HIV INFECTION AND ITS EFFECTS ON INTERPERSONAL RELATIONS: HELPLESSNESS, DEPENDENCY, AND CONTROL-WHAT YOU CANNOT CONTROL, RELABEL

April 18, 2011

Some people maintain control by what mental health professionals call refraining or relabeling. Relabeling means looking at situations in such a way that they seem benign or comforting or controllable. Try paying attention not to where your family or friends fail you, but to where they help. Try calling something a challenge rather than a struggle, a preference rather than a need. If the disadvantages of a situation are undeniable, so are the advantages.     When June’s son had to quit driving, he said that although he felt frustrated at being unable to drive, he also now had extra money to spend on things he enjoyed. Dean was pleased that doctors caught an infection of cryptococcal meningitis early before he began getting the headaches he’d seen his friends endure. Dean also said that now that his partner has had to take over more of his care, they spend more time together and have become closer: “My being sick has made us closer, made us cherish our time together. It’s not depending, it’s mutual caring.” People with HIV infection who have to quit work say they are happy to have more time to spend on gardening, developing photographs, working on old cars, or anything else they enjoy. They say repeatedly that they are happy to have more time to spend with the people they love.     Relabeling can be done only by the person with the problem, not by anyone else, no matter how well-meaning the other person is. If June had told her son that being unable to drive means having more money to spend, he would have felt she was making light of his problem. Having your problems relabeled by someone else is usually annoying.
*87\191\2*

NATURAL HISTORY OF TYPE 1 DIABETES: EFFECT OF INTENSIVE MANAGEMENT – NEUROPATHY

April 5, 2011

Clinically significant neuropathy was defined in the DCCT as an abnormal neurologic examination consistent with peripheral sensorimotor neuropathy plus either abnormal nerve conduction in at least 2 peripheral nerves or abnormal autonomic nerve testing. Among patients in the primary prevention cohort who had no neuropathy at baseline, intensive therapy reduced the appearance of neuropathy at 5 years by 69% (3% vs. 10% in conventional therapy group; p = 0.006). In the secondary prevention group, intensive therapy reduced the appearance of clinical neuropathy at 5 years by 57% (7% vs. 16%, p < 0.001). All three components of neuropathy which were evaluated were reduced by intensive therapy.
*29\357\8*

LEGAL ASPECTS IN TAKING CARE OF ELDERLY AND DISABLED PEOPLE: COURT OF PROTECTION (PUBLIC TRUST OFFICE)

September 22, 2010
This Court has the responsibility for the financial affairs of people who, through mental impairment, are no longer capable of managing their finances. The Court is an office of the Lord Chancellor’s department and it works by appointing a receiver for the person concerned. This comes under the Protection Division of the Court. There is a Management Division which will act as the receiver if no other person can be found to do so. The application for the appointment of a receiver can be made by anyone (carer, friend, relative, neighbour or local authority), though if it is not the nearest relative the Court will want to know why.
The Court usually becomes involved when the person’s assets are over 5,000 pounds though it may be interested in people with sums below this by allowing payments to be made by ‘summary order’ without a receiver being used. The Court supervises the receiver and reviews all transactions to make sure that the finances are being properly managed. Even though the receiver is acting on behalf of the person concerned, the supervision of the Court can mean that there are complications and the Court charges for this supervising role. The Lord Chancellor’s office also has visitors to help with particular problems. The medical visitors are consultant psychiatrists to help with difficult decisions on whether a person can manage or make a will, etc. General visitors will call in on clients in various settings and the visitors from the Management Division make a yearly visit to those clients for whom the Division is acting as receiver.
*82/128/5*

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JET LAG

September 22, 2010
US President, Lyndon Johnstone was said to avoid jet lag by maintaining his Washington schedule whilst travelling in overseas countries. This habit was by no means conducive to good relations with foreign heads of state; but in theory President Johnstone didn’t suffer jet lag when he returned to the United States. Another well know globe trotter was Henry Kissinger. He started to synchronize his home time with his destination time by going to bed an hour earlier each day. When bed time at home matched bed time at his destination it was time to leave. Unfortunately this tactic produced jet lag before the journey; instead of afterwards.
Multiple factors contribute to the production of jet lag; but by far the most important is the effect of light and dark on the human 24 hour biological clock. It is possible to synchronize times with intended destinations if the lights at home are slowly brought into phase with the light and dark cycle of the intended destination. To achieve this effect it is necessary to stay in a room that can be brilliantly lit and as the occasion requires be completely blacked out. The same technique can be adapted to suit the needs of shift workers. It takes about a week and a half to adapt to a new time schedule and trips or shifts that last a shorter period than this are just going to be unmitigatedly unbearable.
Home Remedies
Bedrooms that can completely black out the light of day are essential both before and after an international jet flight. Some say, fly by day and arrive at night; but more importantly a body clock cannot be rescheduled unless it is on a timetable in the first place. So don’t stay up late at night before long trips and don’t take naps until bed time in the city of your destination. If you do get jet lagged; don’t make any important decisions. Put them off until your mind is in better shape.
*81/131/5*

