BDC #33 - Celiac Disease: and the battle against gluten

Lately I have been indulging myself with lots of BBC Documentary series about food, obese vs skinny people, eating disorder, etc. And eventually, I bumped to this interesting  name: 'Celiac Disease'. I don't think many people in Asia is familiar with this disease (especially since most Asian countries have been mistakenly analogize as rice-eaters), but I believe it is quite common for Caucasians. 

Why it is more common to Caucasians? Well, because in contrary to the assumption over Asian's diet of rice, European and American's diet are mostly about wheat. Nearly every food might contains wheat, starting from the obvious bread and pasta, followed with cereal, cookies, cakes, and various processed foods. 

OK... where is the correlation?

Celiac disease (or Coeliac Disease in European spelling), is basically an allergy. It is an autoimmune disorder in which people can't eat gluten because it damages their small intestines (1). Gluten itself is a kind of protein abundantly found in wheat, barley, and rye. Gluten gives elasticity to the dough and the chewy texture.

Anyway, I am not going to talk too much about gluten, but, YES.. you can easily guess the link in between. 

Back to the topic. So, when a person with celiac disease eats something containing gluten, the body will release a specific antibody. Unfortunately, this antibody attacks the small intestine and destroy the intestinal villi. In the end, the destroyed small intestine has poor absorption rate which effect the person's health.  

 

I don't own the picture. Click it for direct link

Symptoms of celiac disease include abdominal bloating, diarrhea, constipation, iron (and any other minerals and vitamins) deficiency and anemia, fatigue; and sometime even lead to extreme weight loss and malnutrition. For a long term period, celiac disease might leads to thyroid problems, diabetes type 1, osteoporosis and arthritis, dermatitis herpetiformis (an itchy skin rash), and miscarriage or infertility. If it happens from childhood, it might also effect the child's growth and menstruation cycle (for girls). To make it even worse, there is no definite age of the development of celiac disease. You can start developing this disease at any point of your life. 

If we are talking about number, in US alone, a study in 2003 (2) found that one out of every 133 Americans has celiac disease, but only approximately 4,700 Americans has been diagnosed. It means that 97% of cases are undetected. In Europe is not even better. In Hungary around one out 85 people and in UK at least one out of 100 people has celiac disease. Germans are the least with only one out of 500 people with celiac disease (3). However, those data are from more than 10 years ago.. Along with the rise of popularity of processed food, I believe there are more people developing celiac disease day by day. Based on World Gastroenterology Organization in 2007, there are at least 1:100 - 1:300 of people all around the world have this disease, and it just the tip of the iceberg (4).    

Who knows, Celiac Disease might hit more and more people in Asia too? Especially since local food is not local anymore. Not only exchanging food from all around the world, we are also exchanging disease. I am not saying that we are not allowed to eat anything. Let's just be more aware of what is your body telling you... There is no harm to be more cautious.

If you want to check if you possibly have this disease, why don't you try this quiz?

ps: Click the bracket numbers for direct link ^^

 

BDC #32 - Fragmented Sleep Disorder: woken up countless times is definitely not fun!

Do you sleep disorder? Let's say... insomnia, couldn't sleep until really late at night or nearly dawn? Well, you better treat it before too late. As you know lack of sleep will definitely, definitely, DEFINITELY effects you on the next morning.

HOWEVER, do you know that there are more and more variation of sleep disorders than just 'regular insomnia'. 

I have this really annoying sleep disorder. I am always woken up around 3 hours after the moment I fall asleep, and on my worse days, I will keep waking up every one hour after the first 'wake up call', until my alarm rings violently. It's bloody frustrating and sleeping for 5 hours straight sounds like a luxury for me.  

Well, ladies and gentlemen, let me introduce you to fragmented sleep disorder. As it's name, it is basically a sleep disorder where we are woken up during our sleep for several times. People with fragmented sleep disorder is, in contrast with people insomnia, actually could easily fallen asleep like normal people. However, they are woken up for several short times and fallen asleep again during the night. In the end, the total time of sleep they actually have is less than they thought. It's totally annoying and unsatisfying. Even if the effect isn't immediately felt by the patients, in the end they will experience the same agitation and terrible mood swing as insomniacs.  

Some people might say they experience fragmented sleep – in two periods of sleeping during the night, with a large gap in between. However, it isn't considered as fragmented sleep, but biphasic sleep, and it is very common. While a bi-phasic sleep pattern is something you can adjust to and live with, truly fragmented sleep with many short awakenings is simply terrible.

There are some causes of fragmented sleep disorder, and most of them are the same as insomnia; such as stress and mental problems. Caffeine addiction might also lead to the restless feeling during sleeping which effects the sleeping stage. One additional reason is due to sleep apnea. It is a cessation of breathing during sleep, and mostly happened on overweight or obese people. 

One important thing to point out is the fact that fragmented sleep could lead to memory problem, as we need to 'lock down' some memories of the day during our sleep but unfortunately enough the cycle is disrupted.     

So, don't just think about insomnia, we have more sleep disorders than we thought.

 

I don't own the picture

BDC #31 - EDNOS: the deadliest-but-totally-unwellknown eating disorder

Do you know about eating disorder? Probably you are quite familiar with anorexia and bulimia, or with over-eating lead to obesity. However, are you sure those are the only eating disorders?

UNFORTUNATELY NO

There is the deadliest, the most common, but totally hidden from public attention; the EDNOS, an abbreviation of Eating Disorder Not Otherwise Specified. It is an eating disorder that doesn't yet meet the criteria for anorexia, bulimia, nor obese over-eating, but still has a significant constriction towards eating behaviour. 

There are 3 spectrum of EDNOS in general:

1. those with the threshold similar to anorexia or bulimia,

2. those with mixture of both disorders, or

3. those with extremely atypical to either of the major disorders.

People with EDNOS usually don't go to the super extreme as the 2 major disorders, but they DO experience the same uneasiness, guilt, and unusual obsession towards foods and those thoughts per-occupied their mind and control their lives. In the end, people with EDNOS tend to be "yo-yo dieters". There are series of eating-limitation and binge-eating through the whole life. Thus, in other words, EDNOS is actually the most common eating disorder appeared. HOWEVER, sadly enough, most of therapists categorize people with EDNOS as "Not-sick-enough" and just suggest the patients to "eat properly" and say "it's just only in your mind".

BL**DY HELL!!!

People with EDNOS are as sick as anorexic, bulimic, or food-obsess patients. They are totally exhausted in mind and it might lead to depression, or even worse. They might actually SCREAM for your help.

