Medical Blog

December 16, 2009


Filed under: General health — admin @ 12:10 pm

A sprain is the tearing of the ligaments, fibrous structures which support the joints. The most common sprains occur on the limbs, such as sprained ankles, wrists and thumbs, but can affect almost any joint if the ligaments are suddenly or excessively stretched beyond the normal range of movement. ‘Whiplash’, for example is the spraining of the ligaments between the vertabrae of the neck. The joint will swell and often bruise and will be extremely painful.

Initially, sprains should be treated much the same way as bruises. Much of the pain of sprains arises from the swelling and the bleeding in the tissues. Immediately apply ice to the area and elevate the affected limb. Rest as much as possible. Apply arnica as a cream or tincture, or a compress of either arnica or comfrey root, directly on the swelling. Under medical supervision only, arnica can be taken in tablet form to help limit the bruising and Vitamin C and the herb horsetail aid the healing of muscle tissue. Initially, the joint may be strapped firmly to provide support, limit swelling and ease the pain. Soon, however, gentle massage and movement is required to prevent the ligament tissues shortening and tightening as they heal. To begin with, a physiotherapist will only stroke the affected area firmly, progressing to deeper tissue massage with fingers and thumbs only when the injury is healing. Hydrotherapy can also help the patient maintain movement and build up strength in the joint. Note that sprains take longer to heal than fractures do, up to six or eight weeks, and that a joint which has been sprained may be permanently weakened and more prone to dislocation, requiring special care and strapping with elastic bandage when exercising.

Rather than arising from one single over extension of the joints, strains result from the overuse of muscles, through careless exercise or even because of poor work practices. Strained muscles can result in temporary discomfort or the development of more serious nerve and muscle conditions.


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Filed under: Pain Relief-Muscle Relaxers — admin @ 12:10 pm

There are essentially two main ways of reducing stress:

To identify the sources of your stress and where possible seek either to reduce or eliminate these; and/or

To find ways to enable you to cope better with those sources of stress you can neither reduce nor avoid.

The most effective way to get your stress level down is usually by working towards both of these aims simultaneously. These tips from the experts will help you do just that:

Much stress is linked to always being in a rush, to constantly fighting the clock to get everything you need to do completed in time. Plan your day more carefully, allow yourself enough time for what you must do and so meet deadlines more gracefully, and you’ll find this cuts out a great deal of stress.

Directly linked to the above is the recommendation that you should be careful not to set yourself unrealistic targets, especially those that you know beforehand you will probably be incapable of meeting or where you will only manage to do so by rushing like mad or cutting corners, this being a sure-fire recipe to push up your stress level.

Always think things through carefully before you act or commit yourself to a course of action. Impulsive and less than well-thought-out actions are frequently the source of subsequent regrets, and the latter can be extremely stressful.

Set aside time to relax both physically and mentally for at least a part of every day, no matter how busy your schedule may be.

Retain control of your own life by learning to say ‘no’ if saying ‘yes’ would commit you to what is likely to become a stressful situation.

Whenever possible, take a break now and then, as a change of routine can recharge your mental and emotional batteries and improve your resistance to stress, thereby effectively reducing your level of it.

Learn to accept sensible limitations. If something is beyond your control, accept it as gracefully as possible until the time comes when you can do something to change it for the better. Agonising and worrying about things that can’t be helped is a major cause of stress and can also be a precursor to chronic anxiety.


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Filed under: Epilepsy — admin @ 12:10 pm

Before the development of CT scanning, simple skull X-rays or air-encephalograms (in which the structure of the brain was outlined by injected air) were the only techniques available. These have been superseded entirely. Another technique, angiography, is still used in some patients with epilepsy due to a structural cause. In this technique, an iodine-containing solution which is opaque to X-rays is injected directly into one or other carotid artery (in the neck), or through a catheter introduced into the brachial (elbow) or femoral (groin) arteries and passed into the region of the carotid. Immediately after the injection, a series of X-ray pictures are taken which outlines the arteries and veins containing the iodine solution. This technique identifies precisely any abnormal blood vessels and may be extremely valuable if surgery is being considered on an angioma or tumour. Advances in MRI mean that the circulation can usually be imaged by special pulse techniques and image processing software, so angiography is likely to be superseded in the near future.

