Let’s start with a brief note on the evolution of the backbone, not in the very beginning, but at the level of the primates. When primates walked on all fours the spine was horizontal (as in dogs, horses, monkeys etc). The spine supported the weight of the various internal organs while the forelegs supported much of the weight of the body. The weight of the internal organs and the actual weight of the spine were supported by the back muscles.Now this is important. Animals struck with a tranquillising dart collapse within minutes as the muscles of the legs and the spine collapse. Although the spine consists of tightly bound vertebrae, which give it great strength, on its own, without the muscles, it is not able to support internal organs (lungs, heart, liver, intestines, etc). Thus the spinal muscles attached to the various parts of the vertebral column of primates had to create a horizontal force that would keep the spine in that position. These muscles acted like steel wires or ropes and just as the weight of the washing is supported by a clothes line, so the weight of the visceral organs is supported by spinal muscles.Let us look at some of the functions of the spine in general and see how the structure of the spine caters to these functions.Human beings walk erect (since Homo Erectus in the evolutionary chain) and, therefore, the vertebrae of the spine become larger in the lower part to facilitate that. Just like the Eiffel Tower or a bamboo stem, which is thin at the top and becomes progressively thicker towards the base, the spinal vertebrae too become increasingly larger at the base of the spine so that the extra weight can be carried.*60\330\8*



Some people express anger directly and openly, usually in private, though Dean has cried in church. “Tremendous anger wells up in me,” Dean says. “I cry during hymns, reading those words. At home alone, I lose my temper, bang doors, throw things, yell. It’s important to me to release my anger, but I try to be careful not to hurt anything.” Steven uses almost identical words: “I feel anger building up on a weekly basis. I want to run up and down the road and cry. When I’m really angry, I beat on the bed with a piece of hose, which is noisy and very satisfying.       Or I go in the bedroom and jump up and down and yell.”     Other people express anger more obliquely. “I’d cry every morning and night in the car on the way to and from work,” said Helen. “Sometimes I’d have to pull over to the side. And I went through a period where I snapped at my customers in the post office. When they asked why, I’d say, ‘Oh, the stupid Xerox machine won’t work.’ ” In fact, people generally express anger not at the true causes, at unfairness or at loss of control. Instead, like Helen and the Xerox machine, they get angriest at little things: “My husband expressed a lot of anger about things so small, they were all out of proportion to what he was angry about,” said Lisa. “I’d fix him oatmeal, and it was not what he’d wanted, or it wasn’t hot enough.”     People also get angry at whatever is nearest. Sometimes, like Lisa’s husband, they get angry at their caregivers. Some people turn their anger toward the medical system. They say that government medical assistance requires that you first become impoverished before you can get help, and that you fill out an amount of paperwork equaled only by the IRS. They say that hospital clinics make you wait for hours, that the clinic doctor you felt you had rapport with last time has been replaced by someone else, and that the clinic clerks are rude. The drugs have unpleasant side effects, tests are painful and invasive, and so are the procedures. Hospitals do not allow a sense of control and privacy. Doctors seem impersonal and inattentive, nurses too slow. The rooms are too hot or too cold. And, Steven said to his doctor angrily, “Why are they taking so long to find a cure?”     Some people, like Alan Madison, say they are not particularly angry. They are uncomfortable with expressing an emotion which is, after all, overwhelming. They worry that giving in to anger means losing face or losing self-control. Their anger at unfairness and loss of control, however, often has not disappeared. Instead of getting angry at co-workers or the medical system, these people turn their anger on themselves. They feel depressed or guilty or they dislike themselves: Alan felt hopeless and stopped seeing his friends. Some eat too much: Lisa gained twenty pounds after her husband’s diagnosis. Others rely too heavily on alcohol or drugs. Some continue the behavior that put them at risk for the infection in the first place: for a while, though she denied doing it, Helen went back to injecting drugs intravenously. In general, when people are depressed, they quit taking care of themselves.
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RemicadeRemicade (infliximab) also inhibits the actions of TNF, though it does it differently. This drug is really an antibody against the TNE It is made from both mouse and human protein. It is also called a monoclonal antibody because it is made from only one cell source.Remicade is given intravenously by a doctor or a nurse.The side effects are pretty similar to those experienced with Enbrel, but, in addition, your body can produce antibodies against the drug.You usually have to take another immunosuppressant like methotrexate to prevent the development of new antibodies.
Cortisone Cortisone is a steroid used for the treatment of rheumatoid arthritis, but it should be used sparingly, since patients may become dependent on it.One of the great physicians of the past, Dr. Philip Hench, noted that cortisone was a “cure” for RA back in the 1940s. In fact, it was so good that everyone with RA started to take the drug -until its side effects became apparent.Cortisone will normalize the findings on X-rays. When the drug is stopped or decreased, however, there is the so-called rebound phenomenon, and the patient actually gets worse.This drug is given to treat the most severe forms of the disease, as when vasculitis or fluid around the heart with inflammation of the coverings of the heart is present. Occasionally, it is given to quell the severe pain and inflammation of a very hot joint. *38/141/5*