Disc Inflammation and Nutrition--A Personal Account

I have always been awed by the power of nutri­tion. Nutrition can really make a big difference—I learned that in school. Nu­trition can really make a big difference in areas such as facilitating the holding of | chiropractic adjustments— I learned that after school. And then, in October of | 1999,1 was awed once more, when I learned that nutrition could save me from needing surgery af­ter rupturing a disk.... Sitting in the passenger seat of the car, on my way to give a lecture on the clini­cal applications of nutrition in fibro-myalgia, I was diligently working on my laptop, making overheads for the nutri­tion classes I was teaching at the univer­sity. There was just never enough time to get things done (sound fa­miliar?). I was trying to maxi­mize efficiency by preparing the overheads in transit to the lec­ture (most of you are already cringing at the thought of the neck position). After arriving at my destination and complet­ing the four-hour lecture, I started to pack to return home. Something wasn't quite right, though. Within hours, I was ex­periencing intense pain, and I knew it was something serious. My chiropractor informed me that I had either a bulged or ruptured disk. I had pain and numbness in my left arm, especially in the fingers, and no strength at all in the arm. A visit to an AK chiro­practor increased the strength reading to a 1; but, after three weeks in bed and not being able to move out of a side-lying position without pain, I was forced to en­tertain the possibility that I might suffer permanent nerve damage. I was avoid­ing the thought of surgery, which I knew would ultimately serve to weaken the area; however, now I was being advised that, if I passed "the window" in which surgery could relieve the pressure on the nerves, I did, indeed, face permanent nerve damage. Up to this point, I had made sure I was replete in all the vitamins and miner­als, and I had been taking several appropriate nutri­tional formulas for pain, in­flammation, disk repair, etc., which included nutrients such as bromelain, known for its antiinflammatory qualities. The nutrition helped, but I was still facing surgery. Feeling desperate, I even tried the Western approach with NSAID's (non-steroidal anti-inflammatory drugs, including the new cox-2 inhibitors), and a brief round of corticosteroids (me-thylprednisolone), with no improvement. My routine had included rest, acupunc­ture, chiropractic care (ultrasound, no ad­justing), aromatherapy, nutrition, and drugs; but, 1 was still bedridden. Escaping Imminent Surgery I succumbed to the idea that surgery was looming as a distinct possibility. A neurosurgeon ordered an MRI, which re­vealed some bulging from C-3 to C-6, with a rupture and ensuing broken fragments at C-7. I started discussing surgery dates, when it hit me—I was going under the knife, and I had nothing to lose by pull­ing out all the stops and trying high dose enzyme therapy. After all, I had heard enzyme therapy recommended for inflam­matory conditions, and 1 had been taking a formula containing bromelain; but, was it really enough, or would a higher quan­tity of proteolytic enzymes make a differ­ence? A doctor friend from Calgary, Canada. Ian Smith, D.C., consulted with me on the phone and reminded me that I had a lot of debris to clear out of that area, and that high doses of enzymes were desperately needed. There was one way to tell if they would work, and I was anxious to be a guinea pig at this point. I obtained a quality formula of pancre-atin, which contained a high concentra­tion of proteolytic enzymes. "Proteo" means protein, and "lytic" or "lysis" means to breakdown; proteolytic en­zymes breakdown proteinacious cellular debris that fosters inflammation. I took the entire recommended daily dose that evening, three hours after my last meal. Upon arising, I took another daily dose and then fasted until noon, realizing that the enzymes work better away from food. By mid-afternoon, I was feeling a shift. I ventured out of bed, and actually walked around for more than an hour at a time before having to return to bed. I continued high dose therapy for three days, and after that time, I was almost fully mobile (but, still not able to sit!), and returned to the neurosurgeon to can­cel my plans for surgery. The doctor's response to my recovery was nothing short of amazement. It was just not likely, in my situation, especially after unsuccessful corticosteroid treatment, to turn around the way I had. Still a little wary of what was happen­ing, he cautioned that surgery would be necessary, if I reached a plateau and did not progress to the point that would give me a high quality of life. But, I continued to improve, and the range of motion and muscle strength gradually came back. Within a couple months, I returned to functioning normally, including doing the average lifting and bending of every­day life. I changed the handlebars on my bike to allow for a more upright