A few years ago I posted a blog post: How to improve health, pain and everything else - 2022 edition
Since my last blog post I continued to think about ways to treat chronic pain with lifestyle changes. Recently I decided to make a career change and focus more on my anesthesia practice. I will try to share the wisdom I accumulated over the last few years. Hopefully people with chronic pain will come across this blog post and implement my suggestions. It may seem like a radical change for many people but I think there is no other way to achieve a state of health. I have seen success stories.
One thing that changed since my previous blog post is that I became more philosophical. I came across some pretty unusual ideas about bioelectricity and life in general (watch this lecture by Michael Levin). I realized that we have no real clue about how the human body builds itself from one cell to the whole thing. There is an amazing level of coordination needed to develop organs and other body parts. Apparently the plan of how to build a body is not at the DNA level. Whatever inner intelligence builds the body that intelligence is still in us when we grow older. Somehow modern medicine and science convinced us to trust our doctors and scientists more than we trust ourselves. We forgot that no doctor/scientist created these amazingly complex structures: our bodies. Modern medicine creates the illusion of knowledge. However our bodies are much smarter than modern medicine. I wrote a whole blog post about healing.
Another interesting thing that we completely ignore is the mind body connection. Michael Levin makes the point that our thoughts get us out of bed in the morning. Without thoughts we are nothing. It is truly amazing to think that our thoughts fire up the muscles and coordinate with our eyes and other senses to get us to do something. Somehow most people would never accept that our thoughts can affect the body in any meaningful way.
In the big picture the things that make us sick are: our genes, our behavior, our environment and time. We cannot change our genes yet and even when we can do it I will not sign up for the first wave of gene therapies. We definitely cannot change time. So we are left with our behavior and our environment. From a behavior perspective I think we have known the basics for a very long time, but somehow we forgot what is truly important. In my opinion there are three levels we should be thinking about.
1. Metabolic health. I wrote a blog post about this. Basically, the metabolic health is closely related to our diet. My advice is to eat whole foods, lots of vegetables, avoid excessive fruit intake (especially grapes and other very sweet fruits). Stay away from sugar/fructose, fruit juices and processed foods. The goal of the food industry is to sell us stuff and they create super addictive foods. Billions of dollars are spent on creating and advertising foods that make us sick in the long term. The food industry is so good at getting us sick that it takes only 10-20 years to accomplish this. Just look at children, they are getting obese and metabolically sick at very high rates. It is estimated that 19.7% of American children and adolescents (2-19 years old) are obese according to CDC. One study estimated that only 12% of the US adult population is metabolically healthy. The effort to improve metabolic health needs to be even greater for people with serious metabolic disturbances like diabetes. In addition to everything mentioned so far people with diabetes should look into a low carbohydrate diet. Nowadays, a lot of people are on Ozempic and similar medications with all kind of potential side effects. But if you actually ask these people how they lost the weight the answer is pretty much fasting: they do not eat as often or as much. One cause of their weight issues was food addiction and the medication is helping them break the addiction. People can do fasting without any medication. Jason Fung is a great resource for people interested in fasting.
2. Movement. Most of us don’t move as much as our ancestors. I read the book: “The practice of natural movement” by Erwan Le Corre. In Erwan’s opinion many of us are by choice zoo animals. We limit our movements and our environment so much that we are nowhere close to our ancestors in terms of movement type and frequency. Our children have the instinct of our ancestors and practice all kind of movements by crawling, jumping, climbing everything they can find. But then we restrict what children can do and we put them in chairs at desks. For many people the only movement they do is walking from one chair/couch to another. In my opinion the best is to return to a whole range of movements using as many muscles as possible. One step in that direction is yoga or tai-chi. If you have young children around, try to do whatever they do. If you see physical therapists, ask them how they are going help you improve your whole body.
An inspiring story is the La Sierra High School in California in the 1960s and 1970s. They had an amazing program for their students: see this Youtube video
Another inspiring case is Shirley Sahrmann who is a retired professor of physical therapy. See her exercise routine when she was 86 year old in this Youtube video.
3. Mental health. Our minds are amazing tools but we need to use them properly for our benefit. We should give our minds as much attention as we give to our bodies. A daily practice of mind exercises like meditation can unlock deep levels of the mind. Everybody carries around a certain level of baggage from the past: e.g. traumas big and small. The good news is that we can heal the past. For significant trauma leading to PTSD and depression I think an option in the near future will be psychedelic therapy. Tim Ferris had a good podcast episode and the book “The fellowship of the river” by Joseph Tafur is a good resource. For chronic pain therapies targeting emotions (e.g EAET and PRT) are more successful than the standard cognitive behavioral therapy.
You can find a blog post I wrote about the mind/body connection here.
Another important area is sleep. I wrote a blog post about sleep a few years ago. In my experience if we improve metabolic health and mental health, sleep gets better. But we should not ignore sleep hygiene.
We will probably have little use of the modern medicine outside acute conditions if people master all these levels of health.
