cases and publish them in a medical journal, but unfortunately I have already retired from active medical research at the Institute for Medical Research.
Mechanism not understood:
Quite honestly I cannot understand the probiotic mechanism behind this therapy. The gastrointestinal tract is quite separate from the genito-urinary tracts system. How then does the Lactobacillus migrate from the anus after ingestion and travel up into the vagina and uterus? The anus and the vaginal orifices are anatomically close to each other and the bacteria could migrate from the anus up the vagina but this is not really a very good answer as it requires quite a bacterial load into the vagina to outgrow all those Candidia spp. It is not easy to get rid of these yeasts once they have established themselves. I am keen to know the probable therapeutic dynamics behind this line of management. As I said even powerful antifungals like imidazole, miconazole and clotrimazole failed to stop the growth.
If what I hypotheses is the probable answer, would it be better to insert yogurt as a cream directly into the vaginal canal instead of oral ingestion via the GI tract? Whatever the explanation is, yoghurt treatment always works for women with recurrent vaginal yeast infections where conventional antifungal preparations failed.
Not just yoghurt:
Not just yoghurt, but any probiotics supplements will do this job very well. But make sure the bacterial count from these probitics pills and dietary supplements are still there, and not destroyed due to prolonged storage, high storage temperatures, poor handling, and lack of GMP (Good Manufacturing Practice) during the production.
Other more serious aetiologies of diarrhoeas:
However, I always make sure my patient’s diarrhoea is due to a simple infections of the GI tract, and food poisoning, and not due to other causes such as osmotic diarrhea (e.g. maldigestion pancreatic disease or coeliac disease), inflammatory diarrhea caused by autoimmune disorders, tuberculosis, cancer of the colon, inflammatory bowel diseases (ulcerative colitis, Crohn's disease, etc), IBS (irritable bowel syndrome), celiac disease, food allergy, ischemic bowel disease, hormone-secreting tumors…etc, etc. A differential diagnosis is important if the diarrhoea is persistent and chronic.
Additionally, I always advise that the diarrhoea, especially if persistent, with mucous and with blood, tarry and black (melena), etc, be properly investigated and diagnosed first, albeit most of them are harmless as a normal physiological response to an irritant somewhere in the intestinal tract. Melena could be suggestive of gastric bleeding or ca (cancer) higher up the colonic tract. Medical history, description of the colour, texture, smell, frequency, signs and symptoms themselves will already give us diagnostic inference with 85 % accuracy without even invasive colonoscopy.
How do I treat myself?
If you were to ask me this question, how do I treat myself in an event of a diarrhoea? Well to tell you, I simple do nothing about it. I just let the diarrhoea run its natural course, and I am always much better after a few episodes of watery stools. If there is also vomiting, I too let the vomiting do its normal physiological job by allowing my body to let go all those causative agents I have ingested (food toxins from food poisoning, bacterial, viral invasion, etc) to throw out all of them.
I just leave it:
I don’t even take rice water, coconut water, fruit juice, ORS, and worse still take all those diarrhoeal drugs to block the food poisons and bacterial load from coming out. I take absolutely nothing, not even water to flash out the toxins. I just allow complete bowel rest by adding nothing more to my digestive system that could only add more load and problems to the digestive tract.
I have suffered from diarrhoea tens of hundreds of times in my life, but not a single time did I do anything to stop the. I knew this was a natural response of my body. If I have ingested any harmful thing in the food I just encourage my body to throw everything out – both by vomiting and stool discharge. In short, I take absolutely no medication, not even rice or coconut water. I just allow the body to do its job with bowel rest for 1-2 days.
The Body Buffering System:
A lot of doctors over treat simple diarrhoea with 5-6 different medications. This is really unnecessarily. The more they prescribe, the happier the drug companies. One of them is always an antibiotic which is always there in every prescription. Even the WHO doesn’t recommend antibiotics for diarrhoea anymore. WHO suggests correcting electrolyte imbalance with ORS and re-establish fluid replacement especially in a small child who is malnourished, and already suffering from protein-energy deficiencies (marasmus and kwashiorkor). Few realize that in an adult patient he would probably have to have 30 -40 episodes of severe diarrhoeas before the body’s homeostasis mechanisms and buffering systems give way.
Death due to diarrhoea:
According to WHO most of the infantile mortality from diarrhoea in poor malnourished communities is due not to the actual pathogens causing the gastroenteritis or food borne illness. Death is not from norovirus, rotovirus, adenovirus, astrovirus, or bacterial Salmonella, Shigella, Staphylococcus, Campylobacter jejuni, Clostridium, Escherichia coli, Yersinia, Cholera Vibrio cholera etc, but from dehydration and loss of electrolytes.
So WHO recommends just correcting the fluid and electrolytes imbalance? That is all that is needed in the management. WHO discourages the use of antibiotics to treat diarrhoea
I remember the late Dato Dr Sam Abraham, a Senior Paediatrician at the then General Hospital Kuala Lumpur with whom I was working in a research project in the late 1970-1980 told me that he has not seen even one case of a child dying because of diarrhoea and dehydration. Maybe he saw only well-nourished children from well-to-do families (he was the Consultant Paediatrician to Agong’s and Sultan’s children). Probably even in children they need to have very serve and frequent diarrhoea (maybe 20-30 episodes within 5-6 hours) before the effects of dehydration is apparent. It all depends on the nutritional status of the child at that time.
But in adults:
In adults where the body mass and normal buffering and homeostasis systems are very much better and stronger, it is not easy to suffer from potassium, sodium imbalance depletion from just 10-20 diarrhoeal events. Personally I have suffered 10-25 diarrhoeal episodes within a single night after getting food poisoning. This has happened few hundred times already in the past eating hawkers food outside. Nothing happened to me. I just did nothing about it, but just let the watery stools get out from the system.
I did not interfere with any medication to block this natural response of my body. The next day I was much, much better after all the discharge. I would be an absolute idiot if I were to interfere with the natural working of my body. I did not die of dehydration from sodium, calcium, potassium, chlorine, magnesium, and bicarbonate imbalance. I did not experience muscle twitching, tetany, cardiac arrhythmias, confusion, muscular weakness, shock, coma or any of those disturbances due to dehydration and salt imbalance.
I did not even want to take my own blood pressure, pulse rate, listen to the bowel noises of intestinal hurry through a stethoscope, or monitor my blood for blood urea nitrogen (BUN), creatinine, and glucose as normally done in a hospital. I just leave them without an iota of treatment, and yet I simply get better after having all those stools thrown out a few times.
Let Nature take her course:
The wrongs and pathogens inside the body need to be thrown out, and not silenced by drugs. I know I have done something wrong (eating contaminated foods) that have harmed my body, so my body was giving me warning by ringing the alarm bells (symptoms), and doing its part with a prescription, not prescribed by any doctor (using harsh drugs to silence the warning alarm bells within my body) but by God and Mother Nature that dictates the body to throw them all out naturally (through diarrhoea and vomiting).
As a nutritionist and doctor interested in non-invasive and non-pharmacological approaches in managing diseases, I respect God and Mother Nature with Her prescription. The body responds to rectify my wrong doings by having all the contaminated food I have taken hours previously, all thrown out from my body. Why interfere? Mother Nature and God is the Programmer and Designer of our body. He knows our body best, and He is the Best Physician in this entire Universe.
Treat the Root causes, NOT the symptoms:
The body is NOT designed and programmed to store poisons or made for the inhibition of warning signals (signs and symptoms) with harsh factory-made drugs and chemicals. Only the patients in their ignorance ask for treatment for their ‘undesirable’ symptoms silenced. They never ask the doctor to help them remove the root causes. Symptoms are NOT diseases, but just warning bells ringing. The root causes caused the problem, but drugs cannot remove root causes. Only lifestyle changes can remove root causes (like ingesting wrong foods).
The best remedy for food poisoning is to allow the body to throw them out naturally through vomiting and diarrhoea. Doctors make matter worse by giving so many medicines to block out this action to stop the vomiting and diarrhoea. But the patients ask for it.
Even when I have Spasms:
There were many times I had severe colicky pains with diarrhoea. I could have stopped the spasms by anti-spasmolytic drugs like Hyoscine butylbromide or Buscopan to get relieve from the pain of intestinal spasms, but I didn’t. I always allow time to let the intestinal spasms to relax naturally, and it always does this without fail – without any pharmacological intervention.
Interfering with Nature:
Can you imagine this scenario? We have taken something wrong for lunch or dinner, and our body is trying to get rid of them by triggering off the vomiting and bowel discharge mechanisms? Then we use powerful drugs to block off those natural physiological responses the body is trying to get rid of those offensive substances we have ingested a few hours ago. What happens next?
Both drugs and toxins now cannot get out:
Not only the food toxins cannot get out after the natural peristaltic movements of the colon is paralysed by the pharmacodynamic actions of some of the drugs the doctor gave us, but the drugs and their metabolites themselves cannot be expelled out through the normal pharmacokinetic pathways. When the food poison and the drug cannot get out through natural vomiting and diarrhoeal discharge, they will have no choice but to enter the bloodstream, into the liver (via portal vein), kidneys, and other organs to be lodged somewhere. The accumulation of these drugs if cannot be properly metabolized and excreted, will cause extensive damage to the DNA, cells, tissues, organs, and all systems – all because most patients in their absolute stupidity wants their symptoms to be abolished immediately (quick ‘cure’) using powerful pharmacological interventions the doctor gave because we ask for it. We complain of the symptoms, and not about the wrong food and the bacterial toxins we took during lunch.
Instant Relief:
In so doing, the doctor using powerful drugs do far more damage to the systems than help our discomfort. But just by the act of vomiting the offensive food out itself, would already make us feel much better within 15-20 seconds after throwing out. I think everybody has experienced this feeling of instant relief through vomiting and diarrhoea in their lives, and I need not have to describe more.
But patients are never interested in the root causes of their diarrhoeas (or any illnesses for that matter). They just only want the doctor to prescribe something (anything will do) to stop their symptoms and discomfort instead of asking the doctor how to identify the root causes, and how to treat the root causes, prevent or rid of them to enable the body to repair itself once again.
Treat the root cause first:
Patients normally just want to get rid of their symptoms such as pain and discomfort rather than going into the root causes of pain, itching, swelling discomfort etc. But signs and symptoms are not a disease per sec. Symptoms like diarrhoea is merely signals the body is trying to cry out to us that we have done something wrong to it, and want us to remove the root causes. Root causes may be anything from bad food and poor nutrition, to smoking, alcoholism, to noise pollution, drugs, chemical and environmental exposures, down to bad late nights and unnecessary stress, and negative thoughts. Any of these are extremely harmful to health, and the body reacts to them by the release of stress hormones like adrenalin, and corticosteroidal hormones, elevated blood pressure, sugars, cholesterol levels, etc. Smoking triggers off coughing, as much as certain viruses, bacteria and yeast infections may trigger off digestive upsets. They are all part of a natural response the body is trying to tell us. But unfortunately when we see a doctor about these symptoms, he uses powerful drugs to interfere and suppress these natural responses.
Let the Body heal itself, not suppress with drugs:
If we understand that something has entered the body, the body’s response is to try to get rid of them. This is the treatment prescribed by Nature. But patients only are interested in getting rid off the symptoms and warning systems using 5-6 unnecessary drugs to suppress them. They are not interested in getting rid of the causes to allow the body to heal itself naturally. But the body is specially designed to repair and heal itself naturally if any thing goes wrong, and if given time.
My advice to all doctors and patients is always to treat the root causes, never the symptoms or silence the body warning systems. But if a doctor explains, advises, and educate a patient, then he will not be able to earn a living out of the patients since consultation is the least and smallest part of his income.
Despite my years of rigorous training:
I don’t take any medicine whenever I am unwell. I just allow my body yo heal itself automatically after a few days of rest.
I realize that for every single capsule or tablet I put into my mouth, it will interfere with the body’s natural chemistry somewhere. This will do a lot of damage somewhere to the body. My training in Physiology, Pharmacology Nutrition and Medicine constantly reminds me of this inherent danger. So I am absolutely careful what I put into my mouth. The only tablets or capsules I take are all the natural health and nutritional supplements such as those produced by Diamond Interest because I know that all DI products are safe and health-protective. I take many of DI products daily after food.
But with other drugs for degenerative disorders, we will ultimately either die of the disease or chronic and accumulative drug toxicity if we depend entirely on drugs alone instead of changing the way we eat and live. I am constantly very mindful of this myself as a physician.
Neither my medical colleagues:
Most of my doctor colleagues told me they too do not dose themselves with unnecessary medication. They told me medications are meant for their patients only but they don’t take them for themselves or prescribe them for their families.
So just to make a quick summary – whenever I suffer from diarrhoea due to food poisoning, I don’t add anything more to my digestive system, whether drugs, coconut water or even rice water. I just allow my bowel to rest for a day or two. I respect Mother Nature to be my best doctor. The natural program in my body is to throw everything out, and once done with, the body heals itself naturally when the root causes are removed naturally.
If only patients know how wonderfully the body is made to protect us, they will never want to take chemicals (drugs) to interfere with the body’s chemistry since most drugs silence the body from crying out in pain or in swelling when something goes wrong.
The Power of the Body:
I only wish more doctors concentrate on physiology on how the body response to a stress, an injury, or a disease, and respect that the body can rectify and heal itself, than spending too much time on pharmacology and how to block symptoms.
Thanks for your article Dr BL Chan seeking my advice and comment. I may share your article and my comments to my medical colleagues and other doctor friends later if you don’t mind.
Regards,
Lim Ju Boo
Subsequently this subject was also brought up for discussion by a group of other doctors at a banquet Dr Lim and other medical doctors and scientists attended at the KLCC Convention Ballroom in Kuala Lumpur.
We thought this health issue will be of interest to people as diarrhoea is a very common problem affecting most people especially children. Dr Lim thought he should share his reply and comments to Dr Chan and to other doctors. Here’s what Dr JB Lim wrote to Dr BL Chan
Dear Dr Chan,
Thanks for your advice on the treatment of diarrhea. This is not something new to me. Even way back in the 1960’s as a postgraduate student in Nutrition at the University of London we were already taught the procedure on how to manage cases of infantile diarrhoea in developing countries like those in Africa where medical facilities were so basic and minimal.
We wanted to introduce this approach to all Government Clinics:
When I returned to Malaysia I worked at various Divisions of Rural Health, Community Medicine, Human Nutrition, etc at the Institute for Medical Research (IMR). We conducted health surveys among villages throughout the length and breadth of the country, and we found that diarrhoea was very prevalent in both urban and rural communities. So we thought we should recommend to the Ministry of Health to introduce this simple and extremely effective method of using rice water to treat all diarrhoea in all the villages and government rural clinics all over Malaysia where access to health facilities were at times difficult especially in the remote interiors of Sarawak and Sabah. Our objective was to educate doctors and nurses manning the clinics the use of rice water in managing cases of common diarrhoeas as part of our public health education to the villages.
Surprise response from the medical staff:
But before we did that, we need to conduct a survey to find out the status of how diarrhoeas were managed in government clinics. So we asked the doctors, health and medical team. We expected the doctors to tell us they use diarrhoeal agents - Loperamide (Beamodium), 400 mg of Berberine sulfate, Diphenoxylate HCl 2.5 mg + atropine sulfate 25 mcg (Dhamotil), plus various antibiotics etc, etc.
To our pleasant surprise, the doctors both in the Kuala Lumpur General Hospital (as it was called then) and the government clinics told us that they simply advised the rural folks to drink rice water or take light watery porridge with 2-3 teaspoonful of table salt added. We really didn’t expect them to give us this reply. We expected them to name us the list of anti-diarrhoeal drugs in use then. That was in the 1980’s. Later we found they already learnt of this method before they were posted to the rural clinics.
So this was not new to them nor was it to us. Even Medical Assistants and Rural Health Nurses working in some rural areas were taught this simple method on how to prevent dehydration and reduce infantile mortality in areas where diarrhoeas, malnutrition, and poor hygiene were common. The heath team has already done this even before we could even recommend to the Ministry of Health to introduce them.
Common pathogenic causes:
We know that most of these diarrhoeas in tropical countries like Malaysia are caused mainly by rotavirus, adenoviruses, parvoviruses, astroviruses, and gastroenteritis from bacterial E. coli O157:H7, Salmonella, Shigella, Campylobacter infections, as well as from protozoal infections such as from various types of pathogenic protozoa like amoebasis from amoebas such as Entamoeba histolytica, Gardia (giardiasis), etc, etc…down the list.
Infantile Diarrhoea:
We were aware that in infants persistent diarrhoeas from gastroenteritis can be fatal especially if the child is already suffering from malnutrition. We see children in some of these communities dying unnecessary due to diarrhoeas where dehydration can easily be corrected by merely what we now call it ‘rice water treatment’ There is no need even for so called ‘intravenous drips’ or oral rehydration salts (ORS) as done in a modern hospital. All that is required is to correct for fluid loss and establish electrolyte (potassium, sodium) balance. That is all that is needed.
