1/05/2009

Hypothyroidism and the weight battle

Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone. The main purpose of the thyroid hormone is to run the body's metabolism, which is why people with this condition will have symptoms associated with a slow metabolism. Hypothyroidism is an extremely common condition; ov...
Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone. The main purpose of the thyroid hormone is to run the body's metabolism, which is why people with this condition will have symptoms associated with a slow metabolism. Hypothyroidism is an extremely common condition; over five million Americans have it. Also, as many as 10% of all women may have some degree of thyroid hormone deficiency. Unfortunately, when we talk about slow metabolism, we talk about a patient%26rsquo;s battles against their weight.



Possible causes of hypothyroidism




There are two fairly common causes of hypothyroidism.

1. Inflammation of the thyroid gland: This inflammation leaves a large percentage of the cells of the thyroid damaged and incapable of producing sufficient hormone. The most common inflammation of the thyroid is a disorder called autoimmune thyroiditis (also called Hashimoto's thyroiditis), a form of thyroid inflammation caused by the body%26rsquo;s own immune system.

2. Thyroid gland surgery: The second major cause of hypothyroidism is a previous medical treatment of the thyroid gland. The treatment of many thyroid conditions includes surgical removal of a portion of the thyroid gland. If the total mass of thyroid-producing cells left after the surgery is not enough to meet the needs of the body, the patient will develop hypothyroidism. In case of benign conditions, the purpose of the radioactive iodine therapy is to kill a portion of the thyroid to prevent goiters from growing larger, or producing too much hormone.



Rare causes of hypothyroidism




There are several other rare causes of hypothyroidism. The strangest condition of them causes a completely normal thyroid gland to fail to produce enough hormones because of a problem in the pituitary gland.





If the pituitary does not produce enough Thyroid-Stimulating Hormone (TSH) then the thyroid simply does not have the signal to make hormone.



Signs and symptoms of hypothyroidism




The signs and symptoms of hypothyroidism can vary widely, depending on the severity of the hormone deficiency. Also, symptoms can develop gradually over the years. At first, patients complain of barely noticeable symptoms such as fatigue and sluggishness.

But after some time, most patients develop more obvious signs and symptoms, including:

%26bull; Unexplained weight gain
%26bull; Muscle aches, tenderness and stiffness
%26bull; Pain, stiffness or swelling in joints
%26bull; Muscle weakness
%26bull; Heavier menstrual periods
%26bull; Increased sensitivity to cold
%26bull; Constipation
%26bull; Pale, dry skin
%26bull; A puffy face
%26bull; Hoarse voice
%26bull; Elevated blood cholesterol levels
%26bull; Depression

When hypothyroidism isn't treated, signs and symptoms can gradually become more severe, which could represent a bigger problem. Advanced hypothyroidism is a condition known as myxedema. This is a rare condition, but when it occurs it can be life-threatening.

Signs and symptoms include:

%26bull; low blood pressure
%26bull; decreased breathing
%26bull; decreased body temperature
%26bull; unresponsiveness



Hypothyroidism in children and teens




Although hypothyroidism most often affects middle-aged and older women, almost anyone can develop the condition, including infants and teenagers. Initially, babies born without a thyroid gland or with a gland that doesn't work properly may have only a few symptoms.

The most common symptoms of this congenital hypothyroidism, they may include:

%26bull; Yellowing of the skin and whites of the eyes (jaundice)
%26bull; Frequent choking
%26bull; Protruding tongue
%26bull; Constipation
%26bull; Poor muscle tone
%26bull; Excessive sleepiness

Untreated hypothyroidism in infants can lead to severe physical and mental retardation. As adults, they may exhibit several other symptoms such as:

%26bull; Poor growth, resulting in short stature
%26bull; Delayed development of permanent teeth
%26bull; Delayed puberty
%26bull; Poor mental development



What is the relationship between the thyroid and weight?




It has been acknowledged for a very long time that there is a complex relationship between thyroid disease, body weight, and metabolism. The thyroid hormone regulates metabolism, which is determined by measuring the amount of oxygen used by the body and, if the measurement is made at rest, is known as the basal metabolic rate (BMR). All the patients whose thyroid glands are not working should have low BMR, and those with overactive thyroid glands should have high BMR.



What is the relationship between BMR and weight?




All differences in BMR are associated with changes in energy balance which reflects the difference between the amount of calories one eats and the amount of calories the body uses. However, these connections are probably much more complex then we believe, and there is still much to discover. For example, when metabolic rates are reduced in animals by various means, these animals often do not show the expected excess weight gain. No one knows why.
Experts believe that the relationship between metabolic rates, energy balance, and weight changes is highly complex. The explanation probably is hidden in the fact that there are also many other hormones, proteins, and other chemicals that are very important for controlling energy expenditure, food intake, and body weight. That%26rsquo;s why no expert can truly and precisely predict the effect of changing thyroid state on any individual%26rsquo;s body weight.



What is the relationship between hypothyroidism and weight gain?




BMR in a patient with hypothyroidism is decreased, and therefore an under-active thyroid is generally associated with weight gain. Because nothing in medicine is simple, the weight gain in hypothyroid individuals is also complex, and not always related to excess fat accumulation. Most of the extra weight gained in hypothyroid individuals is due to excess accumulation of salt and water. Therefore, a massive weight gain should not be confused with hypothyroid-type weight gain.



How much weight can a patient expect to lose after the hypothyroidism is treated?




Because the great percentage of weight gain in hypothyroidism is accumulation in salt and water, when the hypothyroidism is treated a patient can expect a small weight loss. In most cases this weigh loss is less than 10% of body weight. Much like hyperthyroidism treatment, treatment of hypothyroidism with thyroid hormone should result in a return of body weight to what it was before hypothyroidism developed.
Because of the fact that hypothyroidism usually develops over a long period of time, it is fairly common to find that there is no significant weight loss after a successful treatment of hypothyroidism. The bottom line is, after hypothyroidism has been treated and thyroid hormone levels have returned to the normal range, the ability to gain or lose weight is the same as in individuals who do not have thyroid problems.

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Inside Bipolar Mind

The bipolar disorder, also known as manic-depressive disorder, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. These shifts can result in severely damaged relationships, poor job or school performance, and even suicide. Fortunately, the bipolar dis...
The bipolar disorder, also known as manic-depressive disorder, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. These shifts can result in severely damaged relationships, poor job or school performance, and even suicide. Fortunately, the bipolar disorder can be treated, and people with the condition can still lead full and productive lives.

Manic-depression is a mood disorder that affects literally millions of people worldwide. It is classified as a mood disorder because it affects both an individual's emotions as well as how an individual interacts emotionally with others.



Incidence of the condition



Statistical data shows that about 5.7 million American adults, or about 2.6 percent of the population age 18 and older in any given year, have bipolar disorder. The disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them later in life.
It is often not recognized as an illness, and people may suffer for years before it is properly diagnosed and treated.



Symptoms of bipolar disorder



As mentioned earlier, the most characteristic signs of bipolar disorder are dramatic mood swings %26ndash; from mania to depression and back again. Periods of normal mood are sometimes found in between, but sometimes there are none. In addition to these changes of mood, there are several other changes, in energy and behavior.

The most common sign of mania include:

* Excessively good, euphoric mood
* Little sleep needed
* Unrealistic beliefs in one's abilities and powers
* Poor judgment
* Spending sprees
* Increased energy, activity, and restlessness
* Extreme irritability
* Racing thoughts and talking very fast, jumping from one idea to another
* Provocative, intrusive, or aggressive behavior
* Denial that anything is wrong
* Distractibility, can't concentrate well
* A lasting period of behavior that is different from usual
* Increased sexual drive
* Drug abuse (cocaine, alcohol, sleeping medications)

On the other hand, common symptoms of depression include:

* Difficulty concentrating, remembering or making any kind of decisions
* Restlessness or irritability
* Lasting sad, anxious, or empty mood
* Feelings of hopelessness or pessimism
* Feelings of guilt, worthlessness, or helplessness
* Loss of interest or pleasure in activities once enjoyed, including sex
* Decreased energy, a feeling of fatigue
* Sleeping too much, or can't sleep
* Change in appetite and weight loss or gain
* Chronic pain not caused by physical illness or injury
* Thoughts of death or suicide




Correlation with other psychotic disorders




Sometimes severe episodes of mania or depression include symptoms of psychosis.





Common psychotic symptoms include hallucinations (audio and visual) and delusions (delusions of grandiosity, guilt or worthlessness).
Also, it is not uncommon for people with bipolar disorder who exhibit these symptoms to be incorrectly diagnosed as having schizophrenia, another severe mental illness.



Possible causes of bipolar disorder




It is difficult to talk about a single cause of bipolar disorder. According to the US National Institute of Mental Health, %26quot;There is no single cause for bipolar disorder - rather, many factors act together to produce the illness.%26quot;
Because bipolar disorder tends to run in families, scientists have been searching for specific genes passed down through generations that may increase a person's chance of developing the illness. They concluded that there is no single gene the mutation of which could cause this illness. However, a family history of bipolar spectrum disorders can impart a genetic predisposition towards developing a bipolar spectrum disorder. Other factors may also be part of the patient's family history. Some of the most common are: anxiety disorders, clinical depression, eating disorders, premenstrual dysphoric disorder, postpartum depression, postpartum psychosis, and schizophrenia



The %26quot;kindling%26quot; theory




This theory claims that people who are genetically predisposed to bipolar disorder can experience a series of stressful events which lower the threshold at which mood changes occur. Eventually, a mood episode can start (and becomes recurrent) by itself.



