The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 01 Jun 2011 02:13 AM PDT The immune system protects the body from the ravages of infections and diseases. What happens when it attacks the body instead? ACCORDING to the divine architect's blueprint, our body is a perfect home, constructed in miraculous detail. The building blocks, like bricks of varying sizes and shapes, are intricately cemented. The plumbing system works efficiently, and power is delivered to the heart of the house. For protection, there is a system of surveillance, with barking sentries which bite, and trained and armed security and back-up units to neutralise any intruding threat. However, in reality, there is no guarantee of perfection. We all know that our roof leaks at times, but that may be repaired. What is extremely worrisome is when the very policing force that is supposed to protect this house turns on the owner and wreaks untold misery, leading to self destruction! This is the bizarre state of autoimmunity, or the immune system attacking one's very own body. We are endowed with a brilliant immune system that confers protection from external threats such as invading viruses, bacteria, parasites, fungi, toxins, chemicals, etc. Without turning this discussion into an immunological thesis, perhaps we should have a cursory introduction to the actors on the stage. Macrophages are the first line of defence, like the four-legged canine. These white cells gobble up invaders and debris of collateral damage. When things get out of control, the handlers (known as T-helper cells) come to the rescue, cleaning up the mess and assessing the situation. If heavy artillery is required, they pass the buck to the B-lymphocytes (located in the lymphatic system), which conjure specific ammunition and fire salvoes of antibodies targeted at the offending agent. In this ongoing war, friendly fire does incur casualties (due to resultant inflammation). The body suffers with aches and pains, and boils with fever. When the threat is over, order is restored by the riot police (T-suppressor cells), which quell the fires of battle (inflammation), and life goes on peacefully again, until the next threat. Another in-house surveillance unit is the NK (natural killer) cells that patrol the internal building for abnormal and potentially malignant cells, neutralising them before they rear their ugly heads. This is, in essence, a form of auto-immunity that keeps us safe from the scourge of cancer. It is often taken for granted that with all these elements in place, we are in safe haven. Unfortunately, errors and mishaps do occur. Multiple sclerosis PL is a 32-year-old dedicated father of two beautiful children, with great dreams for his young family. After completing his tertiary education, he entered the corporate world as a highly creative graphic designer. At age 24, the light that illuminated his world began to dim as he developed vision distortion. In the beginning, he had trouble focusing on images, followed by double vision, before finally receding into the dark shadows of intermittent blindness, caused by inflammation of the nerve for sight (optic neuritis). Gradually, he began to experience numbness of limbs, weakness, and fatigue. He was finally diagnosed as having multiple sclerosis four years after the onset of the first symptoms. Nerves are like a wire conducting current from one point of the body to another. The outer casing is known as a myelin sheath, and promotes transmission of nerve signals. For some peculiar reason, the body's own immune system attacks the myelin, causing inflammation and interruption of smooth conduction, leading to bizarre neurological symptoms (as experienced by PL). His thoughts became a little cloudy and the upheaval of emotions drained him, physically and mentally, until he finally succumbed into bouts of severe depression. Today, he still has intermittent relapses, but this is controlled by medication, and by adopting a positive, healthy lifestyle. Instead of giving in to the challenges, PL has spearheaded the Multiple Sclerosis Support Group For The Northern Region, to counsel and assist similar sufferers with this predicament. (For further information, contact Peter Lim +6014-845 522.) In some other less fortunate patients wth multiple sclerosis, there may be paralysis, imbalance, sexual difficulties, and bladder and bowel incontinence. Sytemic lupus erythematosus (SLE) Somewhere out there is a precious seven-year-old girl who is battling a peculiar form of auto-immune disease called SLE, or lupus for short. Her bright sunny days turned gloomy suddenly, when nebulous clouds of self destruction loomed over her. It all started a week before, with a sore throat. Within a short time, the kidneys and the heart were involved, causing her to pass out blood in the urine, and the heart swelled up. Doctors scrambled to save her. Tubes and needles were repeatedly inserted into her frail body to deliver the intravenous drugs she needed. She summoned all her strength to face the repeated blood extraction daily. With intensive medical care, family support, faith, and the will of a gutsy little girl, she is now recuperating. I take this opportunity to wish her and her loving family well. SLE can affect any age and can be missed in childhood as it is considered to be "not common" in this age group. According to textbook descriptions, the typical appearance of lupus is usually in the female gender within child-bearing age. Characteristic