MORPHINE: OTHER ROUTES OF ADMINISTRATION-INTRAMUSCULAR MORPHINE, RECTAL MORPHINE AND SPINAL MORPHINE

BIG CONTRIBUTORS OF AGEING PICTURES: SMOKING

GYNECOLOGICAL CANCER: YOUR ROLE IN RECOVERY

GYNECOLOGICAL CANCER: YOUR ROLE IN RECOVERYIf you have a lot of confidence in your doctors and the medical professionals and want to try and help yourself within your capabilities, you can play a vital role in your journey toward healing. It may be useful to reflect on your lifestyle, consider any changes you wish to make, have some counseling about issues that are extremely worrying for you, and get out there and help yourself get better. Trying to be optimistic about your future and about getting well will give you the freedom to do the best to your ability and not to the expectation of others.Have the confidence to be a vital part of your health management team as only teamwork can fast track your path back to full recovery and survival. Be prepared before each appointment with questions or other concerns. Avoid blaming ‘others’ if things do not seem to be progressing, as you would wish. It may be a normal part of the process. Health teams occasionally talk of the patients who threaten to litigate, abuse and are generally most unpleasant to deal with. This is often an indication that the person is venting their fear, frustration and anxiety toward those who are working to getting you well again. Being reasonable will not only use less of your energy, but improve your relationship.If you have a lot of confidence in your doctors and the medical procedures and try to help yourself within your capabilities, you can play a vital role in your journey toward healing. It may be useful to reflect on your lifestyle, have some counseling and get out there and help yourself get better. Just try and be really positive about getting well and don’t get bogged down in other people’s expectations of you. You have to do the best to your ability, not theirs.*77/144/5*

EMERGENCIES: HEAT EXHAUSTION

EMERGENCIES: HEAT EXHAUSTIONToo hot for comfort and safetyHeat exhaustion occurs when your body is not able to cool off and maintain a comfortable body temperature. Hot weather, excessive exercise and dehydration can cause the body to overheat. Small children and people who are frail, are older adults, are obese or have a chronic illness are at risk, as well as people in poor condition who overexert themselves.Note your symptomsHeadacheWeaknessFatigueDizzinessNauseaShallow breathingMuscle crampsProfuse sweating, cool, clammy skin, or body temperature slightly elevated or lower than normalWhat you can doIf you are overheating:Move to a cooler place and remain quiet.Loosen clothing.If dizzy, lie down with head lower than feet.Drink small amounts of liquid frequently.Place cool, wet cloth on forehead.Watch for signs of shock and heat stroke.Do not consume alcohol or apply it to the skin.Seek emergency helpHeat stroke is the critical stage of heat exhaustion and is a medical emergency. All of the body’s cooling systems are overloaded when the body temperature reaches 104° F and continues to rise. Symptoms of heat stroke are:Hot, dry skinBright red or flushed skinBody temperature of 105° F or greaterPerson becomes delirious, disoriented or unconsciousWhile waiting for help, sponge the person’s body with cool water or apply cool, wet sheets and monitor the person’s temperature every 10 minutes. Stop cooling if temperature drops suddenly or signs of shock develop with cool, clammy skin and weak, rapid pulse.Call your doctor nowIf symptoms are severe, become worse with self-care or last longer than one hour, seek professional medical care quickly.
PreventionDrink more than 10 eight-ounce glasses of water a day if exercising or working in hot weather.Stay in the shade or air-conditioned areas. Avoid sudden changes of temperature.Wear loose-fitting, light-colored clothing of natural fibers such as cotton or linen.Limit your activity and exercise during the hottest time of the day.Never leave an infant or child alone in a closed auto in hot weather.*5\303\2*

IS IT RELATIVE OF BDD? SCHIZOPHRENIA: DIFFERENCES BETWEEN BDD AND SCHIZOPHRENIA AND PRACTICAL IMPLICATIONS

IS IT RELATIVE OF BDD? SCHIZOPHRENIA: DIFFERENCES BETWEEN BDD AND SCHIZOPHRENIA AND PRACTICAL IMPLICATIONSImportantly, the delusional thinking that occurs in BDD usually isn’t bizarre, as it is in schizophrenia. In addition, other symptoms of schizophrenia (prominent hallucinations, disorganized speech, grossly disorganized behavior, and negative symptoms) are absent in BDD. Data on the cooccurrence of these disorders strongly refute a close relationship between them: in my series of patients with BDD, none were diagnosed with schizophrenia, nor have other researchers found coexisting schizophrenia in people with BDD. Similarly, schizophreniaTreatment response also differs. Antipsychotic medications (neuroleptics) are the mainstay of treatment for schizophrenia and are often effective. In contrast, SRIs seem most efficacious for BDD, whereas antipsychotics alone appear ineffective.Conclusions: Overall, BDD doesn’t appear to be a symptom of schizophrenia. Nor does BDD appear closely related to schizophrenia.Practical Implications: Even though BDD is misdiagnosed as schizophrenia less often than in the past, it still happens. It’s important to differentiate these disorders from each other, especially because effective treatments differ. If a person has both disorders, each disorder should each be diagnosed and targeted in treatment.*385\204\8*

THE IRRITABLE BOWEL SYMDROME: QUICK REFERENCES – SYMPTOMS AND ACTION – ALCOHOL DEPENDENCE & CIGARETTE DEPENDENCE

THE IRRITABLE BOWEL SYMDROME: QUICK REFERENCES – SYMPTOMS AND ACTION – ALCOHOL DEPENDENCE & CIGARETTE DEPENDENCEAlcohol Dependence1 Hold your head up; you are not your addiction!2 Seek help, from your doctor, friends, Alcoholics Anonymous.3 Stop deluding yourself.4 Keep to a strict low blood sugar eating-plan.5 Take supplements, if possible before cutting down on alcohol.6 Read about L-Glutamine.7 Look after your general health.Cigarette Dependence1 If you have failed many times, don’t be discouraged – try again.2 Keep to a very strict low blood sugar eating-plan.3 Take note of all that has been said in this book about coffee.4 Watch out for constipation.5 Ask your doctor for help.6 Start supplements four to six weeks before giving up.7 Look after your general health and be patient. The misery does pass and you’ll wonder how you could ever have taken such a poison.*153\326\8*

