Recovering from Hernia Surgery

hernia surgery
Hernias of any type do not self-correct – they require surgery to be properly repaired. One of the most common hernias in males is the inguinal hernia, which occurs near the groin area when part of the intestine protrudes through a weak spot in the abdomen.

If left uncorrected, a hernia will become larger in size, as well as more uncomfortable. The hernia is typically caused by heavy lifting or straining, paired with a weakness in the abdominal wall. Further lifting or straining can make the hernia worse, but as time goes on, even small amounts of strain such as blowing the nose or having a bowel movement can cause the hernia to expand.

The true danger in a hernia lies in the possibility that a part of the bowel will also poke out through the abdominal wall, leading to a strangulation of that part of the bowel and possibly death for the patient. While this is an unlikely outcome, patients who are suffering severe nausea and a sharp pain in the area of their hernia, rather than the usual sense of pressure, should consult a doctor immediately.

The hernia repair itself is quite simple – the intestine is pushed back into the abdominal wall and sealed up with a mesh. This is a day surgery procedure and usually takes less than an hour.

After the surgery is completed, there are several things which patients should expect to experience.

Pain and Swelling

A pain medication such as Tylenol 3 is usually prescribed for after surgery, and can do wonders in the first few days to alleviate pain. There will have been a small incision made above the groin, which will have been stitched up and is usually covered with small strips that will come off in approximately one week.

There will be pain from the incision itself, as the body has undergone a moderate trauma in being cut open, and there is usually swelling of the incision area as well as one or both of the testicles. Tylenol 3 or other pain medication is used to both assist in the management of the pain and also to reduce the swelling. The time spent on the medication varies from person to person with some using it only for a few days and some for a week or more.

The important thing to know is that any heavy lifting or vigorous activity is out of the question for at least four weeks, or else the patient risks rupturing the same hernia again.

Stiffness

This is a natural consequence of the surgery. As the incision heals, it will become tight and stiff, and the patient will feel discomfort if they try to straighten up fully or walk around. Both of these things are key, however. Walking around not only gets the blood flowing, but helps the body adjust to the incision and the new state of affairs.

The temptation is to remain seated or lying down for the bulk of the recovery time, and while this is necessary to give the body a chance to rest, it is important to move around as well. A few walks around the house can make all the difference in helping to speed recovery.

When initially standing up, most people feel a "pulling" sensation, and will often feel a sharp pain as the incision shifts around. It is important to use the arms and legs as much as possible, rather than the abdominal muscles when getting up, sitting down or any other usual movement – this will prevent strain on the incision and limit the possibility of a re-tearing of the abdominal wall.

As mentioned above, walking around will usually result in a pulling sensation as the body will have become used to sitting or reclining. As long as movements such as standing up or walking are done in a slow and controlled motion, this pulling can be a good thing as the body gets used to the new incision site.

Trouble with Bowel Movements

This is something that isn't always mentioned, but is almost a certainty, according to the May 8, 2008 article at UWhealth. Medication which is taken after hernia surgery, especially anything with codeine, tends to clog up the system. Add to that the fact that the abdominal muscles have been traumatized and that no "straining" should take place when in the process of a bowel movement and it can become quite a challenge.

The first thing to remember is that walking around will help alleviate this by getting the bowels moving. As well, eating foods high in fiber and drinking more water than normal will also be of benefit. If need be, a fiber supplement such as Metamucil can be used, but be careful if choosing to go this route.

Metamucil requires that even more extra water be consumed in order to work, or else the psyllium fiber in the capsules will make matters even worse. Any "harsher" products such as Ex-Lax should be avoided as they could put unnecessary strain on the stomach and abdominal region. A few days without a bowel movement after surgery is quite common, but if it reaches the four day mark, a call to the doctor may be in order.

While recovering from hernia surgery is a slow and sometimes painful process, knowing what to expect can make it a speedier and less intimidating process.

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Post-Traumatic Stress Disorder

post-traumatic stress disorder

Someone may develop post-traumatic stress disorder when he experiences or witnesses an event that causes intense fear and helplessness.

What Are the Symptoms of PTSD?

PTSD symptoms typically begin within three months of a traumatic event. It is important to get treatment as soon as possible after symptoms develop to prevent PTSD from becoming a long-term condition. Symptoms are commonly grouped into three types: Re-experiencing symptoms (flashbacks), avoidance, and increased anxiety or emotional arousal (hyperarousal):
  • Re-experiencing symptoms: flashbacks, bad dreams and repeated frightening thoughts-reliving the trauma over and over
  • Avoidance symptoms: avoiding places, events, or objects that are reminders of the experience.
  • Hyperarousal symptoms: being easily startled, feeling tense, having difficulty sleeping, and/or having angry outbursts.

The symptoms that children or teenagers experience may not be the same as with adults. In very young children, these symptoms can include:
  • Bedwetting, when they'd learned how to use the toilet before
  • Forgetting how or being unable to talk
  • Acting out the scary event during playtime
  • Being unusually clingy with a parent or other adult.

Older children and teens usually show symptoms more like those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors.

What Causes PTSD?

People of all ages can have post-traumatic stress disorder. But it's more common among adults, with about 8 percent of the population having PTSD at some time in their lives. PTSD is especially common among those who have served in combat, and it's sometimes called "shell shock," "battle fatigue" or "combat stress."

Women are four times more likely than men to develop PTSD. Women are at increased risk of experiencing the kinds of interpersonal violence - such as sexual violence - most likely to lead to PTSD.

Many other traumatic events also can cause PTSD, including a fire or natural disasters; mugging, assault or robbery; a car, train or plane crash; torture, kidnapping or terrorist attack; a life-threatening medical diagnosis, or any other extreme or life-threatening events.

Symptoms of PTSC can come and go, and may resurface under times of stress or when a person experiences a reminder of a traumatic event. A war veteran may hear a car backfire and relive combat experiences. Or a woman may see a report on the news about a rape, and feel again the horror and fear of her assault.

When Should Someone With PTSD See a Doctor?

When someone has these disturbing feelings for more than a month, if they're severe, or if she feels she is having trouble getting her life under control, it is likely time to see a health care professional.

The main treatments for people with PTSD are psychotherapy ("talk" therapy), medications, or both. Everyone is different, so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health care provider who is experienced with PTSD. Some people with PTSD need to try different treatments to find what works for their symptoms.

If someone with PTSD is going through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse, and feeling suicidal. If someone has thoughts of suicide, she should go to an emergency room or call 911 immediately.

For less urgent symptoms of PTSD, patients should make an appointment with their family doctor or general practitioner. The doctor can help begin the process of understanding whether symptoms may be related to a traumatic experience. In many cases, this doctor will refer a patient to a mental health professional for ongoing treatment.

Are There Ways to Cope With PTSD?

While waiting to see a doctor, some for PTSD patients to cope include learning more about the disorder as well as talking to friends, family, and PTSD survivors for support. Joining a support group may be helpful.

Other tips include reducing stress by using relaxation techniques (for example, breathing exercises, positive imagery), increasing positive lifestyle routines (for example, exercise, healthy eating, distracting oneself through a healthy work or volunteer) and minimizing negative lifestyle practices like substance abuse, drinking alcohol, social isolation, working to excess, and other self-destructive behaviors.

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Salicylates

All types of salicylates (from the main ingredient acetylsalicylic acid or ASA), have been implicated in a condition called Reye’s Syndrome, associated with ASPIRIN® ingestion, especially by children, used to treat feverish colds or viral diseases.

salicylates

Drugs studies using acetaminophen (paracetamol outside N. A.), as well as ibuprofen and others, have only shown some unproven implications for Reye’s. With the advent of alternative pain killers, Reye’s has become less common in recent years. Nonetheless, it is important to realize that even such routinely used over-the-counter medications must be used sparingly and wisely. Headache and pain sufferers sometimes have to make tough choices.

