Monthly Archives: November 2014

Myth:Testosterone causes cancer

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male-testosterone-myth - CopyThe belief that testosterone causes cancer of the prostate is a myth from the old school. I was also taught this myth 45 years ago in medical school. If it were true then men at twenty when testosterone is highest would have prostate cancer. It is now known that it is estrogen [especially in excess]that contributes to the cause of prostate cancer in men and not testosterone.

All fetuses at first are female and have a uterus until the genes kick in to change an individual to a male. At this point the prostate becomes the organ instead of a uterus. However what would have been the uterus now exists inside the prostate as a vestige of the uterus called a utricle that has estrogen receptors. (This is the same hormone that contributes to women to have breast and uterine cancer ). This is why we need to get estrogen levels prior to initiating testosterone therapy and then again months latter to see if the client is converting the testosterone to estrogen, so that we can stop this aromatization.
While there is a continuing difference of opinion among doctors as to whether testosterone will speed the growth of an already existing cancer of the prostate, since it is a growth hormone, it does not cause the original cancer (www.medaus.com, “Testosterone and prostate cancer: an historical perspective on a modern myth”, April 13, 2007).
I always recommend certain tests before beginning a person on testosterone and then repeating them in the near future. The latter depends on the client and circumstances. These are:
1.CBC
2.PSA (if male)
3.Liver function tests (the liver detoxifys any excess estrogens which can occur with a poorly functioning liver.)
4.Estradiol (for men and women)
5.Testosterone – both free (to see what will get into the cells) and total
6.SHBG-(sex hormone binding globulin)-which can tie up the testosterone if too high. I often get this when I repeat these tests in about 4-6 weeks.
I believe a short history of how the myth of Testosterone replacement therapy (TRT) and prostate cancer (pCA) evolved. It started in 1941 with a poorly unscientific study by C. Huggins and CV Hodges (Cancer Res. 1941; 1:293-297) with a a study on two men. One being castrated and the other on estrogen therapy. They stated that the administration of testosterone (of coarse it was synthetic testosterone) caused the pCA to grow. Actually what they showed was that acid phosphatase increased in these two men when a daily injection of testosterone proprionate was given. There was no following of PSA or free PSA in 1941. (Acid phosphate being a product of the prostate that goes up with pCA). Therefore, their conclusion was based on acid phosphatase and not other evidence. For another the men already had very aggressive and metastatic pCa. For another these studies have never been able top be duplicated. Unfortunately from this non-evidence based study and (no control done with it) the medical community has traveled down a path that is in definitely contra to the scientific method.

This pCA as stated already is rare in in men in their younger years when testosterone is at peak levels. The rebuttal or thought about this may be that it takes many many years for the cancer to manifest itself. This latter statement maybe true but because of the restraint of doing research on this by the National Cancer Institute and the US National Institutes of Health we do not know the answer to this. But if it does take 30-40 years tor testosterone to cause pCA then obviously there should be no problem in offering it to men in their 60s and older if they are manifesting the symptoms and signs of testosterone deficiency which could be quite depressing both mentally and physically (see other blogs on testosterone therapy). Also, I wish the reader to keep in mind when I write about hormone replacement therapy I only use human bio-identical hormones and not synthetics such as testosterone proprionate, ciprioantaen or ethonate which are commonly used in studies.

The studies so far have been scant and synthetic T is the T of choice. Also the studies are most often done with men that already have invasive pCA or even metastatic pCA. There have been, however, some studies showing that pCA is not related to the use of T hormone therapy. For example, Prout and Brewer (Cancer. 1967;20:1871-1878) showed that T injections on men with pCA “Most of these individuals experienced an increase in sense of well being and some noticed vague diminution in pain.” The same two also stated that the acid phospahtase response to T injections was “extremely variable.”