features like facial (butterfly) rash, joint swelling, recurrent mouth ulcers, loss of hair, fever, and fatigue are some common signs and symptoms. SLE can also extensively affect major organs with inflammation and destruction. The heart, brain, and kidneys are often targeted, with resultant heart failure, mental disturbances, and progressive renal impairment. The cause of SLE is not known in full, but we do suspect a combination of genetics and environmental triggers – infections, toxins, drugs and even (postulated) cosmetics. Data is inconclusive, but there are rumblings on prolonged lipstick use and hair dyes. Gullain-Barre Syndrome There are a few occasions in which I felt like hanging up the stethoscope for good, and this one particular experience almost made me throw in the towel. On Day One, a young executive complained of mild sniffles, followed by a slight cough. It was just a common cold. He was given run-of-the-mill prescriptions for symptomatic relief. On Day Five, he complained of a sore throat, and apart from the new discomfort, was not much worse than the previous days. Disaster struck on Day Six. In the morning, he felt numb in the face, and by evening, was in a semi-comatose state, with generalised paralysis to the extent that he need artificial ventilation in intensive care. This is a situation of mistaken identity. After a mild illness, the immune system is triggered to ward off the infective agent, but instead of doing that, it turns on the host, attacking the nervous system in this particular instance. It took a couple of weeks before he gradually regained consciousness. Although he is slowly recovering, the trauma he suffered will scar him for life. Auto-immunity is not such a rarity, and many diseases considered as separate entities in the past are in actual fact some form of "body attacking itself". There are about 80 diseases linked to underlying auto-immunity. Auto-immune diseases are not contagious, but may have a tendency to run in families. It may affect specific target organs (like multiple sclerosis), or can attack multiple organs (like SLE). As in most chronic diseases, genetic factors set up the stage, and environmental triggers pull down the curtain. Type 1 diabetes, thyroid diseases (Grave's and Hashimoto) are examples where hormone-producing organs are attacked. Psoriasis, a troublesome eruption of red, scaly, and unsightly lesions on the skin, can cause embarrassing disfigurement. Vitiligo is patchy depigmentation of the skin. Many intestinal ailments such as Crohn's, ulcerative colitis, coeliac disease, etc, do have an auto immune component. The bad news is that there is no cure, as hitherto, no drugs or alternative methods can instruct the body to cease to self-destruct. The goals of treatment are to reduce symptoms, and suppress the immune response. In recent years, the trend has been moving in the direction of immune modulation. Our immune system is put in place for an immensely important function – to protect us. Something came in between and threw a switch that unsynchronised the defence system. It only makes common sense to safeguard our immunity, which like any system, can go haywire and cause massive problems. Regular exercise, a healthy lifestyle, balanced diet, and optimal cellular nutrition are the foundation that our immune system is built on. The demands on our immune system is ever increasing, and if we do not support it with the right balance, the chances of rebellion increases. Dr C.S. Foo is a medical practitioner. For further information, e-mail starhealth@thestar.com.my. The views expressed are those of the writer and readers are advised to always consult expert advice before undertaking any changes to their lifestyles. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. 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| Posted: 01 Jun 2011 02:13 AM PDT On World No Tobacco Day yesterday, the clarion call to reject the use of tobacco rings loud and clear. ACCORDING to World Health Organisation (WHO) statistics, smoking kills more than five million people a year worldwide. This accounts for one in 10 adult deaths. This annual death toll could rise to more than eight million by 2030 unless urgent efforts are made to control the situation. Heart Foundation of Malaysia director Datuk Dr Khoo Kah Lin has urged all Malaysians to take a stand on the issue, describing tobacco use as "a scourge on humanity". "There are currently three million Malaysian smokers consuming an average of 14 cigarettes a day. Approximately 93% of this number are adults, while the rest are children below 18 years old. "The number of smokers keep on increasing, even though smokers know full well that smoking causes various diseases, and can swiftly take their lives away." Statistics continue to prove that smoking can be equated to activating a time-bomb, with a smoker's health ticking away. "A single cigarette contains more than 4,000 poisons and about 70 carcinogenic substances, which would have a variety of toxic effects," Dr Khoo said. "These poisonous chemicals can be an irritant to the respiratory tract and lead to various diseases." Below is an excerpt of an interview with Dr Khoo on the topic. Why has the number of smokers increased despite the negative effects garnered from research? There may be a number of reasons for this. One major factor is the stress and pressures of modern living, as cigarettes are perceived as a stress reliever. Many people find smoking relaxing