In fact it is not just rice water or water from rice porridge which is just as good as the intravenous drip, but even any fruit or vegetable juice will do. Even coconut water is excellent.
Coconut water as IV drip:
Just to let you know that even the World Health Organization recommends the use of sterile coconut water to be used as an intravenous drip for fluid replacement and electrolyte imbalance in rural areas of poor countries where modern health facilities are hard to come by. Coconut water inside an unopened coconut is completely sterile, of the right biological electrolyte constituency with near equivalent osmotic tonicity as saline.
Imagine the entire baby coconut tree has to feed and thrive on this water which is exactly like mother’s natural milk for the baby coconut tree. So Mother Nature has prescribed the right fluid, nutrient and salts for the baby coconut inside the nut before it is washed away into the oceans to land ashore by harsh salty sea water to another place to start a new independent tree and life at another place.
So this fluid (coconut water) can never be wrong as it is given by God for a young plant to survive. Moreover, coconut water does not have foreign protein in it to trigger an anaphylactic shock even if infused many times (serial infusions) into any animal and human body. There is no built up of antibodies against any antigen (coconut water) if administered intravenously.
A Tribute to my Professors
We learnt of this from 3 of our professors even as students in England – 2 of them at London University and 1 at Cambridge. Later we found this has been in practice already for a number of years on the recommendation by the World Health Organization for poor tropical countries where young coconuts are readily available, and modern medical facilities are not readily available.
Clean, sterile and biologically just right composition:
Coconut water is absolutely clean and completely sterile, and do not have offensive proteins inside to trigger off increasing titres of antibodies against foreign protein antigen that could lead to anaphylactic events and shocks. Not only purer, cleaner and more sterile than pharmaceutical grade saline-dextrose infusion fluids for IV administration, but the electrolytes therein are of the right biological composition. We can’t beat Nature.
Simple, yet so safe and effective:
So this ‘rice water treatment’ may be used instead of using ORS. The use of coconut water as a direct IV infusion is also not something new to me. Even way back in the late 1960s we already knew about this. Both methods are simple, cheap, readily available, and extremely cost-effective.
We are light years ahead of the Internet:
I thought what you sent to me from the Internet would be something from the 21st Century which we are unaware of. I have always thought the Internet is a very powerful IT tool available only in this 21st Century where we can get lots of the latest information. But it looks like what you tell me only now in 2009 was what we already knew when we were students in the 1960’s.
As far as this piece of medical information is concerned, I think we are light years ahead of even the Internet. Thanks to my professors at London and Cambridge Universities who taught us this traditional and simple method half a century ago. No thanks to the Internet of the 21st Century. It is stale information for me.
Natural therapeutics with rice water is best:
My professional advice is, if you have diarrhoea, whether adult or children, just drink rice water, coconut water, or any fruit juice. There are a lot of water, salts, sugars, various vitamins from all these natural juices. Why go for synthetic ORS, or intravenous drips of crystalloids and colloids, dextrose, saline, Ringer’s lactate, etc as used in big hospitals?
Antibiotics therapeutic regime:
Worse still is for patients to take antibiotics for diarrhoeas which are mainly caused by rotavirus and protozoal infections in tropical countries. The problem is when we get rid of all the bacteria in the intestinal gut – beneficial as well as pathogenic forms and strains with antibiotics only make matter worse by giving opportunistic infections to antibiotic-resistant strains of pathogens to colonize there.
More medical problems than it solves:
This can cause another medical problem called dysbiosis (dysbacteriosis) which is the condition of having microbial imbalances on or within the body due to antibiotics. This is jumping from the frying pan into the fire. Instead of getting rid of all the bacteria (friendly and pathogenic) by random slaughter of all of them with antibiotics, it would be much better to flood the entire GI tract with friendly and beneficial Lactobacilli strains from yoghurt and allow them to colonize in the intestine.
The flood of friendly bacteria in the GIT naturally will outgrow and crowd out all the pathogenic strains. Many friendly strains are very useful in synthesizing many vitamins like vitamin K which are needed for normal blood clotting. Why destroy them with haphazard use of antibiotics? Unfortunately a lot of doctors prescribe unnecessary medication.
A lot of diseases are caused by doctors (iatrogenic diseases) by the unnecessary use of drugs, surgery and other invasive modalities. One example is nosocomial infections in hospitals, and the dangerous rise of MRSA (Methicillin-resistant Staphylococcus aureus) superbugs which are resistant to even the most powerful antibiotics. These are all induced by doctors using unnecessary drugs and over-prescription. Because of this random and wide-spread use of antibiotics, we just do not know how to deal with this MRSA problem anymore
What do I recommend to my patients?
Personally, I always prescribe to my patients who came to me with common diarrhoeas to take yoghurt (cultured milk) which they can easily buy in any supermarket or make their own in their kitchen. Not only yoghurt containing natural intestine-friendly bacteria like Lactobacillus acidophilus, L. bulgaricus, Bifidobacterium, etc, gets rid of all the invading harmful pathogens that caused the diarrhoeas, but they also ferment and breakdown the milk sugar (lactose) for patients who are intolerant to drinking milk (lactose-intolerant). The lack of lactase among Asian adults prevents the breakdown of lactose causing the lactose to ferment in the intestines, giving rise to gas, bloating, and causing them to have diarrhoea. This is yet another cause of having diarrhoea from lactose intolerance not just from all those viruses, bacteria, protozoa and pathogens I earlier listed above.
Even for Candidiasis:
I have also in the past suggested consumption of yoghurt and other probiotics as a prescription to my women patients suffering from vulvovaginal candidiasis (yeast candida infection of vagina) where antifungal agents and drugs like imidazole, miconazole and clotrimazole given previously by their gynecologists and doctors have failed to stopped recurrent infections.
A natural ‘drug’ like yoghurt solved all their recurrent problems. I should have complied all my cases and publish them in a medical journal, but unfortunately I have already retired from active medical research at the Institute for Medical Research.
Mechanism not understood:
Quite honestly I cannot understand the probiotic mechanism behind this therapy. The gastrointestinal tract is quite separate from the genito-urinary tracts system. How then does the Lactobacillus migrate from the anus after ingestion and travel up into the vagina and uterus? The anus and the vaginal orifices are anatomically close to each other and the bacteria could migrate from the anus up the vagina but this is not really a very good answer as it requires quite a bacterial load into the vagina to outgrow all those Candidia spp. It is not easy to get rid of these yeasts once they have established themselves. I am keen to know the probable therapeutic dynamics behind this line of management. As I said even powerful antifungals like imidazole, miconazole and clotrimazole failed to stop the growth.
If what I hypotheses is the probable answer, would it be better to insert yogurt as a cream directly into the vaginal canal instead of oral ingestion via the GI tract? Whatever the explanation is, yoghurt treatment always works for women with recurrent vaginal yeast infections where conventional antifungal preparations failed.
Not just yoghurt:
Not just yoghurt, but any probiotics supplements will do this job very well. But make sure the bacterial count from these probitics pills and dietary supplements are still there, and not destroyed due to prolonged storage, high storage temperatures, poor handling, and lack of GMP (Good Manufacturing Practice) during the production.
Other more serious aetiologies of diarrhoeas:
However, I always make sure my patient’s diarrhoea is due to a simple infections of the GI tract, and food poisoning, and not due to other causes such as osmotic diarrhea (e.g. maldigestion pancreatic disease or coeliac disease), inflammatory diarrhea caused by autoimmune disorders, tuberculosis, cancer of the colon, inflammatory bowel diseases (ulcerative colitis, Crohn's disease, etc), IBS (irritable bowel syndrome), celiac disease, food allergy, ischemic bowel disease, hormone-secreting tumors…etc, etc. A differential diagnosis is important if the diarrhoea is persistent and chronic.
Additionally, I always advise that the diarrhoea, especially if persistent, with mucous and with blood, tarry and black (melena), etc, be properly investigated and diagnosed first, albeit most of them are harmless as a normal physiological response to an irritant somewhere in the intestinal tract. Melena could be suggestive of gastric bleeding or ca (cancer) higher up the colonic tract. Medical history, description of the colour, texture, smell, frequency, signs and symptoms themselves will already give us diagnostic inference with 85 % accuracy without even invasive colonoscopy.
How do I treat myself?
If you were to ask me this question, how do I treat myself in an event of a diarrhoea? Well to tell you, I simple do nothing about it. I just let the diarrhoea run its natural course, and I am always much better after a few episodes of watery stools. If there is also vomiting, I too let the vomiting do its normal physiological job by allowing my body to let go all those causative agents I have ingested (food toxins from food poisoning, bacterial, viral invasion, etc) to throw out all of them.
I just leave it:
I don’t even take rice water, coconut water, fruit juice, ORS, and worse still take all those diarrhoeal drugs to block the food poisons and bacterial load from coming out. I take absolutely nothing, not even water to flash out the toxins. I just allow complete bowel rest by adding nothing more to my digestive system that could only add more load and problems to the digestive tract.
I have suffered from diarrhoea tens of hundreds of times in my life, but not a single time did I do anything to stop the. I knew this was a natural response of my body. If I have ingested any harmful thing in the food I just encourage my body to throw everything out – both by vomiting and stool discharge. In short, I take absolutely no medication, not even rice or coconut water. I just allow the body to do its job with bowel rest for 1-2 days.
The Body Buffering System:
A lot of doctors over treat simple diarrhoea with 5-6 different medications. This is really unnecessarily. The more they prescribe, the happier the drug companies. One of them is always an antibiotic which is always there in every prescription. Even the WHO doesn’t recommend antibiotics for diarrhoea anymore. WHO suggests correcting electrolyte imbalance with ORS and re-establish fluid replacement especially in a small child who is malnourished, and already suffering from protein-energy deficiencies (marasmus and kwashiorkor). Few realize that in an adult patient he would probably have to have 30 -40 episodes of severe diarrhoeas before the body’s homeostasis mechanisms and buffering systems give way.
Death due to diarrhoea:
According to WHO most of the infantile mortality from diarrhoea in poor malnourished communities is due not to the actual pathogens causing the gastroenteritis or food borne illness. Death is not from norovirus, rotovirus, adenovirus, astrovirus, or bacterial Salmonella, Shigella, Staphylococcus, Campylobacter jejuni, Clostridium, Escherichia coli, Yersinia, Cholera Vibrio cholera etc, but from dehydration and loss of electrolytes.
So WHO recommends just correcting the fluid and electrolytes imbalance? That is all that is needed in the management. WHO discourages the use of antibiotics to treat diarrhoea
I remember the late Dato Dr Sam Abraham, a Senior Paediatrician at the then General Hospital Kuala Lumpur with whom I was working in a research project in the late 1970-1980 told me that he has not seen even one case of a child dying because of diarrhoea and dehydration. Maybe he saw only well-nourished children from well-to-do families (he was the Consultant Paediatrician to Agong’s and Sultan’s children). Probably even in children they need to have very serve and frequent diarrhoea (maybe 20-30 episodes within 5-6 hours) before the effects of dehydration is apparent. It all depends on the nutritional status of the child at that time.
But in adults:
In adults where the body mass and normal buffering and homeostasis systems are very much better and stronger, it is not easy to suffer from potassium, sodium imbalance depletion from just 10-20 diarrhoeal events. Personally I have suffered 10-25 diarrhoeal episodes within a single night after getting food poisoning. This has happened few hundred times already in the past eating hawkers food outside. Nothing happened to me. I just did nothing about it, but just let the watery stools get out from the system.
I did not interfere with any medication to block this natural response of my body. The next day I was much, much better after all the discharge. I would be an absolute idiot if I were to interfere with the natural working of my body. I did not die of dehydration from sodium, calcium, potassium, chlorine, magnesium, and bicarbonate imbalance. I did not experience muscle twitching, tetany, cardiac arrhythmias, confusion, muscular weakness, shock, coma or any of those disturbances due to dehydration and salt imbalance.
I did not even want to take my own blood pressure, pulse rate, listen to the bowel noises of intestinal hurry through a stethoscope, or monitor my blood for blood urea nitrogen (BUN), creatinine, and glucose as normally done in a hospital. I just leave them without an iota of treatment, and yet I simply get better after having all those stools thrown out a few times.
Let Nature take her course:
The wrongs and pathogens inside the body need to be thrown out, and not silenced by drugs. I know I have done something wrong (eating contaminated foods) that have harmed my body, so my body was giving me warning by ringing the alarm bells (symptoms), and doing its part with a prescription, not prescribed by any doctor (using harsh drugs to silence the warning alarm bells within my body) but by God and Mother Nature that dictates the body to throw them all out naturally (through diarrhoea and vomiting).
As a nutritionist and doctor interested in non-invasive and non-pharmacological approaches in managing diseases, I respect God and Mother Nature with Her prescription. The body responds to rectify my wrong doings by having all the contaminated food I have taken hours previously, all thrown out from my body. Why interfere? Mother Nature and God is the Programmer and Designer of our body. He knows our body best, and He is the Best Physician in this entire Universe.
Treat the Root causes, NOT the symptoms:
The body is NOT designed and programmed to store poisons or made for the inhibition of warning signals (signs and symptoms) with harsh factory-made drugs and chemicals. Only the patients in their ignorance ask for treatment for their ‘undesirable’ symptoms silenced. They never ask the doctor to help them remove the root causes. Symptoms are NOT diseases, but just warning bells ringing. The root causes caused the problem, but drugs cannot remove root causes. Only lifestyle changes can remove root causes (like ingesting wrong foods).
The best remedy for food poisoning is to allow the body to throw them out naturally through vomiting and diarrhoea. Doctors make matter worse by giving so many medicines to block out this action to stop the vomiting and diarrhoea. But the patients ask for it.
Even when I have Spasms:
There were many times I had severe colicky pains with diarrhoea. I could have stopped the spasms by anti-spasmolytic drugs like Hyoscine butylbromide or Buscopan to get relieve from the pain of intestinal spasms, but I didn’t. I always allow time to let the intestinal spasms to relax naturally, and it always does this without fail – without any pharmacological intervention.
Interfering with Nature:
Can you imagine this scenario? We have taken something wrong for lunch or dinner, and our body is trying to get rid of them by triggering off the vomiting and bowel discharge mechanisms? Then we use powerful drugs to block off those natural physiological responses the body is trying to get rid of those offensive substances we have ingested a few hours ago. What happens next?
Both drugs and toxins now cannot get out:
Not only the food toxins cannot get out after the natural peristaltic movements of the colon is paralysed by the pharmacodynamic actions of some of the drugs the doctor gave us, but the drugs and their metabolites themselves cannot be expelled out through the normal pharmacokinetic pathways. When the food poison and the drug cannot get out through natural vomiting and diarrhoeal discharge, they will have no choice but to enter the bloodstream, into the liver (via portal vein), kidneys, and other organs to be lodged somewhere. The accumulation of these drugs if cannot be properly metabolized and excreted, will cause extensive damage to the DNA, cells, tissues, organs, and all systems – all because most patients in their absolute stupidity wants their symptoms to be abolished immediately (quick ‘cure’) using powerful pharmacological interventions the doctor gave because we ask for it. We complain of the symptoms, and not about the wrong food and the bacterial toxins we took during lunch.
Instant Relief:
In so doing, the doctor using powerful drugs do far more damage to the systems than help our discomfort. But just by the act of vomiting the offensive food out itself, would already make us feel much better within 15-20 seconds after throwing out. I think everybody has experienced this feeling of instant relief through vomiting and diarrhoea in their lives, and I need not have to describe more.
But patients are never interested in the root causes of their diarrhoeas (or any illnesses for that matter). They just only want the doctor to prescribe something (anything will do) to stop their symptoms and discomfort instead of asking the doctor how to identify the root causes, and how to treat the root causes, prevent or rid of them to enable the body to repair itself once again.
Treat the root cause first:
Patients normally just want to get rid of their symptoms such as pain and discomfort rather than going into the root causes of pain, itching, swelling discomfort etc. But signs and symptoms are not a disease per sec. Symptoms like diarrhoea is merely signals the body is trying to cry out to us that we have done something wrong to it, and want us to remove the root causes. Root causes may be anything from bad food and poor nutrition, to smoking, alcoholism, to noise pollution, drugs, chemical and environmental exposures, down to bad late nights and unnecessary stress, and negative thoughts. Any of these are extremely harmful to health, and the body reacts to them by the release of stress hormones like adrenalin, and corticosteroidal hormones, elevated blood pressure, sugars, cholesterol levels, etc. Smoking triggers off coughing, as much as certain viruses, bacteria and yeast infections may trigger off digestive upsets. They are all part of a natural response the body is trying to tell us. But unfortunately when we see a doctor about these symptoms, he uses powerful drugs to interfere and suppress these natural responses.
Let the Body heal itself, not suppress with drugs:
If we understand that something has entered the body, the body’s response is to try to get rid of them. This is the treatment prescribed by Nature. But patients only are interested in getting rid off the symptoms and warning systems using 5-6 unnecessary drugs to suppress them. They are not interested in getting rid of the causes to allow the body to heal itself naturally. But the body is specially designed to repair and heal itself naturally if any thing goes wrong, and if given time.
