Natural Health and Herbal Remedies Blog

SPECIAL INVESTIGATIONS OF HEADACHES

admin — Mon, 25 Jul 2011 15:27:58 +0000

In the present scientific era, there is a tendency to rely too much on machines, requests being made for every possible test in the hope that something will show up. This is not only wasteful but the results, instead of being reassuring, can be grossly misleading. Statistically, the more tests that are done, the greater the number of abnormal results. This produces a vicious circle where a healthy patient is investigated extensively to explain a chemical abnormality at great expense; the abnormal results could well be fortuitous or valueless in the first place.With preparatory thought, these disadvantages could be avoided. The purpose of special investigations is to provide information beyond that given by the history and clinical examination so that it is important to define the questions which it is hoped the investigations will answer. The tests most useful in the diagnosis of a headache can be divided, for convenience, into those on the blood and others.
Blood testsWhen a sample of blood is analyzed, information is obtained about the state of the blood cells and the fluid (serum) in which they float.
Blood cells.The main cell in the blood is the red blood corpuscle which contains a chemical that carries oxygen (hemoglobin). Anaemia occurs when the level of hemoglobin drops but, in certain circumstances, there can be too much hemoglobin so that the blood becomes thicker and passes through the small vessels less readily, and this may cause migranous symptoms.Another important test is to examine the rate at which red blood cells settle when put in a vertical glass tube. This is called the erythrocyte sedimentation rate (e.s.r.). In a patient with headache due to sinusitis or temporal arteritis, the rate of sedimentation will be rapid and produce a high e.s.r.Another important type of cell is the white blood corpuscle which helps ward off infection. These can fairly easily be counted and when the count is too low this means there is either an abnormality in production, or they are being destroyed too rapidly. During many types of infection, there is a high count and, as there are several varieties of white blood corpuscle, the group that is increased indicates the type of infection. This estimation may be of value, for example, in distinguishing a migraine attack, where the white cell count will be normal, from sinusitis, where the count will be high.Tests can also be done on platelets to see how easily they clump together (aggregate). This is done by separating the platelets from the rest of the blood and putting them in a chamber through which a beam of light is shone; a substance which aggregates platelets is added to the platelet suspension so that the transmission of the beam of light through the chamber becomes stronger. Some migraine patients have platelets which are particularly prone to aggregate.
The serumIn patients with rarer types of headache it may be necessary to perform tests on the serum, which is obtained by spinning blood in a centrifuge to separate off the cells. In certain allergic illnesses which can cause headache, antibodies to foreign substances can be estimated.
*36/152/5*

EXTERNAL FEMALE ANATOMY: KEGEL EXERCISES FOR MSUSCLE

admin — Tue, 19 Jul 2011 15:09:45 +0000

The set of muscles of the pelvic floor extend from the pubic bone to the coccyx, or tailbone, and is appropriately called the pubococcygeal muscle, or P.C. muscle for short. Some authorities recommend exercising this muscle to strengthen the pelvic floor (especially recommended after childbirth) and to promote the possibility of achieving a heightened degree of sexual sensation. To locate this muscle, a woman can bear down as if she were going to urinate and then contract her muscles as if to stop the flow of urine in midstream. The muscle thus contracted is the P.C. muscle (it contracts the urethral, vaginal, and anal openings). Other ways to locate this muscle are to practice stopping the flow when actually urinating or to insert a finger into the vagina up to about the first knuckle and then contract the vagina around the finger; the contracting muscle is the P.C.One exercise used to strengthen this muscle consists of contracting or squeezing the muscle for three seconds, releasing for three seconds, repeating this pattern ten times, and practicing this sequence three times a day at first, gradually adding more sets. It will take a while (several weeks or months) to experience the effects of the exercise. Advantages to this exercise are that it requires no special clothing or apparatus and that it can be practiced in public (while waiting for a bus or watching television, for example) without anyone else’s knowledge. This exercise was originally developed by Dr. Arnold Kegel, a gynecologist (and is hence known as Kegel exercises), to treat women with urinary incontinence and to help develop urinary control. Women to whom he recommended it reported to him that it also helped increase their sexual sensations. This exercise is also used as an adjunct in sex therapy, to give women “permission” to concentrate on their genital sensations. *106\265\8*