Awareness of Reye's Syndrome is Key to Prevention

Reye's can strike quickly, affecting all body organs, especially the brain and the liver (although usually without jaundice). It is frequently associated with the use of any form of salicylate-containing drugs (ASPIRIN®-type medications) for treating colds, fevers, and influenza-like illnesses.

In 1974, the National Reye's Syndrome Foundation was the first citizens' group to generate an organized lay movement to eradicate Reye's. The U.S. Surgeon General, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics, all issued recommendations to avoid using ASPIRIN®-type products in anyone under 19 years of age (although no age group is immune) to treat episodes of fever-causing illness, especially flu or chicken pox. Most cases of Reye’s occur in children ages 4–12, usually following an upper respiratory or feverish infection by about one week.

User’s Must Check Drug Labeling for Safety

Words that might appear on drug labels containing salicylates could be any of the following: ASPIRIN®, acetylsalicylate, acetylsalicylic acid, salicylic acid, or salicylate, salicylamide, or phenyl salicylates. Having Reye’s Syndrome uncaused by the ingestion of ASPIRIN® has not been ruled out, but all documented cases have been traced back to that connection, so recommendations were developed on that basis, although there is no data that salicylate other than ASPIRIN® has been associated with Reye's.

Reye's Symptoms to Watch For

Reye’s presents with sudden and acute brain damage (often mistaken for encephalopathy) and liver inflammation, and symptoms that may include long bouts of vomiting. This is followed by disorientation, irritability, and aggression, and as the condition progresses, may include lethargy, confusion, loss of consciousness, delirium, and coma, as well as seizures or personality changes with ultimate permanent brain damage.

Also noticed have been unusual placement of arms and legs, with arms extended straight and turned inward toward the body, and legs held straight with toes pointed downward. Other symptoms may mimic a stroke, including double vision, hearing loss, paralysis or muscle weakness in extremities, and speech difficulty. Immediate emergency care is necessary for early diagnosis, and prevention of brain damage or death.

There is no specific treatment for this disorder, other than to monitor the symptoms to confirm the individual’s condition. A comatose victim is considered to have suffered an acute episode, and if recovering, the overall outcome is considered good.

Only Give a Child ASPIRIN® On a Doctor’s Instructions

Reye's syndrome can result in death in children, and the usual brain inflammation and liver damage caused indicate the body reacting as if to poisoning. Few cases of Reye’s have been documented in adults, with most completely recovering within a few weeks. But in children, results have been serious, with permanent brain damage and an average of 30 percent fatalities.

Connection to Chicken Pox

Any ASPIRIN®-like drugs should be avoided if a person has been diagnosed with chicken pox, or for several weeks after a child has received a chickenpox vaccination or any fever symptoms. In addition, the treating doctor must be given this information. OTC medications like Pepto-Bismol® or anything containing Wintergreen oil generally contain salicylates and should not be given to someone with either a cold or fever.

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Respiratory Syncytial Virus

respiratory syncytial virus

When an adult has cardiac related issues, there are numerous factors that may be the cause. Heart disease, high cholesterol, obesity and high blood pressure can all contribute to emergency cardiac incidents. In children and infants whose hearts are typically young and strong, a cardiac event is troubling because it is unexpected. Most cardiac arrests in the very young can be attributed to an alternate cause that is usually respiration related, like RSV.

Respiratory Syncytial Virus (RSV)

A surveillance study published in the Feb. 05, 2009 issue of the New England Journal of Medicine showed that RSV is linked to substantial morbidity in US children. The study, "The Burden of Respiratory Syncytial Virus Infection in Young Children," conducted by Dr. Caroline Breese Hall et al, from the University of Rochester School of Medicine and Dentistry, also showed that most children who presented with RSV were previously healthy.

Worldwide, RSV is the most common cause of lower respiratory infections in children less than three years of age. RSV begins as an upper respiratory disorder but when it moves into the lungs or the airways (bronchioles) of the lower respiratory tract, it can cause pneumonia and bronchiolitis. Infants are the ones most affected by RSV and seem to incur the more significant complications. In some areas, RSV can be seasonal, being more prevalent in the fall.

Long term, RSV is a virus that can reoccur for life. Repeated bouts of RSV have been linked to the development of pediatric asthma, ear infections and in later life, chronic obstructive pulmonary disorder (COPD).

RSV is highly contagious and is passed from one child to another through sneezing, coughing, direct contact and contaminated toys. Keeping children isolated from RSV is a near impossible feat which explains the high rate of incidents.

RSV Symptoms

In older children or adults, RSV presents with symptoms similar to the common cold. Symptoms typically begin to emerge four to six days after transmission and include:
  • a runny or congested nose
  • sneezing
  • a dry cough and irritated throat
  • a low-grade fever
  • a general feeling of being unwell, malaise or irritability in infants
If RSV transitions into the lower respiratory tract and causes pneumonia or bronchiolitis, additional symptoms will occur. These will include:
  • wheezing
  • a high fever
  • a severe almost constant cough
  • difficulty breathing and rapid shallow breathing that includes, sucked in ribs and chest (retractions); see-saw breathing (abdomen moves opposite to the chest) and nasal flaring
  • a bluish tinge to the skin (cyanosis) from insufficient oxygen

Diagnosis and Treatment of RSV

Diagnosis of RSV is typically established through a visit to the doctor. X-rays, blood tests, nasal secretion tests and auscultation (listening to the lungs) is usually sufficient to confirm RSV. Being a virus, RSV does not respond to antibiotics, but they may be prescribed if the virus causes a bacterial complication.

Severe cases may require hospitalization and treatments with IV fluids, humidified oxygen therapy and albuterol administered through a nebulizer to open the airways. If a doctor deems the infant stable enough to be treated at home, then recovery may be aided by:
  • the use of a portable humidifier
  • over-the-counter acetaminophen
  • nasal saline for congestion or a suction bulb for a runny nose
  • keeping the infant propped semi-upright
  • pushing fluids

Some infants are more prone to complications of RSV and should be evaluated by a medical professional as soon as possible. These include premature babies or those less than six weeks of age; infants that have chronic health issues such as cystic fibrosis; infants with established lung conditions and congenital heart defects.

Prevention of RSV includes basic hygiene, avoiding exposure to the virus and keeping the home smoke free. The medication Synagis can be effective in preventing RSV. It is given by injection, once per month during the peak season of RSV. Synagis is a preventative medication and will not treat RSV once it has been contracted.

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RNA Interference

rna interference

RNA interference (RNAi), discovered by Andrew Fire and Craig Mello in 1998, is essentially the use of small fragments of RNA, known as small interfering RNAs (siRNAs) to block, or interfere with, the production of specific genes. These occur naturally in mammalian cells, but can also be generated artificially and delivered into cells. Each RNA fragment has a sequence that is complementary to a part of the target gene, in that it is exactly complementary to the sequence of the gene. When it binds, it effectively blocks that part of the gene, by preventing interaction with the machinery of the cell whose job it is to translate that DNA sequence into protein. As a result, the protein is not made.

Since its discovery, RNAi has been used extensively in the laboratory to research which genes are responsible for what functions. By blocking a gene, and observing the effect it has on a cell or organism, the function on that gene can be deduced. Prior to RNAi, this kind of research was only possible using laborious and expensive gene knockout techniques.

