Diabetes Disease and Fatigue

Your body can experience being tired and worn-down for numerous reasons: stress, pregnancy, medications, and inactivity, just to name a few. After expressing there is pain, tiredness is the second most mentioned general symptom by patients in the doctors’ offices. But fatigue can also be a sign of the diabetes disease.

If you find yourself nodding off repeatedly and used up through your day these signs could be a warning that the diabetes disease is present. If this fatigue is combined with any of the other classic symptoms of diabetes – including excessive thirst, frequent urination, unexplained weight loss even with an increased appetite, blurred vision, irritability, or skin problems – you need to pay a trip to your doctor to have a diabetes screening test.

An imbalance in blood sugar is the main reason for diabetes disease – related fatigue. Your cells make use of glucose – sugar – for fuel. The hormone insulin controls the allocation and use of glucose in the body. In diabetics, due to poor production of insulin, the glucose is not appropriately utilized by the cells; instead, it’s floating around in the bloodstream, where it can’t be used as power.

As a result, you may feel constantly drained. Just like a car that has no gas your body needs the sugar (like gas) to keep it moving. Returning the blood sugar to its normal, healthy levels with proper treatment can alleviate your fatigue. If you’ve discovered your diabetes in its earlier stages, and it’s still considered mild, treatment usually consists of dropping excess body fat, and lowering blood pressure and cholesterol through improvement of your diet and exercise habits. Just being more careful with your health in general will focus you in on what to do to address your tiredness. If your diabetes is a more complicated type or at a more advanced stage, it will be treated through oral medication, alternative remedies or injections of insulin.

What else can I do?

Place yourself on a program. This way you can start to train your body when to feel tired. Eat your meals, go to sleep and wake up at the same times each day. By waking and retiring on your schedule your body will know when to get tired. To further address this tired issue do some moderate exercise and get enough sleep every day. And most importantly maintain stable blood sugar levels to stay away from energy crashes.

Practice relaxation techniques such as positive visualization, meditation, or deep breathing exercises to help lower stress and keep your blood pressure on an even keel. This could be an exciting new page in your life. You are taking responsibility for your condition.

Take a refreshing power nap to re-energize yourself. Twenty to thirty minutes is a good block of time to let your body get a rest. I like doing this because of my late work schedule. Avoid the temporary fix of coffee or over the counter energy boosters. These quicker fixer uppers will quite often make you feel extremely wasted after they wear off. You may also become dependent on the item after using it for a while. Like coffee.

Taking care of your tiredness in a natural way is going to be your best course of action. Fight fatigue with the help of some natural herbs like cinnamon or seek help from your dietician or health care provider.

Resource – Online Diabetes Symptoms

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Meat – Your Key to Attacking Anxiety and Depression

There is no question that vegetarianism is a noble and worthwhile cause. That said, if your car requires gasoline to run, you would never dream of trying to put water in the gas tank. In a similar way, when you do not give your body the proper balance of foods, it simply will not run correctly. Oddly enough, meat deprivation can easily lead to all kinds of mental and emotional problems. Therefore, you may be surprised to find that attacking anxiety and depression may be as simple as eating more beef, or other meat that includes a full range of meat protein.

During the process of attacking anxiety and depression, you need to find out what your body requires in order to function properly. This includes finding out which proteins and other nutrients are required in order to produce hormones and other chemicals that make you feel better. No matter how bad you may feel about eating meat, you may be one of those people that simply needs to rely on a source of meat protein in order to have a normal sense of well being. Today, you don’t have to buy meats that come from commercial farms, let alone the oceans. In fact, you may be able o find several small farms right in your area that sell meat from free ranging animals.

While you are attacking anxiety and depression, you have an opportunity to improve many aspects of your health. Are you anemic, or always tired? These may not be just symptoms of an emotional problem. Instead, they may be key indicators that you are not eating the right foods. Even though you may find it difficult to eat certain foods, you should do what you can to make sure that you listen to what your body needs, instead of what others try to tell you it needs.

Pteromerhanophobia – What Causes a Fear of Flying?

Pteromerhanophobia or a fear of flying has the potential to seriously affect your life in more ways than you would think. For those that suffer, the results have included stopping flying altogether, causing job opportunities to be missed, family gatherings and holidays cancelled or avoided. A totally debilitating phobia.

What causes a fear of flying will vary from person to person. A previous bad event such as severe turbulence may be enough, whereas others may just feel anxious through feeling trapped at altitude. It could also involve a mistrust of the flight crew or a total lack of confidence in the aircraft to remain airborne.

What is important to remember however, is that there is really nothing to fear, whatever the underlying individual cause of the anxiety. Even those that have flown through turbulence have never been in real danger, because the aircraft of today are manufactured to such a high standard that they can easily cope with the sort of turbulence that may typically be encountered. Even danger from engine failure is drastically minimized due to the sophisticated level of the safety systems installed.

That is not to say that anxiety and panic attacks that occur during a flight are not uncomfortable, far from it.The physical and emotional reactions of someone with a fear of flying are just real as if something dangerous actually were happening.

Some of the more common symptoms that may be present include:

– Breathing difficulties

– Chest pains and heart palpitations

– Sweating and dizziness

– Vomiting

– Muscle tension

– Dry mouth

– Abdominal pains

The feeling of loss of control can be overpowering and convince sufferers that they are in extreme danger. Although frightening, this perception of danger is just that, and not real. Easy to say, but true nevertheless.

A really good way of overcoming this fear of flying is to follow a systematic approach to treatment, which covers how safe flying is, as well as teaching how to modify reactions to flying, so enabling an end to anxiety and panic whilst flying.

One such system is The Takeoff Today Program, which teaches all this and more. It makes use of written, audio and video material, as well as free information and reports to download. All this instructional material helps sufferers answer their most common questions, by using interviews with pilots, flight crews and other experts within the aviation industry, all aimed to help you overcome your fear of flying.

Anxiety and Depersonalization Caused By Pre-Workout Supplements

There is a great deal of hype connected with pre-workout supplements and their ability to boost the effects of an exercise routine. They claim to enhance energy, physical capabilities and build greater muscle mass, changing a normal workout session into a “super” workout. The problem with these promises is the fact that these stimulants actually create more physical and emotional difficulties than the benefits they promise.

The majority of these stimulants contain massive doses of caffeine along with a laundry list of sub-standard ingredients. This may seem innocuous to those hoping for miraculous results but in reality these pre-workout supplements are more than often quite dangerous, especially to those who are stimulant sensitive. The problem is that most are unaware of their own reactivity to these substances until they find themselves in the midst of intense adverse reactions.