There are some expert propose to put EDNOS into DSN-5 Eating Disorder group with some subgroups. There are at least 6 subgroups (as written in wikipedia):

1. Atypical Anorexia Nervosa in which all criteria for anorexia nervosa are met except that the individual’s weight is within or above the normal range
2. Subthreshold Bulimia Nervosa (low frequency or limited duration) in which all criteria for bulimia nervosa are met except the binge eating and compensatory behaviors occur on average less than once a week and for less than 3 months
3. Subthreshold Binge Eating Disorder (low frequency or limited duration) in which all criteria for binge eating disorder are met, except the binge eating occurs on average less than once a week and for less than 3 months
4. Purging Disorder (PD) in which patients purge without binging; they consume a normal amount of food and typically maintain normal weight
5. Night Eating Syndrome (NES) in which patients have nocturnal eating episodes, or eat a large proportion of their daily calorie intake after dinner
6. Other Feeding or Eating Condition Not Elsewhere Classified which is a residual category for all other cases that are clinically significant but do not meet the criteria for formal eating disorder diagnoses.

People with EDNOS, as like any other eating disorders, also have high health risks such as osteoporosis, kidney problems, ulcers, heart failure, etc.

THUS....

If you FEEL and THINK you might have eating-behaviour problems
OR you know somebody who might have problems...

SEEK FOR HELP!!!

Don't let the food eat you up !!! 

Check some links for more info:
http://www.waldenbehavioralcare.com/resources/popular-searches/endos-facts/
http://www.b-eat.co.uk/get-help/about-eating-disorders/types-of-eating-disorder1/ednos/
http://www.nationaleatingdisorders.org/eating-disorders-not-otherwise-specified-ednos

 

I don't own the picture, click for direct link

  

 

      

The Tale of a Boy in a Coffee Shop #38

"Should there be any reason for us to miss you, cheeky boy?" The young lady rubbed his head lightly and went to the kitchen.

"Why shouldn't be any reason for it?" The young boy eyes reverted to the old lady, deep and intense.

"Whether there really is any reason or not, is it important for you?" The old lady returned the gaze as deep as the one she got.

"Well, it's not really. It is simply out of my curiosity. I don't see any harm from it." The young boy raised his two shoulders with light expression.

"Don't you ever miss somebody, or want to do something simply because it's been a while?" The young lady came back from the kitchen, bringing 2 pieces of pancake with simple cinnamon sugar on top of it. 

The young boy naturally accepted the plate and started digging the just-ready-from-the-pan pancakes in front of him. While chewing his pancake, his eyes were day-dreaming through the jars across the bar.

"I think I have, sometimes. Like when I was in the harbour, I really missed my mother's tomato soup, or our fresh milk, or the smell of freshly made butter. I got tired with the smell of fishes, so I really missed my home."

The old lady smiled and rubbed her hand on the young boy's head softly. "And why was that?"

"It was because...." The young boy let his words hanging on the empty air.

The day suddenly got warmer as the autumn weather changed frequently through the days.

"I think there is indeed no need for real reason, huh?" The young boy continued his lovely breakfast.

And their days started as usual.

BDC #30 - Schizoid Personality Disorder: Just simply a poker face and loner

Have you ever checked your own personality or mental disorder? Well, just out of curiosity? If yes, how many of you got a tendency of Schizoid Personality Disorder?

Don't worry, Schizoid is not the same as Schizophrenia. You know, the voices in you head..like in the movies.
"Kill your self"
"Kill them"

NO...it's not the same...rest assured

 Schizoid Personality Disorder is actually a personality disorder included in group of conditions "Cluster A" or eccentric personality disorder. People with schizoid tend to be distant, detached, and indifferent to social relationship.

The term "schizoid" was firstly used in 1908 by Eugen Bleuler to designate a human tendency to direct their attention toward their inner lives and away from the external world. Bleuler labeled this exaggeration of the tendency as the schizoid personality.


Studies on the schizoid personality have developed along two distinct paths. The first one is the descriptive psychiatry, focuses on overtly observable, behavioral and describable symptoms and finds its clearest exposition in the DSM-IV revised.
The descriptive tradition began in 1925as Ernst Kretschmer tried to describe the observable schizoid behaviors, which he organized into three groups of characteristics:

1. unsociability, quietness, reservedness, seriousness, eccentricity
2. timidity, shyness with feelings, sensitivity, nervousness, excitability
3. pliability, honesty, indifference, silence, cold emotional attitudes.

The second path, the dynamic psychiatry, began in 1924 with observations by Eugen Bleuler, who observed that the schizoid person and schizoid pathology were not things to be set apart.
Following the dynamic path, W. R. D. Fairbairn presented in 1940 the four central schizoid themes:

1. the need to regulate interpersonal distance as a central focus of concern, 
2. the ability to mobilize self preservative defenses and self-reliance, 
3. a pervasive tension between the anxiety-laden need for attachment and the defensive need for distance that manifests in observable behavior as indifference, and 
4. an overvaluation of the inner world at the expense of the outer world.

Theodore Millon, in his book (2004; Personality disorder in modern life), identified four subtypes of schizoid. Any individual with schizoid may exhibit none or one of the following:

Subtype	Features
Languid schizoid (including depressive features)	Marked inertia; deficient activation level; intrinsically phlegmatic, lethargic, weary, leaden, lackadaisical, exhausted, enfeebled.
Remote schizoid (including avoidant, schizotypal features)	Distant and removed; inaccessible, solitary, isolated, homeless, disconnected, secluded, aimlessly drifting; peripherally occupied.
Depersonalized schizoid (including schizotypal features)	Disengaged from others and self; self is disembodied or distant object; body and mind sundered, cleaved, dissociated, disjoined, eliminated.
Affectless schizoid (including compulsive features)	Passionless, unresponsive, unaffectionate, chilly, uncaring, unstirred, spiritless, lackluster, unexcitable, unperturbed, cold; all emotions diminished.

It might be easy to spot a real loner. However, there are more people with a hidden schizoid tendency. Many fundamentally schizoid individuals present with an engaging, interactive personality style that contradicts the observable characteristic and definitions of the schizoid personality. Klein classifies these individuals as secret schizoids. They present themselves as socially available, interested, engaged and involved in interacting, BUT remain emotionally withdrawn and sequestered within the safety of the internal world.
Therefore, Klein gives big precaution that we should not miss identifying the schizoid patient because we cannot see the patient's withdrawal through the patient's defensive, compensatory interaction with external reality. He also suggests that we need to ask the patient what his or her subjective experience is in order to detect the presence of the schizoid refusal of emotional intimacy.
Actually, descriptions of the schizoid personality as "hidden" behind an good-cheeful-appearance of emotional engagement have been recognized as far back as 1940 with Fairbairn's description of schizoid exhibitionism, where the schizoid individual is able to express a great deal of feeling and to ake it impressive in social contacts, yet, in reality gives nothing and loses nothing. Because they are practically only "playing a part," their own personalities are not actually involved. According to Fairbairn, "the person disowns the part which he is playing and thus the schizoid individual seeks to preserve his own personality intact and immune from compromise."