posi­tion, and in the year following the rup­ture, completed a bike tour of over 300 miles in six days. How could proteolytic enzymes possess the power to turn me around in my situation with a ruptured disk? What is it about them that ad­dresses inflammation? The Inflammatory Process In order to answer that question, it is helpful to understand the inflammatory process, and how enzymes are able to address that inflammation. Inflammation is a response to tissue injury, or damage. Whether the cells are damaged by mi­crobes, chemicals, or physical trauma, the injury sets off a response. The response can be characterized by redness, pain, heat, swelling and, possibly, loss of func­tion, depending on the extent of the in­jury. Blood vessels dilate, or increase in size, and become more permeable, which means that substances normally con­tained in the blood can now travel out of the blood and into tissues. The vessel dilation brings more blood to the site of injury, to remove toxins and dead cells. The increased permeability allows white blood cells to enter the damaged area. The white blood cells (WBC's) con­tain high amounts of vitamin C, and the vitamin C, in turn, helps the motility and efficiency of the WBC's. This attraction of WBC's is instigated by the release of chemicals from damaged cells. These chemicals include histaminc, kinins, and prostaglandins (pg's). The increased cir­culation and leakiness, or permeability of capillaries (small blood vessels), produce the heat, redness, and swelling within minutes of injury. Pain results from dam­age to nerve fibers, toxin irritation, and/ or pressure from the swelling. Prostag­landins magnify and prolong the pain associated with inflammation. Kinins can also affect nerve endings and create pain. After the inflammatory process has been started, phagocytes (bacteria-eat­ing white blood cells) come to the rescue to prevent infection. The various white blood cells squeeze through the capillar­ies to reach injured tissue, and the neu-trophils, sometimes called, "the ware­houses of proteolytic enzymes," clear toxic debris. Enter PE's This is why proteolytic enzymes are utilized in inflammatory conditions—they clear the debris, just like the enzymes re­leased by the neutrophils of our natural immune system. Enzymes are believed to help support the shrinking of fragments, also. When fragments are involved in a rupture, they aren't really going away, un­less they're surgically removed; so, it makes sense to want them to shrink to as small as possible, and not impede the nerves. Enzymes have demonstrated an increased ability to foster tissue regen­eration, and have been noted in literature to be associated with "healing accelera­tion" (Tsitologiia. 1992; 34:70-3). It is worth mentioning that there are many people who suffer gastric upset by taking high dose pancreatin. This prob­ability is increased when the patients are on pain meds, because drugs will increase gut permeability (leaky gut syndrome) and increase the likelihood that enzymes will come in contact with exposed tissue. It's similar to the concept of hydrochloric acid: both HC1 and enzymes are naturally present in our bodies; however, if we have damaged, exposed tissue, then burning or GI side effects can occur. To address this issue, the plant proteases are better tolerated, and they can be combined with synergistic herbal ingredients to tame in­flammation without the GI side effects. An excellent resource book which ex­plains the concept of utilizing enzyme therapy is Enzyme Therapy: Bringing the body back from injury and disease, by Dr. Evan Mladenoff, D.C., Ac, Diplo-mate AK. The healing process occurring after in­flammation places a great demand on the body's store of nutrients. There had been a variety of nutrients that I had incorpo­rated into my nutritional protocol to ac­celerate healing and recovery, so that I was able to return to normal function, which included returning to the gym and starting to lift weights again—less than two months after my "turnaround". Nu­trition can help with pain, inflammation, chiropractic adjustment maintenance, muscle and ligament health, disk rupture...but, more on that later. Since I'm out of space this time, in the next ar­ticle I will address the accessory nutri­ents I used to "get back on my feet". Dr. Toohey would like to express a special thank you to Vern Miller, D. C, whose chiropractic knowledge and care helped speed her recovery. Dr. Lynn Toohey received her Ph.D. in nutrition from Colorado State Univer­sity in Ft. Collins, CO. She has lectured to chiropractors and other health pro­fessionals across the country and also in Canada and Europe on nutrition-re­lated topics and complementary medi­cine. Her various lecture engagements have included speaking for the Interna­tional College of Applied Kinesiology (ICAK), the United Chiropractors of New Mexico (UCNM), and the Florida Chi­ropractic Association (FCA). You may contact Dr. Toohey by e-mail at drtoohevCwnutri-west.net.