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BEATING THE BLOOD PRESSURE BLUES FOR A HEALTHY HEART: GET A PET

June 2, 2010
There’s a little friend out there waiting for you, one who’ll never argue with you, will love you unconditionally, and will always be there for you to confide in and love. A pet can be good for what ails you, especially in terms of helping to control blood pressure.
Pets can provide a sense of self-esteem and a feeling of being needed and wanted. Most dogs and cats live at least 10 years; that’s longer than many marriages survive today! Pets reduce stress and tension as they provide companionship and affection.
Dr Aaron Katcher, a University of Pennsylvania psychiatrist, contends that pets supply a kind of mental medicine that lowers stress levels and blood pressure, making people feel more secure. His research indicates that hypertensive patients with pets live longer and live happier.
As we age, family and friends often don’t need us as they used to, leaving us to feel abandoned and useless at times. A pet can help fill this void. Unequivocal data prove that loneliness causes an increase in sickness and death.
We also know that active people live longer and pets often make demands on us that keep us active. Dogs need their walks, giving us that nudge to go out for some exercise ourselves. You’re likely to walk farther with a dog than alone, since it’s less boring and lonely.
A number of studies indicate that when people talk, blood pressure rises. That’s especially true when talking quickly and pointedly. But it’s quite the opposite when we talk to our pets. At least four studies
I’ve read show that blood pressure actually falls when one talks with a dog or cat. Talk with you ask? Yes, we get feedback from our pets, in the form of a purr or a wag of the tail.
When we address pets we talk more quietly and slowly, much as we would with a small child. And since so many pet owners are convinced that their pets understand them, the experience becomes remarkably calming.
Owning a pet can help us live longer. Dr Katcher has found that pet owners have a real survival edge. Only 3 out of 53 pet owners died within one year of admission for coronary heart disease while 11 out of 39 non-pet owners died during the same period. Amazingly, that remarkable difference in survival rates was independent of physiological status. That is to say, no matter how sick the patient was, he or she was likely to fare better by owning and loving a pet.
Just about anyone can find the wonderful benefits of pet ownership. A study at San Diego State University demonstrated that petting a dog lowered blood pressure even more than resting or reading a book. The subjects studied who had the best attitudes toward their pets tended to have lower blood pressures across the board.
*133\85\2*
Cardio & Blood/ Cholesterol

BEATING THE BLOOD PRESSURE BLUES FOR A HEALTHY HEART: DRAW A PICTURE

June 2, 2010
Biofeedback works so well because one becomes focused on the process itself. For some, prayer can be equally effective, again because of the total immersion involved. A method of relaxation will not be as effective if it allows the mind to wander.
Think back to the last time you saw a child with his or her crayons colouring in a book. Picture those little fingers holding the crayon, trying to stay within the lines. The eyes are intent, and perhaps the tip of the tongue protrudes in deep concentration. That child is thinking of nothing else at the moment. Wouldn’t it be great to share in that complete sense of calm?
Well, you can. I’ve suggested this before, but it’s worth repeating. Go out and buy a box of crayons and a nice little colouring book. Don’t laugh. It’s fun! In fact, it’s even more fun if you invite a little child, perhaps your grandchild, to join you. Or borrow a neighbour’s little one. That child can act as your “calming counsellor” and guide you in the world of colouring.
Does this sound ridiculous to you? I’m here to tell the world that despite my extensive college training, my degrees, my world travel, it’s nice to settle back into childhood once in a while. I surprise my kids now and then by pulling out the colouring book and crayons and spending 30 minutes or so with them. We all enjoy it, and I’ve noticed a very similar warming of the hands during the process, signalling a calming effect which helps control blood pressure.
You may even want to go beyond the crayon stage and “graduate” to more sophisticated painting or drawing. You can find no-cost or low-cost instruction at most community centres, senior centres and YMCAs. Bring out your creative side and you’ll find a marvellous new way to relax.
Too complicated for you, but you’d like something a bit more “adult” than crayons? How about one of those paint-by-numbers kits? Yes, they still make them, and you can find some kits that will help you produce a really beautiful painting you’ll actually want to frame and hang on a wall. Most important, you’ll achieve a level of calming far deeper than you can get by watching TV or reading a book.
*132\85\2*
Cardio & Blood/ Cholesterol

COMMON INFECTIONS OF CHILDHOOD: TONSILLECTOMY

May 21, 2009

In days gone by, most children would have had their tonsils removed — it seemed a ritual for anyone who had had more than a few attacks of tonsillitis. Often the doctor would do all the children in a family in the one morning. It was one of the rites of passage of childhood.

Nowadays tonsillectomy is performed far less frequently. In fact, only a minority of children have their tonsils removed. There is little medical evidence that the removal of tonsils makes very much difference to the general health of the vast majority of children. In particular, it does not reduce the frequency of colds or sore throats that are a normal part of childhood.