My advice to all doctors and patients is always to treat the root causes, never the symptoms or silence the body warning systems. But if a doctor explains, advises, and educate a patient, then he will not be able to earn a living out of the patients since consultation is the least and smallest part of his income.
Despite my years of rigorous training:
I don’t take any medicine whenever I am unwell. I just allow my body yo heal itself automatically after a few days of rest.
I realize that for every single capsule or tablet I put into my mouth, it will interfere with the body’s natural chemistry somewhere. This will do a lot of damage somewhere to the body. My training in Physiology, Pharmacology Nutrition and Medicine constantly reminds me of this inherent danger. So I am absolutely careful what I put into my mouth. The only tablets or capsules I take are all the natural health and nutritional supplements such as those produced by Diamond Interest because I know that all DI products are safe and health-protective. I take many of DI products daily after food.
But with other drugs for degenerative disorders, we will ultimately either die of the disease or chronic and accumulative drug toxicity if we depend entirely on drugs alone instead of changing the way we eat and live. I am constantly very mindful of this myself as a physician.
Neither my medical colleagues:
Most of my doctor colleagues told me they too do not dose themselves with unnecessary medication. They told me medications are meant for their patients only but they don’t take them for themselves or prescribe them for their families.
So just to make a quick summary – whenever I suffer from diarrhoea due to food poisoning, I don’t add anything more to my digestive system, whether drugs, coconut water or even rice water. I just allow my bowel to rest for a day or two. I respect Mother Nature to be my best doctor. The natural program in my body is to throw everything out, and once done with, the body heals itself naturally when the root causes are removed naturally.
If only patients know how wonderfully the body is made to protect us, they will never want to take chemicals (drugs) to interfere with the body’s chemistry since most drugs silence the body from crying out in pain or in swelling when something goes wrong.
The Power of the Body:
I only wish more doctors concentrate on physiology on how the body response to a stress, an injury, or a disease, and respect that the body can rectify and heal itself, than spending too much time on pharmacology and how to block symptoms.
Thanks for your article Dr BL Chan seeking my advice and comment. I may share your article and my comments to my medical colleagues and other doctor friends later if you don’t mind.
Regards,
Lim Ju Boo
Eggs are Good or Bad for Health?
Date: Mon, 4 May 2009 08:33:20 +1000
Subject: Fwd: Egg Yolk Is Good For You
Letter via e-mail from Ir. Cheong C Kwong, Pinkpink devil and Ms Josephine Wong to Dr. JB Lim asking on an article below:
Egg Yolk is Good for You
Here's some advice for all the misguided people who've been throwing away egg yolk.
And affirmation for all the wise people who've been making delicious
pineapple tarts.
And fulsome praise for all those who eat four half-boiled eggs every morning.
Egg yolks are good for you. A lot of lay people do not understand the truth about egg yolks. Many people throw away the egg yolk because they think that's where all the nasty fat and cholesterol is. This is a perfect example of how confused most people are about nutrition. In a world full of misinformation, somehow most people now mistakenly think that the egg yolk is the worst part of the egg, when in fact, the YOLK IS THE
HEALTHIEST PART OF THE EGG! By throwing out the yolk and only eating egg whites, you're essentially throwing out the most nutrient dense, antioxidant-rich, vitamin and mineral loaded portion of the egg. The yolks contain so many B-vitamins, trace minerals, vitamin A, folate, choline, lutein, and other powerful nutrients... it's not even worth trying to list them all.
In fact, the egg whites are almost devoid of nutrition compared to the yolk. Even the protein in egg whites isn't as powerful without the yolks to balance out the amino acid profile and make the protein more bio-available. Not to even mention that the egg yolks from free range chickens are loaded with omega-3 fatty acids. Yolks contain more than 90% of the calcium, iron, phosphorus, zinc, thiamin, B6, folate, and B12, and panthothenic acid of the egg. In addition, the yolks contain all of the fat soluble vitamins A, D, E, and K in the egg, as well as all of the essential fatty acids.
And now the common objection I get all the time when I say that the yolks are the most nutritious part of the egg...'But I heard that whole eggs will skyrocket my cholesterol through the roof.' No, this is FALSE! First of all, when you eat a food that contains a high amount of dietary cholesterol such as eggs, your body down-regulates its internal production of cholesterol to balance things out. On the other hand, if you don't eat enough cholesterol, your body simply produces more since cholesterol has tons of important functions in the body.
And here's where it gets even more interesting...There are indications that eating whole eggs actually raises your good HDL cholesterol to a higher degree than LDL cholesterol, thereby improving your overall cholesterol ratio and blood chemistry.
And 3rd, high cholesterol is NOT a disease! Heart disease is a disease...but high cholesterol is NOT. You can read the following article about why trying to attack cholesterol is a mistake, and what the REAL deadly risk factors actually are...
http://www.truthaboutabs.com/cholesterol-myths.html
So I hope we've established that whole eggs are not some evil food that will wreck your body... instead whole eggs are FAR superior to egg whites!!
Also, your normal supermarket eggs coming from mass factory farming just don't compare nutritionally with organic free range eggs from healthy chickens that are allowed to roam freely and eat a more natural diet. (Like Kampong chicken!).
I recently compared eggs I bought at the grocery store with a batch of eggs I got at a farm stand where the chickens were free roaming and healthy. Most people don't realize that there's a major difference because they've never bought real eggs from healthy chickens...The eggs from the grocery store had pale yellow yolks. On the other hand, the healthier free range eggs had deep orange colored yolks indicating much higher nutrition levels and carotenoids.
So next time a health or fitness professional tells you that egg whites are superior, you can quietly ignore their advice knowing that you understand the REAL deal about egg yolks.
One more thing about eggs... I read a study recently that compared groups of people that ate egg breakfast vs. groups of people that ate cereal or bagel based breakfasts. The results of the study showed that the egg eaters lost or maintained a healthier bodyweight, while the cereal / bagel eaters gained weight.
It was hypothesized that the egg eaters actually ate less calories during the remainder of the day because their appetite was more satisfied compared to the cereal / bagel eaters who would have been more prone to wild blood sugar swings and food cravings.
Reply and comments by Dr Lim Ju Boo to the above article:
Dear Miss Josephine Wong and others,
Thank you for seeking my advice about eggs. Someone has sent me this same article about eggs many months ago, and he has asked me the same question you asked here. They too have requested me to comment on it. Many thanks for your information about the misnomer that egg yolk is nutritionally bad for health. Below is a summary of my assurance.
I powerfully support the above article sent to me for review. A lot of half-cooked ‘nutritionist’ and health freaks need to undergo a proper and qualified 4 year bachelor degree course in nutrition and food science in a properly recognized university before they talk and spread absolute rubbish that egg yolk is bad for health because they contain cholesterol.
Let me straight away tell you that although eggs are high in cholesterol this has no impact in raising blood cholesterol. An average hen’s egg is about 50 gm. and has about 140 mg cholesterol 3.7 gm fat. This means even if I eat 10 eggs everyday, the amount of cholesterol intake daily is 140 x 10 = 1400 mg (1.4 gm).
Blood volume:
The blood volume of an adult male weighing 70 kg is about 5 liters (5000 dl). This is the amount of blood circulating round the body outside the tissues, and does not include the cerebrospinal fluid nor the amount of intracellular fluid found inside every cell of an average human body, estimated to be around 100 million, million (100 trillion) of them. The total amount of water in a man of average weight (70 kilograms) is approximately 40 liters, averaging 57 percent of his total body weight.
Biological fluids distributions elsewhere:
Lean muscle tissue contains about 75% water by weight. Blood contains almost 70% water, body fat contains 10% water and bone has 22% water. Skin also contains much water. The human body is about 60% water in adult males and 55% in adult females.
Cholesterol not only found in the blood:
Let us assume that all the cholesterol in the body is found only in the blood. This is of course not true since many other organs like the brain and liver contain much more cholesterol than in the blood. But let us assume that this is true just for the sake of simple arithmetical calculation.
Cholesterol intake:
A person of about 68 kg (150 pounds), typical total body cholesterol synthesis is about 1 g (1,000 mg) per day, and total body content is about 35 g. A typical daily additional dietary intake in Malaysia and societies with similar dietary patterns is 200–300 mg. The body compensates for cholesterol intake by reducing the amount synthesized. Cholesterol is recycled. It is excreted by the liver via the bile into the digestive tract. Typically about 50% of the excreted cholesterol is reabsorbed by the small bowel back into the blood stream.
How much:
This means that even if we are able to eat 10 eggs a day, the total cholesterol intake from 10 eggs (exogenous source) would only raise the cholesterol in the blood by only 10 x 140 mg ÷ 5000 dl x 100 = 28 mg /dl. The normal desirable total blood cholesterol level is < 200 mg /dl. Most people have a blood cholesterol level of 185 mg /dl. So this means even if we are able to eat 10 eggs a day. This will raise the cholesterol level by just 185 + 28 = 213 mg /dl. But that is not all. We are only assuming that the body does nothing about it.
But the body does not just keep quiet and let the cholesterol just accumulate like dirt daily into the body. The body will throw out all the excess cholesterol it does not want through the bile. But some of them are also reabsorbed.
Biochemistry:
Cholesterol is oxidized by the liver into a variety of bile acids. These in turn are conjugated with glycine, taurine, glucuronic acid, or sulphate. A mixture of conjugated and non-conjugated bile acids along with cholesterol itself is excreted from the liver into the bile. Approximately 95% of the bile acids are reabsorbed from the intestines and the remainder lost in the feces. The excretion and reabsorption of bile acids forms the basis of the enterohepatic circulation which is essential for the digestion and absorption of dietary fats.
Under certain circumstances, when more concentrated, as in the gallbladder, cholesterol crystallizes and is the major constituent of most gallstones, although lecithin and bilirubin gallstones also occur less frequently.
Endogenous and exogenous balance:
Notwithstanding this, the body is able to establish a balance between endogenous and exogenous sources of cholesterol and establish a homeostatic balance in he blood. If this mechanism is not operative, then we will start to accumulate more and more cholesterol into the blood for every spoonful of cholesterol rich foods we take everyday. Even if we take absolutely no cholesterol at all, the liver will still be able to synthesize 10 times more cholesterol than all the cholesterol we can eat in a day. How much eggs, brain or liver can you eat in a day? One thousand eggs, 100 kg of liver or 100 kg of brain?
Out of date belief:
Some 60 years ago it was thought that cholesterol rich foods raised blood cholesterol. This effect is very temporary as the body adjusts itself to sudden influx of ingested cholesterol. But this belief is now completely out-molded and it is now no more fashionable to say that cholesterol rich foods like eggs is unhealthy to consume as it can cause heart disease. This is great grandfather’s theory which is now thrown into the dustbin by modern nutrition scientists. Milk and eggs are world’s most nutritious and health-protective foods
Biological Value:
The biological value and chemical score of protein in a whole egg depends mainly on the egg yolk rather than the albumin in the white of egg. The protein in it has very high nutritive value. In fact the nutritive value of the entire egg rests mainly on the yolk and not the white of egg.
The protein of an egg or whole milk has a score of 100 and this score is taken as the reference score of protein. It is this value around which all other proteins from all other sources of food have to be compared.
The entire un-hatched chick depends on it:
Just remember this – the entire chick from embryo until it is hatched and becomes nutritionally independent has to depend entirely on what is provided from the entire egg (yolk and white) as much as a baby has to depend entirely on her mother’s milk for growth and development till the age of at least 6 months. Both milk and whole egg is the best food in the world – complete in their entire spectrum of nutrients. No other food can beat them in health and growth promoting properties.
Timely to block unqualified health freaks by an Act of Parliament:
If I don’t give out this message and support what you sent me, we will get half-boiled health freaks and ‘nutritionist’ lurking around passing the message round that milk is also bad for health because it contains saturated milk fats and cholesterol.
But you reecho what we already knew only now in 2009 which is also very timely because there are a lot of so-called ‘health experts’ out there, who not only confuse themselves, but confuse others also.
Because of these people, I personally saw, on so many occasions people just threw away the egg yolk and ate only the egg white which is largely albumin - 64 % ovalbumin which actually blocks the action of digestive enzymes while the 12 % ovotransferrin binds with the iron and make it biologically unavailable to the body, and the 11 % ovomucoid has the same action as the ovalbumin that also blocks the digestive enzymes in the gastrointestinal guts.
The Practice of Nutrition to be Legalized:
See this imminent Act of Parliament (website below) to register All Professionally Qualified Nutritionists and the Practice of Nutrition as a Legalized Profession in Malaysia to safeguard the Public against quack nutritionists in Direct Selling, Beauty Saloons, Health Clinics and health clubs, executive clubs, etc
http://www.nutriweb.org.my/article.php?sid=147
Reverse Nutrition by Freaks & Extremists:
These health freaks are doing the opposite thing – all because they listen to another of their equally blind health extremists’ friends chit-chatting in the coffee shop instead of going to a proper university to undergo a proper intensive course in human clinical nutrition.
Just to let you know, I know of many people who eat a minimum of two fried eggs a day ever since they were in their 20s, and now at over 80 years, their blood cholesterol levels is just 4.5 mmol /dl which is well below normal. They do not suffer from any heart disease as far as their yearly medical examination showed.
Yes, I support the article sent to me for advice and comment. I hope this will assure everyone that a whole egg is one of the best and most nutritious foods available on this planet.
Regards
Lim Ju Boo
Formerly
Research Nutritionist
Massachusetts Institute of Technology (MIT) &
Institute for Medical Research, Malaysia
Subject: Fwd: Egg Yolk Is Good For You
Letter via e-mail from Ir. Cheong C Kwong, Pinkpink devil and Ms Josephine Wong to Dr. JB Lim asking on an article below:
Egg Yolk is Good for You
Here's some advice for all the misguided people who've been throwing away egg yolk.
And affirmation for all the wise people who've been making delicious
pineapple tarts.
And fulsome praise for all those who eat four half-boiled eggs every morning.
Egg yolks are good for you. A lot of lay people do not understand the truth about egg yolks. Many people throw away the egg yolk because they think that's where all the nasty fat and cholesterol is. This is a perfect example of how confused most people are about nutrition. In a world full of misinformation, somehow most people now mistakenly think that the egg yolk is the worst part of the egg, when in fact, the YOLK IS THE
HEALTHIEST PART OF THE EGG! By throwing out the yolk and only eating egg whites, you're essentially throwing out the most nutrient dense, antioxidant-rich, vitamin and mineral loaded portion of the egg. The yolks contain so many B-vitamins, trace minerals, vitamin A, folate, choline, lutein, and other powerful nutrients... it's not even worth trying to list them all.
In fact, the egg whites are almost devoid of nutrition compared to the yolk. Even the protein in egg whites isn't as powerful without the yolks to balance out the amino acid profile and make the protein more bio-available. Not to even mention that the egg yolks from free range chickens are loaded with omega-3 fatty acids. Yolks contain more than 90% of the calcium, iron, phosphorus, zinc, thiamin, B6, folate, and B12, and panthothenic acid of the egg. In addition, the yolks contain all of the fat soluble vitamins A, D, E, and K in the egg, as well as all of the essential fatty acids.
And now the common objection I get all the time when I say that the yolks are the most nutritious part of the egg...'But I heard that whole eggs will skyrocket my cholesterol through the roof.' No, this is FALSE! First of all, when you eat a food that contains a high amount of dietary cholesterol such as eggs, your body down-regulates its internal production of cholesterol to balance things out. On the other hand, if you don't eat enough cholesterol, your body simply produces more since cholesterol has tons of important functions in the body.
And here's where it gets even more interesting...There are indications that eating whole eggs actually raises your good HDL cholesterol to a higher degree than LDL cholesterol, thereby improving your overall cholesterol ratio and blood chemistry.
And 3rd, high cholesterol is NOT a disease! Heart disease is a disease...but high cholesterol is NOT. You can read the following article about why trying to attack cholesterol is a mistake, and what the REAL deadly risk factors actually are...
http://www.truthaboutabs.com/cholesterol-myths.html
So I hope we've established that whole eggs are not some evil food that will wreck your body... instead whole eggs are FAR superior to egg whites!!
Also, your normal supermarket eggs coming from mass factory farming just don't compare nutritionally with organic free range eggs from healthy chickens that are allowed to roam freely and eat a more natural diet. (Like Kampong chicken!).
I recently compared eggs I bought at the grocery store with a batch of eggs I got at a farm stand where the chickens were free roaming and healthy. Most people don't realize that there's a major difference because they've never bought real eggs from healthy chickens...The eggs from the grocery store had pale yellow yolks. On the other hand, the healthier free range eggs had deep orange colored yolks indicating much higher nutrition levels and carotenoids.
So next time a health or fitness professional tells you that egg whites are superior, you can quietly ignore their advice knowing that you understand the REAL deal about egg yolks.
