Mitral Valve Regurgitation – Ischemic Valvular Disease

Peri-operative management

Standard techniques of monitoring (arterial line, central venous access, Foley catheter…) are used in patients undergoing a combined mitral valve reconstruction and coronary bypass grafting. A Swan-Ganz catheter should be inserted in every patient. Initially a transesophageal echocardiogram should be performed. It is a key element to determine the functional type of mitral regurgitation and to assess left ventricular size and function. At the completion of cardiopulmonary bypass, it allows the surgeons to assess the quality of valve reconstruction, to detect residual air in left side cavities, and to monitor ventricular filling. An epiaortic scan of the ascending aorta is recommended to rule out the presence of atherosclerotic lesion prior to arterial cannulation.

Surgical approaches, cardio pulmonary bypass, and myocardial protection

Median sternotomy is the surgical approach of choice in patients undergoing combined mitral valve reconstruction and myocardial revascularization. In reoperative setting ( e.g. mitral valve surgery after previous coronary artery bypass grafting), a right thoracotomy approach is a viable alternative. Femoral vessels exposure is recommended if severe mediastinal adhesions are suspected (recent reoperation, multiple previous sternotomies, mediastinitis, and mediastinal radiation) and in patients with patent left internal mammary graft. Mitral valve surgery is classically performed with cannulation of both vena cava and the aorta, intermittent antegrade or a combined antegrade and retrograde cardioplegic arrest with cold blood high potassium cardioplegia for myocardial protection. Further myocardial protection can be obtained by moderate systemic hypothermia between 28-30C and local hypothermia with topical ice.

Exposure of the mitral valve and valve analysis

Following completion of coronary bypass grafting, the perfect exposition of the Mitral Valve Regurgitation is essential before undertaking any type of mitral valve surgery. The most commonly used approach is the interatrial approach through the Sondergaard’s groove.

The valvular apparatus is inspected and then examined with a nerve hook in order to assess tissue pliability and to identify the functional type of mitral regurgitation. The anterior paracommissural scallop of the posterior leaflet (P1) constitutes the reference point. Applying traction to the free edge of other valvular segments and comparing them to P1 determines the extent of leaflet prolapse in patients with papillary muscle rupture. This technique is, however, not very reliable to assess the severity of leaflet tethering in the arrested heart. The presence and severity of annular dilatation/deformation is also evaluated. In postero-lateral myocardial infarction, this dilatation is asymmetrical, involving mostly the p2, p3 and posterior commissural area. In antero-septal infarction, the annulus is symmetrically dilated.

Mitral valve reconstructive Surgery

Type I mitral regurgitation

Type I mitral regurgitation is best treated with a remodeling annuloplasty. The ring is downsized by one size.

Type II mitral regurgitation

Mitral valve replacement with the preservation of the subvalvular apparatus is the surgical treatment of choice in patients with complete rupture of a papillary muscle.

Papillary muscle reimplantation can be attempted in selected patients, provided that necrosis of the supporting myocardial wall is limited and in the absence of akinetic or dyskinetic wall. The non-prolapsed area of the valve serves as a reference point to determine the site and level of implantation of the papillary muscle remnant. At this site a 5mm deep trench is created in the muscular wall. The papillary muscle remnant is trimmed in order to preserve only the fibrous cuff. The papillary muscle remnant is buried in the trench using interrupted 4/0 polypropylene sutures. The trench is then closed around the papillary muscle remnant using a figure of eight suture. The procedure should be completed with a remodeling annuloplasty.

Elongated papillary muscle can be treated by its plication or resection of its extra length followed by reconstitution of the continuity of the remaining segments. The procedure is completed with a slightly downsized ring annuloplasty to reduce the tension on the reconstructed valve. If the papillary muscle is too thin and the anatomic conditions are not favorable, Mitral Valve Regurgitation should be preferred.

Type IIIb mitral regurgitation

Remodeling annuloplasty using a downsized ring is the technique of choice in type IIIb dysfunction. The goals of valve reconstruction are: preserving leaflet mobility, restoring a large surface of coaptation by reducing the septo-lateral dimension, and stabilizing the annulus to ensure long-term stability.

From Carpentier A, Adams DH, Filsoufi F. Carpentier’s Reconstructive Valve Surgery. Saunders (Elsevier), 2010.The prosthetic ring should be downsized by one size or two sizes depending on the severity of leaflet tethering. The use of double-row annuloplasty suture technique is recommended to reduce the risk of ring dehiscence.

From Carpentier A, Adams DH, Filsoufi F. Carpentier’s Reconstructive Valve Surgery. Saunders (Elsevier), 2010 Additional procedure such as the resection of a large aneurysm or dyskinetic plaque may be necessary to enhance the results of valve reconstruction.

During the last decade, adjunct techniques including the closure of the indentation between p2-p3 segments, resection of secondary chordae, patch extension of the posterior leaflet and papillary muscle sling have been described to minimize the risk of residual or recurrent mitral regurgitation. Clinical experience with these procedures remains limited and there are no long-term data available.

