All posts by Mohamed Belhag

covid-19, you are so mean !!

Looking back

The first time ever we heard about the current corona virus pandemic was at the end of January 2020 when the World Health Organisation has declared the outbreak a public health emergency on international concern.

Wuhan, where the current world trouble started !!

Going back trying to trace the routes of this infection would probably lead us to Hubei province in central China where the real first person was infected. It was a person aged 55 years who was one of Wuhan city residents, and that was the first known victim of COVID-19 viral infection, and that was  on 17 November 2019. The first official announcement by China was on 31 December 2019, when health authorities in China reported to the WHO a cluster of viral pneumonia of unknown cause in Wuhan in Hubei region. The WHO then declared the outbreak a public health emergency of international concern on 30 January 2020. At that very time 7,818  cases were identified world wide affecting 19 countries in five WHO regions. 

Let us try to go back a bit to understand where we are now. It is probably fair to say that within the corona category of RNA viruses, there are 4 subgroups named alpha, beta, gamma, and delta based on their genomic structure. Alpha & beta coronaviruses infect only mammals causing usually respiratory symptoms in humans and gastroenteritis in the other animals. Until December 2019, only 6 coronaviruses were known to infect humans, four of them they caused mild common cold type of symptoms in immunocompromised people, and the other two have caused pandemics in the past two decades (SARS CoV in 2002-3, with 10% mortality; and MERS CoV in 2012, with 37% mortality).

That was not just a piece of history in our life, but it could be the key towards knowing more and more about how that mysterious viral pneumonia has happened and where from. Obviously that “mysterious” strange kind of pneumonia would never come from nowhere, and it can only tell us openly and frankly that, the “zero” case is still on the run !. The first source of COVID-19 clearly needs to be found, and if we manage to get that very piece of information honestly and sincerely, we may learn much more about the current COVID-19 pandemic.

Looking around

We will for sure beat you !!.

Since December last year, life has gone forward, events have changed, and people in the whole world have learned, adapted, accustomed and moved on. That is the nature of us humans, we were born with adaptable, progressive, and self-upgrading software. We are flexible, though few may not be, and those who always resist any changes. At the end of the day, even those who resist changes will eventually submit when they find themselves standing at the end of the queue and find nothing to grab.

We are already exceeding 21 million infections with more than three quarters of a million deaths. Is it something that we need to panic about?. No one likes to see people dying, but if we look back to previous pandemics, then we can calm down a bit. We need to do our best, but never to panic.  

Every country has developed its own system of accommodating to live with the new unexpected comer. Every country has managed to keep life going with a lot of success. On the other hand, COVID-19 as well has proved to all of us that it was not just an ordinary virus. It has managed to reshape itself, to resist every trial to contain it, and proved to be a very clever and strong contender. COVID-19 managed to stay with us – against all our previous expectations – until today, and will probably force itself for longer. We have learned to live together as long as it’ll take us.

Is Covid-19 double-peaking?. No, I don’t think so. We are still racing up with new infections, but we haven’t reached a peak yet to start double peaking.

On Friday, 31 July 2020 we observed the highest ever number of COVID-19 infections per day totalling 291,102 persons, but luckily this was not accompanied by the highest number of deaths, which was so far on 17 April 2020 when a total of  8,494 people died in 24 hours from COVID-19 infection complications. 

Few related matters might be looked at here to make things clear and updated for my dear readers. A question about, are we witnessing a second peak?. My best reply to that is “no”. I don’t think we are witnessing a second peak of Covid-19, but probably a nicer and more thorough look around us and back. I am very much aware that countries in East Europe, South-East Asia, and south America did probably with some surprise find themselves becoming late victims of this pandemic, why?. I don’t know, but obviously it is an area for epidemiologists to have a deep look at trying to find an explanation.

Was dexamethasone really a breakthrough?!. No, and not at all. It was helpful as expected, and should has been used much earlier as a strong anti-inflammatory remidy for intubated patients with Covid-19 who were struggling to stay alive.

My second interesting is Dexamethasone, and whether it was really a breakthrough?. My sincere answer to that is very simple: No, it was not a breakthrough at all. It was not a breakthrough because we knew dexamethasone for decades, it was and still is around us and available for anywhere in the world to be used. We knew very well that steroids are used in acute respiratory distresses from acute bronchitis, to exacerbation of bronchial asthma to other respiratory acute conditions. We knew that steroids do work in these conditions, and they can be life saving if we use them rightly. Dexamethasone has nothing to do with Covid-19, but they were used for the respiratory inflammatory changes cause by the infection. They are anti-inflammatory but obviously not anti-viral treatment. Hence, I quiet honestly did not see any breakthrough in connection with dexamethasone, but on the contrary, I might blame the researchers for not considering dexamethasone to alleviate respiratory distresses from the beginning. On the early days of seeing victims of Covid-19 in ITU or on the media and the terrible status there were in, I thought at that very early time that intravenous methyl Prednisolone could be used to safe life.

When politics is mixed with medical inventions, it’ll make the invention suspecious. We need seriously to seperate the two and to keep medical business purely for medical people. Please be alerted.

What about the Russian new vaccine?!. I have nothing to say more than that the Russian president Vladimir Putin himself was the first person to advertise the new vaccine, and that he called it Sputnik v indicating that here we are purely talking about politics, but not medicine. The Russian vaccine as we knew has not gone through phase 3, and just passed phase 2, and that on itself is enough to make it questionable. I think, we need to be very careful, and at the end of the day, we are here dealing with prevention but not a therapeutic option, and from my point of view doesn’t warantee any rushing. We can protect ourselves and waith for a better choice of vaccination.

