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DIABETES: THE HOW AND THE WHY

admin — Fri, 22 Jul 2011 08:51:10 +0000

YOUR BODY makes glucose, a kind of sugar, from the foods you eat. This glucose travels through the bloodstream for immediate use as “fuel”, or is stored in the liver for future use. When there is a build-up of glucose in the blood, the pancreas sends out a hormone, insulin. It is the action of insulin that enables glucose to move from the bloodstream into the body’s cells, which then use the glucose as a source of energy. Diabetes results when, for one reason or another, there is a breakdown in this process and glucose accumulates in the blood. In other words, diabetes signifies the body’s inability to use glucose (sugar) as fuel in the normal way. When diabetes sets in before age 30, it is generally because the pancreas is producing a deficient amount of insulin — or none at all —Because me body mistakenly destroys the cells in the pancreas that secrete insulin. There are no oral drugs for this type of diabetes which usually starts abruptly. It always needs to be treated by supplying the missing hormone through injections of insulin. Even one day without insulin can bring on the risk of diabetic coma and death. This type of diabetes is known as Insulin-Dependent Diabetes (IDD), or juvenile-onset diabetes, or Type I diabetes.When diabetes occurs in adults over age 40, it is often because they are genetically pre-disposed to develop it (A family-history search could uncover close relatives who have or had it). Peoplewith adult-onset diabetes typically produce sufficient amounts of insulin in the pancreas. Bat the hormone has lost its ability to effectively move glucose out of the blood and into the cells, resulting in a condition known as insulin resistance. In effect, the cells resist the action of insulin, causing sugar levels to accumulate in the blood.This results in what is known as adult-onset diabetes or Non-Insulin-Dependent Diabetes (NIDD) — so called because, except in a small proportion of diabetics and in certain emergency situations, it does not need to be treated with insulin. 90 per cent of diabetics have the Type II form of the disease.*61\332\2*

TUMOR RECURRENCE AND TAMOXIFEN RESISTANCE: HOW IS RECURRENT BREAST CANCER TREATED?

admin — Sun, 17 Jul 2011 08:46:14 +0000

For breast cancer that has recurred within the initially treated breast, an aggressive type of surgery is usually performed. If the earlier surgery was a lumpectomy or partial mastectomy, a complete mastectomy may now be required. Once the tumor and surrounding tissues have been removed, the tumor will be evaluated for the presence of estrogen and progesterone receptors. The decision to use chemotherapy, radiation, or hormone therapy will be based on the size and location of the tumor, nodal involvement, the presence or absence of receptors, and the prior use of chemotherapy drugs. For tumors considered to place the patient at high risk of recurrence, or when conservative surgery is performed, radiation is used subsequently to decrease the risk of another recurrence. As discussed earlier, for patients who have estrogen or progesterone receptors in their primary breast tumors, tamoxifen or another hormonal agent may be prescribed to control or prevent further tumor recurrence. Chemotherapy is also considered, depending on the kind of chemotherapy the patient received initially and how well she responded at that time.If the breast cancer has spread to a single site outside the breast, treatment depends largely on where the tumor is located. If the recurrence is in an area that is surgically operable and the tumor impairs the patient’s normal functioning, then the tumor may be surgically removed. For tumors of the bone or other tumors that are not readily operable, radiation may be used to reduce tumor size and alleviate symptoms.Chemotherapy is typically given to patients with rapidly progressing or receptor-negative breast cancer that has spread beyond the breast. At one time it was believed that patients with disseminated breast cancer had little chance of long-term response to chemotherapy. Drugs were given primarily to moderate the symptoms of the disease. Today we know that by using different chemotherapeutic combinations an improved quality of life can be achieved in at least 60 percent of these patients.Most beginning drug therapies will include either methotrexate or adriamycin. Once a patient no longer benefits from the first protocol, she may be given a different course of drugs. Typically, a patient responds to the initial course for 6 to 12 months. When she stops reacting to any of the conventional drug combinations, the patient may elect to take a new and untested drug or combination of drugs that seems promising. Some of these agents have had encouraging results in patients with advanced breast cancer.A patient with estrogen-receptor-positive breast cancer that has metastasized may be offered tamoxifen therapy before chemotherapy. Response to tamoxifen in patients with bone or soft-tissue metastasis is very good, and remission can last more than 12 months. Unfortunately, while response to tamoxifen may be as high as 75 percent in some groups, virtually all patients will eventually develop tamoxifen resistance and no longer respond. Once tamoxifen therapy fails to be effective, other hormonal agents such as aminoglutethimide, halotestin, megestrol, and leuprolide are available. As with tamoxifen, patients may initially respond satisfactorily, but eventually they develop resistance to all endocrine agents as well.*38\320\2*

