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Saturday, March 28, 2009
Saturday, March 21, 2009
Arthritis
Here’s a disease that’s so common that nearly one in seven Americans already has it—and a new case is diagnosed every 33 seconds. In fact, arthritis is the most widespread chronic disease in people over the age of 45, even when you consider the untold millions who never see a doctor about that blasted pain in their joints.
When you do see a doctor about that blasted pain, he will usually tell you what kind of arthritis you have. Although there are more than 100 different types, most fall into two broad categories.
Inflammatory arthritis (or rheumatoid arthritis) is the best treated with anti-inflammatory drugs, through diet and lifestyle changes may help. Non-inflammatory arthritis (or osteoarthritis) results when cartilage in joints deteriorates from injury or excessive use. Weight control, proper exercise and pain relievers are the key treatments here.
Eat your Vegetables. Researchers at the University of Oslo in Norway discovered that people with rheumatoid arthritis who began a vegetarian diet saw dramatic improvements in their conditions within one month after cutting out meat, eggs, dairy products, sugar and foods with gluten, such as wheat bread. A vegetarian diet is good, because the goal for arthritis sufferers is to cut as much saturated fat from their diets as possible and replace it with more polyunsaturated fat.
Try something fishy. One of the best sources of polyunsaturated fat is cold water fish such as salmon, sardines and herring. They are rich in omega-3 fatty acids, which have been shown to have some minor beneficial effect on reducing the inflammatory aspects of arthritis.
Get hot on hot pepper cream. Research shows you can ease the pain by rubbing the joint with an over-the-counter ointment called Zostrix, made from capsaicin—the stuff that puts the hot in hot peppers. You u need to apply it three or four times a day on the affected area for at least two weeks b before you’ll see any improvement. An initial burning sensation at the site is not unusual for the first few days, but this goes away with continued application. Washing your hands immediately after application is advised.
Use a Dehumidifier. If the Humidity is kept constant in your house, it can help calm arthritis pain caused by weather changes. When rain is on the way, the sudden increase in humidity and decrease in air pressure can affect blood flow to arthritic joints, which become increasingly stiff until the storm actually starts. If you close the windows and turn on the dehumidifier—or run the air conditioning in the summer—you may be able to eliminate this short-term but significant pain.
Remedies for your specific aches
From head to toe, there are specific arthritis treatments for specific body parts:
Give your neck a break. Don’t extend your neck by looking up for long periods. If you’re painting, hanging curtains or doing other work that requires you to look up for a long time, get a ladder and bring yourself to the same level as you work.
Support your shoulders. Don’t sleep with your arms over your head, because that strains your shoulders. Advice for women, lighten your handbags so that they carry only what they need. And big-busted women are advised to get bras with more support to ease shoulder strain.
Glove your hands. Wear gloves with thick palm padding—like work gloves—whatever you’re holding something tightly. With thick gloves you don’t have to exert as much force on the hand joints to hold a heavy skillet, a broom or a wrench. Also, you can build up handles of tools and garden supplies with foam rubber padding or terry cloth, so you’re exerting less force on the joints.
Never squat or kneel. That the worst thing you can do to arthritic knee or hip joints.
Wear running or walking shoes whenever possible. To ease the pressure on aching feet, you want footwear that provides comfort and support. When shopping for dressier footwear, look for shoes that have a wide toe or box and good, built-in arch support. The best shoes have heels approximately 1 to 1 1/2 inches high, and they come up high on the instep. For men, lace up oxford, as opposed to slip-on, is the preferable dress shoe.
Stay active. Probably the most important thing you can do for osteoarthritis is exercise as much as you’re able to. You’ll find that the better your physical condition, the less arthritis pain you will have. Recommendation: low-impact aerobic exercises and, if tolerated, very light weight lifting with one- to two-pound dumbbells. Build up the tissue around your joints. They key is to do it regularly, no less than three times a week preferably. Daily exercise is better if possible.
Learn your food “triggers.” Some people find that their rheumatoid arthritis seem to flare up after eating certain foods—especially alcohol, milk, tomatoes, and certain nuts. Although there is really no telling what your trigger might be, if you notice that your condition worsens after eating a certain food, then listen to your body and avoid that food. The same goes for foods that improve arthritis, such as fish and fiber; try to eat them more regularly.
Take time to smell the roses. When you’re tensed up, you hurt more. Many people use relaxation as an effective way of diminishing arthritis pain. It does not matter what you really do; biofeedback, meditation, even listening to music—whatever helps you relax. The point is to practice a regular relaxation periods and then also to use relaxation when pain is particularly severe.
Slim down. Being overweight can enhance damage to joint by putting excess pressure on them. In fact, being overweight increases your chances of developing osteoarthritis, even if you don’t have it now.