We are not ideal, and can never be ideal. This is just a one picture of the many of us human beings trying to live normal despite of everything around us. Holiday makers on the hottest day so far on Bournemouth beach.

In connection to us people or humans, we need always to remember and acknowledge that, we can never ever be ideal, and we can never be the best at all times. We do behave through our instinct sometimes, and listening to our desires other times. We are human, and we can never be ideal. We must not think that we are ideal. We can only do what we think is right, and sometimes what our inner-senses desire without much thinking, and without much consideration.

We can be the best at our time, but we need to know that someone will come and that one will be better than us. That is very natural and must be expected, as we are for sure much better than our ancestors and life is just like that.

Life will go ahead, and we will survive despite what faces us and what might stand in our ways. We are humans and we are able to progress. That was the way we were created with. It is in our software, and we are able to develop and upgrade our human software every time we are faced with a challenge.

Finally in this area, I heard today that the UK is now probably wittnessing some changes in the behaviour of Covid-19 among people. There might be an aparent rise in the number of cases proven to be infected, but it seeked over the last few days that probably more younger people (teenagres & early twenties) are infected in comarison to the previus trend of elderly and the vulnerable. The second oibservation they were talking about today was that the disease severity and the need for ventilation has become significantly less over the last few weeks. No one was able to explain those obsrvations more than by saying that the number of those tested has increased, hence, more picking up of those asymptomatic or with mild symptoms who would never otherwise need to go to hospital or even mention their illness to anyone as they either never knew about it or never thought of any need to do so. That was also a kind of partial explaination to the relatively increased numbers of young infected people. On this area in particular, I was a bit different in my thinking about it. My subconscious mind is telling me that by now, we have been exposed directly or indirectly to the virus, and by now, we have immunologically responded to it by developing a level of anti-bodies depending on each one’s of us internal immune system efficiency and ability. At the end of the day, Covid-19 is nothing but an RNA virus, and it has to be within the influenza virus families. My thinking was, as we have responded to previous flu infections by developing anti-bodies to beat them, we are now doing exactly the same thing against Covid-19. The passage of time is in our favour, and the more exposure for all of us is for sure more chance for us to develop a natural sepsfic vaccination via our own immune systems…. you can call it “herd immunity” if you wish!!.

Looking forward

Tens of attempts to contain the virus so far, but none has proved to be fruitful. A team of researchers in China lead by prof. Li Lanjuan at the Zhejiang University has found  that COVID-19 has mutated into at least 30 different genetic variants, affecting different parts of the world, some of them are clearly more variant than the others. The Chinese researchers have found that within a small pool of patients many mutations not previously reported. These mutations include rare changes that scientists had never imagined could happen. That nature of virus modulating itself to resist elimination has already made anti-viral treatment very difficult to ascertain, and vaccination against this virus became realistically more difficult to obtain.  

Much more to follow later !!

An update on corona’s fate

Since my previous article on virus corona’s early pandemic issue on the 15 March 2020, I have noticed and followed closely a lot of international events with this pandemic.

Well, life is moving on and life events have to change to cope with the time dynamics.

Obviously, the world’s pandemic map has changed dramatically, and from homeland of the virus China, we can see now many new competing hosts for the virus, be it unwilling and unhappy hosts !!.

From China to USA, many world countries lie in between. USA is  the world leader in almost everything, and corona virus infection rate was never an exception to the rule. China is now standing lower in the list of corona virus rate of infections at the 11th. position of world leaders in this area, allowing USA at the top lead followed by Spain, then Italy, then UK, then France to be the top five with confidence. UK has alas risen from level 12 to level 4 on the number of infections, and probably the top in Europe in the number of deaths from corona virus infections.

On today’s figures, more than 3.6 million people in the whole world are now proved infected with covid-19, and obviously many more are not counted in different parts of the world especially those lagging in the tail of world’s economy and welfare. More than quarter of a million are now reported dead because of the virus, and more than a million are now reported as fully recovered. They could be considered immune to be re-infected with the same virus, but even that we are not quite sure. Some, and many cases had re-infection so far, and the dilemma continues.

Colorized scanning electron micrograph of an apoptotic cell (red) heavily infected with SARS-COV-2 virus particles (yellow), isolated from a patient sample. Just look at the numer of viruses surrounding this tiny small cell to see how much agressive this virus can be.

We know it is an RNA virus, and we have been told that it is not “really” like a flu virus, even though Covid-19 has many things in common with the influenza virus.  Covid-19, or call it SARS-2 has more preference to deep inside the respiratory structure and doesn’t favour that much nasal mucosa, or oral mucosa. Covid-19 loves to live and grow deep inside the alveolar/bronchiolar linings. Hence, may be, it hates to travel far away from their subjects, and this might help many people to protect themselves from getting infected by the new term “social isolations” or call it “social repulsion” versus “social attraction” !!.

That is how the virus looks like, and that was the reason why it is called “corona” which means crown. The other name obviously is “wreath” as it looks on the left side of the image.

Anyway, we still are struggling to learn much more about the beautifully looking  current corona virus. It does look very nicely like a wreath, and we know very well what wreaths are used for !!. We for sure need to learn more, and by the time we learn all about the virus, it might decide to leave us to another planet. I am talking here about knowing how to kill the virus(treatment) or how to protect ourselves against any further assaults by the same virus(vaccination). We are now struggling with what we can use to kill the virus, even though we have tried all what is available in our hands from previous experiences with HIV, seasonal Influenza, SARS, MERS, and even Ebola anti-viral agents, but we are still struggling to stop or even contain the covid-19 infections.  We have also tried anti-malaria agents such as Chloroquine but we are still far away from harming this “clever” virus.