So to summarize why T is scary to the medical profession and the myth is the following

1. No reliable marker was used that started this myth such as PSA
2.Control groups were not incorporated too often in the different studies.
3.In the past 25 years there have been no studies that replicate the findings that have brought the original myth into the medical field showing that T causes pCA.
4.Synthetic T is the testosterone that is used in studies which of itself could cause pathologies. Human Identical Testosterone (HIT) made by a an experienced compounding pharmacist is what our bodies have evolved to recognize and use.
5.More studies using bio-identical testosterone on men with pCA both new pCA and advanced and also in men without pCA (the latter in long term studies to see its effects compared to long term non users of testosterone) need to be done.

A Word about Cholesterol

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Cholesterol and statinsFor some time there has been a big medical drive to bring down everybody’s cholesterol. This lowering of the total cholesterol is driven by antiquated academics and the pharmaceutical companies’ sales propaganda to both the public and physicians. Very often, a doctor looks at the total cholesterol, and if it is above 200 considers it too high and prescribes a cholesterol-lowering drug. This family of drugs are called statin drugs, and include Lipitor, Mevacor, Zocor, and Crestor, to name just a few.

However, when we look only at the total cholesterol number, we fail to take into consideration the fact that there are different kinds of cholesterol, some beneficial and necessary, and some harmful. The facts are these: “good” cholesterol is necessary for the production of a lot of our body’s necessary hormones. It is the basic biochemical configuration from which are made cortisol, aldosterone, testosterone, progesterone, estrogen, and Vitamin D.

 All the emphasis and fear around high cholesterol has eclipsed the dangers of low cholesterol. A person with total cholesterol of less than 180 has a 2.7 times greater chance of being depressed. Suicide rates may also relate to this number as far as having an inverse ratio to low cholesterol (Zubrod 2006, Lee, 2004, and Cousins, 1979). It was not infrequent for a person to come to me with a feeling of malaise, low libido, depression, and fatigue because their cholesterol was so low from being on statin drugs that they could not produce sex hormones, vitamin D (now suspected as necessary as a barrier to depression), cortisol and aldosterone.

 And there are other risks associated with lowering cholesterol. About 60% of the brain is fat, a lot of it from cholesterol, (so actually if someone calls you a fathead it’s a compliment). Fat (cholesterol) also helps form the mylin sheath around the nerves, sort of like the insulation around an electric wire, which protects the nerves and helps with the incredibly fast nerve impulses. Recently there has been scientific evidence indicating that cholesterol plays a role in the synapse between nerves, (the space that lets the nerve impulse jump from one nerve to the next.)

“Good” cholesterol is the high density lipoprotein cholesterol (HDL). This is the cholesterol that is needed for our cell membranes and for other body chemicals. HDL takes cholesterol from the cells and organs back to the liver, which disposes of the excess cholesterol by making it into bile and passing it out of the body via the intestines. The liver also stores what may be used later by the body. When HDL cholesterol is not available, or low, the body uses other types of fats to make the cell membranes and this contributes to hardening of the arterial walls.

“Bad” cholesterol is the low density lipoprotein cholesterol (LDL). It is this cholesterol that is responsible for depositing cholesterol on the walls of the arteries, where over time it builds up and creates blockages, kind of like tartar buildup on your teeth.

 So if we consider only the number that indicates total cholesterol, it can be misleading. If HDLs are high, it makes up a big portion of the total cholesterol, but that is not a bad thing.

 The Cardiac Heart Ratio (CHR) is another index of the heart’s health that can also be a predictor of the heart’s future health. It is found by taking the total cholesterol and dividing it by the HDL. It is not a definitive marker but one factor to be considered in a complete evaluation of the cardiac status.

 Triglycerides are the most abundant fats in the human body, and are found in such foods as seeds, yolks and animal fats. There are very few of them in vegetables. They are used as body insulation since they are found just under the skin, dampening shock waves when we bump into things, and even the fat pad under the heel. But mainly they are the emergency source of energy.

The danger of triglycerides is when they are consumed in excess, by eating too much sugar (which in excess is converted to a large degree into triglycerides), and too much saturated fat. In this case the triglyceride is oxidized, and can damage the interior walls of the arteries and cause red blood cells to clump together.

