Health news blog

COMMON COMPLICATIONS OF SPINAL CORD INJURY: PNEUMONIA AND PAIN
PneumoniaIn people with spinal cord injury, difficulty coughing (and thus clearing the lungs), prolonged bed rest, and decreased mobility all contribute to an increased risk of developing pneumonia. Several treatments are used for patients who contract pneumonia. A combination of antibiotics and vigorous respiratory therapy is the first choice. The respiratory therapist pounds with both hands on your chest or back while you are tilted at an angle to help drain the affected lobe of the lung. This is called postural drainage. Inhalants are also used to help dilate and clear airway passages.People with quadriplegia usually need assistance with coughing to prevent or treat pneumonia. In a technique known as quad coughing, the caregiver pushes on your upper abdomen while you cough, and this helps to expel air forcefully from the lungs.
PainMost individuals with spinal cord injury have to deal with pain at some point during the recovery process. For most, the pain is transient and is associated with the initial trauma (for example, the pain caused by a vertebral fracture or an associated injury). This pain may persist for weeks, but it generally is responsive to traditional analgesic medications (painkillers) and resolves over time. However, many individuals have chronic pain after spinal cord injury that is disabling and difficult to treat. This dysesthesia, or neurogenic pain, is caused by abnormal processes inside the spinal cord, not by a pain-inducing stimulus outside the body. Neurogenic pain is particularly frustrating because it commonly affects an area of the body that is anesthetic—that is, a region that has no sensation whatsoever for external stimuli. Individuals with neurogenic pain describe it as feeling like burning, tingling, or an electric shock, sometimes very intense. They often say that it’s unlike any sensation they have experienced before.Neurogenic pain is difficult to treat. It sometimes responds to traditional analgesic medications, but it may be resistant to these. Narcotic painkillers are sometimes necessary but are not always effective. Several medications not usually classified as painkillers may help with this sort of pain. Certain antidepressant drugs, particularly tricylic antidepressants (such as amitriptyline), have been used successfully in treating neurogenic pain. The other medications with proven efficacy for neurogenic pain are certain antiepileptic drugs, especially Neurontin (gabapentin). Psychological approaches, such as relaxation and imagery training, can also be useful for dealing with chronic pain.
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ALLERGIES, CANDIDA AND ASTHMA: THE CANDIDA ANTIBODIES TESTThis, in my opinion, is the simplest and most useful test so far. Dr John Trowbridge in his book, The Yeast Syndrome, New Laboratory Tests for Yeast-related Illness (Bantam Books) describes it thus:The antigen is critical. It is important to test for both cytoplasmic [inside cells] as well as wall fragments [in the blood] as we do. High IgE levels indicate an allergic reaction occurring in the patient to his own Candida. I view this as a more serious case of long-term Candida overgrowth, with drastic effects on the immune system. IgE levels will often be low [immune suppression] to normal, resident Candida which, in a sense, is like an auto-immune reaction going on in the gut. These patients will often have rampant food and chemical allergies.By carefully monitoring the variation in ‘titre’ number (a measure of contamination) before, during and after treatment, it is now possible not only to diagnose Candida but also to establish the concurrence of post-viral illnesses or immune supression. It makes sense that, rather than just look for the presence of these organisms, we should attempt to define what harm, if any, they are doing and how the body reacts or responds to them. It is also important to be able to differentiate between a toxic Candida overgrowth, a topical or systemic infection and a simple allergic response. It is equally important to be able to establish whether the organisms are influencing other, co-existing illnesses, such as post-viral syndrome and CFS, or just suppressing the immune system in general.The latest research findings on candida-related problems indicate that this is a very useful tool for the differential diagnosis of candidiasis, CFS and immunological problems. It allows the doctor to monitor progress and ascertain if the chosen therapy is working and can indicate that other underlying factors may be present.The principle behind this test is that in normal individuals the Candida organism is not in the blood. Should it enter the bloodstream, however, it would be considered an attacking foreign agent. As a result the body will attack it by making antibodies against it.Unfortunately many therapists and even some medical doctors are not familiar with either the methodology or interpretation of this test and, in the past, have tended to dismiss it. We have carried out several thousand such tests and find them useful for a number of reasons.Naturally, antibodies will not be formed by anyone whose immune system is depressed, so that, in the presence of a clear clinical picture of Candida, the therapist is immediately alerted to a serious underlying problem.IgM (immunoglobulin M) antibodies against Candida are the first to be formed, but they tend to disappear shortly after peaking a couple of weeks after the infection starts. IgG (immunoglobulin G) antibodies tend to show the greatest rise in numbers shortly after the initial event. When the patient has chronic candidiasis both IgM and IgG antibodies tend to be occupied and therefore their levels appear low. This is both the main disadvantage and the most important usefulness of this test.MethodologyFirst of all the test should be done before any anti-fungal medication is taken. The reading can be very low (10-20), low (20-40), medium (40-80) or high (160-320) or more. The significance of each of these results depends on the patient’s symptoms.If there are obvious signs of mucocutaneous Candida infection, such as oral or genital thrush or tinea, and the count is negative, low or nil, this usually means that the patient’s immune system is engaged in a full-blown war against Candida and all antibodies are engaged. Such results can also mean that the patient has a poor immune capacity to respond to Candida, in which case, apart from being alerted that a CMI multitest is probably needed, the therapist is immediately aware that Candida is unlikely to be the main problem but rather constitutes a symptom of some other, immune-disrupting threat to the patient’s health. If the count is higher than that, then the body is fighting, and winning the fight to some extent.The treatment is begun as soon as possible after the first antibodies test. A week or so later, the Candida antibodies test is repeated while the patient is on anti-fungals. If the second count is higher than the first, irrespective of what the count was the first time, there is an obvious reason: Candida organisms are being killed and antibodies liberated to float around until they die off (usually two to three weeks). Hence one knows without any doubt that Candida was and still is a problem. In addition, one knows the organisms are being killed.If treatment is continued, the antibody count should rise and then return to the original low level. This indicates that the gut/body reservoir of Candida albicans has been depleted to the point where no more antibodies are needed and the fight has been successful.If the first Candida antibodies count is elevated, then the individual is affected by Candida and the body is fighting. One can help the fight in whatever ways are suitable for that particular patient.Often, but not always, we also try to measure antibodies to several viruses at the same time. I do this because compromised individuals may harbour latent viruses and those may be reactivated. For more details on the implications of this, I recommend you read my book Chronic Fatigue, the Silent Epidemic.In such cases one can retest after the Candida problem has been resolved to find out if Candida played a major or a minor role. In other words: was it the cause or the trigger?Conversely, we run Candida antibodies tests on all patients with immune problems and all CFS patients. It is one of the most elucidating tests one can do to differentially diagnose illnesses related to immunity and viral problems.A study reported in the Journal for Advancement in Medicine (Vol.3, No.2, 1990) compared the validity of several diagnostic methods for Candida infections. It concluded that the antibodies test had a high degree of correlation, as did some of the questionnaires. A combination of the two obviously produces the best results.*64\145\2*

