Participatory Health: A New Paradigm Centered Around the Patient

participatory health

The National Council on Aging reports that one third of all chronically ill people say they leave a doctor's office or hospital feeling confused about what they should do to continue their care; 44 percent of people (aged 44 and older) with chronic conditions want their doctors to spend more time talking with them; and 57 percent report that their healthcare providers have not asked whether they have help to manage their conditions at home.

Most of these concerns arise from the fragmented nature of health care delivery in America and the fact that there's often a gap, a disconnect in the amount of digital health information and the exchange of data among providers, patients and caregivers. How often do patients go in for routine tests but never receive a call about their results, good or bad? Why do some patients wait hours to see a physician, only to spend 15 minutes in the exam room and not have all of their concerns heard or addressed?

The healthcare system today is so taxed that physicians often feel pressure to see as many patients as possible, in the shortest amount of time. Though it's a sad state of affairs, the impact can be minimized through today's increasing reliance by society on mobile devices, which can lead to better patient-provider interactions. mHealth, participatory health and participatory medicine are just a few terms that address this new area of healthcare but what do they all mean?

Understanding mHealth

According to the mHealth Initiative, only one year ago, many people didn’t know the meaning of the term "mHealth." Now more and more individuals are familiar with the term (also written as m-health or sometimes mobile health), a recent moniker for medical and public health practice supported by mobile devices.

With the lofty, ambitious and admirable goal of connecting providers, patients, payers, and others came a complement to this endeavor, the idea of better communication in healthcare through participatory health.

Defining Participatory Health

Most experts define participatory health as a partnership between patients and providers and trusted experts, one in which participation is enabled and enhanced by technology such as the Internet and mobile health platforms.

Participatory health is also sometimes referred to as participatory medicine, a movement in which networked patients shift from being mere passengers to responsible drivers of their own health, and in which providers encourage and value them as full partners, according to the Society for Participatory Medicine.

The Need for Participatory Health

In a September 2009 report prepared for the California Healthcare Foundation, "Participatory Health: Online and Mobile Tools Help Chronically Ill Manage Their Care," Jane Sarasohn-Kahn, M.A., M.H.S.A, Think-Health, includes the following quote that speaks volumes about the state of healthcare today and the need for participatory health:

"In our country, patients are the most under-utilized resource, and they have the most at stake. They want to be involved and they can be involved. Their participation will lead to better medical outcomes at lower costs with dramatically higher patient/customer satisfaction." - Charles Safran, M.D., President, American Medical Informatics Association in testimony before the Subcommittee on Health of the House Committee On Ways and Means, June 17, 2004

To this end, companies like Healthetreatment strive to enable individuals to share health and wellness knowledge so that others diagnosed with the same or similar conditions can learn from their experiences. Simply put, the site is creating a catalog of health conditions, symptoms and treatments compiled by real people.

According to Mike Bennett, the founder of Healthetreatment, user-generated health information is more robust and more current than existing medical resources. The key to being current and comprehensive, in his view, is to keep people coming to the website to provide the latest information on their condition.

Achieving the Best Potential Health Outcomes

By linking the patient back to his or her physician or healthcare provider, the m-health and participatory medicine movements will go a long way toward ensuring that patients receive the best possible care and that they play a critical, central role in their own health and well-being. As the e-patient movement gains momentum, the power of the online crowd will grow, allowing for improved medical outcomes and quality of life through better healthcare communication.

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Scoliosis – One of Several Disorders of the Spinal Column

scoliosis

Scoliosis is a condition where the curve of the spine, or backbone, is not aligned correctly. In a person with scoliosis, the spine curves from side to side instead of in a straight line. On an x-ray, the shape of the spine may look like the shape of the letter S or the letter C.
According to the National Scoliosis Foundation in its “Information and Support” section, scoliosis affects two to three percent of the population. An estimated six million people in the United States has some type of scoliosis.

Classifications of Scoliosis

There are five main classifications or types of scoliosis which relate to the possible cause. The most common class is called idiopathic, which means the cause is unknown. This class is further broken down into subclasses which describe the age of onset. Idiopathic scoliosis is sub-classified as infantile, juvenile, adolescent or adult.


The second class is called congenital scoliosis. In this class, the abnormality of the spine existed at birth or the cause was due to vertebral abnormalities that were present at birth.

The third class of scoliosis is called neuromuscular. Neuromuscular scoliosis develops as a result of a secondary problem of another medical condition. Conditions such as spina bifida, spinal muscular atrophy, marfan’s disease, cerebral palsy or some kind of physical trauma can impact the formation of the spine as well as the curvature of the spine.

The fourth type is called functional scoliosis. An abnormal curvature of the spine develops because of a problem in another part of the body. One leg being shorter than the other, frequent back spasms or pain in the hips and knees can, over time, impact the normality of the curve of the spine.

The fifth class or type is called degenerative scoliosis. This type is more often seen in adults and is caused by changes in the spine due to age. Some conditions that lead to curvature of the spine due to age include arthritis, weakening of ligaments, muscles, and soft tissue and development of bone spurs.

Signs and Symptoms of Scoliosis

Most cases of scoliosis are mild with slight noticeable changes in the body. Most cases do not cause pain. A person with scoliosis may notice that his clothes do not fit as they did before. Or, he may notice that one pant leg is longer than the other.

Other signs of scoliosis may include uneven muscle formation on one side of the spine, a more prominent shoulder blade or rib prominence. The lengths of the hips or the shoulders may be uneven. A female may notice that one breast size or location is slightly different from the other.
In severe cases, scoliosis can cause more severe symptoms. A person may experience slower nerve action or aches and pain, especially in the back. Due to the asymmetry of the chest, a person with scoliosis may find it more difficult to take a deep breath or may have periods of shortness of breath.

In the severest of cases, pressure on the heart and lungs can cause circulatory and more serious breathing problems. And, finally, severe scoliosis can restrict a person’s physical activity and mobility, according to the article “Scoliosis Symptoms” on the Mayo Clinic website.

Treatment for Scoliosis

The treatment or the management of scoliosis is determined by the type of scoliosis, the severity, the person’s age, likelihood of progression and the symptoms. There are four conventional treatments that include observation, physiotherapy, bracing and surgery.

Observation involves routine evaluations and x-rays by the physician. Treatment of idiopathic scoliosis will be based on the age when it develops. If the spinal curvature is minimal and remains below a certain degree, no other treatment is needed.

If during the observation period, the spinal curvature progresses, a brace may be recommended. Bracing may be more effective in the juvenile idiopathic type of scoliosis because it is this type that has the greatest tendency to progress. The goal of bracing is to prevent the curvature from getting worse until the adolescent has finished growing. When bracing is not meeting this goal, a more aggressive type of treatment may be indicated.

In the neuromuscular scoliosis types, bones of the spine have developed abnormally and it is this type that most often will require surgery to stop the spinal curvature from getting worse. When the progression of the curvature causes lung and heart problems, surgery may be the only effective treatment.

With functional scoliosis, the type where the abnormality is caused from somewhere else in the body, treatment is not directed on the spinal curvature. Treatment in these cases, if treatment is necessary, is focused on relieving the symptoms and correcting the source of the problem.
A person with degenerative scoliosis or a type of scoliosis that is causing pain, especially in the back, will be treated with pain relieving methods. Some treatments that could be recommended here are physical therapy, exercises, chiropractic intervention, bracing and pain relieving medications. If these and other pain relieving measures fail, surgery may be the only solution.

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Techniques Expected to Change Health Care

health care

Dr. Mache Seibel, a professor at the University of Massachusetts Medical School uses music to promote health education. HealthRock® uses contemporary songs to convey lessons on how people can live healthier lives. They are encouraged to make common sense lifestyle changes. The technique uses a variety of musical genres from gospel to pop, he said.

The musical technique has won recognition for its effectiveness from many publications and organizations. It is available in recordings and live performances at the Centers for Disease Control and Prevention and elementary schools. The technique is available at other locations too, Seibel added.

HealthRock Addresses Chronic Problems

According to the CDC, chronic health problems, such as cardiovascular disease, cancer and diabetes are among the most prevalent, costly and preventable health problems.

“The fundamental problem is that 90 million American adults and most American children are health illiterate. They don’t know how to keep themselves and their family members well,” he said.