The Potential of RNAi in Medicine

The ability to switch on or off specific genes on demand has important implications for the treatment of genetic disorders. For example, some genetic disorders are caused by the over-production of certain proteins, while others, such as cancer, are caused by genetic mutations that are not inherited. By using RNAi sequences that are specific to the gene that codes for the wrongly-expressed protein, its production can be significantly reduced, potentially even to normal levels (1).

Naturally produced RNAi, especially in lower organisms, is very important in the defense against viruses, and acts by blocking the RNA that is the viral genetic code as soon as it enters the cell. Similarly, siRNAs can be generated against human viruses such as HIV, and therapies are currently being developed for this infection as well as hepatitis B and C amongst others.

However, there are a number of hurdles that must be overcome before RNAi can be used routinely as a therapeutic agent for disease in humans.

Delivery of siRNAs to Tissues

One of the main problems with RNAi is the problem of delivery to the correct cells, especially to those tissues deep in the body. Delivery to deeper tissues is hampered by the body’s defense system, including nucleases that degrade nucleic acids (DNA and RNA) (2,3).

There are few organs that are easily accessible to RNAi, including the eye and the respiratory tract. In both these cases, RNAi can be delivered via saline solution to result in effective knockdown of the target genes. Indeed, one of the first conditions to be investigated for RNAi therapy was age-related macular degeneration.

siRNAs can also be delivered systemically via intravenous injection using liposomal particles to aid uptake into the cells. This may be effective for delivery to the liver and jejunum, but is not appropriate for other organs (2). Viruses are perfectly designed to rapidly and efficiently invade cells, and infect them with their own genetic material, RNA. By replacing viral RNA with the RNAi sequence, the virus is able to deliver the ‘drug’ directly to the cell in which it is needed.

Additional barriers to the use of RNAi therapy in humans include safety and tolerability issues, tissue-specific targeting and duration of effect, and research is ongoing into identifying ways in which these barriers may be overcome. Resolution of these issues could ensure that RNAi becomes the mainstay of treatment of genetic diseases.

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Risks of Tanning

tanning

No matter the season, indoor tanning remains a habitual practice for many individuals. According to the American Academy of Dermatology (AAD), around one million people in the United States tan on average each day, with 28 million tanning indoors annually. Due to the consistent increase in these numbers, many questions have been raised regarding the potential risks of this popular trend.

Skin Cancer and Tanning

The practice of indoor tanning is most often associated with young girls, with the AAD reporting that 70 percent of salon goers are females between the ages of 16 and 29. However, there is no “typical” characteristic of a tanner, as both men and women, young and old, attend salons every day. Throughout the year, there are a number of occasions that patrons use as an excuse to get a tan, including prom, weddings, vacation, graduation, senior pictures, spring break, and more.

With the increased use of tanning beds comes an increase in the research conducted. Organizations such as the U.S. Food and Drug Administration, the World Health Organization, the Center for Disease Control, the American Medical Association, the National Cancer Institute, the Federal Trade Commission, and the AAD have all released statements and fact sheets regarding the risk of skin cancer that comes from UV radiation in the forms of melanoma, basal cell carcinoma, and squamous cell carcinoma.

Some adamant tanners choose to completely ignore the warnings that those who tan indoors before the age of 35 have a 75 percent increased chance of developing melanoma or that there is a significant increase in the risk of skin cancer for those who tan indoors more than just 10 times per year. However, it is often overlooked that the physical act of tanning may come with another set of problems.

Tanning Bed Disinfectant

In the state of Illinois, the Illinois General Assembly provides standard requirements for the sanitation of indoor tanning salons. Before providing information regarding the sanitation of the actual beds, the Tanning Facilities Code also provides specific details on the cleanliness of the restrooms, the floors, and the showers, when provided.

In regards to the cleaning of the tanning beds, the Illinois General Assembly states that all surfaces touched by clients should be sanitized after each use with a U.S. Environmental Protection Agency registered disinfectant, and that the cloth towels used for cleaning or drying must also be washed after each use with soap or detergent. However, each individual state has its own tanning facility regulations.

The problem with the mentioned requirements is that enforcement and attention to detail are not always present. Many tanning facilities are on or near college campuses, and even when not, it is often young adults who are working in or managing the salons. Although not necessarily true for everyone, this demographic tends to focus less on the cleaning portion of the job and more on the sales and commission aspect. Also, some salons do not provide the proper training, and cases have occurred where the same cleaning rag was used on more than one bed, causing the spread of sweat, germs, and bacteria from one bed to the next.

Bacteria and Infection

Although it is difficult to track where certain skin infections come from, there are many issues aside from skin cancer that can come as a result of indoor tanning. In January 2010, research was published in the Journal of the American Academy of Dermatology regarding the issue at hand.

During the study, researchers took a culture from one tanning bed at each of 10 top-rated salons in New York City. Although no cleaning was witnessed, at least one of the sampled beds held a sign stating that the unit had been cleaned. Out of the 10 cultures, all of them grew pathogens, including pseudomonas spp. (aeruginosa and putida), Bacillus spp., enterobacter cloacae, staphylococcus aureus (MRSA), enterococcus species, and klebsiella pneumonia.

While this was a simple study, the results still show that dirty tanning beds are something to be concerned about. Other potential risks mentioned by dermatologists include warts, human papillomavirus, herpes, and tinea versicolor. Many of these thrive in warm, damp environments, and tanning beds should not be excluded.

Although it is said that there is no “safe” tan, millions of individuals will continue to make use of indoor tanning facilities. In order to best avoid risks associated with bacteria and infections, tanning in a vertical or stand-up bed is one possible option. Also, sunless spray tans are a better alternative to beds that contain UV radiation. Regardless of the occasion, tanners should be aware of the potential risk factors and make sure to weigh options before hopping into a bed for a 10 to 20 minute fake bake.

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Non-Opioid Pain Management to Prevent Painkiller Addiction

non-opioid pain management
Even for those without an addictive disorder, the long-term use of opioids will result in an increased tolerance to them and withdrawal symptoms when coming off of them. This has led many primary care physicians to avoid prescribing opioids for chronic pain and instead refer their patients to pain management programs for treatment. For patients in addiction recovery, it is wise to consider the many alternatives to opioid-based pain management.

Addiction versus Dependence

According to the Journal of American Psychiatry, the word "dependence" was introduced in an effort to combat the stigma associated with the word "addiction," differentiating between patients with psychological cravings for a drug and those with isolated physical dependence. Instead of clarifying, however, this distinction has become confusing for patients. The continued interchangeability of the terms in the media compounds the problem.

The New England Journal of Medicine defines physical dependence as a physiological problem, a problem stemming from the body’s organ systems, and addiction as a psychological problem. While physical dependence is the expected outcome of chronic opioid use and involves the acute onset of withdrawal symptoms when they are stopped, those suffering from addiction exhibit an additional psychological craving for the drug. Addiction involves a pattern of behavior, both drug-seeking and drug-abusing, that is not found in those who are simply physically dependent.


Non-Opioid Pain Treatment Options

Fortunately, opioids are not the only option for pain relief. Additional treatments are available and can be used by themselves or as adjunct therapies to pain medications. Options range from non-opioid analgesics to simple exercises done at home. Used alone or in combination, they give each patient a wide array of options to control their pain.

Physical therapy modalities for pain may include ultrasound, paraffin wax, massage therapy, traction and instruction in specific pain-relieving exercises. Patients may be instructed in biofeedback techniques or receive electroanalgesia from TENS, PENS, or CES. Some therapy locations offer aquatic therapy on site, or instruction on water exercises to do at home. Occupational therapists can offer instruction in ergonomics to prevent poor posture and positioning that leads to pain problems.