Finally, it is important to stress that in selected patients particularly those with severe bileaflet tethering and enlarged left ventricle with an end diastolic diameter greater than 65 mm, mitral valve replacement with a bioprosthesis may be the surgical procedure of choice.

How to Treat Keratosis Pilaris Or Itchy, Bumpy Red Skin on Your Arms

If I told you that I am going to help you understand and treat your Keratosis Pilaris, you would say, “What is he talking about?” But if I told you that is a fancy medical term for chicken skin, which is that rough, itchy skin that occurs on the top and outer parts of some people’s arms and also on the front of their thighs, then it might ring a bell.

It is particularly common in teenagers and young adults. It also can itch and get inflamed, but more importantly, it looks really funny. When you have this condition, you will see all these little white studded bumps on your skin with pink skin in between. It is not dangerous but it certainly looks funny and does not feel good.

The treatment for Keratosis Pilaris is to use exfoliants. The hard little bumps that form when you have this skin condition represent over growths of dead cells on the top of the hair follicle. All you have to do is literally dissolve them away with a chemical exfoliant. Whatever chemical exfoliant that you use for your face, you can use on your arms. Wherever you have your chicken skin use your chemical exfoliant twice a day. In three to four week, or more in certain cases, you will notice a shrinking of those little hard bumps. Ultimately, the redness caused by the Keratosis Pilaris will go away, and you will be free of the itching and impact of your chicken skin.

Stop panic attack – calmpose yourself

“Mirror, mirror on the wall. Who’s the most worried of them all?” Do sufferers really feel the problematic aspect involved in it. The question might have been replied genuinely in the last decade which most sufferer know.

Alarming situation with anxiety occurs due to many worrying factors. Today the situation has turned worst. Most of us invite panic attacks by mixing our worries and daily life tensions which ultimately take the shape of anxiety and leave us nowhere. Some of us face pseudo myocardial infarction like situation in today as our physiology gets dominated by panic disorder. We have to think over it and stop panic attacks through applying better options.

Let us begin by trying to understand what panic attacks are.

Short periods of intense anxiety, during which the subject is plagued by acute manifestations like increased hear beat, trembling, sweating, hot flushes or chills, nausea, giddiness, breathlessness, butterflies in the stomach, paresthesias, derealisation or depersonalization, may be termed as Panic Attack.

Sufferers face extreme discomfort due to their panic attacks hence a mechanism should be developed to stop panic attack. The patients also develop suicidal tendencies due to a fear psychosis in them with the fear of death and losing control over self which are most crucial factors. They in fact keep the mental level distraught leading to eruption of numerous disorders. Most problematic thing is that such disorders can occur without any prior symptom.

One must understand major causative aspects to stop panic attack. It is revealed though that hereditary agent is involved in spreading anxiety attack symptoms which transmit from one generation to other through genes. Structural aspects are involved in it and major diseases including thyroid malfunction, Vitamin B deficiency and labyrinthitis are the reasons for developing such symptoms besides phobias, personal traumas, drug and alcohol abuse and hormonal imbalances in the case of women.

Keep control on your diet and avoid harmful elements like drugs, caffeine and extra alcohol consumption. Ensure that your meals are complete with all nutrients. Always select proper antibiotics even though your infections are minor.  You must consult general physicians to sort out minor health problems before it creates unnecessary anxiousness in you which later become a disorder and you are forced to take therapeutic treatment for that.

Stop panic attack through simple remedies like yoga, Thai-Chi, acupressure, acupuncture, ayurvedic massages, spa treatments, laughter therapy, long warm baths and other techniques. Hyperventilation is a symptom associated with panic disorders which helps in exhalation process to provide sufficient oxygen and carbon dioxide for controlling body system. Practice simple exercises and do deep breathing exercises. They would help you lessen the impact of anxiety attacks in emergency and will help you achieve success by keeping panic attacks under control.

Panic attacks are treated by cognitive behavioural therapy (CBT). An experienced psychotherapist is involved in this process and patients are encouraged to speak out his/her mind before the expert who judge mental level of that person. In this process patients speak up their thoughts and share the panic attack experience. It is ensured that discussion remains healthy with continuation of positive statements and chants are encouraged to repeat just to prevent possible attacks. This methodology is applied to keep the situation under control. In alternative panic disorder medicine biofeedback is considered wonderful technique applied upon sufferers. Main emphasis of this therapy is to have proper measurement of scientific parameters of body including pulse rate, blood pressure, temperature, sweat gland activity etc. Usually sufferer links panicky thoughts with reactionary steps of body which helps in having better control over physiological activities required for particular purpose.

The commonest, efficient and highly practical alternative panic disorder medicine option is exposure therapy. Its basic concept is that patients are encouraged to encounter fear which he/she escapes. This process is planned and done in safe environment under protective eye of trained therapist. Last but not the least patients are convinced through this practical experiment that the fear he/she had have waned.