All the focus on lowering total cholesterol levels has led to high dependence on cholesterol-lowering drugs, known as statins. So let us take a closer look at these. Some physicians believe these to be a magical group of drugs. However, there is now enough evidence that besides sometimes bringing cholesterol levels down to such low levels that the cholesterol base is not available to make other needed substances.

 We already know about the dangerous effects statins can have on the liver; liver function tests need to be done biannually for those taking statin drugs. Statin drugs carry warnings about rhabdomyalysis, which is muscle break-down that gives muscle pain (myalgia). When this occurs, the patient should immediately be taken off the drug, but all too often they are just changed to another statin, or the diagnosis of the causal agent (the statin drug) is missed and the patient is put on a non steroidal anti-inflammatory drug for the pain. These NSAIDs have so many side effects that the FDA had to pull some of them off the market.

 The problem here is that if the rhabdomyalysis persists it may never be cured, even if the drug is stopped. There is a simple blood test that shows if this is happening. Creatine kinase in the blood is elevated. If it is, there is muscle breakdown and the taking of the statin should be stopped.

 In Canada there is also a warning on the statin insert that the Statins will deplete CoQ10. This is because the same pathway the statin is using for lowering cholesterol also stops the production of CoQ10. CoQ10 is produced by the liver, and is used for making energy for muscles, especially needed by the heart muscle. CoQ10 is needed to make ATP (adenosinetriphosphate), used by all cells to make energy. Without ATP we lose or depress functions because we don’t have enough fuel to run the engine. Supplemental CoQ10 is necessary if statin drugs are taken. In the USA pharmaceutical companies, and some physicians, do not find a need to alert the clients taking Statins of this and the necessity of taking CoQ10 if on a Statin. The patient should also be alerted that Statins have been implicated by the FDA as potentially leading to Diabetes Mellitus.

 The statin drugs have been implicated in forgetfulness, and as being one of the co-factors for either causing dementia or being an adjunct to dementia. In fact, cognitive problems are an outstanding complaint with the statin drugs. This is very likely due to the fact that the brain also needs ATP to function. It is usually a temporary condition called transient global amnesia; the patient sometimes cannot even remember their spouse. (This came into view when former astronaut Duane Graveline MD was put on Lipitor and developed TGA. He wrote a book about the statins called Lipitor, Thief of Memory.) As mentioned, this is usually a temporary condition that disappears when the drug is stopped.

 The brain depends on cholesterol, other fatty acids and ATP, to be strong and function properly. When someone gets a “foggy brain” they are still alert enough to know that they are not functioning at their usual level. This leads to stress that only compounds the problem. The Framingham study disclosed that older persons with cholesterol under 200 perform worse on mental function tests than those with higher cholesterol (about 250mg/dl). Numerous articles are available both for and against this theory, but like any of our evidence-based drug studies it is necessary to be careful about who did the study and who paid for it. All too often the drug company producing the pharmaceutical supported the positive studies in one way or another, and may have suppressed any negative studies.

Women taking Lipitor (at one time the best-selling drug in the USA) had 10% more heart attacks then the control group taking a placebo (Whitaker, 2007). For people over 70 years of age there is no research that there is life prolongation by taking statin drugs. The same holds true for young men with high cholesterol without heart disease: Statins do not influence their longevity in any studies (Whitaker, 2007).

 Statin drugs may have their place, but there are many natural ways to take down cholesterol, with botanicals, diet and exercise, and I strongly believe they should be tried first. Statin drugs should have a place only in specific circumstances and after a change of lifestyle is programmed and followed. If statins are used the patient should be followed closely for any signs or symptoms of side effects. The drug should also be stopped when the total cholesterol falls below 160-170, because a sufficient amount of cholesterol is essential for our well-being.

I have found that relying on medications often gives the patient the impression that they can continue to follow an unhealthy lifestyle as long as they are on medication. The drug is a crutch that should be gotten rid of as soon as possible by healthy living habits. Before abrupty stopping a medicine and having studied the medicine for your own knowledge You should discuss your concerns with your physician.