Many health insurance companies are now covering the cost of acupuncture and chiropractic office visits to treat pain. Herbal remedies and supplements are not generally covered by insurance, but are an alternative treatment option to consider. Vitamin D supplements have recently been used successfully to treat musculoskeletal pain, and aromatherapy and music therapy have proven successful in some patients.

Psychological interventions for pain include hypnosis and behavior modification techniques. Pain associated with depression or anxiety may be eliminated with an antidepressant or anti-anxiety medication; and Lyrica has recently been introduced specifically for fibromyalgia treatment. Medications for pain include the non-opioid analgesics such as tramadol or Tylenol; muscle relaxants such as Flexeril or Skelaxin; and the topical analgesics like capsaicin. There are a wide variety of medications for specific pain conditions such as migraines, postherpetic neuralgia and peripheral neuropathy. For those seeking arthritis pain relief, it may be as simple as choosing the best NSAIDs for their needs.

If surgical treatment is not an option, interventional therapies such as spinal cord stimulator placement or Botox injections might be considered. Local sympathetic blocks have proven effective for chronic regional pain syndromes, and there are a variety of options available depending on the cause and location of the pain.

With the prevalence of hydrocodone addiction, non-opioid pain treatment options provide both patients and physicians with alternatives to consider. However, if pain cannot be managed with such interventions, opioids are still a safe and effective option when managed correctly. Inadequate pain relief will encourage patients to self-medicate, and a doctor-monitored program that includes opioids is preferable to self-medicating patients. Chronic pain management programs allow patients to explore all the alternatives available, including opioids, while remaining under the management of a single physician.

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Immune System Basics

immune system
The human immune system is a multifaceted entity that is designed to fulfill two tasks: it distinguishes what is “us” from what is “not us,” and then eliminates what is “not us.” Any molecule that can be recognized by the immune system – whether it is self or non-self – is called an antigen. A healthy immune system is capable of effectively handling potentially harmful antigens, including infectious organisms, allergens, and abnormal cells (such as cancer cells).

While not technically part of the immune system, there are several anatomic barriers that must be surmounted by foreign antigens before the immune system is activated: The skin, with its germ-inhibiting sheen of oils and sweat; the mucus that coats the respiratory, gastrointestinal, and urogenital tracts; and specialized, hair-like cilia projecting from respiratory epithelial cells all serve as obstacles that help prevent attacks on the human organism. Any antigen that breaches these barriers can trigger two types of immune response: innate and acquired.

The Innate Immune Response

Innate immunity (also called “natural” or “nonspecific” immunity) does not require prior exposure to a particular antigen in order to be activated. The various components that make up the innate immune response simply recognize foreign antigens as “non-self,” and they react accordingly.

Important components of the innate immune system include:
  • Phagocytic cells (neutrophils and monocytes in the bloodstream; dendritic cells and macrophages in the skin and other tissues) are responsible for “eating” and destroying invading antigens. They also “show” these antigens to other immune cells, thus initiating a cascade of events that ultimately eradicates the antigen and leads to long-lasting immunity.
  • Natural killer (NK) cells are specialized lymphocytes that detect and kill tumor cells and cells infected by viruses.
  • Polymorphonuclear leukocytes (PMNs) release cellular messengers called cytokines that trigger the inflammatory response and recruit more immune cells to areas where they are needed.

The Acquired Immune Response

Acquired immunity (also known as “learned,” “specific,” or “adaptive” immunity) is that component of the immune response that confers immune memory. Following a first encounter with a given antigen, acquired immunity affords a quicker response to that antigen in the future. Vaccinations trigger an acquired immune response, as do initial infections with certain infectious organisms, like chickenpox, measles, or mumps.

Components of the acquired immune response include:
  • T lymphocytes process antigens that are presented to them by phagocytic cells so the antigens can be effectively eliminated. Mature T cells typically only recognize a single, specific antigen; since there are billions of antigens in the environment, the capacity for T cell specialization is nearly limitless. Furthermore, some T cells will heighten the immune response (they secrete cytokines that stimulate other immune cells); others help to suppress the immune cascade once a threat has been addressed; still others are “cytotoxic” and help to kill other cells that are infected, malignant, or foreign (e.g., transplanted tissue).
  • B lymphocytes produce antibodies that bind to foreign antigens, thus making them more easily recognizable to other immune cells. B cells can produce one class of antibody by simply encountering an antigen in the circulation, but this process is slow and only confers limited immunity. However, when B cells encounter specialized T cells, they can be “educated” to produce different classes of antibodies that are manufactured much more quickly and that afford much better immune protection.
  • Antibodies are highly specific and complex proteins that are produced by B cells following exposure to circulating antigens or specialized helper T cells. Each antibody molecule matches only one antigen so, like T cells, B cells have an unlimited capacity to produce antigen-specific antibodies; they are also capable of remembering their uniquely-assigned antigens. Antibodies are ubiquitous: They are dispersed throughout the bloodstream and other tissues or attached to the membranes of immune cells.

Interaction between Innate and Acquired Systems Heightens Immune Response

In order to provide maximum protection against harmful antigens, evolution has conferred a significant degree of overlap between the innate and acquired systems. For example, antibodies that are produced as part of the acquired response will bind to cells that are part of the innate system, thereby accelerating the activity of the latter. Complement, an array of serum proteins that adheres to foreign antigens like butter on bread, stimulates phagocytic cells to engulf the antigens (innate system); at the same time, complement triggers the release of cytokines and the production of antibodies (acquired system).

Together, then, the various constituents of the innate and acquired immune systems cooperate to generate the critical activities of successful immune defense: recognition of harmful antigens; rapid response to those antigens; immune regulation and resolution once the threat has been addressed; and memory of specific antigens to afford effectual responses to future exposures.

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Lumbar Degenerative Disc Disease Symptoms

degenerative disc disease

Degenerative disc disease is one of the most common causes of low back pain, typically affecting active, healthy people in their 30s and 40s. However, since spinal disc degeneration is a natural part of the aging process, this condition also tends to affect the elderly.

What is Degenerative Disc Disease?

Degenerative disc disease is, in fact, not really a disease. It is actually a chronic, gradual deterioration of the soft, spongy discs that separate and cushion spinal vertebrae.

Over time, intervertebral discs break down, naturally losing their flexibility, elasticity and shock absorbing qualities. Ligaments surrounding discs (annulus fibrosis) become brittle and more likely to tear, causing bulges or ruptures. Also, the gel-like center of discs (nucleus pulposus) begins to dry out and shrink, making them thinner and narrowing the distance between vertebrae.

As a result, painful conditions such as spinal stenosis and herniated, bulging and protruding discs may develop by exerting pressure on the spinal cord or nerves.

These changes may also occur as a result of smoking cigarettes, performing heavy physical work or participating in repetitious activities involving bending, lifting or twisting. Obese people are also more likely to display symptoms of degenerative disc disease.

Lumbar DDD Pain

Many people with degenerative disc disease never experience pain, while others with the same amount of disc damage can feel minor discomfort or even severe pain that limits their activities.

Low back pain may start after a major injury such as from a car accident. Pain may also be triggered by minor injuries, such as falling from a low height or normal, everyday motions including bending and twisting. Sometimes, pain may also begin gradually for unknown reasons and grow worse over time.

Lumbar DDD typically causes long-lasting, dull pain in the lower back combined with occasional severe flare ups lasting for relatively short periods of time. Eventually, pain levels either return to lower levels or may go away entirely.