Use of fast-acting panic disorder medicines are always preferred because panic attacks most often have heightened impact. Usually therapists suggest Benzodiazepine group of medicines to treat such chronic disorder. Major drugs of this group include Diazepam, Alprazolam, Lorazepam and Clonazepam etc. Such medicines have certain level of side effect too which can leave great effect on the health of a long time user of this medicine. In other category of panic disorder medicine, Selective Serotonin reuptake inhibitor is major which has drugs such as paroxetine, sertraline, fluvoxamine, escitalopram or fluoxetine out of many.

You wouldn’t like your valuable life too be wasted as hours countering panicky situations. Give space to calmness and keep anxiety at particular distance.

How to Get Rid of Cold Sores Permanently

Cold sore is an annoying and unsightly skin disease. Also known as fever blisters brought by herpes simplex virus. It will start as a red spot and will start to accumulate moisture making it itchy and irritating. It is a contagious skin disease that usually appears in the mouth, lips and genitals. It is important to get rid of cold sores permanently to avoid the annoyance and embarrassment brought by this skin disease.

Of course it is much better to avoid getting cold sore in the first place than to get rid of cold sores. It can spread through direct skin contact like kissing, touching or oral sex. Things used by a person with herpes simplex virus like towels, drinking glass; toothbrush etc. can also help spread the virus. Avoid skin contact or using personal stuffs of people you suspected with cold sores.

In most cases, it appears in the most inappropriate occasions like weddings, big dates etc. because you are more vulnerable to the virus when stressed. You should start to find remedies to get rid of the virus, to stop the annoyance and embarrassment brought by this skin disease.

It is important to find the best treatment available at the onset of this skin disease to prevent it from spreading and to get rid of cold sores as soon as possible. Cold sore can last for weeks if not treated at once. Here are some tips to get rid of cold sores.

Keep your cold sore dry. Regularly wash the area around the cold sore and pat it dry. Cold sore needs moisture and dirt to keep swelling. If they are kept clean and dry, healing will speed up. Shield it with petroleum jelly using cotton swab to avoid swelling.

Replace your toothbrush with a new one once detected you have a cold sore. Toothbrushes incubate cold sore causing viruses and it will keep coming back if you use the same toothbrush. You also need to replace your toothpaste tubes since toothbrush bristles get in contact with the toothpaste tubes each time you use your toothpaste. Buy smaller toothpaste and avoid rubbing your toothbrush bristles against the opening of the toothpaste tube.

Zinc sulfate, available in your local pharmacy can also help get rid of cold sores. You can ask the nearest pharmacy for a zinc sulfate tube once you spot a cold sore starting to burst out.

Amino acid lysine can also help you get rid of cold sores. You can get if from drinking supplements or by eating potatoes and dairy products. But amino acid lysine is not recommended for nursing or pregnant women as this can interfere with the infant’s development.

Lemon balm, tea tree oil, Echinacea and tea bag applied directly to the affected area can also help get rid of cold sores due to its antiviral properties.

Avoid stress. Stress triggers the recurrence of the virus and it also weakens your immune system, making you more vulnerable to viral infections. Get rid of cold sores by eating a healthy balanced diet, exercise and getting enough sleep.

These are just few methods you can use to get rid of cold sore. For more tips and ways to prevent cold sores from annoying you in the future, consult with your doctor.

Treating Plaque Psoriasis Naturally – An Overview of Home Remedies for Plaque Psoriasis

Plaque psoriasis is the most common form of psoriasis-over 80% of people diagnosed with psoriasis have plaque psoriasis. It is characterized by thick, scaly skin lesions that itch and flake. The condition is chronic and can be difficult to manage.

There are no easy shortcuts to beating psoriasis. A psoriasis cure that works for one person may have no effect on another. Luckily, there are a variety of natural psoriasis treatments out there that you can choose from. Here are some of the most effective natural treatments for plaque psoriasis.

Natural Treatment for Plaque Psoriasis # 1: Up Your Antioxidant Intake as a Remedy for Psoriasis

Psoriasis and inflammation are linked. More inflammatory bodies usually have more severe symptoms. Reduce inflammation by taking in plenty of antioxidants in the form of fruits and vegetables. Pick fruits with dark skins; berries are especially high in antioxidants. Eat plenty of green leafy vegetables as they are useful in cleansing your body of toxins. Simply by adding a few healthy choices to your diet can improve your skin's condition-it might just be your psoriasis cure.

Natural Treatment for Plaque Psoriasis # 2: Stop Drinking Alcohol or Quit Smoking for Psoriasis Relief

Drinking alcohol and smoking tobacco are not healthy habits for anyone, but they may be especially detrimental to people who suffer from psoriasis. There is evidence that the bodies of psoriasis patients are more sensitive to toxins than people without the condition, therefore if it would be wise to quit consuming alcohol and tobacco products.

Alcohol negatively affects the liver; the liver is responsible for removing toxins from the body-when it is unable to function properly, these toxins may accumulate and manifest as psoriasis. Alcohol also dehydrates the body, leading to even drier skin.

Cigarettes contain many harmful ingredients that poison the body. People who smoke cigarettes and have psoriasis are more likely to have severe symptoms than those who do not.

