The Problem of Kidney Neoplasm You Should Know

Kidney neoplasm is any cancer involving the kidneys. Some examples of kinds of kidney cancer are like wilms' tumor, transitional cell cancer and renal cell cancer.

Kidney neoplasm is new abnormal tissue of the kidney that expands by surplus cellular division and proliferation faster than normal and maintains to develop after the stimuli that instigated the new growth end.

Another regularly employed word about neoplasm is "kidney masses. Literally translated, the word neoplasm is a new growth. Neoplasms are divided into malignant growths (also identified as cancer), which possess the capability to develop and extend surrounding the body. Non-malignant or benign neoplasms are tissue masses that develop but are not able of extending around the body. it is essential to notice that a benign neoplasm of the kidney could develop and lead to troubles like bleeding although it does not extend by metastasis.

A kidney neoplasm is one of the most often happening solid tumours of childhood. It results from the rising kidney by genetic and epigenetic changes that cause the abnormal proliferation of renal stem cells.

Some of the symptoms of kidney neoplasm comprise no early symptoms, blood in the urine (frequently irregularly), kidney area lump, abdominal swelling, no pain – there is not generally any kidney pain unless the tumor is so advanced.

One of treatments for kidney neoplasm is surgery. And it includes simple nephrectomy (kidney removal), radical nephrectomy (removal of kidney, adrenal gland and local tissues), partial nephrectomy, arterial embolization (blockage of blood flow to the kidney that has the tumor).

Kidney neoplasms are categorized by light microscopy using the World Health Organization (WHO) system. The WHO system classifies histopathologic tumor subtypes with unusual clinical behavior and underlying genetic mutations. In adults, the general malignant subtypes are variants of renal cell carcinoma (RCC).

Histopathologic categorization is significant for clinical management of RCC, but is becoming more complicated with recognition of novel tumor subtypes, progress of procedures yielding small diagnostic biopsies, and appearance of molecular cures intended for tumor gene activity. For that reason, categorization systems founded on gene expression are expected to become indispensable for diagnosis, prognosis and treatment of kidney tumors.

What You Should Know About The Different Liver Cirrhosis Lab Values

Liver cirrhosis lab values are used to diagnose what stage a person’s liver disease is in. Here are some of the blood tests and lab values that your doctor will go over with you:

– Albumin Normal values for an adult are 3.4-5.4 g/dL. People with chronic liver disease accompanied by cirrhosis usually have levels < 3 g/dL.

– Ammonia Normal ammonia values for an adult are 15-45 ug/dL. When the liver and portal blood flow is impaired, ammonia levels rise.

– Immunoglobulins A variety of immunoglobulins will increase with chronic liver disease. The rise of different immunoglobulins suggest specific liver diseases. Here are the normal adult values:

1. IgA — 140-400 mg/dL (elevated levels detect alcoholic liver disease, cirrhosis, hepatitis, laennec’s cirrhosis, hepatobiliary carcinoma)

2. IgD — 0-8 mg/dL (elevated levels detect chronic infections and liver diseases)

3. IgG — 700-1500 mg/dL (elevated levels detect autoimmune hepatitis, hepatitis, hepatitis c, laennec’s cirrhosis)

4. IgM — 35-375 mg/dL (elevated levels detect biliary cirrhosis, hepatitis, viral infections)

– Platelets Normal adult values are 150,000-450,000/mm3

– Bilirubin The bilirubin values vary for men and women. The normal values for adult men are 0.3-1.1 mg/dL, and for adult women the values are 0.1-0.4 mg/dL. Bilirubin measures how well your liver is excreting bile. But note that there are certain drugs can elevate bilirubin levels.

These are just some of the liver cirrhosis lab values that your doctor will go over with you, and there may be more that he or she will include. If you are listed for a transplant, you are given a Model for End-Stage Liver Disease (MELD) score. The lab values used in the MELD calculation include:

– Bilirubin, which, again, measures your liver’s ability to excrete bile.

– INR, which measures your liver’s ability to make blood clotting factors.

– Creatine, which measures kidney function. Kidneys that aren’t functioning properly are often associated with severe liver disease.

The MELD score can go up and down depending on your lab values. For instance, you can have a high score, then receive treatment and your score will then go down. Now, if you’re not at the stage yet where you need a transplant, then consider some treatments and techniques that can help reverse the effects of liver cirrhosis. There are many things you can do that are safe, inexpensive and effective that will give your liver a break and give you back your energy and vitality.

The complete liver cirrhosis solution combines supplements, a healthy diet and stress-reducing techniques, ending your suffering from nausea, discomfort and worry. You can not only prolong your life, but you can also prolong your quality of life.

What Is Pneumonia? Causes and How to Treat Pneumonia?

What is pneumonia? What causes pneumonia? How to treat pneumonia?

Pneumonia is an inflammatory condition caused by a bacterial, viral or fungal infection, affecting primarily the alveoli in the lungs. The alveoli are the small air sacs in the lungs where the exchange of oxygen in the blood takes place.

Recovering from pneumonia can be difficult sometimes, especially in immunity compromised people and babies, and natural therapies such as home salt therapy can be of great help here.

Main symptoms of pneumonia are difficult breathing, coughing, fever and chest pain. Most cases of pneumonia are bacterial infections and the main treatment is with pneumonia antibiotics. It is mainly diagnosed by X-ray and sputum culture to determine the type of bacteria or fungi. Many people may need hospitalization, especially elders, babies and people with compromised immunity.

About seven percent of the population contact pneumonia each year and about 4 millions die each year of this disease, mostly in the poor developed countries and in most affected groups. The risk in developing pneumonia is increased in babies and elders, people suffering from COPD, smokers and people with immunodeficiency. Pneumonia causes list also includes some medical drugs or treatments that are associated with an increased risk of causing pneumonia.

Having a long-term disease such as asthma, chronic obstructive pulmonary disease (COPD), emphysema, diabetes, heart disease or cancer may also predispose someone to pneumonia.

A bacterial infection will quickly bring symptoms such as:

– Coughing – cough up mucus from the lungs that is usually green, rusty or have traces of blood

– Fever and shaking chills

– Chest pain, especially with breathing in and coughing

– Shortness of breath and fast breathing

– Headache and cyanosis from low oxygenated blood

– Fast heartbeat

– Weakness, fatigue and feeling very tired

– Abundant sweating

Nausea, vomiting, diarrhea and even confusion, especially in elders, can also be part of the symptoms. Viral infection usually involves same symptoms but they come slowly and can be milder.

Some people may have very mild pneumonia symptoms and be able to carry on the regular routines, not even knowing that they have a type of pneumonia – this is called "walking pneumonia". Usually the microorganism here is the Mycoplasma pneumoniae . They have mild flu-like symptoms, headache and fatigue. The treatment for walking pneumonia is generally with antibiotics or they most often clear on their own.

How to treat pneumonia?

The classical medical treatment for bacterial infection pneumonia is with antibiotic therapy. For fungal pneumonia, depending on the types of fungi spores isolated or suspected, different antifungal drugs will be selected.

The recovery after pneumonia can take months and to fasten the recovery, salt therapy is the choice, being natural and without any side-effects.

The salt aerosol is well known for its bactericide / fungicide, mucolytic and hydrophilic properties, helping in killing bacteria and fungi, making the mucus fluid and eliminating obstructions in the whole respiratory system. These lead to reducing inflammation and breathing better.

Chest Pain Not Caused by Heart Disease

Before I begin, let me make sure you know that you should consult your doctor for * any * chest pain, to rule out a serious health problem. However, there are other things that can cause pain in that region. Some are minor and some may be as life threatening as heart disease.