Common Adverse Reactions to Pre-Workout Supplements:

– Severe Anxiety

– Intensive Depersonalization

– Hallucinations

– Convulsions

– Heart Rhythm Abnormalities

– Heart Attack

– Tremors

– Addiction, Dependency

– Palpitations

– Irritability, Mood Swings

– Inability to Focus

– Adrenal Fatigue

– Racing Thoughts

– Hair loss

– Memory Impairment

– Sexual Dysfunction

After prolonged use, a great toll is taken on the adrenal glands as they are forced to produce large quantities of energy producing adrenaline. This eventually culminates in adrenal fatigue when the adrenals fail to manufacture enough adrenaline for the individual to function properly. The result being, extreme fatigue, nervousness and heightened anxiety levels. The overload on the adrenal glands must be immediately addressed and treated with a specific, natural approach in order to rebuild and restore complete function of these glands.

One often becomes tolerant to these stimulants requiring higher dosages to receive the same so-called benefits. After prolonged use the individual finds himself using far too much, too often, becoming dependent on these “supplements” for normal energy on a daily basis.

There is also the problem of withdrawal symptoms when halting the use of these stimulants.

Upon Discontinuation of Pre-Work-out Supplements one may initially experience:

– Fatigue

– Headaches

– Craving for the Stimulants

– Mood Swings of great intensity

– Severe Depression

– Intense Hunger

– Mental Confusion

– Initial Increase in Anxiety, Depersonalization and Racing Thoughts

– Extreme Insomnia

– Adrenal Burnout

One must not resort to taking more stimulants in order to counter these reactions. This action will only prolong recovery and add to already damaged adrenals. Instead, one must learn to naturally counter these reactions by beginning a program based upon treating impaired adrenals.

This Adrenal Fatigue Treatment approach includes:

– Sufficient rest, re-establishing sleep patterns, insomnia treatment

– Proper diet/nutrition correction

– Moderation in exercise

– Slow withdrawal from any existing stimulants

– Natural Treatment of Anxiety, Depersonalization and Depression

One must not be tricked into believing more stimulants will alleviate symptoms, as the required correction is the exact opposite. The adrenals require time and patience to repair, rather than an increase in stimulants which only hamper recovery.

Most of all, one must be aware of the hype connected to these supplements, which in reality are merely massive stimulants that have become highly commercialized. The internet is saturated with bogus, glowing reports about these products, preying on and victimizing young people to purchase under false pretenses. Consumer beware by knowing and understanding fully what these chemicals will do to your system and the long road one must take in order to rebuild a truly healthy mind and body.

10 Over The Counter Supplements for Relieving Anxiety

Anxiety and depression are common disorders that many people suffer from. Doctors and scientists will agree that good nutrition and the right combination of vitamins and supplements can reduce or even alleviate the need for prescription based medications. There are several different supplements that may help bring anxiety under control. All of these supplements can be purchased over the counter without a prescription. Consulting a health professional before taking any new supplements is always recommended, especially if they are going to be added with prescription medication.

Passion Flower (Passiflora Incarnata)

Passion Flower is an herbal supplement. The leaves, petals, and stems of the plant are used in making teas or tinctures. When in tea form it may be mixed with other calming herbs to increase its effectiveness. Tinctures can be added to juice or other drinks and taken as needed. Passion flower is primarily used as a calming agent to help with anxiety or insomnia. Doctors agree that is does work as well as some prescription drugs for aiding in anxiety disorders, however, there are few studies on how it actually works. It is theorized that it increases the production of GABA (gamma aminobutyric acid) in the brain. GABA is an amino acid that helps calm and reduce hyper-activity which is why passion flower has become such a popular supplement for treating children.

Valerian Root (Valeriana Officinalis)

Valerian Root is another herbal supplement that is highly regarded for its calming abilities. The root of the plant is ground and used either is tea or pill form. The tea is extremely pungent for people with sensitivity to taste it may be a bit hard to swallow. The pills are generally is gel cap form and are easy to take. Valerian root is thought of as a general sedative and is used to treat both anxiety and insomnia. There are no known side effects, but patients should be careful is they are mixing it with other sedative based prescriptions. This is another herbal supplement that increases the production of GABA in the brain.

St. John’s Wort (Hypericum Perforatum)

St. Johns Wort is one of the herbal supplements that is frequently compared to prescription based drugs such as Prozac. It is generally available for purchase in pill, tea or tinctures. St. John’s Wort has been widely tested for its properties as an anti-depressant and sedative. It is frequently used to treated mild forms or depression and anxiety, and is especially useful is children and young adults. Speaking with a doctor before taking St. John’s Wort is highly recommended. It has been known to interact with some prescription drugs such as birth control, rendering them ineffective.

Rhodiloa Rosea

Rhodiola Rosea is and herbal supplement that is native to the colder regions of the world. It reached popularity is Russia as a supplement that assisting in helping the population deal with the cold Siberian climate. It is generally sold in pill or capsule form. The root is the part of the plant that is used when manufacturing the herbal supplement. Rhodiola Rosea is highly effective as an anti-depressant. It is believed that this herbal compound adjusts the levels of serotonin and dopamine in the brain. It may also act as an MAO inhibitor. Side effects of this herb are unknown. A doctor should be consulted before adding this supplement to the diet.

Winter Cherry (Withania Somnifera)

Winter cherry is an herbal supplement that comes from India. It is sometimes referred to as Ashwaganha. The root of the plant is powered and sold in pill form. This plant is used to treat both depression and anxiety. There are no known side effects for this herbal supplement. It is not recommended for women who are pregnant or nursing. People who are taking MAO inhibitors should also avoid this supplement.

5-HTP (5-Hydroxytryptophan)

5-HTP is an amino acid. It occurs naturally is foods such as turkey, milk, and pumpkins. It is metabolized in the body and turned into the chemical Tryptophan. This chemical is thought to increase production of Serotonin and Melatonin in the brain, both of which are highly effective mood stabilizers. 5-HTP can be found in capsule form and added as a dietary supplement. There are no known side effects and it is generally thought of as being safe.

Vitamin C (Ascorbic Acid)

Vitamin C occurs naturally is fresh fruits. It is often used to protect the body from illness. Research had shown that deficiencies in vitamin C may cause mental disease and anxiety. This vitamin can be found in a variety of forms such as pill and liquid. Often foods are enriched with vitamin C to promote health. There are no known risk associated with vitamin C. It is a water soluble vitamin and the risk of overdose is low.