Natural Treatment for Plaque Psoriasis # 3: Soak in Salt Baths to Beat Psoriasis

Add some Epsom salt into your bath water and enjoy a long soak to alleviate your psoriasis symptoms. Make sure the water is not too hot, or you risk drying out your skin and worsening your psoriasis. Salt draws out toxins and reduces itching. Soak for 15 minutes, or just long enough to soften skin scales. Then exfoliate gently with a wash cloth and rub off the dead skin.

These are only a few of the most popular natural remedies for psoriasis. If none of these are your psoriasis cure, there are still plenty more to be tried. Learn more about To natural remedies for psoriasis, click here .

Missed Diagnosed Heart Attacks Can be Deadly

A missed heart attack diagnosis results in the highest medical malpractice payout among all medical malpractice cases. Every year in the United States, 7 million people go to hospital
emergency rooms
complaining of chest pain or other symptoms that suggest they might be having a heart attack.

When patients enter a hospital or an emergency room, doctors have a professional obligation to perform all the routine tests that will either diagnose heart disease or rule it out. When profit is put ahead of patient care, doctors may not take the required time to do their jobs thoroughly and effectively.

The statistics surrounding heart disease and heart attacks in the U.S. are startling. A heart attack occurs about every 20 seconds, and deaths from heart attacks occur approximately once a minute. Almost 14 million Americans have a history of heart attack or angina (chest pain or discomfort that occurs when your heart muscle does not get enough blood).

Warning signs of a heart attack include:

• Shortness of breath, often occurring at the same time as chest pain but can occur before chest pain, also
• Chest discomfort/pain (squeezing, pressure, or fullness)
• Discomfort in other areas of the upper body (one or both arms, back, neck, jaw or stomach)
• Cold sweat, nausea, light-headedness

More than 233,000 women die each year from heart disease; yet, most women do not experience chest pain when having a heart attack. Instead, they frequently experience nausea and vomiting, which often leads doctors to misdiagnose a woman’s heart attack as a gastro-intestinal problem. According to recent studies, women waited an average of almost 25 minutes longer than men for clot-buster treatments, which can stop a heart attack. Misdiagnosing a heart attack or a heart condition puts the patient, female or male, at risk for stroke, paralysis and death.

Acute cardiac ischemia (ACI) is a deficiency in the blood supply to the heart muscle. ACI includes heart attack and unstable angina; these conditions are among the most difficult to diagnose for even experienced physicians. Because these conditions go undiagnosed, patients are often discharged from the hospital when they should be admitted for further testing and treatment. Patients not admitted to the hospital are twice as likely to die than patients properly diagnosed, admitted and treated.

Heart disease is the number one killer in the nation, and failure to diagnose a heart attack is the number one medical malpractice mistake in our country. Being aware of the warning signs and what diagnostic options should be made available to you in the hospital may just help save your life.

Hand Fungus – Types and Treatment

The incursion of tissues by one or more kind of fungi corresponds to a Fungal Infections. They vary from external skin conditions to deeper tissue viruses to severe lung, blood (septicemia) or general illnesses. Several fungi are opportunistic while others are pathogenic, that can cause sickness whether the immune system is healthy or not.

When fungi infect one or more of your nails, an infection in hands will occurs. A nail fungal disease may start as a white or yellow spot under the tip of your fingernail. As the nail fungus spreads deeper into your nail, may spread all over your the hands – an unpleasant and potentially throbbing problem. It may be difficult to treat an infection in hand and nail fungus and may happen again but medications are available to help cure your hand fungus.

It is truly an irritating condition having a hand fungus and also feeling embarrassed when dealing with people. Some kinds of fungus are can be found in the human body naturally such as yeast, but an excess of even the natural fungi can lead to an infection.

Fungal infections can outbreak any part of the body, not the hands only, though it is more common to everyone. Let’s talk about the most popular kinds of fungal infections especially in the hands. Then move on to some kinds of treatment that are frequently quite effective in curing a fungal infection of the skin.

First is the Ringworm, also known as “Tinea Corporis”. It is a common fungal infection that typically affects the arms and hands. In just a touch can affect others and can spread the condition.

Second is the Tinea Manuum. It is well known as “Tinea fungal virus”. The majority it affects are the hands. Tinea Manuum can be bond all the way through others with the infection, animals, soil, and even objects contaminated with the fungus.

Lastly, is the Pityriasis nigra and known as “Tinea Nigra”. It is a rare infection overall, but it does tend to target the palm area of the hand. Usually spots of a black or brown color appear on the hands, although they do not move up and not scaly in texture.

Applying the affected area with a prescription cream is the most often fungal treatment. It’s very essential that the cream is used all the time that the doctor recommends, do not just stop when the symptoms go away. If you are still suffering from symptoms of irritation, itchiness, burning or if the rash remains visible or continues to spread, you should contact your doctor immediately for a re-examination. If your doctor is unable to treat your disease, he or she may request you to go to a disease specialist or dermatologist who may be able to treat you better. Just always update your doctors on the side effects or any improvement happens during treatment.

