LIVING WITH EPILEPSY: ANTICONVULSANT DRUGS AND PREGANCY

January 13th, 2011 | Tags:

Phenytoin (Dilantin). This drug is believed by most people to carry an increased risk of cleft lip and palate, as well as of congenital heart disease. The risk of these problems is about 5 percent. Since these malformations occur during the first weeks of pregnancy, they cannot be prevented by stopping the drug after you realize you are pregnant. It is alleged that there is an increase in risk of “fetal hydantoin syndrome” when the mother has been taking phenytoin. In this syndrome, the infant has short distal fingers and toes, small fingernails, is of slightly short stature, and has a small head. Whether such children are intellectually disabled or not remains a matter of debate. Some people feel that the risk of this syndrome is perhaps zo to 30 percent. Others feel that the significance of these minor abnormalities is greatly overstated. Similar features may be found in children of a mother with epilepsy who has taken phenobarbital (the fetal barbiturate syndrome) and one who has not been on medication at all.
Fetal hydantoin syndrome may be caused by the way certain women metabolize the drug. If you have a baby who has had the syndrome your chances of having another affected child may be very high if you continue taking phenytoin (Dilantin) during your second pregnancy.
Phenobarbital. This drug causes exactly the same complications as phenytoin—the cleft and heart problems and the “fetal barbiturate syndrome”—but the chances of each occurring appears to be slightly less than with phenytoin.
Valproic Acid (Depakene, Depakote). This drug has been found to increase the risk of malformations, particularly of spinal cord problems (spina bifida), to a rate of 1 to 2 percent. Women taking valproic acid should discuss risks with their physicians before becoming pregnant because it may be possible to substitute another medication. Women who become pregnant while on this drug should ask their physicians about a special blood test that might detect spina bifida early in the pregnancy.
Carbamazepine (Tegretol). This drug has been less well studied than other anticonvulsants. Although it, too, has been associated with problems for the fetus, it appears to be one of the safer anticonvulsants.
A woman who no longer needs medication should have it discontinued before she becomes pregnant. This should be done under a physician’s supervision. For the woman in whom the need for continued medication is unclear, decision-making can be complex.
It is likely that all medications in pregnancy will pose some minimal risk to the fetus. Virtually all anticonvulsants may affect the metabolism of vitamin K in the newborn and may lead to bleeding. Therefore, the mother should receive vitamin K during the last week of pregnancy, or the infant should receive it immediately after birth.
*268\208\8*

0 comments

ANTICIPATORY NAUSEA

December 30th, 2010 | Tags:

It is not unusual for people who have had unpleasant nausea with chemotherapy to develop anticipatory nausea and vomiting. This means starting to feel ill or even vomiting before you get your chemotherapy. If this happens to you, it does not mean that you are going crazy or that you are a weak person. It simply means that your body is anticipating your previous unpleasant experiences. You have developed what we call a conditioned response. A nausea response is being triggered not simply by the chemotherapy itself, but also by other things that happen around the same time. Thus, for example, nausea may be triggered off by the sight, smell or even the very thought of your injection or tablets, the clinic, the clinic staff, the clinic car park, or the vehicle in which you usually travel to and from your treatment.
If you are very anxious about your treatment, and/or have developed anticipatory nausea, you could consider learning relaxation techniques and/or taking a mild tranquilliser before your treatment. Both of these approaches can be very helpful. Try not to feel embarrassed about wanting to try them. Your anxiety and/or anticipatory nausea are normal reactions to a very stressful situation. Your doctor should give these problems the same attention as any other aspect of your cancer and its treatment.
*367/40/1*

0 comments

STAYING OFF DRUGS: GETTING INVOLVED IN NA OR AA

December 23rd, 2010 | Tags:

Most newly recovering addicts need to establish a routine of regular NA or AA meetings, where they see people they know and where other members get to know them. This not only makes for friendship, but also acts as a kind of check on the mental side of recovery. Longer-established members who get to know you will notice if you are going through a bad time or showing signs of dangerous thinking. They can help you with this.
Just going to meetings is probably all you can manage in the first few days and weeks of recovery. But as you begin to feel better, you will need to do a little bit more if you are to get the full benefit of recovery in NA or AA. Getting involved by doing some of the small tasks that make such meetings possible will help you recover. One of the most important things for an addict is to begin to change from a life of self-obsession towards a life of outgoing helpfulness to others.
‘Five months after coming to the fellowship I started making the teas at a meeting. The interesting thing was that at that time I was paralysingly shy. I found I couldn’t talk to anyone. I couldn’t hold proper conversations. I could only issue random statements. I had to re-learn how to do it,’ recalls Alison, a recovering addict and alcoholic who has been clean and sober for eight years. ‘Making the tea helped. One day I was pouring the tea and the meeting secretary came up to me and said: “Will you be nice to Jenny? She’s terribly shy.”
‘I said to him, “But I’m terribly shy too.”
‘ “You’re less shy than she is,” he said. So I made a monumental effort to overcome my shyness. And in the future, that was how I coped. When I was feeling shy I looked for someone even more shy than I was. Doing the teas at a meeting taught me how to talk again.’