What about Winter, the Llama?. She may be the sources of antibodies to beat corona, the virus !!.

However, on the horizon, in fact much closer to us, I can hear some good news about controlling covid-19 all together and forever. Researchers from Utrecht University in the Netherlands, as well as the Erasmus Medical Centre and the company Harbour BioMed (HBM), have identified a potential method of neutralising COVID-19 . They discovered that an antibody which prevents the SARS virus from infecting human cells could also block the novel coronavirus from infecting human cells too, according to a peer reviewed study published on Monday 4th. May 2020, in the journal Nature Communications. Testing their collection of antibodies on cultured human cells, researchers discovered one which binds to a specific part which is present in both SARS and the virus causing COVID-19. This discovery could offer an initial step towards developing a fully-human antibody to treat or prevent the disease. We will keep watching, and hoping , after we have been – for long – just dreaming !!.

Will this drug prove to be the “superstar” or it may be just one of those?!.

Two drugs seemed to be with a potential therapeutic values in patients with COVID-19 infections. One of them is called Remdesivir is a broad-spectrum antiviral agent which blocks adenosine, is a purine nucleotide base which is essential for RNA and DNA viruses to survive. It has been tried and it has some value in reducing the recovery period or otherwise shorten it. The other one is Tocilizumab, an interleukin-6 inhibitor which is used in the treatment of rheumatoid arthritis, and has also shown some potential therapeutic effects in patients with COVID-19 infections. We need to wait for the outcome of phase three trials.

MAy be something promissing, or it could be futile like other attempts. We are human, and we hae the power and will. We will this way or that way beat this virus.

Naturally, as humans, we have been through hundreds of previous pandemics, including those were much more serious than the current COVID-19 pandemic such as the Spanish Influenza in 1918-1920, which infected nearly half of the world population at that time i.e nearly 500 million and killed nearly 50 million. However, COVID-19 was the one which took far much more attention than any previous similar pandemics. It is for sure, the world we are living in is far different from any previous time with our current advances in everything including of course media, economics, technology, politics, health, education and artificial intelligence. We are panicking because we are now the victims. We have read a lot about previous world disasters and pandemics, but naturally we’ve never been so worried and alarmed like we have done on this occasion.

Aaaand, there is always the question: what life is going to be after this pandemic, and how much we can learn from this experience?. Are we going to learn anything at all?. I don’t know, and I do strongly think that, once the “beautiful” virus decides to leave us, we will just celebrate and enjoy our freedom again… we will celebrate our social gathering again. We may forget all about COVID-19 apart of course from the academics, virologists, microbiologists, politicians, and historians who will follow the traces of the pandemic, and write a lot about its dynasty. We probably see COVID to change into CUPID, and we see more hugging, stronger love, more romantic world, and real affection between humans world wide.

At the end of this quick relection, let me be a bit more serious about COVID-19 pandemic and us humans. Let us forget all about the conspiracy theories, political games, and the real thinking among many of the religious people in the world that, this pandemic is a punishment from God to us because we have never been really nice to each other. I just wanted to say and I am so confident, that, this is NOT His Majesty’s punishment to us human beings. It is in fact the other way around… it is his Mercy to us.

Since the creation of the first human on this planet, people were always and always challenged with natural disasters (Earthquakes, volcanos, floods, typhoons, infections, illnesses, congenital defects, etc). the only reason behind all of those natural disasters is for us to ponder, reflect, think, create, modernise and develop ourselves. We are here at our levels of civilisation and modernity because of those disasters. We were created to look forward, to progress, and to move on. That is why we are where we are now, and that is why we need think and believe that tomorrow is going to be better than today, and the future will be much better and brighter than our time. Life is like a running train with one way long trip. That train can only go forward, and it has for now unknown destination. It will just keep going with a lot of happy expectations and dreaming that the next stop will be happier than the one we just left behind.

My deep and sincere condolences to those who lost dear ones in this pandemic. My wishes for a quick recovery for those who are at the moment in intensive care units ventilated and waiting for recovery. My wishes for those who are scared that, they might pick up the infection, and my advice to every one to keep vigilant and strictly follow the rules and regulations in countries, and obviously to wish all of you and myself happiness  and very pleasant future.

CORONA virus

Corona virus, the microscpical shape
Corona virus, the wreath shape

They are a group of RNA viruses, and the word corona meaning crown or wreath. Corona viruses mostly cause infection in mammals and birds. When it infects cattle or pigs, the commonest clinical feature is diarrhoea. When it infets human (mostly children), the commonest clinical feature is chest infections similar to those in common cold infections.

Corona viruses were first identified in the early 1960s, and they are the biggest in size of all known RNA viruses. They are enveloped viruses with a positive-sense single-stranded RNA genome and a nucleocapsid of helical symmetry. To protect themselves, these viruses tend to envelope themselves when they are out of their host targets. In general, they cause mild flu-like illnesses, but there are few virulent small groups such as SARS-CoV in 2003, HCoV NL63 in 2004, HKU1 in 2005, MERS-CoV in 2012, and SARS-CoV-2 in 2019, and the latest of these serious infectious viruses is of course Covid 19, and those virulent viruses are known to cause serious respiratory tract infections and death for the vulnerable group of people.

Corona virus, the shield structure

Currently, there are no identified anti-viral agents against corona viruses, nor there are any discovered vaccinations, but the world now is witnessing a collaborative work between scientists to develop effective antiviral agents and specific vaccinations.