There is no solid medications to treat individual with schizoid, unless they suffer heavy depression, they might get some pills. However, the main problem of the schizoid personalities can only be help with talk therapies. We need to explore more, why did they start to withdraw their selves.  

So, how deep are you willing to involve and help people with schizoid tendency? Try to check on some voices of them. (check out the blog below)

 I don't own the picture, try to check the blog ^^

BDC #29 - Narcolepsy: Are you sure sleeping is a good thing?

Have you ever watched some movies where there are some characters can suddenly fall a sleep, while eating, talking, or even walking? Weird... right? Sounds so unreal?! INDEED... !!

 

BUT, it's not actually a hyperbolic medical condition. It is a real one, and it's called narcolepsy.

Narcolepsy is a chronic neurological disorder where the patient's brain fail to regulate the sleep-awake cycle properly. It's not because of psychological problems nor mental illness, but more likely due to some abnormalities which affect the biological factors in the brain. Narcolepsy could as be triggered by environmental influence, such as virus infection.

There are some consistent symptoms of narcolepsy, as written in Wikipedia (I know.. I am too lazy to write my own words);

「The classic symptoms of the disorder, often referred to as the "tetrad of narcolepsy," are cataplexy, sleep paralysis, hypnagogic hallucinations, and excessive daytime sleepiness.　Other symptoms include automatic behaviors. It is important to be noted that these symptoms may not occur altogether in all patients.

• Cataplexy is an episodic condition featuring loss of muscle function, ranging from slight weakness such as limpness at the neck or knees, sagging facial muscles, weakness at the knees (often referred to as "knee buckling"), or inability to speak clearly, to a complete body collapse. Episodes may be triggered by sudden emotional reactions such as laughter, anger, surprise, or fear, and may last from a few seconds to several minutes. The person remains conscious throughout the episode. In some cases, cataplexy may resemble epileptic seizures. Usually speech is slurred and vision is impaired (double vision, inability to focus), but hearing and awareness remain normal. Cataplexy also has a severe emotional impact on narcoleptics, as it can cause extreme anxiety, fear, and avoidance of people or situations that might elicit an attack. Some narcolepsy affected persons also experience heightened senses of taste and smell.
• Sleep paralysis is the temporary inability to talk or move when waking (or less often, when falling asleep). It may last a few seconds to minutes. This is often frightening but is not dangerous.
• Hypnagogic hallucinations are vivid, often frightening, dreamlike experiences that occur while dozing, falling asleep. Hypnopompic hallucinations refer to the same sensations while awakening from sleep.
• Automatic behavior means that a person continues to function (talking, putting things away, etc.) during sleep episodes, but awakens with no memory of performing such activities. It is estimated that up to 40 percent of people with narcolepsy experience automatic behavior during sleep episodes. Sleep paralysis and hypnagogic hallucinations also occur in people who do not have narcolepsy, but more frequently in people who are suffering from extreme lack of sleep. Cataplexy is generally considered to be unique to narcolepsy and is analogous to sleep paralysis in that the usually protective paralysis mechanism occurring during sleep is inappropriately activated. The opposite of this situation (failure to activate this protective paralysis) occurs in rapid eye movement behavior disorder.」

「There is no cure for narcolepsy, but medications and lifestyle modifications can help you manage the symptoms. As the Mayo Clinic suggests:

• Stimulants. Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Doctors often try modafinil (Provigil) or armodafinil (Nuvigil) first for narcolepsy because it isn't as addictive as older stimulants and doesn't produce the highs and lows often associated with older stimulants. Side effects of modafinil are uncommon, but they may include headache, nausea or dry mouth.
  Some people need treatment with methylphenidate (Concerta, Ritalin, others) or various amphetamines. These medications are very effective but may sometimes cause side effects such as nervousness and heart palpitations and can be addictive.
  
• Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Doctors often prescribe these medications, which suppress REM sleep, to help alleviate the symptoms of cataplexy, hypnagogic hallucinations and sleep paralysis. They include fluoxetine (Prozac, Sarafem, others) and venlafaxine (Effexor XR). Side effects can include sexual dysfunction and digestive problems.
• Tricyclic antidepressants. These older antidepressants, such as protriptyline (Vivactil), imipramine (Tofranil) and clomipramine (Anafranil), are effective for cataplexy, but many people complain of side effects, such as dry mouth and lightheadedness.
• Sodium oxybate (Xyrem). This medication is highly effective for cataplexy. Sodium oxybate helps to improve nighttime sleep, which is often poor in narcolepsy. In high doses it may also help control daytime sleepiness. It must be taken in two doses, one at bedtime and one up to four hours later. Xyrem can have serious side effects, such as nausea, bed-wetting and worsening of sleepwalking. Taking sodium oxybate together with other sleeping medications, narcotic pain relievers or alcohol can lead to difficulty breathing, coma and death.」

In short.... It is a TROUBLESOME condition... and the medicines basically lead to side effects. Thus, BE GRATEFUL you have a normal sleeping pattern.. and DON'T EVER...EVER ruin it by serial all nights....

I did mention before, narcolepsy is mainly caused by abnormalities in the brain's biological function, though the exact related genes are not revealed yet. However, there is a rising concern that virus infection in the form of vaccination might became the lead cause of the increase of narcolepsy cases for these past 5 years. By the early of this year, there are some reports stating that the swine flu (A/H1N1) vaccine has increase the number of narcolepsy cases in 3 countries; Finland, Sweden, and UK. (psst...there are some links to papers investigating the relation of the vaccine and the increasing cases of narcolepsy. You can try to read it thoroughly). Although the government already agreed that the vaccine might be the cause of narcolepsy, they don't immediately agree to give some compensation to the patients; as what Josh and Chloe are fighting to get. 
As the accumulation of the evidence getting bigger, the governments in European countries finally stated that the swine flu vaccine should not be given to people under 20 as the high risk of narcolepsy.


So, how is your sleep?

 

BDC #28 - Pupula Duplex: Is it real or merely a myth?

Have you ever imagined yourself, having a super power? Being invisible, having laser eyes, flying? Well, in my point of view, it's a really common thing to happen. But, how about if this super power is for real? How about if you have the "Evil Eyes"?

Evil Eyes? Yup, Evil Eyes, as scary as in the movies. Something that allow you to "see more" than normal eyes. Something that looks like picture above.

HOLLY MOLLY!!!!

Is that what you say? You think I am joking?