*99\116\2*

0 comments

STAYING OFF DRUGS: GETTING A SPONSOR

December 16th, 2010 | Tags:

When you have been to NA or AA meetings regularly for a number of weeks, you start getting to know the other members. Just like any group of people, you will find some you like very much, others you are less keen on.
Newcomers need a sponsor if they are to make proper progress towards recovery. The idea is to find a friend who has done what you are about to do, and who can therefore give you the benefit of support, comfort and advice.
Find somebody who has been in NA for at least a year or in AA for two years, and who has been completely clean and sober during that period. A member who has had periods back on drugs or drink is somebody who is clearly having difficulty with the programme of recovery. For a sponsor, you need somebody who is practising the programme successfully.
Normally, a sponsor should be of the same sex: women addicts should have a woman sponsor, men addicts a male sponsor. The idea is to avoid emotional and sexual entanglements. If the relationship works well, you will find yourself getting very close to your sponsor – which could lead to a love affair if you are not of the same sex.
Of course, gay men and women may want to have sponsors of the opposite sex, in order to avoid this possibility. The guiding principle is to choose a sponsor who will be a friend, not a lover.
Choose somebody you trust and like. It’s no good having a sponsor whom you do not like, since this will make it much more difficult for you to confide in him or her. Sometimes people choose sponsors who have a similar background to themselves: at other times they choose sponsors who are quite different. Find somebody who works for you.
The greatest advantage in having a sponsor is in having somebody who knows all about you. Like a good long-lasting friend, you can talk out any difficulties with them, and they will know enough about you to know what is going on in your life.
At the beginning of your membership you may not know enough people to be sure of whom you want as a sponsor. But you can always ask somebody to act as a temporary sponsor till you can make your choice.
In the first few months of being clean, all kinds of painful emotions surface for the newly recovering addict. Living without drugs is not always easy, and sometimes daily life seems full of anxious moments or difficult situations. Having a friend to confide these things to makes them much easier to live through.
A sponsor is there to be used. Ideally, it should be somebody whom you see reasonably regularly in the course of your meetings. Regular telephone contact is also important. A sponsor you neither see nor telephone cannot help you properly, and, of course, it is up to you to ask for the help you need.

*98\116\2*

0 comments

Симптомы астмы

November 21st, 2010 | Tags:

Симптомы астмы чрезвычайно многообразны и зависит от стадии, тяжести заболевания, активности воспалительного процесса в лёгких и возраста больного.
Детям раннего возраста наиболее присуще течение болезни в виде бронхита, тогда как у взрослых астма протекает типично.
Для симптомов астмы характерно наличие нескольких фаз, или периодов: предприступного, приступного, постприступного и межприступного.
Предприступный период.
Обычно это 1-2 дня, которые предшествуют приступу. Иногда он бывает гораздо короче – всего несколько часов. Ярких проявлений в этом периоде может и не быть, но чаще всего они выражаются в повышенно раздражительности, страхе, беспокойстве, снижении аппетита. Иногда могут появиться предвестники – катаральные явления. У человека появляется острый ринит, выделения из носа носят водянистый характер, беспокоят чиханье, зуд в носу, появляется покашливание. При осмотре отмечаются: отёчность слизистой оболочки горла, миндалин, гиперемия зева, общий кожный зуд или усиливается зуд поражённых участков кожи (при экземе, нейродермите и т.д.).
Приступный период.
Наиболее часто приступы у больных разыгрываются ночью, но могут отмечаться и днём, особенно  после каких-либо волнений, после прогулки в сырую холодную погоду или если больной случайно получает пищу, содержащую аллерген.
Обычно приступы протекают при нормальной температуре тела, если нет одновременного обострения сопутствующего заболевания (пневмонии, тонзиллита и др.) или если приступ протекает не на фоне острого респираторного заболевания. На первый план выступают признаки нарушения дыхания. Они обычно становятся шумными, свистящими, особенно бывает затруднён выдох. Частота дыхания быстро нарастает.
Механизм приступа, по мнению большинства врачей, различный. Одни считают ведущим развитие бронхоспазма, другие – набухание слизистой оболочки бронхов, третьи – наличие большого количества вязкой густой слизи, которая может закрывать бронхиолы и бронхи. У подростков и взрослых больных ведущим является спазм бронхиол и бронхов, у маленьких детей чаще преобладают явления отёка слизистой оболочки и повышенная секреция слизи.
Во время приступа отмечаются значительная одышка, затруднённый продолжительный «ступенчатый» выдох. У больных пневмонией, если обострение совпадает с возникновением приступа, эти явления выражены ещё более значительно, постепенно нарастает цианоз губ, носогубного треугольника, лица.
При тяжёлых приступах первостепенное значение имеет нарушение дыхания. В связи с затруднённым выдохом мобилизуются вспомогательные мышцы – грудные, брюшной стенки плечевого пояса. Больной принимает наиболее удобную для себя позу, садится, упирается руками в край постели, мало двигается.
Маленькие дети мечутся, т.к. не могут сразу найти удобное положения. Выражение лица у них страдальческое. Постепенно уменьшается шумное дыхание, и начинается мучительный кашель. Во время кашля нередко бывает рвота, выделяется слизь.
В связи с нарушением бронхиальной проходимости возникает эмфизема легких, т.е. грудная клетка расширяется, межреберные промежутки увеличиваются. Постепенно нарастают проявления дыхательной достаточности – значительно снижаются жизненная ёмкость лёгких и резервные возможности аппарата внешнего дыхания. В результате кислородного голодания в крови возникает компенсаторное увеличение числа эритроцитов и гемоглобина. Снижается количество лейкоцитов (если нет обострения хронических очагов инфекции), уменьшается число нейтрофилов, эозинофилов и базофилов в периферической крови. Пульс учащается.
Частые тяжёлые приступы могут вызывать судорожные припадки, нарушения координации движения и другие симптомы гипоксии мозга. У большой части больных в период приступа отмечаются подавленное, депрессивное состояние, вялая реакция на окружающее.
Больные во время приступа отказываются от еды, нередко мучительный кашель сопровождается тошнотой и рвотой, в рвотных массах обнаруживается большое количество вязкой слизи, заглатываемой при кашле. Беспокоят боли в животе, связанные с напряжением мышц брюшного пресса при учащённом затруднённом дыхании и кашле. Во время приступов у некоторых больных отмечаются увеличение печени, лёгкая болезненность её при пальпации. Приступ может длиться от нескольких часов до нескольких суток, с периодами усиления и уменьшения одышки.
Постприступный период.
После снятия острого приступа в течение ближайших 2-3 дней самочувствие больного постепенно улучшается, но общее состояние остаётся среднетяжелым, определяются выраженные сдвиги в различных органах и системах. Больные в этот период требуют большого внимания и активного лечения.
Межприступный период.
Этот период может быть различным – от 2-3недель до нескольких месяцев. Обнаруживаемые в этот период симптомы заболевания и их выраженность зависит тяжести течения астмы, длительности заболевания и возраста.
У больных с небольшим сроком – в стойком межприступном периоде могут полностью отсутствовать какие-либо признаки болезни.
У больных с большими сроками заболевания отмечаются отставания в физическом развитии, деформация грудной клети, «бочкообразная» грудная клетка с широкими межреберными промежутками, с западениями в переднебоковых отделах, выбуханием грудины и, изредка, межлопаточного пространства и т.д.
Нередко в межприступном периоде может развиваться: отёк Квинке, крапивница, дерматиты и т.д.