COVID-19

Covid 19 is the latest of the corona viruses group to cause the current havoc around the world. The latest statistics of today’s 15 March 2020 showed that a total of 163,332 identified infections in the world; with 6,086 deaths, 5,655 critical and 76,219 fully recovered (cured):-

Top 10 countries in the world of corona virus infections on 15 March 2020

Commonest symptoms:

  • Always starts with a fever, then dry cough.
  • After a week, it can lead to increasing shortness of breath, with about 20% of patients requiring hospital treatment.

It is worth noting that, the COVID-19 infection rarely causes runny nose, sneezing, or sore throat. Those symptoms have been observed only in about 5% of patients. Sore throat, sneezing, and stuffy nose are more suggestive of a common cold, than corona infections.

Disease course so far:

  • Mid, with a flu like symptoms = 80.9%.  
  • Severe, with pneumonia and severe short of breath=  13.8%.
  • Critical, with respiratory failure, septic shock, and multi-organ failure= 4.7%.
  • Death = 2%.
  • Increased risk of death with older age, especially those with other medical problems.
  • Relatively much fewer cases among children.

Protection:

  • Get away from gathering places such as busy markets, cinema/theatres, stadia, very crowded gymnasia, holiday busy resorts, busy restaurants. Also; airports, ferries, trains, and underground travelling at peak times.
  • Keep your distance for at least two metres from anyone coughing.
  • If you cough or sneeze, always at least put your hand or elbow sleeve on your mouth if not able to use something else such as handkerchiefs.
  • Always wash your hands, and rub with alcohol spirits after touching any object especially in public places.
  • Always remember that mouth, nose and eyes are the main sources of entry of the virus to your body. Try to avoid touching them, or wash your hands before doing that.
  • If you think that you may had the virus infection by experiencing raised temperature, dry/productive cough, or sudden shortness of breath/sneezing/new wheezes/or new blocked nose. If you experience any of those symptoms, it is better to isolate yourself away from people or at least keep your distance.
  • Never panic about corona virus. Calm down and drink a lot of fluids, eat healthy food, and remember oranges and other citreous fruits are good sources for vitamin C.
  • Exercise, to enhance your circulation, and that dilutes the viruses inside your body to allow your protective white cells to engulf them.
  • At the end of the day, getting corona virus infection is not the end of the world. Probably, less than 1% from all of those infected may die, and those who die are those who were very old, have underlying medical problems, or were immunocompromised. If you are healthy, you will for sure beat the virus and recover very quickly. Please avoid passing it to anyone else by every possible way. Here, we need to be humane and very sincere to each other.

Treatment & Prevention:

For the time being, there is no anti-virus treatment available, and there is no discovered vaccinations as yet. There will be a vaccination, and there might be an anti-virus in the next few weeks. By that time, I think the virus would have gone away and life would go on as usual.

Just to mention here the recent trials of anti-viral agents:

  1. Health officials from WHO have noted that Gilead’s remdesivir has demonstrated efficacy in treating the corona virus infection.
  2. Favilavir, the first approved corona virus drug in China
  3. HIV and flu anti-virals.
  4. Sarilumab(Kevzara), used for Rheumatoid arthritis.
  5. Chloroquine, used for malaria.
  6. Blood plasma exchanges.

Here is a list of the major coronavirus vaccinations those pharmaceutical companies across the world are developing that have the potential to become major coronavirus vaccines to protect against the contagious coronavirus infection:

  1. Altimmune’s intranasal coronavirus vaccine.
  2. INO-4800 by Inovio Pharmaceuticals and Beijing Advaccine Biotechnology.
  3. NP-120(Ifenprodil) by Algernon Pharmaceuticals.
  4. APN01 by University of British Columbia and APEIRON Biologics.
  5. mRNA-1273 vaccine by Moderna and Vaccine Research Center.
  6. Avian Coronavirus Infectious Bronchitis Virus (IBV) vaccine by MIGAL Research Institute.
  7. TNX-1800 by Tonix Pharmaceuticals.
  8. Brilacidin by Innovation Pharmaceuticals.
  9. Recombinant subunit vaccine by Clover Biopharmaceuticals.
  10. Vaxart’s oronavirus vaccine.
  11. CytoDyn-leronlimab. 
  12. Linear DNA Vaccine by Applied DNA Sciences and Takis Biotech.
  13. BXT-25 by BIOXYTRAN to treat late-stage acute respiratory distress syndrome(ARDS).
  14. MERS CoV vaccines for coronavirus.
  15. Inovio Pharma’s INO-4700 .

Many more are currently in progress, and for sure a protective vaccination will be produced in the next few weeks.

Please, be positive, motivated, very well aware, and never panic… wish you all the best.

Finally, just a little reminder to all colleague doctors in hospitals anywhere in the world… you are the best protected people because of your ever activated immune system from previous exposures during your clinical encounters with different patients. Yes, you don’t carry in your blood those antibodies for covid-19 virus, but always remember that your immune system is probably at its best all the time. You definitely need to protect yourselves, and protect your patients and all colleagues; but never run away from your patients. As doctors, you knew very well how to wash your hands, how to use the alcohol wipes, and how to keep your distance. In any suspicious cases, please never try to be a hero. Use your commonsense, and your knowledge, but never run away from your duties.

For all of you readers, please, be positive, motivated, very well aware, and never panic… wish you all a peaceful escape from this yet anther pandemic !!.

Cyrene: The birthplace of love sign

Modern Cyrene(Qourina) on the Green Mountain.
The silphium was born in Cyrene, a beautiful Libyan historic city.

Cyrene was established by the Greecs in 531 BC, and the place was chosen because of its fertile land and rich in water supplies.

Silphium is a plant that was heavily growing in the now known Qourina (Cyrene) in the Green mountain area in Eastern Libya.