NOPE!! This is a real medical condition called Pupula duplex. It is a condition where the eye develops double irises, corneas, and retinas in one eyeball. It can be happened either on both or only one eye of the patient. As you can guess, this mutation is way too weird to be happened for real. It is not even officially accepted in the medical literature, since there is no evidence if there is a person ever have this symptom. People merely believe that it is a mythological condition, where there is only one person in history ever had it, and it was the famous Chinese Emperor, Liu Ch'ung. Check the Ripley's Museum!!!! AND If you guys check more details, there is a claim by Robert Ripley himself that he met a real double-irises man in 1931 named Henry Hawn who lived in Mills Kentucky.   

 

Emperor Liu Ch'ung's statue at Ripley's Museum

To put it more real, there is actually a real medical condition named Polycoria. It is a condition where the eye may has several openings in the iris that result from local hypoplasia of the iris stroma and pigment epithelium. Those multiple pupils all have a sphincter and the ability to contract like a pupil in normal eyes.  

However, there are still lots of debates regarding the truth of this condition. Some ophthalmologist even say it a HOAX...

So, it's up to you to believe it or not...  

The Tale of a Boy in a Coffee Shop #37

It had been quite a sometime since the last time the young boy came to the coffee shop. The young lady suddenly hit by a feeling of missing him.

"Granny Lisda, do you know why that funny little boy hasn't come lately?" The young lady asked the old lady while kept on washing the dishes in front of her.

There was a faint smile on the old lady's face. She held her answer for some seconds.

"Granny? Did you hear me?" The young lady popped out her head through the kitchen's door.

She smiled at her grand-niece, "Loud and clear, darling. Loud and clear." She sipped her hot chocolate. The day had turned colder as the autumn approached earlier that year. "You seem like missing him?"

The young lady went out the kitchen as she finished washing. She wiped her wet hands with her apron, and took a glass of water, walked closer to the old lady who sat behind the bar.

"Shouldn't I?"

"Of course you may. I also miss him."

"He is a very interesting boy. It's a bit lonely without his crazy questions lately." The young lady held her glass with her two hands, looking through the window aimlessly.

Suddenly the bell of the front door jingled. A familiar face came in with huge basket on his tiny hands.

"Hello owner, hello Lynn. Long time not see. I bring these fishes. Hope you two like it." The young boy put the heavy basket on the bar's table. 

He looks a bit different, he is bit more tanned than the usual, thought the young lady. 

"You look refreshed." The young lady put a glass of water in front the young boy who already sat on one of the high chairs.

"Yes. My father got an offer to work at the harbour. He said that I am big enough to start learning how to properly work. So, he took me along for 3 weeks. I've never been to the sea before. It was awesome!" The two ladies could see some sparks in his clear eyes as he spoke.

"Great for you! But, don't you think you should let us know before you go? We miss you." The young lady scrubbed the young boy's head lightly.

"Why? Why would you miss me?"

The two ladies smiled. Here it comes, those lovely questions, they thought unanimously. 

BDC #27 - Bariatic Surgery: You better never have to undergo this one !!

Are you currently studying in medical degree, and/or considering which specialist you would like to be, maybe you could consider to become  a Bariatic Surgeon. It's a specialist in bariatic surgery.

WAIT !! What is it?!!

I can give you a hint... It's a type of surgical procedure which gains its popularity due to rapid increase of the number of people with overweight or obesity. 

Ouh yeah... I think you start to get a glimpse of idea. ^^

Practically bariatic surgery includes all procedures related to the attempt of reducing the size of the alimentary tract, such as the stomach or the intestines. You start thinking of gastric bypass surgery? YUP it's one of it.

Basically, in the major cases, overweight or obese people gain their weight due to the massive amount of food they munch each time. It literally expands their stomach capacity every time their overeat, thus the stomach and all of the digestive tract are getting larger and larger.

Based on the US National Institutes of Health recommends this surgery for people with BMI at least 40, and people with BMI 35 and serious complication (e.g. diabetes and high blood pressure). However, lately they reduce the limitation to people with BMI 35-40 with no comorbidities, or a BMI of 30-35 with significant comorbidities. Even, due to the alarming progression of the obesity, the ASMBS guidelines suggest the bariatic surgery to people with BMI more 30 with comorbidities. OK, in medical term, comorbidity is equal to complication. Let's say, if you have diabetes problem, you might have another problem, like heart failure, high blood pressure, blindness.. YUP !! Those are comorbidities. 

 

Image credit: Walter Pories, M.D. FACS.

The image above is the image of several surgical options.

Practically, the bariatic surgery is divided into 3 subtypes with several types of surgical options, as mentioned:

1. Predominantly restrictive procedures : primarily reduce the stomach size

•  Vertical Banded Gastroplasty: also called the Mason procedure or stomach stapling, a part of the stomach is permanently stapled to create a smaller pre-stomach pouch, which serves as the new stomach.
• Adjustable gastric band: stomach is restricted by using a silicone band, which can be adjusted by addition or removal of saline through a port placed just under the skin.  
• Sleeve gastrectomy : the stomach size is reduced to about 15% of its original size. Under a surgery, of a large portion of the stomach is removed, following the major curve. And then, the open edges are then attached together (often with surgical staples) to form a sleeve or tube with a banana shape. The procedure will permanently reduce the size of the stomach and is not reversible.
• Intragastric balloon : This surgery means to insert a deflated balloon into the stomach, and then filling it to decrease the amount of gastric space. The balloon can be left in the stomach for a maximum of 6 months and results in an average weight loss of 5-9 BMI over half a year. Though this procedure is not yet approved in the USA, the Intragastric balloon is approved in Australia, Canada, Mexico, India and several European and South American countries.

2. Predominantly malabsorptive procedures : although it also reduce the stomach size, but the surgeries are based mainly on creating malabsorption.  However, due to the high case of heavy malnourishment after the surgery, the popularity is remarkably decreasing.

•  Biliopancreatic diversion: This complex operation is also known as ''biliopancreatic diversion'' (BPD), or ''Scopinaro procedure''. This surgery is rare now because of problems with malnourishment. It has been replaced with the Duodenal switch, also known as the BPD/DS. Part of the stomach is resected, creating a smaller stomach (however the patient can eat a free diet as there is no restrictive component). The distal part of the small intestine is then connected to the pouch, bypassing the duodenum and jejunum. 
• Endoluminal sleeve: this procedure is still only performed on mice at present, It involves of placing a 10cm long impermeable sleeve into the intestine to block absorption of food in the duodenum and upper jejunum. A study at Massachusetts General Hospital Weight Center and Gastrointestinal Unit found that mice who had the surgery ate 30% less food and lost 20% more weight than counterpart mice, while blood glucose levels returned to normal levels in all mice who had the surgery.