Heartburn: Acid creeping into your esophagus can cause pain in the chest that is somewhat similar to that of angina. It may seem like a minor nuisance, but it can cause serious problems. Untreated, it can lead to cancer of the esophagus.

Once you've been diagnosed, you may find some herbal preparations useful. To coat the esophagus and stomach, licorice and marshmallow root may help. Peppermint oil could also be useful.

Costochondritis: Inflammation of the rib cage, particularly the ribs and cartilage can cause rib cage pain. If you are diagnosed with this disorder, ask if willow bark and / or gotu kola can help reduce the pain and inflammation.

Pleurisy: This is an acute situation that can threaten your life. It is a swelling of the lining around your lungs. It can cause a high fever and difficulty breathing. It is best treated by a doctor, and may require antibiotics.

Arthritis: Both osteoarthritis and rheumatoid arthritis can effect your chest. While bone density is a major problem in this area, obesity can also be an issue. Watching your diet is important to prevent and also to deal with osteoarthritis of the rib cage. Rheumatoid arthritis is an auto-immune disorder, so it is difficult to prevent an attack on the rib cage.

It is possible to use willow bark and gotu kola for some types of arthritis in your rib cage, but you should clear it with your doctor. RA may be made worse by some herbs. If you're allergic to aspirin, do not use willow.

Liver Transplant Hospitals India At Low Cost-Liver Transplant Hospital

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Liver Transplant Hospitals In India

LIVER Transplant

Liver damage from cirrhosis cannot be reversed, but treatment can stop or delay further progression and reduce complications. Treatment depends on the cause of cirrhosis and any complications a person is experiencing. Regardless of the cause of cirrhosis, it is essential that every patient avoid all substances, habits and drugs that may further damage the liver or cause complications or liver failure…..

There have been over 60 different liver diseases treated with liver transplantation. However, there are several conditions that are more commonly treated with this procedure. They are frequently conditions that cause chronic or continuing liver inflammation. As the inflammation heals, fibrous tissue forms, much like a scar forms when a cut in the skin heals. Severe and advanced scarring of the liver is called Cirrhosis. Cirrhosis is not reversible and leads to end stage liver disease….

Live Donor Liver Transplant

Living liver donation Introduction : –

Liver donation is possible from a living donor who is a relative of the recipient who can donate half his/her liver. The donor operation is entirely safe and the half liver quickly regenerates in both the donor and the recipient in a few weeks. In the first few days after operation even when regeneration is not complete, the half liver is enough to maintain normal donor functions due to the immense reserve in the liver…..

Children’s Liver Transplant

A liver transplant is recommended for children who have serious liver dysfunction and will not be able to live without having the liver replaced. The most common liver disease in children for which transplants are done is biliary atresia. Other diseases may include Alagille syndrome, alpha-1-antitrypsin deficiency, Wilson’s disease, hepatitis, and hemochromatosis…..

Building on a Legacy of Innovation

We Care India partner hospital transplant teams are comprised of surgeons, medical specialists, nurse coordinators, social workers and ancillary staff members who provide superior, specialized expertise in all related transplant services. From careful pre-transplant monitoring to post-surgical care, Stanford’s strong emphasis on continuous quality improvement creates better outcomes for transplant patients.

We Care India partner hospital has long been at the forefront of the field, home to both the first adult heart transplant in the US and the first heart-lung transplant in the world. The transplant programs at We Care India partner hospital have earned a number of distinctions in the field, including the #1 ranking in the country in both patient and graft survival for kidney transplant…..

At We Care India partner hospital, transplant unit was established in 1997 with a view to providing state-of-the-art tertiary level care and service in liver and renal transplantation……

Facilities and expertise available : –

  • Liver Transplantation for children and adults with acute and chronic liver failure /cirrhosis
  • Living related Liver transplant and Cadaveric transplant
  • Pediatric hepatology service including transplant and biliary surgery
  • Adult Hepatology and Gastroenterology
  • Renal Transplantation in adults and children including Lap Donor Nephrectomy
  • Complex vascular and peritoneal access procedures
  • Complex Hepatobiliary Surgery….

Hospitals in India

Hospitals in India are a perfect destination for medical tourism that combines health treatment with visits to some of the most alluring and awe-inspiring places of the world. A growing number of tourists are flocking in large numbers because of the superlative medical care, equipments and facilities that India offers.

These hospitals have also obtained national (NABH – National Accreditation Board of Hospitals) and International Accreditations (JCI – Joint Commission International, NIAHO, ISO). These accreditations validate that these hospitals have qualified and are continuously maintaining the strictest medical and patient care standards….

The list of Liver Transplant Hospitals in India is as follows : –

A ] Apollo Hospital, Chennai

B ] Apollo Hospital, Delhi

C ] Apollo Hospital, Bangalore

D ] Apollo Hospital, Hyderabad

F ] Wockhardt Hospital, Mumbai

G ] Narayana Cancer Hospital, Bangalore

H ] Fortis Hospitals, Delhi

I ] Manipal Hospital, Bangalore

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We Care Core Values

We have a very simple business model that keeps you as the centre.

Having the industry’s most elaborate and exclusive Patient Care and Clinical Coordination teams stationed at each partner hospital, we provide you the smoothest and seamless care ever imagined. With a ratio of one Patient Care Manager to five patients our patient care standards are unmatched across the sub continent.

Chest Congestion Symptoms

This article is about chest congestion symptoms. Allergens, bacteria, and fungi can all cause infections resulting in chest congestion.

You will find the following information very helpful in all situations whether you are dealing with an adult or a child.

This morning a close friend called and asked if she could speak to the 'nurse' in me. Her daughter had called to come home from school. That morning during Athletics the daughter had been running track and experienced some breathing difficulty. This it seems was not the first episode. A doctor's appointment was scheduled for the afternoon but Mom was wondering if a trip to the Urgent Care Center would be better.

Since her daughter is nearly 14 I was able to ask her questions and get reasonable answers. Some of her symptoms were:

  1. labored breathing
  2. difficulty in talking
  3. swallowing was difficult
  4. tightness in her chest
  5. deep, congested cough

Mom and I decided to try an over-the-counter antihistamine and if there was no improvement in 30 to 40 minutes, or if chest congestion symptoms became worse, then a trip to an Emergency Room or Urgent Care Center was necessary.

Mom would be watching for these chest congestion symptoms such as:

  • tongue feeling thick
  • lips swelling
  • breathing became more labored
  • swallowing became more difficult

It's always a tough decision for a parent to make whether or not to go to the Emergency Room or Urgent Care Center because not all children can tell you just how they feel.

So here are some signs to look for to know when to seek care.

  • Congestion you can hear.
  • A fever you can feel,
  • Bluish color to fingernails and around the mouth you can see.
  • Watch chest movements.
  • Is your child just nasally congested or does it go deeper?

My friend's daughter had had a cold a couple of weeks back and she just was not able to shake it. Running track aggravated her ability to breathe.

But are we looking at an infection from the earlier cold, allergies, asthma? These are things only a doctor can tell you. But you can help your child … calmness is contagious.

If you remain calm, your child will feel this and the old adage: monkey see monkey do applies here.

Here as some additional things you can do as you assess your child's chest congestion symptoms:

  • Feel the child's head; is it warm or hot.
  • Listen for nasal congestion or deep-coughing congestion.
  • Is there any drainage?
  • Is the child coughing up secretions?
  • What color and consistency are the secretions (nasal and coughing)?

The difference in secretion coloring.

  1. Clear and thin … okay
  2. Yellow to grey or thick … need attention?

These are things you need to be able to tell your medical doctor.

