Skip to content
pharmacy canada;citalopram 40mg;lasix no prescription;clonidine

SPINAL CORD INJURY: HOUSING

Comments Off
by admin

The major part of our lives is spent at home, whether in a duplex with five children or a bachelor apartment in a big-city high rise. We carry on the essential activities of living – eating, sleeping, relaxing, dressing, being with friends and family, having intimate relationships, disciplining the children, paying the bills – in this space that is uniquely ours. Selecting and arranging our home has a major effect on our lives.Different types of housing meet our needs during the different seasons of our lives. Homes come in a variety of sizes, styles, locations, and prices: single-family homes, apartments, condominiums, multiple-family dwellings, rented rooms. Sometimes home is a room in a nursing home.If you have a disability, “home” takes on new dimensions. It may feel like prison or like liberation: imprisoning when it limits or constricts your movement or ability to come and go; liberating when it allows you free range of movement and the opportunity to get out into the world. Where once steps went unnoticed, they now become major obstacles. Doors that are too heavy or too narrow to let you pass become entrapments. You begin to look at your needs in an entirely new light.In addition to accessibility, your choice of living site will be based on your financial resources, the amount and type of physical assistance and accessibility you need, geographic location, and personal preferences.
*131/156/5*

CHARACTERISTICS OF BDD IN CHILDREN AND ADOLESCENTS

Comments Off
by admin

Even though BDD usually develops during adolescence, there’s very little published research on BDD in adolescents or children. Nonetheless, what we do know suggests that BDD’s characteristics in this age group are very similar to those in adults. Like adults, children and adolescents have prominent, distressing, time-consuming preoccupations that can focus on any body area but often involve the face. Insight is often poor. A majority think that other people take special notice of them in a negative way because of how they look—staring at them, talking about them, or laughing at them. Most perform compulsive behaviors, such as mirror checking. BDD symptoms cause problems with functioning, which can range from mild to extremely severe. This may include poor grades, stopping sports and other activities, and withdrawing from family and friends. In more severe cases, children and adolescents with BDD drop out of school, become housebound, require psychiatric hospitalization, and may even attempt suicide.The following table summarizes some of BDD’s characteristics in 47 systematically assessed children and adolescents. As this table illustrates, BDD in children and adolescents consists of painful and time-consuming preoccupations and compulsive behaviors that cause significant distress and impairment in functioning. Social impairment is nearly universal and often consists of extreme self-consciousness, embarrassment, and avoidance of social interactions. A majority have problems with school, and some even drop out. Of great concern, a very high percentage think about, or attempt, suicide.BDD in children and adolescents appears generally similar to BDD in adults. One apparent difference, however, is that most of the children and adolescents I’ve seen were female. This may reflect boys’ greater reluctance to seek help for appearance concerns, rather than a true difference in how common BDD is in boys versus girls. In the previously mentioned inpatient study in which all hospitalized adolescents were assessed, half were male and half were female. In a recent study, I also found that adolescents had poorer insight than adults and were more likely to have attempted suicide.*154\204\8*

REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: SMOKING- WHY IS SMOKING HARMFUL? WHAT CAN IT CAUSE?

Comments Off
by admin

Smoking may cause ischemia (lack of oxygen and blood flow to the heart muscle) by transiently decreasing the diameter of the coronary arteries. When arteries that are already narrowed by atherosclerotic deposits become narrowed even further, blood flow to the heart muscle may be reduced enough to cause angina or a heart attack. When smokers with angina exert themselves, they get chest pain sooner than they would otherwise, because smoking reduces the amount of oxygen to the heart and also makes the heart beat faster. So, ironically, the heart’s demand for oxygen increases and the supply of oxygen decreases. Smoking blocks the increased blood flow that normally occurs with exercise and reduces the effectiveness of some anti-anginal drugs. Even in the absence of symptoms, studies have shown that there is evidence of myocardial ischemia during smoking. In some cases, smoking can cause coronary arteries without atherosclerosis to go into spasm and narrow enough to cut off blood flow to the heart muscle.The heart and coronary arteries are not the only cardiovascular targets of smoking damage. Smoking is a major risk factor for peripheral vascular disease (atherosclerotic narrowing of the blood vessels that carry blood to your arm and leg muscles). The consequences may range from the exertion-related pain of claudication (see page 98) to the actual destruction of skin or muscle tissue supplied by blocked arteries. When severe, this condition may require operation or amputation. Women who smoke and take birth control pills place themselves at higher risk for another serious vascular problem—stroke.Smoking is the main cause of chronic lung diseases such as chronic bronchitis and emphysema, which put an additional strain on the heart.*230\252\8*