3. Mix procedures : which apply both techniques simultaneously.  

• Gastric Bypass Surgery: A common form of is the Roux-en-Y gastric bypass. A small stomach pouch is created with a stapler device, and connected to the distal small intestine. The upper part of the small intestine is then reattached in a Y-shaped configuration. The gastric bypass had been the most commonly performed operation for weight loss in the United States. It has been considered as the "gold standard" in the U.S.A with a highly strict post-surgical adherence to a gastric bypass diet for healthier pattern of eating.

• Sleeve gastrectomy with duodenal switch: It is a variation of the biliopancreatic diversion includes a Duodenal switch. The part of the stomach along its greater curve is resected. The stomach is "tubulized" with a residual volume of about 150 ml. This volume reduction provides the food intake restriction component of this operation. This type of gastric resection is anatomically and functionally irreversible. The stomach is then disconnected from the duodenum and connected to the distal part of the small intestine. The duodenum and the upper part of the small intestine are reattached to the rest at about 75-100 cm from the colon. 
  (credit to the link above for the explanation)

• Implantable Gastric Stimulation: This procedure implants a device similar to a heart pacemaker, with the electrical leads stimulating the external surface of the stomach. The electrical stimulation is thought to modify the activity of the enteric nervous system of the stomach, which is interpreted by the brain to give a sense of satiety, or fullness. Early evidence suggests that it is less effective than other forms of Bariatric Surgery.

As mentioned before, Bariatic surgery is supposed to be the final effort to help overweight and obese people to lose weight. It is due to the fact that after the surgery, the patient will only get a highly restricted diet. Immediately after the surgery, the patient is only allowed to gulp only sugar-free clear liquid diet until the digestive tract is recovered. Afterward, the diet will get a little more solid with the addition with sugar-free salt-free dietary products, pureed fruit, and mashed potato (YAY !!!). But STILL, it's a baby food !!! Post-surgery, the patient will definitely vomit every time they overeat than the baby portion. They even have to take daily multivitamin pill for life to compensate the highly reduced absorption of essential nutrients. UWAH...it is definitely not nice !!!!

THAT IS WHY... I tell you guys, before it's too late, and we have to control our food intake. Even before we are suggested to undergo this surgery, imagine how hard is life with an overweight body??!! We don't have to have a superskinny body like super models, NO... it's also not healthy...

As long as we are in a proper balance of body proportion, it's GOOD !!

Stay healthy... stay in shape !!!!

  

BDC #26 - Dyscalculia: It doesn't mean they are cloddish

It's been quite a sometime since my last post.. Well, I can't help it. It's SUMMER!!! And I am already in a holiday MODE... But, I still have to keep myself in check, before my real holiday next week. So, I would like you guys to be familiar with something.

I believe you all already quite familiar with dyslexia, but.. Do you know about Dyscalculia? Well, you can guess from the word, calculia. Yes... It's about calculating, numbers, mathematics... Combined with dys-, it's obvious that it's related to some kind of "doing badly". 

Dyscalculia is a popular name of mental disorder with the code DSM-IV 315.1 Mathematics Disorder. It is defined as a difficulty in learning and comprehending arithmetic, fundamentally it is an inability to conceptualize numbers abstractly in comparative quantities. 

Are wondering now, isn't it simply because they are retarded? NO, they are not!! Although, yes, some of those who has dyscaculia have IQs comparatively below average, ACTUALLY the patients are disperse amongst all ranges of IQ. Up to now, there is no globally joined research or survey about dyscalculia, based on separated organization, they predict that dyscalculia effects between 3.6-6.5% of population (link). The ratio of male and female is around 50% each. 

There is no exact reason of dyscalculia itself, but researchers have made some hypothesis regarding the cause, especially a brain disorder on the broadmann area 40 and angular gyrus, at the junction between the temporal and parietal lobes of the cerebral cortex. (I know!! It sounds difficult, but it's nearly impossible to simplify it, when it comes to medical terms.. They LOVE difficult words...) It is hypothesized that this disorder might effect the working memory which is important in maintaining the abstract image of numbers while calculating. OK.... maybe it will be easier if I say, there is some oddity in the RAM while the computer processing the data before permanently saving it into the hard disk, or displaying it as an output on the screen. Thus, it always comes out as an ERROR. 

They are some signs to identify people with dyscalculia as given below

There is no standardized classification of dyscalculia, however, there are some parties proposing the subtypes.

According Ireland, they divided dyscalculia in to:

• Quantitative dyscalculia, is a difficulty in counting and calculating.
• Qualitative dyscalculia, is a result of difficulties in comprehension of instructions or the failure to master the skills required for an operation. When a child has not mastered the memorization of number facts, he cannot benefit from this stored "verbalizable information about numbers" that is used with prior associations to solve problems involving addition, subtraction, multiplication, division, and square roots.
• Intermediate dyscalculia involves the inability to operate with symbols, or numbers.

On the other hand, Kosc, a neuropsysiologist from Czechoslovakia, tried to describe the dyscalculia into six types:

• Verbal dyscalculia, refers to difficulties in naming the amount of things.
• Practognostic dyscalculia, refers to difficulties in manipulating things mathematically — for example, comparing objects to determine which one is larger.
• Lexical dyscalculia, refers to difficulties in reading mathematical symbols; including operation signs (+, -, :, x, /, etc ) and numerals.
• Graphical dyscalculia, refers to problems in writing mathematical symbols and numerals.(I know it looks similar.. but if you check on dyslexia and dysgraphia, reading and writing need different skills. That's why there is time when you can read but you can't write or/and spell it properly)
• Ideognostical dyscalculia, refers to problems in understanding mathematical concepts and relationships.
• Operational dyscalculia, refers to problems in performing arithmetic operations. 

(I have no comment for the last 2 subtypes, since I don't understand the difference either. =P )

Dyscalculia really effects the patients' selves-esteem, since it really hinders them from daily working nowadays. The numbers of job they could do is more likely cut down by half. Isn't it highly discouraging for them? It isn't like they are (pardon me) idiot.. they simply can't understand those numbers... the numbers are just like floating in their head and make them sick.

However, as parents, friends, teachers, and educators, there are some thing that we can do to help them in studying. 

• first of all, BE PATIENT... if you are not patient enough, just move your ass and let other people do the job
• use graph paper, block, figures, and any other physical tools, to help them imagine it easier
• instead of forcing them to memorized the multiplication tables, explain the difference and the logic of the numbers. Like I said, they are not idiot... they do have logic.
• introduce the mathematics skills from the more concrete examples first. 

My last advice, the world is definitely not ended, if we can't solve the difficult mathematical problems. Let the experts do that. What is more important is to encourage people with dyscalculia to concentrate more on their strengths. As long as they can calculate their change while shopping, it's enough for daily life.

