Lead and its health effects

The aim of writing this article is to create awareness about the ill effects of lead on our body as we all knowingly or unknowingly consume lead at least in small quantity most of the time.

Lead is a naturally occurring metal found in small amount in earth’s crust. Lead and lead compounds have been used in a wide variety of products which including paint, ceramics, pipes, gasoline, batteries and cosmetics, glass TV tubes, solder, pigments, covering for power. The single largest use of lead, over 70% of total consumption is for lead storage batteries. Lead is exposed to the body via inhalation or ingestion of lead. Old lead-based paint is the most significant source of lead exposure. 

Another important sources of lead are drinking water and air. High exposure to airborne lead is common, originates primarily from burning of lead-contaminated used oil, from smelting of ores and other industrial processes, and from incineration of municipal refuse. Drinking water has been found as a source of exposure. EPA estimates lead pipes, brass faucets in bathroom or kitchen sinks leads to the leakage of lead in drinking water. 

Health Effects of Lead Toxicity:
Lead is a potent toxin that can damage the health in number of ways. The diagnosis of lead poisoning is based on the blood level of lead. Blood lead level above  10 ug/dL is considered as toxic. Children are more sensitive to lead than adults because of several reason. The most important reason is the absorption of lead through intestine is faster in children than adults. Also the immature nervous system of children are more vulnerable than the mature nervous system of adults. 

There are two signs  of lead poisoning that indicate the presence of lead in the blood tissues:
1) Continuous blue line on the gums
2) Presence of lead in the urine.

Moderate or high amount of lead in the blood can affect the several organs of our body. 
1) Chronic lead exposure can lead to kidney failure, it can increase the uric acid in the blood, with further damage to the kidneys.

2) Lead exposure mainly affect the nervous system causing low IQ and hyperactivity in children. High lead  exposure can lead to brain encephalopathy.

3) Lead exposure during pregnancy can lead to abortions, still births, birth defects, and even death of neonatal.

Prevention of Lead Consumption   
1) Drinking water is the main source of lead as pipes and taps are made from lead. Lead enters the water through corrosion of pipes or corrosion of natural deposits. The amount of lead in water depends on how long the water stays in the pipes, waters acidity and temperature (hot water dissolves more lead than cold water).
Following are some ways to reduce the lead in your drinking water.

          - If you haven't use that tap for more than 6 hours, let the water run from the tap for 30                           seconds 
          - Use only the cold water tap for drinking, cooking, for preparing juice, etc. Do not use hot                      water tap for drinking.
          - Do not boil the water. Although boiling reduces the number of bacteria in the water, it may                 increase the concentration of lead and other metals in the water. Filtered water may reduce the             risk of lead consumption to some extend. However still it may not prevent it. 
          - Get the water tested for lead
          - Change the old pipes in case they are eroded. 

2) Lead based paint on walls are other common source of lead. Children tent to consume the wall paint which leads to lead consumption.  Avoid using lead base paint instead use lead free paints. Get your house tested for lead. 
                 

Homeopathic approach for head injury

Head injury is very commonly seen in children. Head injury is also called as brain injury or traumatic brain injury. Trauma due to fall, or any mechanical force that causes injuries to the brain is referred as ‘brain injury’ or ‘traumatic brain injury’. Head injury can be a small bump over the head due to fall or it can be severe brain injury affecting the life of a person.

Traumatic brain injury is very different than soft tissue injuries, or injuries to other body parts. In brain injuries, one moment a person is fine while another moment life has abruptly changed. Injury to brain do not heal like other injuries and it has serious consequences than injuries to other body part. Some of the consequences are mental dysfunction, seizures, or even death. Hence it is important to treat it immediately and cautiously with continues monitoring of the vitals.

          Types and Causes of head injury

Traumatic brain injury are mainly cause either due to violent blow or blunt force over the head causing contusion, or sharp object penetrating the skull such as bullet causing deep damage to the brain. Head injury can lead to concussion to the brain where a person may feel little dizzy with a loss of vision and balance for a while.

A mild trauma to brain can cause mild or temporary dysfunction of the brain cells, while the severe brain trauma can result in bleeding due to torn tissues, bruising, and leading to long term complications or death.

Types of head injuries, sign and symptoms

Mild injury to brain usually produces following symptoms:

    1)      Brain injury is considered as mild if loss of consciousness and /or confusion and disorientation
            is shorter than 30 minutes.

    2)      Physical symptoms like nausea, vomiting, fatigue, and drowsiness.

