The Diagnosis of Death

DEATH DIAGNOSIS

The duty of a medical doctor is not confined only in the treatment of his patients, but also there are several other duties to be performed. One among them is death diagnosis, and in case of any unnatural death, reporting the same to the concerned authorities. When a person losses consciousness, a doctor should examine the victim to diagnose the condition and to do the needful. If the victim is dead, it is the doctors duty to declare that the person is dead. If a doctor is not available at the site, the situation has to be handled even by a layman. Hence it is very essential to know the basic techniques of first-aid and death diagnosis.

We all know that, death is the termination of the biological functioning of the living organism. It is the ultimate of every living creature on the earth. Once we are born, it is definite that one day our soul will leave the material body for ever. Scientifically, death is due to complete and irreversible cessation of the vital functions of the brain, heart, and lungs.

STAGES OF DEATH

The death occurs in two stages:

1.Somatic, systemic or clinical death

2.Cellular or molecular death

In somatic death, though life ceases in the organism as a whole, it can persist in different body parts, organs, tissues and cells. The body cells can survive for varying periods and can respond to various chemical, thermal and electrical stimuli. The period of survival of cells depends upon the oxygen demand. And when the cells and tissues die, it is considered as molecular death. Normally, molecular death is complete within 3 to 4 hours of somatic death. However, in common parlance, death means somatic death.

WHAT CAUSES DEATH?

Irrespective of the remote causes, a person dies as a result of failure of any one of these organs like brain, heart, lung. This is called the proximate cause of death. The remote causes may be due to injury, infection, blood loss, poisoning, drugs, tumors, malnutrition, dehydration, starvation etc. A sudden death may be due to failure of systems like cardiovascular, respiratory, CNS, abdominal, endocrinal, iatrogenic, special cases in children, malnutrition, disease, accident, injury, predation, suicide, homicide, war, and also due to some indeterminate causes.

SIGNS OF DEATH

The signs of death can be studied under three headings: Immediate signs, early signs and late signs.

Immediate signs: These signs indicate somatic or clinical death.

– Insensibility (Loss of sensation, movements and reflexes)

– Loss of EEG rhythm

– Cessation of circulation indicated by flat ECG and absence of respiration.

But signs like loss of sensation, movements, loss of respiration, absence of pulse and heart sounds etc are also seen in conditions like prolonged fainting attacks, vagal inhibition, epilepsy, narcosis, electrocution. Hence, such signs cant be considered with cent percent surety. They could however be taken as conclusive only when associated with total loss of EEG rhythm for a continuous period of 5 minutes and a flat ECG for 5 minutes.

Early signs: These signs denote molecular or cellular death, which follow about 12 to 24 hours.

– Algor motris: It is the cooling of the body after death.

– Postmortem lividity: It is the discoloration after death. It starts within 1 to 3 hours and gets fixed in 6 to 8 hours.

– Rigor mortis: It is the stiffness of body after death. It starts 2 to 3 hours after death and takes 12 hours to develop, persists for another 12 hours, and takes 12 hours to pass off completely.

Late signs: These signs represent the decomposition or decay of the dead body, or in certain situations, modification of the dead body into adipocere or mummification. Late signs follow after about 24 hours. The putrefaction of the body is indicated by the appearance of greenish discoloration which appears 12 to 24 hours after death. Marbling is the network like markings on the skin, which comes after 12 hours and becomes prominent in 36 to 48 hours after death. Maggots also starts appearing as a result of putrefaction.

BRAIN DEATH

It is the irreversible end of all cerebral activity, but brain stem is still working. When the brain death occurs, the victim can be kept alive by maintaining the working of heart and lungs with the help of sophisticated instruments and some drugs. The body can survive by maintaining the supply of the oxygenated blood to the brain stem. When the brain stem also stops working, it is taken as a significant indication of death.

SUSPENDED ANIMATION

This condition is also called apparent death. Here the vital functions of the body are at such a low pitch that they cant be detected by routine methods of clinical examination. Suspended animation may persist for a few seconds to several minutes. This condition can be noticed in apparently drowned, newborn, after anesthesia, cerebral concession, electrocution, heatstroke, mesmeric trance, overdose of barbiturates, opium, deep shock etc. Suspended animation can be revived by resuscitation techniques.

DIAGNOSIS OF DEATH

Diagnosis of death is not easy when it is performed immediately after death, specially by a inexperienced person. Rarely, some difficulty can be raised due to suspended animation, excessive doses of sedatives and hypnotics, hypothermia, alcohol intoxication etc. When you are asked to do the death diagnosis, the situation should be handled skillfully. The room where the victim is resting should not be overcrowded. Allow only a few people to be present at the site. There should be proper light, air entry and free from noises and other disturbances.

Inspection: The inspection should be finished in a few seconds without wasting much time. Look at the victim from head to foot and look for any body movements of chest, abdomen, wings of nose etc. Then feel the radial pulse. If it is not felt, go for carotid pulse lateral to the thyroid cartilage (never press both carotids at the same time, feel only one side without much pressing). Then take the stethoscope and auscultate the chest for heart sounds and respiratory sounds. If there is sings of cardiorespiratory failure, give mouth to mouth or mouth to nose respiration along with external cardiac massaging to resuscitate the cardio-respiratory function.