Vitamin B Complex

Vitamin B complex is a group of vitamins that are necessary for the body to function. This complex is generally found in pill form. Since Vitamin B complex is a water soluble group of vitamins, the risk of overdose is low. This group of vitamins had a broad effect on the bodies health. Deficiencies have been linked with mental illnesses such as Depression and Bipolar disorder. When paired with Vitamin C, as well as Magnesium and Zinc, Vitamin B complex has proved to drastically reduce depression.

Magnesium

Magnesium in one of the most common minerals in the human body. It is found in pill form, and is always an ingredient in multivitamins. It is also found in several types of over the counter drugs such as laxatives and antacids. The risk of overdose is low. Magnesium works to increase mental function.

Zinc

Zinc is a mineral that the human body needs in order to process other enzymes. Zinc is found naturally in foods, and also comes in pill form and in multivitamins. Zinc overdoses may be potentially dangerous as they interfere with the body’s ability to absorb other vitamins and minerals. Consumers should consult a doctor before adding Zinc supplement to their diets.

Ringworm Cures Made Easy

Ringworm is contagious and is a fungal skin infection. Your ringworm cures will vary depending on the type and location of this infection. In many cases, you can get ringworm from infected humans, infected pets and infected animals.

The species of fungi that cause ringworm can feed and grow on the dead skin and hair cells that are found on your body’s skin. Ringworm loves to thrive in humid and dark environments. The fungi areas can be very itchy and can grow in size if not treated correctly and quickly. The area of your skin where the ringworm exists is usually round in shape and more irritated towards the outer edges. The appearance of ringworm is therefore circular in nature and thus the name ringworm. Don’t worry about a worm or any type of insect being present because it does not exist.

Ringworm cures can be in the form of creams, pills and natural home ringworm remedies. The most common cure is over the counter medicated anti fungal creams. This is what your doctor will normally prescribe because they have great results. The treatment time frame when using anti fungal creams is normally two to three weeks. For advance cases of ringworm, a stronger medication is required. What yields great results is anti fungal pills. The pills must be taken once a day for about seven days. The most popular anti fungal pill is called Terbinafine.

There are home remedies as well, which in most cases are not scientifically tested. Some home remedies include, green walnut hull juice, lemon, vinegar, ginger, grapefruit seed extract, iodine, gentian violet, tiger balm, vicks vaporub, garlic and tea tree oil.

Ringworm cures for pets are different than humans. It is best to seek a vets diagnosis for the proper ringworm cure. Medications for your pet may include ketaconazole or grisiofulvin. Dog treatments may vary from cat treatments..

Arnica Gel – Erase Dark Circles and Bags Under Your Eyes

The skin under your eyes is thin and delicate. At times, lack of sleep, poor diet, dehydration, age, smoking and/or drinking can cause this skin to trap fluid. This can cause bags or dark circles. Dr. Lisa Masterson, OB/GYN from The Doctors television show, recommends Arnica Gel for relief of these dark circles and bags under the eyes.

It has enjoyed success mainly in reducing inflammation and pain. Therefore, it’s not a big leap to believe it will reduce bags and dark circles under the eyes. Natural herbs often have the same benefits as those expensive eye creams. I believe natural herbs should always be used before resorting to man-made products.

What Is It?

Arnica is an herb that belongs to the sunflower family. It grows mostly in western North America, Canada, and Eastern Asia, but angustifolia and Montana are two species that are native to Europe. Montana and chamissonis contain helenalin, a sesquiterpene lactone, which is a main ingredient in anti-inflammatory treatments. It is also by the names Mountain Tobacco, Leopard’s bane, and Wolfsbane. The Scientific/Medical name is Arnica Montana.

What Does It Do?

The Montana species that is native to Europe, Has been used for inflammatory ailments for many years. The roots contain derivatives of thymol which is used as a fungicide or preservative. It is currently used in liniments and ointments that are used for strains, sprains, and bruises. It is commonly used by professional athletes for these symptoms. In many cases, it has provided relief of back and hip pain.

The Creams available are generally formulated using the mother tincture rather than a dilution and therefore, contain measurable quantities of the herb.

How well it works will depend on two key ingredients, sesquiterpene lactones, a chemical found in plants that are known to help reduce inflammation, and flavonoid glycosides, also a chemical found in plants, which are molecules that are known to be antioxidants.

There are about 32 different species of this herb. The flower and rhizome are often used in herbal remedies. It is used in Homeopathic preparations for wounds, infections, and inflammation. It is promoted for use on the skin to help soothe and heal wounds, bruises, sprains, muscle strain, inflammation, irritated skin, insect bites, burns, arthritis, ulcers, acne, eczema, chapped lips, sore throat, and it is believed to help heal bacterial infections. It is also an ingredient in some herbal skin care products and shampoos. Arnica ointments usually contain up to 15% of arnica oil or 25% of a tincture of arnica (the herb mixed with alcohol). Blistering and inflammation may be more likely if very strong solutions are used on the skin. It is a good idea to use a gel with no more than 25%. It is mostly well-known for reducing inflammation and pain.

Is There Evidence For Its Use?

The thymol in the roots has been clinically proven to be effective in reducing blood vessels. A study of this herb in healing wounds after surgery found a reduction of pain and bleeding following surgery. Dr. Lisa Masterson from The Doctors television show, recommends Arnica gel to decrease dark circles and puffiness under the eyes. Many women use it as a moisturizer.

It boosts the normal healing process which will ease the flow of blood and body fluids. It helps reduce the dark color of bruising.

Many medical publications and magazines have given this gel some excellent reviews and ratings. It’s one of the most preferred gels by Americans for day-to-day injuries and bruises. It’s not greasy or sticky and very easy to apply.

Is It Safe?

Arnica contains the toxin helenalin, which can be poisonous if large amounts of the plant are eaten. Just be safe, as you would with any aging skin care product, keep it on the skin. If it is taken internally, it is diluted to the extent that there is almost none of the active ingredients remaining. Homeopathic solutions of 24X or more are not toxic as there is only a tiny amount of Arnica left after the dilution. If the herb itself is taken by mouth, it can be poisonous. It has caused a number of serious reactions, including allergies and at least one death. Small doses of the herb are considered safe to use on the skin. Individuals who are allergic to sunflowers, Echinacea, marigolds, chamomile, or ragweed may be more likely to be allergic to Arnica.