HIV: ON LIVING-TAKING CONTROL: RELABEL THE NEGATIVE; FOCUS ON THE POSITIVE

admin — Tue, 05 Jul 2011 08:40:58 +0000

Relabeling means redefining a troubling situation so that it seems more benign. Relabeling is related to thinking positively: any situation, no matter how bad, contains the possibility for something good. The idea is to focus on the possibilities for good and define the situation in those terms. “If I approach it with the right attitude,” says Steven, “I can see the blessings.” Call something a challenge rather than a struggle, a preference rather than a need, an opportunity rather than a problem, caring rather than dependency. People who have to quit work say they are not losing their usefulness but gaining freedom and opportunity: the chance to volunteer, to read certain books, to learn to paint, to teach, learn a language, put together models, and especially, spend more time with the people they love. Helen knows that even though HIV infection is not curable, it is treatable, and seeing the disease as treatable, she says, “does a lot for me.” Dean, who has lived a long time with the virus and has weathered several serious illnesses, defines himself not as a sick person but as a survivor, a winner: “I’ve survived a lot of illnesses, and some even the doctors thought I wouldn’t,” he says. “So even if I die, I’ll still feel I’ve won.”*241\191\2*

A WORD ABOUT SOY INFANT FORMULAS – SOY AND TESTOSTERONE

admin — Thu, 30 Jun 2011 17:18:51 +0000

Soy’s estrogenic exposure may also be putting little boys a risk. Infant boys go through a “testosterone tide” during the first six months of their lives, during which they normally have testosterone levels nearly equal to those of mature men. This early surge of male hormones programs the reproductive system, brain and other organs to take on male characteristics at puberty. Researchers are now wondering whether the feeding of estrogen-rich soy formula to infant boys interferes with this process and is the explanation for a syndrome, becoming more and more frequent, in which the male sexual organs do not properly develop at puberty.
The New Zealand Medical Journal found that soy-based infant formula may adversely affect hormonal development in neonatal infants and should not be sold commercially. Since soy is the richest source of phytestrogens, a plant form of the female hormone estrogen, neonatal infants are particularly vulnerable. The NZMJ cautioned that there is insufficient research on the long-term health effects of phytestrogens, therefore warranting a ban on the nonprescription sale of soy formula.
*21/165/1*

BDD BEHAVIOURS: MEASURING

admin — Tue, 14 Jun 2011 17:07:55 +0000

Measuring is another form of checking and reassurance seeking. Am I the right size? Do I look okay? People who think they’re too short may repeatedly check their height. Maybe I’m not such a midget! Women who think their waist is too large may repeatedly measure it. Muscle girth, breast size, and penis size may be measured over and over again.
One man measured his penis with a tape measure up to 10 times a day, even though a urologist had told him it was normal. When it seemed somewhat larger than usual, he felt better. But, when the measurement confirmed his fear that it was tiny, he felt devastated. When I asked him why he kept measuring it when he was so often disappointed with the results, he responded. “I measure it because I hope it will be bigger this time.” This response echoes that of people who check mirrors, pick their skin, and seek reassurance: this time it might be different.
*113\204\8*

