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GYNECOLOGICAL CANCER: COLOSTOMY BAGS AND THE IMPACT ON RECOVERY

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July 29th, 2011 Cancer
Colostomy:  The term colostomy is when the bowel, through surgery, opens onto the outside of the abdomen.
Surgery for most gynecological cancers does not require a colostomy except for the most advanced cases, or where bowel obstruction occurs as it can in advanced ovarian malignancy.
Sometimes surgery for ovarian cancer results in the need for a temporary colostomy with less than ten percent (10%) of surgical patients needing a permanent colostomy. A colostomy is needed when the surgeon has no option but to remove or divert part of the digestive system, which may be damaged due to the spread of the cancer beyond the ovaries. This means the body cannot rid itself of waste in the natural way, and needs a surgical opening (a stoma) to help do this. One of the greatest fears for women undergoing surgery for gynecological cancer is the thought of being left with a permanent colostomy that requires a bag. This means that the woman will no longer be able to pass faeces (‘pooh’) through her anus as normally happens. The faeces are now excreted via the colostomy (or stoma). The contents are collected in a colostomy bag that is attached to the outside of her abdomen.
A colostomy bag is seen by many women as having a devastating impact on lifestyle, self-image and intimate relationships.
However, this need not be the case.
Colostomies are temporary when the bowel needs time to heal effectively. Once everything is returned to normal, the bowel is reconnected and the colostomy is removed. No more bag! A marvelous feat of human plumbing! In some cases, however, the damage is so extensive to the digestive organs or bowel that the colostomy may be permanent.
It is important that you discuss with your doctor what all your options are.
The colostomy bags are cleverly designed and come in a range of sizes, and each with its own clamp to prevent leakage, and charcoal filters to reduce any smell.
Your stomal therapist (colostomy expert) will ‘fit’ your correct size and teach you how to manage the bag.
However, despite all these marvelous advances in bag technology, it is perfectly normal that women needing colostomy bags will experience a range of emotions. There will be a feeling of grief at the loss of normal bodily function, the change to body image, a feeling of being ‘ugly’ and loss of self as an active, sexual being. It is quite common for a woman to feel depressed in the early phases of adjusting to life with a colostomy, and before the realization that life (a good life) will continue. It is really important to communicate your feelings to your stomal therapist, partner or close friends about this. If the depression is severe, psychological counseling may be recommended. Some women go through a temporary phase of not eating to avoid the bag filling. In severe cases, this may lead to the onset of anorexia.
It is really important to discuss all your feelings, especially issues around intimacy and sexuality, with your partner. To discuss what feels most comfortable in intimate moments. If you do not feel like sex immediately, (and for some women this may take days, weeks or months to resume) hugging and kissing can still give enormous pleasure. Make your partner an active part of your management team. Include them in formal meetings, and encourage participation in managing your bag. Blocking them out of your feelings and other needs will only create fear and anxiety in them . . . and inevitably damage the relationship.
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WOMENS PROBLEMS: WHEN THE EGG IS NOT FERTILIZED