Common Allergies and Symptoms

Before we discuss common allergies and symptoms, you might find it helpful to have a little background. An allergy is a specific reaction of the body's immune system to a normally harmless substance, one that does not bother most people. Those people who find themselves dealing with allergies will often find they are sensitive to more than one substance.

Common Allergies

There are many types of allergies. The most common are seasonal allergies which result from certain trees, plants, or pollens (birch trees, ragweed, rye grass and timothy grass) in the air at certain times of the year. Approximately 35 million Americans are allergic to pollen (also commonly referred to as hay fever). Pollen is a powder made by flowering plants and trees. Though most people tend to think of pollen season as spring, pollen grains can be in the air in the spring, summer, and fall, depending on the type of tree, grass, or weed.

People can also be allergic to some foods, particularly peanuts, shellfish, milk, fish, wheat and soy. If you're unsure which food allergens are giving you trouble, a visit to your physician or allergist can uncover the guilty culprits. An allergist can perform tests to identify and isolate any specific sensitivity you may have, whether or not they're food related, and the severity of your sensitivities. In addition, since some allergies can be life threatening, the allergist can provide you with instructions on life saving measures to be taken in the event of a severe allergy.

Other common allergies include animal dander (animal hair, cockroach calyx), insect stings (bee venom, wasp sting), dust mites, mold spores, medications (penicillin, salicylates, local anesthetics, sulfonamides), even latex rubber.

Common Symptoms

Symptoms of allergies are classified by degree of severity, including mild, moderate, and severe allergic reactions. Most people experience relatively mild symptoms, such as watery eyes, itchy skin, a runny nose, coughing, and hives. These types of allergy symptoms can usually be controlled by using an antihistamine. There are several over the counter antihistamines, as well as others you can only get with a prescription. You may also want to consider getting an allergy shot.

For other sufferers, the allergic reaction is moderate. In these cases, the reaction spreads to other parts of the body. For instance, you may experience difficulty breathing. Antihistamines, steroids, and immunotherapy can all held remedy the effects.

While very rare, severe allergic reactions do exist. Generally these are the result of food allergies. Peanuts, milk, and eggs are the most common. Symptoms include swelling of the face, abdominal pain, cramps, hives, and angioedema, which are hives inside the throat. Immediate medical attention is generally required for symptoms of a severe allergic reaction. Often a shot can help offset the reaction.

While there is no cure, common allergy symptoms (inflammation, rashes, hives, etc.) can be treated. The best treatment of all, of course, is simply to avoid those factors that trigger an allergy attack (easier said than done).

Heart Disease Symptoms – Alexis Kenne

Cardiovascular disease (CVD) is the leading cause of death in both women and men in the United States. Although many women believe that they’re more likely to be diagnosed with breast cancer, their risk of CVD is actually significantly greater. Cardiothoracic surgery also involves the treatment of the heart, (cardiovascular disease), and lungs (lung disease).

Heart disease symptoms may not always be evident, but usually there are symptoms that can alert you to a potential problem. A classic symptom is chest pressure or left arm discomfort, which occurs during stress (physical or emotional), and goes away with rest, or with nitroglycerin, a medication that dilates blood vessels. Heart disease symptoms differ in intensity and some symptoms might not develop until after there’s been extensive damage to a person’s heart and blood vessels. Some people experience only a few of the symptoms of a heart attack.

Signs and symptoms vary from person to person, and people suffering from a second heart attack may experience completely different symptoms. Some people have no symptoms. Significant differences exist in the symptoms displayed by women and men. Men typically experience the “classic” heart attack signs: tightness in the chest, arm pain, and shortness of breath.

Chest pain or Angina , quite often at rest; the pain may spread to the left arm or the neck, back, throat, or jaw. There might be present a numbness (paresthesia ) or a loss of feeling in the arms, shoulders, or wrists. Chest pain, the medical term for which is Angina, is the most common symptom of coronary heart disease . Chest discomfort, heaviness, pressure, aching, burning, fullness, squeezing or a painful feeling in your chest. It can be mistaken for indigestion or heartburn.

Blood may back up into the system causing still more problems. Persons with high blood pressure are at risk for congestive heart disease and must make every effort to keep blood pressure controlled. Blood pressure should be checked at regular intervals (as recommended by your health care provider) to monitor the condition. Frequent blood pressure measurements performed at home are often recommended for patients who have difficult-to-control high blood pressure.

Patients with diabetes mellitus are at an increased risk of having silent heart attacks. It is generally a good idea to work with your doctor to monitor you heart’s function on an as-prescribed basis, particularly if you have an existing heart condition, are at an increased risk, or know that there is heart disease in your family. Patients are given a pill or injection that is actually a harmless, inert substance, but they are told that it is a remedy for their illness. Various studies have shown that a significant percentage of patients do experience an improvement in the symptoms. Patients with heart disease will also benefit by steam cooking vegetables.