Hints for the Flu Season

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FluEvery year as flu season approaches both the media and the pharmaceutical companies (and recently the government) tend to create a lot of fear. While I do not deny the potential seriousness of the viruses that cause flu (history has shown us how devastating they can be) it is also important to remember that there is action we can take to protect ourselves and our families.

Whether or not to get the flu vaccine is an individual decision. There are arguments both pro and con. Pro of course is the possibility of avoiding the virus. On the con side:

  • There are a great number of flu viruses: the vaccine targets what are expected to be the few most likely, but very often the powers-that-be miss the major causal virus.

  • The possibility of side effects, which occasionally are serious. For example: Guillain Barré Syndrome which causes paralysis. In 1976 the year of the Swine Flu it was reported that more people died of the vaccine then the Swine Flu that never developed. There were claims of 1.3 billion dollars for paralysis and 25 deaths. (Now there is a law that protects the pharmaceutical companies that make the vaccine so that they cannot be sued by the public.)

Maintaining good health through exercise, healthy food and stress management keeps the immune system strong and offers the best protection against viruses and bacteria of all types. There are several other precautionary measures that can increase your protection, or—if one of those viruses has your name on it—shorten the duration and lessen the severity of symptoms.

1. Prevention

The most common way that germs are spread is through human contact. It is important to wash the hands often, especially after going to the toilet. Wash with soap and for as long as it takes to recite a short nursery rhyme like Humpty Dumpty.

Faucets and door knobs have been touched by many others (some of whom did not wash when leaving the bathroom). It is not neurotic, especially in public places, to use a paper cloth or carry hand wipes.

Kitchen sponges (and tooth brushes) are a major source for propagating germs. Every few days or more often microwave your kitchen sponge for about 15-20 seconds. (Be careful when removing them: they stay hot for quite some time.) You can do the same to your toothbrushes.

Grandma’s advice to “keep a window open for fresh air” is especially pertinent at this time of year. In a closed environment we are constantly breathing in each other’s air and lots of folks out there are breathing in hostile microbes. Closed-in areas I believe are a major problem for spreading microbes, more so than going out in the cold or even getting wet. The human animal with a good immune system should be able to get wet and not “catch a cold.”

2. Nutrition

Nourish your body with a diet of colors. This means fruits and vegetables of all types. The more color the more different antioxidants, minerals and vitamins you are taking into your body. Fruits are full of vitamins and minerals that our bodies depend on, but wash all fruits and vegetables thoroughly before eating them raw. A lot of us were conditioned to believe that fruit juice was chock full of Vitamin C and therefore a good idea when colds or flu threaten. However, fruit juice has three times the amount of sugar as a piece of fruit and the juice sugar can theoretically help germs to propagate. If you want to give your child fruit juice, dilute it with 50% filtered water.

If you have a sore throat try drinking tea (preferably herbal), with honey and lemon. The honey coats and soothes the throat while the lemon keeps down the flow of the irritating mucous.

Drink a lot of filtered water. If you have nausea and /or vomiting just sip it through a straw a little at a time throughout the day so you do not activate your stomach with contractions. Food is not important at this time but fluids are.

New York Medical School has shown that chicken soup actually raises the white blood cell count (the cells that eat up microbes). So the old jokes are right on! Chicken soup offers nutrition and fluid and helps the immune system.

Omega 3s: This is a healthy, protective fat that our cells depend on. (Actually, it is a good idea to make sure these are part of your diet all year round.) Foods that contain Omega 3s are cold water fish, almonds and walnuts, and flax. If you prefer to take your Omega 3s as a fish oil extracts make sure it’s a reputable brand because you do not want any mercury and lead in it; and keep it refrigerated to avoid a fishy flavor.