Other imaging techniques are available at research centres. These include positron emission tomography (PET), or single photon emission computerized tomography (SPECT). In these procedures, variations in function in different parts of the brain can be imaged.

The technique involves injecting a glucose solution, or breathing oxygen, either of which is labelled with a specially marked atom. The oxygen or glucose is taken up and metabolized by different parts of the brain at different rates. The marker atoms attached to the oxygen or glucose allows images to be obtained which may show an area or areas of the brain which take up a lot of oxygen and glucose during a seizure, and which could be an epileptic focus. Between seizures, the same areas are relatively silent. Such studies may help neurologists and neurosurgeons decide on the suitability of a child or adult for epilepsy surgery.


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Filed under: Arthritis — admin @ 12:10 pm

Minerals are also considered extremely important in the treatment of arthritis. Disturbance in the body’s mineral metabolism is usually indicated in arthritis. Therefore, the restoration of proper mineral balance in the tissues is imperative for effective and fast recovery.

Various mineral supplements are used by different practitioners. For the United States, the mineral supplements most useful and easily available would be kelp and bone meal. Recommended doses are about five kelp and five bone meal tablets each day. Both also could be obtained in powder form and taken in a dosage of about one teaspoon of each a day. Kelp is especially beneficial for arthritis sufferers. It could be used as a salt replacement in the seasoning of salads and other foods.

In Japan, where kelp (seaweed) is used extensively as an important part of the daily diet, arthritis is virtually nonexistent.

Other Supplements

The following food supplements, in addition to the ones mentioned above, are used and recommended by most biologically oriented practitioners:

Brewer’s yeast (or food yeast) about 3 tbsp. a day.

Note: never use yeast intended for baking! Cod liver oil, plain, not fortified—1 tsp. a day. Raw wheat germ—3 to 5 tbsp. a day. Wheat germ oil—1 tbsp. a day. Lecithin (granules or liquid)—1 tbsp. a day. Whey, tablets or powder (for better intestinal hygiene).

In addition, such natural foods as honey, soybeans, sunflower seeds, sesame seeds, raw nuts, yogurt, black molasses, and cold-pressed vegetable oils should be used liberally to make a diet well balanced and nutritious.

Parenthetically, for best effect and full biological value, all vitamins and minerals and other food supplements should always be taken with meals. Because many vitamins are water soluble, and taken in large doses could be readily lost in urine, it is advisable that the daily dose should be evenly divided between three meals, rather than everything taken with one single meal.


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Filed under: Pain Relief-Muscle Relaxers — admin @ 12:09 pm

While there is a direct correlation between your sleeping pattern and back pain and sciatica, how well you sleep is also likely to have a major effect on your overall health and stress levels, which in turn may also affect your back problems. Here are some extra facts about sleep that underline the importance of this often-neglected aspect of our lives:

Most of us spend up to a third of each day in bed – that’s about 29,200 hours in bed every ten years.

New research has shown that people who try to cut down on sleep are more prone to infection and irritability. In a recent study of 9,000 British adults, it was found that those who slept between six-and-a-half and eight-and-a-half hours enjoyed much better overall health than those who slept for less.

Lack of sleep can sabotage diets and knock our immune system for six: exhausted people are far more likely to pick up bugs and infections because of the way lack of sleep upsets the normal cycle of chemical and hormone release. When a representative sample of more than 300 adults aged 30 to 60 years were asked about the effect a bad night’s sleep had on them, 79 per cent of people saw a direct link between the way they had slept and how they felt the next day. A staggering 52 per cent said that they regularly experienced tiredness/lethargy, irritability, poor concentration, depression or headaches which they attributed to poor quality sleep.

Only 10 per Cent of people stated that they always had a good night’s sleep – these were the people who regularly got more than the average amount of sleep.