 

     

        

The Tale of a Boy in a Coffee Shop #36

"There was one lady near my house, I think around 5 years ago. She was around the same age as my mother, but she looked kinda senile. She just sat on rocking chair at the porch, stared emptily to the garden. Her husband was quite a pity, I think. He worked and also took care of his wife. It were just the two of them. Later, I knew that she lost her newborn baby due to miscarriage. It destroyed her inside out."

The awkward air floated as the young boy let his story half finished. However, the two ladies waited for him patiently, as they felt there was a continuation.

"Around a year later, the husband decided to move back to his wife's parents house. He hoped that her parents could help him to take care of her while he helps them do the farm."

"But I think, if only that lady could let the baby go, and started a new life with her husband, try to get another baby.. they might have another chance of life."

The two ladies kept in silent for two minutes.

"I think you actually know how to let it go. Doesn't he, Granny?" The young lady smiled and went to the kitchen, continued her works.

"Do I?" the young boy looked at the old lady.

The old lady smiled, "There is a saying, Don't regret it because it's over, but be grateful because it happened."

"It's OK to keep the memory, as long as you have the right feeling over the memory, then you know how to deal your lost."

The young boy touched the rim of his glass, circling it with the tip of his index finger several times, "Indeed."      

The Tale of a Boy in a Coffe Shop #35

"Why do you think we have to let them go, Little Boy?" The old lady stroke the young boy's head softly. The deep honey coloured hair was so soft that her fingers could through it smoothly.

The young boy looked at the old lady with his deep blue eyes. He was looking for an answer, why did he have to let go on something. 10 seconds passed, the old lady still waited on him patiently. Indeed, even a short 10-second felt so long in a conversation.

"Because, hem... probably because to let our selves in peace?" The young boy answered uncertainly.

The young lady, who was listening while continue preparing some menus for lunch, stopped her hands and threw her sight to those two. She was interested.

"Why did you say it's for our own peace?" The young lady asked with deep interest in her voice.

"Is it wrong?" The young boy touched the rim of his glass nervously, he didn't expect that his answer would lead to another question on him. It had been a while since he had his last deep conversation.

"Again, it's not about right or wrong, boy. Like I said, you just have a unique logic, and I am interested. Don't take it negatively," the young lady smiled at the young boy tenderly.

"Oh, I see." The young boy exhaled in relieve. "Well, I think when we mourn over something that we lost, we actually torture our selves with grief. The longer we mourn, the longer the torture is. I think it's frustrating to a certain point and definitely unhealthy. That's why I said, if we could let it go, it's for our peace."

What a smart explanation, both the ladies thought, like a telepathy.

BDC #25 - Goldflam disease: Too tired to open your eyes?

Have you ever met somebody how can open their eyelids properly, even if they want and work hard to? Or somebody who can't really control  his/her facial movement? Drooping jaw, shabby talking? Well, that person might be a patient of Goldflam disease.

It is formally called as Myasthenia Gravis (MG). Based on medical dictionary, it is a disorder of neuromuscular transmission marked by fluctuating weakness and fatigue of certain voluntary muscles, including those innervated by brainstem motor nuclei; caused by a marked reduction in the number of acetylcholine receptors in the postsynaptic membrane of the neuromuscular junvction, resulting from an autoimmune mechanism.

OH!! This definition is definitely NOT FUN!! It ends up my whole post in ONE-FULL-CONFUSING-Sentence. SO, I will explain it again, in more sane-shorter-sentences. Let's restart it ^^

Myasthenia Gravis or Goldflam disease is an autoimmune disease on our neural and muscular system (OR neuromuscular system). It is general caused by abnormal antibodies in the body, either blocking or destroying the receptor/receiver of acetylcholine, one of neural signals from our nerves to our muscles. It is practically cutting the communication between our brain with our conscious muscles. It leads to fluctuating muscles weakness and heavy fatigue, and in a progressive phase losing the control over the conscious muscles. Normally, our unconscious muscles like heart or digestive track (except the throat, since we swallow food 'consciously') will be spared. Means, the patient's heart might keep beating thought the patient cannot move his/her body properly anymore. 

The early symptoms can be listed as:

• Heavy fatigue on patient
• Progressive weakening of muscles during periods of activity
• Eye muscles - including ptosis (drooping of one or both eyelids), diplopia (double vision) and blurred vision.
• Facial muscles - involve the weakening of face and throat muscles, leads to:
• Dysarthria - difficulty in speaking, depends on which muscles are effected; speech may become soft or nasal
• dysphagia - difficulty in swallowing
• difficulty in chewing 
• difficulty in controlling facial expression
•  Weakening of limbs mucles   

There are some classifications for MG, but the most widely used is the one by Myasthenia Gravis Foundation of America Clinical Classification, which are:

• Class I: Any eye muscle weakness, possible ptosis, no oter evidence of muscles weakness .. yet
• Class II: Any severity of eye muscles weakness, with mild weakness of other mucles
• Class IIa: predominantly on limbs muscles 
• Class IIb: predominantly on respiratory muscles
• Class III: Any severity of eye muscles weakness, with moderate weakness of other muscles
• Class IIIa: predominantly on limbs muscles 
• Class IIIb: predominantly on respiratory muscles
• Class IV: Any severity of eye muscles weakness, with severe weakness of other muscles
• Class IVa: predominantly on limbs muscles 
• Class IVb: predominantly on respiratory muscles
• Class V: intubation on the throat needed for airway 

Up to now, there is no specific cure for MG. Luckily, most of the treatments are very effective in controlling or delaying the symptoms. The currently available treatments are:

• Cholinesterase inhibitors: helps the muscles to contract properly and maintain good strength. It is effective for mild symptoms, though some side effects like nausea or stomach cramps might occur.
• Steroids or Immunosuppressants: may alter the body's immune system and lower the production of antibodies that cause the MG.
• Removal of the thymus gland. About 15% of MG patients have a tumor in their thymus gland - thus the surgery might be needed. However, it is unclear whether the risks of removing the thymus gland could outweigh the benefits for MG patients.  
• Plasmaphoresis: is a procedure of depleting the body of blood plasma without depleting the body of its blood cells. To put it short, the blood is taken put of the patient, the abnormal antibodies are removed, and the blood is placed back to the patient. OK...It DOES sound scary!!!
• Intravenous immunoglobin therapy: is a procedure of injecting normal antibodies that alter the way the of the immune system. However, the last 2 treatments only give short effect lasted only weeks for the patient. 

In the end...be grateful of your full control over your body !!! ^^

   

BDC #24 - Ondine's Curse: When the Goddess takes you away in your sleep

To get sleepy and falling a sleep is one of very natural things for animals and human. BUT, if the doctor said you will die when you fall a sleep, how would you react?

There is this one curse, The Ondine's Curse. The name was taken from a French folk tale written by Friedrich de la Motte Fouque (though some others say that it's actually a German folklore, I'm not sure). Here is the synopsis from this link

「Ondine was breathtakingly beautiful and possessed of a streak of independence, truly what we call a 'free spirit'.