Silphium coin (one side)

Cyrene was famous with its green land and fertile soils. It was used for agriculture, and silphium was one of the many fennels in the area, but silphium was likely a type of giant fennel, with crunchy stalks and small clumps of yellow flowers. From its stem and roots, it emitted a pungent sap that was described as one of the most precious gifts presented to us by Nature. The valuable product was the plant’s resin which was known as laser, laserpicium, or lasarpicium.

Exports of the plant and its resins made Cyrene the richest city on the continent at that time. It was so valuable, in fact, that Cyrenians began printing it on their money. Silver coins from the 6th century B.C. are imprinted with images of the plant’s stalk—a thick column with flowers on top and leaves sticking out—and its seed pods, which look pretty familiar with its heart shape appearance.

So what was so great about silphium sap?. It was at that time, a kind of cure-all, used to treat everything from chills to fevers to corns. Hippocrates said: it could be used as a poultice, or to soothe the stomach. Cooks also used the plant in their recipes, perhaps the same way we use fennel seeds today.

It may also have been used as a type of birth control. “Anecdotal and medical evidence from classical antiquity tells us that the drug of choice for contraception was silphium,” writes the historian John Riddle in Eve’s Herbs: A History of Contraception and Abortion in the West. He points to the ancient physician Soranus, who suggested taking a dose of silphium “the size of a chick-pea” once a month, both to prevent conception and “destroy any already existing.”

Silphium seeds, heart shaped

Silphium seeds looked heart shaped by their understanding at those days, as the heart at that time was not seen or imagined as we know it in our current knowledge. The heart was thought to be formed of three chambers, and that was probably the reason why silphium seeds where linked to the heart shape, then obviously became historically as the first sign of love.

A Cyrenian coin from the 6th century B.C., with a silphium seed imprinted in it.
A Cyrenian coin from the 6th century B.C., with a silphium seed imprinted in it.

In his Poem, Catullus wrote that he wants to share as many kisses with his beloved “as the number of Libyan sands that lie in silphium-bearing Cyrene.” It’s not too hard to imagine that he’s providing two prescriptions at once here: one for getting busy and one for preventing unintended consequences. Riddle also describes another, more explicit Cyrenian coin: “A seated woman has silphium at her feet, while one hand touches the plant and the other points to her reproductive area.”

Not everyone buys Riddle’s theory about silphium’s ancient use. In a 1994 New York Times article, other experts called it an “intriguing hypothesis” but went no further, saying there’s not quite enough evidence to crown the plant as a common form of ancient birth control. And even if we grant it that status, it’s still a bit of a leap from “heart-shaped seed of ancient contraceptive plant” to “enduring symbol of love.” There are also plenty of other theories about where the heart shape came from, ranging from a Catholic saint’s divine hallucinations to a bad organ description by Aristotle.

Talk to your body

You need to learn how to talk to your body. Talking to your body is not the as talking to yourself !.

 Talking to your body is not the same as talking to yourself. Talking to yourself is a form of hallucinations, delirium , or affective disorder; while talking to your body is a form of reconciliation, internal communication, pondering, contemplation or a real desire to understand yourself….. it is in essence a form of “reflecting”.

Easy going, free spirit, and fresh air are your tools to manage your life despite of your chronic illness.

This article was triggered by reviewing my 63 patients out of 2500 who suffer from multiple sclerosis who all are under our care. These 63 patients are all suffering from a mild form of MS or otherwise could be called “benign MS”.

The interesting thing about all of these patients with not a single exception is that they are all happy, positive, motivated, futuristic, engaged in physical activities, none smokers, drink very small amounts of alcohol or not at all. They are  exceptionally very pleasant people and easy to deal with in their follow up clinics. They are followed up once every two years, and with two or three exceptions, they have no real relapses for more than 10 years. Their disability (EDSS) scales remained less than 2.0, and they do have a very small demyelinating loads(plaques), which are affecting brains, but with no cerebellum or spinal cord involvement. They are very rarely taking any medications, and they appear very healthy in every aspect of their lives.

We were created different and none of us is perfect. We do have one thing in common… we all have will, and we all own minds. All what we need in our lives is to search for those and use them.

When anyone of you is suffering from a chronic illness, and you knew very well that; it is a progressive disease, and contrary to what expected, you’ve felt better, happier, and more confident… that is really very nice and very optimistic. I would like to say in this context that, inside your body, you do produce a lot of chemicals which are in essence and in many ways similar to the medications you may take for your MS to keep it under control. Take for example,  β- interferons.. they are used externally for the treatment of MS in the form of disease modifying therapy. Your body produces that chemical with even much better effect than those commercially available with their many side effects. Your own  β- interferons  are more effective with no side effects !!. Your body produces interferons (α, β, and γ) and each one of them has a different function. Some of them causes inflammations , some of them stop inflammations. Some of them beat cancer and reduce damage from some medical conditions. Your body knows exactly what to produce and when to produce it. Your body if given the right conditions can produce the exact amounts needed for the exact purpose. Your body has the ability to produce thousands of chemicals in different compounds and cocktails to  beat cancer, inflammations, infections, and even the degenerative (wear & tear) materials which are responsible for many medical conditions including dementia, osteoarthritis, ageing, and wasting processes. That is the art of creation and that is how we humans can survive bad times and stressful conditions. Many other chemicals produced by your body have their functions changing in amount, concentrations, timing, and locations in your body in response to any unexpected or expected attacks which may affect you. There are the interleukins, tumour necrosis factors, cortisols, immunoglobulins, and other immune supporting factors.  All those body products have different jobs depending on when , where, how much, in which shape, the structure they are produced in, and the conditions they are produced in or against what state.