LIVING WITH EPILEPSY/SCHOOL: LEARNING AND BEHAVIOR –MARTHA’S PSYCHOLOGICAL AND SOCIAL PROBLEMS

LIVING WITH EPILEPSY/SCHOOL: LEARNING AND BEHAVIOR –MARTHA’S PSYCHOLOGICAL AND SOCIAL PROBLEMS”Martha’s grades are terrible. She was a solid B’ student until her seizure, and since then she doesn’t even finish her homework. Her last report card was C’s and D’s, and she now says that she wants to drop out of school and get a job. Could this be due to her medicine?”In Martha’s case, as in Joshua’s, there are many potential sources for her problems. Puberty, boys, home problems, changes in school, depression, concern and embarrassment over her seizures could all affect school work and should be explored in talking with Martha. We would check the blood level and lower it if it was high. If not, we would strongly consider changing to another medicine. While phenobarbital and phenytoin are the medications that most frequently affect learning, such effects can follow use of any of the medications. Even as we were lowering or changing the medicine, we would explore with Martha what she knows about seizures and her reaction to them. We would want to know how seizures have changed her lifestyle and her sense of self-esteem. We would ask about symptoms of depression and try to help her cope better with her epilepsy, whether or not this was the cause of her school problems.*249\208\8*
Online pharmacy, cheap generic medications

COPING WITH THE UNCERTAINTIES OF SEIZURES AND EPILEPSY: CEREBRAL PALSY

COPING WITH THE UNCERTAINTIES OF SEIZURES AND EPILEPSY: CEREBRAL PALSYCerebral palsy (CP) is a condition in which the body’s control of motor movements or posture is abnormal. It is caused by damage within the motor areas of the brain or spinal cord that has occurred before or during birth or during childhood. It is not caused by a tumor or by degeneration of the nervous system. Cerebral palsy is not progressive; it does not continue to become worse, although it may become more obvious or its symptoms may vary slightly as the child matures.”Will my child who has cerebral palsy be retarded? Will he have epilepsy?”Not quite half of the children with cerebral palsy are retarded to some degree; a number of others may have behavior and learning problems. A number have no such problems, and are of normal intelligence; indeed, some have superior intelligence. Approximately one in three children with cerebral palsy will also have epilepsy, but few children with epilepsy will have cerebral palsy. Epilepsy does not cause cerebral palsy; it does not cause mental retardation. Nor does cerebral palsy cause epilepsy. When cerebral palsy and epilepsy do occur together, underlying damage to the brain has caused both.There are various forms of cerebral palsy, and the present classification is far from satisfactory.*198\208\8*

SALT FOR HEALTHY BLOOD PRESSURE: SALT SENSITIVES, BEWARE

SALT FOR HEALTHY BLOOD PRESSURE: SALT SENSITIVES, BEWARESome people can eat a bag of salty pretzels and their blood pressure remains normal; for others, just thinking about salt wreaks havoc with their blood pressure. An estimated 20 to 30 percent of people with hypertension have a condition called salt sensitivity, which means they have a severely pronounced response to sodium. Sodium restriction is extremely important for these people, as they not only have four times the risk of developing hypertension compared with people who respond normally to salt, but even small amounts of sodium can trigger a dramatic rise in blood pressure. Researchers are still looking into the mystery of salt sensitivity. Who gets it? What causes the condition? Is there a gene responsible? Although many theories exist, we still don’t know for sure. Some of the possible mechanisms include kidney insufficiency, adrenal sensitivity to angiotensin, hereditary causes, or a sensitivity to the chloride fraction of salt (sodium chloride).When I see patients who have been told they have resistant hypertension (abnormally high blood pressure that does not come down despite treatment with at least three drugs), I always suspect salt sensitivity. I have found that resistant hypertension can often – though not always – be remedied by strictly curtailing dietary sodium and supplementing with extra potassium. To find out if you are salt sensitive, check with your doctor or simply monitor your blood pressure response to dietary sodium changes. If you are sensitive to salt, you’ll need to severely curtail your sodium intake and increase your potassium consumption.*64/313/5*

HIV: ON LIVING-TAKING CONTROL: ENCOURAGE YOURSELF

HIV: ON LIVING-TAKING CONTROL: ENCOURAGE YOURSELFProtect your physical health. Eat well, sleep enough, cut alcohol and smoking down or out. Exercise as much as possible; just going for a walk is great exercise. Relax when you can: read, watch a movie, do relaxation exercises. Take good care of your body. If you have HIV, give your body a chance to fight the infection. If you are a caregiver, you also have to take care of yourself. Lisa said, “I am very careful about exercise and food. You owe it to the people you’re caring for.”     Be kind to yourself emotionally. Steven gives himself pep talks: “When I feel good,” he says, “I let myself know that. I tell myself, ‘Steve, you feel great today.’ ” Dean says that every day he rates how he feels on a scale of one to ten: “It’s mostly nines and tens,” he says. Helen says that her best support is herself. “Basically, it comes down to me,” she says. “I want to survive this. So I have to support myself, and when I do something well, I pat myself on the back.”     If an emotional problem seems too severe or does not go away, or if you are seriously considering suicide, or if you simply want someone to whom you can express all your feelings, see a mental health professional.*243\191\2*