Try slow dancing. Dancing is a good way to combine weight loss, exercise and stress reduction. Many of my patients participate in easy dance routines created as part of an overall education and activity program that show them how to exercise while protecting their affected joints. Easy dancing is perfect for those with inflammatory arthritis, or osteoarthritis because it is low impact.
Reach for the “right” pain reliever. Not all pain relievers are the same—at least for those with arthritis. People with inflammatory arthritis should get more relief from aspirin or ibuprofen (Advil) but may get more stomach irritation with these. Over-the-counter pain relief without stomach irritation, the recommendation is Tylenol. Recommended doses of these drugs should not be exceeded, nor regular dosing continued, for more than three weeks without consulting your physician.
Immobilize the pain. Splints, sling, cervical collars and other protective devices are extremely useful when an area is particularly painful or inflamed. Even though these devices help reduce pain, your muscles can rely on them and weaken very much.
Use ice and heat judiciously. Although both ice packs and heat packs can provide some relief, don’t use either for more than ten minutes at a time. Usually ice is used to prevent swelling but may also douse pain; heat in small doses may promote muscle reactions and sooth pain.
Source: Paul Caldron, D.O., Clinical rheumatologist and researcher at the Arthritis Center in Phoenix, Esther Lipstein-Kresch, M.D., an assistant professor of medicine at the Albert Einstein College of Medicine of Yeshiva University in New York City. Joseph Hollander, M.D. and professor emeritus of medicine at the University of Pennsylvania Hospital in Philadelphia,
When you do see a doctor about that blasted pain, he will usually tell you what kind of arthritis you have. Although there are more than 100 different types, most fall into two broad categories.
Inflammatory arthritis (or rheumatoid arthritis) is the best treated with anti-inflammatory drugs, through diet and lifestyle changes may help. Non-inflammatory arthritis (or osteoarthritis) results when cartilage in joints deteriorates from injury or excessive use. Weight control, proper exercise and pain relievers are the key treatments here.
Eat your Vegetables. Researchers at the University of Oslo in Norway discovered that people with rheumatoid arthritis who began a vegetarian diet saw dramatic improvements in their conditions within one month after cutting out meat, eggs, dairy products, sugar and foods with gluten, such as wheat bread. A vegetarian diet is good, because the goal for arthritis sufferers is to cut as much saturated fat from their diets as possible and replace it with more polyunsaturated fat.
Try something fishy. One of the best sources of polyunsaturated fat is cold water fish such as salmon, sardines and herring. They are rich in omega-3 fatty acids, which have been shown to have some minor beneficial effect on reducing the inflammatory aspects of arthritis.
Get hot on hot pepper cream. Research shows you can ease the pain by rubbing the joint with an over-the-counter ointment called Zostrix, made from capsaicin—the stuff that puts the hot in hot peppers. You u need to apply it three or four times a day on the affected area for at least two weeks b before you’ll see any improvement. An initial burning sensation at the site is not unusual for the first few days, but this goes away with continued application. Washing your hands immediately after application is advised.
Use a Dehumidifier. If the Humidity is kept constant in your house, it can help calm arthritis pain caused by weather changes. When rain is on the way, the sudden increase in humidity and decrease in air pressure can affect blood flow to arthritic joints, which become increasingly stiff until the storm actually starts. If you close the windows and turn on the dehumidifier—or run the air conditioning in the summer—you may be able to eliminate this short-term but significant pain.
Remedies for your specific aches
From head to toe, there are specific arthritis treatments for specific body parts:
Give your neck a break. Don’t extend your neck by looking up for long periods. If you’re painting, hanging curtains or doing other work that requires you to look up for a long time, get a ladder and bring yourself to the same level as you work.
Support your shoulders. Don’t sleep with your arms over your head, because that strains your shoulders. Advice for women, lighten your handbags so that they carry only what they need. And big-busted women are advised to get bras with more support to ease shoulder strain.
Glove your hands. Wear gloves with thick palm padding—like work gloves—whatever you’re holding something tightly. With thick gloves you don’t have to exert as much force on the hand joints to hold a heavy skillet, a broom or a wrench. Also, you can build up handles of tools and garden supplies with foam rubber padding or terry cloth, so you’re exerting less force on the joints.
Never squat or kneel. That the worst thing you can do to arthritic knee or hip joints.
Wear running or walking shoes whenever possible. To ease the pressure on aching feet, you want footwear that provides comfort and support. When shopping for dressier footwear, look for shoes that have a wide toe or box and good, built-in arch support. The best shoes have heels approximately 1 to 1 1/2 inches high, and they come up high on the instep. For men, lace up oxford, as opposed to slip-on, is the preferable dress shoe.
