This blog is a vital resource for health knowledge, as it provides a wide array of information through expert- and user-generated articles.

Sometimes, for some people, depression is too severe or it lasts too long. Severe, persistent depression is often best treated with medication. Talk to a doctor. If medication taken for another condition is causing depression, the doctor can change the drug or lower the dose. If the depression is part of dementia, the doctor will prescribe medications that ease the symptoms. Most of the persistent depression in people with HIV infection, however, is simply the natural reaction to knowledge of a devastating disease. Like the depression that accompanies the loss of a loved one or a diagnosis of cancer, it can be successfully treated with appropriate support and medications. In this case, the doctor will recommend a psychiatrist, who can prescribe medication that restores sleep, appetite, and mood. For most people, treatment of depression is temporary but critical.     Either the doctor or the psychiatrist might recommend professional psychological help. Psychiatrists, psychologists, and social workers can help you talk through whatever is blocking the healing process, though only psychiatrists are trained medically and can prescribe medications. Psychotherapy may concentrate on the overwhelming problems people must face and feel they cannot solve: How can I face rejection? How can I deal with anger? How can I feel less guilty? How can I have sex without hurting myself or anyone else? Why me? Why now? What will I do with the rest of my life? What will happen to my kids? My parents? The people I love? Will I die? How will I die? Am I a good person? By helping you confront problems you feel are unsolvable and find new perspectives on those problems, a psychotherapist will help you take control of your life. He or she will help you deny, not the fact of your infection, but your own helplessness and hopelessness in the face of it.     Thoughts of suicide are usually only temporary: the suicide rate among people with HIV infection is low. People seem to consider suicide mostly as a means of regaining a feeling of control over their lives. They seem to be saying, “This disease does not control whether I live or die, I do.” Nevertheless, if thoughts about suicide persist, and if thoughts of taking pills become plans to collect specific pills, and if these persistent, concrete thoughts are coupled with an increase in guilt and sense of punishment, then get help. Call your doctor or psychotherapist.
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There’s nothing like Botox for treating crow’s-feet, those little lines that hover on the outer corner of each eye. These lines are known as dynamic wrinkles, or wrinkles in motion, and their existence is related to the constant movement of that part of the face And like I said earlier, Botox is, without question, the treatment of choice for any type of movement-induced wrinkling. Plastic surgery does nothing for crow’s-feet but pull them tighter and collagen injections will make them appear softer when the patient isn’t animated, but daily facial expressions will bring them back in no time. As for treating them with lasers, you will see an improvement but it comes at the price of two weeks of recovery time and a risk of permanent changes in your pigmentation.A fatty deposit under the eyes is best treated with surgery but I’ve found that a lot of patients, particularly those who are past forty years old, mistake a bulge right under their eye for fat. This bulge is actually an overworked muscle and believe it or not, a touch of Botox injected there will soften it. As bizarre as it sounds to inject your eye with Botox, it is very safe to do so. The only consequence is that this can round out the eye shape. (Some of my Asian patients actually consider this to be a perk.) The bottom line is: if you love your almond-shaped eyes then I wouldn’t recommend this for you.*51\82\8*