Common Symptoms of Lumbar Degenerative Disc Disease

Physical symptoms related to lumbar degenerative disc disease typically include some or all of the following:
  • centralized pain in the lower back
  • radiating pain, numbness or tingling sensation in the hips, buttocks and legs
  • worsening pain when sitting or standing in place
  • increased pain from activities involving bending, twisting and lifting
  • walking and running may feel better than sitting and standing
  • resting eases the pain
  • decreased pain when frequently changing positions

Sitting is often problematic for people with DDD because this position forces lumbosacral discs to support heavier loads than when a person is in a standing position.

The following warning signs are indications of a serious problem. People experiencing any of these issues should seek immediate help:
  • pain is disabling or continues getting worse
  • leg weakness, pain, numbness or tingling
  • loss of bowel or bladder control

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Migraine Headache Remedies That Bring Pain Relief

migraine headache remedies


When a migraine headache strikes, sometimes lying down in a dark room with a cool cloth across the forehead offers some relief. But usually more help is needed in order to bring migraine headache relief.

Taking Medication to Relieve the Migraine Headache Symptoms

For some migraine sufferers, over-the-counter medications offer relief in fighting the migraine pain. These medications usually contain ingredients like ibuprofen, ASPIRIN®, acetaminophen, naproxen, and caffeine. A migraine sufferer should be careful about using these medications too frequently because overuse can cause rebound headaches or a dependency problem. The Cleveland Clinic website recommends that anyone needing to use over-the-counter pain medicines more than three times a week should see a health care provider to talk about other options for treating the migraine attacks.

Where over-the-counter medications are not sufficient to provide migraine headache relief, there are prescription medicines available. These include:
  • triptans such as Axert, Frova, Maxalt, Imitrex, or Zomig. These are the prescription medicines used most frequently for the treatment of migraine headaches.
  • ergots such as dihydroergotamine or ergotamine with caffeine (Cafergot).
  • isometheptene, known as Midrin.

Some of these medicines work by narrowing the blood vessels, so they should not be taken by someone at risk for heart attacks. It is important to work with a health care provider in using these medicines.

For migraine sufferers who experience nausea during an attack, there is help in the form of nausea medicines such as prochlorperazine. Also, if nausea keeps migraine sufferers from taking other pain medications by mouth, some of the medications are available as a nasal spray, suppository, or injection.

Preventing the Migraine Attacks

If a person’s migraines are frequent and not easily controlled, a health care provider may prescribe medications to reduce the number of migraine attacks. The University of Maryland Medical Center website describes these medications as:
  • antidepressants such as amitriptyline
  • blood pressure medicines such as beta blockers (like propanolol) or calcium channel blockers (like verapamil)
  • seizure medication such as valproic acid, gabepentin, or topiramate
  • serotonin reuptake inhibitors (SSRIs) such as venlafaxine
  • selective norepinephrine uptake inhibitor (SNRIs) such as duloxetine

Using Biofeedback to Control the Causes of Migraines

For the person seeking help for migraines, biofeedback training is another possible treatment of migraine headaches. The headache sufferer can be trained to be aware of the stressful situations that might possibly cause a migraine. In some situations, they can use biofeedback (controlling heart rate, blood pressure, muscle tension, skin temperature, etc.) to prevent the attack before it becomes a major problem.

Working with a health care provider, a migraine sufferer might be able to use one or more of these migraine headache remedies to fight the crippling pain and nausea that often accompanies a migraine attack.

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Natural Constipation Relief for Adults

natural constipation relief

Every individual will experience constipation during some point in their lives, but those who are pregnant and the elderly may experience this condition with increased frequency. The National Institute of Health (NIH) in conjunction with the National Digestive Diseases Information Clearinghouse (NDDIC) have determined over 4 million adults experience constipation frequently, and use over-the-counter (OTC) remedies as treatment in a majority of cases. Most individuals perceive this condition as a medical problem when it is only a temporary condition, but it can be a symptom of the body not functioning properly and can potentially be the result of a medical condition.

About Constipation

The average person believes if a bowel movement does not occur once a day, the body is experiencing constipation. However, this condition is only present when a movement occurs less than three times a week. Other symptoms may include, but are not limited to:
  • Straining during bowel movements
  • Bloating
  • Feeling of fullness
  • Sensation of blockage

Also, this symptom has two forms, acute and chronic. Acute conditions last for a period of less than three months, and can be resolved thorough lifestyle changes and temporary use of over-the-counter products. Chronic conditions last for three months or longer and are the result of multiple causes and a potential medical condition.

Causes of Constipation

Finding constipation relief starts with determining the source of the problem, and a majority can be resolved through various lifestyle changes. Causes include, but are not limited to:
  • Fiber intake – a diet low in fiber, high in fats or a combination of these two factors can cause this symptom to appear. Increasing fiber intake by eating fruits, vegetables and grains while decreasing fatty foods such as eggs, cheese and milk can relive the effects of constipation naturally.
  • Dehydration – Hard stools can result because of the lack of fluids in the body, making them difficult to pass through the intestines. Beverages such as soda, alcohol and coffee can increase the effects of constipation, individuals should choose water and juice to increase fluids and hydrate the body.
  • Medications – Schedule an appointment with a physician if a medication is suspected to be causing constipation. Some medications can directly result in constipation or worsen an existing condition.
  • Lack of Activity – Increasing physical activity by walking or participating in mild to moderate exercise can provide constipation relief. It is believed activity can stimulate the action of the intestine, and can be used as a natural remedy.

Constipation Diagnosis, Prevention and Natural Remedies

A majority of cases of constipation will not require an official diagnosis by a doctor, and over-the-counter medications plus natural remedies can provide constipation relief. Consult a physician if needed, who will diagnose this condition through the use of medical history and physical examination. However, most cases of constipation can be relieved naturally through changing patterns of diet and exercise.

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Medical X-rays – Radiological Imaging From Film to Digital X-rays

medical x-rays

X-ray pictures were the earliest medical imaging technique. The first X-ray film of the human body was taken in 1895 by the discoverer of X-rays Wilhelm Röntgen, showing his wife’s left hand with her wedding ring. Despite the development of newer technologies such computed tomography (CT), magnetic resonance imaging and ultrasonography, X-rays remain important for the diagnosis of many disorders.

Radiography Equipment

X-rays are a type of electromagnetic radiation, similar to visible light but with a wavelength shorter than can be seen with the human eye. In nature, X-rays are generated by violent events such as an exploding star. Medical X-rays, in contrast, are produced by passing a very large electrical voltage across a device called a vacuum or X-ray tube.

When the current strikes a metal target inside the vacuum tube, X-rays are emitted, travelling with such high energy that they are able to pass through opaque objects placed in their path, in the same way that light passes through transparent substances such as glass. When the object is a human body, pictures produced by the X-rays can be used to visualize and diagnose a wide range of conditions.

The appearance of different body tissues on an X-ray picture depends on how much each tissue blocks the passage of the radiation. Bone, which blocks the most radiation, appears white, while air, which blocks the least, appears black. Tissues other than bone are represented by various shades of grey.

Digital X-ray Imaging

Traditionally, medical X-ray images have been exposed onto photographic film. X-ray films require processing before they can be viewed, however, and take up large amounts of storage space in hospitals and doctors’ offices. Over recent years, digital X-rays have become increasingly popular for radiological imaging.

To obtain a digital X-ray picture, an electronic detector is used in place of a photographic film. This detector sends the signal produced by the X-rays to a computer, which converts the signal to a digital image that can be viewed on screen immediately and saved as required.

Radiological Imaging Using Medical X-rays

X-rays are especially useful for imaging the bones, but soft tissues such as the lungs and digestive system can also be viewed and X-ray images are important in the diagnosis of illnesses such as lung cancer and kidney stones.