Irritability and Neck Pain Headaches

Irritability caused by stress is common in nearly every family in the United States. Fights about money, raising children and life in general can leave a married couple feeling tension in the relationship. That tension is most often centered in the neck area causing a neck pain headache. A neck pain headache can also be related to previous injury, sitting too long at a computer, watching TV at an uncomfortable angle or sleeping without proper neck support.

While there are several reasons why pain may develop, tension is the number one cause of a neck pain headache. This tension often leads to irritability which can affect the mood within the home where life is supposed to be most relaxing. The work / life balance can be difficult to maintain, but learning how to turn off the work persona and turn on the dad or husband can work wonders for pain relief.

Tips for Leaving Work at Work

After leaving the office for the day, try listening to music on the way home. Refrain from turning to a news station or talk show that may tempt you into irritation. Sing along with the music and release the tension that has built up throughout the day.

Once at home, immediately change clothes and place a physical barrier between work and home life. Even if you are headed out of the house again to dine in a restaurant, take the time to change something whether it is your tie or slacks.

These simple changes in your daily routine allow for the redirection of work tension away from home life. When the tension is relieved, the neck pain headache will often subside or cease to bother you during home time, at least.

Coping With Stress, Depression, And Anxiety!

Stress, Depression, and Anxiety: Put It in Its Proper Perspective!

Do you sometimes think there is nothing you can do about your stress, depression and anxiety levels? You have too many bills to pay, too many responsibilities to meet, and simply just too much to accomplish in a day.

You can say that again !!

The other day I had just finished paying the monthly bills (a necessary chore I simply hate to do), I was late for my Yoga class and driving faster than I should. In order to save time, I passed on the shoulder of the road. Only for a short distance … after all, that pick-up truck ahead of me was doing the same thing!

Lo and behold, would not you know it, the police stopped me. Just my luck … the cop did not understand my pleading, I was late for class, I was a poor retired teacher, it was my first time … they were all true! To make matters worse, the pick-up truck got away.

That did not alleviate the ticket I received and it did not alleviate the stress, depression and anxiety it created. It seems like sometimes you just can not do anything to control your these level.

Well actually, you have more control than you think you have!

The simple thought that you have control of your life is the essence of stress management. This includes learning and practicing relaxation techniques like meditation, yoga, or tai-chi and exercising. Your body can fight stress, depression and anxiety better when it is fit and you have control over your life. Of course that's always a good thing!

You probably agree, that in order to manage stress, depression, and anxiety you yourself must take charge of your life. You must control your thoughts, your emotions, your environment, and your activities (even if it is driving your car on the shoulder of the road).

You are the only one responsible for controlling the way of dealing with all of these things. In essence, you are responsible for balancing your life toward productivity.

Balancing Your Life

Think how you must balance your life to meet the demands you have: for work, for relationships, for relaxation and for play? Then you must develop the strength to hold up under the challenges of life and the pressures of stress, depression, and anxiety.

On top of it all, you must use management to recognize when the Stress, Depression and Anxiety come into your life and what is causing it. This is not as simple as it may seem!

• Is the cause and is it constantly hitting you in the face?
• Is it constantly producing undesirable thoughts, feelings, and actions that are stressing you out?
• Is it constantly worrying you or causing you conflicts?
• Is it the excuses, habits and attitude you use that helps to identify your various causes?

There are some other important questions you must ask yourself:

• How do you explain these problems? Is it temporary? Is it simple? Is it unexplainable?
• How do you define your situation? Anxiety? Is it part of you work? Is it part of your family? Is it part of your behavior?
• To what do you attribute to you life style? Do other people cause it? Is it caused by outside events? Is it normal and acceptable?

If you recognize and accept the responsibility for your stress, depression, and anxiety, that's the first step and maybe the most important. This begins to control and possibly eliminate your situations! Remember: Particular Thinking Leads To Particular Feelings! As do all others too.

Common Night Sweats Causes

Before you can try to eliminate your night sweating, you need to know what is causing them in the first place.  I will go over some of the most common night sweats causes so you can work with your doctor to determine the best path of treatment.

Check Your Medications

The first think you should do is consider the medications you are currently taking.  Make sure you are considering both OTC (over the counter) medications as well as your prescription medicines.  Night sweats are a common side-effect of many common and otherwise safe medications.

For example, the drugs in common pain relievers and fever reducers Tylenol and Advil (acetaminophen and ibuprofen, respectively) may cause you to experience night sweats if you experience a mild fever and these medications then lower your temperature in a rapid fashion.

Other medications known to be night sweats causes are antidepressants, high dosage niacin, tamoxifen and cortisone-based prescription medicines.

Check For Infections or Inflammation

Next you should make sure you are not enduring some kind of illness or inflammation you are not aware of.  Any kind of infection or inflammation may cause your core temperature to rise and fall in a rapid manner.  Any time you experience that kind of rapid temperature change, you are bound to experience excessive sweating, especially while you are asleep.

And one of your body’s most effective tools for fighting infections and inflammation is temperature modulation.  In particular tuberculosis is known to be one of the more severe night sweats causes.