One more thing about eggs... I read a study recently that compared groups of people that ate egg breakfast vs. groups of people that ate cereal or bagel based breakfasts. The results of the study showed that the egg eaters lost or maintained a healthier bodyweight, while the cereal / bagel eaters gained weight.
It was hypothesized that the egg eaters actually ate less calories during the remainder of the day because their appetite was more satisfied compared to the cereal / bagel eaters who would have been more prone to wild blood sugar swings and food cravings.
Reply and comments by Dr Lim Ju Boo to the above article:
Dear Miss Josephine Wong and others,
Thank you for seeking my advice about eggs. Someone has sent me this same article about eggs many months ago, and he has asked me the same question you asked here. They too have requested me to comment on it. Many thanks for your information about the misnomer that egg yolk is nutritionally bad for health. Below is a summary of my assurance.
I powerfully support the above article sent to me for review. A lot of half-cooked ‘nutritionist’ and health freaks need to undergo a proper and qualified 4 year bachelor degree course in nutrition and food science in a properly recognized university before they talk and spread absolute rubbish that egg yolk is bad for health because they contain cholesterol.
Let me straight away tell you that although eggs are high in cholesterol this has no impact in raising blood cholesterol. An average hen’s egg is about 50 gm. and has about 140 mg cholesterol 3.7 gm fat. This means even if I eat 10 eggs everyday, the amount of cholesterol intake daily is 140 x 10 = 1400 mg (1.4 gm).
Blood volume:
The blood volume of an adult male weighing 70 kg is about 5 liters (5000 dl). This is the amount of blood circulating round the body outside the tissues, and does not include the cerebrospinal fluid nor the amount of intracellular fluid found inside every cell of an average human body, estimated to be around 100 million, million (100 trillion) of them. The total amount of water in a man of average weight (70 kilograms) is approximately 40 liters, averaging 57 percent of his total body weight.
Biological fluids distributions elsewhere:
Lean muscle tissue contains about 75% water by weight. Blood contains almost 70% water, body fat contains 10% water and bone has 22% water. Skin also contains much water. The human body is about 60% water in adult males and 55% in adult females.
Cholesterol not only found in the blood:
Let us assume that all the cholesterol in the body is found only in the blood. This is of course not true since many other organs like the brain and liver contain much more cholesterol than in the blood. But let us assume that this is true just for the sake of simple arithmetical calculation.
Cholesterol intake:
A person of about 68 kg (150 pounds), typical total body cholesterol synthesis is about 1 g (1,000 mg) per day, and total body content is about 35 g. A typical daily additional dietary intake in Malaysia and societies with similar dietary patterns is 200–300 mg. The body compensates for cholesterol intake by reducing the amount synthesized. Cholesterol is recycled. It is excreted by the liver via the bile into the digestive tract. Typically about 50% of the excreted cholesterol is reabsorbed by the small bowel back into the blood stream.
How much:
This means that even if we are able to eat 10 eggs a day, the total cholesterol intake from 10 eggs (exogenous source) would only raise the cholesterol in the blood by only 10 x 140 mg ÷ 5000 dl x 100 = 28 mg /dl. The normal desirable total blood cholesterol level is < 200 mg /dl. Most people have a blood cholesterol level of 185 mg /dl. So this means even if we are able to eat 10 eggs a day. This will raise the cholesterol level by just 185 + 28 = 213 mg /dl. But that is not all. We are only assuming that the body does nothing about it.
But the body does not just keep quiet and let the cholesterol just accumulate like dirt daily into the body. The body will throw out all the excess cholesterol it does not want through the bile. But some of them are also reabsorbed.
Biochemistry:
Cholesterol is oxidized by the liver into a variety of bile acids. These in turn are conjugated with glycine, taurine, glucuronic acid, or sulphate. A mixture of conjugated and non-conjugated bile acids along with cholesterol itself is excreted from the liver into the bile. Approximately 95% of the bile acids are reabsorbed from the intestines and the remainder lost in the feces. The excretion and reabsorption of bile acids forms the basis of the enterohepatic circulation which is essential for the digestion and absorption of dietary fats.
Under certain circumstances, when more concentrated, as in the gallbladder, cholesterol crystallizes and is the major constituent of most gallstones, although lecithin and bilirubin gallstones also occur less frequently.
Endogenous and exogenous balance:
Notwithstanding this, the body is able to establish a balance between endogenous and exogenous sources of cholesterol and establish a homeostatic balance in he blood. If this mechanism is not operative, then we will start to accumulate more and more cholesterol into the blood for every spoonful of cholesterol rich foods we take everyday. Even if we take absolutely no cholesterol at all, the liver will still be able to synthesize 10 times more cholesterol than all the cholesterol we can eat in a day. How much eggs, brain or liver can you eat in a day? One thousand eggs, 100 kg of liver or 100 kg of brain?
Out of date belief:
Some 60 years ago it was thought that cholesterol rich foods raised blood cholesterol. This effect is very temporary as the body adjusts itself to sudden influx of ingested cholesterol. But this belief is now completely out-molded and it is now no more fashionable to say that cholesterol rich foods like eggs is unhealthy to consume as it can cause heart disease. This is great grandfather’s theory which is now thrown into the dustbin by modern nutrition scientists. Milk and eggs are world’s most nutritious and health-protective foods
Biological Value:
The biological value and chemical score of protein in a whole egg depends mainly on the egg yolk rather than the albumin in the white of egg. The protein in it has very high nutritive value. In fact the nutritive value of the entire egg rests mainly on the yolk and not the white of egg.
The protein of an egg or whole milk has a score of 100 and this score is taken as the reference score of protein. It is this value around which all other proteins from all other sources of food have to be compared.
The entire un-hatched chick depends on it:
Just remember this – the entire chick from embryo until it is hatched and becomes nutritionally independent has to depend entirely on what is provided from the entire egg (yolk and white) as much as a baby has to depend entirely on her mother’s milk for growth and development till the age of at least 6 months. Both milk and whole egg is the best food in the world – complete in their entire spectrum of nutrients. No other food can beat them in health and growth promoting properties.
Timely to block unqualified health freaks by an Act of Parliament:
If I don’t give out this message and support what you sent me, we will get half-boiled health freaks and ‘nutritionist’ lurking around passing the message round that milk is also bad for health because it contains saturated milk fats and cholesterol.
But you reecho what we already knew only now in 2009 which is also very timely because there are a lot of so-called ‘health experts’ out there, who not only confuse themselves, but confuse others also.
Because of these people, I personally saw, on so many occasions people just threw away the egg yolk and ate only the egg white which is largely albumin - 64 % ovalbumin which actually blocks the action of digestive enzymes while the 12 % ovotransferrin binds with the iron and make it biologically unavailable to the body, and the 11 % ovomucoid has the same action as the ovalbumin that also blocks the digestive enzymes in the gastrointestinal guts.
The Practice of Nutrition to be Legalized:
See this imminent Act of Parliament (website below) to register All Professionally Qualified Nutritionists and the Practice of Nutrition as a Legalized Profession in Malaysia to safeguard the Public against quack nutritionists in Direct Selling, Beauty Saloons, Health Clinics and health clubs, executive clubs, etc
http://www.nutriweb.org.my/article.php?sid=147
Reverse Nutrition by Freaks & Extremists:
These health freaks are doing the opposite thing – all because they listen to another of their equally blind health extremists’ friends chit-chatting in the coffee shop instead of going to a proper university to undergo a proper intensive course in human clinical nutrition.
Just to let you know, I know of many people who eat a minimum of two fried eggs a day ever since they were in their 20s, and now at over 80 years, their blood cholesterol levels is just 4.5 mmol /dl which is well below normal. They do not suffer from any heart disease as far as their yearly medical examination showed.
Yes, I support the article sent to me for advice and comment. I hope this will assure everyone that a whole egg is one of the best and most nutritious foods available on this planet.
Regards
Lim Ju Boo
Formerly
Research Nutritionist
Massachusetts Institute of Technology (MIT) &
Institute for Medical Research, Malaysia
Saturday, May 22, 2010
The following is an email from a Malaysian received by Dr JB Lim
>To: All my dear friends be extra cautious when you need to help others, be very smart and alert at all times.
>
>It's a pity that things like this occur nowadays … you are warned to be cautious and do not take everything for granted.
>
>A NEW KIND OF RAPE (LADIES BE WARNED)
>
>This is a true story.
>
>The woman left the office after working hours and saw a little child crying on the road. Feeling pity for the child,
She went to ask what happened. The child said, 'I am lost. Can you take me home please?' Then the child gave her a slip of paper and tells the woman where the address is. The woman, being an average kind person who didn't suspect anything took the child there.
And then when they arrived at the child's 'home', the kind hearted woman pressed the door bell and she was electrocuted as the bell was wired with high voltage, and fainted..
>The next day when she woke up, she found herself in an empty house up in the hills, naked. Condoms were all thrown around with semen all over her and flowing from her body. There were at least about 20 condoms! She has not even seen her assailants. That's why nowadays crimes are targeted on kind people like her.
>Next time if the same situation occurs, never bring the child to the intended place.. If the child insists, then bring the child to the police station.
>Lost children are best sent and/or taken to police stations. Please send this to all your female friends/colleagues, and your male friends with girlfriends and wives. It is better to receive this email a thousand times than be a victim once!
>To keep my Identity and job safe I will just say that I am Officer Justice.
Keep safe Ladies!
>Please pass this on to family members. It is better to be informed. It is sad that we can't even help children now!
-----------------------------------------
Comment by Lim Ju Boo
How can it be possible for a person to be electrocuted and merely faint and able to wake up later? When a person is electrocuted, electricity passes through the body, and the heart is seriously affected. It goes into what we call ‘ventricular fibrillation’. This means the ventricles just quiver or shiver instead of contracting and pumping blood to the body.
Within minutes of electrocution the heart ceases to function, and without adequate blood flow to the brain the brain is dead within 3 minutes. The only way to revive the person is to instantly shock the heart back into normal rhythm using a defibrillator delivering several shocks between 150 -300 Joules of energy. There is an algorithm for this.
Applying CPR alone to restart the heart is normally not effective. In other words, when anyone is electrocuted, he simply dies. It is not a matter of just fainting and waking up later. I am not aware of any documented case where this is possible?
Who is this ‘Officer Justice’ the sender of this warning circular trying to bluff? She is sending pure rubbish to her friends and to other ignorant people. Ask her to speak to me. Just delete her ‘warning’ about her new form of rape.
lim ju boo
---------------------------
Comments by Ir. KS Tan
Dear Dr Lim,
This is not logical. When a person presses an electrified door bell, the immediate reaction will be that the hand will fly off. Anyone who touches an electrified circuit will instantly fling off his hand. So the electric circuit is broken and no effect. Many people would have experienced this.
People die only when they are unable to get away from the electrified object. It is like holding the door of the fridge. You cannot remove your hand because the muscle seize by the electric current, involuntarily clamp on to the fridge handle. . Or the electric cable fall on your body and you go helpless into convulsion.
Rgds,
Khoon.
--------------------------
Dear Ir. Khoon,
Thank you for your comment.
Unfortunately your half right, half wrong notion on electrocution has forced me here to lengthen my original short explanation.
You were right and also wrong at the same time. You have explained it half correctly. But because I wanted to make my explanation as short as possible without unnecessarily going into the complicated mechanism of reflex action, etc, I just gave the barest minimum about the effects of electricity on the heart. I am fully aware of what you said, but I did not want to make my comment too long with unnecessary physiology about reaction time, reflex action, etc.
Protective mechanisms operative:
Since you mentioned it, let me elaborate a little more on what you said. The body is always ready to protect itself from any danger, whether from electrocution, fire, falling body, infection, sudden threats of any kind…etc. Anybody who understands how the human body works, and the protective mechanisms always there in place, understands and appreciates this.
Overriding the body responses:
What is dangerous about touching and holding on to a electrified door handle, door bell, fridge handle (as illustrated by you) is that we always use the palm of the hand (palmar) to hold any object. Nobody ever grasp an object on the dorsum side (back of hand) because the fingers can flex from the dorsum position to the palmar position in order to grip on to the object on the palm. In short, we hold an object with the palm.
Anatomy of hand:
Unfortunately the joints, ligaments, tendons flexors and extensors of the extrinsic muscle of our finger are such that they restrict movements only in one direction – towards the palm. In other words the fingers anatomically cannot bend backwards away from an object. At best it can do is to open the fingers to their limits or flex the entire hand away from the object voluntarily by reflex action.
All or none law:
Unfortunately also, if an electric current is applied to any muscle it will contract automatically and this is not dependent on the strength of the current, except that the strength of the current need to reach a certain threshold to elicit a contraction. In physiology, we call this ‘all or none law’. I remember learning this in my physiology class as an undergraduate.
Muscles instantly contract:
Unfortunately also, if you hold on to a door handle, door bell, fridge handle, or any object which is electrified, it will instantly cause all the muscles of your fingers to contract towards the palm, causing you to hold on to the electrified object even tighter instead of relaxing your finger muscles outwards. This is an automatic instant response to an electric current.
Reflex Action:
But you were right if you only lightly touch the object with your finger tips. The reflex action will take a fraction of a second as the impulse will have to travel from the finger tips to the spinal cord where it will synapse across the cord, and travel back to the motor part of the fingers and muscles of the hands to ‘ask’ you to remove it.
But this takes some time because part of the message has to go to the brain also to let the brain interpret the stimulus on what to do. The brain has the discretion on what to do, although most of the reflex actions are involuntary to allow the body to react first, and the information can later be sent to the brain on ‘what happened’ and how did the body react to it. In order words, the reflexes takes over with the evasive action and the brain informed of the action taken later.
Speed of contraction faster than reflexes:
So far so good! But unfortunately the contraction of the muscles to an electrical current is so fast, much faster than impulses relayed to the spinal cord, and back again for the motor responses. Some of the impulses will ascend up the spinal cord to the brain of course for more decisive actions.
This is how the muscles react when stimulated by an electric current. Unfortunately it can only contract in one direction – towards the palm making the grip and the contact with the current even stronger.
Speed of nerve transmission:
When a stimulus is applied to the sensory receptor, the impulses travel to the efferent neuron to the interneuron junction in the spinal cord where the stimulus synapse across to the afferent neuron onwards to the muscles to contract (withdrawal reflex). The speed of this nerve transmission varies tremendously, and is between 0.9 - 89.41 m/s.
Speed of nerve reaction time vs. speed of electricity:
Even with the fastest transmission speed, it is still some 3 million times slower than the speed of electricity through a wire. It is slightly slower through a human body. The speed of electricity which is just a flow of electrons or ions through a conductor is some 96 % the speed of light through a copper wire. It may be about 240 000 km (240 000 000 meters) per second through a human body.
This means the body has no time to react at all because of the much, much slower reaction time. By the time even if the fingers or hand managed to withdraw by reflex reaction, the electricity would have already surged through the entire body at near (80 %) the speed of light. Instantly this would already affect the heart into ventricular fibrillation even if you managed to withdraw your hand.
Latent time:
Of course I do agree that there is a latent time. This means the muscle does not immediately respond to a stimulus, but that a period elapses between the stimulus and the commencement of the contraction, which is on the average is about the 100th of a second. This is termed the latent period. But since the stimulus (electricity) has already been applied, the muscles – skeletal as well as cardiac muscles will still respond accordingly - about 100thof a second later even if the hand has already withdrawn by reflex response. So there is no escape. The person will still suffer electrocution unfortunately.
Reaction time (RT):
This is time elapsed between the presentation of a sensory stimulus and the subsequent behavioral response. This time is between 150 - 200 milliseconds. On average, humans have a reaction time of 0.25 seconds to a visual stimulus, 0.17 for an audio stimulus, and 0.15 seconds for a touch stimulus. Reaction times vary from individual to individual. Because of the higher degree of neural processing, reaction times can be influenced by a variety of factors such as sleepiness, emotional distress, or consumption of alcohol. Still, no matter how fast the body reacts, it still is far, far, far slower than the speed of electricity through the body.
Electromyoneurophysiology:
I would not want to go too deep into electromyophysiology, signal strength, neurotransmission, neurochemistry of muscle contraction, (actin, myosin, ATP, etc), comparative speeds of nerve transmission, polarization and depolarization, migration of ions within the cells etc, etc. They would not only be too technical, but boring to others. Moreover, I am not a specialist in electro-neuro-myo-physiology to understand such intense technical complexity.
My simple original message:
My original comment is to make it as sweet, short and simple as possible for the lay readers about the effects of electrocution on cardiac rhythm (ventricular fibrillation) rather than trying to explain neurological effects and protective reflex responses.
My simple advice:
But if you suspect an object is electrified, always use a test pen, never touch it. But if you have none, but must test it with your hands, then always test it with the dorsum (back) of your hand. Using this technique, the fingers will contract towards the palm – away from the object. This way you will never be able to seize it even more firmly. Again, I have to repeat, the electricity would have already affected your heart if it is above the threshold to elicit the ‘all or none law’ (see above).