If no response even after the cardiac resuscitation, it is the doctors duty to confirm death of the victim. Once again confirm the cessation of respiration by keeping the stethoscope on chest/larynx for 5 minutes and also cessation of cardiac activity by keeping stethoscope on the precordium for 5 minutes. Feather test can be done to see for any current of air through the nose. Open the eyelids and move the head from side to side. If the eyeball is fixed and moves along with the head, it is a sign of death.

Take a clinical torch and check the eye for pupillary constriction when the light enters the eye. When the body dies, the pupil dilates and the cornea looses its glossy appearance. But this may not be clear immediately after death. And in those who are having eye lesions specially the aged with diabetes, the findings may be confusing. When a person dies, the pallor appear in a few minutes. Look for the capillary filling after blanching the victim’s nails. In a dead body, the capillary refilling is not seen.

In case of doubt ECG and EEG monitoring can be done. A flat ECG for 5 minutes is an accepted evidence of death. Absence of EEG waves for five minutes confirms death. However, EEG and ECG are not required to give a death certificate since death diagnosis is possible by clinical examination in majority of cases. However, these tests are having a confirmatory value.

LEGAL ASPECTS OF DEATH

Legal aspects of death varies among different countries. There are difference in opinion on the definition of brain death. However, as per the modern thinking, a person is presumed to be dead if he cant spontaneously pickup and survive when the artificial means are withdrawn. The irreversible brain damage can be confirmed by a flat EEG.

In case of any signs of unnatural death or when the death is unexpected, the cause of death has to be confirmed by a medico-legal autopsy. Unnatural death may be an accident, suicide, homicide, or even may be a natural death but unexpected and taken place under doubtful circumstances. All cases of unnatural death cases should undergo a medico-legal autopsy to identify the exact cause of death, time of death, position of the body at the time of death etc. Hence it is the duty of a medical practitioner to inform the authorities whenever he comes across any unnatural death.

Coping With Cancer: When Treatment Ends

It is good news: the intensive stage of cancer treatment is coming to an end. Through chemo, radiation, surgery and other remedies, we cancer survivors have endured a lot and managed the rest of life as best we could. We feel grateful, but that is not all.

When the routine and intensity of treatment ends, painful and troubling emotions emerge for many cancer survivors. Now we begin to feel and process all that we have been through. During treatment, we focused on day-to-day coping. Afterwards, all the feelings of this traumatic time are still within us. In this less busy, quieter time of recovery, we begin to feel them. Ironically, the crisis has faded, but we are just beginning to experience its full impact.

We feel the little things-the pain when a nurse had trouble finding a vein, or the frustration or boredom when we sat a long time in waiting rooms. We also feel the big scary things: when we waited for test results not knowing, when we had to tell friends and family about our diagnosis, when we contemplated the possibility of our own death. The first months after treatment ends are when bottled-up memories and feelings come uncapped.

We also may feel frightened about ending treatment. At least during treatment we have some secure structure in life and some affirmative steps we are taking to beat cancer. After treatment we are not sure how to relate to cancer, and we can feel more alone with it. Our medical support team is gone. Our daily routines are mixed up again.

As our own feelings surge, our families, friends and co-workers think we are done with cancer, and they may be tired of dealing with it. They want to be assured that we are all right and to put the cancer experience in the past. But most of us cannot do that right away, so we feel a little crazy and guilty. We think that we ought to be able to move on, but it’s not that easy. Does this sound familiar to you? I call this time the Feeling and Healing Phase of recovery.

What helps us through this Feeling and Healing time right after treatment? Here are seven specific steps that you can take on your own behalf during this tender time.

* Allow time for your body to rest and recover

* Build emotional support perhaps by joining a support group, doing therapy or coaching, or participating in chat rooms and other virtual forums

* Engage in activities that you enjoy

* Ask for continued support: let dear ones know what’s going on

* Use your creative powers to express your feelings and process the experience

* Discover or design a retreat space for yourself and give yourself some time there

* Take an imaginary retreat through visualization

In the months right after treatment the key is to allow yourself space and time to absorb and process all that you have endured. You need ways to express your emotions and to share them, so you do not feel as alone. With time, the feelings begin to lose some of their grip. We feel less overwhelmed and new questions begin to pop up in our minds.

At some point-usually many months after treatment ends-you will begin to notice that thoughts and feelings of cancer take up a little less time and energy and that you are naturally starting to think more about the rest of your life. This may come in the form of dissatisfaction with some aspects of your life, or it may come in the form of yearnings or wishes for your life. You may find yourself curious and drawn to trying something new. You may be confused. You start feeling the desire to get back to life, but you recognize that you cannot go back to what life was before. Given all that you have been through, you may not know what you want anymore or how to go forward. These thoughts and feelings signal that you are shifting to the next passage of post-treatment recovery which I call the Now What? Phase.

There is some really good news here: at this particular time in your healing, there is a unique opportunity to use the fear, gratitude, and insights that arose from your cancer experience to transform your life. You have had to tap into your own strengths to cope and to manage fear. You may also have gained a lot of clarity about what is most important to you in life. Gather those insights to steer a course forward.

Life coaching is particularly helpful at this time. What is life coaching? It is a relatively new specialty that has evolved over the past 25 years. A coach guides a process designed to help each participant define his or her deepest values and goals and move toward building a life that reflects those aspirations. The assumption in coaching is that the participant is completely creative and resourceful and the expert in his or her own life. Coaches help you put that tap root down into your own insight, and then support you as you take action based on that insight.