A patient%26rsquo;s view on life




Suicide: Some people with bipolar disorder become suicidal because they believe there is no hope for them of living a normal life. Risk for suicide appears to be higher earlier in the course of the illness.

Experts, communicating with people who suffered from this condition, state that signs and symptoms that may accompany suicidal feelings include:

* abusing alcohol or drugs
* feeling like a burden to family and friends
* putting affairs in order
* talking about feeling suicidal or wanting to die
* feeling hopeless, that nothing will ever change or get better
* feeling helpless, that nothing one does makes any difference
* writing a suicide note
* putting oneself in harm's way, especially in life-threatening situations

Creativity: The most interesting and misunderstood aspect of bipolar disorder is its general increase in 'creative energy'. Bipolar disorder is found in a great majority of people with creative talent such as artists, musicians, authors, performers, poets, and scientists, and some credit the condition for their creativity. The disorder's depression symptoms can soon push sufferers into a cycle that many famous talents have had to live with their entire lives. These depression phases of the illness do not allow any concentration on activities, and the manic phases allow for work with minimal need for sleep.

Mortality: Unfortunately, mortality rates have increased in patients with bipolar disorder. The standardized mortality ratio from suicide in bipolar disorder is estimated to be approximately 18 to 25%, further emphasizing the lethality of the disorder.

Hypomania: A commonly mentioned term is hypomania, which represents a less serious form of mania, without progression to psychosis. Patients with hypomania can be perceived as energetic, euphoric, confident, and overflowing with new ideas, but they also often suffer from irritability or aggression.

Mixed State: A mixed state is a condition during which symptoms of mania and clinical depression occur simultaneously. It could be a very complex state because many different symptoms can mix with each other, such as agitation, anxiety, aggressiveness or belligerence, fatigue, guilt, impulsiveness, insomnia, disturbances in appetite, irritability, morbid or suicidal ideation, panic, paranoia, psychosis, pressured speech, indecisiveness and rage.
The problem with these mixed states is that they can result in panic attacks, substance abuse, and suicide attempts.

Rapid Cycling: This symptom is a condition characterized by having four or more episodes per year. It is found in a significant fraction of patients with bipolar disorder, and has been associated with greater disability or a worse prognosis.



Bipolar disorder and other illnesses




Alcohol and drug abuse are very common among people with bipolar disorder. A complication of previous substance abuse problems is common, including self-medication of symptoms, mood symptoms either brought on or perpetuated by substance abuse, and risk factors that may influence the occurrence of both bipolar disorder and substance use disorders.

Also, some anxiety disorders, such as post-traumatic stress disorder and obsessive-compulsive disorder, may also appear in people with bipolar disorder.

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Gastrointestinal Bleeding-When to call a doctor

Gastrointestinal bleeding shouldn’t be observed as a disease, but rather as a symptom. It is an extremely common condition, and causes of the bleeding are often related to conditions that can be cured or controlled, such as hemorrhoids.The digestive or gastrointestinal tract includes the esoph...
Gastrointestinal bleeding shouldn%26rsquo;t be observed as a disease, but rather as a symptom. It is an extremely common condition, and causes of the bleeding are often related to conditions that can be cured or controlled, such as hemorrhoids.

The digestive or gastrointestinal tract includes the esophagus, stomach, small intestine, large intestine or colon, rectum, and anus. Bleeding can come from one or more of these areas, and sometimes occurs without the person even noticing it. Probably the best method for the diagnosis is a simple detection of blood in the stool.
The most common causes of gastrointestinal bleeding are hemorrhoids, inflammation, colorectal cancer and polyps, diverticular disease, and duodenal ulcer.



Possible causes of bleeding in the digestive tract




%26bull; Esophagitis: Stomach acid can cause an inflammation of the lower part of the esophagus (food pipe) which can lead to bleeding. This condition is called esophagitis. It does not normally occur, but sometimes a muscle between the esophagus and stomach fails to close properly and allows the return of food and stomach juices into the esophagus, which can lead to gastro-esophageal reflux disorder. In this condition, enlarged veins at the lower end of the esophagus may rupture and bleed massively.

%26bull; Mallory-Weiss syndrome: Esophageal bleeding can also be caused by Mallory-Weiss syndrome, indicating a tearing in the lining of the esophagus. This tear usually results from prolonged vomiting, but also may be caused by increased pressure in the abdomen from coughing, a hiatal hernia, or childbirth.

%26bull; Medications and gastric ulcer: The stomach is a frequent site of bleeding.





Many medications, particularly aspirin-containing ones, can cause stomach ulcers or inflammation, as can the consumption of alcohol. The stomach is also often the site of ulcer disease. Acute or chronic ulcers may enlarge and erode through a blood vessel, causing bleeding. The most common source of bleeding from the upper digestive tract is ulcers in the duodenum.

%26bull; Tumors: Bleeding can also occur from benign tumors or from cancer of the stomach, but these tumors cause massive bleeding extremely rarely.

%26bull; Hemorrhoids: Representing probably the most common cause of visible blood in the digestive tract, hemorrhoids are in fact enlarged veins in the anal area.

%26bull; Colorectal cancer: This is the third leading cause of cancer and cancer-related deaths in American men and women. It may also cause bleeding at some point.

A number of other conditions can also cause gastrointestinal bleeding, including ulcerative colitis, Crohn's disease, diverticular disease, etc.



How is bleeding in the digestive tract recognized?





Signs of bleeding in the digestive tract vary significantly depending on sites of bleeding, as well as the severity. If blood is coming from the rectum or the lower colon, bright red blood will coat or mix with the stool, but when there is bleeding in the esophagus, stomach, or duodenum, the stool will be black or tarry. This is because blood, while passing through intestine, will be digested.

When the bleeding is hidden, the patient might not notice any changes in stool color but may feel weak, dizzy, faint, short of breath, or have abdominal pain or diarrhea.



How is bleeding in the digestive tract diagnosed?




The main diagnostic problem is to locate the site of the bleeding. That%26rsquo;s why a complete history and physical examination could be essential in order to set the appropriate diagnosis. As mentioned before, bright red bleeding seen on the toilet paper or in the toilet water usually comes from the hemorrhoid area, which means lower colon or anal region. In this case the best thing to do is to perform an endoscopy on the anus, rectum, and lower colon. The problem is that this hidden or occult blood could be coming from anywhere in the gastrointestinal tract. That%26rsquo;s why a professional will always use an endoscopy to check the colon first, and if that is normal, only then should the esophagus and stomach be inspected.

Hemorrhage, or massive bleeding, can be from the stomach and esophagus, or from the small intestine, colon or rectum and in that case, the stool will be black and tarry. Since the intake of iron can give normal stool the same appearance as stool with bleeding from the digestive tract, this should be also taken into consideration.

Endoscopy

Endoscopy is an extremely common diagnostic technique that allows direct viewing of the bleeding site. Although very simple, this is probably the best diagnostic tool because the endoscope can detect lesions and confirm the presence or absence of bleeding directly. The endoscope is a flexible instrument that can be inserted through the mouth or rectum easily, and allows the doctor to see into the esophagus, stomach, duodenum, entire colon, sigmoid colon, and rectum to collect small samples of tissue (biopsies). This could be extremely useful in setting the right histological diagnosis.

Other procedures

Several other methods are available to locate the source of bleeding.

%26bull; Barium X-rays: Some doctors prefer the barium x-ray diagnostic tool, less accurate tool than endoscopy in locating bleeding sites, but also extremely effective. The barium is swallowed before the imaging and, if there are no lesions in the GI tract, the contrast will nicely cover all the GI walls. However, barium X-rays may interfere with other diagnostic techniques if used for detecting acute bleeding.

%26bull; Angiography: Also used to diagnose bleeding, angiography is a special technique that uses dye to highlight blood vessels. It is most useful in situations where the patient is acutely bleeding in a way that allows the dye to leak out of the blood vessel, which identifies the site of bleeding.

%26bull; Radionuclide scanning: Some doctors prefer the radionuclide scanning to visualize the bleeding. This technique is also used for locating sites of acute bleeding, and involves an injection of small amounts of radioactive material, after which a special camera produces pictures of organs, allowing the doctor to see the blood escaping.



Treatment of gastrointestinal bleeding




Endoscopy isn%26rsquo;t just a diagnostic tool, but also a therapeutic one; there is a great number of endoscopic therapies useful for treating GI tract bleeding. Injecting special chemicals into the bleeding site using a needle introduced through the endoscope is an extremely useful therapeutic method. The doctor can also cauterize, or heat treat, a bleeding site and surrounding tissue with a heater probe or electro-coagulation device. Some doctors also use laser therapy to stop bleeding.



What to do after the bleeding had been stopped?