Check For Low Blood Sugar

Did you eat a ton of sugary foods then not eat for a really long time before you went to bed?  The high sugar foods will spike your blood sugar, actually lowering your blood sugar long term.  Then going for a long time after that sugar spike will cause your blood sugar to continue dropping. 

When your blood glucose gets low enough, your body starts to think that something is wrong and might start setting off its various functions for immunity.  And one of its most common and effective tools for immune function, as mentioned earlier, is thermal regulation.  Thus low blood sugar is actually one of the most common night sweats causes.

So don’t eat high sugar food before bed, and be especially careful about eating a high sugar food then not eating for a long time before bed.  In more severe situations, you might discuss diabetes and hypoglycemia with your doctor, as severe night sweats are a common symptom of these conditions.

I hope you now better understand some of the most common night sweats causes and you feel more empowered to address this uncomfortable and possibly debilitating condition with your primary care physician.

Fear of Cats – How to Overcome a Phobia of Cats Easily

People have different reasons for their fear of cats. However, most of them can point to an experience in their past that made them afraid of the animals. While it is always prudent to treat animals with respect, it is not normal to panic at the sight of an ordinary cat or kitten. Pets are meant to bring love and happiness to people. Breeders do not breed animals to create anxiety. Yet, people with a phobia of cats are incredibly anxious when they see a feline. People with this phobia should know that it is easy to overcome their anxiety in just a few hours with the help of neuro-linguistic programming (NLP) and hypnotherapy.

A Fear of Cats Can Negatively Impact a Person’s Life

It might seem like this type of phobia is easy to live with if you do not own a cat. However, people who suffer from this phobia might be afraid to visit homes that have a pet cat or might avoid taking their children outside in case they run into a feral cat. People with a severe form this phobia may even be afraid of seeing a cat on TV.

Don’t Pass the Phobia to Your Children

Children are remarkably perceptive about their parents’ fears. Many parents are, therefore, concerned about passing their concern about pets to their children. They do not want their children to learn to fear felines like they do. They want them to play outside, visit friends and watch TV without fearing a panic attack.

Break the Cycle of Panic

The best way to break the cycle of panic is to end your own phobia. This will require you to recondition your mind. When you see a cat you will no longer fear an attack but will instead see the animal as a gentle creature that means you no harm.

Help is Available

NLP and hypnotherapy have both proven to be effective. Direct NLP and hypnotherapy reconditioning techniques have cured many people with a phobia of felines from their debilitating panic.

How NLP and Hypnotherapy Can Help

Direct NLP and hypnotherapy reconditioning techniques do not take into account why a person is afraid of cats. A person might not remember what started their fear. They might not remember a time when a cat jumped on them suddenly or when a cat scratched them when they were small children.

Yet, they are aware of how their phobia limits their everyday activity. NLP and hypnotherapy will recondition their thoughts. After treatment, they will not panic when they see a cat but will instead see a cat or kitten for what it is, namely a beloved pet or innocent animal that will not hurt someone without provocation.

NLP and hypnotherapy can often help someone fully recover from this phobia in one session. Rarely, a second session might be required. Therefore, in as little as one hour, a person can be rid of his or her fear of cats that so profoundly impacts his or her life.

Anxiety and Depression Self Help

Knowing about anxiety and depression self help is a must if you suffer from those conditions.

You might want to know how and why your anxiety is triggered. For the most part, stress plays a huge factor in triggering an anxiety attack. While the person who suffers from anxiety may react well in a stressful situation, after it is all over, they tend to have the anxiety or panic attacks.

Almost everyone who have an anxiety attack for the first time have experienced a significant stressor in their daily life. Thus, stress plays a major role in the cause of anxiety.

Most people are ashamed that they are feeling anxious and keep this secret from friends and family. This is only making things worse. You will then never have anyone to talk to when needed. When you finally release your secret, then you will be surprised to find out how many people actually suffer from the same anxious feelings! You are so far from alone when it comes to anxiety attacks. The fact is, that the majority of people have experienced some sort of anxiety or panic attack at least once in their lives.

Many women begin suffering from anxiety when they approach menopause. If you are in your mid to late 40s and are starting to have panic attacks, they can very well be related to the fluctuations in your hormone levels. Most women who go through menopause will experience some psychological factors such as mild depression or anxiety. Some women will experience menopause symptoms to the extreme. In such cases, doctors will usually treat this condition with hormone replacement therapy or other types of drugs, so that the woman can go about her daily life.

It is very rare that someone will have anxiety without depression. Most people will have an anxiety attack right after a period of intense depression. The anxiety is almost like the depression trying to escape the body. And after anxiety attack subside, many people tend to become depressed.

Many people who are in a depression do not even realize that they are in this state. They curtail their activities, find no joy in any sort of living and start to shut themselves off from family and friends. Very few people realize it when they are in a state of serious depression. They may tend to sleep a great deal of the time or not be able to sleep at all.

