Doctorweblog. About Health & Medicine

As with heart attacks, most strokes are not illnesses. Rather, they’re the body’s response to something else, often the narrowing of arteries from a buildup of cholesterol.
There are two kinds of strokes. The first, called an ischemic stroke, occurs when a blood clot interrupts blood flow in the brain, or when blood flow to the brain is dramatically reduced because of the narrowing of an artery that feeds the brain. Ischemic strokes account for roughly 70 to 80 percent of all strokes.
The other type of stroke, a hemorrhagic stroke, occurs when a blood vessel in the brain ruptures. Hemorrhagic strokes are the more lethal of the two.
Symptoms for each are about the same: weakness; numbness in the face, hands, arms or legs; slurring of speech or inability to understand what people are saying to you; blindness in one eye; and dizziness.
Doctors say that when someone is diagnosed with a stroke, “time is brain.” This means that the faster the blood flow is restored or the hemorrhage stopped, the more brain function will survive. The more you know about stroke, the sooner you’ll seek help if you or someone else is having one.
“There’s a lot of optimism about strokes. You can identify the risk factors to see if you’re at risk for stroke,” says Patricia Grady, Ph.D., deputy director for the National Institute of Neurological Disorders and Stroke in Bethesda, Maryland.
Moreover, many risk factors are in your control. “The brightest scientists in this country agree that up to 80 percent of all strokes can be prevented. We know what’s causing them and we know how to prevent many of them,” says Marjorie G. Anderson, Director of Communications for the National Stroke Association in Engle-wood, Colorado. “When it comes to strokes, the onus is on the individual. Knowing the risk factors and warning signs isn’t enough. You need to call 911 if you experience them, because it’s a medical emergency.”
*636\257\8*

Short tempered, impulsive, goaded to action by sudden impulse, not controlled by reason. Unbearable pains -physical or mental – when the patient thinks of even ending his life or do harm to others, and may do so on sudden impulse.
Uncontrollable anger, bordering on insanity when the person can beat his wife or even his infant child, or strike his own head against the wall in a fit of anger or may harm himself.
He may feel remorse afterwards. A grown-up person who wails and weeps in the presence of other persons when describing his painful condition in a doctor’s clinic, has evidently lost control of his mind over his actions.
A married man with wife and children trying to molest his maid servant in a fit of lasciviousness or sexual mania is no better.
The son of a Cabinet Minister of India was caught stealing in an American show-room and imprisoned there.
A heart patient was advised to take salt-less food. A chain smoker with bad throat was warned against smoking on pain of cancer of throat, a sugar patient knew full well the implication of eating sweets, and yet none of the above patients could stick to the doctors’ advice because their mind had lost control of their actions.
There is a stage prior to the mind actually losing control of oneself, when due to long-continued mental torture or physical agony, the patient is terribly depressed and cries out “Please leave me alone. I am crazy. I can bear no more. I fear, I am going insane”. Whether the man has actually lost control of the mind, or he is on the verge of nervous breakdown with fear and dread of the mind losing control, the remedy which can bail him out from the above state is CHERRY PLUM. Then there are cases of too frequent thirst in summer, which the patient must quench with cold drinks if water is not available and he may not be able to afford it— a Cherry Plum State: consider the plight of an examinee sitting in the examination hall having frequent urge of urination forcing him to leave the hall ever few minutes -again a Cherry Plum State. The case of a house-wife, who always over-spends whenever she goes on a shopping spree in the market, is a plain act of mind not keeping control over action.
*71\308\8*

A given paradigm determines the observational methods and treatments of the patients. Basic to medicine in all cultures, including ours, is the assumption that people who do not function in a given society are ill; they are not in order and require change. Thus, if we assume that people are sick, we shall find its cause and eradicate it. Our observations focus upon the symptoms which correspond to our definition of a given illness. Curing a patient means, then, eradicating his symptoms so that he corresponds to our definition of normalcy.
My conclusion from supervising psychiatrists and psychologists working with psychotic patients is that when the above paradigm does not produce the desired results, the reason for failure is not always due to a given therapist’s inability to apply the medical model. A core difficulty in dealing with psychotic states is frequently traceable to insufficient training in observing the actual details of the patient’s behavior. Thus, the detailed behavior of the individual patient is frequently glossed over. For example, a patient who is very passive and involved in his treatment is obviously going to be more responsive to medication than another patient who considers herself a revolutionary and finds it necessary to despise authority. In the process paradigm, to be presented briefly in the next chapter, the client is not considered, a priori, to be sick. We do not assume that his brain is functioning improperly, or that he is conscious or unconscious. Rather, the exact nature and content of his utterances and body signals are studied with the idea in mind that appreciating these details will help him best. We assume that if the signals and goals of altered and normal states are followed, life is going to be more worthwhile to him afterwards than if we only attempted to get him back on his feet and function again.
*2\227\8*