You can’t use the plant directly on an open wound. This is why medical companies researched and discovered Arnica Gel. Many homeopathic companies sell it as a gel, oil, or tablets. The gel is the most popular because it is easier to apply. If you price eye cream, you’ll find that this gel is just a fraction of the cost. With so much success behind it, it makes sense to try it yourself. You’ll be very happy you gave it a chance when you see how well it works on those dark circles and bags under your eyes.

Tickle Lipo Advantages and Disadvantages

Liposuction technology has been evolving for decades. One of the most important developments in liposuction was the tumescent technique, popularized by Jeffrey Klein in 1987. The tumescent technique involves the use of large volumes of dilute lidocaine and epinephrine so that complete local anesthesia is obtained and blood loss is virtually nil. The excellent local anesthesia and minimal blood loss allow liposuction to be done entirely without sedation or general anesthesia. After the tumescent anesthesia is infused, the excess fat needs to be suctioned out using different cannulas attached to a suction device.

In traditional liposuction, the surgeon manually passes the cannula back and forth through the tissue, removing small amounts of fat with each pass. As the case proceeds, especially in larger volume liposuction, it can get quite tiring. Also, the physical force required is invariably associated with trauma to the surrounding connective tissues and blood vessels. In vibrational liposuction, such as Tickle Lipo, the cannula is instead attached to a handpiece that gives it side to side, back and forth and rotational movements. This creates a vortex-like force at the end of the cannula that helps to break up fat with minimal muscle force applied by the surgeon. Rather than relying on jerky back and forth movements, the surgeon is able to glide the cannula through the fat with ease. This allows a more artistic approach to sculpting the fat. Less trauma to the surrounding blood vessels means less blood less and less bruising. As bruising can persist for a couple of weeks after surgery, this is very useful. Less damage to supporting ligaments means that better skin tightening is achievable.

There are also some advantages over ultrasound-assisted liposuction and laser lipolysis. Ultrasonic liposuction involves using a solid ultrasonic cannula that first breaks up fat and a second step to remove the fat with a suction cannula. Laser lipolysis is similar, except that laser energy is used to melt the fat prior to removal. With both of these technologies, there is a chance of burns, but that is not the only disadvantage. In the opinion of the author, both require the surgeon to work blindly as they break up fat. Rather than seeing the final look evolve as more and more fat is suctioned away, as with traditional or vibrational liposuction, with these latter two technologies, the final product only begins to be seen after the ultrasonic or the laser portion is over. Although in use in 1993 in Europe, Tickle Lipo vibrational liposuction was only recently FDA-approved in the US. However, it is this author’s opinion that given the multiple advantages over existing liposuction technology, even laser and ultrasound, it is bound to receive a greater and greater share of the liposuction market.

Gastroenterology – When To See a Doctor About Your Digestive Health

Gastroenterology problems can make it hard to function from day to day. If you experience issues with your digestion, you may want to consider seeking out the advice of a doctor who specializes in digestive disorders.

Gastroenterology is the field of medicine which focuses its study on the function of the digestive tract and the diseases which affect it. The digestive tract is considered to be every organ and body part which is involved in digestion, from the mouth and esophagus, to the stomach, intestines and rectal area. Doctors which specialize in this field of medicine are called gastroenterologists. Some gastroenterologists are also hepatologists, because the liver and pancreas are important to the function of the digestion.

There are many reasons you may seek out the services of a gastroenterologist. One of the most common procedures this type of doctor would perform is a colonoscopy. A colonoscopy is a procedure during which the patient is sedated, and the large intestine is examined using a small, flexible camera. Tiny samples of tissue are collected from the large intestine and these samples are biopsied. It is recommended that everyone over the age of 50 have a colonoscopy performed to check for polyps or other irregularities in their colon. For most people, this procedure will be the only time they need to see a gastroenterologist. For others, certain digestive ailments may give them reason to seek out a doctor who specializes in gastroenterology.

Some common ailments that gastroenterology studies are acid reflux and Irritable Bowel Syndrome. Often, gastroenterologists only need you to describe your symptoms in order to make a diagnosis. Acid reflux is also known as heart burn, and is accompanied by a feeling of burning in the esophagus caused by too much stomach acid. Sometimes acid reflux leaves a bad taste in your mouth when it is particularly severe. Almost everyone has experienced heart burn, and it can usually be attributed to eating something particularly greasy or full of carbohydrates. If you experience heart burn regularly, then you may need to see a doctor. If acid reflux is severe enough and is left untreated, it can lead to erosion of the esophagus. Luckily, being conscientious about what you eat as well taking certain kinds of medication can keep symptoms of acid reflux at bay and heal any damage that may have been done.

Irritable Bowel Syndrome, which can also cause heart burn, may cause you to have stomach pains and irregular bowel movements. Some days you may experience diarrhea and then the other days you may experience constipation. It is important to see a doctor if you are having these issues on a regular basis. If medication does not alleviate the symptoms, or if they worsen, a gastroenterologist may want to do further testing in order to rule out a more serious disease called Inflammatory Bowel Disease.

Gastroenterology and its body of knowledge has helped save many lives and has improved the quality of life of many others. Doctors who specialize in this area of medicine are able to help their patients by prescribing them medication, and also recommending diets and supplements that can alleviate their symptoms as well. If you have any concerns regarding your digestive health, or if you are above the age of fifty and have never had a colonoscopy, it may be time to pick up your phone and call a gastroenterologist.

Correct Coding of Skin Lesions

Procedures on skin can be some of the most difficult to code because of the many categories of lesions, location of lesions, number of lesions, diameter of lesions, incomplete documentation, and the terminology used by physicians. Here are some guidelines for correct coding of skin lesions:

Lesion Categories

Lesions are categorized as skin tags, warts, neoplasms, or masses/lumps (cyst, tumor). First consult the ICD-10-CM Index for the term documented. For example, cysts are categorized to the tissue in which they are found. If the documentation shows the cyst or lesion was removed from skin tissue, find the term Cyst, followed by the sub term skin, followed by the type of cyst.

Neoplasms can be either malignant, benign, uncertain behavior, or unspecified behavior. Malignant lesions can be primary, the first site of malignancy; secondary, site where primary malignancy has metastasized or “spread”; and carcinoma in situ, an early form of cancer defined by the absence of invasion of tumor cells into the surrounding tissue.