Other applications of medical X-rays include:
  • dental X-rays, which can detect problems with the teeth at an early stage
  • mammography to screen for breast cancer (digital mammography and computer-aided detection of abnormalities in the breast are recent advances in this field)
  • fluoroscopy, which produces moving images used to examine the action of the gut or to guide a procedure such as implantation of a cardiac pacemaker.

Are Medical X-rays Safe?

As a type of radiation, any exposure to X-rays carries a risk of cancer. However, the amount of radiation produced by a single X-ray picture is extremely low compared with the background radiation that a person experiences every day from natural sources such as cosmic rays and radioactive minerals in the earth. Health professionals consider the benefits of an accurate diagnosis and treatment to far outweigh the small risk involved in X-ray imaging.

The risks of X-rays are greater for young children and unborn babies, but the doctor will always bear this in mind when deciding on the need for medical imaging.

Other Uses for X-rays in Medicine

X-rays are used to treat disease in the form of radiotherapy, while CT scanners employ multiple X-ray beams to produce detailed pictures of soft tissues as well as bones. However, a CT scan exposes the patient to more radiation than a conventional X-ray film or digital X-ray.

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Non-surgical Treatment Options for Lumbar DDD

treatment options for lumbar ddd

Most people suffering from lumbar degenerative disc disease can be successfully treated through a course of conservative, non-surgical care.

Heat and Ice Treatments

Localized applications of heat helps to increase blood flow, which aids in the healing process. Many patients use heat on stiff muscles and joints to increase flexibility and range of motion.

Applications of ice are used to decrease localized swelling, inflammation and pain associated with many different types of injuries.

Medications for DDD Pain Relief

A variety of medications may be prescribed to manage pain associated with degenerative disc disease. Mild pain can be relieved through the use of drugs such as acetaminophen (Tylenol).

Non-steroidal anti-inflammatory medications such as ibuprofen, naproxen and COX-2 inhibitors are used not only to manage pain, but to reduce swelling in the body as well.

Intense episodes of pain are typically managed with oral steroids, muscle relaxants or narcotics. Patients must be careful when using these medications due to their sedative effects, and in the case of narcotics, the potential for addiction.

Each situation is unique and some medications are not appropriate for all patients. Therefore, patients should always discuss medications, side effects and other factors with a physician prior to accepting any prescription.

Epidural Steroid Injections

Epidural steroid injections (ESI) are a common treatment option for low back and leg pain. The primary goal of ESIs is to relieve pain by delivering medication directly to the source. A secondary goal is to decrease inflammation around the damaged disc, providing healthy discs with an opportunity to repair themselves.

ESIs are given by using fluoroscopy to place a needle close to irritated nerve roots or directly into the foraminal space and bathing the area in a steroidal solution.

Chiropractic Manipulation to Relieve Pain

During the first month of therapy, acute and chronic low back pain and degenerative disc disease not associated with nerve compression may respond to chiropractic manipulation. Chiropractic care has the ability to relieve low back pain by taking pressure off sensitive nerves and tissue, reducing muscle tension, increasing range of motion and restoring blood flow to affected areas. These manipulations also may promote the release of natural endorphins within the body to act as natural painkillers.

Exercise Programs for Lumbar DDD

Exercise programs have proven to be successful in relieving pain from lumbar DDD. Elements of a good exercise program include:
  • Low-impact aerobic workouts such as walking, swimming and biking relieve pressure on the discs and provide better flow of blood and nutrients to spinal structures. Aerobics also improve muscular endurance, coordination and strength.
  • Hamstring stretches to reduce tightness, which increases stress on the back and pain caused by a damaged disc.
  • Other stretches to improve flexibility of the back and abdominal muscles. Flexion exercises may also help widen the foramen, which are small canals where nerve roots exit the spinal cord.
  • Strengthening exercises to increase support of the lower back and help patients find and maintain comfortable spine positions.

Patients should discuss exercise options with their doctor before starting any program. It is extremely important to stop participating in any exercise that increases pain levels until consulting with a physician.

Other Conservative Treatment Options

In addition to the above options, with the approval of a doctor, patients can try other treatments including:
  • Massage – Helpful for increasing blood flow and reducing muscle spasms.
  • Acupuncture – Helps control pain, but for best results, should be combined with an approved exercise program.
  • Pilates and yoga – Alternative forms of low-impact exercise that help increase both strength and flexibility.

Surgery is usually considered only for patients whose pain has not been relieved after six or more months of conservative therapy or those who have trouble performing everyday activities.

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Night Blindness: Causes and Treatment of Decreased Night Vision

night blindness

Decreased night vision is a common concern for adults over 50. Although some middle-aged adults may realize that their night vision is not as clear as it once was, others may try to deny there is a problem. Decreased night vision among older adults is especially concerning because it may affect their ability to drive after dark.

Causes of Night Vision Problems

Difficulty seeing in dim light is known as night blindness. Night blindness isn’t actually a disorder – it’s a symptom of other underlying problems. One common cause of night blindness is untreated nearsightedness or myopia. Night blindness can also have a variety of other causes, including vitamin A or zinc deficiency and exposure to the sun.

Night vision problems can be caused by chronic diseases, such as diabetes. People with diabetes often experience nerve damage, which can affect the retina and lead to night blindness. Problems specific to the eye can also cause night vision problems. For example, the first sign of cataracts is often declining night vision. Glaucoma is increased pressure in the eye and may also cause this problem. Complications of LASIK surgery can cause problems with night vision.

Diagnosis and Treatment of Night Vision Problems
Those who suffer with night vision problems should make an appointment to see an ophthalmologist. The doctor will dilate the patient’s eyes and examine them using a bright light to examine the inner parts of the eye. Other tests may also be performed. Any serious cause of night blindness can be detected through this type of exam.

Treatment for night vision problems depends upon the cause. Cataracts can be treated with surgery, and vitamin A and zinc deficiencies can easily be corrected with diet or supplements. If night blindness is caused by diabetes, tight blood sugar control may lead to improvement. For patients who have night vision problems caused by untreated myopia, corrective lenses may correct the problem.

Aging and Night Vision Problems

Night vision problems are especially common among older adults for a variety of reasons. For many older adults, vision changes happen so gradually that they go unnoticed. According to All About Vision, pupils of older people don’t allow as much light to enter the eye. The cornea and lens can become less clear. Older adults have a reduced ability to discern small differences in brightness, which can make it more difficult to see objects in dark or dim light.

More serious eye problems that are related to the aging process can cause decreased night vision. Examples include diabetic retinopathy, age-related macular degeneration, glaucoma and cataracts.

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Nosebleed Causes, Prevention and Treatment

It is very common, especially in children, to suffer from an occasional bloody nose. Nosebleeds are usually easy to treat and are not a cause for concern. However, frequent recurring nosebleeds may indicate a serious condition that requires medical attention.

nosebleed

Causes of Nosebleeds

Nosebleeds may be triggered by numerous factors; here are some of the most common:
  • Dry air: The mucosal lining of the nose is very thin, and when the air is dry, such as in the winter when indoor rooms are heated or in the summer in dry climates, the nasal mucosa can become dry and cracked.
  • Trauma: Trauma to the nose from the outside as by a blow, or from the inside by picking the nose or vigorous nose-blowing can break small vessels.
  • Decongestants: Decongestants, corticosteroids, and other allergy or cold medications can dry out nasal passages.
  • Allergies and infections: Allergies and acute or chronic sinus infections can cause inflammation of the nasal passages, which can lead to irritation. Frequently blowing the nose due to congestion can further irritate membranes.
  • Blood-thinning drugs: Certain types of blood-thinning drugs such as aspirin, heparin and warfarin (Coumarin) inhibit blood coagulation and may produce or worsen nosebleeds.

