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AIDS DEMENTIA COMPLEX: HIV AND THE CENTRAL NERVOUS SYSTEM-PROBLEMS WITH SELF-CAREA

Friday, July 29th, 2011 | HIV | Comments Off

long with apathy come problems with self-care. Eating, drinking, dressing, and staying clean all come to mean less and less. “Some days I’d come home from work,” said Lisa, “and he’d be sitting in a hot house in the middle of summer with the windows closed, no fan on, and he hadn’t eaten all day, or just ate junk food. Once I made hard-boiled eggs and he made himself an egg-salad sandwich. But usually if I made extra for supper so he could heat it up the next day, he forgot it, or would think cupcakes were easier.”     Eating and drinking are the most immediate problems with self-care, because people with AIDS need to eat good meals. People with dementia lose the internal drive to eat and drink. Lisa complained that she made food for her husband, then asked him if he’d eaten. Her husband would say he had, that it was easy and all he had to do was put the food Lisa left him into the microwave. But in fact, Lisa’s husband did not eat—somehow, he couldn’t think of the steps involved in taking the food out of the refrigerator, putting it into the microwave, taking it back out, and eating it. Or else he didn’t notice he was hungry or didn’t care. Caregivers have to try reminders—to make phone calls or set up routine supper dates. They also need to make eating and drinking as convenient as possible—a dorm-sized refrigerator or a cooler full of juices and snacks by the bed keeps food and drink within easy reach.     Staying clean can also be a problem. “Sometimes my husband was not as clean as he should have been, and would go days without a bath,” Lisa said. “He’d say, ‘I don’t need a bath,’ and would resist any reminding.” Lisa found that the only thing that got him into the bathtub was bribery. “Compliments didn’t work,” she said. “Sweet talk did sometimes. But bribery was the best. He’d need to see some concrete benefit—I’d usually bribe him with bread pudding. I’d say, ‘I’ve got some bread pudding in the kitchen. Why don’t you get a bath, and put on your robe, and we’ll eat that bread pudding?’” Other people are not as resistant to bathing as Lisa’s husband and will respond to “You haven’t had your usual bath. Need any help?”     Making certain the person changes clothes regularly can be accomplished easily: clothes that have been worn can simply be put in the laundry and fresh clothes set out. “Every morning I’d lay his clothes out,” said Lisa, “and every night I’d throw them in the hamper. Otherwise, he wore the same clothes.”     Sometimes, in the later stages of dementia, apathy gets the better of the person in the midst of bathing or dressing. Lisa would put her husband in the shower and he would not bother to come out. Or she’d help him with one sleeve of a shirt, and he would not put his arm in the other sleeve. Sometimes people seem to lose their sense of modesty and don’t dress appropriately. At these stages, the caregiver needs to be around fairly constantly, and to remind or help the person to finish up the process that was started.*148\191\2*

COPING WITH THE UNCERTAINTIES OF SEIZURES AND EPILEPSY: SPASTIC QUADRIPARESIS AND DIPLEGIA

Spastic Quadriparesis Children with stiffness in all four limbs (spastic quadraparesis) usually have sustained severe damage to the entire brain. They are likely to have severe or even profound retardation. They often have experienced seizures in the newborn period (see neonatal seizures) and may have had infantile spasms during the first year of life. They will have a high incidence of generalized tonic-clonic seizures as well as of atonic attacks and the Lennox-Gastaut syndrome. Seizures in children with spastic quadraparesis may be very difficult to control.DiplegiaDiplegia is the type of cerebral palsy in which both legs are stiff. It is far more common in children who were born prematurely than children carried to full term. These children are usually of normal intelligence and are less likely to develop seizures. Their principal handicap is a difficulty with walking; physical therapy, bracing, and orthopedic surgery can often be of help.*200\208\8*