If possible, save a sample of the thick or colored secretions. Your medical doctor may look at them and decide a culture needs to be taken in order to help determine which antibiotic to prescribe.

If an antibiotic is prescribed for the chest congestion symptoms, be sure to read the directions carefully.

  1. Is it taken 3 times a day?
  2. Every 6 hours?
  3. With or without food?

Be sure to read the flyer the pharmacist gives you. Above all ask questions and be sure you understand the answers.

Three (3) times a day may mean with each meal. Every 6 hours may mean around the clock and you need to wake up the child to give it. But most importantly … take ALL the medicine.

If you stop taking the prescription too soon just because you feel better and then relapse, the same antibiotic may not work again. The germ (bug) may become resistant and the next antibiotic could be more expensive.

I'm glad to say the antihistamine worked. My friend's daughter felt relief and was able to each lunch and will be seeing her doctor in the afternoon.

Persistent Lower Back Pain – a Possible Sign of Gall Bladder Disease

Gall bladder disease can generate a wide range of non-specific clinical manifestations in patients. Gall bladder disease sufferers usually experience differentiated symptoms according to their age and sex. Although gall bladder affections and problems can occur in both sexes, the female gender generally experiences more intense and diversified symptoms. The clinical manifestations of gall bladder disease are also influenced by the underlying causes of the illness and its stage of progression.

The gall bladder is a small organ situated in the close proximity of the liver, in the right upper region of the abdomen. Its main purpose is to aid the liver in the process of fat digestion, by collecting and storing bile, then releasing this substance inside the small intestine and stomach when necessary. Produced by the liver, bile has a vital role in the assimilation of vitamins A, D, E and K. The composition of bile consists of water, bile acids, phospholipids, electrolytes and pigments. Gall bladder disease can be either caused by chemical imbalances in the composition of bile (which results in thickening of bile, leading to the formation of gallstones), physiological dysfunctions at the level of the biliary system or gall bladder infections.

In the early stages of the disease, people with gall bladder affections rarely experience pain. At first, the disease generates symptoms such as abdominal bloating, indigestion, abdominal discomfort, nausea, vomiting and diarrhea. As the disease progresses, patients experience radiating pain in the region of the right upper abdomen, pain that eventually moves to the lower back side. Although lower back pain is not always very revealing for gall bladder affections, it is still considered to be an important criteria in the process of diagnosis. Recent studies have revealed the fact that gall bladder disease sufferers commonly experience lower back pain in more advanced stages of the illness. This symptom of gall bladder disease is mostly common in patients with ages over 50, rarely occurring in younger adults or children. Gall bladder back pain can be either the result of pronounced inflammation of the gall bladder or biliary colic.

Biliary colic is a common cause of lower back pain. Biliary colic refers to formation of gallstones inside the gall bladder and hepato-biliary ducts. Gallstones, also known as biliary calculi, are small stones formed from excess cholesterol, calcium and bile pigments. When gallstones accumulate in large amounts they can obstruct bile ducts completely, facilitating the occurrence of gall bladder infections. Associated with gall bladder inflammation and infections, biliary colic generates intense, persistent pain in the region of the lower abdomen and lower back. Gall bladder back pain usually occurs in episodes, each attack lasting from 20-30 minutes to a few hours.

The formation and accumulation of gallstones at the level of the biliary system is a common disorder, affecting more than 15 percent of people with ages over 50. Gallstones can be easily observed with the means of ultrasound tests and computerized tomography and patients can be quickly diagnosed with biliary colic. If you experience intense abdominal and back pain, associated with abdominal bloating, nausea and vomiting, it is best to see a doctor as soon as possible, in order to receive an appropriate medical treatment.

If you want to find great information about many gall bladder subjects like gall bladder pain, gall bladder symptoms, gall bladder removal or many more please visit us at .

Bronchitis – How Do You Know That Your Child Has It?

Bronchitis is as a result of inflammation of the large bronchi also known as the medium sized airways. The cause is either a bacterial or viral infection. This can affect anyone. This includes children. Bronchitis in children is as a result of the two pathogens. When the cause is a viral pathogen, the symptoms usually disappear in a matter of days on their own.

Bacterial infections need to be medicated using antibiotics and should be taken together with an expectorant cough syrup. This syrup helps expel harmful bacteria from the lungs. Antihistamines should not be used as they work against the expectorant cough syrup. They thicken the mucous making it hard for it to be expelled out of the lungs. For a successful recovery from a bronchitis infection, medication should be taken after having gotten proper prescription from the doctor. The medication should be taken at the right time and the right dosage.

Usually, you will notice that when a child has bronchitis she feels better after two or three days of taking the medication. This does not mean that you stop giving it to her. For a complete treatment of the condition, a full dosage is quite important. It is also good to teach your child the importance of completing the medication.

A child usually starts having a dry cough when she is getting a bronchitis infection. This cough is usually dry and can even wake her up at night. After a few days, the cough becomes productive. This can be followed by other symptoms such as fever, fatigue, chest pains, headache and general body weakness. These symptoms usually disappear in a few days. The cough can last for up to a month. Bronchitis can lead to pneumonia. It is therefore very important to seek medical advice immediately.

Did Dave Pelzer’s Mother from "A Child Called It" Have Borderline Personality Disorder?

During the entire time I was reading “A Child Called It’ , I couldn’t help but draw correlations between David Pelzer’s mother (Catherine Roerva Christen Pelzer) and Borderline Personality Disorder. After I was finished reading the book, I started my search to see what mental illness Catherine had suffered. All I have managed to find was that she was mentally ill and an alcoholic. No details have emerged of what type of mental illness she suffered. So, with the facts about Catherine from “A Child Called It” and professional resources about BPD, I will pose case that Catherine suffered from Borderline Personality Disorder (BPD).

Dave Pelzer paints the picture of a seemingly normal childhood until his mother’s behavior changed radically. He describes his mother as a “wicked witch” on (pg 30), which hit the nail on the head. She exhibits the behavior of the prototypical BPD Witch. “The darkness within the borderline Witch is annihilating rage. Her inner experience is the conviction of being evil, and her behavior evokes submission… She is filled with self-hatred and may single out one child as the target of her rage. The Witch’s message to her child is: Life is war” (pg 38) Lawson.

WOW. Catherine was most certainly filled with rage. Every page of that book, Catherine was filled with rage that she took out on her son day in and day out. Her inner experience is the conviction of being evil, where she even speaks of it on (pg 41) of Pelzer’s book, “Now it’s time I showed you what hell is like!” Throughout all of her abuse, her behavior was to evoke submission from David. She was constantly beating him down mentally, emotionally, and physically. He says that his soul was consumed in a black void from the intense abuse by his mother (pg 132). She certainly was filled with self hatred as indicated by her alcoholism, not taking care of herself (“Her once beautiful, shiny hair is now frazzled clumps. As usual, she wears no makeup. She is overweight, and she knows it. In all, this has become Mother’s typcial look” pg 5), and being so filled with annihilating rage. And, the fact that the BPD Witch singles out one child as a target of her rage is so revealing because Catherine singled out David. For years he was the only child abused. When David was put into foster care, the younger brother was then singled out as the target of her rage.

David was without a doubt the “no-good child”; however, remarkably he didn’t turn-out to be what Lawson identified as the lost child (pg 171). His mother, Catherine, called him a “bad boy”, and an entire chapter is devoted to the “bad boy” David.