Speaking to a Diverse Audience

Any professional speaker will tell you that one of the most important rules of speaking is to know your audience. For most speakers, this means hours of preparation researching the company or organization to which they will present their material. Speakers know that by reading trade publications, in-house newsletters and promotional materials, they will learn the jargon that is the language of that company.

Real pros will also inquire about the audience members themselves. They will ascertain something about the corporate structure, the VIP’s, those employees who have won awards, etc. This gives a speaker an “insider’s edge” when he or she stands before what is otherwise a roomful of strangers. By the time the speaker takes the lectern, a great deal is known about the audience. However, there is one more piece of information that a speaker might not know but must take into consideration when preparing a talk: Are there any attendees with disabilities? Below are a few tips that will help you to make all of your talks more accessible and inclusive.

When planning the audience seating arrangements, ask if there is adequate access for wheelchair users. Provide an extra-wide aisle for wheelchairs to sit amongst the audience. Wheelchair users should not be forced to occupy the very back of the room, or the very front row, if they do not wish to.

If you are using written materials, make copies available in a twenty-four-point font size. This is a standard large print text size, and will enable most people with low vision to access your valuable talking points. If you are making a presentation using slides or video, make a point to read the text as you go, or provide a brief narrative of the content. This can be accomplished smoothly and with discretion, so as not to needlessly draw attention to any individual.

For attendees who are deaf or hearing impaired, allow for seats to be reserved up front if you are not using a microphone, or near speakers if using amplification. Ask your assistant, sergeant-at-arms or the facility set-up crew to help attendees identify these seats. Remember that if a sign-language interpreter will be needed, provide an extra seat.

If speaking at a function that does not involve a meal, try to arrange for some water and a snack, at least. If no food is available, provide some fruit, candy or even trail mix. This can help attendees get through a long program. Remember that audience members with diabetes or hypoglycemia require access to food. Besides, hungry attendees are inattentive attendees.

When incorporating humor in your presentations, think very carefully about the jokes you choose. If you obtain material from humor websites, use the humor from their “clean” section. When in doubt, don’t use it. If you want to make a joke about an executive or supervisor in the group, approach him or her privately and ask permission first. While this is a good trick to ingratiate you to the rank and file, it may backfire. You never want to risk ruining what may be a well-crafted image. Stay away from the big landmines. You know the ones – no jokes about race, religion or sexuality.

On the other hand, self-deprecating humor almost always works well. Don’t overdo it, though. You don’t want to come across as though you are a victim seeking sympathy. Sprinkle observational humor throughout your presentation, and restrict it to subjects, such as bizarre policies or ridiculous procedures, equipment snafus, or humorous storytelling, with a point as well as a punchline.

As our society becomes more diverse, so does our workplace and so must our speaking skills. Remember that it is unwise to make assumptions about any group. The specific nature of that diversity may not be apparent, but that does not mean a careless remark will not deeply affect or offend a member of the audience who may have friends or loved ones who are proud to belong to a group you just disparaged. No one will remember your silly jokes, but someone is likely to remember that you took the time to provide large print materials. Accommodating the needs of a diverse audience is an act of consideration and respect that can only enhance your professional reputation.

Copyright 2005 All rights reserved.

The Amazing Tape Measure

When the word "Nurse" is mentioned, there are two possible images that come to mind: an incredibly young woman in a white uniform holding a needle and syringe, or an incredibly old surly woman holding a needle and syringe-always a syringe. Never a tape measure.

Many people take measurements for granted, and see this tool as nothing more than an inconsequential, low-tech gadget used to measure things. Almost as obsolete, and as rarely used as the ruler. While it is true that measuring tapes serve nothing but the purpose to measure, several industries actually heavily rely on their use.

For instance, the clothing / fashion industry: seamstresses use tape measure to measure the size, length, width, girth, etc. of a person or a model. Do not think for a second that famous fashion designers such as Karl Lagerfeld would be above using one (sometimes he could ask his assistants to do it for him) -after all, the perfect fit is what they're all aiming for. Similarly, illustrious milliners such as Phillip Treacy, would no doubt have to rely on the use of a tape measure to know how his hats would fit on the members of the English aristocracy.

Another industry that heavily relies on measurements is the construction business. From surveying to carpentry, the deceptively simple tape measure is a necessity for every element of planning, designing and constructing a building, bridge, or anything in between.

But very few would think of the healthcare industry, when the word tape measure is brought up. The two things associated with the former are always the needle / syringe and / or the stethoscope. Surprising as it may be, healthcare workers, particularly nurses, rely a lot on physical measurements too. That deep gash that warranted 13 stitches? They had to measure it and document it.

Grandma who has a heart problem, and has had swollen feet (edema) for several weeks now? Her ankle swelling is monitored -any increase in circumference could indicate worsening of the disease.

Good 'ol John Doe in vegetative state, with a VP / Cerebral shunt that drains fluid from his brain? Measuring the fluid reveals critical information.

The Birthing Center, with mothers to be in various ETAs for their newborns' welcomes? Progress is continually measured (in the examiners's practiced fingers) by the centimeter, both for dilation and advancement down the birth canal.

The newborn then is measured every which way to determine normalcy: head circumference, length, reflexes, and more.

Same little baby that's here for a well-care check-up in the months ahead? Same thing.

While all these may seem insignificant, it's important to note how much of our lives and well-being could rely on an inconsequential, low-tech gadget as the tape measure.