To address these problems, he wrote songs that targeted specific health-related illnesses, such as obesity. “Phat Fat Rap,” “Exercise” and “Don’t Be Afraid of a Squash” are meant to encourage exercise and eating habits that fight obesity.

Guided Imagery Reduces Difficulties

Kathryn Farinholt, a Catonsville, Md., resident, developed a four-step technique that teachers, nurses, supervisors and human resource people can use to deal with difficult employees, students and patients.

Farinholt, who holds a doctorate, created the Defusing Difficulties course and began teaching it to her American clients. Now, she is ready to market the technique to health care providers, educators and stress management teams.

“Defusing Difficulties is a stress reduction technique known as guided imagery anyone can master in four simple steps,” said Farinholt. “Some of my clients who have mastered the technique tell me the problem was reduced or went away or like it never happened.”

On Sept. 10-11, 2009, Farinholt presented her technique to the Mid-Atlantic Association of Community Health Centers 2009 Annual Meeting and Conference. The technique was well received. Farinholt plans to teach the course Oct. 15, 2009, at the Howard County Community College in Maryland.

Although Farinholt does not have a health background, she does have an educator background and has had situations dealing with difficult people. She developed the technique to help her cope with those situations without causing additional problems. Those who have mastered the technique have reported their difficult problems disappeared once they applied the technique.

To master the technique, Farinholt said, health care providers must give it three weeks. They are taught to try it three times a day. She also recommends parents and spouses to use the technique in family situations that are usually highly emotionally charged.

These are two techniques that could revolutionize treatment for medical problems or stressful situations.

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Idiopathic Thrombocytopenic Purpura Symptoms

idiopathic thrombocytopenic purpura

Idiopathic thrombocytopenic purpura, or ITP, is a syndrome in which the blood does not clot properly due to a low number of thrombocytes, commonly known as platelets. Platelets are blood cell fragments produced in bone marrow that stick together, or clot, to seal cuts and stop bleeding.

An individual with ITP will often have purple bruises on the skin or in membranes such as the mouth. The bruises indicate bleeding has occurred underneath the skin. More extensive bleeding can create a hematoma, which is a collection of clotted blood under the skin that looks and feels like a lump. ITP is not contagious and cannot be passed from one person to another. However, it is possible for a pregnant woman affected by the syndrome to pass the symptoms to her baby during delivery.

The Cause of ITP

The exact cause of ITP is unknown. Therefore, it is labeled as idiopathic, which means "of unknown cause." Doctors do know that the syndrome is a result of a malfunction within the immune system. Antibodies produced by the immune system mistakenly attach themselves to platelets which targets the platelets for disposal. The spleen recognizes the antibodies and removes the platelets from the individual's system, resulting in a low number of platelets. As the amount of platelets decreases, the risk for bleeding increases.

The syndrome is not usually dangerous until the platelet count reaches 10,000 platelets per microliter of blood. At this point, internal bleeding may occur despite the absence of injury. When ITP occurs in children, the syndrome usually follows a viral infection. However, no correlation between infection and ITP exists for adult cases.

The Symptoms of ITP

ITP exists in two forms: acute and chronic. Acute ITP will last six months or less, mostly occurs in children and is the most common type of ITP. Chronic ITP lasts six months or longer and can affect an individual for a lifetime. This form usually affects teenagers and adults. Women contract the syndrome two to three times more often than men. Knowing the symptoms of ITP is necessary to know whether or not to seek treatment. The symptoms of this syndrome include:
  • easy and excessive bruising.
  • excessive bleeding from cuts and scrapes.
  • spontaneous bleeding from gums or nose.
  • blood appearing in urine or stool.
  • heavy menstrual flows.
  • excessive bleeding during surgery.
ITP is not a serious or life-threatening condition. However, doctors and dentists should be informed if a patient has ITP in order to be prepared for any extensive bleeding during surgery or other medical procedures.

Treatment for ITP

Children and adults with mild cases of ITP often never need treatment for the syndrome. Typically, a hematologist, a doctor specializing in blood disorders, will monitor the individual's platelet counts on a regular basis to ensure the count does not become dangerously low. Several treatment options exist for individuals with severe cases of ITP. Immunosuppressant drugs, such as prednisone or Rituxan, can increase platelet levels by suppressing activity in the immune system. Another treatment option for severe ITP is a splenectomy, which removes the spleen. The spleen is responsible for disposing cells that antibodies have marked for destruction. Therefore, removing the spleen can help preserve these cells.

Preventing Symptoms of ITP

ITP is not a serious condition, and the syndrome rarely creates dangerous complications. However, there are certain steps individuals can take to relieve the symptoms. Individuals with ITP should avoid over-the-counter medications that affect platelets, such as ibuprofen and ASPIRIN®. ITP patients should also protect themselves from injury as much as possible to decrease the occurrence of bleeding under the skin. Avoiding sports or other recreational activities may be necessary. This population should also seek immediate medical care for infections, especially those who have had splenectomies. Individuals with ITP should also be under the supervision of a hematologist to regularly monitor platelet counts.

Living with ITP does not require drastic lifestyle changes or treatments for most individuals. Staying informed and paying attention to symptoms can help individuals with ITP effectively manage the syndrome for the duration.

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Tennessee Teenager Cries Tears of Blood

tears of blood
Calvino Inman regularly sheds tears of blood, up to three times a day and up to an hour each time. The first time it happened his mother, Tammy Mynatt, rushed him to the Emergency Room but by the time they arrived, the bleeding had stopped. Inman was so frightened that he asked his mother if he was going to die.

Tests and Specialists Come Up Empty

Inman has had MRIs, ultrasounds, CAT scans and has seen several specialists, but nothing can give them a concrete explanation. Ophthalmologist Rex Hamilton believes he may be suffering from haemolacria, which literally means “bloody tears.” He told Good Morning America, “That is just a descriptive term of the manifestation of the bloody tears. It says nothing about what’s causing that. It’s a one-in-a-million kind of condition.”

Is Teenager Possessed?

Kids that go to school with Inman are afraid, thinking he may be possessed. While cases are uncommon, they are not unheard of. Some cultures treat this type of thing with fear, while others associate it with stigmata, meant to represent the blood of Jesus on the cross. Other examples of eye-ducts crossing wires are people who drink milk and squirt it out of their eyes, and smokers who blow smoke out of their ears.

Indian Girl Bleeds Through Skin

13-year-old Twinkle Dwivedi of India has a disorder where she loses blood through her skin without any cuts or scratches. She must undergo transfusions after pints of blood seep through her eyes, nose, hairline, neck and soles of her feet. Medics believe this is an extreme version of a rare blood platelet disorder that has no cure. Her blood is dangerously low in clotting particles, making her blood watery.

Hamilton Eye Institute Study

Dr. Barrett G. Haik, Director of University of Tennessee’s Hamilton Eye Institute, says haemolacria is common in people who have experienced extreme trauma or have recently had a serious head injury. Haik and a team of researchers published a 2004 study in the Journal of the American Society of Ophthalmic Plastic & Reconstructive Surgery between February 1992 and January 2003. Only four cases were recorded and in all cases the bleeding stopped on its own.

Hamilton Eye Institute to Do Analysis

Dr. James C. Flemming, ophthalmologist at the Hamilton Eye Institute, is reviewing Inman’s medical records, looking for complications such as blood clots, growth or tumor near the eye, or even a simple infection. An analysis will also include a psychological evaluation to rule out the possibility the tears were faked. There have been cases where children seeking attention found creative ways to simulate haemolacriatic symptoms. Tammy Mynatt just wants someone to help her son.

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10 Tips For Day Surgery Procedure Patients

day surgery procedure

Day Surgery admission enables a surgical procedure to be undertaken with preparation, recovery and discharge home all on the same day. As successful Day Surgery is a streamlined and time-efficient process, the patient should be well-prepared and organised to minimise delays and maximise safety. Follow these ten handy tips that address areas of concern for patients and staff to achieve a Day Surgery procedure experience that runs smoothly from start to finish.

