Hiring a Veterinary Locum for Your Holiday Needs

Taking a vacation from your business can be very stressful. Finding a locum vet replacement can seem impossible, and the idea of a stranger stepping into your clinic to be the face and reputation of your business is daunting. Everyone needs a vacation, and it is usually best to keep your doors open. How will the locum fit into the group dynamic with the support staff? Will the clients like the locum? Will the clinic make any money while you are gone? What if the locum is horribly incompetent? Do you find yourself wondering if you really need that vacation after all (answer: Yes you do!)

Here you will find some points to consider, that I have learned as a locum, and through conversations with locums and practice owners. My biggest tip is to have a checklist (contact me for a sample) of things that should be discussed with your locum in advance. Read on to learn questions that you might not even think to ask!

Billing

Your first task with your newly appointed locum is to get a contract. If the locum does not provide you with one you should ask for one. This should outline at a minimum; dates and times of work, arranged payment and any extras like accommodation or on call duties.

Make sure that your billing policies are clear. You may think it obvious that you give a 10% discount to Peter and his Pomeranians, or that you charge extra for a nail trim if it takes three people. The locum should be billing according to your written fee guide. In addition, the locum should not be responsible for determining fees, discounts or payment. Have these in writing, or, if available, delegate this responsibility to a trustworthy senior staff member who knows your client relationships.

A locum is not necessarily going to make you money. If you accept this before your vacation you may be less stressed on your return. Profits should be considered an added bonus to your vacation. Your job is to relax, the locum’s job is to hold down the fort and see the work presented to them. You can’t force your clients to see a locum, and some clients will wait for your return for routine appointments.

Appointments

Scheduling a day for a new locum can be challenging. The locum does not know the clinic, the staff, the clients or the clinic layout. Be honest about how you book your appointments. Locums are also usually very meticulous about records, to avoid miscommunication, which takes some time. Most locums charge a fee for time out of hours.

At all costs, avoid the client surprise! It is crucial that clients know they are seeing a locum. Many clinics are worried that they will lose money on a locum day (see note in Billing). An unfortunate experience for everyone is when the locum walks in the room, and the client exclaims “Where is Dr. X today?!?” with an accompanying horrified expression. Here’s what I suggest; when a client books an appointment, the receptionist will say “Thank you Mrs. Jones, your appointment is on Tuesday at 4pm with Dr. Smith”. In this case, a client who wants to see Dr. X will say that they would prefer to see Dr. X, which can then be arranged if possible. A client who is willing to see a locum will not comment and come to the appointment. Certainly this is a great opportunity to promote the locum, for example; “Dr. Smith is a great veterinarian with 8 years experience, and she cares very much about the animals in her care. Dr X trusts her and other clients are really happy with her”

Technical skills

During the first few days with a locum there will be an adjustment period to find out where the locum’s skill sets fit in with your practice. The locum should be informed whether an AHT is on staff. If there is no AHT then the locum has the right to dictate what procedures are acceptable. Avoid booking a solo new or locum AHT with a solo locum veterinarian, a recipe for potential disaster.

A locum will also likely not know how to use your x-ray machine, so have staff on site that are trained, or have a contingency plan for cases requiring radiology, such as a neighbouring clinic or referral centre.

Don’t micromanage! Or worse, delegate a staff member to micromanage for you! A good locum tries to fit in with the practice philosophy but will do things the way they see fit. Locums will not necessarily use your first choice of antibiotic, suture pattern or type, etc. Locums must be given the flexibility to work within their comfort zone. By having a discussion about case management styles, using a checklist, and your very specific requirements in an interview ahead of time, an understanding is possible.

Euthanasia, in my experience, is a source of potential conflict. If you are particular about your euthanasia method, use your checklist to discuss with the locum (i.e. whether an IV catheter is placed, whether the animal is sedated, owners present, whether the locum will agree to “convenience” euthanasia)

We all know vets with different comfort levels with surgery. Get a list of acceptable surgeries from the locum. Do not book a locum a cruciate surgery without confirming that they do this procedure, and their experience – is it their second or seventieth time doing a cruciate? Some locums may not do cosmetic surgeries such as tails, ears, declaws, and debarking, if you expect your locum to do these procedures use your checklist to discuss them.

Be honest about your caseload; use your checklist to review with the locum. Do you see birds sometimes for beak and wing trims? No big deal? A locum might feel completely overwhelmed. Do you book 10 minute or 30 minute appointments? How many surgeries do you perform in a morning? Make sure your locum comes prepared for the pace at your clinic.

Case Management

Most locums enjoy their job because they love learning new things; however the locum should have the flexibility to do things their own way. Your staff may feel like they are protecting your interests by telling the locum how you do things, but this can make a stressful experience for staff and locum if not delivered delicately. Discuss with your staff in advance how they should deal with these situations.

What do you do with emergency cases? A locum might not feel comfortable hospitalizing a patient overnight with no staff in attendance. If a locum stays to see an emergency they will likely charge extra. Use your checklist to discuss! Also, what should the locum do with a referral? Discuss your referral policies with the locum in advance, but respect the locum’s comfort zones.