Benign lesions are not malignant and do not metastasize or “spread” to other parts of the body. Benign lesions look similar to the tissue where the lesion originated and grow slowly. Though benign lesions are not cancerous, they may cause problems because of their location and often there are multiple benign lesions which can cause adverse effects on the body.

Lesions of uncertain behavior are categorized as uncertain when the lesion has not been identified as malignant or benign. The physician needs to document uncertain behavior in order for this category to be used. Usually, uncertain behavior is documented on preoperative diagnoses and documentation prior to surgical removal and submission to pathology. The pathologist will then clarify whether the lesion is benign or malignant.

Lesions of unspecified behavior are lesions where there is absence of documentation of benign, malignant, or uncertain. This is the “catch all” category and should be used as little as possible.

Location of skin lesions

Skin tissue has three main layers which are divided into sub layers. The location of the skin lesion in the skin layers will determine the code category that is used.

The epidermis is the outermost main layer of skin. This layer includes the stratum corneum (horny sub layer), followed by the keratinocytes (squamous cells sub layer), and finally the basal sub layer. The horny sub layer is continuously shed and prevents foreign substances and loss of fluid from the body. The squamous cells sub layer lies just beneath the horny sub layer. The basal sub layer is the deepest sub layer of the epidermis. Throughout the epidermis are melanocytes, specialized cells which produce melanin (skin pigment).

The second main layer of skin tissue is the dermis, also called the middle layer. Blood vessels, lymph vessels, hair follicles, sweat glands, collagen bundles, fibroblasts, and nerves are located in this layer. The dermis is held together by collagen. The dermis is flexible and strong. Because the nerves are located in this layer, this is where pain and touch receptors are located.

The third main layer of skin tissue is the subcutaneous layer. The subcutaneous layer is also known as subcutis, meaning under the skin. This is the deepest layer of skin made of collagen and fat cells. This layer helps preserve body heat and protects against injury by acting as a barrier.

Common terminology for skin lesions

Physicians may use a variety of terminology to describe lesions of the skin, even within the same document. The lesion may be described as a cyst, sebaceous cyst, tumor, subcutaneous mass, soft tissue lesion, skin tag, and wart, etc.

When coding skin lesions and their removal, try not to get caught up in the terminology and stick to the facts. The ICD-10-CM table of neoplasm has clear instructions and guidance on coding skin lesions. “Where such descriptors [malignant primary, malignant secondary, carcinoma in situ, benign, uncertain behavior, or unspecified behavior] are not present, the remainder of the Index should be consulted… ” [CMS.org ICD-10-CM]

The coder should always first consult the Index for the terminology used by either the physician or the pathologist. The Index will lead the coder to the correct section of the ICD-10-CM Tabular List.

Important Facts the Coder Needs to Know

  • Where was the lesion located? Skin, bone, muscle…
  • Size of lesion in centimeters?
  • Type of wound closure? Simple, intermediate, complex…
  • Length of closure in centimeters?
  • What was actually done to the lesion? Biopsy, removal, shaving, excision…

Code selection is based on a number of factors including the answers to the above questions. By first consulting ICD-10-CM Index and then Tabular List, this will help guide your procedure code selection. If a benign tumor is excised from the soft tissue in the left arm, the procedure code will reflect excision of lesion from soft tissue or connective tissue, upper left extremity. It would be inappropriate to select codes from the skin category for either the diagnosis or procedure codes as this particular tumor was in the soft tissue.

Common Procedures for Skin Lesions

Some of the most common procedures for skin lesions include biopsy, shaving, excision, destruction (cryotherapy and electrosurgical), cutting or paring, debridement, excisional debridement, and curettage. Depending on whether the procedure is performed as an inpatient (ICD-10-PCS) or outpatient (CPT®) will guide your procedure code selection.

ICD-10-PCS Inpatient Procedures for Skin Lesions

Excision is defined in ICD-10-PCS as cutting out or off without replacement some of a body part with the use of a sharp instrument including scalpel, wire, scissors, and bone saw, electrocautery, etc. The qualifier DIAGNOSTIC is used to identify excisions that are biopsies in ICD-10-CM.

Destruction is defined as eradicating without replacement some/all of a body part so that the body part is no longer there. Destruction is accomplished with the use of direct use of energy, force, or a destructive agent. None of the body part is taken out and therefore there will most likely not be a pathology report on lesions removed by this method.

Extraction is defined as pulling or stripping out or off all or a portion of a body part (by use of force either manual or suction. The qualifier DIAGNOSTIC is used to identify extraction procedures that are biopsies. Debridement and curettage would fall under this category.

Outpatient Procedures for Skin Lesions

Definitions for CPT® procedures are included in the AMA CPT® Code Book. Procedures used to treat skin lesions include biopsy, shaving, excision, destruction (cryotherapy and electrosurgical), cutting or paring, excisional and non-excisional debridement, and curettage.

Biopsy is the removal a sample of the lesion and submitted to pathology. The pathologist will evaluate the lesion under the microscope and help guide the care required for treatment of the lesion by identifying the type of lesion in the sample. At times, the entire lesion may be removed as a biopsy sample.

Biopsies that are documented as shave biopsies are either coded to biopsy codes or shave excision codes. There is not a CPT® code that directly correlates with shave biopsy. Review the documentation carefully. Match the documentation to the CPT® code description.

Excision is the removal of the lesion completely with margins and submitted to pathology.

Destruction employs heat, freezing, chemicals, lasers and/or curettage to destroy the lesion in place. Destruction does not usually leave any material as specimen to be submitted to pathology.

Cutting or paring involves the use of a blade, curette, or similar sharp instrument. Paring and shaving involve removing the lesion just to the level of the skin, similar to scraping.

CPT® code selection is based on anatomic location (arms, legs, trunk, face, nose, etc.) and size of the lesion in centimeters. The physician must document the size of the lesion either in width and length or diameter. Be careful not to confuse the wound closure length with the lesion size. These are often very different measurements.

Lesion Excision and Margins

For outpatient procedure coding, it is important to include the margin of the lesion in the size of the excision code. CPT® Code Books instruct the coder to select codes based on the greatest clinical diameter of the lesion plus the margin required for complete excision. Code selection is based on the sum of the size of the lesion and its margins.

For example:

3.4 cm lesion of the upper back excised

1.5 cm surrounding margin

Total sum of excision 4.9 cm.

Coding Excision of Multiple Lesions

CPT® Code Books have detailed instructions on the code selection for removal of multiple lesions in the same operative session.