 

лечение навязчивых состояний

Comments Off

ALZHEIMER’S DISEASE

September 15th, 2010 | Tags: ,
The term Alzheimer’s disease refers to a condition first recognized in 1907. In that year Alois Alzheimer reported in the medical textbooks that a woman of 51 had died of ‘dementia’. It wasn’t the ‘dementia’ that caused the interest but the fact that this woman’s brain had been examined under the microscope and it showed changes not seen before. In certain parts the brain fibres were tangled up and there were areas of clumping together of brain matter. As time went by, some more quite young people who had died of ‘dementia’ were found to have brains that showed the same abnormalities. The condition was then called Alzheimer’s disease. At that time it was only described in younger people (before retirement age) and the dementia was called ‘pre-senile dementia’.
It was then noted that the same type of dementia (with the same symptoms) occurred much more frequently in older people. Their brains when examined under the microscope showed the same abnormalities. Because Alzheimer had described his condition in younger people, the elderly were described as having senile dementia of the Alzheimer type or SDAT This tended to make things rather complicated, and as dementia in younger people is quite rare it is becoming increasingly common to call the whole group Alzheimer’s disease.
The two words Alzheimer’s disease can’t convey the complicated set of symptoms that make up the condition, unless you personally know a suffer. A quick description often used is the slow onset of memory loss with a gradual progression to loss of judgment and changes in behaviour and temperament. A more complicated definition has been issued by the Royal College of Physicians:
Dementia is the global impairment of higher functions, including memory, the capacity to solve the problems of day to day living, the performance of learned perceptuo-motor skills, the correct use of social skills and the control of emotional reactions, in the absence of gross clouding of consciousness.
These definitions are only guides to the whole complicated condition called Alzheimer’s disease, so we need to work through some of the more common problem areas. The condition starts very slowly, so much so that close relatives and carers often do not notice that anything is wrong for a long time, then when certain things are pointed out they can often think back and realize that the dementia began a few years previously. It has been calculated that someone needs to lose about 80 per cent of their working brain cells before mild symptoms develop, i.e. problems occur late and the brain must adapt very well for a long time. It is useful to think of the condition having three phases: mild, moderate and severe -a sufferer does not always move on to the worst phase. A sudden deterioration usually means that an acute condition (such as a chest or urine infection) has occurred. A small group of sufferers do seem to have a more rapid and downwards course (like a malignant cancerous disease) and death can occur within a few years. For most however the decline is quite slow, especially if the person is well cared for and any other medical problems are tackled early and effectively. Many people with Alzheimer’s die of something else (heart attack, stroke and even old age).
The most common problems are those of memory loss, disorientation, loss of judgment, changes in personality, difficulty in communicating, loss of practical skills and changes in behaviour. Thus, it can be understood that Alzheimer’s disease is far more than just memory loss (as some of the definitions try to show) -eventually the condition affects all of the parts that make us an individual who relates and responds to other people. Even in the very late stages, however, a sufferer is able to show responses to kindness and gentleness, but early on part of the personality, the person’s individuality, is affected.
*27/128/5*

cialis canada online pharmacy

0 comments

EYE CARE CONTROVERSIES: THE POLITICS OF THE EYEBALL

September 15th, 2010 | Tags:
“Eyeball politics” is created by the struggle for potential patient attention among the three eye care professions. Confusion reigns, in particular for the patient, when he or she is forced to determine if eyeglasses and/or contacts should be purchased from the optician who designs, manufactures, and sells lenses and frames or from the optometrist who not only prescribes such lenses but also has them made by prescription and sells them at profit.
Additionally, the patient must further decide if the optometrist he sees regularly for eyeglass prescriptions is I detecting eye health problems. Ophthalmologists say only al medical doctor can do this. Optometrists say they, as O.D.’s, have the training to catch a health problem and refer the patient to an eye surgeon, saving the patient an] extra professional visit.
Judith Doctor, M.D., an ophthalmologist practicing in Westport, Connecticut and affiliated with Norwalk Hospital (in Norwalk, Connecticut) says that eye doctors are the sole professionals licensed to use drugs that dilate the pupils, making it easier to spot the early signs of disease “Only a medical doctor has the training to give a complete medical exam,” she added.
Robert Ross, O.D., practicing optometry in Westport, responded that most people who see an optometrist regularly will get the necessary exams to catch eye health problems. He said, “Ninety-six percent of the patients visiting eye professionals have vision, not medical problems but any possible trouble could be detected by a good optometrist.” As an example he referred to a machine in his office that does a sophisticated test for high pressure in the eye, the sign of glaucoma.
Around  the  country optometrists are  lobbying  in state legislatures  for  permission   to  use  drugs  that  dilate  the pupils.  Such  lobbying  for  the  more  medically-oriented  effort has angered  ophthalmologists,  who  declare  that  only  those with  an   M.D. degree should be  allowed  to  administer drugs   to  eye  care  patients.  They argue that the dilating drugs   could   trigger a sudden glaucoma attack.   Eye physicians are unable to  tell  when a stimulus might set off an  unexpected  increase  in  eye  pressure,  which  may  build to  dangerous  levels,  according  to  Bernard  Singer,  M.D., chief of the section of ophthalmology at Norwalk Hospital.
If an acute glaucoma attack should strike, it is essential that the patient have a medical doctor on hand to treat the disease, Dr. Singer said. Along with the blinding pain from an acute attack, Dr. Singer stated, “An untreated, undiagnosed acute attack can result in total blindness within twenty-four to forty-eight hours.” He added that many such victims will need immediate surgery.
Dr. Ross countered with the statement that the fears of an acute glaucoma attack are overrated. “These kinds of attacks are rare; I don’t think a patient should fear getting one when the eye is dilated,” Dr. Ross said. He added that the patient could always go to a local hospital with little risk of permanent eye damage.
*27/127/5*