Epilepsy and Nutritional Guidelines

Epilepsy is a fairly common condition that can cause repeated or prolonged seizures. These seizures can cause a number of different sensations, depending on the type of seizure that is involved and the severity of the epilepsy. It is important to note that not everyone who has a seizure has epilepsy and that not all seizures will be repeated. Because of some negativity surrounding the term epilepsy, some doctors now prefer to use the more neutral term seizure disorder.

There are two main categories of seizures: partial or generalized. In a partial seizure, there is a focus and only a small part of the brain is affected, while in a general seizure, more of the brain is involved. A simple partial seizure may cause a change in consciousness but not a loss of consciousness. Complex partial seizures typically involve unconsciousness.

The most serious and severe type of seizure is the grand mal seizure, a generalized seizure that involves the motor systems in the brain and involves convulsions. The grand mal seizure is marked by a tonic phase (forceful contractions of the muscles) and a clonic phase (slow, jerking movements). In addition, there are less severe types of seizures, including the petit mal seizure, which is also called the absence seizure and may be dismissed simply as daydreaming unless the actual diagnosis is made.

Epilepsy may be related to another problem, including a head injury, a brain tumor, a brain infection or a stroke. However, less than half of the people who have been diagnosed with epilepsy or seizure disorder even know why they have it at all. It is important that the disorder be recognized and diagnosed so that treatment can be started – without proper care, the seizures will become progressively more frequent and may become more severe. The doctor will typically rule out other disorders and diseases before diagnosing epilepsy because in its mild or early stages it can mimic other disorders.

The Symptoms of Epilepsy:

– You may notice strange smells or sounds. You may also have double vision.

– You may lose control of your muscles

– You may fall, twitch or jerk.

– You may stare-off into space and be unaware of it.

– You may faint.

In most cases, epilepsy is treated with medication that is meant to reduce or control the seizures. Some of the medications can cause other side effects, so the doctor must experiment with different types and different dosages so that the right control with the fewest side effects can be found. There are other treatment options for seizure disorders, including a special diet, surgery which is meant to remove the damaged tissue in the brain and the implantation of a device which is called a vagus nerve stimulator. This sends signals in the neck to help control the seizures.

The Special Diet

The diet suggested by doctors is called the ketogenic diet, which is high in fat and low in carbohydrates. In a ketogenic diet, the body does not burn carbohydrates for energy like it normally would, but burns fats instead. When the body burns these fats, it produces a carbon substance that is called ketones. In a seizure disorder, the ketones are thought to help suppress seizure activity. (Around 30% of the children who were put on the ketogenic diet have complete seizure control, while another 40% have enough control to continue with the diet).

The ketogenic diet is typically prescribed for a period of around two years and then carbs and other nutrients are gradually added back in. During the time spent on the diet, vitamins and minerals will have to be supplemented because the diet is deficient in a number of these nutrients, especially calcium and vitamin C. The diet has been criticized by a number of health groups because of the high fat content, however, there have not been any problems noted with heart disease or growth retardation for the children. Because childhood obesity is a major concern and there are so many children who have diabetes and other weight-related conditions, the possible benefits of the ketogenic diet must be weighed against its risks.

Other Dietary Considerations

Children and adults who have seizure disorders must try to avoid the artificial sugar called aspartame if it increases seizure activity. Aspartame does cause seizures in people with a metabolic disorder called phenylketonuria. This disorder does not allow the amino acid phenylalanine to be digested and used properly. (Phenylalanine is an essential amino acid which must be supplied by food and supplement sources. It is converted in the body to the non-essential amino acid tyrosine).

People with seizure disorders may also have some food sensitivities and food allergies that they should be aware of. In some cases, these foods may even trigger the seizure activity in the first place. Common foods that can trigger these reactions include dairy foods, including cheese, citrus fruits, wheat and food additives like tartrazine and benzoic acid. The level of food sensitivities can vary from person to person and the person can be eating these foods every day without knowing that they are sensitive to them. It is important to find out if there are food allergies that can trigger or have triggered seizure activity.

Protein supplements may be suggested in the ketogenic diet, however, supplements should only be started at the advice of a doctor. It is important to find the right supplement, especially if there are food sensitivities or other issues as well. Whey protein, for instance, may be difficult to digest if there is any problem with lactose intolerance. Soy or rice protein may be better suggestions in this case; rice protein is considered to be hypoallergenic and may be the best solution. Egg protein may be acceptable as a supplement as well. Protein bars may be suggested, however, the ingredients should be read carefully so that they do not contain any of those that might be considered to be problematic for the person with seizure disorders.

Doctors also suggest supplementing vitamin E, a powerful antioxidant that fights the damages of free radicals that may increase seizure activity by interfering with normal brain cell activity. Selenium is a mineral that is also beneficial in controlling seizures. Good food sources of selenium include mushrooms, broccoli, cabbage, fish, garlic, onions and whole grains. If lactose is not a problem, whey protein helps by supplying the enzyme glutathione, which is an antioxidant that is important for the immune system. Folic acid should be included because some of the medications that are used to treat seizures may deplete many of the B complex vitamins. Folic acid is the supplemental form of the naturally occurring folate.

250cc Motocross – Two Or Four Stroke?