Frequent nosebleeds may be a sign of a serious medical condition. Leukemia, tumors or polyps in the nose or sinus cavity, high blood pressure, and bleeding disorders including hemophilia, von Willebrand disease, and Osler-Weber-Rendu syndrome are some conditions that can produce recurring nosebleeds. If nosebleeds occur more than once a week, or if the bleeding is heavy and continues for more than a few minutes, see a medical professional.

How to Prevent and Treat Nosebleeds

Nosebleeds can be divided into two general types: anterior (front) and posterior (back). The vast majority (over 90%) of nosebleeds are anterior, with the blood coming from the nasal septum, the wall dividing the two nasal passages. Anterior nosebleeds are usually easy to stop with simple first aid. Posterior nosebleeds, which occur more often in older adults between the ages of 50 and 80, can be a more serious condition because the bleeding is from an artery at the back of the nose, and they are more likely to require medical attention.
To help prevent nosebleeds from occurring, keep air inside the house from becoming too dry by using a humidifier or placing a pot of water on low heat on the stove top, radiator or wood stove and allowing it to evaporate.

Gently apply a small amount of ointment such as petroleum jelly or a water-based moisturizer to the inside of the nose with a cotton swab to keep nasal passages from drying out. Saline nasal sprays can also be used to moisten the mucous membranes.

When a nosebleed occurs, do the following:
  • Sit up straight or lean forward slightly to prevent the blood from running back into the throat. If swallowed, blood can cause nausea and vomiting.
  • Gently pinch the nose between the thumb and forefinger and hold it for at least ten minutes, or until the bleeding stops.
  • Spit out any blood that has entered the mouth.
  • Try not to irritate the nose for at least 24 hours.

For those who suffer from occasional nosebleeds due to nasal dryness, taking steps to humidify the air and moisturize the inside of the nose should help to alleviate the problem. If recurring nosebleeds persist with no apparent cause, see a medical professional.

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Over-Sanitization and Its Impact on Health & the Environment

When the H1N1 pandemic struck, health authorities encouraged the use of hand sanitizers and disinfectant spray in an attempt to stem the outbreak. But while there is nothing wrong with the use of sanitizing products per se, too many people might have taken the way advice too far.

over-sanitization

Prevalence of Triclosan and Triclocarban in the Environment

Triclosan and triclocarban are two chemicals commonly used in many household cleaning products and in disinfectants – otherwise known as antimicrobials. In sufficient amounts, these two chemicals are known to cause among other things skin irritation, allergy susceptibility, bacterial and endocrine disruption.

These chemicals do not break down easily once it is washed down the drain. Traces of triclosan have been found in many of the waterways in the United States and even downstream from water treatment plants. This resilience to treatment is cause for great concern because once exposed to sunlight and water, triclosan could change into a toxin called dioxin.

High concentrations of dioxin can cause skin lesions and even alter liver functions. Long term effects of dioxin exposure could cause problems with the immune, nervous, endocrine and reproductive systems in the body. It is no accident that the majority of disinfectants have a warning label disclaiming the toxicity not mentioned in the commercials.

Don't Overuse Hand Sterilizers

Hand sanitizers that use an ethanol or alcohol base, are an effective means of reducing bacteria count on hands. However, only those with ethanol or alcohol concentrations of at least 62% are of any significant use. The effectiveness of sanitizers with anything less are comparable to washing with just plain water.

Alcohol and ethanol chemically denature proteins. Denaturing occurs when a protein is subject to outside chemical or temperature stresses. Frying an egg on a pan is an example of heat-based denaturing. Exactly like how lime juice "cooks" a piece of salmon, alcohol and ethanol literally cooks bacteria off by denaturing the protein found in all bacteria.

Great care must be taken when choosing hand sanitizers. While most commercial hand sanitizers incorporate moisturizers, some do not. Originally used by medical personnel to sterilize their hands between patients, hand sanitizers without a moisturizing component can cause excessive dryness and, in extreme cases, dermititis, or commonly known as rashes.

Over-Sanitization on Children

The risk is even greater for young children. According to a guide by the Department of Health and Senior Services in the State of Missouri:
All sanitizers are classified as a pesticide. If the wrong product is used, or is mixed too strong, it could be toxic to children. Young children absorb chemicals into their bodies easier than older children and adults. Because of their small body size, a small amount of any chemical has a much greater affect on them than adults.

Understandably, home makers want to ensure that their households are clean and free from bacteria. But it seems that the cure could be more dangerous than the problem.

Furthermore, in the effort to achieve new heights of clinical sterility, children are developing weaker and weaker immune systems. Because their bodies are not given the chance to come into contact with as many types of bacteria, their immune systems become under-developed and weak. Weak immune systems translate into more illnesses later in life when they leave their sterile environment.

Back to the Basics of Cleanliness

But no one is suggesting a spit and polish approach to house cleaning either. Not that it is inherently bad to use sanitizing products but moderation is key here. Soap and warm water is still an effective means of removing a vast majority of bacteria harmful to health. There is no need to perforate every inch of the house with disinfectant to stay healthy.

And while hand sanitizers are a convenient means of cleaning hands in the absence of soap and water, they are not a substitute. Hand sanitizers were originally intended to eliminate the chance of cross-contamination in hospitals where the patients either have weak or no immune defences. Instead of using obsessively using hand sanitizers, simply practice the recommended steps of safe hygiene like sneezing into elbows (instead of the hand) or staying home when sick.

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Participatory Medicine

participatory medicine

Participatory medicine is the emerging paradigm of health care. Dr. Zerhouni, Director of the National Institutes of Health, stated in an interview that the relationship between patient and doctor is changing rapidly. Previously, the patient assumed a passive role, receiving direction from an all-knowing doctor. The doctor is now expected to provide more explanation and communication with the patient and the patient is expected to become more literate and take a more active role in his or her own health.

Internet Use Resulted in the Emergence of the e-patient

The availability of the Internet allowed patients to access medical information that was previously unavailable. The medical establishment previously took the view that the lay person was generally unable to understand complex medical problems, so medical libraries and other sources of information were "off-limits." The Internet leveled the playing field, and the results were astounding. When individuals faced medical problems (their own or that of friends or relatives) and found the medical establishment inadequate to supply answers, they found an immense resource of information on the Internet.

Dr. Tom Ferguson was a prime mover in e-patient empowerment, and established the e-patient Scholars Working Group. His ideas were incorporated in a White Paper called "e-patients-how they can help us heal health care." According to Dr. Ferguson, the term e-patients describe individuals who are equipped, enabled, empowered, and engaged in their health care decisions.

Online Research: How Patients Find Answers not Available in Doctors' Offices

The Internet provides networks of support groups of people who have similar interests in particular medical conditions. The interaction among members results in an understanding of the disease that can be difficult for a person researching alone. A survey of members of online support communities found that online groups ranked higher than physicians for:
  • convenience
  • cost-effectiveness
  • emotional support/compassion/empathy
  • help with issues of death and dying
  • medical referrals
  • practical coping tips
  • In-depth information

The Internet is a particularly valuable resource to learn about state-of-the-art treatments at top treatment centers as well as to learn about treatment options. People with limited access to professional care may find that the Internet is the only resource to become informed about a medical condition.

Can the Medical Community Learn from Patient Research?

The explosion of medical knowledge can make it difficult for even specialists to keep up in their field. This is particularly true if the disease is rarely encountered. Physicians are so busy that they can really benefit from the input from their patient "junior partners."

The e-patients White Paper related the story of Norman Scherzer. His wife contracted a rare form of cancer that was initially misdiagnosed. Through online research he found a specialist that made the correct diagnosis as well as a clinical trial on an experimental drug. His wife was eventually cured. Scherzer established an online group with an impressive array of lay people and specialists who keep up-to-date with the disease. This model can be used for other diseases as well.