HIV: PRACTICAL MATTERS-PUTTING YOUR AFFAIRS IN ORDER: ASSIGNING DURABLE POWER OF ATTORNEY

admin — Fri, 08 Jul 2011 14:54:53 +0000

Many people want to provide for the possibility that they might become unconscious or mentally incapacitated. They worry about their ability to hire help, give medical consent, sign their checks, pay their bills. Such an eventuality can be provided for by naming someone as your agent, giving him or her the power to make decisions for you. This power is called the durable power of attorney. You can give durable power of attorney to anyone you trust who is over eighteen years old; that person can be a friend and need not be a spouse or relative. In general, a durable power of attorney gives that person the legal authority to sign your name if you are terminally ill or unconscious and unable to do so. That authority can cover a broad range of functions, including most financial and medical matters. The power of attorney begins either when you decide it will—even before you become incompetent—or when you become incompetent. Incompetence is defined as it was with the right to informed consent: it is the inability to make competent decisions based on the information available to you. Two physicians decide the point of incompetence. To assign a durable power of attorney, however, you must be in capacity, that is, you must be able to make informed decisions. The durable power of attorney lasts until you die or until you revoke it. Assigning durable power of attorney generally costs somewhere around fifty dollars. There are two kinds of durable power of attorney: durable power of attorney for financial matters and durable power of attorney for health care. The two are not the same. A person to whom you give durable power of attorney for your finances cannot give medical consent. Because you specify what jobs you want the person with durable power of attorney to have, you can give medical and financial powers to the same person or to different people.*214\191\2*

PULMONARY TUBERCULOSIS: MONITORING AND FOLLOW-UP CARE

admin — Fri, 24 Jun 2011 08:50:18 +0000

Patients with tuberculosis should be followed monthly to monitor possible complications of therapy, compliance, and success of treatment. Sputum should be sent at monthly intervals until mycobacterial smears become negative. Patients with multidrug-resistant tuberculosis should have sputum sent monthly for the duration of their treatment regimen. Patients should be counseled regarding the signs and symptoms of adverse drug reactions and should be specifically alerted to the signs and symptoms of hepatitis, such as nausea, vomiting, jaundice, malaise, or persistent fevers. Patients should be instructed to stop medications and seek medical attention if these symptoms do occur. If the patient has abnormal baseline values, has signs or symptoms of hepatitis, or is at increased risked of adverse drug reaction, then monitoring of liver-associated enzymes is warranted.Besides hepatotoxicity, there are other common adverse reactions associated with specific antitubercular agents. Peripheral neuropathy is a known complication of therapy with isoniazid, but it rarely occurs in doses used to treat tuberculosis. Patients should be given pyridoxine to prevent the development of peripheral neuropathy. Rifampin and, to a lesser extent, rifabutin can induce activity of the cytochrome P-450 enzyme and are associated with a number of drug-drug interactions. The interaction with protease inhibitors and non-nucleoside reverse transcriptase inhibitors has been previously discussed. In addition, rifampin and rifabutin may increase the metabolism of many drugs, including Coumadin, digoxin, oral hypoglycemic agents, corticosteroids, anticonvulsants, antifungal agents, and oral contraceptives. Care must be taken with these medications to ensure proper dosing. Pyrazinamide may cause hyperuricemia. Acute gout is uncommon, and an asymptomatic elevation of uric acid level does not necessitate discontinuation of therapy. Streptomycin can cause ototoxity or nephrotoxicity. Patients should be monitored for these events and should be counseled to discontinue the medication if vertigo or hearing loss is noted. Ethambutol has been associated with optic neuritis, which may be unilateral. Baseline and monthly testing of visual acuity and color vision is recommended.*63/348/5*

PMS: PHYSICAL OR MENTAL DISORDER?

admin — Sun, 19 Jun 2011 08:39:34 +0000

A major controversy regarding gender bias has been the inclusion of a “provisional” diagnosis for premenstrual syndrome (PMS) in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (fourth edition; known as DSM-IV). The provisional inclusion, in an appendix to DSM-IV, signals that PMS merits further study and may be included as an approved diagnosis in future editions of the DSM. In other words, PMS could be considered a mental disorder in the future.PMS is characterized by depression, irritability, and other symptoms of increased stress typically occurring just prior to menstruation and lasting for a day or two. A more severe case of PMS is known as premenstrual dysphoric disorder, or PMDD. Whereas PMS is somewhat disruptive and uncomfortable, it does not interfere with the way a woman functions from day to day; PMDD does. To be diagnosed with PMDD, a woman must have at least five symptoms of PMS for a week to 10 days, with at least one symptom being serious enough to interfere with her ability to function at work or at home. In these more severe cases, antidepressants may be prescribed. The point of contention lies in whether administering this treatment indicates that PMDD is viewed as a mental disorder rather than a physical disorder. The controversy involves the legitimacy of attaching a label indicating dysfunction and disorder to symptoms experienced only once or twice a month. Further controversy stems from the possible use (or misuse) of the diagnostic label to justify systematic exclusion of women from certain desirable jobs.*1/277/5*