3. Symptomatic relief

But as we know, you can do everything right and still contract a virus. Antibiotics are not effective against viruses. The American Medical Association is trying to teach this fact to both physicians and the public. If your doctor does prescribe antibiotics be sure to take pro-biotics such as acidophilous at the same time and for at least thirty days after completing the antibiotics to prevent yeast problems. Antibiotics do not discriminate: they kill all microbes, including the healthy ones that help to digest food. Losing the good bacteria can cause intestinal problems (called dysbiosis and leaky gut syndrome). This holds true for men, women, and children.

If you have even an inkling of an idea that you are coming down with flu symptoms start taking:

  • Vitamin C 1000 mg every 1-2 hours (I keep a supply in my pocket so I do not forget). If you should develop diarrhea you can cut back and build up to the higher dose.

  • Sambucal: This is black elderberry from Israel – I have tried the newer American brands without success and their taste is not nearly as good. Be sure to follow directions since it tastes so good you may want to take more than is necessary.

  • Oscillococcinum: This homeopathic remedy really works when symptoms first appear. Kids of all ages love it because it tastes and looks like sugar.

I find it a good idea to keep all three of these available, or at least Vitamin C since it is best to take this vitamin every day anyway. Both Sambucal and Oscillococcinum are safe for children over two years of age. But note that both Sambucal and Oscillococcinum work only if one takes one/or both within the first 36 hours of symptoms or signs of the flu.

  • For nausea and/or vomiting ginger is as effective as Dramamine, and you can supplement your fluid intake by sipping on lemon-ginger tea. You can buy the tea in health food stores or make your own. Boil the (well-washed) rind of one lemon with about an inch of ginger root cut in slices for fifteen minutes. Sweeten with honey, real maple syrup or Sucanate (a pure unadulterated sugar with all its vitamins and minerals).

  • If your head and nose are really stuffed up to the point of not functioning then it is alright to use an Afrin-like nasal spray. However, do not use more often than every 12 hours and only for three days. There is an addictive rebound effect if it is used too frequently. After three days if you still need to use it you can alternate nostrils for another two days so that you can sleep and breathe comfortably. (Some would reproach me for this last use of Nasal spray but one has to sleep to get better; using it like this will not have an addictive affect.) There are other methods such as neti pots but when one is sick and miserable this is may be uncomfortable unless one is in the habit of using the neti pot previously.

  • Aloe is very effective and fast acting for itchy rashes due to the flu. Cut a small piece off the plant, slice it lengthwise, cut off the stickers on the side and rub the gooey middle on the rash. It can be wrapped in saran wrap and kept refrigerated. (This also works on fire ant bites, poison ivy, and chickenpox). The itchy irritation is usually abolished within 3-5 minutes.

There are also alternative treatments for flu symptoms that some holistic physicians can administer:

  • Mega C IV (intravenous): this consists of a huge dose of vitamin C, the B vitamins, zinc, selenium, chromium, manganese and magnesium. The advantage of taking these nutrients IV is the security of knowing they have entered the body. If taken by mouth poor absorption may hinder the effect, the time needed for them to reach the right places is a lot longer, and the doses have to be much higher.

  • Hydrogen peroxide IV: creates an oxygen-rich blood environment in which pathogens do not thrive, and can shorten the flu’s duration to 24-48 hours instead of 6-8 days of suffering. The lethargy and the cough can linger for a few more days to weeks as the body recovers and even after it is fully recovered. Annoying but not pathological.

  • Colloidal silver IV: colloidal silver kills viruses, bacteria, fungi and protozoans and has been used for hundreds of years. Now there is available a colloidal silver with none of the side effects of the past (argyria) since it is so pure.

I have used all of these methods hundreds of times on clients and my family and myself always with good effects and no side affects. These measure will not always prevent the flu, but they will help to shorten its duration, severity and uncomfortable aches and headaches.. (To find a holistic physician near you, consult www.acam.com or http://www.holisiticboard.org).

What about the caretaker?

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Take care of the caregiverIt’s time to take care of the Caretaker!