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July 11th, 2011 Women's Health
In most cases, fertilization does not take place. So, the single cell, with its 22 chromosomes plus the X or Y fellow, finally arrives at the uterus, with its lining still prepared to accept a pregnancy.
However, unless It is implanted (as the doctors say) within seven days and H.C.C. production commences (to force corpus luteal activity into manufacturing even greater quantities of oestrogen and progesterone), everything suddenly starts to falter. The corpus hue urn in the ovary rapidly ceases production of hormones. The uterine lining immediately notices this cessation, and lashes back. It sums to crumble. The lining simply falls to pieces.
Bleeding of unclotted blood commences, and the woman knows that a menstrual bleed has started. This will continue anywhere from one to eight days, usually averaging five. Anywhere from 10 to 120 mL of blood is lost, and the average amount each month is about 50 mL.
The uterine lining breaks down irregularly, and a process of fibrinolysis takes place to prevent dotting of the material. It has the appearance of dark blood but really is a mixture of broken down products of the uterine lining.
Contractions of the uterine wall help to expel the blood. Some women experience cramps at this time, and various other forms of discomfort, which will be discussed in more detail later on. In fact, life may be extremely uncomfortable. But this is the exception rather than the rule.
Normally, menstrual bleeding occurs with consistent regularity, exactly 14 days from the dare of ovulation. Although some variations do occur, it is generally remarkably constant.
Bleeding occurs until the uterine walls are completely free from all of the original lining. The surfaces left are raw. But within a very short span of time, new cells start to grow.
As outlined earlier, there is a close relationship between the ovarian hormones circulating in the bloodstream, and the pituitary gland and hypothalamus in the brain. As hormonal levels in the blood gradually fall, this causes renewed activity in the pituitary and hypothalamus, and they quickly recommence to release further amounts of follicle-stimulating hormone and luteinizing hormone. Once more the cycle starts.
So the process goes on and on. It is seemingly never-ending, his a remarkable story of persistence and perseverence. Surely it is an object lesson to us all.
Doctors often talk about specific days in the menstrual cycle, and it is worth knowing how this numbering works.
Day 1 is considered to be the day menstrual bleeding starts. Everything dates from this particular day. Numbering has nothing to do with the day bleeding ceases. Women sometimes become confused over this, especially if taking medication that is geared to menstrual days. On average, there are 28 days between successive menstrual bleeds—dial is. Day 1 to the next Day 1 of the successive cycle. Although this is an average, many women experience fairly wide variations, yet are still within normal limits.
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REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: IMPROVING YOUR ACTIVITY LEVEL

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July 5th, 2011 Cardio & Blood-Сholesterol
Your body is designed so that if you regularly exert yourself a little more than usual, it responds by improving its capacity for exercise. By gradually increasing the amount of exercise you perform, you can noticeably improve your fitness level in 8 to 12 weeks.
Very strenuous exercise is not necessary to improve fitness. The total amount of exercise is more important for health than exercising at high intensities. A moderate amount of exercise, as frequently as 3 days a week, is enough to improve your fitness level. You will probably enjoy moderate activity and stay with it more faithfully than you would with overly strenuous exercise. In fact, you can gain some benefit from short periods of exercise—perhaps as short as 10 minutes— done three or more times a day.
Aerobic exercises increase your cardiovascular fitness. Aerobic activities are those in which the demand for oxygen and nourishment by the exercising muscles does not surpass the ability of the lungs and circulatory system to supply it. It consists/of continuous, rhythmic contracting of the large muscle groups.
Aerobic exercise increases the rate and depth of your breathing. Your body becomes warmer, and if you exercise long enough and vigorously enough, you will perspire. However aerobic exercises are not so inter that the need of the muscle cells oxygen exceeds their supply. This deficiency may occur with such activities as isometric exercise or weight-lifting activities that may increase muscle tone and bulk but are not clearly beneficial from a cardiovascular standpoint.
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DOSAGES OF GLUCOSAMINE FOR OSTEOARTHRITIS TREATMENT

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June 23rd, 2011 Healthy bones Osteoporosis Rheumatic
The recommended dosage of oral glucosamine is 1,500 mg daily (500 mg 3 times a day with meals). In addition to 500-mg tablets and capsules, there are also some products that offer other dosages, such as a 750-mg pill. You can take the 1,500 mg dosage by taking these pills twice a day. Glucosamine is also available in 1,500-mg packets that you can mix with juice or another beverage so that you only have to take it once a day. However you take it, taking glucosamine with meals helps prevent the possible side effect of an upset stomach.
Pain relief usually begins in 2 to 4 weeks and reaches maximum effect in 8 weeks. However, many people will not want to wait this long for pain relief. Research suggests that quicker results can be obtained by combining an NSAID along with glucosamine for the first 2 weeks to ensure prompt pain reduction until the glucosamine takes effect. Glucosamine is often sold in combination with chondroitin. However, although there are some theoretical reasons why chohdroitin and glucosamine might work well when combined, we don’t have any direct evidence that combination therapy is any better than glucosamine alone.
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SURGICAL APPROACHES TO EPILEPSY: SURGERY FOR PARTIAL (FOCAL) SEIZURES – INVASIVE STUDIES

