Blog about medicines and adverse drug reactions.
April 21st, 2009 admin
The purpose of the ACPA is to provide a support system for those suffering from chronic pain. In addition, the ACPA offers training in skills and attitudes that have proven efficacy in helping people to deal with chronic pain.
Members learn to use physician-approved stretching exercises (as used in this book), relaxation techniques, assertiveness training methods, advice on sleeping as normally as possible, nutrition, family involvement and a better understanding of the feelings pain helps to create — all to help the affected person to live more fully.
They learn to recognise limitations and to set realistic short and long-term goals for themselves. ACPA groups do not focus on physical pain, but rather on developing a member’s positive attitude and an enhanced perception of self-control. They seek to exchange the passive role of the patient for that of an independent person whose pain is kept in proper perspective.
The group does not take the place of traditional medical treatment, but works with the medical group to allow members of ACPA to take more responsibility for their own recoveries. Membership is an addition to, not a substitute for, medical and professional services the person with pain may have already pursued.
The organisation publishes a quarterly newsletter, the ACPA Chronicle, produced by group members themselves and twice-monthly meetings are held. The meetings usually last two hours, and ACPA suggests that membership be limited to about ten people. This is because experience has taught ACPA that this allows new members to build trust in each other.
Since much of what is said in the group is personal, trust and comfort are critical; fear of betrayal and censure must be removed.
ACPA supplies for a minimal charge comprehensive manuals for those interested in setting up local chapters. These consist of a Leaders Manual, for those keen enough to take on the leader role, and a members’ manual.’
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April 21st, 2009 admin
In ‘Getting Well Again’2 the Simonton’s give the following outline for reversing some of changes mentioned above. The same principles have a great relevance in the self-management of non-malignant pain.
1. With the diagnoses of a life-threatening illness, the individual gains a new perspective on his, or her, problems. Many of the rules by which an individual lives suddenly seem petty and insignificant in the face of death.
The threat appears to give an individual permission to act in ways that didn’t seem an acceptable option beforehand. Suppressed anger and hostility can now be expressed. Assertive behaviour is now seen as OK. Illness permits the person to say no.
2. The individual makes a decision to alter behaviour, to be a different kind of person. As behaviours change, apparently unresolv-able conflicts may show signs of resolution.
There’s more freedom to act and more resources with which to live. Depression often lifts when repressed feelings are brought into the open, and increased psychological energy is available. The individual makes a decision to become a different kind of person. Cancer serves as a dramatic permission to change.
3. Physical processes in the body respond to the feelings of hope and the renewed desire to live. This phenomenon, not only seen in cancer, creates a reinforcing cycle in harmony with the new mental state.
The renewed hope and desire to live, initiate physical processes that result in improved health. Since mind, body and emotions act as a system, changes in the psychological state result in the physical state changing as well.
This process, of course, has its ups and downs. Even with renewed hope, and a different perception of self and the problem, there are usually difficult times. There may be temporary physical setbacks until the patient again feels confident enough to cope with the situation.
4. The recovered patient is ‘weller than well’. Basically, the same observation applies to those who have actively participated in a recovery from cancer. They have a psychological strength, a positive self-concept, a sense of control over their lives that clearly represents an improved level of psychological development.
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April 21st, 2009 admin
Techniques for hypnotic pain reduction present a number of interesting similarities to familiar psychological defence mechanisms normally used as coping mechanisms. These are amnesia (repression), substitution, denial, displacement and retreat into fantasy. Thus, symptoms may be substituted (pain can become a tingling sensation or ‘painless’pain) or displaced (for example, from the abdomen to the finger). Symptoms may even be denied. To the patient, they simply do not exist! Amnesia can be used to blur or reactivate memories of a previous experience while selective awareness allows patients to divide their attention. For example, the patient may be asked to imagine leaving their painful body behind and taking a rest.
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April 21st, 2009 admin
This includes individual psychotherapy or group psychotherapy. Individual psychotherapy may offer help in changing the way someone feels about his or her pain, or alternatively to employ other supportive measures.
It may also seek to find the cause of the problem. These psychological approaches give both the practitioner and the patient time to explore the patient’s personality and behaviour patterns and also to determine how the patient’s perception of pain affects his or her life. It also helps to define, and measure, the emotional needs of the individual.
Group thorapy Group therapy is a treatment technique which uses the interaction of patients within a group to achieve the treatment goals.