ANATOMY AND PHYSIOLOGY OF THE BACKBONE: AXIAL SKELETON

Comments Off
by admin

Bone first appeared in the evolutionary chain more than 500 million years ago in primitive fish and became very common in many different groups of animals within about 100 million years. This was bone that provided mineral reserves, and protected these animals from predators by providing protective armour plating. The internal skeleton of these fish was composed of cartilage. During evolution this cartilage (soft bones) was replaced by bones.Axial SkeletonThe human skeletal system is classified into the axial and appendicular divisions. The axial skeleton consists of bones of the skull, the vertebral column, the ribs and the sternum (breastbone). It is called axial because it forms the axis around which the main torso of the body is built. There are 80 bones in the axial skeleton and together they form roughly 40 per cent of all bones in the body.The function of the axial skeleton is to create a framework that supports and protects \the various internal  organs (brain, heart, lungs etc) and provides extensive surface area for attachment of muscles that: 1support the head2adjust the body’s posture and position of the head, neck and trunk3move the spine4perform respiratory movement5stabilise or position structures of the appendicular skeleton (hip bone, bones of arms and legs, collarbone etc).The joints of the axial skeleton are bound together by very powerful ligaments. This heavy reinforcement permits only limited movements of the axial skeleton. This is essential because a flexible central axis would not be able to keep the body’s posture erect nor to support the weight of the various internal organs. The axial skeleton has to be strong and rigid or else it would be useless. Its strength lies in its inflexibility. The fact that bones are as strong as reinforced concrete and yet so light makes the axial skeleton function very effectively – it is light but extremely strong.The main component of the axial skeleton is the vertebral column or the backbone, as we commonly call it. This is the main support system for the torso and the head. Without this the body would never be able to stand erect and support its weight. It has, therefore, to be as strong as steel and yet be flexible when necessary. So it is another piece of brilliant engineering work by Nature or the Creator. It is therefore important to understand the functions of the spinal column first, and the structures that have developed to facilitate or carry out these functions. *59\330\8*

IBS AND THE NERVOUS SYSTEM: UNDERSTANDING THE SYMPATHETIC NERVOUS SYSTEM – WHAT HAPPENS WHEN THE DANGER IS OVER?

Comments Off
by admin

When you escape from the bull and are sitting in the farmhouse having a cup of tea, all you need to do to switch off the extra adrenalin that is still making your pulse race is to relax your tight muscles. This releases chemicals which turn off the supply of adrenalin. This is the parasympathetic nervous system working efficiently; the blood pressure drops, the heart rate and breathing slow down, you stop sweating, the blood comes back into your abdomen from your arms and legs – you realize you are hungry. You are also conscious that you need the lavatory. You feel relaxed; your muscles are comfortable. So then your adrenalin/anxiety levels are low.It is easy to see from this example why the nerves get exhausted. Repeated stresses, conscious and unconscious (even small ones), keep us in a state of red alert all the time. It’s like someone continually running away from a non-existent bull; they want to slow down but they can’t. Their adrenalin (and therefore anxiety) levels are still too high. Have you ever been so wound up that you carried on working long after you need to even though you were exhausted?*60\326\8*