    3)      Cognitive problems like headache, lack of memory, difficulty thinking, attention deficit and
            mood swings.

    4)      Sensory problems like blurring of vision, ringing in the ears, change in the taste and lack of
            ability to smell. Sensitive to light and sound.

    5)      Most of the time MRI/ Cat scans are normal.

    6)      Often it is an overlooked injury.

Severe injury to brain produces following symptoms:
    1)      Severe brain injury is associated with loss of consciousness for more than 30 minutes

    2)      Memory loss for more than 24 hours

    3)      Persistent headache and vomiting

    4)      Loss of coordination, numbness or weakness of fingers or toes.

    5)      Convulsions , inability to awaken from sleep

    6)      Dilatation of pupils of eyes

    7)      Clear fluids draining from eyes and ears.

    8)      Cognitive problems like slurred speech, aggressive or unusual behavior, profound confusion    
           and comatose condition.

                   Treatment

Any brain injury, either mild or severe, requires immediate medical attention and treatment. Homeopathy works well mainly in case of mild injury to the brain. It does not mean homeopathy does not yield good result for severe brain injuries. In case of severe brain injuries it is important to first provide an emergency treatment to the patient, once the patient recovers homeopathic management would be useful to recover the patient from the trauma. Some of the research studies shows the effectiveness of homeopathic treatment for mild traumatic brain injury.

Selection of homeopathic remedies are based upon the individualization and totality of symptoms (symptoms similarity). This approach will not only help to manage the head injury symptoms but will also achieve the complete state of health. A qualified homeopath will address the underlying cause if head injury and regain the disturbed vital force and susceptibility through the correct remedy.

                     Common homeopathic remedies for head injury

Following are some of the common homeopathic remedies useful in head injuries: 

·         Arnica

Arnica is the most common remedy and should be the first remedy to think of in head injuries. Arnica is well known to rapidly heal mechanical and blunt injuries. Arnica is useful when there is sore and bruised feeling at physical and/or mental level. Here we will consider the feeling at physical level only. Arnica is not only useful for superficial bruises but also useful in severe brain injuries too.

Arnica can be prescribed when a child falls from bed over the head or hits the wall with a bump over the head. It will heal the bruises and relieve the pain immediately. Along with Arnica, externally, compress the affected part with ice pack so that it does not swell further.

Arnica works well in concussion of brain, even in compression of brain due to skull fracture or effusion of blood in the cranial cavity or in case of hematoma, however these severe brain injuries demand surgery in order to obtain immediate relief and permanent relief. Personally I have not seen complete cure from Arnica in serious brain injuries.

Dose: Depending on the acuteness of the case, repeat the dose. If the pain and bruises are severe repeat Arnica 30C or 200C, 4-5 times a day until the symptoms subsides.

Following rubrics will help to understand the remedy. 

Rubrics from Synthesis repertory 8.1:

Generals – Convulsions – brain – commotion of the ; from

Generals – Convulsions – injuries from – head of

Head – injuries  of head, after

Head – Pain – injuries, mechanical

Head – Concussion of brain

·         Cicuta

When the well-known remedy fails to act, the time comes to think out of the box. Cicuta is one of the remedy to think of in head injury.  Cicuta is mainly indicated when the functioning of brain is paralyzed with complete loss of consciousness. Person gets convulsions, or epilepsy from concussion of brain. The convulsions of Cicuta are the most violent and are often accompanied by bizarre distortions. There is a state of unconsciousness or a dull dream like state following convulsion continuing for a long period of time, even a whole day.

After head injury, a person goes into mental retardation and frequent convulsions. During convulsions, frightful contortions will be seen in such patients, like head drawn backward, biting of tongue, strabismus (crossed eyes).

Dose: Cicuta can be given in 30C potency with less frequent repetition.

·         Hypericum

As discussed in the previous chapters, Hypericum is a great remedy for injuries to the nerves and spine.  Hypericum can be thought for fractured skull following head injury resulting in convulsions and loss of memory. Hypericum is usually followed by Arnica. ⁴

Dose: For acute problems, prescribe Hypericum 30C or 200C pills for 3-4 times a day.

·         Natrum sulphuricum

It is a deep acting remedy and widely used as a specific remedy for head injury. This remedy acts well when mental symptoms are taken into consideration along with physical complaints. Natrum Sulphuricum is one of the most important remedy in suicidal patients from, whether from grief, or head injury or other organic causes. Hence suicidality or suicidal thoughts after head injury is an indication of this remedy. Generally Natrum Sulphuricum patients are very responsible people, and have great sensitivity like weeps from hearing music.