250cc 2-stroke vs. 250cc 4-stroke

If you’re looking to get into racing motocross at AMA sanctioned tracks and are wondering which bike to buy for the 250cc class, then pay attention. Although the four-strokes have pretty much taken over the motocross market lately, it seems that there are a lot of people trying to bring back the two-strokes, and it seems to be working. AMA made it legal so that a 250cc two-stroke can run in the same class as a 250cc four-stroke. Now, the first reaction I had when I heard of this was without doubt to pick the two-stroke. I looked into it a little bit more and came up with this….

250cc Four-Stroke

Now most people would think that a four stroke with the same displacement as a two-stroke would not have a chance. This isn’t the case, due to the fact that companies have put so much more money and effort into making the modern four-strokes extremely high-performance. Some riders that do not like the two-strokes snappy power will often stick to the four-stroke 250 just because they are lazy and like the smoother feel of them. A 250 two-stroke may have more power on top, but when the day gets long and the track starts to get really rough, that’s when the four-stroke starts to shine. Due to the tractability in rough and slick conditions, the four-stroke will be easier to ride faster late in the day. That doesn’t mean it will be faster than a two-stroke though…

250cc Two-Stroke

Two-strokes are fun to ride because they have a bigger top-end “hit” compared to the four-stroke. If you keep the two-stroke on the pipe then it will definitely be faster, as long as the conditions aren’t too rough. For those of you that want more, snappy power, and a lower center of gravity, then go with the two-stroke. It may not have the traction that a four-stroke has in rough track conditions, but the horsepower makes up for it.
So Which Bike??

After reading the info on each bike you would probably guess that the two-stroke is the better bike for AMA racing, and my answer for that would be, “Yes.” Clearly, it’s a faster bike if the track is in good shape, it handles better because it has a lower center of gravity, it has a lighter front-end, and it smells good. But I will say that if you are a four-stroke guy that doesn’t like the snappy-feeling power band on the two-stroke, then you will be fine on a 250F. The 250F is by no means slow, and any good rider will be able to win on it. My choice would be to ride the 250 two-stroke though because it’s faster, and it’s a new rule that I would take advantage of. Good luck, and no matter what stroke you ride, have fun!!

Insomnia Series – Causes of Insomnia

When it comes to insomnia, there are many causes. Some of these may be situational factors, some of these may be due to primary sleep problems, and some of them may be medical or even psychiatric conditions. Insomnia is of three types – transient (where the symptoms last up to one week), short term (where the symptoms last between one and three weeks), and chronic (where the symptoms continue for more than three weeks).

The causes of transient and short term insomnia may include jet lag, excessive unpleasant noise, changes in the shift work, and uncomfortable level of temperature (either the room is too hot or too cold), or even a stressful situation like death of a loved one, loss of employment, divorce, separation, etc. There may also be other causes like a prolonged illness, a surgery, or even withdrawal from drugs, alcohol, sedatives or stimulant medications.

Of course, when it comes to insomnia, there are also psychological factors that come into the equation and act as causes – like stress, anxiety, schizophrenia, mania, depression, bipolar disorder, etc. In fact, you would be surprised to know that insomnia itself is treated as a sign of depression by most psychiatrists.

Various medical conditions that trigger insomnia include acid reflux disease, congestive heart failure, chronic pain syndromes, chronic fatigue syndrome, night time angina from heart disease, obstructive sleep apnea, nocturnal asthma, etc. There are also degenerative diseases like Parkinson's disease and Alzheimer's which cause insomnia, as well as brain tumors and strokes which must also be considered as causes.

However, no matter what the cause of insomnia is, you can be sure that this is not a problem that you have to suffer with, there are treatments and cures you can try – not just natural remedies but also over-the-counter medication. If you try hard enough you can definitely beat the problem.

Crazy in America

“A national scandal” is the coined phrase Ms. Pfeiffer, an investigative reporter, uses to describe mentally ill persons and their shockingly tragic encounters with the criminal justice system. In this heartrending book she meticulously documents the stories of six mentally ill individuals who came into contact with the criminal justice system because of aberrant psychotic behaviors related to their illnesses and suffered tragic experiences in jails and prisons. This is the horrific story of how incarcerated mentally ill human beings are often subjected to dehumanizing experiences. It is a documentation of human beings in a system with “too little mental health care” and a system wherein “people are expendable in a society that’s good at locking people up but not so good at setting them free.”

This is the story of Shayne, who at the age of fourteen was diagnosed with acute schizophrenia. From that point on, she experienced extreme coping difficulties and over the years was hospitalized twenty-five times as well as spending time in prison. Much of her time in prison was spent in “the hole” because of her inability to follow prison rules. She successfully pulled out one of her eyeballs; two years later she succeeded in pulling out the other eyeball, completely blinding herself.

This is also the story of Luke, diagnosed as bipolar and addicted to drugs at a young age. Depression was also a part of his life. After being incarcerated for drug possession Luke’s difficulty with coping skills escalated. He became increasingly emotionally frantic until, regrettably in desperation, he died from suicide.

This is the story of Joseph who had stolen several cars and ended up in a youth correctional facility where he could not successfully cope. After spending two months in a lockdown situation in a small cell with no TV, no family visits, no exercise, no personal possessions, no mental health services the severely distraught Joseph became another tragic statistic when he died from suicide at the age of eighteen.

Crazy in America is an intense, emotionally-draining portrayal of the lost lives of mentally ill individuals within a system that failed them, a system that failed to understand their illnesses and therefore failed to effectively treat them. The individuals are but a few of many that Ms. Pfeiffer could have portrayed. As the author states, “The mass of imprisoned humanity includes at least three hundred thousand people with mental illness.” This book adds to the growing list of books addressing the ever increasing social problem of mental illness and incarceration.