buy cheap drugs

0 comments

KEEP YOUR CHILD’S HEALTH: STRESS AND RELAXATION

May 21st, 2009 | Tags:

Children also suffer from stress in their daily lives. The bully at school may not sound like much of a problem to you, but your child may lie awake at night worrying about him. Children are often not consciously aware of their stress levels, and may need to be actively encouraged to relax. This does not mean that your child has to stand on his head and practise meditation (although this is one option). There are very simple and effective ways of helping a child to relax. These include cuddling, talking over problems, a warm bath, a warm drink, a bedtime story, or releasing excess physical energy by playing sport or dancing to music. Older children can find the time before exams particularly stressful. They may benefit from learning specific relaxation techniques, or perhaps yoga or meditation.

*148\90\8*

0 comments

SPECIAL PROCEDURES FOR PAIN RELIEF – EXTENSIVE CANCER PAIN

May 18th, 2009 | Tags:

For extensive cancer pain, some doctors recommend injection of morphine into the covering around the spinal cord through a small plastic tube which can be left in place (epidural injection). This can result in better pain relief for less side effects, but has some drawbacks such as the risk of infection, inconvenience, and the need for a practitioner who is experienced in placing the tube correctly.

Another specialised method for relieving cancer pain is destruction of the pituitary gland by inserting alcohol, ice cold probes or radioactive substances into it via the nose (see page 00).

The pain relief is not achieved through producing remission of the cancer. This method may therefore be recommended for any cancer pain, not just that due to a type of cancer which could be dependent on the hormone balance in the body. I would not agree to it for myself because I believe that it is too unreliable and temporary in its effects and that the side effects are too great for the benefits. However, you must weigh up the situation for yourself if it is recommended for you. I definitely wouldn’t try it before trying painkillers as I have described.

*185/40/1*

0 comments

CHEMICAL BURNS – GENERAL INFORMATION

May 18th, 2009 | Tags:

Wash with water, plenty of it and keep it up. If it is an acid burn, a weak solution of bicarbonate of soda in water will neutralise the acid. If it is an alkali burn, like caustic soda, vinegar and water will neutralise this.

For the eyes: Wash out with large amounts of water for 10 mintues before doing anything else. Do this at once where you are. Only after you have washed the eye for 10 minutes do you take the patient to the doctor. SUNBURN

This is often worse than you think, particularly in children. As treatment, allow plenty of rest; plenty of cooling fluids; moist compresses to the affected areas. Soothing creams, especially those containing a local anaesthetic, are helpful.

Ask your chemist at the beginning of summer what cream to use. Calomine lotion may be used. If major blistering occurs, see your doctor. PREVENTION OF BURNS

It is important for parents to consider prevention in relation to the safety of children.

NEVER let a child play with matches.

NEVER leave children in the car with matches in

the glove box or cigarette lighter in the dashboard.

DON’T have handles of pots and saucepans projecting from the stove. Little hands do reach up. Keep cups with hot tea and coffee in the centre of the table, not along edges!

NEVER run the hot tap in the bath by itself. Always have the cold one on as well; and do not leave small children in the bath by themselves. They could turn on the hot water.

Pay attention to the night attire your children wear. No night dresses — they look pretty but burn so easily. Tight-fitting pyjamas for boys and girls are best. WOOL IS BEST, it burns slowly. Cotton and flannelette are dangerous, and synthetics melt.

Be responsible . .. demand that your retailer stocks only approved, fire-resistant nightwear.

Check such things as radiators to see that they are adequately guarded. New products, initially, are often unknown quantities so far as safety for children is concerned. Sometimes their dangerous features are not recognised by the manufacturers until a few accidents happen.

*628/71/1*

0 comments