An essential part of sexual identity is sexual orientation. Sexual orientation refers to a person’s enduring emotional, romantic, sexual, or affectionate attraction to other persons. You may be primarily attracted to members of the other sex (heterosexual), your same sex (homosexual), or both sexes (bisexual).
Homosexuality refers to emotional and sexual attachment to persons of the same sex. Many homosexuals prefer the use of the terms gay and lesbian to describe their sexual orientations, as these terms go beyond the exclusively sexual connotation of the term homosexual. The term gay can be applied to both men and women, but the term lesbian is applied only to women.
Bisexuality refers to emotional attachment and sexual attraction to members of both sexes. Bisexuals may face great social stigma, as they are often ostracized by homosexuals as well as by heterosexuals. Little research has been done on this segment of the population, and many bisexuals remain hidden or closeted.
Throughout history, the mental health status of gays and lesbians has been debated by scientists and laypersons alike. In 1973 the American Psychiatric Association’s board of trustees unanimously voted that homosexuality was not a mental illness or psychiatric disorder. This position was affirmed by the American Psychological Association and the Board of Directors of the Sexuality Information and Education Council of the United States (SIECUS). Recently, the issue of homosexuality as a treatable “disease” has been resurrected. Therapies labeled as conversion or reparative therapies are being promoted in a series of full-page print ads in national newspapers and in television ads. Mental health professionals have found these ads so troubling that a special resolution was passed by the American Psychological Association reaffirming that homosexuality is not a disease or disorder in need of treatment or a “cure.”
Most researchers today agree that sexual orientation is best understood using a multifactorial model, which incorporates biological, psychological, and socioenvironmental factors. Biological explanations focus on research into genetics, hormones (perinatal and postpubertal), and differences in brain anatomy, while psychological and socioenvironmental explanations examine parent-child interactions, sex roles, and early sexual and interpersonal interactions. Collectively, this growing body of research suggests that the origins of homosexuality, like heterosexuality, are complex. To diminish the complexity of sexual orientation to “a choice” is a clear misrepresentation of current research. Homosexuals do not “choose” their sexual orientation any more than heterosexuals do.
Much of people’s need for “explaining” homosexual needs, feelings, and behaviors arise from a fear of the unknown. In many instances, those fears are irrational. Irrational fear or hatred of homosexuality creates antigay prejudice and is expressed as homophobia. Homophobia in our society is expressed in many ways, subtle and not so subtle. Homophobic behaviors range from avoiding hugging same-sex friends to name-calling and physical attacks. Herek and colleagues surveyed 2,259 gay and lesbian people and found that one in five women and one in four men had been victimized in the preceding 5 years because of their sexual orientation.
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The origins of human suffering have always been more infectious than has been supposed. By all indications this generalization still holds true. Like other advancements in science, this new understanding of disease has the potential both for damaging and for enhancing the quality of human life. The recognition that pathogens are prone to evolutionary change raises the question of what good or ill human society will make of this new knowledge.
First, it is important to remember that the newly recognized realms of infection are populated by chronic diseases and that the weaknesses of biological weapons are compounded as one moves from the acute to the chronic. Imagine how impotent a biological weapon would be if, like HTLV-1, it caused cancers in only one out of twenty-five infected individuals and did so sixty years after the targets were infected.
The shortcomings of biological weapons go a long way toward reducing the threat of their use, but they do not go all the way. The dangers must still be identified and guarded against to reduce the threat. If anyone could get away with conducting large-scale lethal experiments on humans to generate a vicious biological weapon, the new information would indeed be very dangerous. But with safeguards against such possibilities, the pros far outweigh the cons. To protect against the abuse of this new knowledge, we must make sure that such safeguards are in place, even if it means the abrogation of the sovereignty of any government that would dare to conduct experiments on humans that are designed to enhance virulence.
The world is not as safe as it could be, but it seems safe enough to make good use of the new biological knowledge. To take full advantage of the health benefits arising from the emerging understanding of the evolution of virulence, we need to adjust our environments to do the opposite of what a terrorist would do. We need to selectively disfavor transmission of harmful strains.
One of the greatest difficulties encountered by traditional approaches to controlling disease for good or ill is the flexibility of some pathogens. This flexibility is a difficulty for us if we are fighting against it—when, for example, we use antimalarials to try to suppress the versatile agents of malaria. But the flexibility of an infectious organism can also be a part of the solution to disease control.
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The first priorities for the person with spinal cord injury are to maintain life and stabilize the spine and to treat any coexisting injuries or medical problems. After these priorities have been addressed, a number of other medical interventions and treatments come into play. Some are necessary only in the early days of hospitalization, while others are required either continuously or periodically.