In an in-patient or residential pain clinic, for example, group therapy includes all the interactions among patients. In-patients eat together, exercise together and encourage each other to act in normal ways. They are constantly interacting with one another and testing their new behaviour on new fellow patients and so eventually helping them to better understand how they cope with their pain.
The sharing of experiences and feelings, resulting from such group therapy, helps chronic pain patients to readjust their thinking and to develop new ways of coping with pain.
Such treatments are mainly available from registered psychologists, many of whom work in pain units.
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April 20th, 2009 admin
One of the newest and most exciting fields of biological research at present concerns the relationships between the immune system, the nervous system and the hormones. The realization that these three systems can interact, and the identification of the mechanisms involved, has only come within the past few years. This new science has been given the rather daunting name of psychoneuroimmunology.
Among the discoveries made in psychoneuroimmunology is that stressful events can make the immune cells far less responsive to infection. Bereavement can have devastating effects on our defensive cells, but even something as minor as taking an exam can make us more vulnerable to infection. With long-term stress, it appears that a sense of being in control makes all the difference – feelings of helplessness and inability to improve matters are the most damaging. Controllable stress, on the other hand, can actually improve immune status.
The mechanisms behind these interactions are still waiting to be unravelled, but there are indications that small messenger molecules may be important. These small messengers include the major chemical signals produced by the body (hormones), messenger substances released by the nerves for communication with adjacent nerves (neurotransmitters) and mediators released by immune cells which stimulate or suppress other immune cells (lymphokines). Some of the hormones known to affect the nervous system, such as the endorphins, now appear to bind to immune cells as well, and probably influence their behaviour. Conversely, mediators produced by immune cells can influence nerve cells – histamine and prostaglandins both have this effect. One lymphokine with marked effects on both body and mind is interferon. The hormone, noradrenaline, also acts as a neurotransmitter for some nerves. In other words, these are three closely interconnected systems.
There are also direct links between the nerves and the immune system that do not rely on messenger substances. Detailed anatomical studies have revealed nervous connections that were not previously suspected. It turns out that several parts of the immune system – including the lymph nodes, the spleen, the thymus gland and the bone marrow – are connected by nerve fibres to the central nervous system. Exactly what effect the nerves have on these organs is as yet unknown.
So far, research into psychoneuroimmunology has done no more than scratch the surface of this potentially important topic. But it indicates that the idea of allergies affecting the mind – and vice versa – is not implausible.
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April 9th, 2009 admin
If you’re weight lifting and taking anabolic steroids, your breasts will remain enlarged until you stop both training and taking the medications.
The detection and diagnosis for a breast tumor in men is the same as for women. Sonography and/or mammography is used initially; if the mass appears to be suspicious, your doctor will do a biopsy to determine whether the cells are cancerous or not.
If you are taking either cimetidine or digoxin and you’ve noticed that your breasts have grown since you’ve begun the regimen, ask your doctor if he can switch you to another effective medication that won’t give you these side effects. When you stop taking the drug, your breasts should return to their normal size.
If your breasts have grown because you’ve gained weight, the only treatment is a weight-reduction plan that includes exercise. Some men have actually undergone breast-reduction surgery to eliminate this embarrassing condition, but most either learn to live with it or reduce the prominence of their breasts by losing weight and building up the pectoral muscles that lie underneath.
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April 9th, 2009 admin
Even though many midlife adults worry about getting colon cancer, the truth is that it is actually a treatable disease if it’s discovered early. However, because it is so serious, you should be attuned to the signs of colon cancer and know the risks.
First of all, if you or someone in your family has a history of colon disease—not necessarily cancer, but perhaps colitis or polyps—or if you are over 50 and have chronic constipation, you should be monitored regularly by your doctor.
Besides chronic constipation, some of the other signs of colon cancer include a slow change in bowel habits that occurs over the course of several weeks or months. Diarrhea might also be present, as well as bloating, gas, weight loss, a change in appetite, anemia, and depression. These, however, are what I call “soft” signals; people might think they are appearing due to a change in lifestyle or another health problem. When they do seek help and recognize that it may be colon cancer, they will do so when their intestines become blocked by the tumor or they experience a serious blood loss from a tumor that begins to bleed.