First, the coder must report separately each lesion excised. Select the code based on the diameter of the lesion plus the narrowest margin.

Second, closure of the defects created by the excisions is reported when the closure is intermediate or complex. Simple closure is included in the excision code and is defined as involving primarily epidermis and dermis or subcutaneous tissues. Simple closure requires a simple one layer closure and includes the local anesthesia and chemical or electrocauterization of wounds not closed by suture.

Intermediate closure is defined as layered closure. Intermediate closure also includes simple closure of heavily contaminated wounds that require extensive cleaning.

Complex closure is defined as requiring more than layered closure including extensive undermining of the wound, retention sutures, and skin grafting procedures.

CPT® Code Book instructs the coder “when multiple wounds are repaired, add together the lengths of all those in the same classification [simple, intermediate, or complex] and from all anatomic sites that are grouped together into the same code descriptor [i.e., closure of wound defects of multiple upper extremity lesion excisions would be grouped together; closure of wound defects of the back would be grouped together].

For example:

A) 2.3 cm benign lesion of upper right arm with 1 cm margins. Intermediate closure.

B) 2.5 cm benign lesion of upper left arm with 1 cm margins. Intermediate closure.

C) 1.2 cm benign lesion of upper right arm with 1 cm margins. Simple closure.

D) 2.5 cm benign lesion upper left thigh with 1 cm margins. Intermediate closure.

E) 3.2 cm benign lesion of upper left thigh with 1 cm margins. Intermediate closure.

ICD-10-CM diagnoses:

Benign lesion right forearm

Benign lesion left forearm

Benign lesion left thigh

CPT® procedures:

Excision benign lesion trunk, arms, or legs 3.3 cm [lesion A]

Excision benign lesion trunk, arms, or legs 3.5 cm [lesion B]

Excision benign lesion trunk, arms, or legs 2.2 cm [lesion C]

Excision benign lesion trunk, arms, or legs 3.5 cm [lesion D]

Excision benign lesion trunk, arms, or legs 4.2 cm [lesion E]

Intermediate repair wounds of scalp, axillae, trunk, and/or extremities (excluding hands/feet) 3.3 cm [lesion A] + 3.5 cm [lesion B] + 3.5 cm [lesion D] + 4.2 cm [lesion E] = 14.5 cm

Simple repair wounds of scalp, axillae, trunk, and/or extremities (excluding hands/feet) 2.2 cm [lesion C] = 2.2 cm

Avoid Costly Coding Mistakes

By following these rules for correct coding of skin lesions and their removal, the coder can help avoid costly coding mistakes. Many coders feel comfortable coding directly from the operative report. However, when there are multiple procedures or lesions removed, it is best to sort out the facts before attempting to select codes. Follow these steps in order to avoid coding mistakes:

  1. Review all of the documentation on the medical record.
    • Note lesion location(s)
    • Lesion size including margin
  2. Do not use the pathology report for this information. The process of preserving the specimen alters the size of the lesion.
  3. Type of lesion(s)
    • Cyst
    • Wart
    • Benign neoplasm
    • Malignant neoplasm
    • Uncertain neoplasm
    • Unspecified neoplasm
  4. Exact procedure for each lesion
    • Biopsy
    • Excision
    • Destruction
    • Shaving
    • Cutting
    • Paring
    • Debridement
    • Curettage
  5. Closure type and length for each wound
  6. Select ICD-10-CM code(s) to appropriately report the lesion(s). Multiple lesions of the same anatomic site are coded only once for the ICD-10-CM diagnosis code.
  7. Review the operative note carefully to determine lesion size(s) and type(s) of wound closure.
    • For inpatient encounters, select the ICD-10-PCS procedure code(s) appropriate to report the procedure(s). **is graft included??
    • For outpatient encounters, select the CPT® procedure code(s) appropriate to report the diameter plus margin for the lesion(s).
    • For outpatient encounters, select the CPT® procedure code(s) appropriate to report the closure of the wound defect for the lesion(s). Multiple wound closures in the same anatomic site are coded together by adding the sum of the lengths of the closure(s) of the same type [intermediate or complex].
  8. Add modifiers to CPT® procedure codes are required. See Modifier 59 rules.

By carefully reviewing medical record documentation for category of lesion, lesion location(s), and the terminology used by physicians and pathologists, the coder can appropriately code and expect reimbursement for inpatient and outpatient procedures on skin lesions. Using these guidelines, the coder can avoid costly coding mistakes and need for future rebills.

Chronic Sore Throat – Causes and Natural Treatment

Some people pick up a recurring sore throat, whilst others rarely or never succumb to this condition. Let’s have a look at some of the common causes of a persistent sore throat:

Low immunity

The resistance of your body to disease, can determine how often you get a recurring sore throat. If you have poor immunity you are more likely to pick up infections and their accompanying symptoms. Your immune system can be suppressed by a poor diet, stress, smoking, an underlying disease or a genetic weakness.

Chronic viral infection

Some viruses are latent viruses that remain in the body for life, and can be reactivated when you are run down or under stress. Examples are the Epstein Barr virus that causes mononucleosis or glandular fever, and the herpes virus that causes recurrent cold sores and ulcers. When these viruses recur infective symptoms like a painful throat, fever and malaise are common.

Chronic bacterial infection

Bacteria like Chlamydia pneumonia, mycoplasma and Rickettsia can cause low grade infections which last for years. These bacteria live inside your cells and are difficult to eradicate from the body. A combination of conventional and natural medicine is the best approach.

Chronic fungal infection

A persistent sore throat can be triggered by a thrush or Candida. These infections are characterized by white patches on the inside of the mouth and throat. Candida infections are common in those with suppressed immunity.

Allergy

Food and environmental allergens like pollen, mold, dust mite and animal dander are common throat irritants that can trigger throat pain and inflammation.

Food and chemical sensitivities

Sensitivities to particular foods and chemicals are well known causes of respiratory symptoms like runny nose, sneezing and an irritated throat. Chemicals like chlorine, cleaning agents, nail polish, pesticides, glues, petrol and aerosol sprays are common triggers.

Reflux

If your throat is worse in the morning it may be due to reflux. Acid travels up from the stomach into the esophagus, and if the esophageal valve is weak, the acid can irritate the back of the throat.

Overuse of the voice

Strain of the vocal chords can result in a persistent painful throat. This is commonly seen in teachers, singers and presenters. Voice training can reduce this condition.