The sexual effects of Viagra were originally discovered by patients when they reported on the dramatic side effects of the drug originally designed for angina patients.

A New Journal to Study Participatory Medicine

The Journal of Participatory Medicine was established to create a forum where healthcare professionals, caregivers, and patients all could have a voice to contribute and these voices would be heard. As a result of this participation, a common language could be developed that would describe ideas that resonate among everyone. This communication could result in fresh perspectives brought to the table resulting in clearer understandings and new directions to take in delivering health care. The journal is committed to discover the best practices of participatory medicine and to test their effectiveness in improving health care and reducing costs.

How Can Participatory Medicine be Advanced?

Education is essential to teach people to take care of their own health, to research treatment methods, and to evaluate a doctor's performance. People need to be persuaded to take part in their own health by studies, narratives and reflections.

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Ocular Albinism

ocular albinism

The lack of pigment that defines albinism affects not only outward appearance, but ocular development, as well. Oculocutaneous albinism affects pigment in the skin, hair and eyes. Ocular albinism exclusively affects the development of the eye. In these patients, skin and hair pigmentation appears normal. People with both forms of albinism experience congenital visual problems associated with lack of pigment in the eye.

Albinism is a genetic condition. Because of this, and because of the complexity of the eye, treatment options for vision problems associated with albinism are limited. However, there are existing treatments that can improve patients’ vision, and recent research in gene therapy may give new hope to sufferers.

Vision Problems Associated with Albinism

According to Richard and Laura Windsor of the Low Vision Centers of Indiana (2004), the defining characteristic of ocular albinism is poor development in the center of the retina. This area, called the foveal pit, controls fine vision in a normal eye. Without the ability to focus properly, people with albinism may experience:
  • low visual acuity
  • nystagmus (eye shaking)
  • oscillopsia (disturbed vision in which fixed objects appear to move)
  • strabismus (crossed eyes or eyes that otherwise do not move together)
  • photophobia (sensitivity to light)
  • unusual head or eye movements compensating for variations in vision

There is no surgery or treatment that can correct the developmental defect in the retina of the eye. However, there are some treatments for the specific symptoms associated with albinism. Additionally, vision aids and other treatments that work for the general population can improve the visual acuity of albinism sufferers, as well.

Treatments for Ocular Albinism

While ocular albinism can result in varying levels of visual disability, sufferers can generally adapt well. The disorder is not degenerative, so vision problems that develop later can usually be attributed to the types of vision disorders, such as myopia and hyperopia, that are common in the general population. Treatments for the general population can be used for ocular albinism sufferers, as well. These include:
  • eyeglasses and bifocals
  • prescription sunglasses
  • contact lenses
  • magnifiers
  • surgical laser reshaping (LASIK)
  • lens implant
  • lens replacement

None of these, however, correct any of the congenital defects of ocular albinism. Surgery on the muscles that control eye movements can be used to correct strabismus and improve binocular vision. A similar surgery may be used to minimize nystagmus.

Hand-held telescopes, and bioptic telescope eyeglasses can help with the distance vision issues common in ocular albinism. While some of these devices can be bulky and make the wearer self-conscious, the BITA system is comparatively unobtrusive telescopic eyewear. Another company makes auto-focusing telescoping eyewear.

Research into Albinism

Albinism is a rare disorder that, according to the National Association of Albinism and Hypopigmentation (NOAH) affects approximately one in 17,000 people. Because ocular albinism is rare, non-degenerative, and its sufferers usually adapt well, there is very little research being done into therapies specifically for this condition. However, researchers are working on mapping the specific faulty genes that cause albinism.

Additionally, gene therapy has already been used to improve the vision of patients with congenital blindness. In 2008, researchers at the Children’s Hospital in Philadelphia successfully used gene therapy to improve the vision of three blind patients. While those patients suffered from a different vision disorder, the successful use of gene therapy as a treatment for that retinal disorder indicates that it may one day be used for ocular albinism sufferers, as well.

While there is no treatment specifically for ocular albinism, vision aids, surgery and the adaptability of those affected can minimize the impact of the vision disorder on patients with albinism. The successful use of gene therapy in treating a similar ocular disorder gives hope that a cure is on the horizon for the visual problems associated with albinism.

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Lyme Disease – Know the Signs and Symptoms

lyme disease

Lyme disease is an illness caused by bacteria from the species called Borrelia. This bacterium can live in the stomachs of deer and mice. When a tick feeds from an infected animal, they can become carriers of this bacterium. These ticks can spread the disease to a person by biting the skin thus allowing the bacterium to enter the human body. The disease cannot be spread from person to person. (Journals.uchicago.edu “Clinical Infectious Diseases,” accessed October 6, 2016).

Symptoms of Lyme Disease

Early symptoms of Lyme disease develop within days to weeks of the initial contact. The early symptoms include headaches, fever, weakness and fatigue. The area on the skin where the bacterium enter becomes inflamed with a red, circular, non-raised rash that eventually looks like a bull’s eye target. Not all patients develop this rash and the rash, swelling and redness can resolve on its own in about a month.

Other early symptoms may include muscle and joint stiffness and swollen glands or swollen lymph nodes. According to the Centers for Disease Control, “Lyme Disease”, most cases of the disease can be eliminated if treated early with antibiotics.

If the early symptoms are not treated, the disease can worsen and lead to more serious symptoms affecting other body systems. In a few weeks to months after the initial tick bite, the infection spreads throughout the body. The joints and the nervous system can become affected.

When the disease reaches the joints and nervous system, a person can experience numbness and tingling in muscles and pain and inflammation in the knees and other large joints. Other symptoms may include a stiff neck, light-headedness, confusion, nausea and vomiting and meningitis. Lyme disease can cause anxiety and extreme depression.

As symptoms progress, the patient can have blurred vision, drooping eyelids, sensitivity to light, dysfunctional movement and loss of muscle function. They can develop facial paralysis, also called Bell’s palsy, can experience hallucinations, can have speech impairment, can have decrease in consciousness and become unconscious.

The development of chronic arthritis, usually only in one or a few joints, is a common symptom of this disease. Other late symptoms of Lyme disease can be inflammation of the heart muscle causing palpitations and abnormal heart rhythm. If a patient is not treated effectively, Lyme disease can cause heart failure and death. (Mayoclinic.com “Lyme Disease,” accessed October 6, 2016).

Prevention of Lyme Disease
There are several defense measures that help prevent Lyme disease. One of these measures is to avoid any skin exposure while in areas where ticks live and thrive. These areas include wooded areas and areas with tall grass.

Another preventive measure is to spray exposed skin and clothing with insect repellent prior to engaging in outdoor activities. Other measures include wearing long-sleeves and long pants, and wearing boots while outdoors. Some ticks are very hard to see. Wearing light-colored clothes can help detect exposure.

Pets should be examined routinely for existence of ticks. If pets who acquire ticks play in or around an area where humans play in or around, these play areas should be treated with safe but effective products that eliminate ticks. Ticks should also be removed safely and effectively from pets.

Once back indoors, clothes should be removed immediately. Skin and clothes should be examined thoroughly. The hair and scalp should also be examined closely for ticks. It is also important to properly remove ticks.

If it is necessary to remove a tick from the skin, the area should be cleaned with soap and water immediately after removal. If a person feels like they are symptomatic of Lyme disease, it is important to get diagnosed early by a physician. Early treatment of Lyme disease is the most effective way to prevent it from becoming serious. (Cdc.gov “Lyme Disease Treatment and Prognosis,” accessed October 6, 2016).

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