How much sleep do we really need? While this will vary greatly from person to person, the average amount of sleep needed each day, according to the Ushborne Book of Body Facts, is 16 to 20 hours for a new-born baby; 13 hours for a two-year-old; 10 to 11 hours for a five-year-old; 9 to 10 hours for a ten-year-old; 7 to 8 hours for an adult; and a mere 5 hours for an eighty-year-old. On the average, people sleep for just 6.7 hours before a working day and 7.1 hours before a day off.


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Filed under: Anti Depressants-Sleeping Aid — admin @ 12:09 pm

If your depression is severe, I recommend that you start treatment with a conventional anti-depressant as opposed to St John’s Wort.

I would regard depression as being severe if it disrupts important functions, such as personal relationships or work to a major degree, if it is seriously interfering with physical functions such as sleeping or eating, or if it is accompanied by a sense of hopelessness or suicidal ideas or plans. To date, there has been only one study with St John’s Wort for relatively severe depression.

Although the results of that study revealed a beneficial effect of St John’s Wort equivalent to a modest dose of a conventional antidepressant, there are numerous studies indicating the value of more conventional anti-depressants in severe depression. At this point the benefits of St John’s Wort for severe depression must be considered somewhat experimental, and a more proven first-line approach makes more sense, given how much is at stake when depressive symptoms are severe. Severe depression can jeopardize a person’s job, relationship or the successful outcome of a project. Of even greater concern is the danger of suicide, which is a major risk of severe depression. A delay resulting from starting with a less well-established approach is therefore too risky. A doctor should be consulted and a trial of a conventional anti-depressant should be initiated without delay.

If you are currently being treated with one or more antidepressants and are considering using St John’s Wort, you need to ask how to proceed if:

You are doing well, your depressive symptoms are under good control and side-effects are at an acceptably low level.

You are already being treated for depression but are not doing as well as you would like either because your depressive symptoms are not under control or because side-effects are unacceptable or undesirable.


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Filed under: Pain Relief-Muscle Relaxers — admin @ 12:09 pm

Although the above seems like a simple enough question that should evoke an equally simple answer, the truth is that, as is so often the case, experts do have widely differing views. What’s more, what is a good and comfortable bed for one person is not necessarily so for the next, as what suits best does vary greatly from individual to individual. To take two extreme examples, even today many Japanese still sleep on traditional futons, thin strips of flock-filled bedding which are unrolled on the floor at bedtime, while there is a great vogue for waterbeds in many other parts of the world. The contrast between the two sleeping arrangements could hardly be greater – ranging from the sleeper being almost directly in contact with the hard floor to lolling about in the deep moving trough of a waterbed. Yet both methods have their keen proponents who would argue strongly the merits of their choice. The truth is that neither sleeping arrangement is per se the right one – the fact that both are acceptable for many people just shows that the human body can adapt to and accept a wide range of sleeping conditions.

Even in Britain, where the overwhelming majority of people favour what might be called ‘ordinary’ beds consisting of a base and mattress, there is wide variation in what people find comfortable. Experts, however, agree that to play its part in easing or preventing back pain or sciatica, your bed should meet the following criteria:

It must provide ‘good’ support for the whole body and so prevent the spine from sagging.

It must be of a height that makes it easy to get into and out of bed. The height is also of importance when it comes to making the bed or changing bedding – a low bed means there will be more bending over than with a comparatively high one.

It must be large enough to allow plenty of room for movement during the night. Naturally, if you share your bed it should then be big enough to provide adequate space for two.

Let us now look at these key points in greater detail.


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Filed under: Pain Relief-Muscle Relaxers — admin @ 12:09 pm

How well you sleep and what kind of bed you sleep on can affect your sciatica or back pain in several important ways:

As we’ve already seen, posture affects the spine – and that also applies to the posture you adopt when you’re in bed. It stands to reason that lying for hours on end in a bed with a sagging mattress that provides poor support and forces your spine, legs and neck to adopt uncomfortable positions is simply not going to make back pain or sciatica any the better.

A good restful night’s sleep is one of Nature’s greatest healers. Equally, tossing and turning all night is a sure-fire recipe for waking up the next morning feeling worse than when you went to bed, with a stiff, aching spine and your back muscles all knotted up.