Not every problem drinker starts with a biochemical defect. Because it is an emotional anaesthetic some people use it to blot out the pain of the past or present. Unfortunately this only adds more problems; the self-esteem of sufferers drops even further, they despise themselves for lack of control, suffer from guilt and on top of all this they have the harmful physical effects to cope with. There is no easy way to cope with painful memories, difficulties in the present and fear of the future. You can only start by accepting and loving yourself exactly as you are and acknowledging that pain hurts; you would not be trying to numb the feelings if they weren’t too painful to bear. We start doing this as little children, we overbreathe, tighten our muscles with tension or switch off into depression if life hurts too much.
*50\326\8*

This is something that is brand new in my life. Although it is considered milder than juvenile-onset, it carries with it all the life-threatening complications. I learned I had adult-onset diabetes during a simple physical examination. Up to that point, I had had no symptoms, no complaints, no warning signs. My doctor was dead serious when he explained to me the consequences of not following his orders, which seemed ridiculous to me at first.
My orders were to avoid stress, get plenty of rest, restrict intake of foods (eliminating all good stuff with sugar, of course), eat several small meals a day at specific times, and prick my finger daily to keep track of my blood glucose levels (this lets me know if I’m maintaining good glucose control). Then he finished by saying, “And because you’re not the kind to accept that you have a chronic, debilitating disease, you must attend a support group for diabetic people.”
“ME? ME ATTEND A SUPPORT GROUP? I LEAD a support group. Why ever in the world would I GO to one?”
“Yes,” he said, “otherwise you won’t recognize the severity of it and will neglect taking care of yourself!”
The following week found me dragging my feet as I entered this room full of diabetic sufferers at a local hospital conference room. As I looked around, I saw about forty people, and immediately I decided the doctor had selected the most devastated cases to present themselves that night, just for my benefit alone!
On my first visit I was considered a guest, so I didn’t have to say anything, just observe. That was good because what I saw left me practically speechless anyway. One lady had gangrene and was to have her leg amputated soon. One man there had no feeling in his legs or feet. Another lady was blind from diabetes and also had other complications.
As the stories unfolded, it seemed that each one was more horrible than the previous one. Every complication of diabetes was described, and it seemed that of those present, they all had one or more of them to contend with. I could hardly wait to escape that meeting. What a hopeless group! Their future appeared bleak as they rehearsed the complications that could arise from this life-threatening disease.
The next week I was back in the doctor’s office, pouring out to him how dreadful that diabetic support group was. “These people may need this, but I sure don’t. Can’t you tell me something GOOD to say tonight when it is my turn to share?”
“Well,” he said, “having diabetes is like having carpenter ants in your body. You never know where they might attack … it could be the kidneys, the arteries, your vision, etc.”
“That’s hardly something encouraging that I could share!”
“Well, just pretend that the most upsetting relative you have has come to live with you for the rest of your life.”
“That’s another ZERO to share! But I have to speak at tonight’s meeting, and I just have to say something positive to these poor, pitiful souls.”
The doctor paused and then he smiled. “Well, knowing you, you’ll think this is something good. One good thing about having diabetes is that you won’t end up in a rest home because usually diabetics don’t LIVE that long!”
“Oh, that’s terrific news!” I said. “Who wants to end up in a rest home anyway? Besides, my husband, Bill, has just taken out some insurance with the American Association of Retired Persons which is supposed to cover any needs for a rest home. Now I can cancel my portion!”
I went home and joyfully instructed Bill to cancel my portion of that AARP rest home policy and then headed out for the hospital support group for the diabetics meeting.
There they sat, just as they had done the week before. No one had grown a new leg, and no miracles had happened since the last meeting. All of them just sat there in a circle, pouring out new complaints and new pains.
Finally it got to be my turn. I started out with my name and that I was only at this meeting because my doctor said I HAD to come to at least two meetings, but I wouldn’t be back after this one.
“My doctor told me recently that I have adult-onset diabetes and warned me about all the complications that go along with it unless I take proper care of myself. And even then I have no guarantee I’ll escape them. But I was back to see him today, and he gave me some really terrific news!”
Every face in the group sort of brightened up, and I continued, “The doctor told me I don’t have to worry about winding up in a rest home because diabetics usually don’t live that long!”
At this point, I could see that they were about to fall off their chairs, but I had to continue telling them how exciting it is for me to know that as a Christian I have an ENDLESS HOPE, not a HOPELESS END. It seemed that the Lord wrapped me in so much love for these folks that it just poured out of me. I told them that my exit from earth would be my grandest entrance in heaven and that earth has no sorrow heaven cannot heal. My joy is in knowing that my future is in God’s hands and that heaven is closer to me than long life in some rest home.
*1\316\2*