Internal body products are designed to protect us from many invaders from infectious materials, to foreign bodies, to poisonous substances, to internal body wrong reactions such as auto-immune conditions. The internal body control systems are so much sophisticated, and as much complicated. To the best of our knowledge, we are still far away from understanding their natures, functions, triggers, and switches off or on. I need also to mention those chemical body products which have the medicinal effects similar or even better than the external remedies we – doctors – are prescribing for our patients to help them beat their ordeals. I love always to call the internal products as “the hidden powers”, because they are for real hidden powers those we own and can use when we need them, but we need to learn their secret codes or otherwise “pass words” to  be able to use and adjust them according to our real needs.

The biggest chemical factory in the world is the “bod factory”. Trillions of chemical reactions happen inside this factory.

The human body in essence is nothing more than a “chemical factory” that produces chemicals out of raw materials those we eat, digest, absorb, and then utilise. Each one of us humans has a very sophisticated chemical factory that should be able to produce anything we need in our day to day lives. We can produce chemical materials those are able to prevent cancer or to beat cancer if it does escape all body defensive and protective systems in place. Our natural chemical factories are able to produce everything we need, but we need to learn how to control the productivity through our wills. Some 60 chemical elements are found in the body, but what all of them are doing there is still unknown. Trillions of chemical reactions happen simultaneously in the body. They drive the processes that keeps a human body ‘alive’.

Hundreds of chemical very useful materials are produced inside our bodies. They are produced, regulated, adjusted, and calibrated every minute if not every second to cope with our body functions those we know about(conscious level) and those we don’t feel them (sub-conscious level). These are very simple examples of our own chemical products. They are produced inside us, and we can learn how to control their production inside our bodies if we hardly try:-

Endorphin — the pain-masking chemical.
Encephaline — nociceptive pain control (internal opioids).
Dopamine — the goal-achieving chemical.
Serotonin — the leadership chemical.
Oxytocin — the chemical of love.
It is not just a production issue, but control, balance, and timing of that production. Each factor is as important as the other.The balance of brain chemicals as an example is crucial for healthy mood and behaviours. Any disturbance in brain neurotransmitters such as serotonin, dopamine, nortriptyline, acetylcholine, glutamine, or gaba-amino-butyric acid(GABA) could produce depression, and that can sometimes be very difficult to treat especially if we don’t know how to put chemicals back to their physiological normal balance.

Researchers believe that, lower than normal levels of neurotransmitters can lead to symptoms such as:

  • Feelings of sadness, helplessness, worthlessness, or emptiness.
  • Overeating or loss of appetite.
  • Insomnia or sleeping too much.
  • Feeling of impending doom or danger.
  • Lack of energy.
  • Distancing yourself from others.
  • Feeling numbness or lacking empathy.
  • Extreme mood swings.
  • Inability to concentrate.
  • Thoughts of hurting yourself or others.
  • Being unable to carry out day-to-day activities.
  • Hearing voices in your head.
  • Alcohol or drug misuse.

I must tell you… all of you, that every one of us has the ability to control their own chemical products if we just learn how to do it. Everything is at your disposal because its your own body, and your body can be so generous with you if you just know how nicely you can talk to your body using the very language that your body understands.

You must try to know yourself. You need to know your powers.

I would like here to remind many of you about what will happen if you talk nicely to your body and if you know how to relax, feel positive, confident and if you genuinely believe in your powers. You need to learn how to trust yourself and believe in your abilities. You no doubt need to conciliate with yourself and with your body, then your body will by your slave and you will be the master of yourself.

Always think before you wink !!.

All what you need to do is very simple and can be very easy. You need to relax, to calm down, to concentrate…. to try and touch your soul. Can you do it?. It can be hard, but never impossible. Try today and you will for sure learn tomorrow but you need to put your foot on the first step, then you will soon find yourself on the top of the ladder. Never look down. Try to look forward, and try to be brave… learn how to become confident.

I want you to always remember that your body needs fuel to do things. Your fuel is carried by your blood, and your blood is pumped by your heart to your organs via your blood vessels, and your organs contain cells those work like small factories producing chemicals those you need so much to execute functions. Also please remember that your heart and your blood vessels are controlled by your autonomic nervous system(sympathetic & parasympathetic), and even though it is an autonomic(self controlled), but you can control it if you manage to learn how !.

Mental concentration, physical tuning, and psychological relaxation… your bridges towards talking to your body..

You need to learn how to relax, how to concentrate, and how to control your body functions or at least to be able to subject your body to listen to you. It can be very difficult for some people, but it is never impossible to any one of us. We need to learn how, and we need to learn the art of “self-control”. Concentration and relaxation programmes are available to every one of us such as yoga, meditation, mind fullness, massage, relaxing stretching workouts, spa, life sonic relaxation, etc. All of those tools and programmes are aimed to teach you how to relax;  physical, mental, and psychological relaxation… a kind of full chilling out.

Let me now tell you what could happen inside your body when you fully relax:  When you are happy and deep inside you, you really  feel happy and relaxed; your body organs function much better and more integrated. Your heart beat becomes more regular, stronger and more efficient. Your heart pumping of blood gets stronger, and the amount of blood circulates faster and more efficient around your body and towards your internal organs. In other terms, when you are relaxed, motivated, feel positive and optimistic; your autonomic nervous system works at its best and the harmony between the sympathetic and para-sympathetic nervous systems peaks to send the needed blood to the needy organ or cell for them to do their functions at their best. When you are relaxed, your arteries are wider to receive blood from your heart, and your veins are stronger to take blood from tissues and pump it back to your heart. When your heart receives more blood coming back from your organs, it’ll send it to your lungs to filter out carbon dioxide and other gaseous bad products, then loaded it with oxygen and send it back to your heart to pump it away to every cell in your body. Some of it will be sent to your kidneys to filter out bad products such as urea and creatinine, as well as other products such as salts and trace elements to keep the required balance that your body cells need to do their jobs.