The average adult grows in the night by as much as two centimetres. During the day the spine gradually becomes more and more compressed as the cumulative effect of gravity takes its toll. At night, as we lay down and the weight of our upper body no longer presses downward, the spine is given a chance to straighten and recover. Just how much straightening out and recovery takes place during sleep will be greatly affected by how suitable your bed is.

Confirmation of the importance that their sleeping arrangements hold for back pain sufferers was evidenced by a recent survey that discovered that 93 per cent of general practitioners interviewed agreed that a good new bed can help alleviate back problems. While this survey was admittedly carried out on behalf of a group of bed manufacturers with a vested interest in promoting the sale of their products, the essential message that emerges still remains true: the right kind of bed (although not necessarily a new one) can work wonders for anyone suffering from sciatica or other back problems.

Naturally, just as important as your choice of bed is how you sleep in it. Let us look at these two separate but interlinked questions one at a time, beginning with . . .


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Filed under: Anti Depressants-Sleeping Aid — admin @ 12:09 pm

A recent study reported the annual cost of depression in the US to be approximately $43 billion a year. This amount includes the cost of treating the condition and the loss of productivity and positive contribution to the economy resulting from the illness. Even without taking into account the human suffering involved in the condition, depression is considered to be one of the ten costliest conditions to any nation’s economy.

While depression is costly, its treatment is lucrative. Thus, the anti-depressants such as Prozac and Lustral are among the best-selling medications, representing billions in revenue for their manufacturers. While these medications can literally be life-savers, those who offer these commodities have a marked vested interest in maintaining their share of the market. They might be understandably concerned by the advent of an effective, off-prescription alternative treatment for depression. While some concerns about this new way of treating depression are warranted, others may be suspect, motivated by an attempt to protect economic turf.

In all cases, arguments against the self-administration of St John’s Wort need to be considered on their merits. For example, a leading psychiatrist was quoted in a recent article in the Washington Post on St John’s Wort as saying, ‘If a drug has enough activity to actually treat something that is real and substantial, then it ought to be administered under somebody’s supervision.’ If you consider the many active drugs available without prescription, which are routinely self-administered to treat real and substantial problems, such as aspirin for arthritis or antihistamines for allergies, it is clear that this argument is not universally applied in other areas of medicine. Nor, in my opinion, does it necessarily apply in psychiatry either. Perhaps the psychiatric establishment has yet to get used to the novelty of an over-the-counter treatment for depression.


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Filed under: Anti Depressants-Sleeping Aid — admin @ 12:08 pm

A 50-year-old American woman writes to me as follows:

I first heard about St John’s Wort as a treatment for depression when I was reading about natural remedies for menopausal symptoms. I began taking 300 mg but did not find it all that helpful. This past summer my husband suggested I up the dosage to 600 mg and that was the magic amount for the summer Now that we have turned the clocks back again [at the onset of autumn] I am taking an additional 300 mg in the afternoon, which helps.

I have been in and out of therapy since I was 25. Therapy with the right therapist(s) is helpful, but it is also expensive and time-consuming. My employer has a cap on the number of hours of therapy a person can undergo, and I am getting closer to that cap every week. I am hoping that this next calendar year is my last year of needing therapy. I was not in therapy for several long periods of my life. Often, a tragedy such as a death in the family or major surgery would send me back in.

I prefer natural herbs to drugs wherever I can. I have refused to take Prozac or Lustral. I really don’t want to rely on a drug to control my mood.

Whether or not one agrees with Shirley’s opinions about psychotherapy, herbal remedies or anti-depressant medications, she does seem to embody the trend that Naisbitt mentions in his book. I do believe that she speaks for a very large number of people who are concerned about the cost of mental health care, interested in natural remedies and eager to take their lives into their own hands as much as possible. St John’s Wort provides a solution to all of these concerns. Relatively inexpensive, highly effective, safe and mild in terms of side-effects, it offers millions of people the opportunity to help themselves.

It is, of course, critical to know when self-care has reached its limit and when to seek the help of an expert. Shirley appears to be able to make this distinction. It is an important caveat for others to bear in mind as well.


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