When the bleeding is brought under control, medications are usually prescribed to prevent recurrence of bleeding. Medical treatment of the underlying disease, such as ulcers, to ensure healing and maintenance therapy to prevent ulcer recurrence also can lessen the chance of recurrent bleeding. The removal of polyps with an endoscope can control bleeding from colon polyps. Removal of hemorrhoids by banding, or various heat or electrical devices is effective in patients who suffer hemorrhoid bleeding on a recurrent basis.



How to recognize blood in the stool and vomit




%26bull; Black or tarry stool
%26bull; Bright red blood in vomit
%26bull; black-grounds appearance of vomit
%26bull; Bright red blood coating the stool
%26bull; Dark blood mixed with the stool



Symptoms of acute bleeding




%26bull; Dizziness
%26bull; Crampy abdominal pain
%26bull; Feeling faint
%26bull; Diarrhea
%26bull; Weakness
%26bull; Shortness of breath



Symptoms of chronic bleeding



%26bull; Lethargy
%26bull; Pallor
%26bull; Fatigue
%26bull; Shortness of breath

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Do You Get Stuck in Power Struggles?

Power struggles start early in life – between parents and children and between siblings. A parent wants his or her child to do something – eat, become toilet trained, get ready for bed, get dressed in the morning, brush teeth – and the child resists being controlled by the parent. ...
Power struggles start early in life %26ndash; between parents and children and between siblings. A parent wants his or her child to do something %26ndash; eat, become toilet trained, get ready for bed, get dressed in the morning, brush teeth %26ndash; and the child resists being controlled by the parent. The parent gets angry and the child resists even more or complies but resists in some other area, such as not learning in school. The pattern of control and resist can become so deeply entrenched that it follows you into your adult relationships. Your end of the power struggle depends upon whether you identified with an overtly controlling parent, became a covertly controlling resistant child, or both.

Power struggles insidiously undermine the love and caring in relationships.







When you are intent on being in control or not being controlled, all your focus and energy goes into winning or not losing. Since you cannot be caring and be trying to control or not be controlled at the same time, caring diminishes as power struggles increase.

When controlling or not being controlled is the primary intent in a relationship, conflict can occur over the most minor of situations.

It is not the issue itself that is the problem, but the intent regarding how the issue is handled. Minor situations such as one partner leaving dishes unwashed until morning can explode into full-blown fighting when partners get locked into power struggles. Caring about a partner who doesn%26rsquo;t dirty dishes left out overnight becomes incidental when you are protecting against losing yourself through being controlled by your partner.

The need to be in control and the resistance to being controlled come from the same source %26ndash; fear. The controlling partner fears that he or she will not be cared about, while the resistant partner fears losing his or her sense of self %26ndash; being engulfed and smothered by the other person.

When two people are in a power struggle, their wounded selves are totally in charge, each with their own fears. As long as both of them get triggered into their fear of rejection and fear of engulfment, they will continue to have power struggles.

THE WAY OUT OF POWER STRUGGLES

Power struggles will continue until one person develops enough of a loving Adult self to change his or her intent from controlling/resisting to caring. When it is more important to be kind to yourself and the other person than it is to control or resist being controlled, then you will disengage from the power struggle. Instead of trying to change the other person in the face of the other%26rsquo;s resistance, you will decide how to take care of yourself. Instead of being reactive and automatically resisting in the face of the other%26rsquo;s controlling behavior, you will tune into what is in your highest good and take the loving action in your own behalf. While it is always wonderful when both people learn how take responsibility for their end of the power struggle, it is not necessary for the power struggle to end. One person disengaging from his or her end of the power struggle will totally change the system.

If you are the overtly controlling one, letting go of trying to change the other person and taking care of yourself will stop power struggles.
If you are the resistant one %26ndash; the covertly controlling one %26ndash; choosing kindness rather than resistance will cause power struggles to cease.

It is important to understand that both people in a power struggle are trying to control %26ndash; one overtly and one covertly.
Resistance is an attempt to have control over not being controlled. When caring about yourself and the other person is more important than controlling, then kindness will prevail and power struggles will become a thing of the past.

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The outcomes of Septic shock

Septic shock is a potentially lethal drop in blood pressure due to the presence of bacteria in the blood. This condition, characterized by the presence of bacteria in blood, is also called the bacteremia. It is proven that bacterial toxins together with the immune system which response to them, caus...
Septic shock is a potentially lethal drop in blood pressure due to the presence of bacteria in the blood. This condition, characterized by the presence of bacteria in blood, is also called the bacteremia. It is proven that bacterial toxins together with the immune system which response to them, cause a dramatic drop in blood pressure, preventing the delivery of blood to the organs. What is the greatest danger of this shock? Well, experts are saying that the septic shock can lead to multiple organ failure including respiratory failure, and may cause rapid death.




Possible causes and symptoms of septic shock



Before we skip to the probable cause of septic shock, we should first mention several details about the infection and bacterial toxins. The fact is that, during some infection, certain types of bacteria can produce and release complex molecules, called endotoxins. It is proven that these endotoxins may provoke a dramatic response by the body's immune system. The most important fact is that when, released in the bloodstream, these endotoxins are dangerous, because they become widely dispersed and affect the blood vessels themselves. It is normal that these arteries and the smaller arterioles open wider, but at the same time, the walls of the blood vessels become leaky, allowing fluid to seep out into the tissues, lowering the amount of fluid left in circulation. It is logical to assume where all this leads! Several researches done in the past have shown that this combination of increased system volume and decreased fluid causes a dramatic decrease in blood pressure and reduces the blood flow to the organs.



When does it commonly occur?


Well, although there are no rules, most experts claim that the septic shock is seen most often in patients with suppressed immune systems, and is usually due to bacteria acquired during treatment at the hospital. How come? Well, there are two reasons: first- the immune system is suppressed by drugs used to treat cancer, autoimmune disorders, organ transplants, and diseases of immune deficiency such as AIDS, and second- bacteria, found in hospitals, are much more resistant then the %26ldquo;usual%26rdquo; types found in other places! Some researches done on shock patients showed that this syndrome most often occurs in menstruating women using highly absorbent tampons. How come? Well, it is easy to explain %26ndash; these tampons, when left in place longer than other types; provide the perfect ground for Staphylococcus bacteria, which may then enter the bloodstream through small tears in the vaginal wall.









Statistical data



%26middot; Frequency:


Several researches done in the US have shown that more than 10 million patients who were diagnosed with sepsis. This accounted for 1.3% of all hospitalizations. The overall incidence of sepsis increased 3-fold over this period of time from 83 cases per year per 100,000 population to 240 cases per year per 100,000 population.


%26middot; Mortality/Morbidity


Although mortality from sepsis is extremely frequent, good thing is that these last couple of years-reduction in hospital mortality rates for sepsis from 28% to 18% is present! Some large studies have proven mortality rate of severe sepsis anywhere from 30-50%, whereas simply meeting SIRS criteria carries a mortality of less than 10%.


%26middot; Race


It is important to point out that the incidence of sepsis is higher in the non-white population, with the incidence in black men being the highest at 331 cases per year per 100,000 population.


%26middot; Sex


Most of the researches have confirmed that men are more likely to develop sepsis.


%26middot; Age


Experts are saying that men tend to develop sepsis earlier in life than women.


Risk factors for developing septic shock



Risk factors for septic shock include:


%26middot; Diseases of the genitourinary system, biliary system, or intestinal system


%26middot; Recent infection


%26middot; Long-term use of antibiotics


%26middot; Recent surgery or medical procedure.


%26middot; Diabetes


%26middot; Diseases that weaken the immune system such as AIDS


%26middot; Lymphoma


%26middot; Leukemia


Symptoms



Septic shock is secondary state, which means that it is usually proceeded by bacteremia, which is characterized by:


%26middot; Fever


%26middot; Malaise


%26middot; Chills


%26middot; Nausea


It is extremely important to point out that the first sign of shock is often confusion and decreased consciousness. In this beginning stage, the extremities are usually warm, but later, as the condition progresses, they become cool, pale, and bluish. Fever may give way to lower-than-normal temperatures later on in sepsis.


Other symptoms include:


%26middot; High or very low temperature, chills


%26middot; Lightheadedness


%26middot; Shortness of breath


%26middot; Palpitations


%26middot; Cool, pale extremities


%26middot; Restlessness, agitation, lethargy, or confusion


%26middot; Rapid heart rate


%26middot; Low blood pressure, especially when standing


%26middot; shallow, rapid breathing


%26middot; Decreased urination.


%26middot; reddish patches in the skin


Big problem is that this septic shock syndrome may progress to cause %26quot;adult respiratory distress syndrome,%26quot; ARDS which is extremely dangerous because the fluid collects in the lungs, and breathing becomes very shallow and labored. Experts are saying that this condition may lead to ventilatory collapse, in which the patient can no longer breathe adequately without assistance- a life threatening condition!




Diagnosis



How to recognize and diagnose the septic shock!? Like we have already mentioned in symptoms of the condition-the proper diagnosis of septic shock should be made by measuring blood pressure, heart rate, and respiration rate. Of course, parallel with all this should be searching for possible sources of infection. Most experts claim that the most precise diagnostic tool is simple blood cultures are done to determine the type of bacteria responsible for the bacteremia. If we look on the respiratory symptoms then we should know that the levels of oxygen, carbon dioxide, and acidity in the blood should also be monitored to assess changes in respiratory function.