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June 12th, 2011 Epilepsy
When questions about the exact localization of the seizure focus or about the relationship of the focus to important functions such as speech or movement still remain, further studies may be required.
These further studies are “invasive,” which means that they require an operation and, therefore, carry some risk. Depth electrodes (wires placed deep in the brain) are used when the focus appears to be deep in the brain and when it is difficult to be certain where seizures are coming from. Another invasive approach is to “map” the surface of the brain by a plastic sheet (grid) of electrodes placed directly on the surface of the brain. The grid is utilized when the seizure focus is on the surface of the brain and in areas where other important functions such as speech or motor function might co-exist and could be damaged by the operation. The electrodes in the grid can directly record the abnormal electrical activity from the abnormal area and can be used to stimulate local areas of the brain to assess their function.
While depth electrodes have been used for many years, the use of a grid is relatively new. It is currently used only in very specialized situations. The grid offers a major advance in our ability to define epileptic areas carefully and to separate them from normal tissue. If these procedures are being considered for your child, you should discuss them in detail with the epilepsy center’s staff.
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GUIDELINES FOR DIABETES CARE: CLINICAL ASSESSMENTS – LIPIDS/LIPOPROTEINS

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June 1st, 2011 Diabetes
Guidelines for optimal control of plasma lipid or lipoproteins in c betes mellitus are based on the recognition that both type 1 and type of  diabetic patients have disordered lipid metabolism. In type 1 diabetes, elevations of triglycerides, low HDL-cholesterol and elevation of LDL cholesterol are particularly dependent on poor glycemic control and tend to return to normal with intensive insulin therapy. An atherogenic lipoprotein profile usually accompanies diabetic nephropathy. People with type 1 diabetes have a shortened lifespan that is due primarily either to renal insufficiency or to cardiovascular events—and, often a combination of both. Thus, strict guidelines for lipoprotein control apply to people with type 1 diabetes. In type 2 diabetes, dyslipidemia is often characterized by low plasma HDL-C, high plasma triglyceride levels, and a population of small, dense LDL particles, which are particularly atherogenic. Cardiovascular disease is the major cause of death in type 2 diabetes, and dyslipidemia is probably a major contributor.
In type 2 diabetes (in contrast to type 1 diabetes), abundant evidence from prospective randomized trials shows that intensive management of lipids and lipoproteins is indicated to reduce the risk for cardiovascular events. This subject is covered in detail in future chapters. There is now substantial agreement between the American Diabetes Association and the National Cholesterol Education Program15 regarding guidelines for therapy of lipids and lipoproteins in adults with diabetes mellitus.
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THE BASICS FOR SAFE NON-TOXIC CLEANING SOLUTIONS (ALL-PURPOSE SPRAY CLEANER; FURNITURE POLISH; VINEGAR DEODORIZER)

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May 23rd, 2011 Cancer
1/2 tsp. washing soda a dab of liquid soap 2 cups hot tap water
Combine the ingredients in a spray bottle and shake until the washing soda has dissolved. Apply and wipe off with a sponge or rag.
1/2 teaspoon oil, such as olive (or jojoba, a liquid wax) 1 / 4-cup vinegar or fresh lemon juice Mix the ingredients in a glass jar. Dab a soft rag into the solution, use on wood surfaces. Cover the glass jar and store indefinitely.
Keep a clean spray bottle filled with straight 5 percent vinegar in your kitchen near your cutting board, and in your bathroom, and use them for cleaning. I often spray the vinegar on our cutting board before going to bed at night, and ‘don’t even rinse, but let it set overnight. The smell of vinegar dissipates within a few hours. Straight vinegar is also great for cleaning the toilet rim. Just spray it on and wipe off.
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HOW BDD AFFECTS LIVES: BODILY DAMAGE