When you are relaxed and feel happy, your lungs expand much bigger to let more oxygen in and then squeeze it to your blood. The good expansion of your lungs will ultimately be followed up by a good shrinking(deflation) of your lungs pouring the extracted bad gas out through your breathing pipes to the outside world. When a cleaner blood loaded with oxygen, sugar, protein, and minerals as well as trace elements reaches your organ cells, they function at their best to produce those different chemicals in the form of hormones, neurotransmitters, and other pharmaceutical products those you need to ease pain , to relax muscles, and to secrete liquids such as tears, saliva, sweats, urine, and greasy materials. Those will help to clean your body from toxins, debris, and other waste materials. Your body is a very sophisticated big factory, and you are the one to make that factory function at its best at any time of your life. Talk to your body, and your body will very gently and carefully listen to you and may as well obey your orders including the none-verbal ones !!. Please make your body your first and closest friend, and from their you can build a network of good friends with people you meet and work with every day in your life time. Please have fun, and be happy.

touch of philosophy

Spirit, soul, and the mind. Do we know much about them?. What happens if we happened to know?!.

A human creature is made of four important components: Body, mind, soul, and a spirit. We knew a lot about the body(shape, structure, function, and disposals), but we only knew very little about the other three components. 

I would offer a question here for those who love to think deep, ponder, and work hard to understand the nature of things. The question is: mind, soul, and spirit… are they different or they could be just three names for the same thing?.

If you ask me what I think, I would say: it is hard and can be difficult to distinguish between them as we in reality don’t know much about any of them. We can only guess, imagine, ponder, and wonder about them. We can not subject them to research, and we can not subject them to further analysis…. they are untouchable !.

I always say in my writings and discussions about us(humans), that we are in principle a body and a spirit… but, what is the spirit?. 

Spirit is the unknown secret of our living.

{{They ask thee concerning the Spirit (of inspiration). Say: The Spirit (cometh) by command of my Lord of knowledge it is only a little that is communicated to you (O men!)…}}. From the holy book: we don’t know much about the spirit, and it is God’s affairs as we only – as much as we knew – still knew very little. I think here, we are talking about God’s world… the Universe. Despite of that I can still think and guess about the spirit. 

I do believe that we as humans, were made of a structure(flesh) and function. To make the structure function, you need to find an engine.  Light needs electricity, and electricity needs a generator, and a generator needs fuel, and the fuel needs to be converted into energy…. a bit complicated. I think in a very simple way of pondering, I would rather say the spirit is the means by which our body cells start to function(the igniting spark)… it is the trigger for every thing happens in our bodies to keep things going {{Behold! Thy Lord said to the angels: “I am about to create man, from sounding clay from mud moulded into shape; (28) “When I have fashioned him (in due proportion) and breathed into him of My spirit }}. I believe that the spirit is a tiny part of the Lord who lent it to us to live the given age, and at the end of the contract, He(The Lord) just fetches back what he gave us and we just cease to function… die {{O (thou) spirit, Come back thou to thy Lord}}… return to your Creator !!.

Hence, I guess, we were lent a generator(engine) to keep us going until the last day of our lives, then the engine is taken back, and the deceased will remain motionless, lifeless, and simply “dead”. That is probably the spirit, but is the spirit same as the soul?.

That is another question which needs an answer. I would think that spirit and soul are not the same. I do believe that spirit is part of God, hence, it is pure, innocent and very powerful. When any one of us dies, simply God takes back its belongings and leaves our flesh to be buried. However, our souls I guess remain with us and will be buried with our corpses … to me that is the soul which is different from the spirit.

My next question is: what is the difference between the soul and the mind?. Is the mind simply the trigger of the brain, and the brain is the master of everything in our lives?. I guess, it is an other  valid question.

Do we know anything about our sols?. Your soul is your core, but what is it?.

I would think in this context that the soul is our body software(the way we think, we behave, we love and hate, we care, we function, we desire, we satisfy, etc), and the mind is the ignite of that software to make it function(work). The mind in us is the will, urge, power, intention…. the conscious choice we make. Your mind is you will and your intentions. Your motivation, your eagerness, your way of thinking.

At the end of the day, our brains are the parliaments where decisions are made, our body structures and organs are the government which through its agents everywhere in the body executes the parliament’s decrees and decisions, and our minds are the supreme courts those govern and control everything for us to function properly when we are healthy. We can order our brains to create a function through our minds, and different parts of our bodies to execute that function according to speciality. 

What is the mind, and how your mind can control your actions?. Your mind is you, the person, but what it is?.

In simple terms, if I wanted to say something, I just think about what to say(mind), create what I wanted to say(brain), and execute what I wanted to say into talk(tongue, hard palate, teeth, and lips).

In conclusion, I wanted to say to everyone who reads this loud thinking: you are in charge of your brain via your mind. Your brain is responsible for every thing you do including love via your sympathetic nervous system, urination via your kidneys, circulation via your heart, breathing via your lungs, etc. 

Finally, you may hate me to say that your love is not in your heart, but your heart is nothing but a mechanical pump that pumps blood into every bit of your body. You can donate or receive a heart, but your love will never go with it, or the new heart you receive will never come with its donor’s love.  Think about it, and let me know your way of thinking by commenting on my thinking. Let us talk and share thought and ideas. You are free here to think loudly.