Treatment



Like we have already mentioned, the severe sepsis is characterized by stimulation of a series of inflammatory cascades leading to extensive cardiovascular problems and the most obvious signs are hypotension due to vasoplegia, relative hypovolemia, and widespread dysfunction of the microvasculature. That%26rsquo;s why; the two major priorities in management of septic patients are




  1. To maintain delivery of oxygen to the tissues, by way of optimization of cardiac output and peripheral resistance, and


  2. To modulate the procoagulation response






Most experts say that septic shock should be treated initially with a combination of antibiotics and fluid replacement. Why? Well, it is logical to assume that the antibiotic is chosen based on the bacteria present, although two or more types of antibiotics may be used initially until the organism is identified and these fluids, which should be administrated intravenously, should replace the fluid lost by leakage. Coagulation and hemorrhage may be treated with transfusions of plasma or platelets.










































































Recommended antibiotics in septic shock




Suspected source




Recommended antibiotics




Pneumonia




Second- or third-generation cephalosporin plus macrolide (antipseudomonal beta lactam plus aminoglycoside if hospital-acquired)




Urinary tract




Ampicillin plus gentamicin (Garamycin) or third-generation cephalosporin




Skin or soft tissue




Nafcillin sodium (Nafcil, Nallpen, Unipen) (add metronidazole [Flagyl, Metro IV, Protostat] or clindamycin if anaerobic infection suspected)




Meningitis




Third-generation cephalosporin




Intra-abdominal




Third-generation cephalosporin plus metronidazole or clindamycin




Primary bacteremia




Ticarcillin and clavulanate potassium (Timentin) or piperacillin sodium and tazobactam sodium (Zosyn)






Possible complications



Significant complications from sepsis include:


%26middot; central nervous system dysfunction


%26middot; adult respiratory distress syndrome (ARDS)


%26middot; liver failure


%26middot; acute renal failure (ARF


%26middot; disseminated intravascular coagulation (DIC)




Prognosis



Every patient should know that the chanced for recovery from septic shock depend on several factors and the most important including:


%26middot; the degree of immuno-suppression of the patient


%26middot; underlying disease


%26middot; promptness of treatment,


%26middot; Type of bacteria responsible.


Prevention



Like we have already mentioned- several researches done in the past have shown that septic shock is most likely to develop in the hospital, since it follows infections which are the primary form of this condition. That%26rsquo;s why; in order to prevent this it is crucial to know that careful monitoring and early, aggressive therapy can minimize the possible likelihood of progression. It is logical to assume that the risk of developing septic shock can be minimized through treatment of underlying bacterial infections, and prompt attention to signs of bacteremia.








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Reiki Healing-Introduction and Health Benefits

Reiki represents a form of spiritual healing, a practice proposed for the treatment of physical, emotional, mental and spiritual diseases. This ancient technique was developed by one man, Mikao Usui, in early 20th century Japan. He claimed to have been the recipient of an ability characterized by &l...
Reiki represents a form of spiritual healing, a practice proposed for the treatment of physical, emotional, mental and spiritual diseases. This ancient technique was developed by one man, Mikao Usui, in early 20th century Japan. He claimed to have been the recipient of an ability characterized by %26ldquo;healing without energy depletion%26rdquo; after three weeks of fasting and meditating on Mount Kurama. Since then, Reiki has become gradually more and more popular; in 2002 there were over one million U.S. adults practicing Reiki treatments.
However, modern medicine doesn't approve of this form of healing. There is considerable controversy regarding the legitimacy of Reiki, and none of it is scientifically supported as of this moment. Not only that, certain studies have shown that the effect of Reiki is similar to that of a placebo.



History of Reiki practice



The Japanese Buddhist Mikao Usui, claimed to have gained the knowledge and spiritual power to apply and attune others to what he called Reiki. He also claimed that he had the ability to enable people to enhance their access to the energy through certain initiations. Before this remarkable %26ldquo;achievement%26rdquo;, he had also studied traditional Chinese medicine, Ayurveda, Qigong, and Yoga. He was an admirer of the literary works of Emperor Meiji. This is important because Mikao later used some of the Emperor's works to make a set of ethical principles.







One commonly cited translation is:

The secret art of inviting happiness
The miraculous medicine for all diseases
At least for today, do not be angry.
Do not worry.
Do your work with appreciation.
Be kind to people.
Every morning and evening, join your hands in meditation and pray with your heart.
State in your mind and chant with your mouth.
For improvement of mind and body.
Usui Reiki method



Mikao Usui%26rsquo;s students




Mikao Usui trained several students of his own, who later continued to train other people this ancient discipline. In the beginning it was quite a complicate technique, but one of his students, Doctor Chujiro Hayashi, had it modified into a simpler set of Reiki techniques. Hayashi also trained Mrs. Hawayo Takata, who brought Reiki to the USA. This woman claimed that she had been appointed Grandmaster of Reiki through the lineage of Mr. Chujiro Hayashi, and that there were no surviving teachers of Reiki to be found in Japan after World War II.



Mikao Usui%26rsquo;s schools




There are essentially two broad groups, or schools - the traditional one, and the independent one. The first group teaches and practices Reiki strictly as it was taught from Usui's time until Takata's time, while followers of the second school vary greatly in their practices and methods. Some fundamentally adhere to traditional Reiki practices, but also accept Takata's practice of charging $10,000 for attunement to Reiki %26quot;Master level%26quot;.



How Reiki Healing Energy Works




According to Usui, the body is more than just a collection of functioning parts. Everything, as well as the body and its organs, generates a frequency and causes a special kind of its own energy field, which is continually changing. If our life force is low or blocked; we are more likely to get sick. When the opposite condition is present, we can maintain our health and wellbeing.



In Practical Terms




The simplest form of using Reiki is based on the practitioner placing their hands on the recipient with the intent of bringing healing, and willing for Reiki energy to flow. Of course, there is a set of hand positions which give good coverage of the recipient%26rsquo;s entire body.



Remote Healings




According to Reiki practitioners, to the world of spirit there is no such thing as time or space. %26ldquo;The world we see around us is only a small fragment of all which exists. This small fragment is that which our physical bodies can detect and describe to our consciousness, or which we can construct machines to extend the senses of our physical bodies. There is more in existence than what our bodies can detect in this way (though with some training and practice one can extend the range of what our consciousness can perceive). %26ldquo;
Since there is no time and space to limit spirit, Reiki can operate without regard to limitations of space (at least). When remote%26ndash;healing, one must objectify the recipient somehow; usually via a symbol drawn in the vicinity of the object representing the recipient.



Potential Health Benefits of Reiki Healing Treatments




According to the Reiki theory, a person gets sick when the flow of the %26quot;Life Force Energy%26quot; is disrupted, weakened or blocked. Such imbalances can be caused by many situations occurring in our lives, such as emotional or physical trauma, injury, negative thoughts and feelings, including fear, worry, doubt, anger, anxiety, and many others%26hellip;

Some of the potential health benefits of Reiki Healing include:

* Assists the body in cleaning itself from toxins,
* Reduces side effects of drugs and helps the body to recover from drug therapy after surgery and chemotherapy,
* Supports the immune system,
* Increases vitality and postpones the aging process
* Helps emotional clearing
* Creates deep relaxation and aids the body to release stress and tension,
* It accelerates the bodies%26rsquo; self-healing abilities
* Reduces blood pressure
* Can help with acute and chronic problems and helps the breaking of addictions,
* Helps relieve pain
* Removes energy blockages
* If used with other natural therapies Reiki will reinforce their effect.
* A practitioner will gain a positive outlook on life



Criticism




Safety of this ancient practice: Most doctors express concern when patients with serious diseases choose Reiki as a means of treatment, often cancer patients, Experts claim that Reiki does nothing but exploit the fear and hope of people with serious illnesses. According to them, Reiki experts are offering only a placebo effect in exchange for money. Roman Catholic priests have also denounced Reiki as %26quot;opening the door to evil and occult forces which have later side effects%26quot;.

Internal Controversies: There have been some extremely expressed points of controversy between different groups, teachers, and practitioners of Reiki. These controversies exist on topics such as the nature of the Reiki energy itself, fees charged for courses and treatments, training methods, secrecy of symbols, and attunement methods.


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Aromatherapy:Hype or Hope?

Aromatherapy: Hype or Hope? As a certified Aromatherapist, I am bombarded regularly with statements such as, “I bought a scented candle and it did nothing for me.” Or, “I bought brand X aromatherapy body wash and I didn’t feel any different.” “How come aromatherap...

Aromatherapy: Hype or Hope?





As a certified Aromatherapist, I am bombarded regularly with statements such as, %26ldquo;I bought a scented candle and it did nothing for me.%26rdquo; Or, %26ldquo;I bought brand X aromatherapy body wash and I didn%26rsquo;t feel any different.%26rdquo; %26ldquo;How come aromatherapy doesn%26rsquo;t work on me?%26rdquo;




Is it a problem that aromatherapy doesn%26rsquo;t work on them or is there another reason that they may not be getting the benefits they expect?