Natrum Sulphuricum is primarily useful in after effects of concussions. Hence this remedy is more effective in mild brain injury and to some extent for severe brain injury.  Confusion, mental dullness, depression and convulsions after head injury are one of the important aspect of this remedy.  For old history of head injury Natrum Sulphuricum works to a great extent.

Headache with photophobia after head injury is also indicative of Natrum Sulphuricum.

Natrum Sulphuricum can be administered orally in the form of pills in 30c dose 2-3 times a day.

·         Helleborus

Helleborus is indicated when after injuries and blow to head, especially when there is stupefaction of brain and mind is completely blank. Hahnemann described the state of stupefaction as ‘ where with sight unimpaired, nothing is seen very clearly,; with hearing perfectly sounds nothing is heard distinctly.’   Mental dullness and poor concentration is marked.

It works well in head injury when a person will answer slowly with great effort; his memory becomes so weak that he can hardly remember what was said to him; goes into depression with suicidal tendency.

Dose: Helleborus can be taken in 30 C potency orally 2-3 times a day. Depending on the acuteness of the complaint, it should be prescribed. Personally I have seen only one dose of Helleborus 30C working for significant amount of time. Usually frequent doses are not required.

·         Hyoscyamus Niger

Hyoscyamus patient experiences excitation of nervous system after head injury or concussion to brain. Excitation of nervous system is in the form of delirium, mania with rage, restlessness, cursing and or exhibition of other inappropriate behavior.

Gestures, chore-like; restless fingers; muttering; etc, shows the delirium stage of hyoscyamus. Hyoscyamus is indicated if patient develops convulsions, with excitation of nervous system.

Lascivious mania is common aspect of Hyoscyamus where he/she uncovers the whole body, and sings obscene songs. Mania with ridiculous gestures. Convulsive jerks of single muscles, or sets of muscle with long lasting muscle spasms.

Vision gets affected too. Dimness of vision; object looks red as fire, or too large or appear smaller. Speech is difficult and confused. Paralysis of tongue. All these effects on head, vision and speech are after effects of head injury and concussion to brain.

Dose: Hyoscyamus can be prescribed orally in 30c or 200c potency, three times a day.

·         Cuprum Metallicum

Cuprum Metallicum is another remedy useful in after effects of head injury, however this remedy is occassionally used for head injuries. Cuprum is specific remedy for seizures and epilepsy after concussion of brain.

Cramps and spasms with epilepsy which develops after head injury is the striking indication of Cuprum Metallicum.

Delirium is of violent character where the patient bites; and loquacious delirium. Convulsion with blueness of face and lips, and froth at mouth. The convulsion is followed by deep sleep.

According to Vithoulkas, Cuprum metallicum patients has intense emotions or impulses which are strongly suppressed. In order to maintain control over strong emotions, patient rigidly closes down every expression. Hence this suppression comes out in the form of spasms and convulsions.  Even though it seems head injury is the main cause for convulsions, deeper case taking will help you understand the patient clearly. Hence Cuprum Metallicum may not be the first remedy of indication in head injury.

Dose: Cuprum metallicum can be given in 30c pills for 1-2 times a day.

·         Stramonium

Head injury causes violent jerks in Stramonium patients. Behavior of Stramonium patient is very similar to Hyoscyamus, only difference is the degree of violence and fear of violence. Stramonium is highly violent than Hyoscyamus. The rage is uncontrollable and impulsive and comes in an outburst as convulsion. These patients are equally fearful too.

Stramonium can be wisely used in severe brain injury. It is may not be your first choice of remedy in head injury. However it can be the best remedy to complete the cure.

Dose: Stramonium can be given orally in 30 C potency, 1-2 times a day.

       I       Conclusion

·         Head injury is also referred as brain injury or traumatic brain injury. Trauma due to fall, or any mechanical force cause injuries to the brain.

·         The brain injury is mainly cause either due to violent blow or blunt force over the head or sharp object penetrating the skull. Such violent trauma leads to contusion, concussion to brain or fracture of skull. Brain injuries are commonly seen in athletes like football players.

·         Mild and severe brain injuries requires immediate medical treatment to avoid further consequences.

·         Homeopathic remedies work very effectively in mild head injury. In severe kind of head injury, homeopathic remedies may or may not work effectively. 