These are the commonly accepted reasons for performing a tonsillectomy on a child:

1. Repeated attacks of tonsillitis — three to five attacks per year over at least 2 years. The doctor will also take into account the severity of the attacks, the response to treatment, the effect it has on the child’s general health and lifestyle, including his absences from school.

2. Obstruction of the child’s airway or breathing passages. The child may have apnoea (forgets to breathe), may snore at night, may have difficulty swallowing, may not gain weight satisfactorily, or may fall asleep during the day. Airway obstruction is relatively rare in children.

3. Other causes such as an abscess in the tonsils (quinsy), or chronic tonsillitis (persistent infection which does not clear up despite repeated courses of treatment, and which is more common in adolescents and adults than children).

Sometimes the doctor may recommend that the child’s adenoids be removed (adenoidectomy) because they are enlarged. Like the tonsils, the adenoids are a collection of lymphoid tissue at the back of the throat, which are part of the body’s defence against infection. If they become chronically enlarged, they may contribute to a number of problems, including middle ear disease (glue ear), deafness, and obstruction of the breathing passages. The latter may cause the child to snore at night, breathing with his mouth open because his nose is blocked.

An adenoidectomy is most commonly performed in a child who has frequent ear infections and resultant hearing loss. It is often done in conjunction with another procedure, such as the insertion of tubes in the ears (grommets) or tonsillectomy.

*225\90\8*

BIRTH — COMMON PROBLEMS: BONE INJURIES AND BRUISING

May 19, 2009

Bone injuries

If the birth has been difficult because your pelvis is small and the baby is big, his collarbone (clavicle) may break on one side. This injury is also more common with breech deliveries. Because babies’ bones are malleable, the fracture heals well without treatment, occasionally leaving a small lump. Gentle handling until the break heals will reduce pain and discomfort. More rarely, fractures of the long bones of the arm or leg (humerus and femur) are seen. This kind of break will require splinting until it heals. Skull fractures are also rare, but need to be watched carefully, although they generally heal without complications.

Bruising

Your baby may come out looking like he’s been in a fight! His face or head may be swollen and bruised. If this is a mirror injury, it requires no treatment and will resolve itself. If there is marked swelling due to significant bruising, then a skull X-ray may be performed to rule out a fracture, and the baby’s blood may be checked to make sure there have been no complications from bleeding. In the majority of cases the results of these tests are normal, and the bruising is due to the pressure on the face and head during the baby’s passage through the birth canal. If forceps are used, they may leave visible marks on each side of the face and head. These usually disappear after a few days and are not a cause for concern.

*58\90\8*

YOUR MARITAL HEALTH/THE MOST OFTEN ASKED QUESTION: WHY DO YOU THINK WE HAVE SUCH GOOD SEX UP NORTH THAN AT HOME?

May 18, 2009

    ”Why do you think we have such good sex up north [at their

cottage] than at home? We’re the same people.”

ANSWER: That’s exactly the point. You are the same couple, so the trick is to look at how you relate and what you do up north compared to what you do at home. Most likely you have more time, less pressure, and you make sex a priority away from home. You should know, however, that this is very good news, because vacations are also times when couples fight, draw further apart, and exaggerate their problems. The fact that time away becomes time together reflects a strong relationship just waiting to get some of the same attention and priority at home. One more thing. Different places for sex seem to be invigorating, and you don’t have to go all the way up north for that. Try going downstairs at home, even out to the garage.

*249\97\8*

WHY CANT WE CURE ALL CANCER WITH RADIATION? – THE REACTION OF NORMAL TISSUE LIMITS THE SAFE DOSE (CONCLUSION)

May 18, 2009

Don’t forget that the average doses that can safely be given and the average doses that will destroy particular types of cancer are just that: average. They are not doses which can be guaranteed to produce the same result in every person. Some people’s tumours are less sensitive than average. Some patients’ tissues are more sensitive than average. This means that radiation fails to cure some people of cancers which are usually curable. Sometimes this is simply because their tumour is less sensitive than average—a dose that would cure most people is not effective. Sometimes it is because the usual dose cannot safely be given because the person’s; tissues cannot take it.

On the whole, healthy tissues can take more radiation than tissues that are scarred, infected or otherwise diseased. As a rule, the tissues of older people can take less radiation than those of younger people, because they tend to have less ability to heal, a poorer blood supply and so on. Tissues that have previously been exposed to the average safe dose of radiation can never safely be re-treated, not even many years later, because the effects of radiation are permanent. Some chemotherapy drugs increase the sensitivity of some normal tissues to radiation. A dose of radiation that is normally safe can produce some serious reactions in people having these particular drugs. Thus there are many factors which can make a usually effective and safe dose of radiation unsafe for some individuals. These should all be considered by your radiotherapist when treatment is planned.

*264/40/1*

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