As I looked a little deeper into the stories that were conveyed to me I noticed a very obvious problem with all of them. Do you want to know what my findings were? I am sure you do %26lt;smile%26gt;. All of the products that these people had tried actually had the word %26ldquo;aromatherapy%26rdquo; written on the product label but in fact had no essential oils listed on the label.




What was written? Fragrance added. (Amongst other chemicals of course.)




According to the National Association for Holistic Aromatherapy, N.A.H.A., the definition of aromatherapy is: Aromatherapy is... the skilled and controlled use of essential oils for physical and emotional health and well being.%26quot; Valerie Cooksley [i]




As practicing Aromatherapists this is how we view aromatherapy. We use essential oils and essential oils only, added in a base carrier oil and applied to the body via various methods of application. We do not, and will never use fragrance oils.




Fragrance oils are synthetic in nature and are not pure, unadulterated essential oils. There is a huge difference in their composition and make up. There are many people who find themselves sensitive to fragrance chemicals and their number seems to be increasing almost daily. They are known as %26ldquo;fragrant intolerant%26rdquo;.




Fragrances used in many products are synthetic and petroleum based. These can cause such symptoms as asthma, dizziness, headache, and nausea.





There is no law stating that a fragrance manufacturer needs to place all of its ingredients on the packaging label as this may give away the manufacturer%26rsquo;s trade secrets. All they need to do is write %26lsquo;fragrance%26rdquo;.




Even many so-called %26quot;natural%26quot; aromatherapy products can be adulterated by adding extra linalool to Lavender for example, to make it smell more.




People must be very careful with whom they are dealing with and be sure they are buying from a reputable dealer of pure essential oils.




It appears as if aromatherapy has become a fad in the marketing industry and everyone is trying to jump on the bandwagon, from perfumers to even bakery good manufacturers. If it smells good then people want it associated with aromatherapy.




The actual definition of the word aromatherapy technically would be: %26quot;therapy by the use of aroma%26quot;, so in this sense, any aroma that is pleasant and brings about pleasant memories can be placed under the umbrella of aromatherapy. This is where true aromatherapy and Aromatherapists have the problem. The population has to be informed how true aromatherapy really works and that not all things that smell good are in reality aromatherapy, but can actually be bad for you.




True aromatherapy has been around for centuries, unlike the latest commercial craze. Even the ancient Egyptians were known to embalm their dead with oils infused with herbs which was the forerunner of our modern day distillation.




As early as the 11th century, a Persian named Avicenna, invented a pipe which was coiled and allowed the vapor and steam from the plants to cool down making the first distillation of rose oil. This is very similar to the way in which essential oils are distilled today.




By the 12th century Germany was growing and distilling Lavender for its medicinal properties.




It did not take long for the pharmaceutical industry to be born and this encouraged more distillation of essential oils due to their wonderful healing properties.




It is impossible in a small article such as this to get into all of the studies and healing properties of all of the oils but I hope to give you a glimpse of the importance of using pure essential oils instead of falling for %26ldquo;fad%26rdquo; products.




For today I will give you some information on Tea Tree oil. This is one of the most often used oils in aromatherapy. Captain Cook in Australia discovered it when he saw the Aborigines using it as a tea to treat ailments. Hence came the name Tea Tree. It%26rsquo;s real name is Melaleuca Alternafolia and it is best known for its antibiotic effects. It was used in World War I as an antiseptic for open wounds.




Below you will find the properties of Melaleuca Alternafolia:




Tea Tree


Melaleuca alternafolia




Family: Myrtaceae


Extraction: Steam Distilled


Part : Leaves and twigs



Harvest: Australia: All year


Color: Clear to yellowish green


Smell: Camphoraceous, tart, musty


Note: Top/Middle


Effect: Stimulating


Planet: N/a


Element: N/a


Magic: N/a


Chakra: 5th (Throat Chakra)






Description: Tea Tree is cultivated in Australia. It is similar to cypress with small narrow leaves and yellow or purple flowers. It is related to Eucalyptus but has a softer smell.






Historical Info:


Tea Tree has historically been used as a first aid oil and as a herbal tea. In fact, Captain Cook saw the Aborigines using the herb for tea and it is believed that is why it was called Tea Tree. It was used widely during WWI and in the 1st aid kit of every Australian soldier.






Warnings: May cause sensitization in some individuals, Do a skin patch test first.






Blends With: Bergamot , Clary Sage , Cypress , Eucalyptus , Frankincense , Geranium , Ginger , Grapefruit , Lavender , Lemon , Lemongrass , Mandarin , Marjoram , Orange , Pine , Rosemary , Thyme , Oakmoss, Ylang Ylang




Main Chemical Constituents


Terpine-4-ol, cineol, pinene, terpinenes, cymene, sesquiterpenes, sesquiterpene alcohols, cineole




Properties: Anti-bacterial, Anti-fungal, Anti-Inflammatory, Anti-Viral






Symptoms: Abscess, Acne, Athlete%26rsquo;s foot , Bacterial Infections , Bronchitis , Burns (also said to protect from radiation burns in cancer therapy) , Candida, Chicken Pox, Colds/Flu , Cuts/Wounds , Dandruff , Diaper rash, Ear ache, Fever, Fungal infections , Genital Infections , Herpes , Insect bites, Low Immunity , Mouth/Gums , Respiratory problems/Infections, Ringworm, Shingles, Sinuses, Throat Infections , Urinary Infection , Vaginal Infections, Viral Infections , Warts








Emotional: Apathy, Feelings of Uncleanness, Hypochondria, Hysteria, over preoccupation with detail, Shock, Strengthening






Essential oils do contain chemical constituents that can help heal the body. Fragrance oils cannot do this. My hope is that you have gleaned enough information from this article to make more educated decisions when it comes to aromatherapy.




My suggestion is to always consult with a certified Aromatherapist. They have studied and know how to guide you with their knowledge.




Aromatherapy is something that should be enjoyed by all. Infuse your life with excellence.












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Psychological elements of eating disorders

Eating disorders are complex and yet very common conditions, affecting adolescents all around the world. They rank as the third most common chronic illness in adolescent females, with an incidence of up to 5%, a rate that has increased dramatically over the past three decades. Two major subgroups of...
Eating disorders are complex and yet very common conditions, affecting adolescents all around the world. They rank as the third most common chronic illness in adolescent females, with an incidence of up to 5%, a rate that has increased dramatically over the past three decades.

Two major subgroups of the disorders are recognized:

%26bull; A restrictive form, in which food intake is significantly limited (anorexia nervosa)
%26bull; A bulimic form, in which eating episodes are followed by attempts to minimize the effects of overeating via vomiting, catharsis, exercise, or fasting (bulimia nervosa)

Both anorexia nervosa and bulimia nervosa are associated with serious biological, psychological and sociological morbidity, and significant mortality. Eating disorders affect a person%26rsquo;s physical and emotional health. These dangerous illnesses can be fatal if left untreated.

Eating disorders are more common in cultures focused on weight loss and body image. %26ndash;Fortunately, an increased awareness about these types of illnesses is noticeable; people seem to realize that it is a very serious problem.





Possible causes of eating disorders




There are many different theories regarding the causes of eating disorders. Most likely, eating disorders are caused by a combination of psychological, family, genetic, environmental, and social factors.

Family history of mood disorders

Eating disorders are often associated with feelings of helplessness, sadness, anxiety, and the need to be perfect.





This can cause a person to use dieting to provide a sense of control or stability. Teens who participate in competitive sports, such as ballet, running, gymnastics, or skating, are more likely to develop an eating disorder.



Anorexia Nervosa




An estimated 0.5 to 3.7 percent of women suffer from anorexia nervosa in their lifetime.

Symptoms include:

%26bull; Almost absolute resistance to maintaining body weight at a minimally normal weight for age and height
%26bull; Intense fear of gaining weight
%26bull; Infrequent or absent menstrual periods

The most common characteristic is the fact that these people see themselves as overweight even though they are dangerously thin. The process of eating becomes an obsession. Most people with anorexia develop unusual eating habits, such as avoiding certain kinds of food or eating in extremely small quantities. They might repeatedly check their body weight, practicing other techniques to control their weight such as intense and compulsive exercise, vomiting and abuse of laxatives, enemas, and diuretics.

The course and outcome of anorexia nervosa vary across individuals: some fully recover; some have a fluctuating pattern of weight gain; others experience a chronically course of illness over many years. The mortality rate among people with anorexia has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population.



Bulimia Nervosa




About 1.1 to 4.2 percent of women suffer from bulimia nervosa in their lifetime.

Some of the most common symptoms include:

%26bull; Eating excessively in a short period of time
%26bull; Inappropriate compensatory behavior, such as self-induced vomiting, or misuse of laxatives, diuretics, enemas, or other medications, fasting, or excessive exercise
%26bull; Self-evaluation unduly influenced by body shape and weight

Because purging or other compensatory behavior follows the binge-eating episodes, people with bulimia usually weigh within the normal range for their age and height.



What is EDNOS (Eating Disorder Not Otherwise Specified)?




EDNOS represents an condition showing some, but not all, symptoms of anorexia or bulimia. This may result in a very low body weight, but not technically anorexic.



Diagnosis




Diagnostic criteria for eating disorders may not be entirely applicable to adolescents.