Like all nymphs and mermaids, she was leery of men. If a nymph ever falls in love with a man and bears his child, she will begin to age like a mortal woman, losing her eternal youthfulness and everlasting life. 

Nonetheless, when Ondine saw the handsome young Palemon she was smitten and began to watch for him on his daily walks. When Palemon noticed her, he was taken by her incredible beauty and came back frequently to try to get a glimpse of her again.  

Eventually they talked and fell in love. He broke his engagement with the young noblewoman Berta and, in time, convinced Ondine to marry him. When they exchanged their wedding oaths, Palemon vowed that "My every waking breath shall be my pledge of love and faithfulness to you."

But it was not to be.

The following year Ondine gave birth to their son. From that moment on, her beauty began to fade, her body suddenly susceptible to the effects of age. As her youthful attractiveness gave way to a more mature beauty, Palemon's eye began to wander to the younger women he met at court.

One fateful day Ondine was out walking on their estate when she heard the sound of Palemon's familiar snoring. Planning to take him back home so he could finish his nap, the amused Ondine entered the stables to wake him.

The scene she encountered filled her with great sorrow. Discarded garments littered the floor and her beloved Palemon lay sleeping in the haystack, his arms wrapped around his former fianceé Berta. Having sacrificed her immortality for this man, she was filled with anger and regret.

Kicking her sleeping husband, she woke him and uttered her curse. "You pledged faithfulness to me with your every waking breath and I accepted that pledge. So be it. For as long as you are awake, you shall breathe. But should you ever fall into sleep, that breath will desert you."

Ondine still retained some of her magic . . . enough to make the curse come true. And so it was. Palemon would never sleep again.」

The lesson of the story is...NEVER EVER break your vow from a woman..!!!

NO!! That's not what I would like to discuss today. Well, it's related though. In this post, Ondine's curse is the popular name of Congenital Central Hypoventilation Syndrome (CCHS) or also called Primary Alveolar Hypoventilation.

CCHS is a respiratory disorder due to neurological trauma in the brain or spinal cord. Practically, people who suffer CCHS could lead a normal life..while awake. BUT, once they fall a sleep, they will usually hypoventilate or suffer for apnea. In short, they will have a difficulty do external breathing. So.. YES, they will die because out of breath while sleeping. Scary isn't it?!

 From the deeper studies by some researchers, they found that one of the reason of this disorder (actually around 92% of the cases) is the mutation on one of the homeobox gene which is important in the development of automatic nervous system. Since while we awake we could consciously take our breath, but once we sleep, the automatic nervous system will take over the job and unconsciously help us breath. 

Up to now, there is no medical treatment available to cure this disease. Patients usually need tracheotomies, where they put a certain tube into the trachea to open a direct airway, and a lifetime mechanical ventilator system. Although, lately there is a ventilator system named Biphasis Cuirass Ventilation which doesn't require a tracheatomy. However, these ventilators rise problems like fatal infections and pneumonia. Most children suffering CCHS couldn't survive infancy, unless they receive the ventilatory system while sleeping.

So, be grateful for every breath you could take, consciously and unconsciously.

  

 

The Tale of a Boy in a coffee Shop #34

The young lady kept silent awkwardly. She couldn't really answer the question. She was definitely not an expert in this area of conversation. Ow, Granny.. come here quick. She screamed at heart. The young boy kept on his eyes to the young lady as she poured another serving of cold water to her own glass. It was a boiling hot day. 

The sound of chime jingled as the door was pushed finally broke the awkwardness between them two.

"Hello, I am sorry I am late. The procession was quite long. Besides, we chatted a little, since it has been a very long time for us to meet each other." The old lady came in, spoke in a less excited tone than usual.

"Was it a good conversation?" The young boy came closer as he took the big bag over the old lady hand.

"Oh, thank you little boy. Well, it was awkward actually, since instead of a happy occasion, we met at the cemetery. There was definitely nothing joyful to talk about."

The old lady walked to the bar, gave a code to the young lady for a glass of water, and sat heavily on the chair.

"But..."

"But?" The young boy put the bag beside him, between him and the old lady, as he sat on the another chair. He was curious over the hanging word.

"But, as we spoke, slowly the old memories filled our conversation. We recalled all the good, funny, even sad memories amongst us. Then, we didn't feel that bad anymore over our dear friend's death."

"Is that how we let them go?"

"How to let them go?" The old lady was interested with the young boy's words. She took a look to her grand-niece.

The young lady moved her lips without any voices. He asked me about how we let go our dearest one, she said.  

"Ah... I see," the old lady smiled and rubbed the young boy's head dearly.

Yet, the sun crept high in the sky, leaving its heat in that summer air.

BDC #23 - BIID: When you feel that your limb is NOT yours

For most of the people, losing one of your body part is one of the least desirable thing to happen. But do you know; for a small percentage of world's population, losing one or more of their super healthy limbs is something that supposed to be done? OK...I know, it is a super scary thought. Unfortunately, for people suffering BIID, having those limbs is one of the biggest tortures in their life, since those limbs are 'NOT theirs'.

OK...I see some of you start to furrow your eyebrows. 

BIID is an abbreviation of Body Integrity Identity Disorder. It is also referred as Amputee Identity Disorder, is a psychological disorder where they think that they will be happier as an amputee (a patient of body amputation). As mentioned before, mostly the sufferers believe that those body parts are 'extras' and not theirs, thus it will be better to be 'removed' from them. They feel as a whole being after losing those extras.

Woops, don't puke... I know it's unimaginable. 

Unfortunately lately, the experts found that the BIID patients are not limited only to the desire of removing their limbs. The experts said that basically, BIID patients need the feeling of paraplegic, or the feeling as a disable. It doesn't necessarily have to be amputated, but at least the limbs are not moving and they don't feel it anymore. Being paralyze over their bod parts is good enough. Thus, the definition is not limited to limb anymore, but also being deaf or blind. 

Fortunately due to the ethical reason, people with BIID can't just recklessly forced some surgeon to amputate their body part. Though as the result, some of them try to harm their selves by amputating their own selves, or try to do any other harm; like purposely make them selves fall into accident. To reduce these conscious-accident-cases, some therapies offer to treat BIID patients as disables; such as giving them wheelchair, bandage the arms, etc.     

BIID was firstly recognized from a note of sexologist in 1977, writing about two men who experienced intense sexual arousal when imagined becoming amputees. This phenomenon is called apothemnophilia. It is said as result of combination of neural disease and psychological disorder. 