EMERGENCIES: HEAD/SPINAL INJURY

admin — Fri, 03 Jun 2011 15:20:04 +0000

Watch closely, act quicklyAny trauma to the head or spine is cause for concern because of the potential for injury to the delicate structures within the brain and spinal cord. After any injury involving the head, neck or back it is important to watch for signs that may indicate damage to the brain or spinal cord. This can be serious and requires professional medical assistance immediately. Fortunately, most injuries are limited to the surrounding protective tissues and can be treated with self-care.
Head injuryWhat you can doFollowing an injury to the head, treat any surface injury, protect from additional damage, and watch for signs of internal bleeding. Observation for 72 hours is important since bleeding inside the skull may be slow and symptoms may develop gradually.If there is external bleeding, apply pressure on the wound for 15 minutes or until bleeding stops completely. Use a clean cloth and if the blood soaks through, apply additional cloths over the first one.Apply ice or cold packs to ease pain and reduce swelling. A “goose egg” may develop. For protection, place a washcloth between bare skin and ice.Check for signs of bleeding inside the skull immediately after injury, then every two hours for the first 24 hours, every four hours for the next 24 hours, and every eight hours through the third day. Signs include:Changes in mental state that may include unconsciousness, confusion, decrease in alertness, abnormally deep sleep, or difficulty waking up.Unequal size of pupils after the injury; some people normally have a difference in pupil size, but a change after an injury can be a serious signSevere, forceful vomiting that is repeated or continues (one single episode of vomiting may be a reaction to the pain)Change or decrease in ability to move parts of the body or a change in the ability to see, smell, hear, taste or touch
Check for other injuries, especially to neck and back.Keep person sitting or lying down with head slightly elevated to decrease swelling.Avoid heavy exercise or exertion for at least 72 hours.Be alert to chronic headache or changes in personality months after a head injury. These may be signs of very slow bleeding which can cause pressure on the brain much later.
Spinal injuryInjury to the spine can occur in any accident involving the neck or back. Strain from incorrect positions or movement, and damage from disease such as arthritis can injure the spinal nerves. Self-care is directed toward preventing additional damage and permanent paralysis, decreasing symptoms and eliminating future injury.What you can doIf you suspect an injury to the spine:
DO NOT MOVE THE PERSON unless there is an immediate threat to life, such as a fire.Call for professional medical help to move the person. Keep the person still and warm. Do not give anything to eat or drink.If there is immediate danger and you must move the person, immobilize the neck and back. Slide a board or other firm surface under the person’s head and back without moving the neck or back from the position it was in. Place soft, bulky material on each side of the head to prevent rotation.In a diving accident, do not pull the person from the water. Float the person face up. The water will help support the neck and back.If there is much bleeding from the nose or mouth, roll the person onto their side (the entire body needs to roll in one, even movement) without twisting the neck or back. If the bleeding is minor, wipe out the mouth and nose without moving the person.PreventionWear your seat belt while in all motor vehicles and place children in proper car seats.Wear a helmet while biking, motorcycling, skating, skateboarding or horseback riding.Don’t dive into shallow or unfamiliar water. Exercise to keep back, neck and abdominal muscles strong.*15\303\2*