Some of the symptoms which could hardly be applied to adolescents are:

%26bull; Wide variability in the rate, timing and magnitude of both height and weight
%26bull; Absence of menstrual periods in early puberty
%26bull; Unpredictability of menses soon after menarche
%26bull; The lack of psychological awareness regarding abstract concepts (such as self-concept, motivation to lose weight or affective states) owing to normative cognitive development

In addition, clinical features such as pubertal delay, growth retardation or impairment of bone mineral acquisition could be seen as the part of the sub-clinical level of eating disorders.

In clinical practice, the diagnosis of an eating disorder should be considered in an adolescent patient who:

%26bull; engages in potentially unhealthy weight control practices
%26bull; demonstrates obsessive thinking about food, weight, shape or exercise
%26bull; fails to attain or maintain a healthy weight, height, body composition or stage of sexual maturation



Medical complications




An eating disorder affects almost all the organs in the body. Fortunatelt, the majority of physical complications in adolescents appear to improve with nutritional rehabilitation and recovery from the disorder. However, once the line is crossed, some may be irreversible.

Potentiallt irreversible medical complications in adolescents include:

%26bull; growth retardation (if the disorder occurs before closure of the epiphyses)
%26bull; pubertal delay or arrest
%26bull; impaired acquisition of peak bone mass during the second decade of life
%26bull; increased risk of osteoporosis in adulthood

The treatment should be taken seriously, and extended until the adolescent has demonstrated a return to both medical and psychological health.



Psychosocial disturbances




Eating disorders that develop during adolescence interfere with adjustment to pubertal development. As such, they also interfere with several important developmental tasks necessary to become a healthy functioning adult. Also, isolation and family conflicts often arise, even though this is a time when families should provide a milieu that supports development. All this leads to the impaired issues related to self-concept, reduced self-esteem, autonomy, separation from the family, reduced capacity for intimacy, and various affective disorders; sometimes even substance abuse and suicide. That's why all patients should be evaluated for psychiatric illness, including disorders of anxiety, depression, and dissociation. Early mental health intervention for adolescents with eating disorders could be extremely helpful, and sometimes is the only cure. Family therapy should also be considered an important part of treatment.

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The best approach to alcoholism recovery

What is the best approach to alcoholism recovery? This could be a very complex question, because alcoholism is a complex disease with physical, social, and psychological consequences, not only for alcoholics but also for people closest to them, family and friends. In the past, alcoholism was often v...
What is the best approach to alcoholism recovery? This could be a very complex question, because alcoholism is a complex disease with physical, social, and psychological consequences, not only for alcoholics but also for people closest to them, family and friends. In the past, alcoholism was often viewed as a moral weakness or character flaw; today, people accept that alcoholism is a life-threatening, chronic illness, involving psychological and physical dependence. In the United States, alcohol-related automobile accidents are a major cause of teen deaths. Alcohol is often the indirect cause in other teenage deaths, including drowning, suicide, and homicide.

There are several approaches to alcoholism recovery, but the most effective ones include detoxification, medical treatment, and psychological support!



Incidence of the condition




Alcoholism is a very common illness, and thus represents a major public health problem facing many countries. More than 15 million Americans are estimated to suffer from alcoholism. In the United Kingdom, the number of alcoholics was estimated at over 2.8 million in 2001.



Alcohol and neurotransmitters




Alcohol dependence occurs gradually; while the person is drinking alcohol alters the balance of certain chemicals in the brain. In most cases we%26rsquo;re talking about altered balance of gamma-aminobutyric acid (GABA), which inhibits impulsiveness, and glutamate, which excites the nervous system. Alcohol also raises the levels of dopamine in the brain, which is associated with the pleasurable aspects of drinking. Excessive, long-term drinking can deplete or increase the levels of some of these chemicals, causing the body to crave alcohol to restore good feelings or to avoid negative feelings.









Possible causes of alcoholism




Several factors contribute to the risk of developing alcoholism, including but not limited to:

- Genetics: Some genetic factors may cause a person to be overly vulnerable to alcoholism.
- Emotional state: High levels of stress or anxiety can lead to alcohol, trying to forget the causes of stress.
- Psychological factors: Certain personality traits, such as low-self esteem or depression, can make a person more prone excessive drinking.



Four classic signs of alcoholism




Psychiatrists recognize four signs of alcoholism:

%26bull; Loss of control over drinking
%26bull; Continued use of alcohol despite social, medical, family, and work problems
%26bull; Increased alcohol tolerance over time
%26bull; Withdrawal symptoms such as anxiety, agitation, increased blood pressure, and (in extreme cases) seizures

Other signs of alcoholism:

%26bull; Drinking alone
%26bull; Inability to limit the amount of alcohol
%26bull; Losing interest in activities and hobbies that used to bring pleasure
%26bull; A compulsive need to drink
%26bull; Keeping alcohol in unlikely places at home, at work, or in the car
%26bull; Physical withdrawal symptoms such as nausea, sweating and shaking



Types of alcoholism




%26bull; Type I alcoholism: This is the most common form, occurring in both men and women, and is associated with adult-onset alcohol dependence. This type appears to be the result of both genetic predisposition and environmental provocation.

%26bull; Type II, or male-limited, alcoholism: This form of alcoholism, on the other hand, is due mainly to genetics. It occurs only in men, usually with an early onset. It is more difficult to treat than type I alcoholism.




Alcoholism recovery




The biggest main problem in the alcoholism treatment is the fact that most people enter treatment reluctantly, still denying that they have a problem. The best possible treatment is only available to those who recognize and accept the need for treatment.



Determining level of dependence




Although most people believe that the first step should always be the strict abstinence, the first step in treatment is to determine whether the person is really alcohol-dependent. In case of alcohol dependency, simply cutting back is ineffective. The effective treatment should be based on counseling with alcohol-abuse specialists. Possible interventions may also include goal-setting, behavioral modification techniques, use of self-help manuals, counseling, and follow-up care at a treatment center.



Residential treatment programs




As mentioned earlier, a good residential program should include several things beside simple abstinence which is why mostresidential alcoholism treatment programs in the United States also include:

%26bull; individual and group therapy
%26bull; participation in alcoholism support groups
%26bull; educational lectures
%26bull; family involvement
%26bull; work assignments
%26bull; activity therapy
%26bull; counselors and professional staff



Typical residential treatment program




It is important that patients get familiar with a typical residential treatment program because that%26rsquo;s how they will know what to expect.

%26bull; Detoxification and withdrawal %26ndash; Treatment should start with a good detox program, usually taking four to seven days. During this period a patient should be taking sedatives to prevent delirium tremens
%26bull; Medical assessment and treatment %26ndash; Treating alcoholism also means treating different kinds of alcohol complications such as high blood pressure, increased blood sugar, and liver and heart disease.
%26bull; Psychological support and psychiatric treatment %26ndash; Every good treatment program should offer couple and family therapy, because family support can be an important part of the recovery process



Drug treatments




%26bull; Disulfiram (Antabuse%26reg;): This alcohol-sensitizing drug does not cure alcoholism, nor can it remove the compulsion to drink. It does, however, produce a severe physical reaction to alcohol that includes flushing, nausea, vomiting and headaches.
%26bull; Naltrexone (ReVia%26reg;): This drug is known to block the narcotic high, thereby reducing the urge to drink.
%26bull; Acamprosate (Campral%26reg;): This anti-craving medication may help an alcohol addict combat alcohol cravings and remain abstinent from alcohol.
%26bull; Vivitrol: Recently a major breakthrough has happened - the FDA approved the first injectable anti-alcohol drug. Vivitrol is nothing more then a version of Naltrexone (see above). Vivitrol is injected into the buttocks once a month by a health care professional; it reduces the urge to drink by blocking neurotransmitters in the brain thought to be associated with alcohol dependence.



Alcoholism prevention




Recognizing a family history of alcoholism may help prevent possible cases of alcoholism. This is an important step toward seeking treatment before alcohol use or abuse progresses to alcoholism.

Early intervention is crucial in preventing alcohol dependence in teenagers. Alcohol use among teens increases dramatically during high school years.

Family and surroundings of a possible addict are also important. For young people, the likelihood of addiction depends on the influence of parents, peers, and other role models.

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From Ow to Wow: demystifying painful sex!

At least once every couple of days, a woman posts or writes into Steadyhealth reporting that vaginal entry -- usually heterosexual intercourse or manual vaginal sex ("fingering"), and usually (but not always) with male partners -- is painful, uncomfortable, or unfulfilling for them. Sadly, many you...

At least once every couple of days, a woman posts or writes into Steadyhealth reporting that vaginal entry -- usually heterosexual intercourse or manual vaginal sex (%26quot;fingering%26quot;), and usually (but not always) with male partners -- is painful, uncomfortable, or unfulfilling for them. Sadly, many young women report having painful intercourse or other vaginal sex again and again, many without even saying anything about it to their partners.



In fact, plenty of women of all ages simply assume intercourse is going to be, or has to be, painful or uncomfortable -- some for the first few times, others that it simply always is to some degree. Whatever sort of vaginal entry we're talking about -- with fingers, a penis or a dildo, with partners of any gender -- not only doesn't have to be painful, it really shouldn't be. More than that, any kind of sex shouldn't be about a lack of pain, but about the presence of pleasure.