What are your routine protocols like vaccines? Heartworm and deworming protocols? Do you vaccinate for Feline Leukemia? All cats? Only indoor cats? Do you require a blood test prior? Do you vaccinate with a three year or one year vaccine? Iron out any issues with routine procedures before the locum comes to the clinic. Use your checklist and make sure the locum is getting the correct information directly from you, to avoid confusion during the locum term.

If a checklist sounds like a lot of work, I guarantee it is a lot easier than dealing with a mutiny from your support staff because the locum went horribly wrong (I see you grimacing because we have all been there!). Ask your staff for help designing or editing your checklist. If you have specific policies, some idiosyncrasies, or you like to tap your feet three times before you spay a cat, your support staff certainly know it – probably better than you do!

Summary

1. Get your staff and clients excited about your locum, focus on the locum’s positive attributes and the new ideas they will bring to the practice.

2. Find a locum that makes you think about your vacation and not the practice.

3. Use your checklist to discuss how your practice works.

4. Make sure you have a detailed contract – and verify their license status.

5. Consider any profit a bonus.

6. Hire a locum for a day if possible in advance of a large block of time to iron out any conflicts.

7. Have a checklist of issues to review before you go to minimize any misunderstandings – Did you read the title? I know I said this already – are you getting the picture? You can get a sample by contacting me at info@canadalocum.com or check out http://www.canadalocum.com. Give a copy to the locum, so you both know what you have discussed before you go on vacation. Give a copy to the support staff so they know how to book appointments.

8. Enjoy your time off!

Beware Of Zantac Side Effects

Zantac is a medication that is commonly prescribed by doctors to reduce the amount of acid produced by the stomach.  Drugs like Zantac are most often prescribed to patients suffering from acid reflux disease, gastroesophageal reflux disease (GERD) and Zollinger-Ellison syndrome. Although your doctor may have prescribed Zantac, you need to be aware of the many possible side effects.

The active ingredient in Zantac is ranitidine hydrochloride and belongs to the H2-antagonists group of medications. Ranitidine is used to reduce stomach acid to minimize the pain from heartburn and ulcers, to prevent ulcers and to aid in recovery from ulcers. While these drugs may help many suffering from these problems you should know which Zantac side effects are normal and which need to be reported to your doctor immediately.

Before medicine like Zantac is approved for treatment, it undergoes clinical trials to assess the side effects. These clinical trials are typically performed on thousands of people and compared the side effects to those given a placebo. However, once a medication is approved, there are often no more trials. 

The recommended approved dosage for Zantac users is between a 150mg dose once a day to 300mg twice a day. Zantac comes in various strengths and forms including; Zantac 15 syrup, Zantac 25 vial, Zantac 75 vial, Zantac 150 tablets and Zantac 300 tablets. There are many different factors that affect the correct dose including your body weight, other health problems and other medicines you are taking. As with any other medication you must carefully follow the directions given to you by your pharmacist and doctor.

Drugs like Zantac can have a wide range of side effects, with some being very minor and others possibly life threatening. Of course not everyone will suffer from these side effects or the same side effects. Commonly reported Zantac side effects include the following; headaches, diarrhea, constipation, upset stomach, abdominal pain and rash. More serious possible Zantac side effects that need to be reported to your doctor include; confusion, agitation, hallucination, depression, fast heart beat, slow heart beat, abnormal heart rhythms, hepatitis and liver problems includes yellowing of the eyes, dark urine and pain in the abdomen or Angioedema a life threatening swelling of the nose and mouth.

Zantac side effects that suggest an allergic reaction could range from an unusual rash and itching to wheezing and trouble breathing to swelling of the throat and mouth. Rare Zantac side effects that some patients have suffered include; dizziness, drowsiness, insomnia, muscle and joint pain, hair loss and blurred vision.

Natural health remedies are a safe and effective alternative to dangerous prescription medication side effects.  You can cure acid reflux using 3 everyday items found in most kitchen cabinets.

Home Remedy for Cold Sore Treatment – How to Stop Lip Fever Blisters

When you hear the phrase home remedy for cold sore it can bring up questions about the validity of those kitchen recipes and if they are valid. Looking on the internet can reveal a variety of suggestions which may be overwhelming. More importantly, the lip is a fragile area and if you have a fever blister or herpes sore there, you don’t want to aggravate it or create additional problems or infections.

First of all , look at your diet to see if you are eating a lot of foods high in argine (an amino acid). Foods such as peanuts, peanut butter, protein powder or certain grains can put your system vulnerable to cold sores. Taking a lysine supplement and minimizing these foods high in argine is helpful. Argine is in a lot of body building products. Lysine supplements are in the health food store and the body doesn’t produce lysine.

I’ve read that some people recommend vaseline, but my own experience is that when I was camping once I used it and the cold sore on my lip then became three cold sores! Although vaseline softens the skin, for me it spread the virus. When you read a recommendation on the internet, be sure to see if there are more testimonials for that approach to try to validate it. Remember that sometimes people also try to sell products and prey on people on forums to sell their wares.