The author is a strong advocate for change and has written numerous articles on incarcerated mentally ill persons. She clarifies her meaning of the word crazy. She does not use it to refer to mentally ill individuals; she uses it to describe what she says is the crazy way society reacts toward mentally ill individuals. Ms. Pfeiffer appropriately and fittingly concludes her book by stating, “America needs to try again to heal its ills and to help them heal themselves, with the wisdom of history and the knowledge that the people we will help, the people we will heal, will be ourselves.”

Viral Infection Headache From Meningitis

A viral infection headache can come from different types of viruses. The concern about having such headaches is that the root cause may be meningitis.

So what is meningitis all about? This is an infection in the membrane that surrounds your brain. Brain and spinal cord infections can be very dangerous because they cause inflammation, which places pressure on your nerves. This will cause you to have a viral infection headache.

Inflammation can also cause the following symptoms:

o Fever

o Severe headache

o Feeling confused

Severe inflammation can cause these symptoms:

o Brain damage

o Stroke

o Seizures

o Death

A bacterial infection or virus causes meningitis. The body can usually fight and beat an infection. However, when the infection travels into the blood stream, it can then go into your brain and spinal cord’s fluid. It can then affect your nerves and move into the brain causing inflammation and swelling. This can damage or kill nerve cells and cause bleeding in the brain. It can also cause you to have a viral infection headache.

Brain swelling is very dangerous because the brain is a soft organ in a hard box (the skull). If the brain swells, there is nowhere for it to go, except against the walls of the skull. This is what causes the most damage.

There are several causes of meningitis. These include

o Bacterial infection

o Viral infection

o Fungal infection

o A reaction to medications

o A reaction to medical treatments

o Lupus

o Some forms of cancer

o A trauma to the head or back

Bacterial meningitis is the worst type because it can kill you. It often begins as an upper respiratory tract infection. From there it travels through your blood vessels to your brain. Then it can block up your blood vessels inside your brain triggering a stroke and brain damage.

Viral meningitis is the most common form. Usually viruses that enter your body through your mouth before going to your brain and multiplying cause it. You can find these viruses in the mucus, saliva and feces.

Other viruses that may cause meningitis include:

o Chicken pox

o Flu

o Mumps

o HIV

o Genital herpes

Anyone can catch meningitis. This is especially true if your immune system is weak.

Meningitis often begins like the flu does. You may get a rash. The major symptoms include:

o Running a sudden fever

o A severe headache

o Stiff neck

o Dislike of light

Bacterial meningitis must be treated quickly. Severe bacterial meningitis will require intravenous antibiotics.

Antibiotics cannot be used to treat viral meningitis because they do not kill viruses. Thus, the best prescription is to simply take a rest at home or in the hospital.

As your body takes a break, your viral infection headache and other symptoms will also recede. It is important that you pay heed to your doctor’s advice while trying to recover from a viral infection headache.

Consider Products Like Hair Growth Shampoos

Pattern baldness is a very real issue, and many people are facing it on a daily basis. The worst part of this issue is that it can hurt a person's level of self-confidence. This is the reason that this article is going to be discussing some things to consider about hair growth shampoos. There are some products like this, that are quite effective, and this article is going to explain exactly why.

Some people might not know it, but it is a condition called androgenetic alopecia that is responsible for the pattern baldness issue. Another misconception that so many people have about this issue, is that men are the ones that suffer from it. Many people are not aware that this occurs in women as well. This is why women who are suffering from this issue, should never feel irregular.

This condition works by converting hormones into something that destroys follicle production. In men, the hormone called testosterone converts into something called DHT with age. This DHT buildup is easily capable of destroying the functions of follicles and rendering them useless. Women too, have great buildups of this DHT as they begin to age.

Understanding the whole DHT issue, makes it so much easier for the reader to know how a product like this is working. Many of the products are going to come in the form of a shampoo, and they work by destroying DHT build ups. This saves the follicles, and in some cases, they might be able to begin producing again. It is important to remember that there are many shampoo products out there.

The best type of shampoo product is going to be the type of product that is made from all natural ingredients. These products are called organic solutions, and they have special advantages over other options. This is because some shampoo products might be utilizing harsher chemicals. These chemicals can make the scalp burn, and maybe even result in a person suffering from sexual side effects.

If a person finds an organic product that works for them, they might be surprised to learn that their level of confidence has grown. This is because some products are able to save follicles and with time, they will begin producing once again. This will result in people receiving a lot of follicle production, and they will look and fell much younger.

There are so many shampoo based products on the marketplace of today, even when dealing with the all-natural ones. People that desire to find a product like this one, are going to have to carefully research any product that they are considering spending money on. These products are very far from cheap, so making sure that one might actually work is of a high level of importance.

The goal of this article was to explain some of the products on the market that work like the hair growth shampoos do. A product like this is actually very important in the world of today, this is because it possesses the ability to give people confidence. People feel much better when they catch this condition early enough to allow complete follicle restoration and production.

DHT and Hair Loss

DHT hair loss affects both men and women.

DHT stands for Dihydrotestosterone which is the resulting product
of direct contact between the enzyme 5-alpha-reductase, found in
the skin and the scalp, with the hormone testosterone.