  • Catherine had David look in the mirror and recite, “I’m a bad boy” repeatedly (pg 31).
  • Even though he was successful with school, his mother told him he was a “bad boy” and held him back in the 1st grade (pg 36).
  • David was left out of Christmas due to Santa only bringing “good boys and girls” toys (pg 38).
  • His mother accuses David of making her life a “living hell” (pg 41) and talks to the other siblings saying how she didn’t have to worry about them becoming like David, “a bad boy” (pg 43).
  • Even when David was awarded the honor of naming the school newspaper, Catherine says, “There is nothing you can do to impress me! Do you understand me? You are a nobody! An IT! You are nonexistent! You are a bastard child! I hate you and I wish you were dead. Dead! Do you hear me? Dead!” (pg 140).

As mentioned above, the BPD Witch’s message to her child is that life is war. David recieved that message pretty early into the story as he states on (pg 43), “For the first time, I had won! Standing alone in that damp, dark garage, I knew, for the first time, that I could survive. I decided that I would use any tactic I could think of to defeat Mother or to delay her from her grizzly obsession.” Catherine put David in the middle of an all out war with her, even making him sit in the prisoner of war position (pg 50, 84, 111, 114, 123) by sitting on his hands with his head thrust backward. Lawson states (pg 125), “The Witch’s children feel like prisoners of a secret war.”

In Lawson (pg 137), rejection triggers the desperate fear of sinking into the cold, dark abyss of abandonment, a fate the BPD Witch feels worse than death. Catherine was an alcoholic who had been drinking from the age of 13. Brought up in the Mormon community of Salt Lake City, she would hide in the outhouse during Prohibition to wince down bootleg whiskey. Her parents were divorced, which made them outcasts in that religious community, and Catherine was frequently locked in a closet, denied food, and told how despicable she was. Catherine primarily appears as a Witch, which a BPD who primarily appear as a Witch is filled with self-hatred as a result of surviving a childhood that required complete submission to a hostile or sadistic caregiver (pg 131) Lawson.

The BPD Witch is sadistically controlling and punitive with her children where they fear their survival. The Witch’s children are forced to submit to her control and may be victims of sadistic emotional, physical, or sexual abuse. Lawson explains, “Therapists hear horrifying stores of child abuse that never make the headlines… Some children may not survive simply because they are too young to get away” (pg 122). David Pelzer is VERY fortunate that he survived his horrifying ordeal with his mother.

Throughout the book, David speaks of being able to survive his mother’s abuse. He made a promise to himself when the discipline drastically turned to punishment out of control, “I knew, for the first time, that I could survive. I decided that I would use any tactic I could think of to defeat Mother… I knew if I wanted to live, I would have to think ahead… I could never give in to her. That day I vowed to myself that I would never, ever again give that bitch the satisfaction of hearing me beg her to stop beating me” (pg 43). He later refers back to that promise when he was stabbed by his mother, “I wanted to lie down and quit, but the promise I made years ago kept me going. I wanted to show The Bitch that she could beat me only if I died, and I was determined not to give in, even to death” (pg 91). He was a survivor from the start through his determination of thought. References of survival also include:

  • He also talks about that “water was my only means of survival” (pg 104) as his mother starved him for ten consecutive days.
  • Later, when his mother used chlorine gas while locking him in the bathroom, David relates that “to survive her new game, I had to use my head” (pg 108).
  • He started to lose his instinct for survival when his mother had him sit in POW style on a 1 inch diameter of rocks, stating “all my efforts for mere survival seemed futile. My attempts to stay one step ahead of Mother were useless. A black shadow was always over me” (pg 111).

Because the Witch emerges when the mother and child are alone, no witnesses can verify the child’s experience (pg 125) Lawson. Catherine typically abused David when no one else was around, making sure to cover up the abuse if and when family members returned to the house. David says on pg 42, “I knew Mother never acted his bizarre when anyone else was in the house.”

  • When Ron came home, Catherine ceased to attempt to burn David further on the stove (pg 42).
  • When Catherine tried to have David eat the dirty diapers, the abuse stopped when Ron, Stan, and David’s father returned to the vacation cabin (pg 57).
  • David always noted that he appreciated when his father was home, calling him his protector, as the abuse was not as prevalent. (pg 101).
  • When he would come home from school and his brothers weren’t home, David knew that his mother’s “game” would be full force.
  • After Ron and Stan went go to bed, Catherine ordered David upstairs to feed him ammonia (pg 73).
  • David even devotes an entire chapter to “When Father is Away”, starting the chapter with, “When he was home, Mother only did about half the things that she did when he was gone” (pg 101).

The BPD Witch can be cruel to the target of her rage; however other children may not perceive her as a Witch if they do not possess qualities that trigger her rage. With the information contained in Pelzer’s book, Catherine did not treat the older two or younger baby abusively. They were immune to her physical abuse. Being cruel, the BPD Witch may make a statement such as “I’m going to make your life a living Hell” or “I’m going to kill you” (pg 137) states Lawson. Catherine said both of these statements to David: (pg 41) “Now it’s time I showed you what hell is like!” and (pg 85) “If you don’t finish on time, I’m going to kill you.” David continues by saying that she said that same statement over and over for almost a week (pg 86).

The need for power and control over others is important to the BPD Witch as well as the need to elicit a response of fear and shock. Catherine certainly illustrated how she needed each of these. She exerted power over David, reducing him to a “slave” (pg 50, 84, 126), an “it” (pg 140), and “the boy” (pg 50). She controlled every part of his life down to what he ate (or rather, what he didn’t eat). He was controlled through having to “work” constantly around the house with only being allowed to attend school. Her pathological “needs” resulted in David viewing his home as a “madhouse” (pg 104) and “hell house ” (pg 137), as well as his existance as a “morbid life” (pg 116). He felt as if his soul was consumed in a “black void” (pg 132).

She used fear and shock throughout her abuse. He was relegated to the basement on a cot, not knowing when he would be fed, allowed to see sunlight, or beat (ten rounders (pg 111), whipped with dog chains (pg 116), broom handle blows to the backs of legs (pg 117)). He was often intense with fear: shaking, unable to concentrate, heart skipping beats, and startled. He was put though tremendous shocking situations such as being fed ammonia, subjected to chlorine gas, submerged under cold water for long lengths of time, burned on a gas stove, arm dislocated, stabbed in the abdomen, smashed into the counters breaking his teeth, forced to eat dirty diapers & rancid food, and so much more.

Children who resist the control face worse punishment. David did not resist her control. He knew the rules & punishments to his mother’s “game”: (1) if he took too long to do his chores, his mother would withhold food (2) if he looked at one of his siblings without permission, he was slapped (3) if he was caught taking food, he was subjected to hideous punishment (pg 83).

David did not resist control. He would do everything in his power to get his work done under her strict time restraints. He says (pg 50) during the time when he had to stand until summoned to perform chores, “It was made very clear that getting caught sitting or lying down in the basement would bring dire consequences. I had become my Mother’s slave.” Without putting up a fight, he took his “punishments”: remaining in the chlorine gas filled bathroom, submerged under cold water & then forced to sit outside on rocks 1 inch in diameter (Bathtub and Backyard Treatment pg 114), and skating in icy cold weather without appropriate clothing (pg 120). Additionally, he would sit for extraordinary lengths of time on the bottom step standing and in POW position as she instructed. Once when he decided to not “take anybody’s crap anymore” (pg 142), the results were a stomping from his brothers and Mother, a special batch of chlorine gas in the bathroom, and a choking.