Remedies that people seem to agree upon are applying ice, applying a tea bag (due to the tannic acid), increasing b-complex vitamin, taking lysine regularly and sage tea. Also getting enough sleep and improving your immune system is helpful because we are susceptible to viruses when it is weak. In fact, the term cold sore is used since people get it before a cold at times when their immune system is low and they are run down.

Qualifications and Skills Required For Industrial Engineering Jobs

Job of Industrial Engineer

The estimation of production cost, creation of effective product design, development of production standards, revision of production schedules, delegation of responsibilities to the workers and completion of production within the given time frame are the major tasks executed by an engineer.

Industrial Engineer decides and monitors the quality control objectives, and resolves any sort of problem that occurs during the production process. His main focus is always on the efficient production and cost minimization. He also keeps an update of the project status, purchases, manufacturing and production processes. Also, the design, layout and draft of the equipments and materials are summarized by him.

Required Qualifications

Mechanical knowledge is one aspect without which a person can not realize the dream of making a career in industrial engineering. An engineering degree coupled with the knowledge of industrial production and technology is the foremost qualification required for a job of industrial engineer. A keen design sense, command on English language and computer knowledge are the other requirements to do the work of an industrial engineer.

A strong background of Mathematics is compulsory since the work involves the application of arithmetic, calculus, algebra, geometry and statistics. The job profile also demands a command on management and administration principles which are the basic tools for resource allocation, production and strategic planning, and; work coordination and delegation.

Skill Requirements

An ability to think logically and critically helps industrial engineers to weigh the various available options and take the best decision in favor of efficient production. They should also possess the active listening and fast reading skills to take the desired steps in flick of seconds. Quick decision making and excellent time management skills make the person doing industrial engineering jobs, quite resourceful.

Candida Albicans Fungi Home Remedies

Candida albicans fungi is a ubiquitous organism that is present in approximately 80% of all humans living on the earth. Candida albicans is a common member of intestinal microbiota (bacterial flora). The majority of the Candida albicans living within humans is commensal; rarely producing any symptoms associated with Candidiasis. Candida albicans can become a hazard to the body whenever conditions become favorable to its growth. When Candida albicans multiplication is unrestricted, a harmful yeast infection quickly ensues.

Yeast infections are nothing more than an infestation of Candida albicans at a specific location in the body. The most common locations for Candida albicans overgrowth include various areas of the digestive system (esophagus, intestines) oral cavity, and the genitals (more frequently occurring in the vagina than the penis).

Whenever Candida albicans fungi invades the vagina it often attacks in such a way to produce painful symptoms that make yeast infections extremely exasperating. Common symptoms include a thick, cottage cheese like discharge and various forms of vaginitis.

Systemic yeast infections, a more severe form of yeast infection, result when Candida albicans invades multiple areas of the body. Systemic Candida albicans infections can cause a wide variety of symptoms that may not be commonly associated with Candidiasis. For this reason, it is essential to keep Candida albicans in check; especially if you suffer from an immunological disorder, such as HIV. Systemic fungal infections have been often related to morbidity in individuals suffering from a compromised immune system.

If you are searching for information on Candida albicans fungi is often thought of as a harmful organism. However, as mentioned earlier, it can help keep dangerous pathogens at bay, much like probiotics such as acidophilus. For more information on probiotics and yeast infections, check out my Acidophilus Yeast Blog. Fungi, like bacteria, also use the resources in an environment to maintain themselves. As a result, when fungi is present, it can help stymie the growth of harmful bacteria; keeping the body safe from deadly microbial life. It is only when Candida albicans fungi overgrows does painful Candida albicans fungi infestations occur. The only course of action then is to remove it.

According to Bill Gottlieb in Alternatives Cures: The Most Effective Home Remedies for 160 Health Problems, there are a few powerful natural treatments that can rid the body of unwanted Candida fungus. Gottlieb states:

[Grape seed extract] is a very potent anti fungal that can help kill Candida, says Dr. Metzger. Because it’s so potent, she cautions women not to use more than is recommended on the label. Continue treatment with capsules for 3 to 6 months she advises… [Additionally,] take 500 milligrams three or four times a day for 4 to 6 weeks…Eat highly colored foods such as…peppers…leafy vegetables; and a variety of squashes.
(Alternatives Cures page 238)

There are many different plans of attack when it comes to removing Candida albicans fungi from the body. Before you use any of them, make sure you consult your doctor. You never want to try something you are unsure of, as there are many dangerous treatments that you may encounter without realizing it. Trusted herbalists are an excellent place to get exceptional advice that will most likely be effective and extremely safe.

For more information consult What Is Yeast Infection dot com; a comprehensive website with detailed information on Candida albicans fungi and yeast infection treatments. You will not only find a variety of the best treatments but a comprehensive compilation of Candida albicans facts. Using What is Yeast Infection dot com may be able to help you greatly!