DIABETES & EYE LONG TERM COMPLICATION OF DIABETES:WHAT IS DIABETIC RETINOPATHY ?The retinal vascular complications that occur due to uncontrolled longstanding diabetes in adult individual is called diabetic retinopathy. It is basically microangiopathy affecting arteriole, the capillaries and venules of retina due to metabolic disorder. The large vessels may also become involved. Vessels are either blocked or blood leakage occurs from the vessels.Who gets these eye complicaitons ?1. Type-1 patients, particularly elders whose duration of diabetes is longstanding.2. Pregnant women having diabetes are liable to get eye complication3. In western countries and even in our country this is the most common cause of blindness in type – 2 or diabetes of adults, specially elderly group.Background retinopathy or Non-proliferati ve diabetic retinopathyDiabetic maculopathy which may be(a) Focal (b) Cystoid (c) Ischaemic (d) MixedPre-proliterative Diabetic RetinopathyAdvance diabetic eye disease —a) Persistant vitreous haemorrhageb) Retinal detachmentc) Opaque membrane formationd) Neovascular Glaucoma*68\329\8*

TYPES OF HEART DISEASE: YOU CAN HAVE MORE THAN ONE TYPE OF HEART DISEASEHeart disease can affect any and all parts of the cardiovascular system the myocardium, the valves, the coronary arteries, the conduction system, the arteries and veins, and the pericardium. Disease in any of these areas may be called “heart (or cardiovascular) disease.”You Can Have More Than One Type of Heart DiseaseThe process of diagnosing heart disease is complicated. To begin with, more than one type of cardiovascular disease or problem can occur at the same time in the same person. In fact, this is often the case. However, one problem may overshadow the others. This problem may be the most direct cause of symptoms, or it may have the greatest effect on your overall health and life span.When more than one problem occurs, the conditions can sometimes be related to a single underlying cause. For example, “hardening of the arteries” due to cholesterol plaque deposits(atherosclerosis) can occur in your coronary arteries (arteries to the heart muscle itself), carotid arteries (arteries carrying blood to the brain), aorta (the main artery leading from the heart), and leg arteries. Thus, you could have symptoms of angina (chest pain), stroke (brain injury), and claudication (limb pain or tiredness), all of which are caused by insufficient blood flow due to atherosclerosis.Knowing that certain problems occur together, doctors must sometimes piece together evidence of associated disease even if you have only one symptom or evidence of only one problem. Suppose, for example, that your doctor has detected an abdominal aortic aneurysm and recommends an operation to repair it. Experience has shown that coronary artery disease is present in more than 50 percent of people with aortic aneurysms, even if it is not causing symptoms of angina. Because coronary artery disease might make the aneurysm operation risky, your doctor may recommend tests to see whether serious coronary artery disease is present. Looking for and treating the coronary artery disease first make the operation for the aneurysm less risky.*79\252\8*