DHT hair loss is caused by the DHT binding to receptor sites on
the scalp and hair follicles which interrupts and interacts with
the normal chain of events involved in continual healthy hair
growth.

To put it another way, DHT hair loss happens when DHT takes over
the receptor cell (the cells on the hair follicle that bind to
DHT) and sends false signals to the functioning cells responsible
for proper hair growth.

Men usually lose hair first in the temporal area, second in the
crown, and third, in the vertex or top of the scalp. This is due
to the concentration of sweat glands that carry DHT in these
areas.

Women on the other hand generally thin in a diffuse manner.

Nisim International, leaders in hair science for over 20 years,
produce NewHair Biofactors shampoos which stop DHT hair loss
within 1 week guaranteed!

The deep cleansing scalp shampoo removes unwanted oils, sweat,
dirt and excess sebum as well as neutralizing surface DHT. The
stimulating extracts penetrate further into the scalp to
neutralize DHT in the scalp thereby creating a healthy scalp
environment needed for hair growth.

Facts About The Daschund

When it comes to Dachshund dogs, people love how cute and adorable they are. But, most people do not know much about them. If you are interested in learning all about these dogs, read on.

The Dachshund dog are part of a breed of dogs that are born and bred to hunt a number of animals, including foxes, rabbits, and other “tunneling animals”. In past times, they were even put in packs to hunt wild boar. Nowadays, the fact that they are so versatile has made them a popular family pet. They are also used as show dogs and to hunt.

Dachshunds are on the smaller end, as far as size goes. They are only roughly eight to nine inches in height around the shoulder and can weigh anywhere from 16 to 32 pounds. On average, they live to be between 12 and 15 years old.

Playtime is usually a Dachshunds’ favorite time of day. Most of these dogs love to play, though what kind of play is what separates them from many other dog breeds. Their intelligence level makes it difficult for them to enjoy normal play, with toys and such. They much prefer chasing after birds or small animals.

In the United States, the most common type of Dachshund is the smooth breed. They have short and shiny coats that require little to no grooming. However, because of this short coat, they need a sweater or jacket in the wintertime when going outside. Black and tan, black and cream, red, chocolate and tan, and just cream are some of the most popular coat colors of these canines.

Dachshund dogs were originally found in Germany. Unfortunately, it is this fact that decreased their popularity during World War II. Those on the ally side did not want to own anything of German symbolism, even an innocent dog. However, once the war ended, they became more popular one again. In fact, they became so popular once more that Waldi, a Dachshund, was used as the mascot of the 1972 summer Olympics.

As great as these dogs are, it is important to know that there are some health issues that are semi-common in Dachshunds. Gastric dilatation-volvulus, Epilepsy, Cushings Disease, and deafness are some common health issues many Dachshunds are plagued with. Just be aware of these issues and be ready to handle them if you get this type of dog.

Training is an important duty for anyone that owns a Dachshund. Ideally, this type of dog tends to develop positive habits when they are trained as puppies. For instance, Dachshunds tend to “use the potty” indoors. But, if you train them properly (preferably at a young age), you can probably eliminate this problem.

The above article has given you many facts about Dachshunds. Now that you have read this information, you can probably see why these dogs are so popular as pets. If you are looking to get a new dog for you and your family, take this breed into consideration.

What Would the FTC Say?

Are you kidding me?! That is more than likely what the FTC would have to say with the continued lack of consideration towards the past and most recent FTC Guidelines. The FTC has written these guidelines to protect the consumers. Infomercial Testimonial Group has published numerous articles since 2004 in an attempt to protect the infomercial industry concerning just this issue. However, it all seems to fall on many deaf ears and ultimately creates an unfair advantage for the abusers while playing with FTC fire. In essence, companies are stealing YOUR sales by not abiding by the guidelines.

Are you kidding me?! – Example 1. “We are looking for 3 females and 1 male model to read fake testimonials for a work out video. We are in the process of producing a work out commercial and need the models/actresses beforehand.” But wait, there is more….. “Your job will be to arrive at a park or beach (to be determined) and read a prewritten script about your workout plan. This will consist of saying, “I’ve toned down, I have more energy, I have dropped one size, etc”. (San Diego) Date: 2010-02-06, 6:05PM PST

Are you kidding me?!

At the end of the day, it is simply about creating a level playing field for all in the industry when it comes to testimonials. The unfortunate reality is that the industry does seem to still have more than just a few bad apples. There are many ‘good guys’ in the industry doing their best to abide by the rules and not intentionally or unintentionally deceiving the consumer. However, on a daily basis some production companies and casting agencies are blatantly recruiting for materially connected ‘testimonials’ and not disclosing the fact. The typicality issue is a completely different article yet is mute if the testimonial recruitment process was erroneously conducted from the beginning. If a supposed testimonial provider or experienced infomercial producer uses these tactics, then it is obvious they do NOT know enough to provide a legitimate testimonial service and are setting up themselves and their client for potentially painful FTC scrutiny. Usually, the actual client is not even aware of this practice as some production and casting agencies convince their clients they have it handled, doing their best to keep the testimonial budget line item. Some companies utilize cheap and faulty recruitment and research practices while thinking more of their profitability from ‘casting’ a few ringer testimonials rather than thinking of client long term issues. Take a look at recent headlines and excerpts from 3 different examples. If you are one of the ones who conduct testimonial programs properly – this DOES affect you. Think of the sales stolen away from you by a competitor that, even from the beginning, didn’t follow the rules/guides.