Ways for Men Over 60 to Deal with Erectile Dysfunction

As a man gets older the ability to get and to maintain an erection can be harder. Some men find it just takes a bit more foreplay. They may also find they can’t get a second erection soon after like they once could. This is normal and most couples find it to be an issue they can easily deal with. They are still able to have a very satisfying sex life in spite of such minor issues.

However, some males end up with what is know as erectile dysfunction. This can become a serious issue that affects the individual both mentally and physically. At first they may only have the problem once in a while. It can be embarrassing but couples can deal with it. The partner needs to be very encouraging and supportive so it won’t become a mental issue the next time sex is initiated.

For other men though erectile dysfunction can end up being a very serious problem. It can result in them becoming angry or upset. It can also lead to depression as many men do associate their manhood with their ability to have sexual intercourse. There are many reasons why a man may suffer from erectile dysfunction when they are 60 or older.

Medical concerns are the number one factor. Heart disease, high blood pressure, and even diabetes can all cause erectile dysfunction. Seeing a professional about what is going on is very important. They can help prescribe medications that can help with the issue. Sometimes it turns out to be the medications that you are on that make it hard to get an erection. The doctor can help to determine the cause and get the person back on track.

Mentally a man can prevent himself from being able to get an erection. Issues about not being able to in the past can certainly cause a great deal of anxiety. Not feeling attractive or worrying about being able to perform can also be a problem. Talking to your partner about your fears can help to alleviate them.

Changing lifestyle habits can really make a difference too. Some men over 60 aren’t able to get an erection due to heavily smoking or drinking. Working to get rid of these habits can help the issue of erectile dysfunction to take care of itself. Likewise, changing your diet and losing weight can be helpful as well.

There are several reasons why males over 60 years of age may be experiencing erectile dysfunction. Yet it doesn’t have to mean the very end of your sexual lifestyle. There are ways to deal with it that can get you back on track again. Be willing to try different things in order to get to the bottom of your problem.

One of the most frustrating things for men with erectile dysfunction is that it can take time to discover what is going to make a difference. You have to be willing to follow the doctor’s orders. You have to be open to trying a course of action for a couple of months and then exploring another one if that one wasn’t effective for you.

Sex for men over 60 is still very important and it can be very fulfilling. Don’t be afraid to look at your lifestyle to see where you can make changes. Go to a doctor you can trust and you are comfortable with. This way you can share your feelings and discover what your options are for effectively dealing with erectile dysfunction.

Some of the different treatments that a doctor can offer include various medications. With advances in technology there are also implants that are surgically placed inside of the penis. Counseling can be very effective when the doctor feels there may be a mental link to the erectile dysfunction. Exploring the various options can help you to be able to get and maintain an erection again like you did when you were younger.

Must Know Before Getting Close To Menopause Symptoms

Female body is always going through several hormonal changes especially her reproductive system and hence, it is necessary to get the exact details about Menopause symptoms. More than 70 per cent of females have to face these symptoms while getting closer to menopause. Normally, these symptoms will begin to appear from the first stage of menopause. Females around the age of 38 to 40 start experiencing the symptoms of menopause. If women search on the internet for Menopause symptoms, they will surely get ample number of results. Women may experience certain type of dryness in their vaginal area. Due to genital deterioration, the vagina becomes dry. The portion of vagina may experience some sort of bacterial infections. Some of the menopause signs are cold and hot flashes as well as night sweating.

But, before going through all these signs, patients may experience irregular cycle of menstruation. Sometimes, woman may have quick bleeding period and in another cycle, she might have normal bleeding. During these days, women behavior is unpredictable. Some remaining signs consist of memory lapses, sudden weight gain or loss, fatigue, brittle nails, weakness in concentration, hair loss, and dizziness. But, it is not necessary that female who is suffering from any of these above mentioned signs is entering the menopause stage. Some symptoms such as softness in the breasts or breast pain, headache, and change of body color are still not clearly seen in women. All these symptoms are varying from female to female.

Nowadays, large numbers of children are suffering with ADHD and hence, person needs to understand more about this disease. It is the need to throw some light on this topic and to spread more awareness in the society. it is sad that still more numbers of parents are not aware with the exact list of ADHD symptoms. From the internet, parents can easily get each and every detail about this dangerous disease. Hyperactivity is considered as the major ADHD sign which is generally seen in a child. In this symptom, child is not able to sit at one place for a long time and he or she is always moving around. Even if he or she engaged with some kind of task, child is talking constantly. Inattentiveness is also one of the major ADHD symptoms. Kid who is experiencing this symptom is unable to pay constant attention on the single task and child gets quickly bored or distracted.

Some ADHD patients show Impulsiveness and these suffering children are quite impatient and they are not ready to wait for their turn at the game. The behavior of these kids is improper because in a wrong condition, they comment unpredictably. Symptoms like impulsiveness and hyperactivity are some of the signs which are easy to detect.But, inattentiveness is the only symptom that can be difficult to detect. According to the research studies, it is confirmed that patient exhibit some of these signs around 6 months before this disease can be detected. Hence, to save the child, regular check up is the best option which helps to detect this disorder.

