Form and Function

I spent the weekend at the Yoga Journal conference in Estes Park steeped in anatomy, not the least of which was an acute awareness of being sore in just about every muscle group from my elbows to my knees. Child's pose? I'll meet you there in about 5 minutes because it will take me that long to get down to the floor. But I did attend one lecture towards the end (a lecture! sitting on a chair! i've never been so happy to see a chair in my whole life) that touched on the relationship between both anatomy and the chakras and the biochemistry (physiology) and the practice of yoga.

First, the chakras. I'm not necessarily a woo-woo chakras kind of girl, but the speaker did make an interesting point about the location of the chakras in relation to the major endocrine organs and their functions. As I search around online, this seems to be "common chakra knowledge" but it was all new to me. The piece about the gland functions connecting to the chakra functions isn't really firmed up in my mind yet so I'm going to skip writing about it, but here's the anatomy piece.

1st chakra - base of the tailbone - no endocrine activity
2nd chakra - pelvic region - gonads
3rd chakra - just inferior to the ribcage - pancreas and adrenals
4th chakra - level of the sternum - thymus gland
5th chakra - at the throat - thyroid gland
6th chakra - between the eyebrows - hypothalamus, pituitary and pineal glands
7th chakra - crown of the head - no endocrine activity

Okay, so that seems interesting. The speaker also mentioned a study showing that yoga increases GABA levels by a significant amount, accounting for one's feeling of well-being after yoga class. I could only get to the abstract and the study itself has some design issues as far as I'm concerned (total of 19 participants, not controlled for other types of exercise), but the results looked promising:
"There was a 27% increase in GABA levels in the yoga practitioner group after the yoga session (0.20 mmol/kg) but no change in the comparison subject group after the reading session ( −0.001 mmol/kg) (t = −2.99, df = 7.87, p = 0.018)."

There was quite a bit of attention paid to CPR in 2005 when the American Heart Association announced that CPR using chest compressions only had been shown to be as beneficial as chest compressions plus rescue breaths. My first CPR recertification since the announcement was earlier this year, and although the press had widely reported that the breaths were being eliminated from CPR training, that turned out to be untrue. (Side note: I took the class at PVH with mostly PVH staff, and there was one NICU nurse in the class who had never once taken CPR or neonatal resuscitation in her 20 year career. How does that happen?)

We learned both the chest compressions and rescue breaths, although at a higher compression:breath ratio than in years past. The instructor explained that they'd found that some potential rescuers did not want to perform mouth to mouth breathing on a stranger and were therefore doing nothing. For those victims who's collapse or accident is witnessed (i.e. it is known immediately rather than discovered after an unknown amount of time) and who can receive professional emergency care within only a few minutes, compression-only resuscitation is as effective as compressions plus breaths. Anyone who has been down an unknown amount of time or will experience a time delay before paramedics arrive must receive breaths to oxygenate the blood. Most resources suggest 4 minutes is the time frame in which the brain can survive on oxygen already in the blood, but the world record for breath holding is 8 minutes plus, so I suppose 4-8 minutes from collapse to EMS care is an approximate range of time in which compression-only CPR can be effective.

I'm obsessed with Etsy at the moment, and I came across a heart scarf that I think is actually quite lovely, though not very anatomically correct.

So, this can be filed in the "creative posts" category, because I don't know anywhere else one could categorize a recipe for placenta smoothie. Yeah, eating one's own placenta. Gross? Yes. But maybe not crazy. The placenta manufactures and presumably stores many hormones, the same ones that go haywire shortly after birth, and who's to say upping those maternal hormone levels through ingestion of the placenta can't have any benefit? Maybe a little oxytocin to encourage uterine involution? How about a little estrogen and progesterone to counteract the emotional effects of the giant postpartum hormonal crash? Physiologically, I can buy it. Gastronomically, it's hard to swallow. Oh yeah, it's my blog and I'll pun if I want to.

There are some studies out there that address the postpartum benefits of placentophagy but mostly I've found lots and lots of anecdotal stories from women who've once suffered postpartum depression (PPD) and rave about how eating their placenta prevented a recurrence after future births. As one blogger described her PPD: "It's like PMS a thousand times over. I don't know how else to tell you how bad it was except to say "It got so bad that I'm eating my placenta in order to get rid of it." Yeah. That bad."