Family Medical History
Your family medical history is useful for determining possible hereditary aspects of disease or identifying risk factors. For example, if a close family member had a heart attack at a young age, you may have a higher risk of coronary artery disease.
Make a list of any chronic diseases affecting your parents, grandparents, brothers, sisters, and children.
Social History
Your social history includes information about your life-style or living habits that may have an impact on disease, such as smoking and alcohol use, recreational activities that may influence general fitness, or job-related factors such as toxic exposures.
Review of Organ Systems
Your doctor will review potential symptoms related to each organ system during the medical interview. This review is a checklist for you and the doctor to go through to make sure that nothing is overlooked. For example, someone who complains of chest pain may neglect to mention that he or she experiences calf tiredness when walking a short distance. This information is important to the doctor, because both chest pain and calf discomfort or tiredness can be related to blockage in the coronary and leg arteries, respectively. Items such as this should be brought out during the course systematically reviewing other systems.
*334\252\8*

Respiratory viruses that live in the throat can make their way to the vocal cords, causing inflammation that leads to hoarseness and occasionally to a total, albeit temporary loss of the ability to speak audibly. Laryngitis, as this condition is called, is best treated with vocal rest. In other word, stop trying to talk and don’t attempt to communicate in whispers. This only further irritates the vocal cords and prolongs the problem. Take up writing instead. Drink as much fluid as you can, avoid dairy products and smoke, humidify your bedroom with a room vaporizer, suck on soothing lozenges, and wait it out.
WHEN CAN ANTIBIOTICS HELP?
Antibiotics like penicillin, tetracycline, and sulfa drugs are potent killers of bacteria, but they have absolutely no effect against the viruses that cause colds and flu. Unless you suffer from a chronic lung disease, it is not helpful—and it could be harmful—to take antibiotics in anticipation of a possible bacterial infection.
However, since colds can set the stage for more serious bacterial infections like sinusitis, bronchitis, and otitis media (ear infection), antibiotics can then be called upon to attack the offending organisms and cure the infection. When antibiotics are prescribed, it is very important to take them according to the recommended frequency for the entire time specified by the physician. Otherwise, small pockets of bacteria may survive and return to cause another infection.
CAN I TAKE ANYTHING FOR THE FLU?
An analgesic/antipyretic like aspirin, acetaminophen, or ibuprofen will help to reduce a raging fever and ease the muscle aches and headache that often accompany influenza. An expectorant and/or cough suppressant can be helpful if a bad cough disrupts sleep. For type A influenza only, two drugs are available—amantadine and rimantidine—that can often shorten the illness, but they are usually reserved for those who, like the elderly and chronically ill, are most at risk of suffering serious complications.
FEED A COLD, STARVE A FEVER, OR IS IT THE OTHER WAY AROUND?
Most people can’t remember which way this phrase goes. But either way, it’s a myth. When a body is struck by illness, it needs food for energy and protein to help repair the damage, so there are few circumstances where starvation is an appropriate tactic. A high fever will suppress the appetite and dictate a diet that is primarily liquid and very easy to digest.
If the illness involves serious gastrointestinal upset, it may be difficult if not impossible to retain any solid food for a few days. But as soon as this symptom abates, resume eating, starting with small amounts of easily digested foods such as Jell-O, rice, banana, hot cereal cooked in water, and the like. And no matter how upset your system might be, consuming lots of liquids is always very important, and especially so if you are vomiting or have diarrhea.
HOW DOES SMOKING MAKE IT WORSE?
Anyone with a cold or flu would be wise to avoid smoking as well as the smoke produced by others. The protective hairs that line the respiratory tract are already under siege from the infection, and smoke will further paralyze their task of ridding the tract of microorganisms and other debris. Passive smoking has been shown to worsen respiratory illnesses in children and increase their chances of developing pneumonia.
*26\296\2*