There are many signs and symptoms of depression and they often mirror that of anxiety. The most common sign of depression is that the person suffering from this condition does not get much joy out of life. They may feel what their life is worthless, may feel angry or even guilty about something that happened in the past. There are all sorts of reasons why we can get depressed.

What Is Delayed Growth Following A Hair Transplant?

The asynchronous cyclical nature of human follicular activity contrasts sharply with the synchronized “molting” pattern seen in other mammalian species. In the process of molting, animals shed their hair in a synchronized, seasonal pattern to adapt to the changing climate. This shedding of hair is controlled by mediators released by the hypothalamus, pineal, and anterior pituitary.

Humans differ from other mammals in that their growth cycle is almost totally asynchronous, and this pattern is established shortly after birth. Human hair has a growth cycle of approximately three years. Since human hair grows approximately 1/2 inch per month, it would reach a length of about 18 inches before it is shed. Therefore, in the average person, hair length is limited to approximately 1 1/2 feet. There is, of course, significant normal variation with hair cycles varying in each individual and from person to person. At the extreme end of the bell curve, continuous patterns of growth may be seen (Angora). In a given period of time about 13% of hair is in the resting (telogen) stage, which lasts about three to four months. For example, if the average person had 100,000 hairs on his head, approximately 90 should be shed each day, and 90 would begin to re-grow.

Generally, following a transplant, all of the transplanted hair is shed in an effluvium and enters a resting phase. If all the hair was to simultaneously begin a new anagen cycle, the asynchronous normal growth pattern in man would be effectively converted to the synchronous growing/molting pattern of animals, and much of the new hair would fall out during the next normal telogen three years later. This obviously doesn’?t happen to any significant degree.

To prevent this from happening and to keep our hair cycle “human,” there are at least two possible mechanisms at work. In the first, each hair might resume its growth cycle at the point where it was interrupted, thus continuing the previous totally asynchronous pattern of growth. In the second possibility, each hair would begin a totally new 3 year cycle. In this case, if all the hair was to begin growing simultaneously, this new hair would fall out at approximately the same time three years later. In the second scenario, in order for nature to restore its normal asynchronous pattern, it would have to delay the onset of growth in a portion of the follicles. In theory, to be totally asynchronous, new crops of transplanted hair would continue to appear over an extended period of time, possibly up to three years.

It is unclear which of these two physiologic mechanisms best explains the natural course of events, but it is likely that both are at work. In the first, abundant new hair growth would be seen at 3 to 4 months with each follicle resuming its original cycle. In the second scenario, hair would gradually reappear over an extended period of time with each follicle at the beginning of a full new cycle. It is noted that in some patients substantial hair growth is delayed significantly past the usual “three to four months,” with some new growth occurring as late as a year or more after surgery. It is possible that in this subset of patients, the second natural mechanism is at work.

We wonder if this phenomenon of delayed growth is unique to the newer techniques or has always been present and is only now being recognized. With 4mm grafts, containing an average of 20 hairs, a delay in the growth of some of the hair would largely go unnoticed. With the use of smaller grafts, such as mini-grafts, but especially with micro-grafts and follicular implants, any delay would be immediately apparent. In fact, it has been the experience of these authors that the appearance of the large grafts often worsen with time as the full complement of hairs in each graft become visible.

If delayed growth is indeed a new phenomenon unique to the implantation of very small grafts, it is possible that the growth cycle of the hair in these grafts may react differently to the trauma of transplantation than those in the larger grafts. In other words, the desiccation, temperature change, and mechanical trauma to which small grafts might be more subject actually cause a delay in growth in situations where there was not quite enough injury to completely destroy the follicle. Thus, small degrees of trauma may either induce the second physiologic mechanism to occur, or may cause a more pathologic delay in growth. Of course, with increasing trauma, poor growth or no growth would be the result and this “point of no return” must be elucidated in carefully controlled studies. An additional type of trauma that may contribute to delayed growth has been recently reported by doctors Cooley and Vogel. They suggest that when the dermal papillae is lost during graft preparation and handling, it must regenerate from the fibrous root sheath before the hair will re-grow, and this regeneration can often take several months. The role that this important mechanism plays in the delay that we see clinically must also be determined.

Our guess is that “delayed” growth has always been part of the transplant process, representing a normal physiologic shift in the growth cycle on one hand and a reaction to sub-lethal injury on the other; with the very small grafts making both of these changes more obvious. What percentage each represents and how much of “delayed growth” will turn out to be no growth at all still needs to be determined. But before we panic about “perceived no growth” and before we set our patients up for unrealistic expectations about how soon their growth may occur, we should work to have a better understanding of all the biologic factors that impact our surgery.


1. Ebling FJ, Hale PA: The control of the mammalian molt. Mem Soc Endocrinol 18:215, 1970

2. Pecoraro V et al: Cycle of the scalp hair of the new born child. J Invest Dermatol 43:145, 1964

3. Cooley J, Vogel J. Loss of the dermal papilla during graft dissection and placement: Another cause of x-factor? Hair Transplant Forum Int 1997; 7:20-21.