As a physician for about forty years I have encountered so much stress in people taking care of their loved ones. The sad part of this is that so often they do not get any positive recognition, or worse just criticisms. It seems everybody knows how and what the caretaker should be doing, but so often that is the extent of their participation in caring for the person in need. I do not think it wrong for the caretaker to be assertive when outsiders (even friends) criticize the caretaker for what and how they are doing this task. It is alright for the caretakers to state they are the ones that are doing this job and “I will consider what you say, but remember that you are not me and not in my shoes or circumstances.” This may even be the time to hint strongly that positive active help would be appreciated.

This is a typical case! Sylvia is an 88-year-old woman that is having her fourth bout of cancer. Her husband has progressive Alzheimer’s Disease (AD). Sylvia was never a patient person and may even be described as a hyper -obsessive personality. She was also a very demanding and angry person with her husband who she believed did not make enough money although they lived quite comfortably. But she was a caring mother and wife and always worked to help support the family. She was also very active in many social activities about everyday of her life before having to be watchful every minute due to her husband’s dementia that could potentially cause a dangerous situation if left alone. When her husband Martin was diagnosed with AD he was at first quiet, but as the AD progressed it was not a case of just not understanding, he also became quite abusive to Sylvia and often got mixed up who his wife was with other women and was abusive to them. Martin in his salesman’s life was a very gentle person with a good sense of humor, even to the point of injecting his humor when the conversation was serious and therefore he could be annoying even in his cognitive days. He became not only abusive verbally but also started to get physically abusive. Fortunately he was feebly weak; but to an 88-year-old woman this was scary.

When friends and relatives came to visit they were always concerned about how Martin was doing and of course had many suggestions of what Sylvia should and could do for him. Most stopped coming after awhile since Martin could not communicate and Sylvia was always too tired to really entertain. Visitors showed little concern about her cancers, her treatment status, taking care of Martin and her emotional and mental status of caring for him. In a short time Sylvia was depressed and tired and often in tears. She decided it was time to put Martin in a nursing care center, which she did. She visited him many times a week, which was not easy for her at 88 years old especially one with cancer.

This case is so typical and the story can go on and on. But we are interested in the psychology of the caretaker and options they can take to alleviate a sad situation. We have an elderly person (but the person could be much younger) taking care of a person that they have been with for many years. She still loves the person but also a lot of this love has turned to obligation and guilt. She also has anger.

The anger may or may not be on a conscience level or admitted to oneself. So the following are hypothetical but could be real with some caaretakers. She could be angry because her life has been completely changed from being an active person with lots of friends and acquaintances to one of being a stay-at-home caretaker. Angry because she herself has health problems that she has to put in the background to be a caretaker. Angry because most of her recognition by others for being a caretaker is negative contributions of what she should be doing and/or could be doing foor her spouse. In line with the latter is also that she is not getting recognition for having cancer since all the sympathy is going towards her husband. Angry because she has guilt about not wanting to be in this situation with someone that she may not even love anymore except in her past memories. Anxious maybe because we all know that we may be the one that needs to be taken care of someday and who will be there? If it is a loved one will they feel angry about being put in this situation? There is the visual knowledge when caring for someone that they may be in the same situation having to give up their independence such as a car for example. This may not be an overt thought but just underlining the conscience mind that we are getting older and our society has no great provisions for these “golden years”.

Another negative emotional feeling that may creep into a caretaker’s mind is guilt for the way they believe they treated this disabled person in the past. They can of course talk to this person and discuss calmly why they did not always understand the other person’s side and instead became aggravated by this person that they really did love. This is even more apparent and difficult when the loved one dies and then it is very difficult to communicate regret of how they acted toward this person. But the caretaker can still forgive himself or herself. This can be done in a verbal way with different techniques using visualization. There are counselors and psychologists trained in the latter. It works!

This case study only illustrates one common situation whether it is a man or a woman that is the caretaker caring for a long time companion. As stated some of this case can be applied to young people that fall into a caretaker situation with a spouse or girl/boy friend. Or a young person that is involved in a similar situation with a parent and that their life now revolves around care-taking that person. They may love that person but it is a change of life that may interfere even with other evolving opportunities in their life. There may be an ambivalence of love and anger of the situation. This guilt diminishing the love because care taking can be a full time job. This is especially true if money is inadequate to get help and the government only helps sparsely, and this after very time consuming paperwork and interviews.