CHILDREN AND YOUNG adults are more vulnerable to sudden, unpredictable attacks of asthma. However, not all asthma episodes require a visit to the doctor. Attacks triggered by allergens or exercise, usually respond to one or two puffs from a pocket inhaler or a home nebulizer treatment. When an acute attack persists, or if it is accompanied by any of early warning signs of deteroriating asthma, parents should contact their doctor or take the child to the nearest or the best-equipped hospital for further evaluation and care. There are several signs that parents can use to decide whether a trip to the doctor or the emergency department is necessary. The telltale signs that signal the need for immediate medical care, or emergency treatment are discussed in the following pages.
While children and young adults are more prone to acute asthma requiring emergency care, they are also more likely to respond to treatment and avoid an unwanted hospitalisation.
*102\260\8*

Humans are prey to a variety of fungal infections. Most infest the skin and bowels but occasionally parasitisation of the blood stream and vital organs occurs. Thrush, ringworm and athletes foot are but a few of the common human fungal infections. Dandruff is frequently seen in relation to a yeast called Pityrosporum Ovale. The fungi are nearly all at home in the soil, on animals and on other humans. From these reservoirs infection usually arises. Modern medicine provides effective treatment of superficial fungal infections in the form of Imidazole drugs such as Canesten, Daktarin, Monistat and Nizoral.

Home Remedies
Fungi belonging to the tinea family produce athletes’ foot and ringworm. Infection often involves skin breaks in the presence of heat and humidity. For these reasons the groin and between the toes are inherently predisposed to the overgrowth of fungi. Prevention of tinea in the groin calls for loose cotton underwear and baggy shorts. As far as athletes foot is concerned the wearing of sandals and thongs cools infected areas and allows them to stay dry. Over the counter antifungal remedies like Tinaderm, Whitfield’s Ointment and Vioform Cream are not as good as the Imidazoles; but still work. They cleanse the outer layers of skin exposing tinea to an unfriendly external environment.

*1/131/5*

Что же заставляет дыхательные пути, т.е. бронхи, сжиматься, впадать в судорожное состояние или воспаляться? Ответить на этот вопрос пытаются сразу несколько теорий, но среди них есть одна, которой придерживается большинство врачей – это иммунная теория. В чём её суть?
У любого человека на любые вещества, которые попадают в организм, образуются антитела, т.е. антитела именно к этому веществу. Антитела защищают организм от воздействия этих веществ, в том числе, от очень многих микробов и вирусов. Среди антител есть одна группа – иммуноглобулин Е (ИгЕ). Когда–то, в древности, ИгЕ активно защищал первобытного человека от атак окружающей среды, но со временем, он превратился во вредное антитело. Любимое место нахождения ИгЕ в организме человека – поверхность тучных клеток.
Во внутренних стенках кожи, бронхов, носа, кишечника есть миллионы тучных клеток. Внутри каждой тучной клетки находятся сотни маленьких гранул. Внутри гранул образуются вещества, которые врачи называют медиаторами. Медиаторов много, но больше всего – гистамина. Иногда тучные клетки называют «заряженным ружьём». При вдохе в бронхи вместе с воздухом попадают различные мельчайшие вещества. У здорового человека медиаторы обычно удерживаются внутри тучной клетки, но вот у больного человека, когда из вне попадает раздражитель первый раз, сразу же запускается процесс образования ИгЕ. Эти антитела располагаются на поверхности тучных клеток и ждут своего часа. Если с воздухом вторично попадает именно опасный раздражитель, то его встречают ИгЕ на поверхности тучной клетки. Происходит «взрыв» и содержимое клетки выбрасывается на окружающие ткани. Следствием такого воздействия является резкая отёчность, жжение и воспаление.
Если тучные клетки взрываются в носу, то человек чихает, если в коже – появляется лёгкая отёчность, покраснение и зуд. А вот бронхи реагируют затруднённым дыханием, одышкой, кашлем.
Поэтому, астма более не рассматривается как заболевание, которое вызвано спазмом бронхов. Скорее, это состояние, при котором сами бронхи постоянно воспалены и сверхчувствительны. Любое вдыхаемое вещество – загрязнители воздуха, химические испарения, табачный дым и т.п. – вызывает кашель и хрипы. Правильным лечением в настоящее время считается снятие хронического воспаления при помощи таких лекарств, как кромолин и кортизон.

лечение депрессии