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May 19th, 2011 Anti Depressants-Sleeping Aid
Other types of bodily damage can occur. Some of the damage is inadvertent. Harsh chemicals used on the face or scalp irritate and burn the skin. Excessive face washing leaves skin bleeding and raw. “Stuck-out” ears are superglued. To get rid of acne or white skin, severe sunburns are endured. Excessive weight lifting causes back strain or more serious harm to muscles and joints. Skin picking can cause skin lesions, scarring, and even severe bleeding that requires stitches or emergency surgery.
Other people purposely damage their body in frustration or because they hate it so much. While such behavior occurs only rarely, it does happen. Тага was so frustrated and depressed over how her breasts looked that she cut them with glass from a mirror she’d smashed. “I hated them,” she said, “and I wanted to die.” A beautiful teenager I saw despised her nipples, thinking they were grotesque and deformed, so she cut them off.
A young man hit his stomach when he got very upset over the “shriveled” skin around his navel. “This problem has made my life really unbearable,” he said. “I say to myself 1,000 times a day, ‘I hate my guts and want to die.’ When it gets really bad, I take my anger and frustration out on myself.”
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HIV: SKIN PROBLEMS-THICK, DISCOLORED NAILS; RED, FLAKING CIRCLES AND SMALL, COLORLESS BUMPS

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May 2nd, 2011 HIV
Thick, discolored toenails or fingernails are usually caused by a fungus. Patches of red, flaking skin, on the feet or in the groin area, are called athlete’s foot or jock itch. When the patches of red, flaking skin are in circular patterns on the scalp or the skin, they are called ringworm.
Athlete’s foot, jock itch, and ringworm are also caused by fungi. These fungi cause infections of the skin and nails, but are not capable of causing much else.
Treatment of ringworm with antibiotic ointments—clotrimazole (commercial name, Lotrimin) or miconazole—applied on top of the involved area, is usually effective. Most of these ointments are available without prescription. When the nails are involved, when large areas of the skin are affected, or when ointments do not work, other antibiotics, like ketoconazole or griseofulvin, can be taken as pills and are usually effective.
Small, Colorless Bumps-A crop of small, colorless bumps is usually caused by a virus called Molluscum contagiosum. Each of the bumps often has a central indentation. The most common location is on the face, especially around the mouth, and in the genital region. Molluscum contagiosum seems to be especially common in people with HIV infection.
The major problem is cosmetic. No antibiotics are successful, but a dermatologist can remove the bumps by surgery or by freezing.
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SKIN DISORDERS IN ADULTS: PUVA TREATMENT OF PSORIASIS

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April 26th, 2011 Skin Care
PUVA (oral psoralen plus ultraviolet A light) is a special form of ultraviolet A light which is highly effective in treating psoriasis. It was first developed in the early 1970s and is still the most effective treatment available. PUVA involves taking one tablet of Psoralen two hours before exposure to ultraviolet A light. Psoralen sensitizes the skin to the ultraviolet A light, causing the psoriasis to disappear over twenty to thirty treatment sessions.
The main problems with PUVA therapy are the risk of long-term skin cancer and premature ageing of the skin. Special eye protection is also necessary, as the Psoralen tablets also sensitize the eyes to ultraviolet light.
In order to minimize the risk of skin cancer, it is best to combine PUVA therapy with Tigason, which is also taken in tablet form. It is also advisable to cover areas of the body that do not have psoriasis such as the hands, face and genital regions. More recently, ‘bath’ PUVA has become popular. Rather than taking a tablet prior to ultraviolet A light exposure, the sufferer is bathed in a special Psoralen solution which sensitizes the skin to ultraviolet A light.
*58/150/5*
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