Tumors

A recurrent sore throat which is accompanied by weight loss, a lump in the throat, blood in the phlegm and voice hoarseness may point to a throat tumor. Excess alcohol and smoking can contribute to throat cancers.

Mouth breathing

People who breathe through their mouth or those with sleep apnea often complain of a constant sore throat.

Dry air

Dry air like that found in heated homes or offices can dry out the mucous membranes of the throat, leaving it prone to irritation. A humidifier or some natural plants can help maintain a good moisture content of the air and minimize throat soreness.

Drug reactions

Certain medications can trigger adverse side effects in some people. If you suspect your medication may be causing your chronic sore throat then discuss it with your doctor or pharmacist.

Emotional blocks

Recently there has been a resurgence in the belief that our emotions can trigger recurrent health problems. In the case of a constant sore throat, there may be a block in the ability to stand up for oneself, express thoughts and to reveal true emotions. If you think there may be an emotional component in your health problems it is worth chatting to a counselor or NLP practitioner.

Chronic sore throat treatment

Fortunately, through general lifestyle practices like a healthy diet, stress reduction, regular exercise, pinpointing allergens and sensitivities and boosting immunity through nutrients, herbs and emotional support, most of these triggers for chronic sore throats can be eliminated.

101 Tattoo Facts

1: An Ohio restaurant specializing in cheeseburgers offers a lifetime 25% discount for anyone who has a tattoo of a cheeseburger and at an unrelated tattoo studio in a nearby town, they’re offering a 25% discount on cheeseburger tattoos- Sounds suspicious.
2: Tattoos are rarely done in ink, what is commonly called inks, are actually suspended solid color particles, mostly metal salts and plastics, but not vegetable dyes as commonly believed.
3: There are no reported cases of HIV infection from a tattoo in the U.S., but there are three from dentist’s offices.
4: More women than men are getting tattooed today.
5: Tattoos are considered a minor medical procedure.
6. Until 2006 it was illegal to get a tattoo in Oklahoma
7: Lucky Diamond Rich of New Zealand is the most tattooed person in the world, and after running out of space, has started putting lighter tattoos on top of the darker ones, and vice versa.
8: Robbie “the coon” Koch recently broke the world’s record by inking 577 tattoos in 24 hrs. The old record was held by Kat Von D of the television show, “LA Ink.” Update- Hollis Cantrell actually owns the record as of 2009 (801 tattoos) but Robbie the coon sounded better. Hollis’s final tattoo was on his thigh.
9: The first recorded tattoo is believed to have been found on a mummified iceman in 3300 BC. He had 58 tattoos, mostly dots and lines.
10: In 1876 Thomas Edison invented a machine that ultimately became the tattoo machine, but it took modifications by Samuel O’Reilly in 1891 to adapt the device for tattooing.

11: The record for the longest tattoo session is 43 hours and 50 minutes and was completed by the very observant and talented artist Melanie Grieveson, of Australia. The tattooed was Stephen Grady.
12: In 2005 Kimberly Smith was paid $10,000 to have Golden Palace.Com tattooed on her forehead by the casino, to help pay for her daughter’s education. The casino is noted for its outlandish promotions.
13: Thomas Edison had five dots tattooed on his left forearm, similar to the dots on dice.
14: Lip tattoos only last 1 to 5 years and need to be frequently retouched, the most common a cosmetic lip liner.
15: The second most common reason for tattoo removal is mistranslation.
16: In 2010 Channel will unveil its new line of fashionable temporary tattoos. The set of 55 tattoos sells for $75.
17: Most Tattoo machines hold between 1 and 10 needles and some ancient methods using rakes hold up to 27.
18: Anil Gupta is considered NYC’s most expensive tattoo artist at over $350 per hour.
19: In the majority of cases, the outline of a tattoo shouldn’t bleed at all, and the shading for only a few minutes.
20: As of 2006, 1 in 4 women aged 18 to 50 have at least one tattoo.

21: U.S. President James Polk is said to be the first white man to have a Chinese character as a tattoo.
22: A brothel in Cologne, Germany is offering any patron who gets a tattoo of the businesses logo, by their in house artist, free entrance for life ($6.25 US) and discounts on lap dances ($25.00 US. ea)
25: The word “tattoo” has been in the top ten searched terms since Lycos started tracking search engines.
26: Democrats are more likely to have a tattoo then republicans, 18% to 14%.
27: January 23, 2010. A new US Marine Corp directive prohibits anyone with a full sleeve tattoo from becoming an officer. It also prohibits tattoos on the hands, wrists, fingers, and the inside of the mouth.
28: July 17th, 2009. 18 year old Kimberly Vlaminck sues a Romanian tattoo artist over the 56 stars that she awoke to, scattered across her face, 53 more than see asked for. She later admitted that she lied in the lawsuit and had asked for all fifty six.
29: Blues singer Janis Joplin had a wristlet tattoo and a small heart on her left breast.
30: In Oregon, it is a felony to practice tattooing without a license or in an unlicensed shop.

31: Heiress and socialite Paris Hilton had one tattoo to her credit, the name of then boyfriend Nick Carter on her right butt cheek. It has since been removed by laser.
32: The traditional Samoan tattoo, pe’a, covering the body from mid torso to the knees, takes 3 months to complete and up to 1 year to fully heal. A typical session lasts from dawn till dusk, or until the pain becomes too great, and resumes the next day unless the skin needs a few days to heal.
33: In a 2002 survey, 8 of the top 10 voted, “most beautiful people in the world” had tattoos.
34: Tattoos done today don’t turn blue when they age, unless they were originally blue, the inks are much more stable.
35: The first occurrence of the word tattoo in the Oxford English Dictionary came in 1769 and is credited to Captain John Cook.
36: A rooster tattooed on one leg and a pig on the other is said to protect a sailor from drowning. Neither animal can swim.
37: Queen Kamamalu of Hawaii (1808-1824) was the first woman to have her tongue tattooed.
38: Most tattoo artists will not tattoo a pregnant woman.
39: Some tattoo artists claim that if you shield a new tattoo from sunlight for the first two years it will remain brighter and clearer for decades.
40: Over 40 million people in the U.S. have tattoos.

