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Be Stroke Aware

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This summer, my entire family gathered to celebrate my mother's ninetieth birthday. The event didn't go as planned. The day before her birthday, just as we all sat down for lunch, Mum had a stroke. Even as a doctor, I'd never actually been present when someone had a stroke before. As an A&E/ER doctor, you see people right after a stroke, not during the actual process. Yet understanding that someone's 'funny turn' is actually a stroke can lead to life-saving treatment being given in a timely manner.

What is a stroke?

More properly called a cerebro-vascular accident (CVA), a stroke is a sudden incident affecting the critical blood supply of the brain. This could be a bleed into the brain (haemorrhagic stroke) or, more commonly, a blood clot in the arteries supplying the brain (ischaemic stroke, similar to a heart attack but happening in the brain instead).

Who gets strokes?

Anyone can have a stroke. When I was a junior doctor, the youngest stroke patient we saw was only fourteen. Fortunately, she had an excellent prognosis for full recovery. But strokes occur more commonly in elderly people, diabetics, people with untreated high blood pressure and people with a prior history or family history of strokes. So when an elderly person or a diabetic has a 'funny turn,' stroke should be uppermost in your mind. Of course, a diabetic could also feel strange or get an alteration in consciousness if their blood sugar goes too low or too high. However, as we'll see, stroke has some quite specific symptoms that don't appear with a blood sugar fluctuation.

When is a stroke not a stroke?

A TIA or transient ischemic attack is like a passing stroke that doesn't cause permanent damage. However, it signals increased stroke risk. Sometimes a migraine headache can cause symptoms similar to a stroke. A person with this type of migraine is also at increased stroke risk.

How can I recognize a stroke?

Key markers that your friend, colleague or loved one is having a stroke include:

  • A sudden alteration of consciousness.
  • A sudden change in speech, or inability to speak, or slurring of speech.
  • One side of the mouth droops down.
  • Person falls to the ground, or starts sliding off their chair.
  • They can't move one arm, or grip is much weaker on one side, or they can't raise both arms.

What should I do?

Call 911 (or 999 in the UK). Do not give the person any food or water. Their swallowing may have been affected and they could choke. If it's really a blood sugar crisis rather than a stroke, the paramedic will know what to do. Getting your friend or loved one to hospital on time will enable appropriate treatment to be given while it has the most chance of helping.

How can Ayurveda help stroke patients?

During the acute phase of a stroke, Western medicine is the appropriate method. Once a stroke patient is out of hospital and able to take herbs or receive treatments such as oil massage or shirodhara, Ayurveda can be tremendously helpful in the ongoing process of stroke recovery. The texts of Ayurveda discuss hemiplegia or stroke paralysis under vatavyadhi (nervous system disorders due to vata). Specific herbs and therapies are outlined to help in the recovery process. A skilled and experienced Ayurvedic doctor may be able to contribute significantly to the process of stroke recovery.

How can I reduce my stroke risk?

If you have risk factors such as diabetes or a family history of strokes, you do have an increased risk of having a stroke yourself. These are known as non-modifiable risk factors. However, you can help yourself by reducing or removing modifiable risk factors like smoking, excess alcohol consuption, overwork, stress,obesity, poor diet and sedentary lifestyle. As always, an Ayurvedic diet and lifestyle suited to your prakriti (body type)can help keep you in balance and reduce the likelihood of a stroke.

Thyroid Disorders

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by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

An overview of thyroid diseases
The thyroid is an endocrine gland situated in the neck at the level of the cricoid cartilage at the base of the larynx and extending from the level of the fifth cervical vertebra down to the first thoracic. It is butterfly shaped with 2 elongated lateral lobes with superior and inferior poles connected by a median isthmus. The gland contains two hormones, L-thyroxine (tetraiodothyronine, T4) and L-triiodothyronine (T3). Affecting between one and two percent of the population worldwide, thyroid disease is among the most common endocrine disorders. Thyroid disorders and thyroid cancer disproportionately affect women.