THE IRRITABLE BOWEL SYNDROME: THE IMPORTANCE OF DAYLIGHT – POSITIVE IONS

admin — Sun, 05 Jun 2011 15:11:07 +0000

Electrically polluted air can be the cause not only of respiratory problems but also of headaches, irritability, digestive problems and depression. Particles in the air around us – called ions – are electrically charged, positive and negative. We breathe in these particles and absorb them through the skin. If the air is overloaded with positively charged particles it can have a powerful effect on the nervous system. The brain overproduces a chemical called serotonin, and this can produce nasal congestion, lethargy, feeling sticky (not the same feelings as being too hot) and swollen. The oppressive feeling before an electrical storm best describes this, a restless feeling – being ‘under the weather’. We can also experience this in cities where stale air is trapped between tall buildings or in workplaces where the air is filled with positive ions from VDUs. At home this effect can be felt if we sit in badly ventilated rooms surrounded by plastic and electrical equipment, wearing clothes made from synthetic fibres.
Geological location and climate are also factors which affect the air. Warm winds – like the Mistral in the Mediterranean and the Santa Anna in California – are loaded with positive ions, and are dreaded by many people because they make them feel enervated and depressed.
*128\326\8*

RELAXATION TRAINING FOR WAYWARD NERVES: THE MUSCLES OF THE HEAD AND NECK – HEAD, NECK AND SHOULDER MASSAGE

admin — Fri, 20 May 2011 15:08:32 +0000

You will need a partner for this and you will also need to allow him/her to help you; just sit there like a sack of potatoes and if you feel a little discomfort just try to bear it; it is an indication of how much you need those muscles moved.
Instructions for the helper
Areas of tension feel harder and resist the pressure of your fingers, so just work away in these areas and you will feel the muscles becoming less tight. Your fingers are bringing more blood to the area and allowing waste products to be taken away. Don’t be too concerned about technique, if your thoughts are gentle towards your partner and you desire to help him/her you cannot do any harm; just follow these simple rules and let your fingers take over.
• Don’t massage over broken skin or varicose veins.
• Don’t massage the front of the neck.
• Don’t poke hard into muscles that feel hot and swollen.
• Do relax when you are massaging.
• Do allow your partner to do the same for you.
• Do remember to do shoulder exercises every day.
Be as relaxed as you can; let your breath out as you drop your shoulders; balance your partner’s head, make sure his/her back is straight but slack, press her/his shoulders gently down.
J Support the forehead with one hand and move the muscles of the scalp just as if you were washing the hair with the other.
2 Continue to support the forehead and massage quite firmly at the base of the skull using the thumb and fingers to make small circular movements.
3 Now move onto the back of the neck using the thumb and index finger on either side of the neck bones; again using a circular movement.
4 Place your hands over the shoulders and use the thumb or heel of the hand to knead the muscles in a circular motion. Ask if there are any places needing extra attention.
5 Put one arm across the top of your partner’s chest and encourage them to relax forward onto it. With the other hand continue massaging down the side of (but not on) the bones of the spine. Work in a similar fashion around the shoulder blade. Use the other arm and repeat for other side of spine.
6 Stand in front of your partner, pick up the wrist and shake the hand letting it flop (don’t do this if there is pain in the joint); and ask them to imagine a wet sweater on the washing line. You will feel the arm become heavier when they think ‘heavy’. Give the hand a little shake then do the other hand and arm.
7 Stand behind your partner, support her/his head against your chest and stroke the brow with both first fingers from the centre outwards.
8 Finish off by stroking lightly and rapidly from the head down the back and then down the arms and hands.
Sometimes people are quite sleepy after a head and neck massage. Your partner might need a short rest before helping you.
For the very tense person, it is a great help if they can have a massage daily. The therapeutic value of massage is becoming more recognized in this country. Aromatherapy – massaging with the essential oils of plants – has been proved to have a beneficial effect on the nervous system.
*117\326\8*

MEDICAL TREATMENT OF SEIZURES: COMMON QUESTIONS ABOUT BLOOD LEVELS – BLOOD LEVEL HAS SLIPPED BELOW THE THERAPEUTIC’ RANGE