So often the caretaker starts off feeling love and responsibility for the person but after a time they may not see this person as the same one that once bonded them together. In fact, the caretaker may view the person as a complete stranger occupying the body of the loved one. Because of this they may feel stuck in a situation of a time consuming and often an unclean job of taking care of the person.

For both the caretakers young or old, there is often the unromantic role of the caring of someone that was once strong and often the caretaker of the caretaker. So often the new role of caretaker is worsened because they were always the one cared for by this new person and they themselves do not know how to manage all the everyday business things that are required by our society.

One trap that the caretaker may fall into or create themselves is that of being an enabler. This is a person that does or overdoes so much for the person that the person becomes less and less capable of doing things for themselves or even gives up trying to do anything for him/herself. The incapacitated person still may be able to do a lot of things themselves and probably wants to do so. An example of an enabler is the following: take a person that is an alcoholic and ends up in jail a lot. If the same person rescues them from jail all the time they are allowing the alcoholic to remain status qua since the alcoholic knows he will be rescued. The person doing the rescuing is not really helping the alcoholic make decisions to change but rather enabling the person not to have to make this decision. This simple example can be transferred to an incapacitated person when the caretaker does not allow or more so encourage the person to do things for themselves.

When compassion becomes pity and nurturing becomes rescuing there is a problem. Compassion and nurturing are empowering to the caretaker and the patient. Pity and rescuing are not only a burden to the rescuer but also devalue the targets of those sentiments. Because the underlying message is that the disabled are incapable of growing or learning to take care of themselves.

Enabling people may have different paths that lead them to be enablers. They may have been taught to be so since childhood watching one of the parents enact this. It could be that it makes them feel righteous or powerful. With the later I find that this type of person is often an enabler to many people not just for the one that they are in charge of caring; but it may just be the one person. They may even have ambivalent feelings for the person and get enjoyment at having them at their mercy. Then there is the martyr personality type person that wants all to see including the invalid how they are sacrificing their life away by care taking.

There are probably other reasons for people becoming enablers. Of course, there are the caretakers that have really earnest, loving motives. But in their method of showing love, if they are not cognitive of overdoing things for the person, they may not be realizing that they could be furthering a crippling situation or facilitating an eventual progression. For example, there is the parent that keeps feeding their child to show love and the child is getting fatter and fatter causing social problems and eventually maybe even diabetes. So often this is done with good and loving intentions. This latter example of the type of loving person can be forwarded to the caretaker that believes they have to do everything right away for the invalid and more because this is what love is to them – no guilt or anger-just love.

So what are some of the things a caretaker can do to protect and take care of him/herself? If the caretaker does not take care of his/her health physically and mentally they may not survive the ordeal of helping another. They may even be shortening the time that they will be the patient.

1-I believe first the caretaker should analyze the situation as to how much money and how much time caring for another will be.

2-Consider what available helpthere is for giving the caretaker time off for themselves. This couold be close friends, relatives, and I have had good luck when I worked as an ER physician with Social Services. Also, as an holistic physician I have called Social Services and almost always received help or optioans for my client.

3-Either at the same time or just after this assessment they should try and reason out why they are undertaking this task. What are their real feelings about becoming a caretaker? This is so that they can come to terms with the situation and themselves.

For this latter they may need outside help that helps them discover the whys. They can do this with a person that is non-judgmental and gives unconditional love. It is difficult to find a friend that can do this being the latter two qualities are rare in a friend who can step outside the situation knowing the two people involved. A trained social worker or counselor I think would be the best source for this task.

Another option, is to venture into hypnosis or integrated guided imagery; I know from many experience of my own and clients that this helps. Again with a trained person that gives unconditional love and is non-judgmental.

Namaste, and maybe being a caretaker is the road for some of us to realize and come to terms with evolving; it did for me.