1. Day Surgery Information is Important

  • Patients must read the pre-surgery instructions provided by the hospital or Day Surgery Unit.
  • Always follow exactly the advice given by the doctor and hospital.
  • Patients should arrive on time. Day Surgery Unit schedules are carefully arranged. Check where and when the patient needs to present. Allow time for traffic, parking and finding the location of the Day Surgery centre within the hospital.

2. X-rays and Scans

  • The most recent X-rays and scans of the area on which surgery will be performed should always be brought to hospital.
  • Surgery may be cancelled if the surgeon cannot access the images.

3. Fasting For Day Surgery Procedures

  • Patients must remember to keep fasting before surgery, following the times given by the doctor or hospital. Fasting for surgery requires abstaining from all food and drink including throat lozenges, cough syrups, bubblegum and dissolvable sweets.
  • If food or drink is consumed by mistake, patients should note the time and inform the Day Surgery nurse on arrival. This is of extreme importance as insufficient fasting time before anaesthetic has the potential to cause life-threatening complications.

4. Medications and Day Surgery

  • If fasting from midnight for surgery, it is usual for patients to take their morning medications with a sip of water, but always follow the instructions given by the doctor or hospital. These instructions may include stopping some medications days before surgery, especially if they promote bleeding, and other medications like diuretics (fluid tablets) may be with-held on surgery day only. Bring medications to hospital if clarification of the instructions is needed.
  • Diabetic patients will not be eating before surgery so should have instructions from the doctor regarding with-holding diabetic medications and/or reduction of insulin dosage. The patient’s blood glucose level will be checked at regular intervals by the Day Surgery nurse. If the pre-surgery patient notices any symptoms of hypo-glycaemia they should alert the nurse immediately.

5. Provide Patient Information to the Day Surgery Nurse

Patient safety and well-being will be enhanced if this information is prepared for Day Surgery
  • a list of the regular medications the patient takes
  • the date that any medications were ceased before surgery
  • any patient allergies
  • any pain-killers taken on surgery day before arriving at hospital
  • a list of phone numbers of the person (plus back-ups) to collect patient after recovery from the Day Surgery procedure.

6. Sight and Hearing

  • Day Surgery patients who wear glasses or contact lenses should bring the corresponding case for safe storage as they cannot be worn to the operating theatre.
  • Patients who wear spectacles for reading should bring them to hospital as they may need to read or sign consent forms or paperwork.
  • Hearing aids should be worn to hospital so the doctors and nurses can communicate well with the patient before and after surgery.

7. Teeth

  • Dentures should be worn to hospital. A decision on whether to remove dentures will be made by the anaesthetist as dentures left in place may allow a better fit of the anaesthetic equipment.
  • For fragile partial plates or teeth on wire fittings removal before surgery may be safer so bring a case for storage. If patients have any loose teeth or removable capped teeth they should inform the Day Surgery nurse.

8. Personal Care Before Day Surgery

  • Surgery patients should shower in the morning on the day of operation. Depending on the procedure to be done and the hospital protocols, patients may be asked to use an anti-bacterial wash. Menstruating patients should use pads not tampons.
  • Loose clothing should be worn to make it easier to dress and be comfortable after surgery.
  • Makeup or nail polish should not be worn for Day Surgery procedures.

9. Possessions

  • Patients can minimise stress by not bringing money or valuable items to hospital. Mobile telephones are not necessary as the Day Surgery nurse will contact the relative or friend on the patient’s behalf to advise of discharge time.
  • Jewellery and body piercings should not be worn as they will have to be removed before surgery. The Day Surgery nurse cannot take responsibility for valuables while the patient is in theatre or recovering from anaesthetic after surgery.

10. Discharge Time Expectations

  • Day Surgery patients should not expect any discharge time quoted to be definite; it can only be an estimate as discharge time is dependent on known and unknown variables. Patients will avoid undue stress if they relax and anticipate Day Surgery may take the whole day, perhaps into the evening, and refrain from making arrangements based on exact time-frames for discharge.

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Temporomandibular Joint (TMJ) Disorder Overview

temporomandibular joint

The most complex joints in the body are the two temporomandibular joints (TMJ). These joints are located in front of the ears and connect the lower jaw (mandible) to the temporal bone of the skull. Temporomandibular joints are complex, both rotating and sliding, and involve numerous components: muscles, nerves, tendons, ligaments, bones, connective tissue, and teeth.

TMJ Symptoms are Varied and Mimic Other Health Issues

TMJ is difficult to diagnose because many of the symptoms of TMJ are also symptoms that can be attributed to other heath problems. Some symptoms are periodic; some improve over time while others can worsen. Symptoms of TMJ are described as:
  • pain in the shoulders or neck
  • migraines or chronic headaches
  • stiffness of the jaw muscle
  • limited movement of the jaw or locking of the jaw
  • painful clicking jaw
  • popping, or grinding of the jaw when opening or closing the mouth
  • ear pain such as pressure or ringing in the ears
  • decreased hearing
  • dizziness or vision problems
Other health issues have to be ruled out before a TMJ diagnosis is considered. TMJ patients may see a multitude of providers that include primary doctors, specialists such as ear, nose and throat doctors, chiropractors and dentists before a diagnosis of TMJ is made.

Causes and Treatments for TMJ

Not all causes of TMJ are known but genetic, hormonal, and biological factors can influence the development of TMJ disorder. Factors that can contribute to developing TMJ are teeth clenching or grinding of teeth, nail biting habits, an injury to the area, infections, previous dental treatments, or auto immune disease. Most TMJ patients report a hypersensitivity to pain.

TMJ is not recognized as a specialty in either the American Dental Association (ADA) or the American Medical Association (AMA) due to the lack of basic or clinical science; and most insurance companies will not cover treatment for TMJ because there is no standardized method of treatment. There is also no empirical evidence that TMJ can be prevented by any treatment. However, there are some treatments that seem to help diminish TMJ pain.

The National Institute of Health (NIH) suggests the following treatments:
  • self-care practices (eating soft food, avoiding extreme movements of the jaw such as yawning, avoiding repetitive movement such as chewing gum, or applying moist heat or cold to the area)
  • avoidance of treatments that cause permanent change to the bite or jaw such as crowns, bridges, grinding down of teeth
  • avoidance of surgery on the teeth or jaw area
  • replacement of the temporomandibular joint as a last resort
Many TMJ patients are fitted with a mandibular repositioning (MORA) device. Though this is a widely used treatment option; the scientific validity of the device is unproven. Over time, some symptoms go away without any treatment. Others seem to improve temporarily with some self-care practices. Other treatments include using a stabilization splint which is a nightguard that is fitted to the patient’s teeth. Over-the-counter bite guards are not recommended as they may actually increase pain if they shift the teeth.

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The Dog Days of Summer

dog days of summer
No matter your age, if you don’t take certain precautions, the hot weather can be a miserable experience. A lot of what we know about protecting ourselves is common sense but some people live more dangerously than others.

The hottest and muggiest days of summer have been known to fall between early July and early September. During this time period, the reward comes from an opportunity to move a bit slower, dress in clothes that reveal some skin and go to the beach or have a holiday cookout. This and more can be the result of experiencing the sultry days of summer as long as you follow these simple rules first.

Beating The Heat

  • Always dress children in light-colored cotton clothing. Babies should wear cotton t-shirts instead of going to an outing shirtless. Cotton can absorb heat and keep babies cooler. Also try shirts made from 100 percent Bamboo to reap the benefits of staying cool without perspiration.
  • If babies get sunburn, never put medicated lotions on their bodies unless instructed by a physician first. Instead, be sure to buy baby lotions with the necessary sunscreen protection already in them.
  • Choose sunscreens that have a broad spectrum of protection. Dry skin is not the only cause of wrinkles. Intense sunshine exposure is one of the leading causing of skin damage and wrinkles. Your options for sun protection are SPF moisturizers, basic sunscreens or tinted moisturizers.
  • Drink plenty of liquids and stay away from sugar filled carbonated drinks. Carbonated drinks have an alarming amount of sugar, overwhelming calories, harmful additives and can ruin your appetite for healthy foods that your body needs.
  • Senior citizens should try to stay in cool places during warm weather. Now that the dog days of summer are upon us, the risk of heatstroke among older people is much higher. If you do not have air conditioning, go somewhere that does. A movie theater, the mall, a friend or relatives or a community center for seniors are a few good places.
  • Try to do all chores in the morning or afternoon when it's cooler, instead of the peak hours between noon and 5 p.m. Never try to overexert yourself in warm weather. It slows you down and increases your chances of passing out. Arm yourself with water bottles and damp towels to keep cool even if you're just outdoors at a cookout.
  • If you have been out in the sun for an extended period of time and feel tired, weak and nauseated, drink plenty of liquids, soak in cool water and seek medical attention if symptoms are severe.