THE CANDIDA-ASTHMA CONNECTION: RESULTS OF ANTI-CANDIDA TREATMENT

Comments Off
by admin

When Candida infections or allergies are successfully treated, most, if not all the respiratory symptoms decrease in both frequency and severity. People reduce or stop using inhalers and they experience renewed energy levels.The diet, regimen and life-style changes prescribed for the treatment of candidiasis and asthma are health-enhancing for all members of the family.The diagnostic work-up for candidiasis often shows up immunological abnormalities that help the physician undertake a number of preventive measures.The successful treatment of candidiasis will remove a potentially disruptive load on the body’s defence mechanisms and this will make any other treatment for any other illness more successful.Because Candida infections can spread easily, controlling them will minimise potentially dangerous problems for close friends and relatives.Because it is quite possible to have a Candida infection without a Candida allergy, and vice versa, the differential diagnosis exercise will often unmask other, pre-existing conditions.Because Candida infections always require the concurrent treatment of one’s sexual partner and usually of any small children in the household, the potential for mould-allergy-related asthma is greatly reduced in the whole family.Careful monitoring of respiratory functions (spirometry) before, during and after anti-candida treatment will allow the patient to reduce or stop using inhalers (puffers) with relative safety.To successfully treat candida-related illnesses one must carry out a number of important steps:Differential diagnosis between Candida and/or related fungi-allergy or hypersensitivity and Candida infections. This is essential for asthmatics, since anyone with a mould-fungi-yeast-candida allergy may get much worse when starting almost any anti-fungal treatment and could experience a severe asthma attack when first taking medications;An assessment of the virulence, proliferation and immune-engaging capabilities of Candida albicans either via antibody stimulation or allergy-spreading phenomena.A trial of chosen therapeutic measure(s) such as antifungals and diet, and a quantifiable measurement of their efficacy. (It is difficult to diagnose candidiasis with absolute certainty from symptoms alone, because many other illnesses present the same or a similar cluster of symptoms.)Abnormally high levels of anti-candida antibodies, Candida antigens and immune complexes are diagnostic. When the test results are positive and symptoms and signs are present, treatment is justified.Although we all use the term ‘systemic candidiasis’, it is actually a misnomer, since only the symptoms are systemic. The yeast infection is not, because it occurs predominantly in the mouth, throat, digestive tract and urogenital areas.Vaginal, stool and other cultures are not reliable diagnostic measures.Candida infections can spread easily. Studies have found toothbrushes, dentures, fabrics, juices and soups among the common sources of Candida cross-infections. Candida infections can be the cause of many, often seemingly unrelated, health problems ranging from allergies, asthma, latent viral re-activation, mood swings and premenstrual syndrome, to arthritis and heart disease. On the other hand, Candida can be a symptom of all these, as well as of many other, sometimes more serious, underlying conditions. In such cases treatment directed solely at Candida will be unsuccessful or will allow the infection to recur. In the meanwhile, the underlying cause of one’s health problem may go undetected and untreated. It is therefore essential that such differential diagnosis be made thoroughly before or as soon as possible after commencing any therapy.Treatments for each of the above possibilities may differ and treatment of an infection will be less likely to succeed if there is also a concurrent allergy or if a sensitivity to Candida is the problem, rather than the infection. The reverse is also true. In fact, the so-called ‘die-off’ reaction, once believed to be caused only by toxins released by the dying Candida organism, is often a result of the patient’s being allergic to Candida and /or allied moulds/fungi. It seems that the die-off reaction often indicates fungi/ mould allergies.Contrary to a general belief, there are some useful tests for the condition and its many manifestations. While no single test is absolutely accurate in every case, it is possible to determine whether someone is infected by or allergic to Candida albicans or some of its fungal family. It is possible to detect if there is an underlying immunological problem or not and it is possible to monitor the success and progress of any chosen treatment.If you suspect that you have Candida, either because of the symptoms or as a result of a Candida questionnaire, it is essential to undergo a thorough physical examination, a Candida antibodies blood test and other tests to determine if you are suffering from viral, immunological or other underlying conditions. This is not only because the tests may confirm the problem, but also because the interpretation of Candida, immunological and viral tests can alert your doctor to the possible presence of other underlying problems.Candida can cause infections as well as allergies. It can cause allergies by altering the immune system and problems by the release of toxins, both at the same time. Such a situation can result in a variety of symptoms which involve organs and glands anywhere in the body, even those remote from the areas infected by the organism. It can be associated with foods, chemicals or environmental allergies, intolerances or sensitivities, as well as dysfunctions of many glands and therefore hormone and enzyme systems. It can also cause heart problems.*53\145\2*