Death from electrocution is common:
Hence, death from electrocution is quite a common form of accidental death. Else, if your explanation is as simple as that, and completely right, then nobody can ever get electrocuted. They just remove their hands as you explained.
But it is not as simple as that when the speed of electricity is almost the speed of light. Your body’s reaction, speed of nerve transmission, and hence reflex action is tens million times slower than the speed of electricity.
Electricity is entirely different:
It is not like touching a hot iron where you only respond to a heat stimulus that hardly travels through the body. This is electricity that travels at near the speed of lights throughout the body, and your protective reflexes never be as fast as that.
You will still get electrocuted even if you managed to withdraw your hand. Your heart will already be in fibrillation. Someone needs to apply CPR instantly in the event of a cardiac arrest and shock your heart with a defibrillator once available as I have already explained in the last letter.
I hope my simple explanation here will help you to understand better, and also reach out to the lay people. Your comment has unnecessarily lengthened my original message.
Lim Ju Boo BSc PG Dip Nutr MSc MD PhD FRSPH FRSM
Special Medical and Science Adviser
----------------------------------------------------------
Dear Dr Lim,
Wow. Your writing is fantastic and awesome. May I borrow it for my PhD thesis?
However, not everything is correct. Not every time you touch an electric cable, you get electrocuted. Certainly not for the girl who rang the door bell with her index finger.
You need to understand electricity to understand why the girl is OK.
The electric equation V = IR means when the girl is wearing a high heel + rubber sole + a small push on the door bell button which is normally plastic, but now fixed up into metal by the bad guys, it means R is very, very big. So current is very small. The girl
just get a jolt. So nothing serious happened.
Rgds,
Khoon.
------------------------------
Comment from Professor Dr Lee Chai Peng, Dept of Geology, University of Malaya
Have you not heard of taser or stunt-gun used by law enforcement officers in US and other places? Maybe the lady could not express herself so well but to a lay person that's how it appears when someone is hit by a stun-gun.
C.P.Lee
------------------------------------
Comment by Perry Tan
Wow! Thanks Dr. Lim for the lengthy and highly academic explanation of electrocution supported by the argument of the human anatomy of the hands and physiological thesis on the effects of strong electrical current through the human bodies that might and actually can cause tissue damage, cardiac arrest leading to ventricular fibrillation and in most cases, sudden death, which is obviously, irreversible.
It is such a professional presentation so well presented that, myself, as a common lay man, not only found it interesting but admittedly, it added on to my minisculte knowledge of both the human physiology and the incidence of electricity through the body.
Very Important Rule
Nevertheless, it reminded me of a VERY IMPORTANT RULE, OHM's Law. V = IR Where, V is inversely proportional to I if R is constant
Body and Skin Resistance
Can I confidently say that, the human body got its own Resistance, and there is such thing called Skin Resistance?
Applying Ohm's Law, the current drawn through the body depends on the resistance of the body. The resistance of human skin obviously varies from person to person and fluctuates at different times of the day, depending on the concentration of the bodily fluid and is probably proportional to the salt contents.
If the skin is dry, it is a poor conductor, and the resistance can be as high as R=100k Ω. If the skin is broken or wet, the resistance can be as low as 1 k Ω
(It is generally estimated that currents approaching 100 mA are lethal if they pass through sensitive portions of the body)
Assumptions and Calculations
Assuming that the door bell is connected to the domestic supply of 240 V AC, and the body resistance is 100k Ω, applying the V=IR,,, give us an I =0.0024 Amp which may cause electric shocks and convulsions but may not amount to a full electrocution.
Taking the average body resistance of 50k Ω, the current passing through the body works out to be I=0.0048 Amp which is still well below the threshold of 100mA =0.1 Amp.
Moreover, if the would be rape victim happens to wear platform shoes of 3 inches high heel, which is wood and with rubber soles, the chances of complete electrocution is further prevented. The shoes and rubber soles are poor conductors of electricity and the flow of electricity from the finger to the ground is incomplete.
Conclusion:
The chances of the rape victim to enter an electro-convulsion and survive the electric shock is high
As a layman, I believe, the would be rape victim wont die of electrocution.
The would be rapist wont want a dead body, and i guess they are knowledgeable enough to conduct a simple cpa, if not defibrillation, just to revive the victim to semi-conscious state.
Original Article and advice:
Prevention is better than cure, and the original advice to the ladies are of utmost importance.
Layman Disclaimer:
I may be wrong, and I sincerely hope my Ir friends from IEM can make some comments on electric calculation and prevention of electric shocks
Thanks Dr Lim
Perry Tan
----------------------------------
Dear Ir Rocky Wong,
You are the right person to comment on the Electric current issues.
Could you kindly give us your expert opinion please?
Warmest regards,
C K Cheong
----------------------
To All the Learned Gentlemen,
I am fascinated and at the same time amazed at the sudden landslide of volcanic eruption of information and knowledge derived from this forum that i may present this subject to my friends at a coffee talk discussion.
But one thing is sure; I would not want to be at the receiving end of an electrocution whether it is an accident or by intrusion through an assault.
Encore to all the parties who are giving so much enlightenment of the subject though.
Best wishes
An ordinary layman
David
-------------------------------------
Hi Perry,
Your threshold figure of 100 mA is far too big. To feel an electric current, it must exceed 1 mA. To die by electrocution current through body must exceed 30 mA.
Your analysis of the girl surviving the door bell electrification is agreeable.
The girl may get an electric shock but will not die.
Rgds,
Khoon
-----------------------------
HI David,
Don’t try this at home.
But one thing is sure, I would not want to be at the receiving end of an electrocution whether it is an accident or by intrusion through an assault.
Yes. Nobody enjoys to be electrocuted. But there was a case in Brazil some time ago. The police came to investigate a death from electrocution. The man uses electricity to stimulate his sexual activity. Probably he steps down the electricity current for a tingling stimulating shock. But things went wrong and he got electrocuted instead. Cardiac arrest leading to ventricular fibrillation
Rgds,
Khoon.
>To: All my dear friends be extra cautious when you need to help others, be very smart and alert at all times.
>
>It's a pity that things like this occur nowadays … you are warned to be cautious and do not take everything for granted.
>
>A NEW KIND OF RAPE (LADIES BE WARNED)
>
>This is a true story.
>
>The woman left the office after working hours and saw a little child crying on the road. Feeling pity for the child,
She went to ask what happened. The child said, 'I am lost. Can you take me home please?' Then the child gave her a slip of paper and tells the woman where the address is. The woman, being an average kind person who didn't suspect anything took the child there.
And then when they arrived at the child's 'home', the kind hearted woman pressed the door bell and she was electrocuted as the bell was wired with high voltage, and fainted..
>The next day when she woke up, she found herself in an empty house up in the hills, naked. Condoms were all thrown around with semen all over her and flowing from her body. There were at least about 20 condoms! She has not even seen her assailants. That's why nowadays crimes are targeted on kind people like her.
>Next time if the same situation occurs, never bring the child to the intended place.. If the child insists, then bring the child to the police station.
>Lost children are best sent and/or taken to police stations. Please send this to all your female friends/colleagues, and your male friends with girlfriends and wives. It is better to receive this email a thousand times than be a victim once!
>To keep my Identity and job safe I will just say that I am Officer Justice.
Keep safe Ladies!
>Please pass this on to family members. It is better to be informed. It is sad that we can't even help children now!
-----------------------------------------
Comment by Lim Ju Boo
How can it be possible for a person to be electrocuted and merely faint and able to wake up later? When a person is electrocuted, electricity passes through the body, and the heart is seriously affected. It goes into what we call ‘ventricular fibrillation’. This means the ventricles just quiver or shiver instead of contracting and pumping blood to the body.
Within minutes of electrocution the heart ceases to function, and without adequate blood flow to the brain the brain is dead within 3 minutes. The only way to revive the person is to instantly shock the heart back into normal rhythm using a defibrillator delivering several shocks between 150 -300 Joules of energy. There is an algorithm for this.
Applying CPR alone to restart the heart is normally not effective. In other words, when anyone is electrocuted, he simply dies. It is not a matter of just fainting and waking up later. I am not aware of any documented case where this is possible?
Who is this ‘Officer Justice’ the sender of this warning circular trying to bluff? She is sending pure rubbish to her friends and to other ignorant people. Ask her to speak to me. Just delete her ‘warning’ about her new form of rape.
lim ju boo
---------------------------
Comments by Ir. KS Tan
Dear Dr Lim,
This is not logical. When a person presses an electrified door bell, the immediate reaction will be that the hand will fly off. Anyone who touches an electrified circuit will instantly fling off his hand. So the electric circuit is broken and no effect. Many people would have experienced this.
People die only when they are unable to get away from the electrified object. It is like holding the door of the fridge. You cannot remove your hand because the muscle seize by the electric current, involuntarily clamp on to the fridge handle. . Or the electric cable fall on your body and you go helpless into convulsion.
Rgds,
Khoon.
--------------------------
Dear Ir. Khoon,
Thank you for your comment.
Unfortunately your half right, half wrong notion on electrocution has forced me here to lengthen my original short explanation.
You were right and also wrong at the same time. You have explained it half correctly. But because I wanted to make my explanation as short as possible without unnecessarily going into the complicated mechanism of reflex action, etc, I just gave the barest minimum about the effects of electricity on the heart. I am fully aware of what you said, but I did not want to make my comment too long with unnecessary physiology about reaction time, reflex action, etc.
Protective mechanisms operative:
Since you mentioned it, let me elaborate a little more on what you said. The body is always ready to protect itself from any danger, whether from electrocution, fire, falling body, infection, sudden threats of any kind…etc. Anybody who understands how the human body works, and the protective mechanisms always there in place, understands and appreciates this.
Overriding the body responses:
What is dangerous about touching and holding on to a electrified door handle, door bell, fridge handle (as illustrated by you) is that we always use the palm of the hand (palmar) to hold any object. Nobody ever grasp an object on the dorsum side (back of hand) because the fingers can flex from the dorsum position to the palmar position in order to grip on to the object on the palm. In short, we hold an object with the palm.
Anatomy of hand:
Unfortunately the joints, ligaments, tendons flexors and extensors of the extrinsic muscle of our finger are such that they restrict movements only in one direction – towards the palm. In other words the fingers anatomically cannot bend backwards away from an object. At best it can do is to open the fingers to their limits or flex the entire hand away from the object voluntarily by reflex action.
All or none law:
Unfortunately also, if an electric current is applied to any muscle it will contract automatically and this is not dependent on the strength of the current, except that the strength of the current need to reach a certain threshold to elicit a contraction. In physiology, we call this ‘all or none law’. I remember learning this in my physiology class as an undergraduate.
Muscles instantly contract:
Unfortunately also, if you hold on to a door handle, door bell, fridge handle, or any object which is electrified, it will instantly cause all the muscles of your fingers to contract towards the palm, causing you to hold on to the electrified object even tighter instead of relaxing your finger muscles outwards. This is an automatic instant response to an electric current.
Reflex Action:
But you were right if you only lightly touch the object with your finger tips. The reflex action will take a fraction of a second as the impulse will have to travel from the finger tips to the spinal cord where it will synapse across the cord, and travel back to the motor part of the fingers and muscles of the hands to ‘ask’ you to remove it.
But this takes some time because part of the message has to go to the brain also to let the brain interpret the stimulus on what to do. The brain has the discretion on what to do, although most of the reflex actions are involuntary to allow the body to react first, and the information can later be sent to the brain on ‘what happened’ and how did the body react to it. In order words, the reflexes takes over with the evasive action and the brain informed of the action taken later.
Speed of contraction faster than reflexes:
So far so good! But unfortunately the contraction of the muscles to an electrical current is so fast, much faster than impulses relayed to the spinal cord, and back again for the motor responses. Some of the impulses will ascend up the spinal cord to the brain of course for more decisive actions.
This is how the muscles react when stimulated by an electric current. Unfortunately it can only contract in one direction – towards the palm making the grip and the contact with the current even stronger.
Speed of nerve transmission:
When a stimulus is applied to the sensory receptor, the impulses travel to the efferent neuron to the interneuron junction in the spinal cord where the stimulus synapse across to the afferent neuron onwards to the muscles to contract (withdrawal reflex). The speed of this nerve transmission varies tremendously, and is between 0.9 - 89.41 m/s.
Speed of nerve reaction time vs. speed of electricity:
Even with the fastest transmission speed, it is still some 3 million times slower than the speed of electricity through a wire. It is slightly slower through a human body. The speed of electricity which is just a flow of electrons or ions through a conductor is some 96 % the speed of light through a copper wire. It may be about 240 000 km (240 000 000 meters) per second through a human body.
This means the body has no time to react at all because of the much, much slower reaction time. By the time even if the fingers or hand managed to withdraw by reflex reaction, the electricity would have already surged through the entire body at near (80 %) the speed of light. Instantly this would already affect the heart into ventricular fibrillation even if you managed to withdraw your hand.
Latent time:
Of course I do agree that there is a latent time. This means the muscle does not immediately respond to a stimulus, but that a period elapses between the stimulus and the commencement of the contraction, which is on the average is about the 100th of a second. This is termed the latent period. But since the stimulus (electricity) has already been applied, the muscles – skeletal as well as cardiac muscles will still respond accordingly - about 100thof a second later even if the hand has already withdrawn by reflex response. So there is no escape. The person will still suffer electrocution unfortunately.
Reaction time (RT):
This is time elapsed between the presentation of a sensory stimulus and the subsequent behavioral response. This time is between 150 - 200 milliseconds. On average, humans have a reaction time of 0.25 seconds to a visual stimulus, 0.17 for an audio stimulus, and 0.15 seconds for a touch stimulus. Reaction times vary from individual to individual. Because of the higher degree of neural processing, reaction times can be influenced by a variety of factors such as sleepiness, emotional distress, or consumption of alcohol. Still, no matter how fast the body reacts, it still is far, far, far slower than the speed of electricity through the body.
Electromyoneurophysiology:
I would not want to go too deep into electromyophysiology, signal strength, neurotransmission, neurochemistry of muscle contraction, (actin, myosin, ATP, etc), comparative speeds of nerve transmission, polarization and depolarization, migration of ions within the cells etc, etc. They would not only be too technical, but boring to others. Moreover, I am not a specialist in electro-neuro-myo-physiology to understand such intense technical complexity.
My simple original message:
My original comment is to make it as sweet, short and simple as possible for the lay readers about the effects of electrocution on cardiac rhythm (ventricular fibrillation) rather than trying to explain neurological effects and protective reflex responses.
My simple advice:
But if you suspect an object is electrified, always use a test pen, never touch it. But if you have none, but must test it with your hands, then always test it with the dorsum (back) of your hand. Using this technique, the fingers will contract towards the palm – away from the object. This way you will never be able to seize it even more firmly. Again, I have to repeat, the electricity would have already affected your heart if it is above the threshold to elicit the ‘all or none law’ (see above).
Death from electrocution is common:
Hence, death from electrocution is quite a common form of accidental death. Else, if your explanation is as simple as that, and completely right, then nobody can ever get electrocuted. They just remove their hands as you explained.
But it is not as simple as that when the speed of electricity is almost the speed of light. Your body’s reaction, speed of nerve transmission, and hence reflex action is tens million times slower than the speed of electricity.
Electricity is entirely different:
It is not like touching a hot iron where you only respond to a heat stimulus that hardly travels through the body. This is electricity that travels at near the speed of lights throughout the body, and your protective reflexes never be as fast as that.
You will still get electrocuted even if you managed to withdraw your hand. Your heart will already be in fibrillation. Someone needs to apply CPR instantly in the event of a cardiac arrest and shock your heart with a defibrillator once available as I have already explained in the last letter.
I hope my simple explanation here will help you to understand better, and also reach out to the lay people. Your comment has unnecessarily lengthened my original message.
Lim Ju Boo BSc PG Dip Nutr MSc MD PhD FRSPH FRSM
Special Medical and Science Adviser
----------------------------------------------------------
Dear Dr Lim,
Wow. Your writing is fantastic and awesome. May I borrow it for my PhD thesis?
However, not everything is correct. Not every time you touch an electric cable, you get electrocuted. Certainly not for the girl who rang the door bell with her index finger.
You need to understand electricity to understand why the girl is OK.
The electric equation V = IR means when the girl is wearing a high heel + rubber sole + a small push on the door bell button which is normally plastic, but now fixed up into metal by the bad guys, it means R is very, very big. So current is very small. The girl
just get a jolt. So nothing serious happened.
Rgds,
Khoon.
------------------------------
Comment from Professor Dr Lee Chai Peng, Dept of Geology, University of Malaya
Have you not heard of taser or stunt-gun used by law enforcement officers in US and other places? Maybe the lady could not express herself so well but to a lay person that's how it appears when someone is hit by a stun-gun.