SCREENING FOR BREAST CANCERBreast cancer is one of the most important medical problems in the United Kingdom. There are almost 25,000 new cases every year and 15,000 deaths. Breast cancer accounts for 5 per cent of all deaths in women in the United Kingdom and is the commonest cause of death of women in middle age. The United Kingdom has almost the highest breast cancer mortality of any country which keeps records.Breast cancer occurs in an organ which is easily examined. When the cancer is small it can be removed without much surgical damage to the breast. This would suggest that early diagnosis of the kind achieved by screening might result in a useful outcome in chat the cancer would be easily treated and the patient might be readily cured. However, we have already discussed the reasons for caution in believing that early diagnosis would necessarily lead to cure and it has required many decades of work to establish the curative potential of screening in breast cancer.The evidence that screening can lead to an increased cure rate in breast cancer and reduce the overall mortality in the population is now very strong. Three countries (the United States, Sweden and Scotland) have performed trials in which a population of women were either screened or not according to the study design. The first study was carried out in New York using methods of clinical examination and breast X-rays (mammograms) and screening women between forty and sixty-four years of age every year. The second was carried out in Sweden and used mammography alone in women over the age of forty every eighteen months to three years. Both studies showed a reduction in mortality of about 30 per cent compared to mortality in the control group. It remains difficult to be precise about the size of the benefits. In the age group 50-69 years, the deaths from breast cancer are probably reduced by between 20 and 30 per cent if screening is introduced to the population. If an individual woman of this age goes for screening her personal risk of dying from breast cancer in the next ten years may be reduced by more than this – perhaps 40 per cent. Slightly less rigorous studies have been carried out in Italy and the Netherlands using the case-control method. They all used mammography but the ages of patients studied differed somewhat. Screening was at between one- and four-yearly intervals. The studies also showed a reduction in mortality compared to that of the unscreened population. All this evidence is pretty compelling. Screening for breast cancer is feasible and can be effective.This is not all that we need to consider. We have to ask who should be screened, how often they should be screened and by what technique. The evidence suggests that the benefits are greatest for women over the age of fifty. The benefit of screening women below fifty is uncertain and further research will be necessary before screening can be firmly recommended for women under that age. Mammography seems to be a necessary part of a successful screen. As we shall explain, breast examination alone is insufficient. It seems as though screening has to be carried out at least every three years.The obvious screening test is for a doctor or other healthcare professional to examine the breast. It is difficult by this method to pick up cancers that are smaller than about I cm and many lumps that are not cancer will be detected. Examination by itself is therefore potentially rather insensitive and most evidence to date suggests that this approach is insufficient. Mammography is a technique that uses very small doses of X-rays to produce a picture of the breast which is much more sensitive than physical examination and can give useful information about whether the abnormalities seen are due to a cancer or are not. The radiation dose is tiny and mammography is at present the most sensitive technique for finding a breast cancer in screening.In 1988 Health Authorities in the United Kingdom began phasing in the National Breast Screening Programme. A nation-wide service is being established to apply mammography every three years to women aged between fifty and sixty-four years. This is a huge and expensive undertaking but it can potentially reduce the death rate from breast cancer by one quarter in this age group. There remain arguments about the cost-effectiveness of the programme and the possible anxieties provoked by screening. Nevertheless it is a major health initiative and deserves support.*126\194\4*

SUPERSTITIONS AND FALSE REMEDIES FOR ARTHRITISIf we are to find a modern cure for arthritis, we must first know all the past methods which have failed. We must eliminate all of the wrong theories, learn to disregard just plain superstitions.Any scientist—when he sets out to discover the correct medicine or treatment—will first go back into history to consult centuries of past knowledge. He will want to know what other scientists did wrong, and why these mistakes were made.You, too, should be interested in knowing the false remedies, the quack ideas and the failures of old-time medicine men. Unless you know the difference between a “legend” and a correct cure, how can you hope to choose the right road to recovery?So this chapter will trace the course of medical progress back through hundreds of years. By reading about these superstitions and strange treatments, you will be able to see how arthritic research has grown. You will be able to recognise the wisdom—or the false hope—offered to modern patients.Many of the methods used today to fight arthritis began ages ago. Some brilliant men and women, the best brains of their day, were interested in arthritis. Read on, and learn what they contributed toward helping you.*54\146\2*