Exponential Growth and Music

A sequence of numbers increases or decreases exponentially when you get each number from the previous one in the sequence by multiplying it by a particular number. For example, the sequence 1, 2, 4, 8, 16 is generated by multiplying by 2. This number you multiply by obviously changes for different sequences.

Some people claim that mathematicians are often good musicians, although if you ever heard me play the piano, you might not agree! Using music to introduce exponential growth follows a valuable theme: there is a mathematical pattern in something we can recognize around us. Most of us can hear an octave in music, or a dominant chord or a subdominant, even though we may not be able to put a name to any of them. So, something around us fits a pattern; that pattern is about to be revealed.

When a symphony orchestra tunes up, one instrument, usually an oboe, plays a note and the other instruments tune relative to it. That note is the A-above-middle-C which sounds when air vibrates at 440 beats per second. A note one octave (8 notes or 13 semitones) below this is heard when air vibrates at 220 beats per second (220 is half of 440). An octave above the A will vibrate at 880 beats per second. The twelve spaces between the thirteen semitones of a scale are equally divided these days. This division is called “equal temperament” and is what J. S. Bach meant when he used the title “The Well-Tempered Clavier” for one of his major works.

The technical term for “beats per second” is “Hertz;” A has 440 Hertz (Hz).

As each note rises in pitch by one semitone, the number of beats per second increases by 1.0595 times. If you want to check the figures in the list below, you might like to take this increase as 1.0594631.

Here is a list of the beats per second for each of the notes (semitones) in a scale starting at A. The figures are to the nearest whole number. Note that the sequence of numbers is an exponential sequence with a common ratio of 1.0594631. Who would have guessed?

A is 220 Hz, A# is 233, B is 247, C is 262, C# is 277, D is 294, D# is 311, E is 330, F is 349, F# is 370, G is 392, G# is 415, A is 440.

For the musical fuss-pots among you, note that I had to put D# rather than E flat because there is a symbol for “sharp” – the hash sign – on a keyboard, but not one for “flat.”

When playing music in the key of A, the other key you are most likely to drift into from time to time is E, or the Dominant key of A which is what it is called. If you want to make a grand final bar or two to your next piece of music, you will probably finish with the chord of E (or E7) followed by the final chord of A.

Another interesting point here is that the key signature of A is 3 sharps, while the key signature of E is 4 sharps. More of that later.

There is a lovely word in English: “sesquipedalian.” “Sesqui” is a Latin prefix meaning “one and a half,” while “pedalian” gives us “feet.” Notice the word “pedal” here. So the word means “one and a half feet” (in length) and is used sarcastically of people who use long words when shorter words will do. Yet another aside here is that the word sesquipedaliophobia means a fear of long words. Sesquipedaliophobics will not know that, of course!

Now back to music: sesqui, or the ratio of 2:3 takes us from the beats per second of a key, to the hertz of its dominant key. A has 220 Hz. Increase it in the ratio 2:3 and you get 330, the Hz of E, the dominant key of A.

The fun continues! Look at the Hertz of the note D in the list above – 294 – and “sesqui” it, increase it in the ratio 2:3. You will get 294 + 147 = 441 (it should be 440, but we are approximating). So? A is the dominant key of D, and D’s key signature has 2 sharps to A’s 3.

To summarize: here are the keys in “sharp” order, starting with C which has no sharps in its key signature, and increasing by one sharp at a time (G has one sharp).

C, G, D, A, E, B, F#, C#. That will do. Notice they go up by the musical interval of a 5th. To go “downwards” from C, you take away a sharp, or in other words, you add a flat.

I do not have space to show you how to tune a guitar, but it is related to this work and is a lot clearer because you can see the relationships of the keys on the fret-board. Perhaps another article later?

Tinnitus Natural Remedies and Techniques

After you have checked with a physician and found that you do not have any of the physical conditions that cause tinnitus, you will be ready to look at tinnitus natural remedies. The physical causes of this condition include high and low blood pressure, diabetes, allergies, reaction to some drugs, head or neck injury, or tumors. There are over 12 million people who have this condition and as many as a million of them have disruptions in their ability to work and live normal lives.

Tinnitus can occur on one or both ears and it can come on suddenly, then stop, or be continous. A person will hear a roar, squeal, buzz, whining hum, hiss, or clicking. When it is continuous, it often disables sleep, makes it hard to focus, making working difficult and can create problems with your hearing.

Among the triggers for this condition, stress is the one that is most prevalent. New studies have shown that tinnitus is affected by brain activity. A person under stress often triggers the brain activity that creates the condition. When you identify the triggers of your condition, you have more control in treating it effectively.

Environmental conditions or stress are things that you can control. One way to reduce stress is to take a brisk walk each day. This type of exercise will increase circulation and blood flow to your brain. You will also be strengthening and toning your muscles. Many people find that adding walking to their daily activities helps to reduce the ringing in their ears significantly.