Skin Inflammation

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by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Skin inflammations are quite common conditions, with atopic dermatitis or eczema affecting 10-20% of all children and 1-3% of adults (1) and psoriasis affecting between 2 and 2.6% of the US population. The prevalence of atopic dermatitis has doubled or tripled in industrialized countries during the past three decades. The visible and often disfiguring nature of skin inflammations leads to far greater levels of distress and depression than would be experienced with a more severe but less disfiguring condition. (2) Because a number of patients are suspicious of cortisone creams prescribed for them by their family practitioner or dermatologist, they may frequently present for Ayurvedic care as an alternative.

According to Ayurveda, skin has seven layers, corresponding to the seven dhatus. Similarly, in modern physiology, skin has been found to have seven layers, stratum corneum, on the surface, stratum lucidum, stratum granulosum, stratum spinosum, stratum basale, the basement membrane and the dermis. (For a diagram of the seven layers of the skin, click here.) At the same time, the epidermis of the skin, as whole, is seen as an upadhatu of rasa dhatu, and the dermis as part of mamsa dhatu. Skin belongs to bahya marga, the external pathway of disease, and as such is very vulnerable to toxins carried by rasa and rakta dhatus during the prasara stage of disease, accounting for the relatively common nature of skin inflammations.

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Sinus Infections

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by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

In the Ayurvedic approach to sinusitis, exposure to an infective agent such as pathogenic bacteria is just one factor in the development of the illness. Of far greater significance is the build up of excess doshas in the body, due to incorrect diet and lifestyle. Once excess doshas have built up and become prevalent due to repeated errors in daily regimen, they are readily carried by vata upwards to the head, where they lodge in any weak spot, creating acute illness. Unfortunately, due to today's polluted environment, the integrity of the mucus membranes of the nasal sinuses is under constant attack. Thus weakened, the sinuses are particularly vulnerable to invasion by provoked doshas. It is the unwholesome situation created by a combination of weakened sinuses, accumulation of doshas and build-up of ama or toxins in the body that provides a fertile ground for the multiplication of pathogens.

Sinusitis, as an inflammatory condition, always involves some component of pitta, the fiery humour. However, provocation of either vata or kapha within the sinuses can give rise to pitta irritation of the mucous membranes. Sinus infections thus can be regarded as either vata, pitta or kapha in nature, each type having specific causative factors and symptoms.

Silent Bladder Infections

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by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Silent bladder infections, also known as asymptomatic bacteruria, may result in generalized ill health or may lead to acute cystitis or to pyelonephritis, a potentially life-threatening kidney infection. Hence it is important to appreciate the groups affected by silent bladder infection, as well as how to make an Ayurvedic diagnosis of this condition and give appropriate chikitsa.

The White Powder: Ayurvedic Strategies for Sugar Addiction

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by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Addiction to sugar is a significant cause of overweight, obesity, diabetes, dental caries, candidiasis and adrenal deficiency. In addition, by lowering immunity, white sugar may contribute to the incidence of cancer and acute and chronic infections. Although white sugar as an addiction of choice affects all ages from infancy on, individuals born in the 1950s are particularly susceptible, due to the prevalence of sweetened infant formula at that period. All types of agni may be involved in sugar cravings, but the nature, consequences and management of sugar addiction differs depending upon the agni type.

Kapha Toxins: Candidiasis

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by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)
Candida, Liquid-based Pap

Candida, Liquid-based Pap (Photo credit: euthman)

In this article, we will consider candidiasis as a condition of kapha ama, reviewing the epidemiology, diagnosis and Ayurvedic management of this common condition.

Candida is a unicellular yeast whose cells reproduce by budding. A normal flora which can under certain circumstances become an invasive pathogen, it can flourish in most environments. Candida species frequently colonize the oropharynx, skin, mucous membranes, pranavahasrotas (lower respiratory tree), annavahasrotas (gastrointestinal tract) and mutravahasrotas (genitourinary tract). Candida can be found on foods, countertops, air-conditioning vents, and floors (6).