Destroying valued objects and being intentionally withholding, the BPD Witch may intentionally withhold what their children need. David’s mother withheld food from David, severely starving him. He only had his brother’s left-overs from breakfast on occasion, a P&J sandwich with a few carrot sticks for lunch, and rarely any dinner. Due to the obsession to find food, David resorted to taking other kid’s lunches, (pg 48), food from the grocery store (pg 59), frozen cafeteria food (pg 63), begging for food (pg 69), and frozen from from his basement (pg 79). He also would eat scraps from his garbage can after his family ate (pg 62) until his mother started to add ammonia to the waste or planting rotten food so that he would get sick (pg 63). She also would tease the starving boy by putting food in front of him then taking it away (Two Minute Game pg 105 -107). When she found out about his eating of frozen cafeteria food, she forced him to vomit it up by forcing her finger down his throat, scooping the vomit out of the toilet, and then eating the vomit later that evening (pg 66 – 68).

Along with withholding food, Catherine also intentionally withheld proper hygiene and clothes for David. Kids made fun of him for how he smelled calling him David Pelzer-Smellzer, and teachers not used to his smell wave their hands in front of their face. He was consistently in tattered and worn clothes, even if new clothes existed in the home for him.

  • David says, “Because my Mother had me wear the same clothes week after week, by October my clothes had become weathered, torn, and smelly” (pg 47).
  • He continues further in the chapter, “In September, I returned to school with last year’s clothes” (pg 57).
  • He indicates that his mother had newer clothes for him but withheld them: “One Sunday during the last month of summer … Mom let me put on new clothes that I had received last Christmas” (pg 123).
  • By the time he was rescued, “My long sleeve shirt has more holes than Swiss cheese. It’s the same shirt I’ve worn for about two years. Mother has me wear it every day as her way to humiliate me. My pants are just as bad, and my shoes have holes in the toes. I can wiggle my big toe out of one of them” (pg 6).

The BPD Witch organizes a “campaign of denigration”, enlisting others as allies against the target of her rage. “She may seek out friends, family members (including siblings and children), and co-workers of her victim in whom to confide fabricated stories designed to discredit her enemy” (pg 141) says Lawson. David’s mother, Catherine, denigrated David by turning family against David including his father and other siblings. She also had the school turned against him, pegging him as a thief and “bad boy”. She told neighbors negative things about David, further denigrating him. Many believe the allegations because of the intensity of emotion. When the ability to enlist allies disrupts and divides groups, such as neighbors and the school system, that could actually help him.

The Witch does not recognize boundaries and exploit the child’s trust by denying right to privacy and humiliating & degrading the child.

  • Catherine stripped off David’s clothes having him stand naked, where he “shook from a combination of fear and embarrassment” (pg 40).
  • For months, David was forced to sleep under the breakfast table next to a cat litter box with newspapers as his covers (pg 68).
  • After his mother made David drink dish-washing soap, David needed to use the bathroom and begged his mother to use the bathroom, and she refused. David “stood downstairs, afraid to move, as clumps of the watery matter fell through my underwear and down my pant legs, onto the floor. I felt so degraded; I cried like a baby. I had no self respect of any kind… I felt lower than a dog” (pg 77).
  • While lying naked in the tub submerged as his mother instructed, his brothers would come into the bathroom, glare at him, shake their heads, and turn away (pg 113).
  • After all the humiliation he endured, he talks about how he ate like a homeless dog, grunted to communicate, didn’t care if he was made fun of, and nothing was below him (pg 132).
  • At one point, his morale became so low that he hoped to be killed (pg 141).

The BPD Witch seeks and marries a “Fisherman”, someone she can dominate and control, which is EXACTLY who Catherine married. Stephen Pelzer was completely dominated and controlled by Catherine. He was a subservient partner who relinquished his will at her command (pg 179), as Lawson describes the Fisherman. Further, this type of husband has little or no self-esteem and see himself as a loser. He also fails to protect his children from abuse. All of these characteristics fit Stephen who does not step in to stop the abuse (pg 50, 58):

  • When David was first deprived of food, Stephen gives David scraps of food and tries to get Catherine to change her mind about feeding David.
  • Catherine and Stephen begin to fight, and as the arguments between them became more frequent, the Stephen began to change– he is not around for David.
  • When David was forced to eat his own vomited hot dog, his father “stood like a statue”and watched him eat something “a dog wouldn’t touch” after unsuccessfully “trying to talk Mother out of her demand” (pg 66 -67)
  • David’s father stood by as David’s mother refused to let David use the bathroom but instead had to use a five-gallon bucket to relieve his diarrhea (pg 77).
  • David’s father started to help David with the dishes. Catherine stopped this, as well as she said that Stephen gave David too much attention. After that, David notes that his father “gave up” (pg 101 -102).
  • When David was stabbed by his mother, David’s father didn’t even look at David when David reported the incident.

David said, “I knew that Mother controlled him like she controlled everything that happened in her house… All my respect for my Father was gone” (pg 90 – 91). Stephen gave up on David without a fight and started not even staying at home on his days off. One day he told David that he was sorry (pg 103) and eventually left the family all together (pg151), leaving David at the hands of his terribly abusive mother, Catherine. David said that he was fully aware of his father’s lack of courage to rescue him, and he hated him for it (pg 134).

Marsha Linehan, in her book Cognitive Behavioral Treatment of the Borderline Patient, describes the normalcy that BPD’s present to others. When people around the BPD mother hear her complaining about her child, the assumption is that the child is troubled rather than the mother. Further in social settings, the BPD mother may be engaging, gracious, and endearing.

  • David talks about how when his mother was a den mother for the Cub Scouts, the kids commented how they wished their mother was like Catherine (pg 39).
  • She snowed the school administration by showing up with her infant son in her arms and agreeing to cooperate with the school regarding David (pg 53).
  • Additionally, he notes that in the presence of neighbors, his mother “played the role of the loving, caring parent– just as she had when she was a Cub Scout den mother” (pg 122).
  • Catherine also painted a different picture of their home life when David’s Grandmother came for the holidays (pg 126).

Lawson points out that “children have faith in their parents and believe in their greater wisdom. No child wants to believe that his mother is capable of brutality” (pg 273).

  • After stabbing David, he accepted his mother’s increased compassion towards him. He hoped that she was trying to make up to him and hoping that he was back into the “family fold” (pg 94).
  • Later that night, when he goes to bed with the large laceration, he goes so far to say “I felt safe knowing she was nearby to watch over me” (pg 95).
  • Before a visit from Social Services, Catherine manipulates David into thinking that his ordeal was over and that she will “try to be a good mother” (pg 123). He even starts calling her “Mom” at this point.
  • Near the end of the book, David is called an “It” by his mother, and he reveals, “I gave all that I could to accomplish anything possible for her recognition. But again, I failed. Mother’s words were no longer coming from the booze; they were coming from her heart” (pg 141).

So, even through the devastating and intense abuse, David still held onto the hope that his mother loved him and that she would return to being a nurturing and caring parent.

Through and through, I believe that Catherine suffered from Borderline Personality Disorder. She illustrates the maternal functioning of a Borderline Mother, including:

  1. Confusing her child
  2. Not apologizing for or remember inappropriate behavior
  3. Expects to be taken care of
  4. Punishes or discourages independence
  5. Envies, ignores, or demeans her children’s accomplishments
  6. Destroys, denigrates, or undermines self-esteem
  7. Expects children to respond to her needs
  8. Frightens and upsets children
  9. Disciplines inconsistently or punitively
  10. Feels left out, jealous, or resentful if child is loved by someone else
  11. Uses threats or abandonment (or actual abandonment) to punish the child
  12. Does not believe in her children’s basic goodness
  13. Does not trust her children

Catherine fully qualifies for each of these points. Further and more specifically, as the Witch BPD mother, she sent the following messages to David:

  • I could kill you
  • You will be sorry
  • You won’t get away with this
  • You deserve to suffer
  • I’d be better off without you
  • You’ll never escape my control
  • It’s my right as your parent to control you
  • I’m going to make you pay

The Witch’s child is raised in a hopeless situation– and David made it out with his resolve, smart thinking, and strong will. The Witch’s words can be vile, her heart cold as stone– thankfully David survived the vile words and the heartless mother to become a highly successful man and an inspiration for all.