C.P.Lee
------------------------------------
Comment by Perry Tan
Wow! Thanks Dr. Lim for the lengthy and highly academic explanation of electrocution supported by the argument of the human anatomy of the hands and physiological thesis on the effects of strong electrical current through the human bodies that might and actually can cause tissue damage, cardiac arrest leading to ventricular fibrillation and in most cases, sudden death, which is obviously, irreversible.
It is such a professional presentation so well presented that, myself, as a common lay man, not only found it interesting but admittedly, it added on to my minisculte knowledge of both the human physiology and the incidence of electricity through the body.
Very Important Rule
Nevertheless, it reminded me of a VERY IMPORTANT RULE, OHM's Law. V = IR Where, V is inversely proportional to I if R is constant
Body and Skin Resistance
Can I confidently say that, the human body got its own Resistance, and there is such thing called Skin Resistance?
Applying Ohm's Law, the current drawn through the body depends on the resistance of the body. The resistance of human skin obviously varies from person to person and fluctuates at different times of the day, depending on the concentration of the bodily fluid and is probably proportional to the salt contents.
If the skin is dry, it is a poor conductor, and the resistance can be as high as R=100k Ω. If the skin is broken or wet, the resistance can be as low as 1 k Ω
(It is generally estimated that currents approaching 100 mA are lethal if they pass through sensitive portions of the body)
Assumptions and Calculations
Assuming that the door bell is connected to the domestic supply of 240 V AC, and the body resistance is 100k Ω, applying the V=IR,,, give us an I =0.0024 Amp which may cause electric shocks and convulsions but may not amount to a full electrocution.
Taking the average body resistance of 50k Ω, the current passing through the body works out to be I=0.0048 Amp which is still well below the threshold of 100mA =0.1 Amp.
Moreover, if the would be rape victim happens to wear platform shoes of 3 inches high heel, which is wood and with rubber soles, the chances of complete electrocution is further prevented. The shoes and rubber soles are poor conductors of electricity and the flow of electricity from the finger to the ground is incomplete.
Conclusion:
The chances of the rape victim to enter an electro-convulsion and survive the electric shock is high
As a layman, I believe, the would be rape victim wont die of electrocution.
The would be rapist wont want a dead body, and i guess they are knowledgeable enough to conduct a simple cpa, if not defibrillation, just to revive the victim to semi-conscious state.
Original Article and advice:
Prevention is better than cure, and the original advice to the ladies are of utmost importance.
Layman Disclaimer:
I may be wrong, and I sincerely hope my Ir friends from IEM can make some comments on electric calculation and prevention of electric shocks
Thanks Dr Lim
Perry Tan
----------------------------------
Dear Ir Rocky Wong,
You are the right person to comment on the Electric current issues.
Could you kindly give us your expert opinion please?
Warmest regards,
C K Cheong
----------------------
To All the Learned Gentlemen,
I am fascinated and at the same time amazed at the sudden landslide of volcanic eruption of information and knowledge derived from this forum that i may present this subject to my friends at a coffee talk discussion.
But one thing is sure; I would not want to be at the receiving end of an electrocution whether it is an accident or by intrusion through an assault.
Encore to all the parties who are giving so much enlightenment of the subject though.
Best wishes
An ordinary layman
David
-------------------------------------
Hi Perry,
Your threshold figure of 100 mA is far too big. To feel an electric current, it must exceed 1 mA. To die by electrocution current through body must exceed 30 mA.
Your analysis of the girl surviving the door bell electrification is agreeable.
The girl may get an electric shock but will not die.
Rgds,
Khoon
-----------------------------
HI David,
Don’t try this at home.
But one thing is sure, I would not want to be at the receiving end of an electrocution whether it is an accident or by intrusion through an assault.
Yes. Nobody enjoys to be electrocuted. But there was a case in Brazil some time ago. The police came to investigate a death from electrocution. The man uses electricity to stimulate his sexual activity. Probably he steps down the electricity current for a tingling stimulating shock. But things went wrong and he got electrocuted instead. Cardiac arrest leading to ventricular fibrillation
Rgds,
Khoon.
Burundanga Drug used for Raping and Robbing?
Dear Uncle Ju Boo,
This is about using "Burundanga Drug" to rob. Please do tell us more about "Burundanga Drug" and "what we should do, if we are one of the victims?" I am pretty sure, every one of us would be interested to learn more from you.
Thks and send my warmest regards to Auntie Sally.
----- Forwarded Message ----
From: Karen
Sent: Tue, May 4, 2010 9:04:52 AM
Subject: Fwd: FW: BURUNDANGA - to rob
---------- Forwarded message ----------
Subject: Fwd: FW: BURUNDANGA - to rob
From: Chong Kok Kuan
Date: 3 May 2010 10:17
Subject: FW: BURUNDANGA - to rob
To:
Subject: BURUNDANGA - to rob
NAME CARDS
Please be careful. Yesterday, a friend was at the Carrefour carpark after shopping and about to start the car engine. Suddenly, one man appeared holding a name card and asking me to wind down the window to give me the name card. She refused using the sign language but he kept on pestering. She was terrified and quickly started the engine and sped off. Fortunately, she locked the car doors immediately after she got in...
Thank you for the warning email I received earlier.
Rgds,
May
Subject: NAME CARDS
Must Read and Please be careful out there!!
A man came over and offered his service as a painter to a female putting gas in her car and left his card. She said no, but accepted his card out of kindness and got in the car. The man then got into a car driven by another gentleman.
As the lady left the service station, she saw the men following her out of the station at the same time.
Almost immediately, she started to feel dizzy and could not catch her breath. She tried to open the window and realized that the odor was on her hand; the same hand which accepted the card from the gentleman at the gas station.
She then noticed the men were immediately behind her and she felt she needed to do something at that moment. She drove into the first driveway and began to honk her horn repeatedly to ask for help.The men drove away but the lady still felt pretty bad for several minutes after she could finally catch her breath. Apparently, there was a substance on the card that could have seriously injured her.
This drug is called 'BURUNDANGA' and it is used by people who wish to incapacitate a victim in order to steal from or take advantage of them.
This drug is four times more dangerous than the date rape drug and is transferable on simple cards.
So take heed and make sure you don't accept cards at any given time alone or from someone on the streets. This applies to those making house calls and slipping you a card when they offer their services.
PLEASE SEND THIS E-MAIL ALERT TO EVERY FEMALE, OR EVEN MALE THAT YOU KNOW
Regards,
HC Goh
REPLY FROM DOCTOR JB LIM
Dearest Niece Ai Lian and to all your girl friends and other concerned girls too,
Thanks for referring to me for advice.
Pharmacology:
The pharmacology and toxicity of this agent you are referring to is very complicated and highly technical, and I do not expect you and your friends to understand the
pharmacodynamics, pharmacokinetics, clearance, volume of distribution, t ½ values, L50, and all those technical jargon of this agent we, as research and R&D scientists in the drug industry, would normally present or publish in scientific papers. But it is not necessary to explain all that for lay people to answer your question.
Simple info only:
So instead of that, I will very, very briefly in layman’s language explain to you what I know about this agent (drug).
This agent called Burundanga Drug or more correctly ‘Scopolamine’, also known as levo-duboisine, and hyoscine, is sometimes, but more rarely used in Malaysia for the folowing:
• Treatment of nausea and motion sickness
• Treatment of intestinal cramping
• For ophthalmic (eye) purposes
• As a general depressant and adjunct to narcotic painkillers
Less often used as:
• As a preanesthetic agent (sedative before given anesthesia)
• As a drying agent for sinuses, lungs, and related areas.
• To reduce motility and secretions in the GI tract
• Uncommonly used for some forms of Parkinsonism.
• As an adjunct to opioid analgesia, such as in the product Twilight Sleep
Unfounded reports:
However, according to reports circulating around, this drug (scopolomine) in the form of burundanga is also in "epidemic use" in Bogota Colombia in 1995.
What this means was that the drug has been given to unwitting victims who were not only robbed, but were put to work as "mules" carrying smuggled cocaine across the border, only to wake up with very little memory of the event. It is a form of "chemical hypnosis", and the victim can talk, drive a car and navigate while still under its influence.
As far as scientists know, such effects are only stories carried around, but have not been proven scientifically. It was just some rumours.
Business cards to rape victims:
Then again, there are also unfounded rumors circulating around in the Internet and e-mails that a transcutaneous (over the skin) delivery mechanism of Burundanga into the body was possible by using business cards, pamphlets or flyers laced with the drug. It was then used on girls to rape them. I have received such e-mails before.
In my professional opinion as a Special Medical and Science Adviser to an international group of drug companies, I do not think that the drug is as potent as that to have such a powerful effect on the human body by merely touching the card. I do not know of any drug, chemical or poison that can have such powerful effects by merely touching a paper laced with such agent.
No documents:
I have not read in any literature of any drug in existence that can have such stunning effect by merely touching of a piece of paper for a few seconds laced with the drug?
A lot of drugs may be delivered subcutaneously (under the skin) by skin patch – but they have to be literally pasted over a period of 24 hours or longer for slow released absorption over a larger area of skin where the epidermis is thinner, such as the back, or inner thighs, etc, and not over horny parts like the soles of the feet, or the finger tips.
This mode of delivery is transdermal or transmucosal. Sometimes it is called "topical" administration. But such effect is much slower than via enteral – meaning systemic through oral, rectal, sublingual, sublabial (between the teeth and gingiva). Even faster is via bolus, IV, IM, which would-be-rapists would not understand or able to do.
Dose related toxicity:
The quantity of toxin diffusing through the skin after one short contact of the fingers with an object like a business card is much too small to be readily absorbed in the body and to have any significant effect. The use of burundanga (scopolamine) impregnated into visiting cards to attack and to rob isolated people is often propagated by chain emails. In my opinion they are just hoaxes.
Enteral route:
But spiked alcoholic drinks (direct ingestion into the gastrointestinal tract) could have been occasionally used, and this may have effect because the drug is actually ingested, and enters into the system via the gastrointestinal tract. It is not by merely touching it with the fingers.
Suggestions only, but unnecessary:
However, if girls are that scared as that, I would then suggest that if any strangers in lonely places, or those whom they do not know, and for no rhyme or reason they give you a card, it is advisable to use a piece of folded tissue paper or a glove or handkerchief to hold it. But if you have none, do not worry. Just hold the card or pamphlet at the edge using her two fingers. This way almost no substance can ever be absorbed by the fingers.
Bear in mind the skin over the fingers are quite thick, and it is very difficult for anything to penetrate except poked by a needle, a sharp point of a knife, or a piece of broken glass.
Only through these cuts in the skin can things enter into the blood stream. But definitely no drug can penetrate the skin over such a tiny area, especially holding it for just a few seconds or even an hour or even longer.
Ventilate:
One more thing! If you are in a car, and if you are afraid of inhaling anything including burundanga, then do not close your car window as you drive off. Switch off the air-conditioner, and open all the car windows, and let in a lot of air from outside as you drive. Actually even this is unnecessary. How is it possible for a simple card to pour out so many fumes? A card is not a nebulizer machine, steam or smoke emitter.
Calculate out diffusion rate:
You can actually calculate out the amount of molecules of any substance emitted from a card of a certain square area into a cubic meter of air. From there it would be possible to determine how much of the substance is inhaled and circulated into the blood stream as we know the vital capacity of the lungs and the respiration rate. Hence from the concentration in the blood, it is possible to determine if the substance can affect a person since its concentration in the blood can easily be calculated out through respiratory exchange of gases in the lungs.
If I have the data I can easily calculate this out for you without problem from my simple undergraduate training in physics, chemistry and in physiology – I have not forgotten them even though I have since
specialized in medical research with doctorate degrees and post-doctoral Fellowships in other areas.
Scientific logic:
Use your simple scientific logic. If that card can affect you, it can even more affect the person who has been working on them. He probably has been touching it (them) all day long while looking for victims. His exposures of making, storing, smearing the drug on the cards – probably hundreds of them all day long would have knocked him off instantly (if it was so powerful), and he would probably remained unconscious for as long as he still holds and inhales all those impregnated cards – before he could even hand a single one to you.
Use your brains:
Use your simple intelligence to logically and scientifically think. Do not believe everything people send you by e-mails like an idiotic mule. The Internet is full of hoaxes and rubbish ‘information’ written by
unqualified human mules and donkeys. I receive tens of thousands of such mails even from strangers. Listen to me as your uncle.
Love & Regards
Uncle lim ju boo
Comments from others
Dear Dr Lim,
Fully agree with you, sir.
I have observed, some are logically born with others may need some guidance and practice to gain logical skill....
Best regards,
C K
- Hide quoted text -
On Mon, May 17, 2010 at 3:20 AM, JB Lim wrote:
Dear Ir Cheong,
You may share it with anyone you wish. It is just a simple explanation. The only thing I forgot to add is that, if girls are so afraid of some non-existence ‘magical scent' coming from the card while viewing it, I suggest they hold it far away from their nose at full arm's length, and better still, if there is a wind or even a small breeze around, they let their back face the wind blowing from behind, so that the wind will blow the 'magic scent' well away from their body. As simple as that!
We don't require a PhD to understand simple logic.
Regards
lim ju boo
On Fri, May 14, 2010 at 9:23 AM, AE Consultant wrote:
Dear Dr Lim,
Thank you very much for the detail and systematically arrive at the conclusion. I am able to learn from the way your presentation of a highly technical issue in the moat direct and simple way for a lay person's understanding & information.
How a researcher's view with logic is amazing.
Thank you again, I would like to share this information
of yours with my family and friends, hope it is okay with you
SIR.
Warmest regards,
C K Cheong
Reply from Dr JB Lim to Ir CK Cheong,
Dear Ir Cheong,
You may share it with anyone you wish. It is just a simple explanation.
The only thing I forgot to add is that, if girls are so afraid of some non-existence ‘magical scent' coming from the card while viewing it, I suggest they hold it far away from their nose at full arm's length, and better still, if there is a wind or even a small breeze around, they let their back face the wind blowing from behind, so that the wind will blow the 'magic scent' well away from their body. As simple as that!
We don't require a PhD to understand simple logic.
Regards
lim ju boo
This is about using "Burundanga Drug" to rob. Please do tell us more about "Burundanga Drug" and "what we should do, if we are one of the victims?" I am pretty sure, every one of us would be interested to learn more from you.
Thks and send my warmest regards to Auntie Sally.
----- Forwarded Message ----
From: Karen
Sent: Tue, May 4, 2010 9:04:52 AM
Subject: Fwd: FW: BURUNDANGA - to rob
---------- Forwarded message ----------
Subject: Fwd: FW: BURUNDANGA - to rob
From: Chong Kok Kuan
Date: 3 May 2010 10:17
Subject: FW: BURUNDANGA - to rob
To:
Subject: BURUNDANGA - to rob
NAME CARDS
Please be careful. Yesterday, a friend was at the Carrefour carpark after shopping and about to start the car engine. Suddenly, one man appeared holding a name card and asking me to wind down the window to give me the name card. She refused using the sign language but he kept on pestering. She was terrified and quickly started the engine and sped off. Fortunately, she locked the car doors immediately after she got in...
Thank you for the warning email I received earlier.
Rgds,
May
Subject: NAME CARDS
Must Read and Please be careful out there!!
A man came over and offered his service as a painter to a female putting gas in her car and left his card. She said no, but accepted his card out of kindness and got in the car. The man then got into a car driven by another gentleman.
As the lady left the service station, she saw the men following her out of the station at the same time.
Almost immediately, she started to feel dizzy and could not catch her breath. She tried to open the window and realized that the odor was on her hand; the same hand which accepted the card from the gentleman at the gas station.
She then noticed the men were immediately behind her and she felt she needed to do something at that moment. She drove into the first driveway and began to honk her horn repeatedly to ask for help.The men drove away but the lady still felt pretty bad for several minutes after she could finally catch her breath. Apparently, there was a substance on the card that could have seriously injured her.
This drug is called 'BURUNDANGA' and it is used by people who wish to incapacitate a victim in order to steal from or take advantage of them.
This drug is four times more dangerous than the date rape drug and is transferable on simple cards.
So take heed and make sure you don't accept cards at any given time alone or from someone on the streets. This applies to those making house calls and slipping you a card when they offer their services.
PLEASE SEND THIS E-MAIL ALERT TO EVERY FEMALE, OR EVEN MALE THAT YOU KNOW
Regards,
HC Goh
REPLY FROM DOCTOR JB LIM
Dearest Niece Ai Lian and to all your girl friends and other concerned girls too,
Thanks for referring to me for advice.
Pharmacology:
The pharmacology and toxicity of this agent you are referring to is very complicated and highly technical, and I do not expect you and your friends to understand the
pharmacodynamics, pharmacokinetics, clearance, volume of distribution, t ½ values, L50, and all those technical jargon of this agent we, as research and R&D scientists in the drug industry, would normally present or publish in scientific papers. But it is not necessary to explain all that for lay people to answer your question.
Simple info only:
So instead of that, I will very, very briefly in layman’s language explain to you what I know about this agent (drug).
