Health News

If our attention can be distracted we obtain respite from our pain. It would seem that our mind can only hold one topic in consciousness at a time.

If our attention can be diverted away from our pain on to some other matter, then we are no longer conscious of our pain. A child falls and hurts himself. He cries with pain. Mother picks him up, and looking out the window says, “Oh, I thought I saw a rabbit under that bush.” The pain ceases. If his attention is diverted only momentarily his pain returns. But if his mother can maintain his attention for a few moments, while the painful stimuli settle down, then there is no return of the pain.

The same tiling happens with us adults. The patient with arthritis says, “I am better when I am doing something. I am really better at work; the pain does not worry me so much then.” We often make conscious efforts to divert our attention from pain by going to a show, watching TV or by conversation with our friends. The difficulty, of course, is that our brain gives a very high priority for attention to pain of any severity. It therefore usually requires something of real urgency to divert our attention. This is seen in soldiers wounded in battle who continue to fight with little awareness of their wound. In a similar way injured football players often finish the game before they are fully aware of the extent of their injury.

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Q. The mouth, tongue and lips are very obvious parts of the body, both because they are readily visible and also because they have an enormous nerve supply which makes disorders here fairly uncomfortable. At least this is fortunate for it brings it to the attention and increases the chances of seeking proper medical help. What are some of the more common problems in this area?

A. There are several which are worth discussing. First let’s talk about cold sores, these have been in the news for the past few years and affect nearly everybody. Cold sores are also known as herpes simplex and appear in the form of multiple tiny blisters. Herpes simplex may occur on the lips but is more common in the area surrounding them. It is caused by a virus HSV-1 and sometimes this can rapidly spread and become a serious disease necessitating urgent medical attention.

Q. What about treatment?

A. A new antibiotic called acyclovir, which will soon become available in Australia, is said to be curative. Apart from this the application of ice to the sores, ideally before the blister appears, for about 60 minutes often helps. This is called cryotherapy ( = cold treatment). The drug idoxuridine (‘Stoxil’) may help if applied very early before blister formation, and another called poridone iodine (‘Stoxine’) may help. Otherwise, simple methylated spirits applied every hour and antiseptic are about all that is left. Avoid too much sunshine or foods to which you are allergic.

Q. Some people seem to suffer from a horrible looking black tongue.

A. A dark brown to black coating can occur on the surface of the tongue. It is common after treatment with antibiotics and merely means that the superficial layers of cells on the tongue are not being shed (desquamated) as they normally are. It disappears without treatment soon after the course of antibiotics has been completed.

Rinsing with hot, salty water (1 tsp salt in glass of hot water) 3-4 times a day assists if the condition feels unpleasant and unhygienic.

Q. What causes little clear coloured lumps to occur inside the lips. Quite a few people seem to develop these.

A. These are called mucous cysts or mucocoeles.

These usually occur as a single, simple swelling on the inner side

of the lip the shape of a pea. It may gradually increase in size and is due to a blockage of a mucous gland. Sometimes a swelling of a blood vessel in this area can simulate a mucous cyst. If the cyst is proving troublesome (such as when eating) it may be removed surgically by the doctor. It is excised (often under local anaesthetic) and sutured or the base diathermied to check bleeding. Because of the copious blood supply to the mouth, tongue and lips, bleeding can sometimes be profuse but this is readily checked during any surgical operation.

Q. I guess many mothers have to cope with a facial injury when her child happens to sustain a fall.

A. Injuries to the tongue, lips and mouth are common. A very common injury is with children who slip from scooters and wheeled toys onto a hard surface. A tooth is commonly forced through the tongue or lip. With any injury in this region bleeding is usually profuse. It indicates that a vast network of blood vessels exists to bring blood to this region. In most instances, simple cleansing of the injured part with cool water, plus pressure (e.g. with a fabric pad, such as a handkerchief or gauze swab) for 10-15 minutes will usually check this. Deeper wounds may need suturing (stitching) by the doctor. Any dirty wound (on any part of the body) needs an anti-tetanus injection. The doctor usually does this automatically. With the widespread use of immunisations from an early age, many children and adults are already protected against tetanus. But a “booster shot” may be required if none has been received in recent years.

Q. Are many people troubled with foreign bodies in this part of the system?

A. Yes. One of the most common is a fish bone which can easily become stuck in a large protruding tonsil. Alternatively it may become lodged in the throat or in any part of the oral cavity. Removal is essential. Often it may be seen without difficulty and, with a little dexterity, simply removed. No further treatment is required. Professional help is sometimes needed if it is hard to find or remove.

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Apart from the methods outlined above, you may also be able to lessen the extent to which you feel pain by making changes in your diet, as modern medical research has underlined the long-known fact that some foods have properties that can reduce how strongly you perceive pain.

Here are some recent key findings:

Extremely promising results have been obtained with a diet specifically formulated to reduce many forms of chronic pain, including those resulting from back problems and joint dysfunction. Dr Samuel Selzer, of Temple University in Philadelphia, who headed the group that developed the special diet, however, warned: “Although this diet has brought great relief to many who followed it and it is safe for most people, you should always consult your doctor before you try it.” The pain-relieving diet consists of several components:

Increase your intake of complex carbohydrates – such as whole-grain foods (but excluding corn), beans, vegetables, and fruit -so that these account for about three quarters of your food intake; and

Avoid all fats and oils, including butter and margarine, as much as possible; and

Also avoid refined carbohydrates, including sugar, honey, and syrup; and

Keep as low as possible your consumption of processed or baked foods that contain a great deal of fats, oils, or sugar; and

While following the guidelines above, you should take three grams of tryptophan, an amino acid normally available from health foods stores, daily, dividing the total amount into six equal doses of half a gram each, one of these being taken at about three-hourly intervals. Tryptophan is converted by the body into serotonin, a natural pain-relieving chemical.

Follow the diet rigorously for at least four weeks. If after that time it has brought benefits and there has been less pain, then reduce the tryptophan to a total of only two grams daily. Assess the results again a month later; if progress continues, once again cut down on the tryptophan, this time to only half a gram a day.

Instead of taking tryptophan supplements, you can follow the diet above without the tryptophan, but make up for this by substantially increasing your intake of foods with a high tryptophan to protein ratio, these including soya beans, dairy products, fish, meat, and eggs.

Other food-related suggestions for combating pain:

The effect of aspirin will be accelerated if you drink a cup of strong coffee at the same time, according to research conducted by Dr Bernard Schachel of Yale University.

Eating chilli peppers can help reduce pain because they are an excellent source of capsaicin, a substance found by researchers at the University of Alabama to diminish many kinds of pain, especially chronic pains, including those associated with pinched nerves as in sciatica.

Easily available foods with proven pain-reducing properties include cloves, garlic, ginger, onions, and peppermint.

Many plant foods have a high content of salicylates, a sort of natural aspirin that has analgesic effects and can also combat inflammation. Good sources of this natural painkiller include cherries, prunes, blueberries, curry powder, dried currants and dates, paprika, and liquorice.

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