BACH FLOWER REMEDIES: CHESTNUT BUD – HARMEET’S CASE

Comments Off
by admin

Harmeet, aged 5, was taken to a swimming pool to learn swimming. Before the instructor came to him, he suddenly jumped into the tank on a sudden impulse. He was saved from drowning by the instructor, but he could not be made to learn swimming afterwards. At school he was inattentive, made the same spelling mistakes again and again and several times missed his evening tuition class on one pretext or other – to escape studying. The 1st quarterly examination showed 6 out of 50 marks.He was given a combination of Cherry Plum (for his impulsive temperament) and Chestnut Bud for his slow learning and escapist mentality.After taking the above combination regularly 3 times a day, he was a changed person after 2 months. His next quarterly examination showed 24 out of 50 marks. It was no longer necessary to goad him to study against his will. He had already started taking interest in his studies*81\308\8*

DEALING WITH UNPREDICTABLE PERIODS: I HAVEN’T HAD MY PERIOD FOR THREE YEARS; COULD I GET PREGNANT?

Comments Off
by admin

I haven’t had a period in three years. At first I was worried, but my doctor told me that he could give me hormone shots and it would start again. I decided not to take the shots because I saw no reason to bring on menstruation unless I wanted to get pregnant. Since I am not married, I do not want to have a baby. But I’m beginning to get a little nervous because I’ve recently met a man and started to have sex regularly. I haven’t used any contraception because I’ve always thought I was probably infertile without the shots. Lately, though, I’ve been thinking that maybe I can get pregnant anyway. Do I need contraception?—A.V.Durham, North CarolinaA woman who has experienced her menstrual period at one time, but not recently, has female organs that have stopped functioning for some reason. Perhaps this woman was stressed, or maybe she lost or gained weight dramatically. Any of these situations may have caused her menstrual pattern to change. Sometimes a subtle shift in a woman’s lifestyle goes unnoticed, but it alters her hormonal balance. Then if another shift occurs, her period may unexpectedly return.Women who have become involved in romances and fallen in love have been known to have spontaneous ovulations. A wonderful relationship can certainly start the body functioning, and many women who have not had menstrual periods for years were amazed when they learned they were pregnant. Since Ms. V. certainly does not want to incur an unwanted pregnancy, I would suggest that she consult her doctor for a contraceptive that would be right for her.On the other hand, a woman who has no periods and wants to become pregnant should make an appointment with an infertility specialist for an evaluation. If there is no problem other than amenorrhea, he can prescribe a fertility drug to induce menstruation. In fact, one new fertility drug, Parlodel (bromocriptine mesylate), is being used with much success on women who have amenorrhea in combination with a condition called galactorrhea, which is a leakage of breast milk from their nipples.Galactorrhea occurs when too much of the brain hormone prolactin is being produced by the pituitary gland. The result is a nipple discharge that may vary from barely noticeable—only occurring when the breast is pressed or squeezed—to an obvious leak. Therefore, if a woman who has missed several periods also notices that she has a milky discharge from her nipples, she should see her doctor for blood tests to determine whether she is living with an excess of prolactin. If a prolactin imbalance is her problem, Parlodel will block the production of this hormone, stop her milk secretion, and reinstate her menstruation, and then she could become fertile.*44\333\2*