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April 9th, 2009 admin
Description and Possible Medical Problems
If you occasionally feel your heart start to race for a minute or two and then return to normal, and you’re under 50, you have nothing to worry about. Usually, this condition is the result of an excess of caffeine ot stimulant medications, anxiety, or thyroid disease and is not an indication of heart trouble. Only if the rapid heartbeat lasts for more than several minutes should you call your doctor.
If you’re over 50, however, and become short of breath when your heart rate goes above 100 beats per minute, and it lasts for several minutes, you should see your doctor; heart disease may be the cause.
Treatment
If you’re under 50 and your rapid heartbeat is caused by caffeine, anxiety, or a thyroid disease, your doctor will probably prescribe beta-blockers to slow your rapid heartbeat. Long-term medication will not be used.
If you’re over 50 and develop a rapid heartbeat, your doctor will want to evaluate you for heart disease. An example of a rapid heartbeat that’s the result of heart disease is a trial fibrillation, or atrial flutter; the underlying heart disease will then be monitored with an electrocardiograph or a Holtor monitor and treated with medication such as verapamil, digoxin, or Inderal. In an elderly person, a rapid heartbeat will also be treated with these medications and requires close monitoring in a hospital to help slow the heartbeat. If the rapid heart rate is not slowed, heart failure can result. If an elderly person has had a series of small strokes and now exhibits a rapid heartbeat, the doctor will prescribe an anticoagulant medication such as Coumadin, which will require weekly blood tests after being discharged from the hospital to help determine the correct dosage. Since Coumadin is a potent medication, side effects such as blood in the urine, a black stool, a nosebleed that won’t go away, or any new symptoms that appear anywhere in your body require the immediate attention of a doctor.
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April 9th, 2009 admin
Description and Possible Medical Problems
From time to time, we all get one of these common conditions: skin rashes, pain in the joints, and a feeling of fatigue. Usually, however, these conditions appear by themselves.
When they appear simultaneously, it’s probably not a coincidence, but a disease called lupus erythematosus. Lupus has long been considered to be somewhat of a mystery due to its various symptoms, which may change in severity from one day to the next. This occurs because lupus is primarily a disease of the body’s connective tissue. Since connective tissue appears throughout the body, it’s no surprise that lupus is so pervasive—and so stubborn. Not only the skin and joints can be affected but also vital organs such as the kidneys and brain, the circulatory system, and the sacs that surround the heart and lungs.
The rash that generally appears across the cheeks and nose is more likely to occur when the skin is exposed to strong sunlight, since another characteristic of the disease is that the skin becomes more sensitive to light.
Lupus is primarily a woman’s disease; about 10 times as many women as men are affected. It is a chronic disease, and there is no known cure.
However, many people with lupus are able to enjoy long periods between flare-ups.
Treatment
The diagnosis for lupus is made by a blood test called FANA or lupus prep. If the test is positive and only the skin is affected, no systemic treatment is needed. Treatment of the rash will involve a combination of the corticosteroid medication prednisone and antiarthritic medication. However, if the disease affects the kidneys, brain, or other vital organs, treatment obviously requires a multidisciplinary approach depending on the organs involved.
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April 9th, 2009 admin
Description and Possible Medical Problems
Because the tissues of the mouth and tongue change with age, becoming thin and less elastic, they tend to become more sensitive to extremes in temperature. A burning feeling in the mouth and on the tongue is one result of these changes.
In addition to the changes that come with age, a vitamin B deficiency is frequently to blame for a burning tongue. Studies show that a lack of iron might also be a contributing factor to a burning tongue. Some women who have gone through menopause and don’t take estrogen replacement therapy complain that their tongue feels as though it’s “on fire.” Studies have shown that a decrease in estrogen levels is linked with the appearance of a burning tongue.
But a burning tongue can occur in anyone at any age, and spicy foods as well as foods with a high acid content can make it worse. This is a related condition called glossodynia.
Treatment
To alleviate the symptoms of a burning tongue, it’s a good idea to start taking a multivitamin supplement such as Z-Bec that contains 100% of all of the B vitamins to see if this helps. One tablet or capsule each day is the recommended dosage. For postmenopausal women, beginning a program of estrogen replacement therapy may help ease a burning tongue.
However, if these methods don’t work, some temporary treatments are available. You can buy benzocaine in several over-the-counter preparations to apply to your tongue when the burning becomes severe. Anbesol in gel or liquid form applied three to four times a day can also offer relief. Some people also find that increasing their consumption of dairy products helps to soothe the burning, at least temporarily.
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