This agent called Burundanga Drug or more correctly ‘Scopolamine’, also known as levo-duboisine, and hyoscine, is sometimes, but more rarely used in Malaysia for the folowing:
• Treatment of nausea and motion sickness
• Treatment of intestinal cramping
• For ophthalmic (eye) purposes
• As a general depressant and adjunct to narcotic painkillers
Less often used as:
• As a preanesthetic agent (sedative before given anesthesia)
• As a drying agent for sinuses, lungs, and related areas.
• To reduce motility and secretions in the GI tract
• Uncommonly used for some forms of Parkinsonism.
• As an adjunct to opioid analgesia, such as in the product Twilight Sleep
Unfounded reports:
However, according to reports circulating around, this drug (scopolomine) in the form of burundanga is also in "epidemic use" in Bogota Colombia in 1995.
What this means was that the drug has been given to unwitting victims who were not only robbed, but were put to work as "mules" carrying smuggled cocaine across the border, only to wake up with very little memory of the event. It is a form of "chemical hypnosis", and the victim can talk, drive a car and navigate while still under its influence.
As far as scientists know, such effects are only stories carried around, but have not been proven scientifically. It was just some rumours.
Business cards to rape victims:
Then again, there are also unfounded rumors circulating around in the Internet and e-mails that a transcutaneous (over the skin) delivery mechanism of Burundanga into the body was possible by using business cards, pamphlets or flyers laced with the drug. It was then used on girls to rape them. I have received such e-mails before.
In my professional opinion as a Special Medical and Science Adviser to an international group of drug companies, I do not think that the drug is as potent as that to have such a powerful effect on the human body by merely touching the card. I do not know of any drug, chemical or poison that can have such powerful effects by merely touching a paper laced with such agent.
No documents:
I have not read in any literature of any drug in existence that can have such stunning effect by merely touching of a piece of paper for a few seconds laced with the drug?
A lot of drugs may be delivered subcutaneously (under the skin) by skin patch – but they have to be literally pasted over a period of 24 hours or longer for slow released absorption over a larger area of skin where the epidermis is thinner, such as the back, or inner thighs, etc, and not over horny parts like the soles of the feet, or the finger tips.
This mode of delivery is transdermal or transmucosal. Sometimes it is called "topical" administration. But such effect is much slower than via enteral – meaning systemic through oral, rectal, sublingual, sublabial (between the teeth and gingiva). Even faster is via bolus, IV, IM, which would-be-rapists would not understand or able to do.
Dose related toxicity:
The quantity of toxin diffusing through the skin after one short contact of the fingers with an object like a business card is much too small to be readily absorbed in the body and to have any significant effect. The use of burundanga (scopolamine) impregnated into visiting cards to attack and to rob isolated people is often propagated by chain emails. In my opinion they are just hoaxes.
Enteral route:
But spiked alcoholic drinks (direct ingestion into the gastrointestinal tract) could have been occasionally used, and this may have effect because the drug is actually ingested, and enters into the system via the gastrointestinal tract. It is not by merely touching it with the fingers.
Suggestions only, but unnecessary:
However, if girls are that scared as that, I would then suggest that if any strangers in lonely places, or those whom they do not know, and for no rhyme or reason they give you a card, it is advisable to use a piece of folded tissue paper or a glove or handkerchief to hold it. But if you have none, do not worry. Just hold the card or pamphlet at the edge using her two fingers. This way almost no substance can ever be absorbed by the fingers.
Bear in mind the skin over the fingers are quite thick, and it is very difficult for anything to penetrate except poked by a needle, a sharp point of a knife, or a piece of broken glass.
Only through these cuts in the skin can things enter into the blood stream. But definitely no drug can penetrate the skin over such a tiny area, especially holding it for just a few seconds or even an hour or even longer.
Ventilate:
One more thing! If you are in a car, and if you are afraid of inhaling anything including burundanga, then do not close your car window as you drive off. Switch off the air-conditioner, and open all the car windows, and let in a lot of air from outside as you drive. Actually even this is unnecessary. How is it possible for a simple card to pour out so many fumes? A card is not a nebulizer machine, steam or smoke emitter.
Calculate out diffusion rate:
You can actually calculate out the amount of molecules of any substance emitted from a card of a certain square area into a cubic meter of air. From there it would be possible to determine how much of the substance is inhaled and circulated into the blood stream as we know the vital capacity of the lungs and the respiration rate. Hence from the concentration in the blood, it is possible to determine if the substance can affect a person since its concentration in the blood can easily be calculated out through respiratory exchange of gases in the lungs.
If I have the data I can easily calculate this out for you without problem from my simple undergraduate training in physics, chemistry and in physiology – I have not forgotten them even though I have since
specialized in medical research with doctorate degrees and post-doctoral Fellowships in other areas.
Scientific logic:
Use your simple scientific logic. If that card can affect you, it can even more affect the person who has been working on them. He probably has been touching it (them) all day long while looking for victims. His exposures of making, storing, smearing the drug on the cards – probably hundreds of them all day long would have knocked him off instantly (if it was so powerful), and he would probably remained unconscious for as long as he still holds and inhales all those impregnated cards – before he could even hand a single one to you.
Use your brains:
Use your simple intelligence to logically and scientifically think. Do not believe everything people send you by e-mails like an idiotic mule. The Internet is full of hoaxes and rubbish ‘information’ written by
unqualified human mules and donkeys. I receive tens of thousands of such mails even from strangers. Listen to me as your uncle.
Love & Regards
Uncle lim ju boo
Comments from others
Dear Dr Lim,
Fully agree with you, sir.
I have observed, some are logically born with others may need some guidance and practice to gain logical skill....
Best regards,
C K
- Hide quoted text -
On Mon, May 17, 2010 at 3:20 AM, JB Lim
Dear Ir Cheong,
You may share it with anyone you wish. It is just a simple explanation. The only thing I forgot to add is that, if girls are so afraid of some non-existence ‘magical scent' coming from the card while viewing it, I suggest they hold it far away from their nose at full arm's length, and better still, if there is a wind or even a small breeze around, they let their back face the wind blowing from behind, so that the wind will blow the 'magic scent' well away from their body. As simple as that!
We don't require a PhD to understand simple logic.
Regards
lim ju boo
On Fri, May 14, 2010 at 9:23 AM, AE Consultant wrote:
Dear Dr Lim,
Thank you very much for the detail and systematically arrive at the conclusion. I am able to learn from the way your presentation of a highly technical issue in the moat direct and simple way for a lay person's understanding & information.
How a researcher's view with logic is amazing.
Thank you again, I would like to share this information
of yours with my family and friends, hope it is okay with you
SIR.
Warmest regards,
C K Cheong
Reply from Dr JB Lim to Ir CK Cheong,
Dear Ir Cheong,
You may share it with anyone you wish. It is just a simple explanation.
The only thing I forgot to add is that, if girls are so afraid of some non-existence ‘magical scent' coming from the card while viewing it, I suggest they hold it far away from their nose at full arm's length, and better still, if there is a wind or even a small breeze around, they let their back face the wind blowing from behind, so that the wind will blow the 'magic scent' well away from their body. As simple as that!
We don't require a PhD to understand simple logic.
Regards
lim ju boo
Patients letters to Dr JB Lim
The following was a letter, actually two separate letters from two persons I received from a lady. It was sent to me by e-mail. I then replied hurriedly to her. But their names were changed to ethically protect their identities as patients before I post their letters and my reply into my blog for educational purpose only.
First letter
Dear Dr. JB Lim,
I had this back problem (S4 & S5) which recur last year.
After the MRI, I was only put on observation and some physiotherapy. I secretly did some pelvic exercise like lying flat on my back, bending both legs (in crouching position) swaying from left to right and some light leg movements. This help tremendously in my healing process and I was back on my feet in a week.
The only thing that worries me is the jab which my family doctor gave me during my first treatment is still down there in my buttock. It's been there for 4 years now. This lump did not worry me until my cousin brother's wife had a pelvic and spinal bone recurring problem.
Even in Singapore there isn't much help or enough doctors to go about the operation. (Maybe only happen in that hospital.)
My question is how are we going to tackle this bone loss degeneration as osteophrosis normally attack women faster than men. My mother is 89, her back is now almost ''r'' shape but I don't hear her complaining much about her backache.
I guess the rest would also want your expertise reply as precaution is always better than cure. Please advice on the drug Tramadol administration and other side effects too.
Following is the extract of the mail.
Best regards always
Ms Christine (name changed)
Second letter
I was having a difficult time for the last 3 weeks or so after my wife had a recurring spinal bone problem and a pelvic bone problem which came on suddenly about 3 weeks causing her so much agony that she had to stop baby sitting and and wanted a specialist to attend to her immediately as she was in tears due to her pain.
I was having a harrowing time shuttling her to hospital for so many days while keeping my work in balance.
Just a brief outline of what she went through. Her family strongly recommended that she went back to see her old bone specialist who had operated on her before some 13 years ago but this doctor had retired. Her sister recommended the next best thing to do was to see a bone doctor in Mount Elizabeth Hospital (recommended by her boss). We were all hoping to seek early and fast treatment as she could not bear with the pain and was weeping everyday. X-ray and MRI scan was done at Mt. E and she was asked to go for Physiotherapy instead of surgery first to see if it works.
After about 4 days, nothing seems to work and it was waste of time, money and resources to go to Mt Alvernia hospital for this physio therapy. I now strongly suspected that there wasn't enough operating theatre time slot for her for that week and this doctor was playing for more time.
On the second appointment to see him, he finally agreed that 2 places on her body need to be operated on Spinal and Pelvic bone.
All these came about because of bone degeneration in her spinal and then there was this muscle tissue tear which were all having a friction or rubbing effect on her nerves thereby causing her to be in great pain whenever she stands, let alone walk. I even had to go borrow a wheelchair from a past neighbour who now stays in Ang Mo Kio for her to use.
My shock came when this so called specialist doctor admitted that he was not qualified to operated on back bone or pelvic bone and he only can do surgery on knee cap. I was disgusted deep inside. He only knows of 2 doctors in Singapore who can operate on Pelvic bone (One Private one in Mt.E but he was out stationed for another week and the other one was Doctor Paul Chang at SGH). We were left with no choice but to make appointment to see Paul Chang and had to go to SGH as a private hospital patient paying the higher private medical fees for treatment. Another setback was earliest appointment had to be a week later.
We could not wait for 1 more week as the Pelvic bone pain was almost killing her. Very strong pain killer was given to her so much so that she developed very severe skin rashes. Don't take this strong painkiller drug called Tramadol if it was ever prescribed for you. You may end up scratching yourself non stop from head to toes like a monkey and the rashes are like big mosquitoes bites on the whole body. She poured half a bottle of medicated oil on her body when the rashes were coming on that day.
Luckily for me, I contacted a friend who knew Dr.Paul Chang well and managed to squeeze in an appointment at SGH on the same day after seeing the Mt.E hospital doctor. Dr. Paul Chang gave her an injection to immediately neutralise the Tramadol effect on her and it works well. Next problem was the Operating theatre time slot for her has to be about 5 days later and again she has to bear with the pain again. They said we could only book B1 class bed for her otherwise if we insist on B2 wards the operation date could be as long as 4 to 6 weeks later as they only allocate for 2 B2 beds each day. What kind of medical infrastructure and facilities are we having in this First World country called Singapore?
It was another long nightmare for her to bear with the pain for 5 days before she was finally operated on.
The operation was actually strongly recommended to be aborted due to her persistent cough , but she had begged the doctors to operate on her immediately without any more delay. She was operated by robot with 2 doctors doing the operation just moving their hands near a computer screen. More like the latest Wii game console. It is called keyhole operation with smaller cut and smaller wound and therefore less bleeding.
She stayed for 2 nights at B1 ward before she was discharged. Total cost spend on all her medical so far was S$13,000 and still counting. She is now recuperating at home. She is in less pain now but she could not stand for long because a second operation on the spinal bone may be due soon depending on her coming appointment on 25th May with Dr. Paul Chang.
She admitted she still need another operation as the pain in her legs are coming from the back bone vertebra abnormal growth getting on to her nerves. Seems like there is another Part 2 of medical nightmare for me to go through with her.
Seems like I will not be able to go head north so soon. I will let you know again as there are times when my colleague will need my help at JB and I may just go up there without much planning. I will try my best to make a trip maybe on the 26th or 27th of this month.
Meanwhile you take care and I will contact you again.
Best Regards
William (name changed)
--------------------------------------------
Doctor JB Lim’s reply:
Dear Ms Christine (name changed to protect patient’s identity),
I am unsure if you needed my advice, or was it another person there called William (name changed to protect patient’s identity as given in e-mail) as there are two letters in your letter with back bone problems. I have just opened your mail, and I have made a very quick scan of both letters. I have not made a detailed study of both letters as yet as I have a lot of other reports attend to
Anyway, I am just giving you or your friend a very fast emergency reply since both of you seemed to be in pain with some back problem. I shall read your letter a little slower later for the details.
Wrong and Right Doctor:
I think your friend in Singapore has gone to the wrong type of doctors for spinal and bone problems. The best type of doctor to treat neuromuscular and skeletal pain such as spinal problems is the osteopath. I think William went to see an orthopedic surgeon in Singapore, which is not the right doctor to go to as they are only interested in operations, and more operations that’s all.
An osteopath or osteopathic doctor is the best alternative doctor to consult for backbone problems. This type of doctors is fully qualified who uses alternative medicine called osteopathy to treat such cases as spinal problems. They do not use powerful pain killers like Tramadol and other powerful drugs merely to suppress the problem like the doctor who treated William did in Singapore. Neither do they use surgery and other invasive methods. They just align the body and musculoskeletal systems into good shape and correct order to solve the problem.
Osteopathic Doctors are more appropriate:
Osteopaths employ manual therapies for the treatment of many muscles, bones and skeletal pains such as lower back pain with excellent results. They neither use invasive procedures like surgery, nor drugs to mask the symptoms. Instead, they use therapies like dietary, posture alignment, occupational advice, as well as counseling to help patients recover from illness and injury to minimize and manage pain and disease quite effectively.
Unsure if Osteopathic Doctors available in Singapore?
However, I am unsure if there are osteopathic doctors practicing in Singapore? But there are a number of American osteopaths and Australian university trained osteopathic doctors in practice here in Kuala Lumpur. They are alternative medical doctors who can do a very good job with all sorts of muscles, ligaments, muscle, spinal (backbone) problems without using all sorts of unnecessary surgeries, harsh drugs and pain killers.
Chiropactic Doctors:
There is also another kind of alternative doctors called chiropractors. They too are very good for this sort of problems. They treat by aligning the bones and musculoskeletal systems. It is very lengthy for me to explain all these to you. It takes a lot of my time.
Types of spinal disorders:
Briefly, there are many types of spinal conditions that can cause a lot of pain. Most of them are degenerative spinal diseases. Degenerative spinal disease is related to chronic wear and tear on the spine due to aging and physical activity. It can lead to a number of different spine disorders such as Herniated Disc. This includes the following:
• Cervical Herniated Disc
• Thoracic Herniated Disc
• Lumbar Herniated Disc
• Spinal Stenosis
• Cervical Stenosis
• Lumbar Stenosis
• Foraminal Stenosis
• Spinal Instability
• Osteoporosis (as in women in post-menopausal stage due to bone loss from hormonal imbalance)
• Osteomalacia (example in rickets)
Actually I cannot give you any elaborate advice via e-mails as I need to have a look at the patient, see his / her medical records, understand his / her medical history, lifestyles, dietary habits, body weight, genetics, age, gender, family history, current treatment given, medication, lab results, radiological scans (X-rays, MRI, CT, etc). Without all these, I really cannot diagnose and suggest any specific treatment. This is just a general discussion to your possible problem.
Tramadol:
As to your question about Tramadol, yes this is a very powerful analgesic (pain killer drug). It is much more powerful as a pain reliever than paracetamol (Panadol). In fact Tramadol belongs to the opioid group of drugs like morphine, but it is slightly less powerful and a little safer than morphine. But it is a narcotic-like pain reliever acting centrally on the brain and central nervous system and it is used for managing moderate to moderately severe pain.
Adverse Drug Reactions:
Unfortunately like all chemical drugs, Tramadol do have moderate to severe side-effects even though normally it is well tolerated. Some of these side-effects may include sweating, drowsiness, diarrhoea, constipation, appetite loss, nausea, breathing difficulties, tightness in the chest, restlessness, chest pains, disorientation, mood changes, swelling and redness of the skin, giddiness, swelling of the face, mouth, lips, etc, and in some cases as in William’s case, there is severe allergic reactions such as pruritus (itchiness), rashes and beehives.
I think William’s case was severe allergic reaction to Tramadol. This can subside by just withdrawing the drug, or by an injection of an antihistamine. Drugs are all chemical substances foreign to the body, and being a foreign chemical when ingested, the body reacts badly to some drugs by trying to reject them. That is how the body cries out with all these symptoms. The symptoms are just the body’s reactions trying to reject the chemicals.