Are you kidding me?! Example 2: WEIGHT LOSS INFOMERCIAL TESTIMONIALS! “We are seeking motivated men and women between 25 and 50 years of age who have between 10 and 40 pounds to lose. Specifications: Testimonials (can be real people or actors) Females: Ages 25 to 60 (mostly 25-40’s). Caucasian. These women must be 10-20 pounds overweight. We can also see a few thin/normal weight females who have cellulite. Most importantly they must be motivated to want to lose the cellulite and do the Weight Watchers for a month.”

It is best to have a third party testimonial provider with no material connection as to the success or failure of a show. Meaning, a legitimate testimonial provider should only be one who does not have a percentage share of the success. At this point ignorance to the guidelines is a non excuse. The title says it all -Are you kidding me?!”

These are only a few examples of companies around the country who, more than likely (you be the judge), are not going to divulge the material connection they have created with their testimonial program. Are you kidding me?! This is a huge FTC No No.

Please note: These advertisements are real and very recent as of this article. Here is even another example of how not to recruit for perceived non-materially connected testimonials.

Are you kidding me?! Example 3: “Fitness weight loss program is looking for testimonial actors to go on fitness program for a National TV Infomercial project. Great exposure and TV footage (25-45 Female ) testimonial actress needed women ages 25-45 TV National campaign must be in NYC area willing to workout with trainer”

So, if after having read this article you still are one who recruits testimonials in such a manner as described above then the only rational assumption is that you are intentionally deceiving the consumer, intentionally challenging the FTC and challenging those in the industry doing their best to play fair. One more time “Are you kidding me?!”

Are you using the ITG seal? Did you know? Infomercial Testimonial Group is recommended in SELF Magazine and so is the ITG Seal for Verified Testimonials! Next article will provide tips on proper recruitment procedures to get your testimonial program off on the right foot. Eddie E Gaut Detuag Testing Centers – home of Infomercial Testimonial Group 714 850 9777

Are People Who Stutter Shy and Nervous?

Shyness and nervousness are two traits which are commonly associated with the personality of every stutterer. It is not something that is inborn to them or something which is caused as a side-effect to the stuttering problem. But these attributes are developed in the stutterers because of the incidents that have happened in their life. And since most of the people in the world treat stutterers the same way – as tease toys – the incidents in every stutterer’s life is more or less the same. This behavior meted out to them not only makes them hesitant to approach others but also makes them uncomfortable in their communication with others. This lack of communication portrays them as a reserved lot who basically keep to their own work.

Most people consider the nervousness associated with a stutterer to be part of the disorder itself but it is not so. The nervousness and anxiety is just a reflection of the way the stutterers feel within them as they speak. During a casual talk in a group, if a stutterer happens to stammer a word, the immediate reaction from others would be a slight chuckle which in turn could embarrass the stutterer. The stutterer doesn’t want such incidents occurring and hence becomes conscious of his speech thereafter. So at the next instance when he realizes the need to utter a word which he is bound to stutter on, he tries hard not to stutter to avoid the expected giggles from the others. This inevitably leads him to become more uneasy with the word causing him to stutter even harder. This fault of his not only evokes laughter from others but also triggers a fresh round of teasing which eventually leads him to feel insecure about himself thus making him even more reticent.

As a result of such instances, the stutterer tries to limit his talks to the minimum and avoids communication with the outside world as much as possible. Sometimes, these events may happen as early as primary school which may make the stutterer a shy kid and ultimately a reserved adult. Such withdrawal behavior is unnoticed by many and stutterers are branded as shy people. Since most stutterers go through this phase, most of them turn out to be introverted individuals. And since a majority of the stutterers are introverted, nervousness and shyness have become the signature characteristic of stutterers.

How to Give Him Oral Sex – The Sexiest Fellatio Techniques You Must Learn

Giving a man great oral sex is the key to his heart because men love a woman who knows what she is doing in that aspect. Nothing feels better to a man than oral sex so if you really want to get him going, then you need to learn how to give him fellatio today.

You need to learn how to give him oral sex and you need to learn how to enjoy it as well. It is one thing to give your man oral pleasure but it is a whole different story when you love it as well. That is when you are going to give him the best fellatio of his life. By learning the sexiest fellatio techniques, you should be able to learn how to love it too.

To give him oral sex, it is more than just about stimulating him with your mouth. A lot of things go into giving him great oral and you need to learn all of them. You need to learn the right hand to mouth ratio and how much saliva or lubricant you need to really get him going and to make him orgasm.

Some sexy fellatio techniques that will help you on your way include performing oral sex in front of a mirror. All too often, men are on their backs and the female’s hair is blocking his view from actually seeing what you are doing to him. Men are very visual and he wants to see what you are doing so he can see and feel. This contributes to his orgasm and makes it stronger. If you really want to blow his mind, then do it in front of a mirror. Now he can see what is going on and he will love it.

Another sexy oral sex tip that all women should know is to make some noise during oral. You don’t want to be going south on him and be a mute. He is going to feel awkward by the silence. By moaning with him in your mouth, you send these neat little vibrations throughout his member and this will drive him wild. As well, this lets him know that you are into it and that you are enjoying yourself and that is a huge turn on to him. By doing this, he won’t be able to last much longer and he will have an amazing orgasm that he won’t soon forget.

Become the total siren that you know you are and give your man amazing oral pleasure tonight. Guaranteed, it is going to turn you on too.