Archive for February 2011

SURGERY FOR EPILEPSY: CALLOSOTOMY

Another type of operation is sometimes considered for someone who has very severe epilepsy in which the seizures arise all over the brain and cause ‘drop attacks’ during which they may be badly hurt. This is callosotomy, an operation to cut, either partially or completely, the nerve tracts (corpus callosum) that connect the two halves of the brain. Occasionally the operation is also offered to people with severe partial complex seizures.
Usually about a third of the corpus callosum is cut to begin with. If this does not prove successful, another third of the fibres will be cut, and finally a total split may be made.
Success of callosotomy
Callosotomy will not end the seizures, but it will change their nature. The operation will stop the seizures spreading from one side of the brain to the other, which in turn will help prevent the drop attacks. Between 65 and 100 per cent of patients have at least a 50 per cent reduction in drop attacks, rising to nearer 100 per cent some time after the operation.
Some patients are mute for a few days after the operation, but, perhaps surprisingly, it has been found that full callosotomy proves to be no more of a disadvantage to the patient than partial callosotomy. There may be some unwanted effects, for example a lack of co-ordination between the two hands.
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TAKING COMMAND OF YOUR DIABETES: ADJUSTING YOUR INSULIN DOSE

It is your diabetes and you are the person who has to live with it. The sooner you get used to adjusting your own insulin dose the better. I am astounded by the number of diabetics who know that their glucose control is poor but who wait, sometimes for months, until their next appointment for the doctor to tell them to increase their insulin. Many diabetics are afraid that a small change in their insulin dose will cause a catastrophic hypoglycemic reaction. It is most unusual for this to happen. I usually suggest that anyone who needs to alter the insulin dose starts by adjusting it by one unit at the appropriate time and watches what happens over the next two or three days, making further one unit changes as needed after this. Gradually, most diabetics find that they can make adjustments of two, three or four units at a time if necessary. Discuss how you should set about adjusting your insulin dose with your doctor or diabetic adviser.
I need hardly say that you should reduce your insulin if you are suffering hypoglycemic episodes and increase it if your blood glucose level is high. If you are taking a combination of insulins you must consider which one is acting at that particular time.

Adjusting your diet
In trying to correct a low or high blood glucose level at a given time of day, it may be simpler, or more appropriate, to adjust your diet rather than your insulin or pills. Perhaps you are using extra energy at that time and need an extra snack. But beware of a common trap – too much insulin makes you hungry or hypoglycemic, so you eat more and your glucose level goes up, then you take more insulin and get hungry again, then you eat more and get fat and become even more resistant to the action of insulin. Perhaps the timing of your meals or snacks could be modified.

Energetic Ed attends our clinic. He has succeeded in adjusting his diet to suit a varied and very active life.
Ed is twenty-four years old and works as a general builder and decorator. He is a very athletic man; he plays tennis several times a week, plays football most weekends and plays the drums in a rock group. He has been diabetic for four years and has never let his diabetes get in his way. He takes rapid-acting and medium-acting insulin twice daily – sixteen units Velosulin and twenty-eight units Insulatard in the morning and ten units Velosulin with eighteen units Insulatard in the evening.
One Monday morning he was going to demolish a brick wall as part of a renovation scheme on a large project. He knew that this would use more energy than, for example, painting or carpentry. That morning therefore, he reduced his fast-acting Velosulin by four units and not only ate a larger breakfast than usual (double helpings of cereal, and an extra slice of toast) but took an extra snack to eat during the morning. He always plays tennis on Monday nights so his usual food and insulin were already adjusted for that.
The following day Ed’s job was to prepare some of the outside woodwork for painting. Because this was less energetic, he had his usual insulin and food that morning. However, at lunchtime he played an unexpected and vigorous game of football with his mates and ate his emergency biscuits from the tin he always keeps in his toolbox. That night his rock group was booked to play at a birthday party. Ed puts everything he’s got into the drumming! He reduced his evening Velosulin to eight units and, because it was a late night party, reduced his Insulatard to sixteen units. He ate his usual evening meal but had a snack while he was setting up the amplifiers at the party. He also ate some bread, cheese and fruit at the party. He restricted his beer intake to one pint (unlike the rest of the group) because he had had a bad hypoglycemic attack two years previously after a similar party when he drank too much and ate too little and his glucose fell during the night. When he finally got home at three in the morning he had a bowl of cereal before he went to bed.

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BIOLOGICAL TREATMENTS FOR HIGH BLOOD PRESSURE

1.     In my experience, juice fasting is the most effective treatment for high blood pressure, bringing about in almost every case a sharp reduction in the systolic pressure in a short period of time. Vegetable and fruit juices and vegetable broth will supply blood and tissues with the important mineral, potassium, which helps to eliminate accumulated sodium (salt) from the tissues. A juice fast also normalizes and corrects most other disturbances and malfunctions in the body which might be contributing causes to the elevated pressure.
Recommended length of fast: 3 to 4 weeks, or several repeated one-week fasts if longer fast is inconvenient. The therapy can be repeated several times with an interval of 6 months between each long fast.
2.     For those who for some reason cannot fast, a watermelon diet for a week (eat nothing but watermelon for one week) can be tried.
3.     Rice-fruit diet is also shown to be effective: eat nothing but whole cooked rice and cooked and raw fruits for one or two weeks.
4.     Dry brush massage morning and evening. Lots of exercise, walking and deep-breathing exercises. Although strenuous exercises such as weight lifting or competitive sports are not advised, high blood pressure patients should exercise as much as possible, starting with mild exercises and walking, gradually increasing their length each day.

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