Sleep is very important in controlling the condition. Many people find that when they are tired, they encounter more triggers for the condition. A lack of sleep weakens the body and decrees the immune system. When you do relaxation and breathing exercises to reduce stress and get enough sleep, you will be addressing some of the major triggers of tinnitus.

Sudden stops during driving and jerking the head are both triggers for the condition. Loud noise is also one of the triggers. By slowing to a stop and moving the head more slowly you can take care of your condition more easily. Getting away from loud and constant noise will also help in decreasing and eliminating triggers.

As with everything in our lives, diet plays a big part in our health. This condition is no different. Reducing salt in your eating habits and switching out for healthier foods will help you to feel better and stop the ringing in your ears. You will also find that reducing stimulants like coffee, tea, etc., will also help you to reduce the tinnitus.

There are many vitamins, herbs, and homeopathic remedies that are provided to reduce or eliminate tinnitus. Some of these herbs, such as Gingko, may take up to two months to become effective. Others offer a quicker result when they are used regularly.

> The techniques and methods for tinnitus natural remedies include some very basic changes in lifestyle and diet. They also include the addition on supplements, vitamins, herbs, and homeopathic remedies. When you begin looking for a way to stop your ears from ringing, you may need to experiment with different combinations of treatment to find the right remedy for you.

What is the Best Social Anxiety Treatment?

Social anxiety disorder has become a problem of numerous individuals in the modern civilization. Because it prevents people to have a decent social life and a successful career, I have decided to write an article that covers several of the most successful social phobia treatments. Once you end reading it, you will understand precisely what treatments are available at this moment and how to pick the right treatment for you.

The Use of Cognitive Behavioral Therapy for Social Phobia

This treatment is extremely successful and is therefore most commonly used treatment to battle social phobia. This therapy is based on finding the negative beliefs that are accountable for becoming anxious in anxiety provoking situations. This means that the major objective of this therapy is that you discover what beliefs make you feel anxious whenever you find yourself in an anxiety provoking position.

Once you recognize what your negative beliefs are, you have to find better ones that will assist you in social situations. You need to come up with more empowering beliefs that let you do things and meet people without the fear. However, the cognitive behavioral therapy goes even further. Once you are fitted with a new belief system, you need to rehearse your new behavioral patterns in anxiety provoking events. You need to rehearse for as long as needed to feel secure in social situations.

The bad news is that cognitive behavioral therapy may be rather expensive. If you want it to be as effective as possible you need an experienced psychoanalyst and this can be very expensive.

The Next Best Thing is NLP

An additional extremely effective treatment for social anxiety disorder is done with NLP or Neuro-linguistic Programming. NLP makes it possible to experience anxiety provoking events from a different point of view. This makes it less complicated for you to reprogram your brain and consequently your behavioral patterns and responses to social events.

Just like cognitive behavioral therapy, NLP requires an experienced therapist that is capable of guiding the clients throughout the entire process of overcoming social anxiety.

Exposure Treatment and Social Anxiety

Some think that social anxiety disorder can be overcome with exposure treatment. This means that you have to expose yourself to anxiety provoking situations and tolerate the nervousness while you are there. You are expected to do that until you don’t feel nervous anymore. However, exposure treatment alone is not very effective. It takes much more to defeat social anxiety and one of those things is altering the limiting beliefs.

Self-help Treatment for Social Phobia

Before I finish I need to talk about one more extremely successful social anxiety disorder treatment that is truly affordable. Self-help courses and publications have helped numerous people recover from their social anxiety and you must think about this option if you can’t afford an expensive therapy. You should think about following a detailed plan, and you can find one of the better plans for getting over social anxiety disorder in the Social Anxiety Survivor course.

Autism and Anxiety

Autism and Anxiety

We are all vulnerable to feelings of anxiety at various points in our lives and our responses to such can depend on the elements of our ‘fabric’ – those parts of us that make up who we are, the support we have and our abilities to know what to do, how and when.

Some of the elements that make us the individual and unique characters we are, are our personality, temperament, gender, age, life experience, health status, family structure and place in the familial hierarchy; physical, psychological and cognitive abilities, race, religion, culture, economic status…….and so on.

Any shift in or deliberate or accidental assault on any of these elements in our life, can have the effect of producing anxieties for us and as we respond to these experiences, many of the other elements can become adversely affected too.

For a person on the autism spectrum, the impact of an adverse event, for example experiencing bullying, can heighten their experience of resulting anxieties and impact on many of these elements to a debilitating level.

A notable response to anxiety causing experiences is an involuntary condition in an autistic person, appropriately termed – exposure anxiety (as referred to by Donna Williams, an internationally renowned Autism consultant and author). This condition can present as being mildly affective through to being severely incapacitating for the autistic person. It can deeply affect a person’s daily functioning and/or, for example, when social contact or personal performance (e.g. in the classroom) is required or happens in the moment.

When an autistic person is experiencing exposure anxiety, you may observe them, for example, looking down at their feet, or wringing their hands or their hands may be set flat against their thighs, looking fearful or frozen to the spot, or outwardly distressed (e.g. behaviour outburst) and so on. Also, their fight or flight response may be exaggerated and efforts to return their state to a relative calm may be very difficult.