and enjoyable. Another reason can be attributed to social and psychological factors. Many smokers start smoking during their adolescent or early adulthood years due to peer pressure. Some may smoke because they want to "rebel". With the many warning signs of the dangers of smoking advertised everywhere, some smokers have "rebelled" by ignoring the warnings and increasing their cigarette intake. Some smokers have even convinced themselves that "if it makes you happy, then it can't be that bad; after all, we are all going to die one day." What are the main diseases caused by smoking? The most common diseases from smoking are respiratory diseases, because when you smoke, it goes through your whole respiratory system. The more common ones are bronchitis, pneumonia, asthma, lung cancer and emphysema (a type of lung disease which makes it hard for a person to breathe). It may also lead to cancer of the throat, bladder, kidneys, cervix, pancreas and stomach. Statistically, lung cancer remains the main cause of death from smoking. A smoker may also develop cardiovascular diseases such as ischaemic heart disease, where there is a reduced supply of blood to the heart muscle, or suffer from a stroke. Heart disease is the second leading cause of death from smoking. Quitting smoking is the most powerful intervention possible, and can reduce mortality by as much as 36%. Smoking in women seems to be a trend in Malaysia. What caused this trend? Social pressure and stress are the main motivations for smoking. I do not deny that women nowadays face more challenges. Playing the different roles of a wife, mother, daughter, housekeeper and a leader at the workplace can place some amount of stress on women. However, some women take up this habit because of a misconception about female empowerment. For others, they view it as a fast route to losing weight. Some may even smoke as a way of dealing with relationship problems, or emotions like loneliness or boredom. Are women at a higher risk compared to men in terms of smoking health risks? That is a clear yes. Women are at higher risk than men because of their genetic make-up and intolerance to drugs in general. A woman's body cannot handle the same quantity of cigarettes smoked by a man. Women who smoke are also 12 times more likely to develop lung cancer than non-smokers, not to mention all the other smoking-related diseases that come with the habit. In fact, women who smoke 40 or more cigarettes daily have a 74% greater chance of dying from breast cancer. The sad fact is that smoking takes a greater toll on women than it does men. How serious are the consequences of exposure to second-hand smoking? It has been scientifically proven that adults who inhale second-hand smoke face the same risks of developing lung and heart diseases and cancers, as smokers themselves. The effects of second-hand smoke on children include various infections, low birth weight, and Sudden Infant Death Syndrome. Side effects like chronic coughing, wheezing, and eye and nose irritation can occur in adults and children alike. Not only that, third-hand smoke can be equally as harmful as second-hand smoke. Is there such a thing as third-hand smoke? Yes, there is. Third-hand smoke is essentially an invisible toxic brew of gases and particles that cling to a smoker's hair and clothing, not to mention furniture, walls and carpeting, which lingers on long after second-hand smoke has cleared the room. This residual smoke includes heavy metals, carcinogens, etc, that young children can get on their hands and ingest, especially if they're crawling or playing on the floor. Similar to second-hand smoke, the risks associated with third-hand smoke occur when particles from the residual smoke penetrate into the deepest parts of the lungs and contribute to asthma or other respiratory diseases, and more seriously, cancer. If a person is a smoker, would quitting have any effect on his or her health? There are definitely tremendous benefits if you quit smoking. You will first be adding more days to every year of your life. Within 20 minutes of smoking your last cigarette, your body will start its internal healing process. You will also be greatly reducing your chances of developing or dying from diseases and cancers associated with smoking. Seriously, think about quitting, as the benefits are many and there are a multitude of resources out there to help you in your effort to shed this habit. What types of treatments are available for a smoker who wants to quit? Currently, there are two types of treatment approaches: pharmacologic therapy and non-pharmacologic treatments. Pharmacologic therapy, in simple terms, is the use of drugs to treat a certain condition. This treatment method is used to alleviate the withdrawal symptoms from smoking cessation and helps a smoker abstain from smoking. Non-pharmacologic treatments include counselling, health education, hypnosis and acupuncture. Hypnosis can, in certain cases, be very successful in convincing a smoker to develop and strengthen the desire not to smoke. Acupuncture is useful to alleviate smoking jitters, irritability, cravings and restlessness. If you stop smoking now, and remain so after 10 years, the risk of developing any smoking-associated diseases drops to one-third to one-half of the risk for smokers. n Article courtesy of Heart Foundation of Malaysia. Full Feed Generated by Get Full RSS, sponsored by USA Best Price. |
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