Hip Replacement Complications

Close to 200,000 hip replacement surgeries are performed each year in the United States. Over 90% are successful with no hip replacement complications during or after surgery. But as with all surgeries, the risk of complications is always a possibility. However, complications are infrequent and often reversible.

The older the person is the higher the risk of complications. A person over 80 years old has a 20% chance of developing at least one complication after hip replacement surgery.

Hip replacement complications during surgery

Nerve damage

The sciatic nerve is at risk of being accidentally surgically cut due to its close proximity to the capsule of the hip joint. This same nerve may also become over-stretched during hip manipulation during surgery.

Depending on the extent of the nerve damage, temporary or permanent damage may result. There may be loss of muscle power and feeling in parts of the leg. It may take up to 6 months or more for recovery. Most patients have some numbness around their incision site which may be permanent.

Vascular damage

The damage involves direct trauma to the blood vessels in the area of the surgery. The damaged blood vessel can be repaired by a vascular surgeon if it is caught in time.

Femur fracture

Force is applied during the surgical procedure. This can result in a femoral shaft fracture, especially in older or osteoporotic patients. Again, the problem is addressed during surgery, but may lead to extended rehabilitation. The surgeon may place weight bearing restrictions while you are walking.

Leg length discrepancy

In some cases, it may be difficult to get the exact same leg lengths. The result is usually a longer leg on the surgical hip. It may be unavoidable and deliberate in order to improve muscle function or stabilize the hip. If there is more than a quarter of an inch difference, a shoe lift may be necessary.

In some patients, both legs are the exact same length but they think their surgery leg “feels” longer. In most cases this “feeling” goes away as the patient adjusts to their new hip.

Rarely does shortening of the leg occur. If the leg is significantly shortened after surgery, it may have dislocated.

Anesthetic complications

Complications can occur, and in rare cases even death. Your anesthesiologist will explain the risks involved prior to your surgery.

Hip replacement complications after surgery

Blood clots (DVT-deep vein thrombosis)

This is one of the most common complications after hip replacement. The most common area is in the calf. Increased leg pain is usually the most obvious symptom. Redness around the area of the clots may also occur. It’s a minor problem if the clots stay in the leg. But if they dislodge, they can reach the lungs (pulmonary embolism) and can possibly result in death (very rarely).

If your surgeon suspects blood clots, he will immediately order an ultrasound to confirm or rule out clots. Most surgeons will order bed rest until the test results come back positive or negative for blood clots. He will prescribe a blood thinner. Compression boots and ankle/leg exercises help reduce the chance of blood clots.


Infection can occur during surgery or develop afterwards. It is one of the most serious risks to the joint replacement. If the infection settles deep into the joint and surrounding tissues, the new joint often has to be removed until the infection clears with treatment. If the patient develops an infection elsewhere in the body (bladder, teeth, chest), it must be controlled to prevent the possibility of it spreading through the blood to the new joint.

If you have rheumatoid arthritis or diabetes, or have been taking cortisone for a long time, you are more prone to infection in the weeks following your surgery.

Infection can occur many years after the surgery. Bacteria can travel through the bloodstream from an infection in other parts of your body (bladder infection, infected wound, kidney infection). Oral antibiotics may need to be taken before and after routine dental work years after your hip replacement operation.

Hip dislocation

The first six weeks after hip replacement is the most vulnerable time for your new hip. During this period, muscle tension is the only thing holding the metal ball in the socket. If the metal ball slips out of the socket, it’s dislocated. As the hip muscles regain their strength and scar tissue forms around the ball, the risk of hip dislocation diminishes.

Traditional hip replacement requires that certain precautions be taken and some positions/movements are restricted, at least for the first 6 weeks. Your surgeon and physical therapist will instruct you in your hip precautions. Basically, the precautions are:

  • do not turn your toes inward
  • do not cross you legs
  • do not bend your hip more than 60-90 degrees (when sitting, your knee should not be level with your hip, it should be lower)

If dislocation occurs, call an ambulance to get you to the hospital. Your surgeon will pop the hip back into place. If it happens frequently, a hip brace worn for several months will prevent further dislocations. Hip replacement using the anterior approach eliminates the need for hip precautions or restrictions of positions/movements.

Those people who are overweight or have weak muscles are more prone to dislocation. Avoid heavy exercise that puts too much stress on your new hip (running, playing basketball, tennis, heavy lifting). Instead, participate in activities such as walking, swimming, stationary bike.

Trochanteric problems

Your greater trochanter, a large boney part of your femur, is located below and to the outside of the ball of your hip joint. Many of your large hip muscles anchor on the trochanter, so it’s essential for normal hip function.

During lateral approach surgery, the trochanter is detached to access the hip joint. It’s then reattached. If the trochanter does not heal back on the femur bone, it remains as a separate piece. This may result in pain, weakness, and loss of hip function.

Bowel complications

Constipation frequently occurs for the first week or so after surgery. This can be caused by medication, immobility, loss of appetite, not drinking enough fluids. Stool softeners or enemas may be needed.

Urinary problems

A catheter may be inserted during surgery. Your doctor will order its removal as soon as is practical, as catheters pose an increased risk of urinary infection.

Hematoma formation

During surgery, the main areas of bleeding are controlled by cauterization. But some oozing of blood and fluids still occurs, so a drain is attached from the wound to the outside of the body. If the drain does not work as planned, a collection of blood and fluids forms in the hip area. This can cause pain, pressure, and possible infection. Your surgeon may take you back to surgery to drain the hematoma.

Loosening of the prosthesis

The harder your bones are, the longer your hip replacement will last. Hard bones create a stronger bond. People with rheumatoid arthritis and osteoporosis are more at risk.

Running and heavy impact activities can also loosen the bond of the implant. Keep your weight down, as this will put more stress on the hip joint. Every pound you gain adds three pounds of force on your hip.

Choose a surgeon who has performed many hip replacements. Talk to some of his previous patients to see how they are doing after their hip replacement. Not all surgeons are alike. I have seen a few hip revisions that were necessary only because the initial hip replacement was done poorly by the original surgeon.

Pressure sores

In the immediate days after your hip replacement, you may be spending quite a bit more time in bed. Spending a long period of time in one position can lead to pressure sores. Your heels, especially on your surgery leg, are very susceptible. A pillow or towel roll under your calves will float your heels and relieve pressure. The elderly are especially prone to pressure sores because their skin is softer and they do not move around as well. A close eye should be kept on their heels and tailbone area, and should be regularly repositioned in bed with pillows.

Blood transfusion complications

All blood intended for use in transfusions is screened for Hepatitis B virus, Hepatitis C virus, syphilis, Human T Cell Leukemia virus, and the AIDS virus. But infections still occur. Hemolytic Transfusion Reaction occurs due to incompatibility with the donors blood type. The most common cause of Hemolytic Transfusion Reaction is clerical error (mislabelled specimen or improperly identifying the patient receiving the blood).

If you plan to use your own blood for possible transfusion, let your doctor know ahead of time so arrangements can be made. Your blood can only be stored for 35 days. Collection should begin at least 10-14 days before your surgery. The final collection occurs not later than 5 working days before the surgery date. Your blood will be screened as well.