Are you (or is your partner) experiencing vaginal pain during sex? Then read on, while we look at the most common culprits and talk about how to identify, address, process and be rid of them, and help make vaginal stimulus a big %26quot;Wow,%26quot; instead of a big %26quot;Ow.%26quot;






1. Those annual sexual health exams up-to-date? If not, that's the very first place to start. If you're having painful vaginal entry, then you're sexually active, and you positively, absolutely need to be getting annual sexual health exams, including a basic bimanual/pelvic exam, a pap smear and a full STI screening.



If you're having more than one partner in a year -- yep, even if you're using latex barriers for manual sex, oral sex, vaginal and/or anal sex -- you need those STI screenings even more often. Painful vaginal entry or intercourse can be due to certain infections, as well as conditions like vaginismus, pelvic inflammatory disease (which usually arises from unidentified and/or untreated STIs) or an imperforate or particularly stubborn hymen. Before you look for any other culprits, start in the office of your healthcare pro: that's important both to find out what the root of the problem is AND to safeguard your sexual and general health.



Been having unprotected sex? Having pain during intercourse? Unexplained bleeding during and/or after? While Chlamydia can often be asymptomatic, these are also very common symptoms. Chlamydia rates in young women are incredibly high, and chances are good that part of why is because male partners saying they have been having STI screenings just plain haven't, and young women aren't insisting on safer sex. Many more women here report their male partners have been screened here than is statistically realistic. If you haven't had a copy of your partner's recent screening results in your hands, assume they have NOT been screened, and insist on using all aspects of safer sex with those partners. If you haven't been, even without vaginal pain or bleeding, get in and get your own screenings NOW, and insist that your partner does the same, even if you intend to wise up and practice safer sex from now on.



Once that is taken care of, and if either no medical culprits are found, or they are and are treated but you're still having discomfort or pain, look further.

2.
Are you highly aroused well BEFORE any sort of vaginal entry?

If you answered yes without even a thought (or an enjoyable, long sigh), and you haven't been sexually active for a long time or actively masturbating on your own for a good while, you may not be or even know when you are. Liking our partner, even being crazy in love with them, isn't the same thing as full arousal.

If you're a young, healthy woman without any medical conditions which can alter how your sexual response system system works, when you're very aroused, generally, you will feel a bit flushed. Your heart rate will be a bit quicker, your body may feel tingly, your muscles alert but relaxed. You may be breathing more quickly. Your vagina will usually naturally lubricate, sometimes profoundly (though at some times in your monthly cycle, that may be more or less) so that you feel %26quot;wet.%26quot; Your genitals and whole body will feel more and more sensitive the more highly aroused you become; your clitoris will enlarge slightly, your vaginal opening will loosen, your breasts may also swell. You will feel a very strong desire to be sexually engaged with your partner, usually more so than when the two of you got started initiating sexual activity.

What sorts of things might inhibit (keep you from) full arousal?









  • relationship conflicts, problems or doubts


  • worries about STIs or pregnancy (which usually are more likely when you're not practicing both)


  • previous sexual trauma or shame


  • lack of trust in a partner


  • an emotionally, sexually or physically abusive partner


  • worries about embarrassing oneself, doing sex %26quot;wrong%26quot; or really letting go in front of a partner


  • certain prescription (like some antidepressants) or recreational drugs or alcohol


  • poor general health, sedentary lifestyle or poor nutrition


  • body or self-image problems


  • anticipating pain; feeling scared or nervous


  • orientation questioning or strong doubts


  • ethical conflicts about being sexually active


  • being with a partner you really don't want to be with


  • feeling like you might get caught (having limited privacy) or being in a rush or hurry


  • the old wham-bam-thank-you-ma'am: in other words, jumping (or being pushed) right into vaginal entry without any sort of fanfare, without foreplay, etc.







  • entering into certain sexual activities before you really want to or feel ready


  • feeling like sex is a performance, or a way to prove your worth to a partner


















Say what? %26quot;Loose%26quot; is BETTER?!?
When a woman isn't sexually aroused, her vaginal opening and canal are more constricted, %26quot;tighter,%26quot; than when she is aroused. During arousal, the vagina self-lubricates, engorges with blood (which causes the clitoris and clitoral sponge to grow in size not unlike the male penis does), hormones secreted in the body help to relax the canal and opening of the vagina, and the back of the vagina %26quot;tents,%26quot; expanding in both width and depth. And the vagina isn't static: so %26quot;looseness%26quot; or 'tightness%26quot; change in the day-to-day. There aren't %26quot;loose%26quot; women and %26quot;tight%26quot; women as a whole.

So, when people go on about a %26quot;tight%26quot; vagina being ideal, what they're really saying -- even if they don't realize it -- is that an unaroused, uncomfortable woman is ideal. For women, that absolutely is not so. It's not even so for their partners: when a woman is aroused, and the vagina is engaged, that muscle contracts around what is inside it; a penis, toy or fingers can move much more freely than inside a vagina that is unaroused, dryer, and constricted by the lack of relaxation and arousal so as to not even allow for deeper penetration.

Of course, for a well-adjusted person interested and invested in sex being a mutually pleasurable experience, there's nothing at all desirable about an unaroused, uncomfortable partner.



And in that same vein:

3. Do you really WANT to be having intercourse/manual sex or any sort of sex? That might sound silly, but it's important to consider every time you have sex: do you want to have intercourse or other vaginal sex for YOUR pleasure and satisfaction as much as your partners? Do you find yourself attempting intercourse or manual sex with a partner when you suspect or know you aren't aroused or interested? Because you know it'll get them to stop nagging you or placate them? If so, in a word, knock it off. You truly don't want to get into that habit or set that precedent.

Is your male partner (presuming we're talking about heterosexual intercourse and dynamics) attempting intercourse when HE doesn't feel aroused? Nope. Even if erection weren't required for sex, given the usual sexual dynamics of our culture, he likely wouldn't be. Good for him if he isn't: sex out of nothing but obligation tends to be really detrimental physically, sexually, emotionally and to a healthy relationship. But YOU should be held to no different standards, neither by a partner nor by yourself. If you have a male partner who's not especially informed or on-the-ball, he may say or think something to the effect of, %26quot;Well I can't even HAVE intercourse if I'm not aroused,%26quot; meaning because he doesn't have an erection. But the truth is, if you're not aroused, it's just as physically impossible for you to do so without discomfort, without it really %26quot;working%26quot; as it is him.

Certainly, especially in
long-term relationships, we'll sometimes find ourselves in the position where one of us is in the mood, but the other just isn't so much, or is only halfway there. And when that's so, we have plenty of options. We or our partners can always masturbate. We also always have the option to engage in sexual activities which we do feel up to, or are aroused enough to enjoy, many of which don't require our genitals to be all-ready to go, and which we probably enjoy even at moderate-level arousal just because they please our partners. Sometimes, we are in a headspace to enjoy bringing a partner pleasure (and vice-versa), even if we're not in the mood (maybe we're too tired, maybe we already got off and feel finished, maybe we don't have time on a given day for the spaciness orgasm can bring, maybe we can just feel our bodies aren't going to go there right then) to get off ourselves. Engaging in manual, oral sex, phone sex or some level of mutual masturbation with a partner, for instance, are these kinds of options.

Once you start a sexual relationship, that doesn't mean your partner (or you, for that matter) has an all-access-pass to sex whenever, wherever, or however they want it with you. That's what masturbation is for: that's the only 24/7 pass to sex at anytime any of us gets to have. Even in a long-term relationship, sex is a request, a possibility, and in a healthy, mutually respectful partnership, only when both partners are aroused -- or interested in becoming aroused -- and truly interested in sex.

In many cultures, ours certainly included, heterosexual intercourse is set up as the default from of sex, as the %26quot;real%26quot; sex, as the sex that all other sex acts should lead up to, as the sex everyone should be having most often. But one has to remember that those ideas cemented during times when women's comfort, pleasure and autonomy was in no way a priority, when women engaging in sex was viewed as a %26quot;duty%26quot; to one's partner, whether or not the woman in question was experiencing pleasure, or even basic comfort; when women weren't even recognized as having a sexuality of our own. Sadly, marital rape is still considered okay by a lot of people, based in part on those ideas: that women's bodies become owned, depersonalized or subservient property in sexual relationships. Up until fairly recently, pervasive myths were spread that women who couldn't reach orgasm via intercourse weren't %26quot;real%26quot; women, and those myths still continued -- albeit slightly less prevalently -- even when more study was done on female anatomy to understand that often, our own physiology often prevents orgasm or physical pleasure from vaginal intercourse alone. Of course, the notion that heterocourse is the default sex, the %26quot;real%26quot; sex is also based in heterosexism and homophobia as well as sexism.

You may find your older siblings, aunts or uncles, parents or even your peers give you the message that you are somehow obligated to have intercourse or any other form of sex with a partner whenever they want it, but you've got to understand that anyone sending you that message is just plain wrong; is voicing a message that is harmful, painful and detrimental to women. Plenty of people don't question those beliefs because they're so rooted in history and some traditions they somehow seem normal, fair or sound (some people who don't question them don't because they benefit them, even if they harm others). But they aren't: not if mutually respectful and caring partnership is what you're after, and not if women's minds, hearts and bodies are being treated with respect, love and care.