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The United States Nursing Shortage Crisis

nursing

In The Desperate United States Nursing Shortage, we examined the statistics that define the nursing shortage in the U.S., particularly in California. Here, we will go deeper into the issues and offer possible suggestions.

There are so few spots available in academic nursing programs because there are just not enough educators. To be a nurse educator, you must possess a bachelor's degree, at the very minimum. A master's prepared educator is ideal. Additionally, all nurse administrators in hospital settings must be bachelor's prepared or higher as well. Hospital administration pays more than education, so the candidates that are qualified for both, often pursue administration. As hospitals become more expansive and service-oriented - which they must do to survive in this precarious industry - they will have to increase salaries to draw highly qualified administrators. This, in turn, increases the salary gap between hospital administrators and nurse educators even more.

According to Diana Christiansen, president of The Atticus Group, a health care consultancy, "In California alone, enrollment must expand by 90 percent to meet the expected need for nurses. However, nursing schools are struggling to hire the faculty to meet the current 16 percent expansion in place. And 2010 this is predicted to be the biggest year for nursing faculty retirement in history."

Consider the pipeline behind those retiring nurses. There aren't enough BSNs to replace the retirees, much less support a large expansion, which will be necessary to replace the Baby Boomers. "We know the nursing doctoral programs are expanding," says Christiansen. "But 50 percent of the people in the programs do not plan to teach. So, this whole expansion effort on the part of the schools is a house of cards."

Ideas for Nursing Recruitment and Retention

In order to recruit new nurses, hospitals need to develop an expansion or recruitment partnership with their supporting schools. Riverside Community Hospital (www.rchc.org) in Riverside, California and Long Beach Memorial Hospital (www.memorialcare.com/long_beach/) in Long Beach, California created proprietary partnerships with their local colleges and universities with nursing programs, which allowed the institutions to double their enrollments.

The other storm brewing and gaining strength is the aging of nurse leaders. Have those nearing retirement had replacements identified and are they receiving the education and support they need to be ready? It is already extremely difficult for nursing schools to maintain enrollments, and this will occur at the time hospitals and colleges are losing staff to retirements. Meanwhile, part of hospital expansion efforts include adding more and more beds, which again expands the nurse-to-patient ratio into a greater, desperate deficit. And the cycle continues.

Another issue is that graduates of two-year RN programs have their choice of jobs unpon graduation. After spending at least two years of completing prerequisite classes and general education, and perhaps idling at least a year on a waiting list, they are eager to get out and get to work. They know that for future advancement they will need their Bachelor's of Science in Nursing (BSN), but they feel they need to work first and they can eventually go back. Many never do.

Once they begin working, the nurse to patient ratios are extremely high. Why? The nursing shortage. When nurses come in they are often extremely excited to begin the careers that they trained so hard and sacrificed so much for. However, because of hospital politics, the high nurse-to-patient ratio and the stereotypical dynamic that rookie nurses are often treated badly by their senior counterpoints and patronized by doctors frequently leads to disillusionment and then burnout.

Develop Academic Partnerships

So what can be done? For starters, adises Christiansen, hospitals need to be aggressively proactive. A head-in-the-sand approach simply will not do. In essence, this has what has brought us to this potentially catastrophic brink as it is. "Hospitals need to partner with their academic institutions and develop innovative programs that will increase enrollment and nurture their nurses once they have entered the workforce." Christiansen adds that the first year of a nurse's career is the most tenuous. Many dropout and never come back to the profession.

Next, employee mentoring programs must reverse the traditional hospital culture. Like the residency programs that are essentially a baptism-by-fire, it's a catchphrase in the industry that nurses "eat their young." In other words, the veterans had to endure strict treatment when breaking in, why shouldn't this generation of rookies do the same? Well, because in the situation the industry is in, they simply cannot afford to lose a single, qualified nursing professional to such treatment. Their jobs are difficult enough as it is, as they struggle to accomodate the needs of their patients, the demands of the doctors and the rigorous policies of the hospitals - talk about your perfect storms ...

Educating and nurturing baccalaureate-trained nurses should be the utmost priority for any hospital that expects to weather this storm that is already causing a deluge of debt and devastation in hospitals in many regions of the country. California is particularly vulnerable because of its enormous population. Offering nurse educators comparable salaries is another step. Or, perhaps balance the two by allowing hospital nurses to teach one or two days a week, alleviating their burnout, while maintaining their salaries and allowing them to educate the next generation of nursing professionals.

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The Symptoms of Piles and How To Deal With Them Effectively

symptoms of piles
Piles (also called hemorrhoids) can make life quite uncomfortable for those who need to deal with them. Even simple things like sitting, lying, or standing can become a hardship; people dealing with the symptoms of piles may find it almost impossible to find a comfortable position. This condition is caused by enlarged veins in the anal area. It can be triggered by a number of different events such as straining too hard when trying to pass a stool, spending too much time sitting or standing, or as a result of pregnancy.

The Symptoms of Piles

Sometimes the symptoms of piles can pass quickly with minor inconvenience and only mild discomfort. Other people may have a much harder time of it, and these hemorrhoids can really interfere with life. The usual pile symptoms include;
  • Itching in the anal/rectal area
  • Fresh blood on toilet paper (if the blood is a darker color then this could indicate a problem higher up in the bowel). People might also notice stained underwear or even blood dripping when they try to pass a bowel motion.
  • There may be a lump in the anal area if the hemorrhoid has prolapsed. Sometimes a prolapsed hemorrhoid can be eased back under the skin, but other times it becomes stuck and this will increase the symptoms.
  • Individuals may find it hard to get comfortable in any condition because of pain and discomfort
The symptoms of piles can be unpleasant but hemorrhoids rarely cause serious problems. It is important though that anyone noticing blood in their stool gets this checked out by their doctor. This is due to the possibility that it might be caused by something more sinister than piles.

How to Deal with Piles

There are a number of options for people who have to deal with the symptoms of piles. It is recommended that people speak to their doctors about the problem but there are some home treatments that might help.
  • Many people how have needed to deal with piles have found that sitting in a warm bath can provide some relief which lasts for an hour or two afterwards.
  • Most chemists will have a selection of creams that can be used to help ease the symptoms of hemorrhoids.
  • It is important to not spend too much time sitting or standing; this can exacerbate symptoms.
  • Eating more fiber and drinking plenty of fluids can make help people cope better with the discomfort caused when passing a stool.
If the symptoms of piles persist or get worse then people need to return to see their doctor for other options to deal with the problem.

The symptoms of piles can be hard to deal with. Most people will be able to deal with the problem without too much hardship, but all rectal bleeding should be investigated by a doctor to rule out more serious complaints.

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Pupil Anomalies

pupil anomalies
Taking a set of vitals is standard procedure for all medically trained caregivers and while patients rarely give it a second thought, health professionals love vital signs. The importance of these signs is self-evident to the medical world; they are the clues to a condition, an attribute of life and once in decline, a harbinger of death.

Vitals are not just numbers; they reflect a patient's well-being and show changes in circumstances, often particularly important ones. The eyes may be the windows to the soul, but just the pupils can reveal plenty of information for diagnosis purposes.

The Pupil

The pupil of the eye resembles a black hole that can constrict (close), or dilate (open), in response to various factors. Essentially the role of the pupil is to adapt and change size to allow the maximum amount of light into the retina without causing damage. The retina converts the light into nerve impulses which travel to the optic nerve and then directly to the brain, allowing a person to see.

Pupils have an involuntary reflex but they can and do react to emotional states. Pupil sizes can portray the following emotions:
  • fear
  • hostility
  • sympathy
  • love

Pupil Changes Caused By Medical Conditions

Medical caregivers examine pupil size because they can be directly correlated to health conditions. In this case, it isn’t only the size of the pupils that are noted but their reactivity and equality too. In normal circumstances, pupils should be neither large nor small, but average. If extra light is supplied, both pupils should constrict and if surroundings become darker, both pupils should dilate, equally. What happens in one eye should also happen in the other, giving a bilateral reaction.