ROUTINE ODDS AND ENDS: ORDERLY FASHIONORDERLY FASHION

Comments Off
by admin

First you cleanse, then you tone – you’d be surprised at how many people still get that wrong!But seriously, the order of products is determined by how many, and what types, of product comprise your routine. For example, I often advise my patients to use a vitamin A product, like prescription retinoids or over-the-counter retinols, only at night. These powerful ingredients tend to make the skin extra sensitive to light and can leave your skin terribly burned if not properly protected. Also, the sun can decrease the ingredients’ efficacy.Protective antioxidants, such as green tea, grape seed extracts and vitamin C are ideal for daytime use. If a bleaching product is a part of your routine, you can safely add it on lop. Top it all off with a moisturiser, if necessary.If your routine incorporates several active ingredients, it’s best not to use them simultaneously. Some skin care brands emphasise the combination of actives like glycolic and salicylic acids, for example, within the same product. This, however, isn’t a beneficial attribute, since they need to work more efficiently at different concentrations and their combined appearance in a single product might cause them to inactivate each other.*37\82\8*

HIV INFECTION AND ITS EFFECTS ON INTERPERSONAL RELATIONS: SYMPATHY AND WORRY-RESOLVING THE CONFLICT

Comments Off
by admin

Balancing sympathy and intrusion is difficult. For people dealing with HIV infection, sympathy, both as a blessing and a burden, is as much a fact of life as the infection is. At times, people make each other feel comforted and reassured. Other times, people’s feelings are so overwhelming that they need to protect themselves from the pain, and just cannot help another person. When this happens, the person with HIV infection and the caregiver might want to take a break from each other. They might find other, temporary supports. Family members, friends, nurses, mental health professionals, support groups, buddies, home health aides, clergy—all can take some of the heat off, give both people some time out.     Caregivers especially need to take breaks. They often feel guilty about this, but breaks are essential to good caregiving. Without breaks, caregivers start burning out. June, who had expected herself to do everything, even carry her son down three flights of steps, said, “But I can’t do everything. I need to enlist people. I have a friend who’s a nurse. She can help my son some afternoons—she’ll give me a breath of air.”     Resolving the conflicts among people affected by HIV infection is a matter of managing these difficult facts of life, of balancing the blessings against the burden. No one resolution of the conflict will last forever. Nor will a single solution apply to all problems. Instead, people solve different problems, some small, some large, one after another. Those who do this best have learned to focus on the blessings and to negotiate the burdens. They appreciate the virtues in the relationship. They are willing to acknowledge another person’s needs and to be flexible about their own. They are willing to lose something less important in order to gain something more important.     People who solve problems well often negotiate by talking. They acknowledge the other person’s point of view, then state their own. Alan could say to his partner, “I know you’re worried that I’m dying. I’m not dying. I’m just tired and have come home early. I know you love me and you’re always worried. I wish you didn’t have reason to worry.” Alan’s partner could say back, “I worry because I love you. I wish you didn’t have the problem and I didn’t have the worry.” This way, what began as a source of tension ends as a source of comfort.     Caregivers can avoid asking for reassurance that creates a burden or that cannot be given. They can respect the abilities of the person with HIV infection to find his or her own solutions. They can understand that some things cannot be fixed. They will allow the person to talk freely and openly and without interruption or fear of judgment. They can listen, though they find it hard. They can let the person cry, and not try to make him or her stop. They can also allow the person to be alone, and not talk. They can understand that talking about depression, fear, anger, or guilt sometimes seems to undercut the positive attitude that is important to people with HIV infection. Caregivers can learn to accept their own helplessness, to give up trying to make everything right again. At the same time, they can learn not to run away. Lisa understood that her husband had all the burdens he could handle: “He needed me to keep talking, to reminisce about good things, to bring up happy memories, to touch him.” People with HIV infection can see worry as love. Dean understood that his mother needed to ask him questions, and they worked out times when she could: “My mother has felt so helpless with this disease. Everyone does. But she talked only when I wanted to. She’d say, “Do you want to talk about this now?”
*82\191\2*