4. Are you communicating with your partner, and is he (or she, if we're talking manual sex, or intercourse with a sex toy) responding to what you're communicating? In other words, when you say, go slow or not so deep yet, or grab more of that lubricant, or ow, I think I need more oral sex first, or let's try this position instead, or can you rub my clitoris while you do that ... is he or she both listening AND following your lead? (Remember, for a partner to do that, you've got to speak up in the first place: body language can give some things away, especially when we're really familiar with a partner and their physical cues, but verbalizing this stuff clearly often does that better and is really vital when either a partner or sex in general is new to either or both people.)

Faking orgasm or pleasure, for the record, is a complete barrier to satisfying sex and good sexual partnership. If, via faking, you're lying to a partner about what feels good and doesn't, he or she isn't very likely to be able to find out what WILL feel good. And keeping at it when you're in pain makes it much more likely that you'll continue to have pain every time you engage in the same activity, because our vaginal muscles actually anticipate the pain with cues from our brains, and that can both keep us from full arousal and cause the vagina to constrict upon itself, rather than opening up.

















HEY, BOYFRIEND!
How can you help out here? Pretty easily. If you're concerned about your partner's pleasure as much as yours to read something like this, you're already halfway there. Whoohoo!





  • Make clear to your female partner, from the onset of your sexual partnership, that she should always feel free to let you know when she's feeling any pain or discomfort, even if you appear to be enjoying yourself, and that you have exactly zero problem halting or changing the action for her so that she, too, feels good. You can also make clear that you only want to be having sex together at times she wants sex, too. (P.S. If you don't actually feel that way or can't deal with that? Then you just aren't ready for sound sexual partnership yet. To treat a partner like a whole human being, not an object or sex toy, those are entry-level requirements.)


  • Ask questions during sex. We're not talking about anything complicated: %26quot;How does this feel?%26quot; and %26quot;Is that comfortable for you?%26quot; and %26quot;Need more lube?%26quot; and %26quot;What position feels best for you?%26quot; and %26quot;Want me to go deeper/faster or not?%26quot;


  • Don't bang away with your penis or fingers if your partner's vagina appears to be putting up resistance. Instead, go back a step or two: if inserting your penis is problematic or is causing your partner discomfort, go back to her clitoris for a while, maybe lube up a single finger and massage her vaginal opening until the vagina itself almost seems to %26quot;suck%26quot; that finger in readily. Think baby steps. Think about the sort of care, for instance, your testicles or your anus need. Umm hmm.


  • Let your partner initiate sex just as much as you do.


  • Don't rush. Period. It's understandable to want to hurry due to short or unpredictable erection times, or because it just feels so intense, but other sex when erections don't hang around, or additional sexual activity for your partner with hands or mouths if you reach orgasm yourself quickly is always, always better than pain for your partner.


  • Remember that her vaginal canal not only isn't where all her sexuality and pleasure lies, but that for most women, it's secondary. Paying attention to her whole body and her whole vulva -- not just her vagina -- is the real deal (and, in fact, equally encouraging your partner to pay attention to YOUR whole body and the whole of YOUR genitals --the penis, but also the testes, perineum and anus, pressure points around the pelvis -- also will enhance YOUR sex life and the level of your pleasure, too!).


  • When your male friends start riffing off on a bunch of sexist sex myths (like a %26quot;tight%26quot; vagina being ideal, or intercourse being obligatory), find ways to pass on more accurate, healthy information.




P.S. This isn't being said to you and not female partners of women because we think boys are jerks or stupid. Rather, this is being said to you because you don't have a vagina, and unless you've engaged in receptive anal sex -- which isn't identical, but is similar -- you're not going to have any real idea what this feels like to a woman AS a woman, which other women usually do. Too, social and cultural standards in terms of gender roles and heterosexual dynamics often come into play with this stuff, so gender isn't a nonissue.





5. Is your partner being observant and patient enough to really pay attention to the contours of your body, inside and out? For instance, the vaginal canal is curved, not straight, so sticking stiff, pointed fingers in there isn't likely to be pleasant, nor is approaching intercourse at an angle in which the penis or toy is poking the walls of the vagina, rather than following its more curvilinear contours. Make sure you're both taking the time to adjust positions or postures so that they are in harmony with your anatomy.

6. Using lubricant as needed? Lube can't replace arousal, mind you: it can't loosen the vaginal canal and opening the way that arousal can. But when you are already there, and things don't feel very slippery, it can be a big help. When using condoms and barriers, it's essential, not just to keep the barrier from tearing, but because often our own natural lube isn't enough when a barrier is added. Too, if you're also using hormonal contraceptives, often one of the side effects is an increase in vaginal dryness. During certain times of the fertility cycle as well (for those who are not using the pill, the patch or other hormonal methods), cervical mucus is thicker, which can make things more sticky and less slippery. Friction is part of what makes any kind of vaginal stimulus -- like intercourse or manual sex -- feel good, but too much friction causes discomfort. using plenty of latex-safe, water-based lube helps you strike the right balance.

7. Have you had previous sexual trauma (like any form of rape, molestation or other sexual abuse)? Have you had pain during vaginal entry before, or previous partners who were too rough, inconsiderate or who you felt fearful with? These previous experiences can result in current pain from intercourse or manual sex, because, in essence, our bodies remember the pain we've felt before and anticipate it by locking up and inhibiting arousal. If you suspect this is an issue, you can deal with that via counseling, and/or by letting your partner know about these experiences, and making sure you're both taking as much time as you need to introduce vaginal entry -- that can be weeks, months, even years. Whatever pace works for you -- makes you feel safe and relaxed over time so your body can -- is absolutely fine. So very many women have some form of sexual abuse or assault in their history, that any partner who has women as sex partners needs to be willing to work with those issues and the extra time it sometimes takes survivors to really get comfortable.

Sexual shaming is also a form of sexual trauma. If you have been raised with the strong message that wanting or having sex, or being aroused is shameful, dirty or makes you a bad person, that can make full arousal and pleasurable, comfortable sexual activity difficult.

















Not as simple as 1 - 2 - 3 , but it's a start.
One: Not sure if you're really highly aroused or if that's an issue? Try having an orgasm BEFORE attempting sexual intercourse or manual sex. In other words, engage in other sexual activities with your partner which bring you to orgasm first, then right afterwards, try vaginal entry. If your answer to this is:



a) You haven't had an orgasm yet or found out how to reach orgasm: then invest some time and energy, solo and with your partner, in finding that out well before getting to intercourse. You can even add a smaller amount of vaginal entry in that mix when exploring, via just a gentle finger or smaller toy, if you like.
b) Your partner isn't willing to hold off on intercourse or spend time exploring what does feel good and does bring you pleasure and/or orgasm: ditch that partner if a couple honest talks don't change that. Seriously. That may sound harsh, but a partner uninvested or uninterested in their partner's comfort or pleasure, or putting it second, isn't willing or ready to treat you like a partner: they're treating you like an accessory for masturbation, and that just isn't healthy, respectful or good for anybody.


If you discover that orgasm before intercourse or other vaginal entry makes the pain go poofie, then it's safe to assume that you haven't been aroused enough when you've tried before. So, you can then focus more on getting you aroused, or heck, make a habit of getting to orgasm first before vaginal sex.

Two: BE VERBAL AND CLEAR when you're not feeling good. Don't fake pleasure or say something feels okay when it doesn't. Neither you nor your partner are going to be able to figure out what DOES feel good, and isn't painful, if you're not communicating freely and clearly. If you don't feel ready or able to communicate during or about sex with a partner pretty honestly yet, then it's just not wise to engage in sex with a partner until you can. Suffice it to say, if you are earnestly fearful to say anything with a partner, you're with the wrong partner, period, and you need to get out of that situation, pronto.

and Three: Respect yourself. Caring for and honoring your body (and what's it's telling you with how it feels), saying no to someone else's pleasure which is your injury, pain and discomfort, and expecting and insisting that any sexual partner treats you and your body with equal care and consideration are the barest bones of self-respect in a healthy sexual partnership. Plenty of things in relationship are things where we have room for compromise and negotiation. Basic self-respect isn't one of them.






One last thing: some women discover that they just do not like intercourse or any other kind of vaginal entry, with partners of any gender. Having that preference is JUST as okay as it is for a man to discover that he just doesn't like anal entry for himself, or as a person just not liking oral sex or deep-mouthed kissing (or having their ears licked, or their toes kissed, or their testicles cupped, whatever). Again, having a sexual partnership doesn't oblige or commit anyone to agree to all sex acts al the time, or even at all. You may find you need to shop a bit for a partner whose wants and needs are compatible with yours in that regard, but nearly all of us have to do that no matter what our preferences and desires are. So if NONE of this stuff works for you, if you discover that you just plain don't like vaginal entry or penetration, don't make yourself crazy over it, or become convinced there's something wrong with you. Instead, invest your energy in exploring what DOES work for you, what you DO like and with whom that all works just fine. I assure you, finding partners with whom it does is less tricky than you'd think



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