Stay active. Probably the most important thing you can do for osteoarthritis is exercise as much as you’re able to. You’ll find that the better your physical condition, the less arthritis pain you will have. Recommendation: low-impact aerobic exercises and, if tolerated, very light weight lifting with one- to two-pound dumbbells. Build up the tissue around your joints. They key is to do it regularly, no less than three times a week preferably. Daily exercise is better if possible.
Learn your food “triggers.” Some people find that their rheumatoid arthritis seem to flare up after eating certain foods—especially alcohol, milk, tomatoes, and certain nuts. Although there is really no telling what your trigger might be, if you notice that your condition worsens after eating a certain food, then listen to your body and avoid that food. The same goes for foods that improve arthritis, such as fish and fiber; try to eat them more regularly.
Take time to smell the roses. When you’re tensed up, you hurt more. Many people use relaxation as an effective way of diminishing arthritis pain. It does not matter what you really do; biofeedback, meditation, even listening to music—whatever helps you relax. The point is to practice a regular relaxation periods and then also to use relaxation when pain is particularly severe.
Slim down. Being overweight can enhance damage to joint by putting excess pressure on them. In fact, being overweight increases your chances of developing osteoarthritis, even if you don’t have it now.
Try slow dancing. Dancing is a good way to combine weight loss, exercise and stress reduction. Many of my patients participate in easy dance routines created as part of an overall education and activity program that show them how to exercise while protecting their affected joints. Easy dancing is perfect for those with inflammatory arthritis, or osteoarthritis because it is low impact.
Reach for the “right” pain reliever. Not all pain relievers are the same—at least for those with arthritis. People with inflammatory arthritis should get more relief from aspirin or ibuprofen (Advil) but may get more stomach irritation with these. Over-the-counter pain relief without stomach irritation, the recommendation is Tylenol. Recommended doses of these drugs should not be exceeded, nor regular dosing continued, for more than three weeks without consulting your physician.
Immobilize the pain. Splints, sling, cervical collars and other protective devices are extremely useful when an area is particularly painful or inflamed. Even though these devices help reduce pain, your muscles can rely on them and weaken very much.
Use ice and heat judiciously. Although both ice packs and heat packs can provide some relief, don’t use either for more than ten minutes at a time. Usually ice is used to prevent swelling but may also douse pain; heat in small doses may promote muscle reactions and sooth pain.
Source: Paul Caldron, D.O., Clinical rheumatologist and researcher at the Arthritis Center in Phoenix, Esther Lipstein-Kresch, M.D., an assistant professor of medicine at the Albert Einstein College of Medicine of Yeshiva University in New York City. Joseph Hollander, M.D. and professor emeritus of medicine at the University of Pennsylvania Hospital in Philadelphia,
Monday, March 16, 2009
What are fertility problems?
You may have fertility problems if you have not been able to get pregnant after trying for at least 1 year. Another word for this is infertility. Infertility may not mean that it is impossible to get pregnant. Often, couples conceive without help in their second year of trying. Some do not succeed, but medical treatments help many couples.
Age is an important factor if you are trying to decide whether to get testing and treatment for fertility problems. A woman is most fertile in her late 20s. After age 35, fertility decreases and the risk of miscarriage goes up.
If you are younger than 35, you may want to give yourself more time to get pregnant.
If you are 35 or older, you may want to get help soon.
What causes fertility problems?
Fertility problems can have many causes. In cases of infertility:1
About 50 out of 100 are caused by a problem with the woman’s reproductive system. These may be problems with her fallopian tubes or uterus or her ability to release an egg (ovulate).
About 35 out of 100 are caused by a problem with the man's reproductive system. The most common is low sperm count.
About 5 out of 100 are caused by an uncommon problem, such as the man or woman having been exposed to a medicine called DES before birth.
In about 10 out of 100, no cause can be found in spite of testing.
Should you be tested for fertility problems?
Before you have fertility tests, try fertility awareness. A woman can learn when she is likely to ovulate and be fertile by charting her basal body temperature and using home tests. Some couples find that they simply have been missing their most fertile days when trying to conceive.
If you are not sure when you ovulate, try this Interactive Tool: When Are You Most Fertile?.
If these methods don't help, the first step is for both partners to have some simple tests. A doctor can:
Do a physical exam of both of you.
Ask questions about your past health to look for clues, such as a history of miscarriages or pelvic inflammatory disease.
Ask about your lifestyle habits, such as how often you exercise and whether you drink alcohol or use drugs.
Do tests that check semen quality and both partners' hormone levels in the blood. Hormone imbalances can be a sign of ovulation problems or sperm problems that can be treated.
Your family doctor can do these tests. For more complete testing, you may need to see a fertility specialist.