admin — Fri, 13 May 2011 13:10:56 +0000

“Sally had several grand mal seizures and was placed on a medicine. She has had no more seizures since age three, but she has grown and gained weight. Her physician finds that Sally’s blood level has slipped below the therapeutic’ range. What should he do?”
This question of maintaining the level over time also needs to be addressed. In Sally’s case there are two alternatives. The physician could increase the dose, and thus the blood level, to keep it in the therapeutic range giving her greater protection against another seizure. Or he could leave the dose alone, let it gradually continue to decrease as she grows, and when she has been free of seizures for two years, then he can discontinue the medicine. There is not, however, necessarily a correct thing to do. Children who have been free of seizures for two years can discontinue medication with a high probability of remaining seizure free. That chance is higher if the blood levels are low at the time the medicine is stopped because a child who is sensitive to the level of medication is more likely to have a seizure when the level drops below the therapeutic range. Then the doctor increases the dose and waits another two years. If the child is unlikely to have another seizure, then it doesn’t matter if the blood level is low. Allowing the level to drop slowly is a form of testing. If Sally passes the test, her chance of having a seizure when we stop the medicine is low. If she fails the test and has another seizure, we believe that it is better for this to happen at a younger age. Therefore, our suggestion to this parent and this physician would be not to increase the medicine. We believe that the risks and consequences of another seizure at this age are outweighed by the possible side effects of a higher dose on Sally’s learning capacity. Other physicians (and other parents) may believe differently.
*116\208\8*

TREATMENT OF DIABETES: PILLS REDUCING THE BLOOD GLUCOSE LEVEL

admin — Wed, 04 May 2011 12:44:26 +0000

Because pills have to be absorbed from the gut before they can work, anything that upsets absorption may interfere with their action. This may include a stomach or bowel operation years ago. Diarrhea and vomiting are obvious problems but taking them after a big meal may delay absorption. Some foods may slow their absorption more than others. Taking them on an empty stomach can irritate the stomach in some people. You must never take them and then not eat. Instructions for taking sulphonylureas vary depending on which book one reads. Most suggest with the meal – I interpret this as swallowing them when you have eaten some, but not all of your food – for example, between the cereal and the toast, or, at dinner time, between the soup and the main course. Wash your pills down with a drink of water or other non-alcoholic beverage.
If your pills are prescribed twice a day, then take them twice a day. With oral hypoglycemic pills this usually means with breakfast and with your evening meal – but if you are taking tolbutamide or glipizide it may mean with breakfast and lunch – so ask your doctor. It is rare to need more pills with the evening meal than with the morning meal. Too much sulphonylurea at night increases the risk of nocturnal hypoglycemia. But I do see one man who eats very little in the day and a great deal in the evening who needs 80 mg gliclazide with breakfast and 160 mg gliclazide with his evening meal. This sort of adjustment is only possible in someone who is monitoring their blood glucose carefully. If you take your pills at the wrong time, or take them all at once when you have been advised to divide them you run the considerable risk of hypoglycemia.

Getting the best out of your treatment
•       Diet is the basis of all treatment for diabetes.
•       If you are on additional treatment learn everything you can about it.
•       If you are taking insulin:
1.       Learn how fast and for how long each of your insulins acts – both theoretically and in your own case.
2.       Gain confidence in adjusting your own insulin dose.
3.       Consider advances in insulin injection techniques.
4.       Consider whether you have injection site problems.
•       If you are taking oral hypoglycemic pills:
1.       Learn how fast and for how long your pills act.
2.     Learn the maximum safe dose of your pills and consider making adjustments within this maximum.
•       Do not be upset if you cannot control your diabetes on pills and diet. The need for insulin treatment is not a disaster and you will learn how to cope with it very quickly.

*22/102/5*

HYPERTENSION: ACTION ALERT

admin — Thu, 28 Apr 2011 12:26:35 +0000

Hypertension affects an estimated 50 million Americans – more than one in three American adults. It is the lit fuse of a bomb waiting to go off. Hypertension triples your risk of dying from a heart attack and increases your risk of stroke sevenfold over someone with normal blood pressure. Yet hypertension is largely symptom-free – until it’s too late. Hypertension is classified as a cardiovascular disease (CVD), a disorder afflicting the heart or blood vessels. According to 1999 American Heart Association (AHA) statistics, 58.8 million Americans suffer one or more of the cardiovascular diseases, making CVD an epidemic of unbelievable proportions. CVD mortality rates actually outrank our country’s next seven leading causes of death combined (including cancer). Every year 959,227 Americans die of CVD. That’s 2,600 per day, or 1 every 33 seconds, which accounts for 41.4 percent of the total deaths in the United States. Imagine, nearly half of all Americans will die from cardiovascular disease – and hypertension is a primary contributor to many of these deaths. If you don’t take control of and effectively manage your blood pressure, it will take control of you.
*2/313/5*