Drugs are by no means the single factor of pupil change, but depending on the type of drug involved they can cause pupils to constrict, dilate, or show a lack of reactivity. Drugs are often the first suspect in any pupil changes where there has been no trauma and no history of an existing illness.

Pupil Appearance

Significant or possible causes of constricted pupils include:
  • drugs such as Heroin, Fentanyl, Codeine, Tramadol and other narcotics
  • migraine
  • corneal ulcer
  • Horner Syndrome (damage to the sympathetic nervous system serving the eyes)
  • pancoast tumor (carcinoma of the lung apex)
  • uveitis (inflammation of the inner eye)
  • prescription eye drops
Significant or possible causes of dilated pupils include:
  • adrenaline
  • drugs such as antipsychotic agents, atropine, cocaine
  • blood loss
  • OTC and prescription eye drops
  • Seratonin Syndrome (a toxic reaction to serotonin)
Significant or possible causes of unequal pupils include:
  • stroke
  • head injury
  • artificial eye
  • eye Injury
  • Adie’s Syndrome (light response slower in one eye possibly due to a mechanism malfunction)
  • third cranial nerve palsy
  • tumor
  • meningitis
  • encephalitis
Significant or possible causes for lack of reactivity in pupils include:
  • drugs
  • lack of oxygen to the brain
  • brainstem coma
  • death
Pupil Facts and considerations:
  • Most of the light entering the eye does not escape, which is why the pupil appears black.
  • It takes longer for a pupil to dilate than constrict.
  • Pupils can miss the mark immediately; they will shrink down and then reopen slightly.
  • If both pupils are dilated, it is usually due to drugs, not disease.
  • Red eyes are the result of the camera flash bouncing off the retina, back out of the eye and into the camera lens.
  • Emergency medical responders carry pupil gauges to measure pupil size.
  • Pupils that are fixed and dilated typically indicate impending death.

Baseline Pupil Sizes

As with any vital sign, a baseline should always be taken for comparison purposes. When checking the pupils, note the size before shining a light into them. Do one eye at a time covering the opposite eye with your hand. When the light hits the pupil it should constrict and when the light is removed, it should dilate back to its normal position.

While the pupil size, reactivity and equality will not specifically diagnose a condition, it can offer tremendous clues for health professionals in the pursuit of a diagnosis.

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The Role of Flossing in Teeth Cleaning

floss

Teeth cleaning is a daily chore, with some people cleaning their teeth up to two or three times per day. Not only is it required for fresh breath, but cleaning teeth is necessary if one wants to avoid plaque stains and tooth decay.

Another desired benefit of teeth cleaning that most people wish to attain is whiter teeth. It may appear to sound obvious that whitening one’s teeth comes with brushing, but there’s a lot more to it than that.

Dentists recommend the use of floss to reach in places that the normal toothbrush cannot.

Dental Floss and Flossing Teeth

When people clean their teeth, they often don’t realise that there are places that standard and electric toothbrushes miss. It might not matter how many times per day individuals clean their teeth, but failure to reach certain areas around the teeth may facilitate the build up of plaque and subsequent tooth decay.

That is why the use of floss to supplement the teeth cleaning process is necessary.
Dental floss itself is a collection of plastic fibres or thin nylon filaments. Flossing is done when individuals place the dental floss in between their teeth, hold it down and rub it back and forth.

Flossing and Whiter Teeth

Teeth cleaning by standard or electric toothbrush should be supplemented with flossing, if one hopes to achieve the regular status of whiter teeth. This is because flossing reaches in places that traditional brushing cannot. People may not realise it but the build up of plaque – and subsequent tooth decay – occur when toothbrushes do not scrub away the accumulated gunk from inaccessible places.

In fact, the most common areas where dentists instruct people to brush more often are in the small gaps between teeth. This isn’t surprising.
For the best results, it is recommended that one engages in flossing prior to traditional teeth cleaning by toothbrush. People tend to notice whiter teeth when they have flossed twice a day for several weeks. Thus it is a good habit to adopt.

Indeed, research carried out by Milan University Medical School in Italy reveals that the risk of heart disease is surprisingly lowered by regular flossing. This is because gum disease is prevented, and there is a link between gum disease and heart conditions, hence the reduced risk.

Floss for Whiter Teeth

Many perceive flossing as an added burden to an already mundane chore of teeth cleaning. But if individuals desire whiter teeth, they should overcome the reluctance and commence flossing today, citing the reduction in heart disease as a worthwhile incentive.

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The Safety of Dental Amalgam Fillings

dental amalgam fillings

Mercury is now regarded as the most common cause of heavy metal toxicity and can get into the bloodstream in various ways from injected vaccines, eating fish and by amalgam dental fillings by chewing. The World Health Organization estimates that between three to 17 micrograms of mercury are released daily into the body by chewing alone.

History of Mercury

Mercury is the second most toxic metal in the world after plutonium. Mercury has a history of being known as quicksilver due to it being a silver liquid. The symbol, Hg, is Latin for hydrargyrum, meaning watery silver. Mercury does not readily react with oxygen in the air but does reacts with some acids when they are hot.

Mercury toxicity has been reported since the first century when Roman prisoners were sentenced to work in cinnabar mines where they usually died due to the lethal levels of mercury. In the 1800s felt hat workers exposed to mercuric nitrate exhibited symptoms such as memory loss, angry outbursts, depression, insomnia, hallucinations and delusions. This condition was coined the “Mad Hatter syndrome” and was referred to famously by Lewis Carroll in Alice in Wonderland. Similar symptoms were reported in syphilis patients who were treated with mercury in the mid-19th century.

In the last 50 years, more has been discovered about the toxic effects of mercury. Mercury enters the body fairly easily and its vapours pass through the skin into the blood stream. Once in the blood mercury interferes with bodily chemical reactions that can lead to illness and even death.

Amalgam Fillings in Dentistry

Mercury consists of approximately 50% of an amalgam filling, and is mixed with silver, copper and tin. This combination has been used for well over a century and has proved to extremely durable. Mercury is used in amalgams because it helps it is effective in making the filling material pliable and it also hardens quickly and can withstand biting and chewing. The US Food and Drug Administration (FDA) caused controversy in July 2008 when they issued a final regulation with altered language on their website: "While elemental mercury has been associated with adverse health effects at high exposures, the levels released by dental amalgam fillings are not high enough to cause harm in patients.” They also advocated better warnings about mercury sensitivity and dental amalgams. The association also reclassified the mercury component of dental amalgam from Class I (low risk) to Class II (moderate risk).

With increasing concern over the safety of amalgam fillings, more than five hundred mercury-free practices have been set up in the UK. There are alternatives to amalgam fillings such as composite resin, porcelain and gold. The durability of these alternatives is increasing with time and further research. Removing existing amalgam fillings isn’t advised in healthy people as it is a skilled procedure and involves the release of mercury vapour.

Health Risks of Amalgam Fillings

A report in the British Journal of Industrial Medicine finds that dentists have higher concentrations of mercury in the body and double the number of brain tumours. Female dentists and assistants have more than three times the risk of sterility, stillbirth, and miscarriage. Exposure over long periods of time to mercury vapour can result in brain damage and studies have found extensive mercury exposure to be a factor in Alzheimer’s, Parkinson's disease, dementia and multiple sclerosis. Mercury is particularly toxic to fetuses and babies. Women who have been exposed to mercury in pregnancy have sometimes given birth to children with serious birth defects.

A study that followed more than 500 Portuguese and American children for seven years after they received amalgam or mercury-free fillings found no differences in the neurological symptoms between the two groups.

In contrast a 2004 study concluded that amalgam fillings may be an important risk factor for patients with autoimmune diseases. The study found that patients responded positively when amalgam was removed from a group of 35 patients with autoimmune diseases and replaced them with composites. Six months later more than 70% had shown improvement in health notably in multiple sclerosis.