There are many possible placenta preparations, including cooked and dried, but I'm including a recipe for raw placenta smoothie.

1/2 c. raw placenta, cubed, membranes removed
1 c. frozen berries
1/2 frozen banana
1 c. berry juice

Whir until smooth in a blender.

Warning, long post ahead. I have a lot to say on this subject.

Unfortunately my "real world" hormone experience and my conventional medical experience of same have been less that what we might call awesome. Just thinking about it makes me want to drag out the trusty soapbox for a good old-fashioned rant, but I'll try to stick to the physiology as best I understand it (not well) and minimize the ranty side-notes.

Once upon a time and for quite a few years I took hormonal birth control in the form of a monophasic combined estrogen and progesterone pill and had few complaints. Side effects were limited to the occasional hot flash: real deal I-will-either-die-or-cook-my-internal-organs-by-being-this-hot hot flashes. Not too bad compared to what was to follow. At some point I decided to change pills to try and combat my chronic skin issues and was prescribed a triphasic with a much different formulation. Big, big, huge mistake.

Old Rx
progesterone - high
estrogen - low
androgen - moderate

New Rx
progesterone - low
estrogen - moderate
androgen - low

Some of the resulting side-effects are easy to explain. For example, the low androgen level that was supposed to improve my acne totally bottomed out the old sex drive (irony - my skin never did improve). Other side-effects are commonly attributed to BCP's with this particular hormone profile¹ but I can't seem to find any physiological explanation of exactly how these effects come about. In this category we have moodiness and migrane-type headaches (both supposedly due to higher estrogen). I even had some side-effects that were directly opposite what one would expect with this formula¹ - major depression and extreme nausea despite lower progesterone, and weight loss despite higher estrogen.

Also on the list of side-effects I experienced during this time (a whole year this went on):
extreme anxiety
insomnia
memory problems
difficulty focusing on a task
unusual glucose sensitivity, swinging from hyper- to hypo- states
poor immune function/frequent respiratory infections
feeling jittery, "amped up"

I finally went off BCPs altogether and many of these issues improved; some resolved within months, some over the course of several years, some remain at lower levels even today (I've been off for five and half years). After stopping the Pill, however, one new symptom emerged: tremendous, bone-crushing fatigue. I initially suspected thyroid issues and saw more than one doctor for thyroid testing but the results always came back normal and no alternative theories were ever suggested. I finally, finally, after a few years came across what I believe to be an explanation for everything: the adrenals. I came across some information indicating that changing sex hormone levels can impact adrenaline and cortisol levels². And why not? The adrenals produce them all. In 2007 I diagnosed myself as having had adrenaline/cortisol overproduction during the Year of Hell (explaining many of those symptoms), followed by hypoadrenia/adrenal fatigue after I stopped the Pill, explaining the overwhelming fatigue. Since I'd gotten nowhere looking for a solution with conventional doctors, I found a licensed naturopath (not covered by insurance) who would send in my saliva for hormone testing (also not covered), and validated my own theory. Lab results from July 2007:

Cortisol
7am 18 normal (range 13-24)
11am <1 depressed (range 5-10)
4pm <1 depressed (range 3-8)
11pm <1 depressed (range 1-4)

I wont' go into the treatment protocol I've been following (lots of effective but "not approved by 'real' doctors" stuff there) and I'll try not to be too bitter about all the time it took to get it sorted out and how profoundly unhelpful so many medical professionasl were throughout the process, but I think there are some good take-home lessons to be found here:

1. Hormones are inter-related. You can't go banging away at one (or more) without affecting something else. Hormone interactions are often poorly understood and related functional conditions may be denied altogether (just ask Wikipedia).
2. If you don't get an answer from the expected sources, that does not mean no answer exists. Expect to have to do all the work yourself to find it.

Sources
1. Family Practice Notebook Online, oral contraceptive pages: http://www.fpnotebook.com/Gyn/Pharm/OrlCntrcptvSdEfctMngmnt.htm
2. Schwarzbein, M.D., Diana. The Schwarzbein Priciple II: The Transition. 2002.