About hip revision surgery

Most people who undergo hip replacement surgery will never need to replace their artificial joint. But because more and more people are having hip replacements at a younger age, the wearing away of the joint surface can create problems. After 15-20 years of wear and tear, replacement (revision surgery) of the artificial joint is becoming more common. Revision surgery does not have as good an outcome as the initial surgery.

Consider all the hip replacement complications before you decide on surgery. This is not a complete list of risks, as there may be some rare complications not mentioned here.

Common Wrist Fractures and Repair

Distal Radius Fracture

The most commonly broken wrist bone with a fall on an outstretched hand is a break of the distal radius. The radius is the larger of the two forearm bones and the end toward the wrist is called the distal end. When the area of ​​the radius near the wrist breaks it is considered to be a fracture of the distal radius. Distal radius fractures are very common.

Symptoms of a distal radius fracture are immediate pain, bruising, swelling, and tenderness. Often times the wrist hangs in an odd or bent way, otherwise known as a deformity.

What are the risk factors for a distal radius fracture?
Osteoporosis is a risk factor for all types of fractures, especially a distal radius fracture. A broken wrist can happen in healthy bones as well. The majority of these types of fractures occur in people older than 60 years of age who fall from a standing position. The other subset of people who injure their wrist are young patients with a high impact fall, causing a break in an otherwise normal wrist.

How is a distal radius fracture treated without surgery?
Treatment for a distal radius fracture involves the nature of the fracture, the age and activity level of the person injured, and the orthopedic specialist's personal preferences. The doctor can cast the broken bone if it is in good position and is stable. Sometimes the orthopedic specialist must straighten the bone (reduce it) before a cast is applied. This is what doctor's call a closed reduction. The cast is usually worn for about 6 weeks and at that time the doctor could order physical therapy to help with rehabilitation.

What is involved in surgical treatment?
There are times when distal radius fractures result in the bone being so much out of place that it can not be corrected without surgery. The orthopedic surgeon will make an incision to directly access the broken bones to improve alignment. The bone can be held in correct position with the use of a plate and screws, metal pins, an external fixator or any combination of techniques.

Scaphoid Fracture of the Wrist

The scaphoid bone is one of the small bones in the wrist, and it is the wrist bone that is most likely to break. It is located on the thumb side of the wrist in the area where the wrist bends. It can be easily located when the thumb is held in a "hitch-hiking" position. The scaphoid bone is at the base of the hollow made by the thumb tendons.

Symptoms it is fractured include pain, swelling, and tenderness at the base of the thumb. The pain will worsen when the person grips something or tries to move the thumb or wrist. A scaphoid fracture is usually caused by a fall onto an outstretched hand and is not always as painful as one might think.

What are the risk factors for a scaphoid fracture?
Anyone can fracture their scaphoid bone but it is more common in athletes who participate in activities where falls are common. Men aged 20 to 30 are most likely to experience this type of injury.

How is a scaphoid fracture treated without surgery?
If the bone is in proper position and has good blood supply, the orthopedic specialist may treat it by casting. The cast is usually worn for 12 weeks. Many opt for surgical stabilization to minimize the length of immobility.

What is involved in surgical treatment?
Due to the precarious nature of the blood supply to the scaphoid, the orthopedic specialist may recommend surgery to optimize healing and prevent long term wrist arthritis. During the procedure metal implants (such as screws and wires) are used to hold the scaphoid in place until the bone is completely healed. The surgeon makes an incision over the front or the back of the wrist to align the bone, insert the metal implants, and repair the damage. In special situations where the bone is not healing well on its own, a bone graft may be needed to aid in healing. A bone graft is new bone that is place around the broken bone to help stimulate bone healing. This allows the bone pieces to heal together into a solid bone.

Accident Claims Helpline – Carbon Monoxide Posioning

If you have been exposed to carbon monoxide due to the negligence of a third party you could claim compensation.

Due to the seriousness of carbon monoxide poisoning claiming for compensation can often be the best thing to do if you’ve been hospitalised, taken time off work or lost your job due to the poisoning.

Carbon monoxide is often referred to as ‘the silent killer’, due to it being odourless and colourless. It is therefore most likely that you won’t know carbon monoxide is there until you started suffering the side effects of inhaling it.

Side effects of carbon monoxide include headaches, nausea and dizziness, vomiting, tiredness, stomach pains and confusion. In some cases, carbon monoxide poisoning has lead to fatalities when the problem has been left untreated.

In more serious cases, carbon monoxide poisoning can cause brain and heart damage as well as urinary incontinence.

A lot of the time, carbon monoxide exposure may only be realised if you feel ill in only in one particular place. For example, you may find that you show symptoms whenever you are at work, but when at home you feel much better. This could be because of a carbon monoxide leak at your place of work. This is easier to determine if everyone in the vicinity also feels the same symptoms.

Carbon monoxide poisoning is usually caused by poorly maintained gas appliances such as gas fires or central heating systems, or bad ventilation.

If there’s a possibility of exposure in your workplace, it is up to your employer to ensure that appliances are regularly checked and maintained, and perhaps even to install a carbon monoxide detector.

Similarly, if you’ve been affected when living in rented accommodation, in a public house or otherwise, it is the responsibility of the landlord or manager to make your safety a priority.

If a third party has failed to put your health and well being first then you could make a claim for compensation.

Conditioning Work Out Routines Following an Arm and Shoulder Injury in Sports

Arm and shoulder injuries can be acute (e.g. occur in an instant during an accident, bone fracture) or chronic (e.g. overuse, bursitus) and classified as mild, moderate or severe. Tendon injuries (strains) and ligament injuries (sprains) are classified as first degree, second degree or third degree (worst).

The arm consists of two main parts; the upper arm with one main bone (the humerus) and the forearm that has two bones (radius and the larger ulna). These are connected together by the elbow joint (described in a previous article) and connected to the body by the shoulder. The shoulder is actually composed of five joints that allow a great deal of mobility but also instability. Suffice it to say that there are a multitude of muscles, ligaments and tendons that connect the humerus to the scapula (shoulder blade), clavicle (collar bone) and eventually the sternum (e.g. including the ribs).

With such a complicated joint there are many potential injury mechanisms such as:

1. Fracture of the collar bone usually caused by a direct impact on an outstretched arm when falling over in sports like football.

2. Shoulder dislocation usually occurs in an anterior (frontal) direction when the ligaments connecting the humerus to the scapula are torn or stretched. Subluxation is a partial dislocation of just the main shoulder joint. Typically these may be caused by a strong collision between athletes, falling over with an outstretched hand or a violent twist of the shoulder.

3. Ligament tears in for example, the connections between the collar bone, shoulder bone and sternum (acromioclavicular and sternoclavicular separation). Typical causes include direct blows to the shoulder or sternum and falling over with an outstretched hand.

4. Bicep injuries, including tendon rupture (near the shoulder joint), bruising and muscle strain. Typical causes include overloading (e.g. weightlifting) and direct impacts (e.g. checks in hockey).

5. Impingement syndrome is a chronic injury caused by repeated overhead movements (e.g. in swimming, golf, weight lifting) damaging the long head of the biceps tendon (connecting the biceps to the humerus at the shoulder) and the subacromial bursa (i.e. a fluid filled sack in the shoulder to reduce friction between soft tissues). The space between the rotator cuff (a group of muscles and tendons securing the arm in the shoulder joint) and part of the shoulder bone (acromion) is reduced and this leads to pain and loss of full motion (e.g. in raising the arm or reaching around to the back).

6. Rotator cuff and bicipital tendonitis both involve inflamed tendons, the first usually caused by repetitive overhead movements (e.g. tennis, baseball) and the second by repetitive weight lifting with poor technique.