Supporters of amalgam fillings emphasised that mercury is locked in and inert. It has now been conceded that mercury vapour escapes, and filters into the bloodstream and organs. Now scientists and the FDA claim that mercury levels are very low. Opponents argue that mercury accumulates in the body and no level of mercury should be deemed safe. Insufficient published data exists on the potential health effects of dental amalgam to completely support or refute the health effects attributed to it.

The safety of amalgam fillings is still inconclusive, though due to the toxicity of mercury an increasing amount of people are choosing alternatives such as composite resin, glass and gold. Read Ayurvedic Home Remedies for Tooth Pain for natural ways to maintain optimal oral health and treat toothache.

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Laropiprant Side Effects

laropiprant

Laropiprant becomes an adjunct drug with the administration of nicotinic acid that helps lower the cholesterol levels of the body. Its potent action in managing the flushing effects of nicotinic acid makes Laropiprant an essential drug to administer together with nicotinic acid. Side effects are often evident on the use of laropriprant that every patient must be cautioned upon.

Lapopiprant together with niacin is indicated for the treatment of dyslipidemia, a condition characterized by high levels of cholesterol and triglycerides. It is also an indicated treatment for hypercholesterolemia.

Side Effects of Laropiprant

Just as with any drug, the administration of laropiprant may induce side effects. Common ones are diarrhea and loose bowel movements, abdominal discomfort, rashes and allergy, itching and hives. Indigestion, stomachache, vomiting, headache and tingling of the hands and feet are also common.

More serious side effects induced by the drug include allergic reaction, bloating of the face, lips, tongue, and throat. Some experience breathing difficulty, angiodema or difficulty in swallowing, shortness of breath, inability to stop urine and stool and cold sweating.
The elevation of liver enzymes is also another side effect of laropiprant, seen in 0.3% of patients who took laropiprant-containing medicines, like Zocor and Cordaptive. This effect is, however, asymptomatic and liver enzymes eventually return to the normal level once the medication stops.

Hepatic Upshots Due to Overdosage of Laropiprant

Severe hepatic toxicity is a risk of lapopipant overdose. The drug may dangerously interact in the presence of excessive amount of alcohol. Complications are also possible in the presence of liver disease. Patients with history of this illness should undergo liver function tests before administration, every six to 12 weeks for the first year and occasionally afterwards. Patients with increasing transaminase levels should be monitored to resolve ensuing abnormalities brought about by the intake of this drug. If found to be detrimental for the health, reduce or withdraw the medication.

Rhabdomylysis

Unusual cases of rhabdomylysis have been found due to attendant administration of lipid-altering lipopiprant and nicotinic acid. If a patient shows symptoms of this illness, constant monitoring is needed for muscle aches, tenderness, or weakness during the first months of medication, especially when dosage of this drug is increased. Periodic creatinine kinase (PCK) should be considered, though little is known if it inhibits the development of severe myopathy.

Patients older than 70 showing symptoms of rhabdomylisis should be given utter care and medication as they are more likely to suffer renal impairment, unrestrained hypothyroidism, hereditary background of muscular disorder, and muscular toxicity.

Reminder about Laropiprant

Always take laropiprant in its proper dosage to avoid undesirable side effects and complications. Continue with the prescribed schedule of intake and dosage even in the event of a missed dose. Always consult a physician and never self-medicate to avoid undesirable side effects of laropiprant.

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The Coral Calcium Controversy

coral calcium

Coral calcium, a dietary supplement made of calcium carbonate and a wealth of trace minerals, is harvested off the shores of Okinawa, Japan. This much acclaimed mineral is best known for its proclaimed ability to change the alkalinity of water-based solutions. Many individuals, inspired by the teachings of Robert Barefoot, hold to the belief that coral calcium is a cure-all for a number of diseases.

The Robert Barefoot Theory Concerning Coral Calcium

Robert Barefoot is a bio-chemist and promoter of coral calcium. His theory advocates that while a healthy person has a high pH or alkaline reading and high oxygen levels, a person that is ill has a low pH reading and low oxygen levels. If the the pH levels of the sick can be raised or changed to alkaline, that person can overthrow any illness in question. Barefoot believes that the alkalinity of coral calcium can cure some 200 degenerative diseases caused by calcium deficiency.

Controversial Issues Concerning Coral Calcium

Laboratory analyses performed on coral calcium reveal that this supplement contains significant amounts of heavy metals, including lead. These findings pose a direct confrontation with Robert Barefoot's Coral Calcium theory for ultimate health. In fact, according to Andrew Weils, founder and director of the Arizona Center for Integrative Medicine, the claim that better health can be achieved by creating a more alkaline body has no basis in science. Coral calcium supplements, although more expensive than regular calcium supplements have not been proven any more effective. It is recommended that individuals needing extra calcium should take calcium carbonate products which are 30-35% absorbable in the body. Coral calcium is not 100% absorbable.

Another concern is that coral calcium causes severe allergic reactions. Shortness of breath, swelling and hives are characteristic of individuals who are allergic to shellfish. Shellfish living amongst the coral reefs contaminate the limestone deposits which can negatively affect individuals with allergies.

Coral Calcium Manufacturing Destroys the Environment

The widespread health claims concerning coral calcium has led to mass production of the supplement.This raises environmental issues because of the destruction of the beautiful ocean reefs that have taken thousands of years to grow. The reefs are also home to many ocean creatures, including fish and lobster. Becuse living coal reefs are now endangered, it is forbidden by law to harvest them. As an altenative, harvesters are using loose limestone deposits to make the coral supplements. Calcium from limestone deposits contain pollutants and heavy metals.

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Stretching Exercises Keep Your Muscles Healthy

Humans are made up of different types of muscles. The two main groups are phasic and postural. The phasic muscles are made up of fast twitch fibers (type 2), examples are: quadriceps (the muscles in the front of the upper thigh), rectus abdominis (abdominal muscles).

stretching exercises

These muscles are activated in short explosive activities, such as sprinting to the bus, and are prone to getting weak. The postural muscles are made up of slow twitch fibers (type 1), some examples are: gastrocnemius and soleus (muscles in the back of the lower leg) pectoralis major and minor (chest muscles). These muscles are activated in long duration sustained positions and movements, and overtime are prone towards getting tight and restricted.

What Stretching Does

The physiological effect of stretching is that it reduces increased tone of a muscle. The ability to stretch is influenced by: age, gender, body type, temperature, psychological and physical stress, and muscle imbalances.

Stretching after exercise will ensure muscle relaxation, facilitate normal muscle resting length, and improve circulation to structures and removal of unwanted waste products (lactic acid). It is evident that lifestyle will influence the health and function of the musculoskeletal system.

Humans require the activity of specific muscle groups all the time. Many studies indicate that a lot of low back pain cases are due to muscle imbalances. For a well balanced body, it is essential to add stretching as well as exercise to our daily routines.

Stretching Tips

How often you should stretch is not fully understood; however, experts agree that daily stretching is the best, or at least after a warm up before and after a sporting activity. Frequent stretching reduces muscular imbalances sustained by daily activities or exercise.
  • Static, prolonged and sustained stretches are the most effective. Do not bounce as this can cause microtrauma at the musculo-tendinous junction.
  • Connective tissue elongation (plastic deformation) requires low intensity and long duration stretching. Evidence suggests that in order to involve the connective tissue (tendon) and muscle it is essential to hold stretches for at least 15 – 20 seconds.
  • Complete 10 times for each muscle doing both the left and right sides of the body.
You should stretch only when your body is warm, as this facilitates range of motion around a joint structure .Never stretch first thing in the morning. If you exercise in the morning, always do a light warm up (5 – 10 minutes) to facilitate blood circulation before you stretch.

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Tips to Reduce Swelling in Hands, Ankles and Feet

Swelling of the hands, ankles and feet is caused by many different things and can occur in people of all ages. The causes can be as simple as high heat, standing too much or eating too much sodium, or it could be a sign of another health issue. For most people, however, swelling in the hands, feet and ankles is not life-threatening and can be treated easily by taking a few precautions or making small lifestyle changes.

swelling

Causes of Swelling of the Hands, Ankles and Feet

There are many different reasons why hands, feet and ankles swell. These reasons include:
  • pregnancy
  • pre-menstrual syndrome
  • medications
  • sitting too long in one position
  • standing too long in one position
  • not drinking enough water
  • too much sodium (salt) in the diet
  • allergies
  • being overweight
  • eating an unhealthy diet
  • too little exercise
  • drinking alcohol or caffeinated beverages
In most cases, a person who experiences swelling occasionally can reduce it with home remedies. However, if swelling persists on a regular basis, see a doctor. There may be another underlying cause.