A discussion of candidiasis leads us to larger look at considerations of the ways in which epidemiology has changed from classical times until now. Many factors pertinent to the development of Candida overgrowths are relevant to modern industrial society and were not in effect in ancient times. These factors include a diet high in refined sugar and refined flour products, antibiotic therapy, environmental stresses that weaken immunity including EMFs (1), ELF radiation (2), chemical toxins and increased background radiation; sedentary lifestyles (3), epidemic obesity (4), development of immunodeficiency diseases such as HIV, and medical use of immunosuppressant therapies including inhaled corticosteroids. All these factors play a part in the frequency with which candidal conditions are seen in a typical Ayurvedic practice setting. Patients with endocrine disorders including diabetes, hypothyroidism and adrenal insufficiency are at increased risk for Candida overgrowth (6).

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by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Tulsi's your special servant; his heart's your abode
Yet, God, he seems to have a surfeit of suffering.
This limb pain's like a wild creeper, so seize
It's spreading roots in monkey play and yank them out!
Whether from my own sins, or just the triple-torment of this world,
Or someone else's curse, this arm pain's passed expression or endurance.
I've tried every tonic, spells, talismans,
Propitiated a whole herd of gods--all in vain.
Tulsidas, Hanuman Bahuk(1)

As vividly portrayed by Tusidas, one of North India's greatest poets and a fibromyalgia sufferer in his later life, the causation of fibromyalgia syndrome (FMS) is unknown and there is likewise no known cure. FMS is widely understood as a yapya condition--one that cannot be cured and yet is not fatal. FMS sufferers may make up a disproportionate amount of the Ayurvedic practitioner's caseload because the lack of effective biomedical treatment, combined with the severity of the suffering involved, often drives patients with FMS to seek out alterative care.

Prostate Cancer

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by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Prostate cancer, Ayurvedically, is a tumor of the prostate gland involving provocation of all three doshas. Because the prostate gland forms part of the male reproductive system, shukra dhatu, prostate cancer reflects the physical, emotional, and spiritual relationship which the affected man has had with his reproductive capacity. And because the shukra dhatu is the seventh and last dhatu, receiving the essence of food refined through the previous six dhatus, any disorder at this level also reflects the overall relationship with the entire body. Negative lifestyle habits and diet, which seem at the time to have caused no harm, may eventually manifest in the form of tridoshic disturbance of the prostate gland.

by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

From rail-thin models making fashion shows look like the liberation of a concentration camp to films like Supersize Me, we are a culture obsessed with food and fat. Recently the Norfolk and Norwich Hospital in the UK underwent a major revamping, installing new beds, trolleys, hoists and mortuary equipment that could handle patients weighing up to 450 lb, a response to the growing obesity epidemic. Meanwhile, children in American public schools are offered menus featuring corn syrup-sweetened chocolate milk, French fries and almost no vegetables. For some doshic types, severe eating disorders can result from poor habits instilled in childhood. Even the more resilient pitta types still have recourse to food addictions in response to forms of severe trauma that are prevalent in our society. Ayurveda's unique understanding of the different challenges encountered by different prakruti types enables us to help clients make appropriate and necessary changes more effectively than other modalities that use a 'one size fits all' approach.


Table 1 Eating Disorders
  Vata Pitta Kapha
Agni Type Vishamagni Tikshnagni Mandagni
Common Food Allergies Vegetable proteins
May also have gluten sensitivity
Yeast, nuts, blue cheese, food colorings Wheat, gluten, cow dairy
Stress Response Under eater Resilient, unless extreme trauma Over eater
Weight Underweight Overweight Obese
Common Eating Disorders Anorexia/Bulimia
Drive and binge
Bulimia following extreme stress
Sugar addiction
Sugar/wheat/carb addiction
Binges at home



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