Up to now, there is no specific cause has been revealed as the cause of BIID. Theories have rose creating countless debates within the medical experts. Some theories say that this disorder is developed during childhood and present as a result of traumatic child experiences. Various theories have been formulated as children seeing that becoming an amputee disabled might earn them more attention and love by their closed ones. The other thing that is widely recognized is that this is a mental disorder due to abnormalities of neuro-psychological condition on the right side of the brain. The brain's inner body mapping function does not incorporate the certain body part in its understanding of the body's physical form, thus the brain exclude that body part in the conscious part of the brain.

In the end, this super puzzling condition remains as one of the mysteries to medical science, and a lot more researches are required to discern its true causes, how the disorder is triggered; and if possible, how to treat it without following their desire.

If you are interested to read more true stories from the BIID sufferes, maybe you can check this forum.

   

 

BDC #22 - The Mediterranean Diet: A Legacy from Ancient Wisdom

As I realized the number of the readers increase by double when I talked about body and diet instead of history, I try to take one of my junior's advice to write a mixture of diet and history. I hope I could write it well. 

Some of you might understand the Mediterranean diet a lot better than me. Thus, pardon my poor knowledge in this diet and feel free to discuss it.

The current Mediterranean diet is a modern nutritional recommendation inspired by the traditional dietary patterns of southern Italy, Crete of Greece, and Spain. This diet is basically consist of high portion of olive oil, legumes, unrefined cereals, fruits, and vegetables; along with moderate to high consumption of fish, moderate consumption of dairy products (mostly in form of cheese and yogurt), moderate wine consumption, and low consumption of meat and meat products. The pyramid below could explain it better.

Though the name is Mediterranean Diet, this eating habit was firstly named by an exile from Modena, Italy, named Giacomo Castelvetro. He was saved by the British Ambassador from the inquisition in Venice and brought to England. After living in his saviour country for 3 years, he was horrified by the British eating habit; a high amount of red  meat and sweets (yeah..no wonder my friend in UK once said that Adele's size is considerably medium size...sorry fellow Britain people..no hard feelings). He tried to persuade the England people to eat more fruit and vegetables as he always enjoyed in his home country. This effort led to the release of his book in 1614, the first `bible` of Mediterranean Diet: "A Brief Account of Fruit, Herbs, and Vegetables of Italy". This book doesn't only contain delightful recipes, but also lots of gardening tips; all organized by the seasons. If you want to try it, there is a newer translation by Gillian Riley in 1989. 

Hundreds of years later, the Mediterranean still faces the struggle to be adapted in England diet. In fact, the England diet history is filled with lots of transformers. Health professionals are still facing resistance from patients unwilling to change their diet, mostly due to cultural and psychological needs. 

This struggle also happens in USA, the country with high historical legacy from England. As the so called junk foods destroying the national health, the nutritionists desperately trying to change the view of food of the Americans. They even dare to  conduct a long-term study of the 400,000 men and women participating in the U.S. National Institutes of Health–AARP Diet and Health Study. It was found that participants with eating patterns most closely matched to the Mediterranean diet were about 20% less likely to have died of heart disease, cancer, or any cause over a five-year follow-up period.This result was highly convincing to the nutritionists to force the Americans to change their junky eating habit with a better one. But, to be honest... I don't think the efforts can be said 100% successful, though the numbers of health-conscious people are definitely increasing.

The most wonderful thing of this way of life (as so you know; diet comes from Greece diaeta, means way of life) is that..... It's been acknowledge by UNESCO as one of World's Intangible Cultural Heritage on November 19th, 2010. As the UNESCO announced: "The Mediterranean diet (encompasses more than just food. It promotes social interaction, since communal meals are the cornerstone of social customs and festive events. It has given rise to a considerable body of knowledge, songs, maxims, tales and legends."

So, will you follow the legacy?

BDC #21 - Kizhi Pogost: A World Heritage surrounded in magnificence

My desire to travel around the world is not fulfilled yet, but I still can increase my knowledge by not-stop digging. Since the internet turns into one big encyclopedia, we would never running out topics. In this post, I would like to introduce to you guys, one of the most stunning world heritage that I've put in my must-visit-checklists. 

Kizhi Pogost (Кижский Погост), is a historical site announced as one of the world heritage by UNESCO in 1990. It's located in Kizhi Island, one of islands in the Lake Onega, Republic of Karelia, Russian Federation. 

If you are curious enough, here I gave you guys some pictures of the beautiful heritage.  

(I don't own any of these pictures)

 

 

As you can see, this is a beautiful ortodox church. This church was built around the 16th century and said was rebuilt on the same site after destroyed by a lightning in 1693. The highly remarkable thing is that this building has been standing for over 300 years aside the fact it's completely made out of wood, include all the nails and joining. WOOD!!!!! Can you believe it??!!

Basically, there are two main buildings of this church complex; The Church of Transfiguration (Церковь Преображения Господня) and The Church of Intercession (Покровская церковь).

The Church of Transfiguration, also called the Summer Church, is might be the famous part of this church. It's not heated, means it will be super freezing cold during Artic winter, thus it doesn't held any service during winter. That's how it got its Summer Church title. The church has 22 domes and with a height of 37 meters is one of the tallest wooden buildings of the Russian North. Its perimeter is 20×29 meters. All structures were made of scribe-fitted horizontal logs, with interlocking corner joinery — either round notch or dovetail — cut by axes. The basis of the structure is the octahedral frame with four two-stage side attachments. Two smaller octagons of similar shape are mounted on top of the main octagon. The structure is covered in 22 domes of different size and shape, which run from the top to the sides. The refectory is covered with a three-slope roof. The iconostasis has four levels (четырёхъярусный) and contains 102 icons. It is dated to the second half of the 18th – early 19th century. The icons are from three periods: the two oldest icons, "The Transfiguration" ( Преображение) and "Pokrov" (Покров) are from the late 17th century and are typical of the northern style. The central icons are from the second half of the 18th century and are also of the local style. Most icons of the three upper tiers are of the late 18th century, brought from various parts of Russia.

   

Inner part of the Church of Transfiguration

The Church of the Intercession is a heated, thus we get our winter church. Services are held from October 1 until Easter. The church was the first on the island after the lightning put it on fire in 1693 destroyed all previous churches. It was first built in 1694 as a single-dome structure, then reconstructed in 1720–1749 and in 1764 rebuilt into its present 9-dome design as an architectural echo of the main Transfiguration Church. It's still a smaller and simpler structure, compare to the Summer Church. It stands 32 meters tall with a 26×8 meter perimeter. There are nine domes, one larger in the center, surrounded by eight smaller ones. Decoration is scant. A high single-part porch leads into the four interior parts of the church. As in the Transfiguration Church, the altar is placed in the eastern part shaped as a pentagon. The original iconostasis was replaced at the end of the 19th century and is lost; it was rebuilt in the 1950s to the original style.

Now, do you desire to see the world more?