Treatments for Swollen Hands, Ankles and Feet

While most cases of swelling of the hands, feet and ankles aren’t serious, if left untreated it can cause complications such as an increased risk of infection, decreased blood circulation and a decrease in the elasticity of veins, arteries, muscles and joints. Ways to treat swollen hands, feet and ankles include:
Reduce sodium in the diet – Too much sodium in the diet causes the body to retain water and contributes to the swelling. Lower the amount of salt added to foods when cooking monitor sodium in processed foods. The American Heart Association suggests eating less than 1,500 milligrams of sodium per day.
Drink plenty of water – Not drinking enough water sends a message to the body to hold onto the water it already has stored, and causes hands, feet and ankles to swell. Drinking at least 64 ounces of water each day will keep the body hydrated and help it to expel extra fluids properly.
Don’t stand or sit for long periods of time – Standing or sitting for long periods of time can cause ankles and feet to swell. Try sitting with feet and ankles propped up above the heart for 30 minutes to relieve the swelling.
Avoid alcohol and caffeine – Drinking too much alcohol or caffeinated beverages can cause swelling in the hands, feet and ankles.
Eat a healthy diet – Eating a balanced diet rich in fruits, vegetables, protein and whole grains keeps the body’s system working properly so the body doesn’t hold onto excess fluid.
Avoid extreme temperature changes – According to the Mayo Clinic, changes in temperature can aggravate swelling. Avoid hot tubs, saunas, hot showers and baths and take care when out in hot temperatures.
Try a diuretic – Taking a diuretic (water pill) may help ease swollen hands, feet and ankles. Do not take during pregnancy unless advised by a doctor.
Exercise regularly – Regular daily exercise has been shown to help reduce swelling.

Swelling of the hands, feet and ankles is uncomfortable and sometimes painful but it can be reduced by making a few lifestyle changes. If swelling occurs on a regular basis, seek medical attention as it may be a sign of a more serious health issue.

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Toradol Pain Medicine

Toradol is commonly prescribed after surgery. It is also sold under the generic name of Ketorolac. It helps reduce hormones in your body that cause inflammation and pain. It is available as an IV additive, injection, and as a tablet form. Tablets should only be used if you have already received the injectable form first. Toradol is not indicated for mild or ongoing pain.

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Important Facts Regarding Toradol

Toradol is used short-term (five days or less) due to the increased risk of serious side effects on your stomach and intestines. Serious life threatening gastrointestinal effects can occur while taking Toradol. Toradol can also increase your risk of life-threatening circulation and heart problems, such as stroke and heart attack. Risks increase with longer use of Toradol. Seek medical care immediately if you experience chest pain, weakness, slurred speech, shortness of breath, vision or balance problems, black or bloody stools, tarry stools, or if you are coughing up blood or vomit that appears to look like coffee grounds.

Reasons Not to Take Toradol

You should not take Toradol if you are allergic to ketorolac, aspirin, or other NSAIDs. People should not take Toradol if they have severe kidney disease, a closed head injury, bleeding in the brain, bleeding or blood clot disorder, stomach ulcer, history of stomach or intestinal bleeding, or if you are breast-feeding an infant. This medication should not be used on anyone under the age of 18 years old.

Administration of Toradol

Toradol should be taken exactly as prescribed. Never take larger amounts of this medicine and never take it for longer than recommended by your physician. Toradol is generally given first as an injection. If you are given a prescription for the tablet form, take the tablet with a full glass of water. Toradol taken long-term can lead to damage of your kidneys and or cause bleeding.

Side Effects of Toradol

Common side effects of Toradol can include upset stomach, nausea, vomiting, diarrhea, constipation, bloating, gas, mild heartburn, stomach pain, sweating, dizziness, headache, drowsiness, and ringing in your ears.

Seek emergency care immediately if your experience an allergic reaction such as hives, swelling of your face, lips, tongue, or throat, and or difficulty breathing.

Contact your physician at once and stop taking Toradol if you experience chest pain, weakness, black, bloody, or tarry stools, swelling or rapid weight gain, shortness of breath, slurred speech, fever, sore throat, mouth sores, skin rash, neck stiffness, chills, increased sensitivity to light, purple spots on your skin, or seizures.

Drug Interactions with Toradol

Taking certain anti-depressant medications with Toradol can cause you to bruise and bleed easily. Inform your doctor if you are taking any blood thinners, lithium, alprazolam, thiothixene, methotrexate, diuretics, muscle relaxers, steroids, seizure medications, heart or blood pressure medicines, aspirin or other forms of NSAIDs, and ACE inhibitors. Other medications not listed may interact with this medicine. Always discuss all prescription, over-the-counter medications, supplements, and herbal medications with your physician. Serious drug interactions can occur.

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Treating Stomach Acid and Heartburn

When food is eaten, digestion actually begins in the mouth where the process of chewing, along with the production of selected enzymes, readies the food for swallowing and processing in the gastrointestinal tract. In order to perform its job, the stomach produces hydrochloric acid and some digestive enzymes to aid in the breakdown of the food that was just eaten.

In order to activate the digestive enzymes that it produces, the stomach must produce acid. This takes place in the parietal cells. The stomach lining normally has special secretions which protect it from the corrosive effects of this acid. Unfortunately, the lining of the esophagus does not. Sometimes excess acid production, or mishandling of the acid that is there, leads to some of it reaching the bottom of the esophagus causing heartburn. There are numerous ways to deal with this “burning issue”.

Regular Antacids

Common over-the-counter antacids have been around for many years. Consisting of compounds such as calcium carbonate or aluminum hydroxide or other similar chemicals, these substances are all alkaline in nature. When they enter the stomach they combine with the acid neutralizing it; that is they bring the pH of the stomach up from the acid range closer to neutral pH. These compounds are used by millions of people every day and are generally both well tolerated and safe with some exceptions.

Prokinetic Agents

One class of medicines that is used for short terms to treat sustained heartburn is known as “prokinetic agents”. Drugs such as metoclopramide (known widely as Reglan) increase the speed at which the stomach empties its contents into the small intestine. This class of drugs has been used extensively over the years but care must be taken as they are known to cause muscle movement problems, especially in older women.

Histamine Receptor Blockers

cimetidine
Drugs of this class are more recent additions to the armamentarium of treatments for problems related to stomach acid. Some of the more widely used forms of these drugs include: cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid). These drugs act by inhibiting the activity of a specific class of receptors for the chemical known as histamine. When the above drugs bind to these receptors on the parietal cells in the stomach, they act to interfere with the signals that tell these cells to produce acid.

Proton Pump Inhibitors (PPIs)

Stomach parietal cells produce acid because they can pump significant quantities of protons (H+ in chemistry terms) across their cell membranes. To counteract the ability of parietal cells to actually make acid, the proton pump inhibitors were developed. These drugs act directly on the cell membrane pump most responsible for the production of acid, blocking it and thus lowering the acidity of the stomach. This class of drugs includes medications such as omeprazole (Prilosec), lansoprazole (Prevacid), esomeprazole (Nexium), and pantoprazole (Protonix).

Drugs used to treat stomach acid and heartburn are some of the most widely taken compounds in the world. Remember that persistent heartburn can be a sign of more serious conditions. If you suffer from serious heartburn always remember to speak with your family health care professional.
To learn more about stomach acid and gastroesophageal reflux disease (GERD) visit this informative site at the US National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK).

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Travel Health Advice


Suffering from traveller's tummy is a fear many people have when visiting a foreign place, especially a developing county. Research shows that one in three people may be genetically susceptible to traveler’s diarrhea, caused by an E coli bacteria. “In the future, we might be able to do a quick test to determine if someone is susceptible and if so, the logical thing would be to give them antibiotics before they travel, to prevent them from getting sick,” says Dr. Herbert DuPont, co-author of the University of Texas study.