ADHD (ATTENTION DEFICIT HYPERACTIVITY DISORDER):  IF COPING TECHNIQUES SUGGESTED BY ADHD SPECIALISTS DON’T WORKQ: My husband and I are trying desperately to help our son cope with his ADHD and, at the same time, change his abusive behavior. Our doctor gave us a list of tips that are supposed to make things easier, but they’re not very realistic. What should we do?A: Unfortunately, many of the coping techniques suggested by ADHD specialists sound good in theory, but are next to impossible to enact at home. For example, parents may be told that their ADHD child needs a quiet place to study, one with few distractions. But most normal households would be hard put to find such a place, especially if they have other young children. Or they may be told to stick to established routines for the sake of the ADHD child—a near impossible task for today’s modern, on-the-go family. As a result, adjustment and behavior modification can take months or longer to show results.You need to raise these important issues with your physician and ask for additional help in changing your son’s behavior. Explain the realities of your family situation, and ask him for information that’s more pertinent to your specific needs. Every family is different, and their approach to easing the problems of ADHD and changing disruptive behaviors will be different. Nothing related to the treatment of ADHD is set in stone.*69\173\2*

WHY YOU CAN’T STAY AWAKE: WHO SUFFERS FROM SLEEP APNEA?Surprisingly, sleep apnea was not identified as a diagnosable condition until the early 1970s. Now, however, it is ranked as the single most frequent cause of sleep disturbance, occurring in almost half of patients with sleeping problems. Overall perhaps 5 percent of the U.S. population—roughly 12 million people— may suffer from it. One out of ten men over forty have clinically significant sleep apnea. The older you are, the greater the risk: some experts estimate that 40 to 50 percent of the population over the age of fifty may experience sleep-disordered breathing.The pattern of daytime sleepiness resulting from apnea varies widely. Some people with OSA are prone to sleep attacks and microsleeps—dozings that last only a second or two. Usually they find naps do little to refresh them. Like narcoleptics, they may experience hallucinations as they wake up or drop off, but they don’t exhibit the telltale narcolepsy symptom of muscle paralysis. Other OSA victims fall asleep whenever their activity level drops below a certain point—when they sit down, for example, or as soon as they begin to read. Driving is a notorious trigger for sleepiness; one patient described himself as “catnapping on the straightaways and waking up for the curves.” Sufferers may have lower levels of attention and concentration and have been found less able to perform small manipulations with their hands, such as knitting or typing. In severe cases OSA can make it impossible for a person to function on the job; many a patient, like the one I mentioned earlier, has told me of stern reprimands or even firings by unsympathetic bosses. Diagnosis is often made more difficult by patients who deny the severity of the problem.*135\226\8*

COMBATTING ASTHMA IN CHILDREN: ANTI-INFLAMMATORY DRUGS – STEROIDS: THE CORTISONE DRUGS – INHALED STEROIDSInhaled steroids have become the mainstay of treating asthma. Inhalation is preferred because it is easier to get adequate steroid concentration into the bronchial tubes through inhalation than it is through the oral route. Smaller doses as compared to tablets or injections can be given to achieve a high degree of local activity. The low rate of absorption by the body ensures relativefreedom from side effects. Medical studies and experience with inhaled steroids have demonstrated not only their effectiveness in controlling chronic asthma in all groups, but also their ability to reduce need for oral administration of cortisone.The first inhaled steroid to be introduced was Betametliasone but is less commonly used now.Beclomethasone dipropionate (BDP) is perhaps the most widely used steroid and has been in use for over 20 years. There is not much difference in the efficacy of the drugs if we compare BDP and budesonide in doses up to 800-1000 mg day. The difference between these compounds is seen only in higher doses. There is a difference in safety, because budesonide is inactivated more rapidly, which means higher doses of budesonide do not cause harmful side effects.Inhaled steroids should preferably be started at higher dose levels to achieve a rapid control and then gradually reduced to the lowest possible dose which keeps the patient on the best level of control. This requires continuous careful monitoring.In children receiving regular treatment with oral steroids, for safety reasons, these should be gradually withdrawn and inhaled steroids introduced. In most studies, it has been shown that half the number of patients can stop oral prednisolone altogether and some 30 per cent can reduce the dose. The reduction has to be slow, otherwise patients may develop a steroid withdrawal syndrome. Some patients cannot reduce oral steroids at all.*58\260\8*