Other indicators of a person experiencing exposure anxiety can be, for example, when the individual feels incredibly self conscious and overloaded and ‘speaks’ through ‘characters’ or phrases from TV shows; jingles; objects; as another person or retreats to a corner, drawing up the knees to their chest; mumbling; tumbling words etc.. Each person’s response to anxiety can be as individual as they are.

Underlying and possibly influencing the intensity of this experience may be undiagnosed and/or previously known medical/health, physical or psychological conditions, such as intolerances to certain substances in foods, depression, phobias etc..

When assisting an autistic person or child with dealing with exposure anxiety, assuming other co-morbid conditions are simultaneously being addressed appropriately, a counsellor, parent or other helper can be most effective in helping alleviate anxieties with and for the (autistic) individual by assuming a non-confrontational/indirect approach with them.

Being non-confrontational can involve, for example;

**being seated beside (nearby) them – not directly in front of them;

**not demanding eye contact (expecting or ‘demanding’ eye contact can ‘shut down’ the autistic person to being receptive to any mutual conversation and it is disrespectful of/to their ‘being’ and dignity);

**speaking at a moderate pace and in a calm, warm manner;

**allowing for quiet times or lulls in the conversation (to allow time for them to process what is being discussed);

**maybe not launching straight into talking directly about the person’s issues of concern – but a short, general conversation surrounding ‘things’ which can make one happy and some ‘things’ which can make one anxious and so on.

**being genuine in your care, desire to help and interaction with them. An autistic person can ‘pick’ a ‘fraud’ or non genuine character a mile off. Their intuition and perception of ‘you’ will immediately determine whether they wish to participate in a conversation, interaction with or trust you.

These are only but a few of the conditions which help create a situation conducive to really assisting an autistic individual presenting with exposure anxiety.

We can assist the autistic person/child to manage and control their exposure anxiety by offering our understanding, empathy and, for example, ‘what to do; how to do and when’ and with behavioral/cognitive management skills and teachings inherent in Cognitive Behaviour Therapy, as well as ensuring that any other ‘conditions (medical or otherwise) are equally addressed.

Other important elements of helping a person eliminate or reduce anxiety can be role playing, modeling, drawing pictures, sand play/therapy, social interaction skills assistance, incorporating their passions and interests, experiencing soothing activities (e.g. horse riding, going to the beach), writing in a journal, music, dance, relaxation exercises….. the list could be endless. The chosen methods, ultimately, are those that are suited to the individual.

P.s. A sense of humour enjoyed with the autistic person is of paramount importance to their happiness, growth, learning experience, wellbeing, bonding with you, learning from you and their feeling of understanding, acceptance, respect and unconditional positive regard from you.

Donna Williams, an internationally renowned Autism consultant, is believed to be the first published author to have written on the subject (and regarding the term) –  ‘Exposure Anxiety’, as it can apply to persons on the Autism spectrum. Her book, “Exposure Anxiety – The Invisible Cage”, informatively explores this subject.

Novel Stem-Cell Procedure Saves A Boy’s Leg

Stem cells have opened so many gateways to personalized medicine that no one could ever imagine a few years back. Not only the traditional transplants, with stem cells, medical practitioners are now able to treat many rare conditions. Thanks to the researchers and their novel techniques, involving stem cells.

This is a story of Javier Tan, a 9 year old boy, who was suffering from a rare genetic illness, Fanconi anaemia, which led his blood count drop to a significantly low levels. He required a stem-cell transplant; so that his body would be able create new blood cells

He received his first stem cell transplant when he was 7. The surgery was meant to save his life but call it irony of fate that it turned his life into a nightmare. Instead of healing, he contracted a bone infection. His condition was so severe that his doctors anticipated he would lose the limb.

In that scenario, the optimum option was to wait for another donor, which might have taken several months. Instead his doctors administrated another transplant and that too within weeks. When his doctors realized that they would require the donor to be only a 50% and not 100%, his father became the donor, who was earlier rejected.

Human leukocyte antigen (HLA) matching is important in both cord blood and bone marrow transplant. It’s a protein, which is found in cells, used to match a donor’s stem cells with that of the patient’s. However, this time Javier’s doctors went for a different method, called haploidentical transplant. In this process, the T-cells, the immune cells that are responsible for attacking foreign elements in the body were removed. So in Javier’s case, the T-cells could not attack the newly transplanted cells.

After seeing the immense improvement, Javier’s mother is very happy. Mrs Vivian Tan recalled the day when doctors told her that they might need to amputate his son’s leg. And now look at him. He is a healthy student of Primary 3, excelling in English and Chinese. His surgery was done in January and Javier was back in school in May. She said, “I am definitely relieved and thankful that he has his health back.”

Dr Rajat Bhattacharyya, the consultant at the department of paediatric sub-specialities at KK Women’s and Children’s Hospital (KKH) confirmed that the new transplant method is versatile enough to find anyone the suitable donor. However, the technique has been in existence since 2010. The National University Hospital (NUH) successfully conducted the procedure successfully on 38 children. The National University Cancer Institute, Singapore (NCIS) has administrated 8 transplants on adults. KKH doctors have treated 4 kids with this technique since October 2014. 10 adult leukaemia patients have been treated with this method by Singapore General Hospital (SGH) since 2004.