THE SUMMER TREASURES

Summer days are:Long, shiny, cheerful, and happy…

Some countries in world hate summer, and others dream of its arrival. That is our life, and that is the way how it was designed for us to live in it and to enjoy our lives and dream for the best.

For those countries in the world which experience long, cold, and wet winters always long for few summary days… few days is enough all what they can realistically dream of. Few says of sunshine are better than many days of rain in the middle of the summer !!.

Summer days: Happiness is natural and innocent moments…

See, how much our reaction to things is different?!. How much sometimes we hate things and get angry about things, but the very same things are a source of happiness and joy for others.

Summer days: We need to prepare ourselves…

In the summer of course, our days are longer, but our energy bills are much less !!. In the summer, people from other countries travel to the more sunny places, but those in the sunny places themselves travel away to probably less sunny places. We are humans, and we are diverse. Our reaction to the very same things is different, and our priorities are different.

Summer time: Nature can be so beautiful especially when everything in very much natural !!.

We need to be that way, because we have been created that way. 

We were born with different shapes, heights, sizes, colours, features, and ways of thinking. Our  creation was not random, and our differences were calculated. Every event in our life is designed to be, and every outcome is meant to be. Life is colourful, and we need to see it colourful to enjoy it.

Summer brings to us in Western Europe warmth, hope, and happiness. Summer makes us cheerful, more interactive, and more communicating with each other… we become more sociable in summer, and we wish every year that summer remain with us a bit longer, but it does not listen to us !!.

Summer loves to show for short time, then just goes away before we even had enough of it. It’ll remain lovable, and we remain in love with summer all of our lives.

Summer days: Time to feel happy !!.

Let us enjoy summer days and celebrate summer nights. Let us talk to each other, become good friends with one another. Let us share the season happiness and make life happier for those who were not lucky, or were not gifted in this life. Let us try to be nice to each other, and feel the suffering of others… let us become more empathetic, and more sympathetic. Let us share happiness, welfare, and share the burden of those who  for whatever reason found themselves ill, poor, in conflict zones, or  born disabled. Let us see the blue sky as a mirror our actions reflected on its surface, and see our deeds expressed in its silent but expressive language. Let us be nice to one another, and always remind ourselves that we are all humans, and we do all feel the pain and resent suffering.    

THE HIDDEN POWERS

The human body is formed of flesh and spirit. We can easily recognise the flesh(structure) and realise its functions via many means including laboratory recognition. Anything that is recognisable via feasible means, we can easily learn about it and we can recognise the normal and the abnormal about it, hence, we know when it is outstanding.

The hidden powers inside us are immense. We only need to know how to reach them.

My problem is with functions those I know they do happen, but I can not measure their values. I am talking here about the hidden powers in each one of us… those are, the non-recognisable ones.

Here, I am talking about the will-power, motivation, realisation, concentration, practicality, and pondering.

We only use around 17% of our innate powers at best. What will happen if we manage to use an extra 1%?!.

Humans are the most highly evolved of all living beings, and thus have the unique intellectual capacity to resolve the problems and overcome the difficulties that confront them within their environment and their destiny. 

I believe that in every one of us there are hidden powers. I also believe that every one of us can reach those hidden powers and can use them. The legible question in this context is “how”…. how can any one of us digs deep inside his/her  hidden powers and put them in their disposal?.

I am here talking about Endorphins, Enkephalins, Dynorphins, and Orexin. These are four famous endogenous neurotransmitters those help us to feel better, happier, and more relaxed. 

Endorphins:  Are endogenous morphines those produced in the nervous system to inhibit the transmission of pain signals; they may also produce a feeling of euphoria(happiness) very similar to that produced by other opioids.

Enkephalins: Are endogenous peptides those bind to the body’s opioid receptors, and they are involved in regulating nociception(somatic pain) in the body.

Dynorphins: Are endogenous opioid peptides those involved very strongly in modulation of pain response in different parts of the brain and spinal cord.

Orexin(hypocretins): The orexines are recently described hypothalamic neuropeptides thought to have an important role in the regulation of sleep and arousal states. They are produced by the hypothalamus, and have specific receptors mainly in the amygdala and locus coreoleus. It has receptors in few other locations in the limbic system and to a lesser extent in the basal ganglia. The orexines are thought to be excitatory  in relation to noradrenergic innervation, including vigilance, attention, learning, and memory. Their actions on serotonin, histamine, acetylcholine and dopamine neurotransmission is also thought to be excitatory and a facilitatory role on gamma-aminobutyric acid (GABA) and glutamate-mediated neurotransmission is suggested.

Therefor, we can notice from above that, these endogenous morphine like products are naturally produced by our brains to control pain, improve our well-being, and make us feel happier and more relaxed. They could make us vigilant with better attention and more ability for learning and improve memory.

What is important for me to say that, these internally produced (self-produced) morphine like products are our own morphines, but without the fear of addiction or dependence. These self-produced chemicals are very important for our pain tolerance, happiness, and relaxation. These chemicals are better produced when we are at our best of mind and relaxation. They are produced in larger amounts when we are celebrating, camping, performing pleasurable exercises, partying, and when we are on a holiday and enjoying ourselves. We can also produce more internal opioids when we are meditating, playing yoga, listening to or playing music, or practicing other relaxation programs. 

We can learn how to produce more of these chemical substances to beat pain, migraine, stress, anxiety, depression, fibromyalgia, IBS, and beat bad habits such as smoking. We can also improve our concentration and memory functions via producing larger amounts of these internal opioids, but we need to learn how we can do it. We need to learn how to control our tempers, how to sit down and think, how to be able to talk to ourselves, how to reflect, and how to ponder about every thing around us as we are part of our environment.