EXTRAPULMONARY TUBERCULOSIS

admin — Sat, 21 May 2011 14:32:21 +0000

In the HIV-negative patient, extrapulmonary disease is uncommon, occurring in about 15% of cases. With HIV infection, the incidence of extrapulmonary disease has dramatically increased, and as the level of immunosuppresion progresses, the incidence of extrapulmonary tuberculosis rises. The locations of extrapulmonary disease in HIV-negative and HIV-positive patients are similar, with different severities and presentations.Central nervous system involvement with tuberculosis manifests typically as an indolent basilar meningitis, with neck stiffness, cranial nerve involvement, and delirium. Computed tomography (CT) of the brain may reveal hydrocephalus. The lumbar puncture typically reveals high protein levels, low glucose levels, and a mononuclear cell pleocytosis, although early in the course of disease, spinal fluid may show a predominance of neutrophils. Rarely, central nervous system involvement may be in the form of tuberculomas. These are one or more ring-enhancing lesions seen on CT scan or magnetic resonance imaging (MRI) scan of the brain. Biopsy is necessary for definitive diagnosis. Miliary tuberculosis results from the failure of the immune response to locally contain either a latent or a newly acquired infection. The chest radiograph reveals a “miliary” pattern consisting of multiple small nodules approximately the appearance of millet seeds. Disseminated disease is common in miliary tuberculosis, occurring hematogenously, and multi-organ involvement is typical. The clinical presentation is nonspecific, with fevers, weight loss, night sweats, and weakness. More specific symptoms are dependent on the severity of specific organs involved. The central nervous system may be involved in miliary tuberculosis. Bone marrow involvement may also occur, resulting in pancytopenia. Gastrointestinal involvement may also be seen, most often manifesting as right upper quadrant or diffuse abdominal pain. Liver-associated enzymes may reveal an elevated alkaline phosphatas level or elevated tranaminase level. Pancreatitis and cholestasis may also result.Pleural tuberculosis most often results from a hypersensitivity response to tuberculosis infection. In approximately 30% of cases, there is no radiographic evidence of parenchymal tuberculosis. Tuberculous effusions are typically unilateral and moderate in size. Pleural fluid analysis reveals an exudative effusion with a lymphocyte-predominant; pleocytosis. The pleural fluid protein level is typically elevated, and the glucose level is often greater than 60 mg/dL. Because of the low organ ism load in the pleural space, mycobacterial smears are typically negative, and diagnosis often relies on demonstrated granulomas on pleural biopsy specimens. Less commonly, a large number of organisms gain entrance into the pleural space, causing a tuberculous empyema.The patient with skeletal tuberculosis typically presents with pain localizing to the site of the infection. Systemic symptoms are not common. Joint involvement may manifest as a monoarthritis. Spinal tuberculosis, also known as Pott’s disease, can cause spinal cord compression and permanent neurologic injury. An MRI scan of the spine should be obtained when there is suspicion of spinal infection. Bone biopsy is often required to make the diagnosis.Genitourinary tract infection with tuberculosis often manifests without systemic involvement. Symptoms localizing to the genitourinary tract are often subtle and include dysuria, hematuria, and frequent urination. Urinalysis results are abnormal in more than 90% of patients, with hematuria or sterile pyuria. The diagnosis is confirmed with mycobacterial cultures of the urine. The yield for mycobacteria on smears of urine is low.A patient with tuberculous peritonitis often presents with abdominal swelling suggestive of ascites and prominent systemic symptoms of fever, anorexia, and weight loss. Physical examination may suggest an intra-abdominal infection, although signs and symptoms of peritonitis may be subtle. Paracentesis may suggest a cause for the ascites other than portal hypertension, although coexisting cirrhosis may obscure the diagnosis. Laparoscopy with peritoneal biopsy is often required to secure the diagnosis.Patients with pericardial tuberculosis present with prominent systemic symptoms. Chest pain may be present, and symptoms of dyspnea, orthopnea, cough, and ankle swelling suggestive of pericardial tamponade or constriction typically occur late. Diagnosis requires pericardiocentesis and often pericardial biopsy.*61/348/5*

ALTERNATIVE APPROACHES TO EPILEPTIC SEIZURE CONTROL: AROMATHERAPY

admin — Tue, 17 May 2011 13:45:53 +0000

Aromatherapy is a pioneering treatment for epilepsy. At present only one unit (The Seizure Clinic and Epilepsy Liaison Service at Birmingham University) offers it, but there is increasing interest in it and it may soon be more readily available in other epilepsy centres. At the very least it is a pleasant and totally safe treatment with no side-effects; at best there is a good chance that it may reduce your seizure frequency. A few people have even become seizure free using this method.Aromatherapy may help you if you usually have a warning or aura before a seizure, and if you have kept a seizure diary so that you know the psychological state in which you are most likely to have a seizure — perhaps when you are very tense and anxious, for example.You will be asked to choose an aromatherapy oil from a selection which are believed to have relaxing properties. You will then be taught how to relax, using a self-hypnosis technique, while at the same time sniffing the oil you have chosen. If you find it hard to relax, or are one of the many people who are in such a continual state of tension that you do not really recognize the difference between tension and relaxation, you will be given between three and six body massages with the oil. The smell of the oil will gradually become associated with the feeling of relaxation, and eventually the association becomes so strong that by simply sniffing the oil you will be able to make yourself relax.Your seizure diary may show that you are one of the minority who actually have more seizures when they are relaxed. In this case you will be taught to develop a similar association between the smell of the oil and some technique for making yourself more alert and aroused.Once you have learned the association, when you experience a warning aura, or know you are in a situation in which you are liable to have a seizure, sniffing your bottle of oil may be enough to abort it. A few people even develop a ‘smell memory’ for the oil so that they need only think about it to stop the seizure.Do not try do-it-yourself aromatherapy, but find a properly trained aromatherapist. Pure aromatherapy oils must be used (some commercially-available ones, such as those from the Body Shop, will not do) and it is important to use the same brand all the time so that the smell is absolutely consistent. The choice of oil is important too; it has been suggested, though as yet the evidence is not conclusive, that some oils have anticonvulsant properties and may inhibit seizures. But there are others which can occasionally cause fits, so always consult an expert.*42\193\2*