ADOLESCENT ALCOHOLISM TREATMENT: ALCOHOL/DRUG ASSESSMENT

Once the issue of confidentiality has been cleared up, it is important to take a family history. Ask about alcohol or drug problems, prescription or nonprescription. Include the grandparents, uncles, aunts, brothers and sisters, and cousins, as well as the parents. Other important parts of the history include asking the adolescent how he spends his time. Ask him to describe a typical day. Ask what he and his friends do Saturday night. Ask about his peer group, about their age, activities, drug and alcohol use. Ask how they are seen and described by other groups in the high school, and then ask about his own use of drugs and alcohol. Ask about parental relationships. Ask about sleep, appetite, depression.The fact that adolescent alcohol abuse can go on for as long as 6 years without being diagnosed is a tribute to the ability of these adolescents to hide their problems, to the ability of parents to avoid recognizing problems in their children, and to the ability of school systems to ignore or expel problem children. It is not unusual for parents to be actively protecting, rescuing, and taking care of a substance-abusing adolescent without realizing that this supports and prolongs the abuse. They make good on forged checks. They hire lawyers or pay to have legal charges dropped. They go to bat for them at school or blame school authorities for the problems. In our experience, parents must stop protecting these children and seek help for them instead.When asking about drug and alcohol use begin by asking about the first time he or she was drunk, how much they drink now, how often, if they have ever tried to stop or cut down. Ask about blackouts, legal problems, and school problems. Finally, don’t assume that an adolescent is providing a wholly accurate history about drug and alcohol use. Denial is a central characteristic of adolescent alcohol or drug abuse. It is important to get information from parents and teachers whenever you are concerned about adolescent alcohol or drug problems.*151\331\2*

SKIN DISORDERS IN ADULTS: MALE-PATTERN HAIR THINNING AND ALOPECIA AREATA

Male-pattern hair thinningBalding in women occurs in the same way as it does in men. It is generally less severe and usually occurs diffusely from the front of the scalp to the crown. Some women have a hormone disturbance which causes the hair loss, and can also suffer from excessive hair growth on the face, irregular periods and facial acne. These women produce an excess of male-type hormones.Because it is genetically determined, this type of hair loss cannot be readily prevented. However, oral contraceptive pills which contain high levels of progestogen can aggravate hair loss, while those with high oestrogen and low progestogen can improve the situation. There are no special shampoos, conditioners, lotions or hair treatments that prevent or decrease hair loss.There are several ways this male-pattern hair loss can be treated. These include the use of topical Minoxidil, hair transplantation, the use of hair pieces and make-up, and hair fusion. Refer back to pages 70 to 71 for more details on these techniques. If there is a true hormonal disturbance, hormone treatment can be an option. There are now two anti-male hormone drugs on the market, called Androcur and Aldactone, which can be effective if used on a long-term basis.
Alopecia areataThis condition, which can occur in both adults and children, results in patchy hair loss. It occurs more commonly in people with eczema, and may appear suddenly after a stressful episode. In children it often improves spontaneously, but in adults it can lead to permanent, severe hair loss.The exact cause of alopecia areata is unknown, but it is thought to be caused by an abnormality in the body’s immune system, whereby the body rejects its own hair in the way it would a foreign protein. If hair loss is limited to a few patches, cortisone injections will successfully treat the problem. If hair loss is extensive however, there are few effective remedies and fifty per cent of sufferers will lose all their hair.
*38/150/5*

PHYSIOLOGICAL ANALYSIS OF POSTURE: FUNCTIONS OF SPINAL MUSCLES – REFLEXES AND REFLEX MOVEMENTS

In the body, however, more complex reflexes take place to maintain the balanced erect position. For example, it is not only the forward and backward movements that maintain the erect position, there are lateral (sideways) movements too that need to be coordinated. The stretch reflex explains the basic mechanism by which posture is maintained, although the complexity of reactions or movements is very intricate.When a person trips on the street, a series of quick reflex movements are automatically put into action to prevent the body from falling and injuring itself. Most of these movements are involuntarily and only a few quick response voluntary movements are made to react to this emergency situation. A marvellous part of this reflex action is that in an open space the reflex is entirely one of regaining balance, while if there is a wall or a post handy the arms will involuntarily shoot out for support. Similarly during walking, jogging, working in an erect position and in sports activities, a whole series of reflexes (involuntarily movements) and voluntary movements maintain the posture of the body. In the above situations, the posture changes all the time and therefore it is up to the spinal muscles to shrink, relax and extend to keep the spine erect in these altered positions of the body.*81\330\8*