The number of patients undergoing haploidentical transplant is gradually increasing. And why not! Without the procedure, the chances of finding the most suitable donor might take several months or year. The haploidentical transplant offers hope for patients, who suffer from rare conditions and are left with minimum hope to live a healthy life ahead.

Sports Injuries That Require Attention From a Shoulder Surgeon

Every now and then, we hear sportsmen suffering from injuries. While they tend to get hurt practically everywhere on their body, one of the most common spot that is susceptible to injury is the shoulder. The most common shoulder injuries seen on field include dislocations, Acromioclavicular joint (ACJ) injuries, rotator cuff tear, shoulder labrum tear thrower’s shoulder, biceps injuries, bursitis and fractures. While dislocations and ACJ injuries are more common in contact sports, such as rugby and wrestling, rotator cuff tears and SLAP lesions are common in sports involving explosive heavy weight-lifting.

Usually, it is quite difficult to identify the severity of a shoulder injury. Which is why, people tend to ignore them further aggravating the injury. Thus, it is advised that early assessment from a skilled

Shoulder Surgeon or Therapist is the right way forward when experiencing discomfort in the shoulders.

There are number of injuries known to be common on field. The most prominent of which are listed below:

Shoulder Dislocations

Being the most mobile joint in the body also makes the shoulder potentially unstable. Therefore, it becomes a common joint for dislocations in the body. Minor traumas in the shoulder result in the shoulder to ‘pop out’ of the joint. To fix it, the doctor fixes it back into the joint following by rounds of physiotherapy.

But, more than half of dislocations hold possibility of recurrence, especially among the youth indulging in sports. Repeated dislocations lead to more instability and stretching of the shoulder joint that require long periods of rest and decreased performance. Therefore, it is generally recommended that one should opt for shoulder dislocation surgery before the injury aggravates.

Rotator Cuff Tears

The rotator cuff is a crucial bunch of tendons that provide movement and stability for the shoulder. Therefore, in the event of damage, pain and weakness in the area can be significant. Those who choose to fix these tears early show faster recovery. That’s because when left unattended, these tears get bigger and more difficult to repair later on. Rotator cuff repair can be done by keyhole surgery or open surgery.

SLAP Lesions

Superior Labral Antero-Posterior (SLAP) tears of the shoulder are common among those in sports requiring overhead throwing, heavy lifting and tackling. In most cases, the biceps anchor in the shoulder is forcibly peeled or pulled off its bone attachment by a large pulling or peeling force. This can occur during a heavy lift, hard throw, tackle or fall. As for symptoms, deep pain is experienced inside the shoulder owing to the heavy duty lifting action the patient is subjected to.

Arthroscopic shoulder surgery (keyhole surgery), is the recommended courses of action to treat such cases.

Shoulder Labrum Tear

The labrum is a cushion like muscle surrounding the socket of the shoulder joint that is susceptible to tear. Common causes behind these tears are attributed to falls or direct blows to the shoulder, but may also occur with throwing or pulling injuries. Larger tears are generally associated with shoulder dislocations and are called Bankart tears.

Shoulder Fractures

Fractures around the shoulder have always been difficult to treat surgically. But with new fixation devices and safer surgical techniques, doctors are now capable of fixing difficult fractures early and allow swifter recoveries from injuries.

Ways to Stop Insomnia

Before we look at ways to stop insomnia, let’s first look at the problems insomnia can cause. When you don’t get enough sleep, you can feel sluggish, depressed or irritable. You may also suffer from a lack of concentration. There are many causes of insomnia, such as too much stress, too much caffeine, being depressed, changing your work shifts, and pain if you have some sort of health condition, such as arthritis.

Most adults need about 7 to 8 hours of sleep each night (or day, if you are a shift worker). If you aren’t feeling tired when you’re at work or school, you are getting enough sleep.

You may be asking, will seeing a doctor stop insomnia? First off, your doctor will ask you a lot of questions, such as what time do you go to bed, do you take medicine, and do you consume caffeine and alcohol. You may also be asked if you smoke cigarettes. In addition, your doctor may ask how long you have suffered from insomnia, if you’re suffering from pain, and if you snore while you are asleep. You may also be asked questions about your personal life, and whether it’s causing you stress that keeps you awake.

A common thing many people to do try and stop insomnia is taking sleeping pills. This is not recommended. The relief they provide is only temporary, and the insomnia will quickly appear. You should only use sleeping pills on an occasional basis. Also, if you have certain health problems, sleeping pills can be unsafe. Consult your doctor before using sleeping pills.

Here are a few ways to stop insomnia:

* Go to bed and wake up at the same time every day, including weekends

* Do the same thing every night before going to sleep

* Only use your bedroom for sleeping or having sex

* Get rid of light and noise in the bedroom