YOUR SUCCESS STORY: LOOKING WITHIN -COGNITIVE BEHAVIOR THERAPY

admin — Tue, 03 May 2011 13:36:02 +0000

Unlike old-school psychoanalysis with its focus on the past, cognitive behavior therapy centers on the present to help us resolve current issues. Rather than try to unravel subconscious conflicts generated in early childhood, it works with people’s present attitudes, thoughts, and feelings about who they are. For example, if a person has an eating disorder, a therapist trained in cognitive behavior therapy will help him to overcome his dysfunctional dietary patterns by developing healthy ones instead that he can put into practice on a daily basis. Why the eating disorder actually developed is not of particular concern.Cognitive therapy also can help us develop coping mechanisms for dealing with high-risk situations that trigger eating episodes. Binge eating is often emotionally triggered, and the job of the cognitive behavior therapist is to help a client identify emotionally charged situations— such as a fight with a spouse or difficulties at school—that are likely to precipitate an eating episode and then learn how to deal with those situations in a more constructive way. Once we recognize the situations that impede our weight-loss attempts, we experience “cognition,” or awareness, that helps us overcome the problem.You don’t need to work with a therapist to do this—I recommend using your journal to try to pinpoint emotion-laden situations and then making a list that you carry with you. When you feel one of the situations coming on, look at your list and remember your resolve to not let circumstance get the better of you. Ask yourself, “Do I need this tiramisu? Do I need to have a beer with dinner? Can I really afford to skip exercising today?” This type of self discipline can be extremely challenging, so don’t get discouraged if you can’t always talk yourself away from certain temptations. You will get better the more practice you have, and as we said earlier, awareness is the first step.*278\233\8*

THE IMPORTANCE OF AIR AND LIGHT ON THE SKIN

admin — Mon, 25 Apr 2011 13:26:36 +0000

As we have already seen, the skin is able to breathe, and it is also an eliminating organ. The skin, if it is to be really healthy, must not be impeded in these important functions.In the ordinary civilized way of living we are obliged to wrap ourselves up in clothes, and thus make it very difficult for the skin to perform its breathing except under great difficulty. By doing this we tend to throw more of a burden on the lungs, and that is probably one of the reasons why all of us tend to develop colds when the weather turns cold and we are obliged to add to our covering of garments.No one is going to suggest that in most parts of the world we should be able to do without these defenses against inclement weather, but the fact has been gradually forced on us that we may use common sense in selecting and arranging our clothes. The point is – and it is a hopeful sign that many young people today are aware of the fact – than some clothes are less harmful to the skin than others, and to promote a healthy skin we must bear this in mind. In brief, the clothes we wear must allow the skin to breathe, and when we are able to do so we must remove our clothes and allow the air to disperse the gases that constantly pass through the skin.The skin is constantly perspiring, and so a certain amount of water has to be evaporated from its surface. Now heavy, unsuitable clothes may impede this function and maintain on the skin its own exudations and secretions. Whilst the skin may not actually reabsorb these toxins, there is no doubt that the health of the skin is jeopardized by their presence. Thus again, our clothes, necessary as they may be, may place a burden on the eliminating processes of the skin. If the skin is to maintain a healthy condition we must remember that it must be given air and light.Among the millions of cells forming the skin there are some that have the special function of developing pigment. It is the pigment in these cells that determines the different colour tones in the human skins.We all know that if we live indoors, and remain well covered up, our skins are of a very light colour, ranging from almost white up to a pinky white. If, when the sun begins to shine in the summer, we gradually expose the skin to the light and the sun-rays, the reaction will soon be seen. The skin will become quite reddened, and, if we persist in doing this – and depending, of course, on the inherent amount of pigment potential we may possess – the skin will take on a brownish tan. What we have done is to develop the pigment cells in the skin. Such a skin is a healthy skin because we know that it has been exposed, as it should be, to sun and light, and it is generally assumed that such a development has a good effect upon the vitamin content of the body, the sun-rays helping in some ways to fix, as it were, essential vitamins.But the pigment has another important function to fulfill: it is protective. The sun may be a very good thing, but it is also a very powerful agent, and if we had to be in its rays without some other protection the skin might be unable to protect us against them unless it developed the pigment in the special cells. So when the skin has been thoroughly tanned it enables us to be in the sunlight without danger of the rays penetrating too deeply into the body.
*14/154/5*