MINERALS: IRON

Functions: Forms red blood cells and is vital part of the pigment haemoglobin which carries oxygen around the body; converts blood sugar to energySources:   Liver, meat, chicken, eggs, fish, green leafy vegetables, pulses, wholegrains, dried fruitCauses of Deficiency:     Heavy periods, pregnancy, poor diet, vegetarian diets (the vegetable sources of iron are harder to absorb than the animal sources), gastric ulcersDeficiency Signs   Anaemia, pallor, fatigue, shortness of breath,   encourages growth of Candida, irritability, lowered resistance to infection.Function:   Vital in enzyme activity; needed for health of all cells and for healing of wounds and burnsSources:   Meat, nuts, seeds, pulses, wholegrains, seafoodsCauses of  Deficiency:    Poor diet, dieting, adolescence, old age, bowel disorders, alcoholism; tranquillizers and sleeping pills are known to block the absorption of zinc (and it is likely that other minerals and vitamins are lost as well); profuse sweatingDeficiency Signs Acne, inflamed eyes, sore mouth and tongue, slow healing of wounds, white spots on nails,inflammation around nails, anxiety, depression, loss of appetite, anorexia nervosa, hair loss.*145\326\8*

WHAT DOES “BLOOD PRESSURE” MEAN?

Blood pressure refers to the amount of pressure exerted in the bloodstream as it passes through the arteries. When the left ventricle of the heart contracts or squeezes down, it forces the blood out into the arteries. The major arteries then expand to receive the oncoming blood. The muscular linings of the arteries resist the pressure; the blood is squeezed out into the smaller vessels of the body. The blood pressure is the combined amount of pressure the blood is under as a result of the pumping of the heart, the resistance of the arterial walls and the closing of the heart valves.The maximum pressure in the arteries is related to the contraction of the left ventricle and is called the systolic pressure. The minimum pressure, which exists when the heart is at maximum relaxation, is referred to as the diastolic pressure.Everyone needs blood pressure to move blood through the circulatory system. The pressure goes up and down within a limited range, but when it goes up and stays up, it is called high blood pressure. A systolic pressure of 150 and a diastolic reading of 95 (or 150/95) is generally considered high blood pressure. A normal reading would be about 120/80, although it is recognized that the definition of normal varies from person to person.In some people, high blood pressure is associated with another ailment such as diabetes, a kidney disorder or tumours. But usually, no cause can be detected. Still, the risks are all too clear.Hypertension places the heart and arteries under abnormal strain. Excess pressure constantly pounds the body organs fed by the blood supply. As a result, a blood vessel in the brain can burst, causing a stroke. Or the capacity of the kidney to filter wastes may be impaired. The heart, which must work harder to pump blood against the increased pressure in the arteries, may begin to show signs of strain. If ignored, high blood pressure can cause irreversible body damage.
*2/151/5*

BACH FLOWER REMEDIES: LARCH PEOPLE

Monday, May 16th, 2011 | Herbal | Comments Off

Not that Larch people are in any way inferior to others. More often than not, the negative Larch person is above average in his physical and mental condition and he may possess above-average qualities of head and heart, and may be capable of doing any job. His friends know it, his foes know it, his superiors know it and his juniors know it, but alas he does not know it and is not convinced when others tell him of it. Even when his well-wishers try to goad him to appear for his departmental examination, his stock reply is “What is the use” I know, I cannot pass the examination, why waste time, preparing for it.”But with all his diffidence and lack of confidence standing in the way of his own progress, he is not jealous of other’s progress. He is not bitter if his colleague gets ahead of him in service or business by his initiative. He may inwardly want that he should also progress as others, but he would always wish the others well.The foundation of such genuine inferiority feelings presumeably laid in infancy from the negative attitude of the parents, which sapped the self-confidence of the child and certainty of failure became an in-built automatic response.*134\308\8*