Most drugs hence give side effects in one way or another. The only way is to take them off instead of trying to suppress the symptoms by giving yet another drug such as an antihistamine. To use another drug to suppress the symptoms due to another drug is exactly like sweeping dirt under a carpet. This was exactly what William received and underwent when another doctor gave him an injection to suppress the itch caused by the first doctor. This is the tragedy of conventional drug-based medicine. Mainstream hospital type of medicine is like that.
Alternatives modalities of managing pain:
There are so many much safer, non-drug ways to treat pain rather than giving harsh and powerful drugs like Tramadol. Non pharmacological and much safer ways are (examples):
• Acupuncture
• Aromatherapy
• Breathing exercises
• Biofeedback
• Hot and cold compresses
• Guided imagery
• Massage
• Self-hypnosis
• Transcutaneous Electrical Nerve Stimulation (TENS)
• Touch energy therapies
• Spinal cord stimulation
• Physical therapy
• Distraction therapy
• Laughter therapy, etc.
Drugs are foreign substances to the body:
I do not recommend drugs to solve health problem. Many drugs merely suppress the symptom temporarily, but in the long run damage the liver, kidneys, nervous system, haematological (blood) and circulatory systems. All drugs are like that. They only temporary suppress and mask the problem, but do not cure the disease. To properly treat a medical problem you need to treat the root causes, not suppress the symptoms with harsh and powerful chemical drugs.
Unfortunately that is how modern conventional medicine treats an ailment. The drug company works hand in glove with the medical profession to promote their products, because the doctor does not know how to treat without the drugs, and the drug industry depends on the medical profession to sell them to the patients, and the patient has to pay to both of them. Unfortunately I am from the drug industry as their Special Medical and Science Advisor, but I am extremely honest and very ethical about this.
Medical Professor who opted for Natural Medicine:
A very good and old friend of mine who is actually a medical specialist - a Professor of Psychiatry at the former University Hospital, University of Malaya, but now in private practice, recently told me he had the same knee and bone problem but did not respond to treatment using conventional medical treatment with drugs, surgery and pain killers. He then sought alternative natural therapies using a number of herbs, and nutritional approaches which other doctor relatives bought for him from Australia and New Zealand.
These natural medicines finally gave him a lot of relief. I also advised him further what to do. All these have helped him tremendously.
I think I have spent a lot of time writing this letter. I hope you appreciate the time and effort I have spent.
Relatives and colleagues at SGH:
By the way, my youngest brother Professor Dr Lim Yew Cheng, a Professor of Cardiothoracic and Vascular Surgery was previously from Singapore General Hospital (SGH) before he came here to the University Hospital, University of Malaya. He is now in Gleneagle Intan Medical Centre, Kuala Lumpur.
But one of my nieces, Dr Hsu Anne Ling, a Senior Consultant Respiratory Physician is still there at the SGH, Singapore where Willie was treated. I have other doctor friends also working at SGH.
I shall read your two letters later as I have other things to attend as it is now nearly 1:00 a.m. in the morning.
Regards,
Lim Ju Boo BSc (Physiol), Postgrad Dip Nutrition, MSc, MD, PhD (Medicine) FRSPH, FRSM
Special Medical & Science Adviser &
Head of the Technical Advisory Board
The Dynapharm Pharmaceutical Int’l Group
http://www.diamondinterest.com.my/technicalboard.htm
http://dng.com.my/
Reply from patient
Dear Doctor Lim
Thank you for the quick respond and your reply had greatly opened my choices of alternative medication for precautionary measures.
I shall forward your email to William separately.
best regards always
Christine
(This is not her real name to protect patient’s confidentiality. Professional ethics is observed)
Hi doc,
One slight change, it's William’s wife. Thanks so much.
best regards always
Christine
First letter
Dear Dr. JB Lim,
I had this back problem (S4 & S5) which recur last year.
After the MRI, I was only put on observation and some physiotherapy. I secretly did some pelvic exercise like lying flat on my back, bending both legs (in crouching position) swaying from left to right and some light leg movements. This help tremendously in my healing process and I was back on my feet in a week.
The only thing that worries me is the jab which my family doctor gave me during my first treatment is still down there in my buttock. It's been there for 4 years now. This lump did not worry me until my cousin brother's wife had a pelvic and spinal bone recurring problem.
Even in Singapore there isn't much help or enough doctors to go about the operation. (Maybe only happen in that hospital.)
My question is how are we going to tackle this bone loss degeneration as osteophrosis normally attack women faster than men. My mother is 89, her back is now almost ''r'' shape but I don't hear her complaining much about her backache.
I guess the rest would also want your expertise reply as precaution is always better than cure. Please advice on the drug Tramadol administration and other side effects too.
Following is the extract of the mail.
Best regards always
Ms Christine (name changed)
Second letter
I was having a difficult time for the last 3 weeks or so after my wife had a recurring spinal bone problem and a pelvic bone problem which came on suddenly about 3 weeks causing her so much agony that she had to stop baby sitting and and wanted a specialist to attend to her immediately as she was in tears due to her pain.
I was having a harrowing time shuttling her to hospital for so many days while keeping my work in balance.
Just a brief outline of what she went through. Her family strongly recommended that she went back to see her old bone specialist who had operated on her before some 13 years ago but this doctor had retired. Her sister recommended the next best thing to do was to see a bone doctor in Mount Elizabeth Hospital (recommended by her boss). We were all hoping to seek early and fast treatment as she could not bear with the pain and was weeping everyday. X-ray and MRI scan was done at Mt. E and she was asked to go for Physiotherapy instead of surgery first to see if it works.
After about 4 days, nothing seems to work and it was waste of time, money and resources to go to Mt Alvernia hospital for this physio therapy. I now strongly suspected that there wasn't enough operating theatre time slot for her for that week and this doctor was playing for more time.
On the second appointment to see him, he finally agreed that 2 places on her body need to be operated on Spinal and Pelvic bone.
All these came about because of bone degeneration in her spinal and then there was this muscle tissue tear which were all having a friction or rubbing effect on her nerves thereby causing her to be in great pain whenever she stands, let alone walk. I even had to go borrow a wheelchair from a past neighbour who now stays in Ang Mo Kio for her to use.
My shock came when this so called specialist doctor admitted that he was not qualified to operated on back bone or pelvic bone and he only can do surgery on knee cap. I was disgusted deep inside. He only knows of 2 doctors in Singapore who can operate on Pelvic bone (One Private one in Mt.E but he was out stationed for another week and the other one was Doctor Paul Chang at SGH). We were left with no choice but to make appointment to see Paul Chang and had to go to SGH as a private hospital patient paying the higher private medical fees for treatment. Another setback was earliest appointment had to be a week later.
We could not wait for 1 more week as the Pelvic bone pain was almost killing her. Very strong pain killer was given to her so much so that she developed very severe skin rashes. Don't take this strong painkiller drug called Tramadol if it was ever prescribed for you. You may end up scratching yourself non stop from head to toes like a monkey and the rashes are like big mosquitoes bites on the whole body. She poured half a bottle of medicated oil on her body when the rashes were coming on that day.
Luckily for me, I contacted a friend who knew Dr.Paul Chang well and managed to squeeze in an appointment at SGH on the same day after seeing the Mt.E hospital doctor. Dr. Paul Chang gave her an injection to immediately neutralise the Tramadol effect on her and it works well. Next problem was the Operating theatre time slot for her has to be about 5 days later and again she has to bear with the pain again. They said we could only book B1 class bed for her otherwise if we insist on B2 wards the operation date could be as long as 4 to 6 weeks later as they only allocate for 2 B2 beds each day. What kind of medical infrastructure and facilities are we having in this First World country called Singapore?
It was another long nightmare for her to bear with the pain for 5 days before she was finally operated on.
The operation was actually strongly recommended to be aborted due to her persistent cough , but she had begged the doctors to operate on her immediately without any more delay. She was operated by robot with 2 doctors doing the operation just moving their hands near a computer screen. More like the latest Wii game console. It is called keyhole operation with smaller cut and smaller wound and therefore less bleeding.
She stayed for 2 nights at B1 ward before she was discharged. Total cost spend on all her medical so far was S$13,000 and still counting. She is now recuperating at home. She is in less pain now but she could not stand for long because a second operation on the spinal bone may be due soon depending on her coming appointment on 25th May with Dr. Paul Chang.
She admitted she still need another operation as the pain in her legs are coming from the back bone vertebra abnormal growth getting on to her nerves. Seems like there is another Part 2 of medical nightmare for me to go through with her.
Seems like I will not be able to go head north so soon. I will let you know again as there are times when my colleague will need my help at JB and I may just go up there without much planning. I will try my best to make a trip maybe on the 26th or 27th of this month.
Meanwhile you take care and I will contact you again.
Best Regards
William (name changed)
--------------------------------------------
Doctor JB Lim’s reply:
Dear Ms Christine (name changed to protect patient’s identity),
I am unsure if you needed my advice, or was it another person there called William (name changed to protect patient’s identity as given in e-mail) as there are two letters in your letter with back bone problems. I have just opened your mail, and I have made a very quick scan of both letters. I have not made a detailed study of both letters as yet as I have a lot of other reports attend to
Anyway, I am just giving you or your friend a very fast emergency reply since both of you seemed to be in pain with some back problem. I shall read your letter a little slower later for the details.
Wrong and Right Doctor:
I think your friend in Singapore has gone to the wrong type of doctors for spinal and bone problems. The best type of doctor to treat neuromuscular and skeletal pain such as spinal problems is the osteopath. I think William went to see an orthopedic surgeon in Singapore, which is not the right doctor to go to as they are only interested in operations, and more operations that’s all.
An osteopath or osteopathic doctor is the best alternative doctor to consult for backbone problems. This type of doctors is fully qualified who uses alternative medicine called osteopathy to treat such cases as spinal problems. They do not use powerful pain killers like Tramadol and other powerful drugs merely to suppress the problem like the doctor who treated William did in Singapore. Neither do they use surgery and other invasive methods. They just align the body and musculoskeletal systems into good shape and correct order to solve the problem.
Osteopathic Doctors are more appropriate:
Osteopaths employ manual therapies for the treatment of many muscles, bones and skeletal pains such as lower back pain with excellent results. They neither use invasive procedures like surgery, nor drugs to mask the symptoms. Instead, they use therapies like dietary, posture alignment, occupational advice, as well as counseling to help patients recover from illness and injury to minimize and manage pain and disease quite effectively.
Unsure if Osteopathic Doctors available in Singapore?
However, I am unsure if there are osteopathic doctors practicing in Singapore? But there are a number of American osteopaths and Australian university trained osteopathic doctors in practice here in Kuala Lumpur. They are alternative medical doctors who can do a very good job with all sorts of muscles, ligaments, muscle, spinal (backbone) problems without using all sorts of unnecessary surgeries, harsh drugs and pain killers.
Chiropactic Doctors:
There is also another kind of alternative doctors called chiropractors. They too are very good for this sort of problems. They treat by aligning the bones and musculoskeletal systems. It is very lengthy for me to explain all these to you. It takes a lot of my time.
Types of spinal disorders:
Briefly, there are many types of spinal conditions that can cause a lot of pain. Most of them are degenerative spinal diseases. Degenerative spinal disease is related to chronic wear and tear on the spine due to aging and physical activity. It can lead to a number of different spine disorders such as Herniated Disc. This includes the following:
• Cervical Herniated Disc
• Thoracic Herniated Disc
• Lumbar Herniated Disc
• Spinal Stenosis
• Cervical Stenosis
• Lumbar Stenosis
• Foraminal Stenosis
• Spinal Instability
• Osteoporosis (as in women in post-menopausal stage due to bone loss from hormonal imbalance)
• Osteomalacia (example in rickets)
Actually I cannot give you any elaborate advice via e-mails as I need to have a look at the patient, see his / her medical records, understand his / her medical history, lifestyles, dietary habits, body weight, genetics, age, gender, family history, current treatment given, medication, lab results, radiological scans (X-rays, MRI, CT, etc). Without all these, I really cannot diagnose and suggest any specific treatment. This is just a general discussion to your possible problem.
Tramadol:
As to your question about Tramadol, yes this is a very powerful analgesic (pain killer drug). It is much more powerful as a pain reliever than paracetamol (Panadol). In fact Tramadol belongs to the opioid group of drugs like morphine, but it is slightly less powerful and a little safer than morphine. But it is a narcotic-like pain reliever acting centrally on the brain and central nervous system and it is used for managing moderate to moderately severe pain.
Adverse Drug Reactions:
Unfortunately like all chemical drugs, Tramadol do have moderate to severe side-effects even though normally it is well tolerated. Some of these side-effects may include sweating, drowsiness, diarrhoea, constipation, appetite loss, nausea, breathing difficulties, tightness in the chest, restlessness, chest pains, disorientation, mood changes, swelling and redness of the skin, giddiness, swelling of the face, mouth, lips, etc, and in some cases as in William’s case, there is severe allergic reactions such as pruritus (itchiness), rashes and beehives.
I think William’s case was severe allergic reaction to Tramadol. This can subside by just withdrawing the drug, or by an injection of an antihistamine. Drugs are all chemical substances foreign to the body, and being a foreign chemical when ingested, the body reacts badly to some drugs by trying to reject them. That is how the body cries out with all these symptoms. The symptoms are just the body’s reactions trying to reject the chemicals.
Most drugs hence give side effects in one way or another. The only way is to take them off instead of trying to suppress the symptoms by giving yet another drug such as an antihistamine. To use another drug to suppress the symptoms due to another drug is exactly like sweeping dirt under a carpet. This was exactly what William received and underwent when another doctor gave him an injection to suppress the itch caused by the first doctor. This is the tragedy of conventional drug-based medicine. Mainstream hospital type of medicine is like that.
Alternatives modalities of managing pain:
There are so many much safer, non-drug ways to treat pain rather than giving harsh and powerful drugs like Tramadol. Non pharmacological and much safer ways are (examples):
• Acupuncture
• Aromatherapy
• Breathing exercises
• Biofeedback
• Hot and cold compresses
• Guided imagery
• Massage
• Self-hypnosis
• Transcutaneous Electrical Nerve Stimulation (TENS)
• Touch energy therapies
• Spinal cord stimulation
• Physical therapy
• Distraction therapy
• Laughter therapy, etc.
Drugs are foreign substances to the body:
I do not recommend drugs to solve health problem. Many drugs merely suppress the symptom temporarily, but in the long run damage the liver, kidneys, nervous system, haematological (blood) and circulatory systems. All drugs are like that. They only temporary suppress and mask the problem, but do not cure the disease. To properly treat a medical problem you need to treat the root causes, not suppress the symptoms with harsh and powerful chemical drugs.
Unfortunately that is how modern conventional medicine treats an ailment. The drug company works hand in glove with the medical profession to promote their products, because the doctor does not know how to treat without the drugs, and the drug industry depends on the medical profession to sell them to the patients, and the patient has to pay to both of them. Unfortunately I am from the drug industry as their Special Medical and Science Advisor, but I am extremely honest and very ethical about this.
Medical Professor who opted for Natural Medicine:
A very good and old friend of mine who is actually a medical specialist - a Professor of Psychiatry at the former University Hospital, University of Malaya, but now in private practice, recently told me he had the same knee and bone problem but did not respond to treatment using conventional medical treatment with drugs, surgery and pain killers. He then sought alternative natural therapies using a number of herbs, and nutritional approaches which other doctor relatives bought for him from Australia and New Zealand.
These natural medicines finally gave him a lot of relief. I also advised him further what to do. All these have helped him tremendously.
I think I have spent a lot of time writing this letter. I hope you appreciate the time and effort I have spent.
Relatives and colleagues at SGH:
By the way, my youngest brother Professor Dr Lim Yew Cheng, a Professor of Cardiothoracic and Vascular Surgery was previously from Singapore General Hospital (SGH) before he came here to the University Hospital, University of Malaya. He is now in Gleneagle Intan Medical Centre, Kuala Lumpur.
But one of my nieces, Dr Hsu Anne Ling, a Senior Consultant Respiratory Physician is still there at the SGH, Singapore where Willie was treated. I have other doctor friends also working at SGH.
I shall read your two letters later as I have other things to attend as it is now nearly 1:00 a.m. in the morning.
Regards,
Lim Ju Boo BSc (Physiol), Postgrad Dip Nutrition, MSc, MD, PhD (Medicine) FRSPH, FRSM
Special Medical & Science Adviser &
Head of the Technical Advisory Board
The Dynapharm Pharmaceutical Int’l Group
http://www.diamondinterest.com.my/technicalboard.htm
http://dng.com.my/
Reply from patient
Dear Doctor Lim
Thank you for the quick respond and your reply had greatly opened my choices of alternative medication for precautionary measures.
I shall forward your email to William separately.
best regards always
Christine
(This is not her real name to protect patient’s confidentiality. Professional ethics is observed)
Hi doc,
One slight change, it's William’s wife. Thanks so much.
best regards always
Christine
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