How are fertility problems treated?
A wide range of treatments is available. Depending on what is causing the problem, you may be able to:
Take a medicine that helps the woman ovulate.
Have a procedure that puts sperm directly inside the woman (insemination).
Have a surgery that corrects a problem caused by endometriosis or blocked fallopian tubes.
Have a procedure to increase the man’s sperm count.
If these options are not possible or don't work for you, you may want to consider in vitro fertilization (IVF). During an IVF, eggs and sperm are mixed in a lab so the sperm can fertilize the eggs. Then the doctor puts one or more fertilized eggs into the woman’s uterus. Many couples try IVF more than once. Of women who try IVF:2
Up to 40 out of 100 of those younger than 35 have a baby.
About 20 out of 100 women who are age 39 have a baby.
About 6 out of 100 women who are age 43 have a baby.
Treatment for fertility problems can be stressful, costly, and hard on your body. Before you start testing, make some decisions about what you want to do. You may change your mind later, but it’s a good idea to start with a plan.
Learn all you can about the tests and treatments, and decide which you want to try. For example, some couples agree to try medicines but don't want surgery or other treatments.
Find out how much treatments cost and whether your insurance will cover them. If you don't have insurance coverage, decide what you can afford.
Treatments for infertility can increase your chances of getting pregnant. But they also increase your chance of having more than one baby at a time (multiple pregnancy). Be sure to discuss the risks with your doctor.
Fertility problems can put a lot of strain on a couple. It may help to see a counselor with experience in infertility. Think about joining an infertility support group. Talking with other people with the same issue can help you feel less alone.
Sunday, March 15, 2009
Endometriosis
As if those monthly cramps weren’t enough, now your period has been punctuated with new pain. Maybe your lower back aches more than an overaggressive bellboy’s or you feel pain during bowel movements or sex.
Your doctor may tell you its endometriosis, a condition that occurs when the tissue that lines the uterus becomes implanted on their pelvic organs—usually on the overaries, the fallopian tubes or the ligaments that support your uterus. It may affect the bowel, bladder, or urters as well. This misguided tissue imitates the menstrual cycle, leaving a discharge that can’t exit the body and cause inflammation and scarring. It can also cause infertility in a small percentage of women.
Pregnancy and breastfeeding can end symptoms of endometriosis, but here are some easier and faster ways to get relief.
Get into workouts. While a rigorous workout may be the last thing on your mind when pain strikes, plenty of exercise is often recommended. Research shows that women who exercise on the regular basis have less endometriosis pain and easier periods.
Exercise decreases estrogen production—and estrogen makes the disease worse. Recommendation, a vigorous workout three to six times a week for at least 30 minutes each time.
Eat for a stronger immune system. Just as a diet influences the severity of the diseases, it may have a role in causing endometriosis pain. There are data suggesting an association of autoimmune disease with both the risk of developing endometriosis and the extent or severity of endometriosis. To build a stronger immune system, eat plenty of fresh fruits and vegetables that are rich in vitamins. Vitamin C is especially important, so fill up your plate with vegetables and fruits such as broccoli, red bell peppers, oranges, strawberries and cantaloupe—all high in vitamin C.
Don’t forget fish. Rich in omega-3 fatty acids, fish such as mackerel, herring and sardines are also helpful, because they suppress prostaglandin production. Prostaglandin is a hormone in the uterine lining that causes cramping.
Try hands-on healing. Acupuncture relieves pain in some women. When pain begins, press the area on the inside of your leg about two inches above your ankle bone. To locate that spot, press with your thumb until you locate an area that feels tender. Another spot where pressure can ease pain is the web of your hand, at the base where the bones of your thumb and index finger meet. If it doesn’t hurt when you press it, it’s not the right spot. Know that it will hurt, but you need to keep pressing, and you should feel relief in the pelvic area.
Keep a calendar of symptoms. If you know when endometriosis pain is likely to occur each month, you can plan around it. Charting helps you get control your disease, so you can plan your life better. For instance if you know that you always have severe pain on the 22nd day of your cycle, you can avoid planning important events for that day. You can also plan your pain relief medications prior to that day, so you won’t wake up on the 22nd day with severe pain.
Sources: Owen Montgomery, M.D., and OG/GYN specialist at Thomas Jefferson University Hospital and Jefferson Medical College. Dan Martin, M.D. Clinical associate professor of OB/GYN at the University of Tennessee and a reproductive surgeon at Baptist Memorial Hospital. Gynecology and fertility specialist Camran Nezhat, M.D., director of the fertility and endoscopy center and center for Special Pelvic Surgery in Atlanta. Susan Anderson, sufferer and member of the national board of the Endometriosis Association self help group based in Milwaukee.
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