7. Frozen shoulder (adhesive capsulitis) occurs when abnormal bands of tissue form between joints to cause pain and loss of motion. Typical causes include scar tissue after surgery and repetitive soft tissue tearing around the glenohumeral joint (main shoulder joint).

As with other types of injury in sports, immediate treatment should include RICER (Rest, Ice, Compression, Elevation and specialist Referral) for three days and prompt medical care (e.g. for joint misalignment or bone fracture). More serious fractures or ligament tears may require six to eight weeks of rest and at least three weeks of rehabilitation to restore the function of the shoulder.

To reduce the risk of future injuries and ensure a complete recovery, up to 3 months of conditioning with more strenuous work out routines are then required. The first priority is to get back the full range of motion of the shoulders by using simple stretching exercises. Some of these can also be turned into isometric exercises by actively tensing instead of relaxing. Dumbbells provide a convenient way of progressively adding more weight to lift. A work out routine may include the following:

1. Stand in front of and facing away from, for example, a kitchen work top. Reach both hands behind you and interlock your fingers lightly above the work top. Keep both elbows slightly bent and slowly bend your knees so that both arms are rotated further behind you. Hold a position for 10 seconds and then lower further and repeat until it is no longer possible to go any lower without discomfort.

2. Stand upright with a small towel in your right hand. Place your left hand behind you as if you are trying to scratch the middle of your back. Bring your right elbow above your right shoulder and bend your right forearm down so that your left hand can grasp the other end of the towel behind your back. Hold for 30 seconds and then swap sides.

3. Stand upright next to a kitchen work top with the body facing parallel to it. Rest your left arm on the top and move your right leg forward slightly into a small lunge. Straighten your right arm next to your side and move it away from your side until it reaches about 45 degrees. Then move it straight back as far as possible. Rotate the whole arm about its axis so that your hand rotates inwards and then outwards. Repeat on the other side.

4. Stand upright with the feet slightly apart, knees slightly bent and a light dumbbell in the hand of each straight arm by your sides. Simultaneously slowly raise both straightened arms sideways until the dumbbells reach shoulder height and then slower lower. Repeat at least 15 times.

5. Lying on your back on a weight bench rest a single dumbbell on your chest with both hands grasped around the handle. Straighten your arms so that the dumbbell is held above your groin and then slowly rotate both straightened arms above your face and then behind your head as far as possible. Slowly return to the starting position above your groin and repeat at least 15 times.

6. Standing upright with your hands by your sides and a dumbbell in each hand, slowly curl each arm so that the axis of each dumbbell starts facing forward and ends up at 90 degrees to this. Keeping the elbows stationary and in line with your back alternate each arm at least 15 times.

7. Stand upright with a dumbbell in each hand but this time rest the axis of each one on your thighs in front of you. Without any twisting of the dumbbells slowly and simultaneously raise your elbows until your upper arms are horizontal. Slowly lower and repeat at least 15 times.

Cerebral Palsy Information – What You Need to Know

What is cerebral palsy?

This is the question that most of us can not answer. Although we already heard or read the words, but we are still unaware of what it really means as well as its possible implications. That is why it is important that we know pertinent information about this condition. There can be an instance that one of our loved ones can be affected by it, thus we already knew what it is as well as the possible treatments.

Let us first define each term. Cerebral is the medical term for human brain, whereas palsy means posture or movement disorder. In other words, it is a group of conditions which are characterized by damage on certain areas of the brain, resulting to movement and posture disorder. It is more of immobility or lack of full control of body's motor functions, particularly on muscle control and coordination.

The following signs may be present on an individual affected by such condition, although such signs depend on the affected areas of the brain:

o Coordination and balance problems;

o Difficulty in controlling as well as maintaining posture;

o Statistics show that 1 out of 3 children affected is said to be epileptic;

o Difficulty on drinking, eating, swallowing, and speaking; and

o Certain learning disabilities.

It is most common on children. About 1 out of 400 children that is born in developed countries is affected by this disorder. In United Sates, there are 764,000 children and adults estimated to show one or more signs. Meanwhile, there are about 8,000 infants and babies diagnosed with said condition every year. Although there are medical advances that are made every year, the trend has not declined for the last 60 years.

The cause of developing cerebral palsy to children has yet to be determined, although there are contributing factors which includes infections like meningitis, brain hemorrhage, and shortage of oxygen. It may happen before, during, or after birth and the severity of the condition will depend on the damaged done to the brain.

It is categorized into 3 main types, which are as follows:

o Spastic CP- characterized by stiff muscles, making an affected individual difficult to execute movements such as extending his arms and legs and difficulty to stand without being unaided. It is accounted for nearly 70 to 80 percent of all incidents.

o Athetoid CP- the damage is on the cerebellum area of ​​the brain, which is responsible for maintaining body posture and coordinated body movements. It is accounted for the 10 percent of all incidents.

o Ataxic CP- characterized by poor movement coordination and low muscle tone. Individuals with this type look unstable and shaky. It is apparent when he walks. They also suffer from shaky hands which makes difficult for them to hold a pen and write.

If you have a loved one with this condition, you should take care of them for they need that loving as well as understanding for their condition. There are available therapies for him / her-it is still possible for him / her to live normally like other individuals. With you care and support, it is possible.

Mouthwashes to Treat Mouth Ulcers

Mouth ulcers-those small yellow or white eruption lined inside your mouth! They are simply painful and they can make your life miserable with their miniscule presence. These rashes as small as a few millimeters are caused inside your mouth by break in the mucous membrane and appear like a depression in them.

Although mouth ulcers may be of different types, the two most common types are
– Ulcers caused by minor injuries
– Aphthous ulcers

The first type of mouth ulcer occurs when a person has a sharp edge on a tooth, or poorly fitting dentures. In these cases, the mouth is continuously getting hit by the edgy tooth that ultimately results in ulcer. These ulcers are treated by removing the source of the injury.

Aphthous ulcers are very small, but painful ulcers that most people experience in their lives at least once, especially in adolescence or young adulthood. The aphthous ulcers occur mainly when the body’s own immune system attack the mucosal lining of the mouth. These ulcers often are the result of deficiency in vitamin B12, folic acid or iron. They can also appear at the time of stress or certain hormonal circulation. They commonly occur due to the eating of certain foods. This type of mouth ulcer also may appear as a result of certain types of viral infections.

The mouthwashes are the most effective way of healing both types of ulcers. The mouthwash may be of two types: home made or commercial. In certain ulcers, the simple salt and warm water solution come to great help. The compound thymol glycerin mouthwash is another simple solution for certain ulcers. For more advanced ulcers, antiseptic mouthwashes such as chlorhexidine povidone iodine mouthwashes are applied.

If the ulcers are too painful, the mouthwashes containing local anaesthetics are applied. Local anaesthetics like benzydamine hydrochloride, choline salicylate gel or lignocaine provide temporary numbness at the affected area. However, the mouthwashes containing local anesthetics are not recommended for young children suffering from mouth ulcers. Mouthwash containing Carbenoxolone can be used to relieve the irritations of certain types of ulcers.

So far as the aphthous ulcers are concerned, treatment is based on medical advice. To treat this ulcer, mouthwash containing corticosteroids is most commonly prescribed. However for more severe cases, in addition to mouthwash, oral medications or injections are also recommended. But before you start using corticosteroids containing mouthwash, it is important to make sure that the ulcers are not caused by a viral infection.

There is another type of mouthwash to treat aphthous mouth ulcer. These mouthwashes contain a type of antibiotic called tetracycline.

Most of the mouth ulcers can be easily treated by the application of the mouthwashes. If they persist long, it is recommended to seek medical help, as they may be the outcome of poor immunity or other medical conditions.