Respiration
The diaphragm is the main muscle for inhaling air: contraction of the diaphragm sucks air in but does not push it out. The chest is elastic and springs back into place when we stop breathing in, and as the chest springs back, air is naturally pushed out of the nose and mouth. The muscles of the chest and abdomen allow us to exhale air forcefully, as in coughing, shouting, or clearing the throat.
The diaphragm receives its nerve supply primarily from the C4 level of the spinal cord via the phrenic nerve. Spinal cord injury affecting the C4 level or above can cause permanent weakness or paralysis of the diaphragm, so that the injured person cannot breathe. A mechanical ventilator is then needed to pump air into the lungs, substituting for the diaphragm.
An endotracheal (breathing) tube carries the air from the ventilator into the lungs, and a tracheal suction tube is used to clear phlegm from the windpipe. The endotracheal tube temporarily makes speaking impossible, and if left in place too long it can damage the larynx (voice box). Damage to the larynx can be prevented by a minor operation called a tracheostomy, the formation of a small opening in the front of the neck that allows air to enter the windpipe directly. The tracheostomy is usually held open with a small plastic tube.
Several different types of tracheostomy tubes are available. Some include a small plastic cuff in the windpipe that directs air into the lungs and prevents it from leaking out of the nose and mouth. This is important to provide adequate airflow to the lungs, especially during surgery when the patient may be unconscious. The problem with this cuffed tracheostomy tube is that it generally makes speech impossible. When the individual exhales, all the air flows out through the tracheostomy tube and none through the larynx. If a cuffless tracheostomy tube is inserted, airflow through the larynx is possible. Individuals who require long-term use of a tracheostomy tube or a mechanical ventilator can usually learn to speak with a cuffless tracheostomy tube and special techniques for breathing and speaking. This often requires the use of a tracheostomy speaking valve, which helps to direct airflow through the larynx. If the strength of breathing muscles improves, the tracheostomy is easily reversed by simply removing the tube and allowing the opening to heal.
After use of a mechanical ventilator for more than a day or two, the resumption of independent breathing may be difficult. This problem is handled by a process called ventilator weaning. During the weaning process, the amount of respiratory support provided by the ventilator is gradually reduced, and the individual is permitted to have short periods of time off the ventilator. These periods are gradually increased until the ventilator is no longer necessary.
People with permanently paralyzed breathing muscles must use a ventilator for the rest of their lives. This is especially common in cervical spinal cord injuries. (Some people with lower spinal cord injuries also need a ventilator, if only temporarily.) Thus breathing is a focal point of treatment for many people with spinal cord injury. Long-term dependence on a ventilator has a significant effect on mobility and can require attendant care, and it may affect psychological adjustment.

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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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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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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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Depression is a common feature of RA. People with RA may be envisioning a life filled with pain or feeling old before their time. They may feel cheated. And self-esteem may waver when they find they can’t do things they once did with ease. These are good reasons to feel sad, and prolonged or intense sadness can lead to depression.
The following statements contain subtle cues that indicate the person is depressed:
“I’m too tired to visit the Bensons tonight.”
“Nothing’s wrong. I just don’t have anything to say.”
“It’s Jimmy’s birthday? I forgot.”
“I feel okay. I’m just not hungry, that’s all.”
“I hardly shut my eyes all night.”
“Honey, my joints are just too sore tonight.”
Feeling melancholy is not the only symptom of depression. Loss of energy, decreased interest in previously enjoyed activities, forgetfulness, loss of appetite or excessive appetite, difficulty sleeping, and decreased libido can all be symptoms of depression. But these same symptoms can be caused by RA, so it’s important to clarify their source.
Depression results in further pain, poorer sleep patterns, added muscle tension, and increased fatigue – all of which can lead to deeper depression. This cycle needs to be broken. The primary motivating agent must be you.
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Stopping using drugs is simple. Not easy, but simple. Anybody who really wants to stop using drugs or drinking can do so. Thousands of people are living examples of how it is done – and of the happiness that results from a life free from drugs and alcohol. You can do it too. You’ve probably done it numerous times, but with all those past attempts to stay clean or stop drinking behind you, you are probably frightened of what may happen when you do try again.
Cold turkey is nonsense-The first thing is to put out of your mind all the bad movies, harrowing chapters in thrillers and newspaper stories which you have seen and read. Their descriptions of coming off drugs are usually so much rubbish.
The agonies of cold turkey are a myth. Coming off the so-called ‘hard’ drugs like heroin or methadone is not dangerous. Uncomfortable, perhaps – undoubtedly an uncomfortable experience. But not dangerous at all.
Oddly enough, it is the legal drugs that are likely to cause the worst withdrawal problems. Coming off alcohol is worse than coming off heroin, and can sometimes be dangerous. Coming off tranquillisers can be worse still. The only other risky drugs to come off are barbiturates and Heminevrin (chlormethiazole edisylate). Barbiturates are even more dangerous than tranquillisers.
So there is no need for people on illegal drugs like heroin, cocaine and so forth to fear withdrawing; it does help, though, if you understand a little about the process of coming off.

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