HERBS FOR TREATMENT OF RHEUMATOID ARTHRITIS: CURCUMIN

Turmeric, the flavoring and coloring spice derived from the root of Curcuma longa, has been used for centuries as a food and a medicine in Indian and Southeast Asian cultures. It is one of the dominant ingredients in red curry sauces.The study of herbs for rheumatoid arthritis is an area of research still in its infancy.Turmeric is traditionally believed to have tonic (strengthening) and carminative (gas-relieving) properties. Curcumin, one of the primary constituents of turmeric, has been investigated as a potential anti-inflammatory agent. Curcumin has been found to be a rather potent inhibitor of inflammation in animal tests, affecting the production of both prostaglandins and leukotrienes. It is this finding that is the primary basis for the belief that turmeric may be effective in rheumatoid arthritis. However, it is a long step from animal and test tube studies to results in people. There is not really any direct evidence as yet that turmeric or curcumin are effective for rheumatoid arthritis.
What Is the Scientific Evidence for Curcumin?There has been one small double-blind study of curcumin for rheumatoid arthritis. This study was designed to compare the effectiveness of curcumin and the older NSAID drug phenylbutazone. Phenylbutazone proved to be more effective.Nonetheless, symptoms improved in the curcumin group as well. For this reason, this study is often incorrectly cited as evidence that curcumin is an effective treatment for rheumatoid arthritis. It actually doesn’t prove anything of the land. The benefits seen in the curcumin group could simply have been due to the power of suggestion, which can be counted on to produce some effects even with a completely worthless treatment. We really need double-blind studies that compare curcumin to placebo to know whether it is truly effective. Still, curcumin is widely used in India as a treatment for rheumatoid arthritis, and physicians there report that it appears to be effective.
DosageFor the treatment of rheumatoid arthritis, a commonly recommended dosage of curcumin is 400 mg 3 times a day. You would need to take 8 g of ordinary turmeric a day to get that much of curcumin, but products that contain nearly pure curcumin are available.
Safety IssuesTurmeric is a common spice that has been consumed in large dosages over long periods of time by millions of people. It is on the GRAS (Generally Regarded as Safe) list published by the U.S. Food and Drug Administration. However, concentrated curcumin products may present presently unrecognized risks. Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has definitely not been established.*72/306/5*

DIABETES: PROBLEMS WITH BLOOD GLUCOSE TESTING

Getting blood If you have problems obtaining blood, a quick test can become a prolonged misery. Some people have thicker skin than others – most finger-pricking systems have several different platforms allowing different depths of penetration of the lancet. Some trial and error will help you to find the right depth. If your fingers are cold you will have trouble obtaining blood. Squeezing the finger tip hard makes it sore and dilutes the blood with serum, giving an unduly low reading. So warm your hands before testing. Milk the blood up from the base of your finger. Another trick to increase blood flow is to shake your hand vigorously with the fingers downwards by your side. See your fingertips go pink. (This is rather like shaking the sauce bottle to get the last drops out!) People with thin skin or who bruise easily need less needle penetration so use a thicker platform. Your fingers should not become sore. If they are ask your diabetic specialist nurse for help.
Inaccurate results If you do not put the right amount of blood on the test strip you will not obtain an accurate answer. Smearing or dabbing invalidates the result as does drowning the pad in a giant drop. If you mistime the reaction the result will be meaningless – this includes failing to look at your watch or not pressing the button on the meter or biosensor immediately. Failure to press the biosensor button as soon as the blood touches the pad will lead to unduly low readings. Do not tilt the strip or biosensor while the blood drop is on the strip. Cold, heat, wind or rain can all make nonsense of the result by affecting the glucose oxidase (heat, cold) or by drying out (heat, wind) or diluting the blood drop (rain).John is 15. He has had diabetes since infancy. He always produces a neat diabetic diary. But his clinic glucose concentrations are always higher than his home tests. One day, away from the hospital, I saw him test his glucose. He pricked his finger, smeared some blood onto the test strip, counted up to sixty out loud, wiped the blood off on his trousers, counted up to sixty (faster this time) and glanced at the strip – “9,” he said, casually.
*6/102/5*

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