In the meantime, the ‘boil it, peel it, cook it or forget it’ rule is sensible for visits to developing countries. To further guard against poor restaurant hygiene, Dr. David Shlim, medical director of Jackson Hole Travel and Tropical Medicine in Wyoming suggests ordering only freshly cooked dishes (like meat), avoiding reheated items such as lasagna or quiche and carrying a quick-acting antibiotic such as ciprofloxacin.

Heart Smart Travel

If you sit in a cramped airline, bus, train or car seat for hours at a time you may be at risk for a heart attack says a study from the University of Innsbruck. Comparing trips by plane and bus, the research showed that tight seating (not high altitude or low oxygen pressure) prompts coagulation of the blood and can make travelers prone to deep vein thrombosis (DVT)— a blood clot in the leg which can lodge in an artery and block blood going to the heart. To help prevent DVT, drink plenty of non-alcoholic fluids and move your “ankles and legs every hour to work those calf muscles and get them pumping blood,” advises Dr. Bo Eklof, an expert on travelers’ thrombosis with the University of Hawaii, Honolulu. He also suggests wearing support hose and for those at high risk (recent surgery or seriously ill), getting a blood thinner injection before your trip.

See a Travel Medicine Expert

The Swine Flu crisis has brought awareness of travel health risks to the fore. However, findings of a survey by the European Travel Health Advisory Board (ETHAB) a few years ago revealed that the majority of travelers in the Asia-Pacific and U.S. did not seek travel health advice before going to an area with a risk for infectious disease. The survey reported that of 8,000 people questioned, the majority hadn’t had a hepatitis vaccine while 40 percent of Americans and 97 percent of the Asia-Pacific respondents did not carry anti-malarial medication. Dr. Francesco Castelli, a member of ETHAB, noted there was a “60 to 70 percent chance that a traveler will develop a health complaint on a trip to developing countries.”

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Ultram, Side Effects and Addiction

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Ultram is indicated for treatment of moderate to severe pain. It is an opiate agonist and works by changing the way the body senses pain. Patients who are in chronic pain and need around-the-clock pain can be prescribed the extended-release version of Ultram.

Usage and Dosage of Ultram (tramadol)

Ultram is prescribed either as a regular tablet or an extended-release tablet. The regular form of Ultram is generally taken every four to six hours as needed for pain control. The extended-release form should be taken once a day, at the same time each day. The physician will generally prescribe a low dose of Ultram and increase the dosage of regular Ultram approximately every three days if needed, the increase for extended-release is done, if necessary, every five days. Never take more than 300 milligrams of Ultram in one 24-hour period.

This medication can be taken with or without food. Do take the medication with a full glass of water. Never crush, chew, break, or open an extended release tablet. This could cause the pill to release too much of the drug at one time. Serious side effects or death could result.

Side Effects of Ultram

Seek emergency medical treatment if there is any allergic reaction to Ultram. Symptoms can include hives, difficulty breathing, and swelling of the face, lips, throat, or tongue.

Stop taking Ultram and call a physician, if while taking this medication, a fever develops, fast heart rate, hallucinations, agitation, vomiting, nausea, diarrhea, loss of coordination, fainting, overactive reflexes, seizure, shallow breathing, weak pulse, or red, blistering and peeling skin rash.

Common side effects experienced while taking Ultram can include blurred vision, flushing, insomnia, nausea, vomiting, constipation, loss of appetite, weakness, drowsiness, and dizziness.

Drug Interactions with Ultram

Seizures are more likely to occur if Ultram is taken with certain other medications. Do not take this medicine without first telling the physician if an MAO inhibitor or an antidepressant is being taken. Inform the doctor before taking Ultram if taking any of the following; Tegretol, Coumadin, digoxin, Nizoral, erythromycin, rifampin, St. John's wort, quinidine, or any medication that causes drowsiness.

Considerations

Patients who have been addicted to drugs and or alcohol should not take Ultram. They have a higher risk of experiencing a seizure while taking Ultram if there is a history of drug or alcohol addiction, a history of epilepsy or other seizure disorder, history of head injury, a metabolic disorder, or if taking antidepressants, muscle relaxers, or medicine for vomiting and nausea.

Ultram has been known to cause impairment to thinking and reactions. Always use caution when driving or doing any type of function that requires a person to be awake and alert.

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Prevent West Nile Virus

west nile virus
The West Nile virus season has arrived. The season begins in spring and runs through the late fall. However, in the warmer states, West Nile virus is a year-round threat. The West Nile virus was first discovered in the 1930s in the West Nile district of Uganda. Now, the US has been plagued with this deadly disease too.

This is the time of year to worry about mosquito bites. The West Nile virus is an infectious disease, which is spread to humans by mosquitoes. This virus can cause serious problems. Symptoms can be as mild as a slight headache or as severe as respiratory failure. Discover how to prevent virus-carrying mosquitoes from breeding and biting. Become educated about the signs and symptoms of this potentially fatal disease. Knowing this information could be a matter of life and death.

Birds are the Culprits and Mosquitoes are the Carriers

The West Nile virus actually infects birds, not mosquitoes. The mosquito is merely the vehicle that carries the virus from an infected bird to an unsuspecting human. First the mosquito bites an infected bird and then it bites a human. The virus then goes into the human’s bloodstream. From there, it can spread to the spinal cord or the brain.

According to the Center for Disease Control, humans don’t spread the West Nile virus to other humans (except nursing mothers can transfer it to their babies). The germ that causes the West Nile virus is in a group called flaviviruses. Mosquitoes or ticks transmit these viruses. People need to learn how to prevent this life-threatening viral infection.

West Nile Causes Meningitis, Encephalitis, and Poliomyelitis

Anyone can contract this virus. However, people over 50 and those with autoimmune problems are at higher risk for potential problems. The most serious form of the disease is West Nile encephalitis. Encephalitis means inflammation of the brain.

The virus can also cause meningitis when the virus attacks and inflames the membrane around the brain and spinal cord. This can cause symptoms that vary greatly in intensity. An infected person may experience anything from a stiff neck to a coma.

West Nile poliomyelitis occurs as a result of inflammation of the spinal cord. This type of poliomyelitis can occur suddenly. People need to be diagnosed quickly and correctly. Testing blood and spinal fluid can pinpoint the problem so the correct treatment can be initiated promptly. Polio weakens muscles, paralyzes, and causes the lungs to stop working.

Prevent Mosquitoes From Breeding and Biting

Remove all freestanding water around the neighborhood. Water containers for birds and pets need to be emptied and cleaned weekly, at the least. Install, repair, or replace house screens. The Center for Disease Control recommends using insect repellents to protect against bites.
There are three often-recommended insecticides that are registered with the EPA.
  1. DEET
  2. Picaridin
  3. Oil of Lemon Eucalyptus
Spraying exposed skin and clothing will ward off potential trouble. However, don’t apply sprays to the skin that is under the clothes—that could cause irritation. Follow all directions carefully. (Be sure to wash off the insecticides after each use.) For the best protection, wear shoes and socks and long sleeved shirts and pants. Tuck in all clothes to avoid insects crawling next to the skin. Avoid the outdoors at dusk or dawn, as these are the times of day when mosquitoes swarm.

Learn How to Spot Potential ProblemsMost people who contract this virus don’t ever know it. The symptoms are mild and they fade away without treatment within a couple of weeks. Those symptoms are usually vague and mundane such as: headaches, body aches, and loss of appetite, fever, diarrhea and sometimes a rash. These complaints are minor so people usually don’t seek medical attention when they occur. Other symptoms are more severe: high fevers, severe headaches, stiff neck, confusion, convulsions, sudden weakness or coma. These problems are serious enough to warrant immediate medical attention.

Outcomes range from complete and rapid recoveries to little progress after a year of medical treatment. If anyone exhibits unexplainable symptoms, they might want to be screened for the West Nile virus.There is no specific treatment, so prevention is key. There is no specific protocol of treatment for the West Nile virus. Most often, no treatment is even recommended. The symptoms simply fade away on their own within two weeks. However, for people with more serious symptoms, misdiagnosis can delay life-saving treatment. Blood and spinal fluids can be tested to detect the West Nile virus.

For those with serious complications the treatments can be intense and long term. And even after all that, the damage sometimes can’t be repaired. Many scientists are working on it, but no vaccine has been developed yet. So prevention is the key to avoiding this mosquito transmitted, life threatening, virus.

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