Health Literacy and Plain Language - A growing concept

Health literacy is growing concept in the United States. I believe in over the period of time, the concept of health literacy will be taken by other less developed countries. What is the meaning of health literacy? According to the Institute of Medicine report, Health Literacy: A Prescription to End Confusion, Health Literacy is defined in the as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

In a simple language, Health Literacy means the ability to apply reading, listening, analytical and decision making skills to health situation. For instance, health literacy includes the ability to understand the information given in health insurance forms,  instructions on prescription bottles, on consent form, appointment slips, patient brochures, and doctor’s directions. Remember it is not merely ability to read but it is ab ability to understand.

Importance of Health Literacy

Nearly half of all American adults—90 million people—have difficulty understanding and acting upon health information. Nearly nine out of ten adults may lack the skills needed to manage their health and prevent disease. Fourteen percent of adults (30 million people) have Below Basic health literacy

Health care professionals often use technical language specific to their areas of expertise with the expectation that individuals who are not familiar with the professional jargon will understand the meaning of complex terms. Even people with strong literate skills finding difficult to understand and use the health information. For instance, a doctor may have difficulty in helping the family members with health insurance forms.  

Limited Health Literacy affects people’s ability to –

·         Search any health information

·         Understand and use health information

·         Adopt healthy behavior

·         Act on any public health alerts

The problem of limited health literacy is widespread and multiple studies have demonstrated the seriousness of limited health literacy. 

• Adults with low health literacy are at increased risk of hospitalization, encounter more barriers to receiving necessary health care services, and are less likely to understand medical advice that can affect disease progression. 

• Individuals with limited health literacy skills have poorer health status than the people with enough knowledge of health literacy. The reports concluded that limited health literacy is negatively associated with the use of preventive services (e.g., mammograms, flu shots or regular physical checkups), management of chronic conditions (e.g., diabetes, hypertension, and HIV/AIDS), and self-reported health. 

• Researchers also found an association between limited health literacy and an increase in preventable hospital visits and admissions. 

• Additional studies have linked limited health literacy to misunderstanding instructions about prescription medication, medication errors, poor understanding of nutrition labels, and mortality.

• The few published studies have linked limited health literacy and an increase in medical or healthcare cost. For example, costs associated with medical errors may result from health literacy factors. 

• Limited Health Literacy has psychological costs. Adults with limited health literacy report feeling a sense of shame about their skill levels. They may hide their struggles with reading and vocabulary.

Strategies to improve Health Literacy

Successful demonstrations of evidence based strategies can improve the health literacy. Most of the research studies have shown the positive outcomes by simplifying and improving the written materials and use of plain language to communicate the health issues. Clear communication, in plain language, about health information and services will help create and promote health literacy. Studies have shown that picture-based instructions promote better understanding of how to take medication and decrease medication errors among patients.

Plain language is a strategy for making written and oral information easier to understand and an important tool for improving health literacy. Plain language is communication that users can understand the first time they read or hear it. Plain language is not unsophisticated or dumbing down, however it is clear and effective way of communication. Some key elements of plain language are:

·         - Speak plainly so it’s easy to understand;

·         - Write plainly so it’s easy to read;

·         - Organize information so that  the most important behavioral or action points come first;

·         - Break complex information into understandable chunks;

·         - Use simple language or define technical terms;

·         - Avoid using jargon

·         - Use everyday examples to explain technical or medical terms.

    Let me explain you the concept of plain language with the help of examples:

1) 'The Dietary Guidelines for Americans recommends a half hour or more of moderate physical activity on most days, preferably every day. The activity can include brisk walking, exercise, and dancing'.

In plain language  you explain the same concept in easier way -  'Do at least 30 minutes of exercise, like brisk walking, most days of the week'.

2) 'Give two drops three times a day for earache'.

Although this example seems to be easy to understand, it does not make any sense because it does not clearly mention where to use the drops, either you have to take it orally or locally in to the ears. 

Here plain language will help to make this instruction clear. The instruction should be 'Put three drops in the painful ear thrice a day' 

Benefits of Using Plain Language

1)       Plain language helps to communicate the health information in correct manner. Patients and their family are able to understand the information correctly with fewer misunderstandings or error. Hence patients are always satisfied with the information.

2)       It takes lesser time to explain the information to patients and their family. Hence it saves time of healthcare professionals and patients.

References: 

National Network of Libraries of Medicine. Health Literacy. 2013.