41: 26% of Americans with a tattoo say they make them feel more attractive, with women voting that way almost 2 to 1 over men.
42: Tommy Lee of Motley Crue holds the record for highest altitude tattoo, having been inked in 2008 at 45,000 feet. The tattoo was said to cost $150,000 dollars.
43: 73 year old Isobel Valley, the world’s most tattooed women, has every square inch of her body tattooed, except her face, and also has fifty piercings, 15 of which are visible. The majority of the piercings are below the belt because she wants to jingle when she walks, she says.
44: An increasing number of people are having medical alerts tattooed to aid doctors in case of an emergency.
45: 43 year old former soldier Shawn Clark has the names of all 232 British soldiers killed in Afghanistan tattooed on his back.
46: At one time red ink was known to fade; not so with today’ inks.
47: The title of The “Hardy Boys” #47 is “The Mystery of the Whale Tattoo.”
48: When Cortez landed on the Mexican coast in 1519 he was horrified to find the natives practicing devil worshiping and had somehow permanently marked images of their idols on their skin. He called it the work of the devil.
49: A tattoo of an anchor on a sailor indicates they have sailed across the Atlantic.
50: One third of Americans with tattoos say they make them feel sexier.

51: Tattoo ink is injected into the second layer of the skin, the dermis, and become encapsulate by the body as a defense mechanism, leaving the image stable and intact.
52: Gabrial Carbona, an American teenage hit man for a Mexican cartel, has his eyelids tattooed so they never look closed. His idea is not working as well for him in prison.
53: Jimmy Buffet sings about tattoos in this song of the same name, “It’s a permanent reminder of a temporary feeling.”
54: In the 1920’s, American circuses employed more than 300 people with full body tattoos and paid them up to $200 a week, a lot of money during those times.
55: The percentage of males and females with tattoos is now statistically equal.
56: Tattoo equipment is sterilized in an autoclave, a high pressure steam machine, similar to a pressure cooker and how hospitals do theirs.
57: 57% of people without a tattoo feel that those with them are more rebellious and threatening.
58: 35 0f the first 43 U.S. Presidents reportedly have tattoos.
59: Tattoo inks are not regulated by the by any government agencies so there is no way of knowing exactly what’s in them.

60: Winston Churchill’s mother, Lady Randolph Churchill, had a tattoo of a snake on her wrist. They were popular for rich aristocrats during that period. She chose a snake because it could be easily covered by a bracelet.
61: U.S. President Andrew Jackson had a giant tattoo of a tomahawk that ran down the length of the inside of his thigh. No one knows exactly why.
62: Almost all U.S. corporations have some form of restrictions or policy regarding tattoos on the job.
63: As of Sept. 29th 2009, the 19 year old ban on tattooing was lifted in DeKalb, Illinois.
64: Actress Halle Berry has a tattoo of a sunflower on her rear end covering up the name of her ex, baseball player David Justice.
65: The popularity of tattooing during the latter part of the nineteenth century and first part of the twentieth century owed much to the circus sideshow.
66: People with antisocial personality disorder are more likely to have a higher number of tattoos in more visible locations, and covering a larger percentage of their bodies.
67: Ancient Egyptians used tattoos to differentiate between slaves and peasants.
68: During the late 18th century in Europe, collecting the tattooed heads of Maori people became so popular that many were murdered to meet the demand. The heads were commonly paid for in guns.
69: In the 1870s the Japanese government outlawed tattoos forcing the practice underground where it flourished.
70: 3% of Americans say having a tattoo makes them feel more athletic.

71: The world’s most tattooed women, Isobel Varley got her first tattoo, a flower, at age 49.
72: 4% of consumers spend over $1000 on a tattoo.
73: When you see someone’s tattoo you are viewing it through the first layer of the skin, the epidermis.
74: 50% of all tattoos are not covered up by clothing and are openly visible.
75: Tattoo machines can make upwards of 200 hits per second, that’s up to 12,000 times a minute and 720,000 an hour.
76: In ancient Greece and Rome, tattoos were considered barbaric and were only used to mark slaves and criminals.
77: 52% of those in prison are tattooed.
78: In recent studies, memorial tattoos have been shown to overwhelmingly turn grief into joy and morning into celebration by creating a lasting memory.
79: A 2009 study conducted at Liverpool Hope University found that people with three or more tattoos had significantly lower levels of self esteem.
80: 4% of Americans say that their tattoos make them feel healthier.

81: It is untrue that white or lighter colored inks are more painful to use.
82: A tattoo is art, only, if the person doing the tattoo is an artist and a skilled technician.
83: President James Buchanon had a tattoo of a scantily clad woman on his chest with the initials BFL (bachelor for life).
84: In 2002, 18 year old hair dresser Lee Becks was shocked to find out the tattoo he thought said, “Love, honor, and obey” actually translated to, “at the end of the day, this is an ugly boy.”
85: New York City outlawed tattoos from 1961 to 1997 because of a tattoo related outbreak of hepatitis “C”.
86: In a 2002 study a group of male high school and college students viewed pictures of models with and without tattoos, and graded them in 13 categories. The models with tattoos scored much lower in 9 of the 13 ratings.
87: Some people experience pain or a burning during sensation during an MRI because of the metallic particles in some inks.
88: The US Navy prohibited tattoos of naked women during World War II, so many future sailors had to get their tattoos reworked to include cloths.
89: The first recorded instance of death following tattooing was reported in 1837 in France. The young woman, a prostitute, was covering up another unwanted tattoo and died from the infection that followed.
90: Apr. 30, 2009. To celebrate Barbie’s 50th birthday Mattel comes out with the new “Totally Stlylin’ Barbie, complete with a set of place able tattoos, one a lower back tattoo featuring the name Ken.

91: 35% of all NBA players have tattoos. Michael Jordan has none and teammate Dennis Rodman has at least 22.
92: Lorette Fulkerson was the last woman to work the circus sideshows, retiring in 1995 at the age of 80.
93: Eyeball tattoos are not done with a machine, but rather, the ink is directly injected into the eye with a syringe.
94: Urine was sometimes used in early ink mixtures.
95: 5% of Americans with a tattoo say they make them feel smarter.
96: The first case of a syphilis being transmitted by a tattoo came in 1853. The artists ink was drying up so he spit in it, transferring the disease.
97: Never go back to the person who gave you a bad tattoo to have it fixed, it will not get better.
98: The time to ask questions is before you get a tattoo.
99: Good tattoos aren’t cheap and cheap tattoos aren’t good.
100: Women are more than twice as likely to have a tattoo removed as men.

101: Over 50% of the tattoos created today will be removed by laser at great expense, intense pain and permanent minor scaring. Think before you ink.

The Benefits of Jujube

Jujube is rich in protein, fat, carbohydrates, carotene, vitamin B, C, P, and ingredients of phosphorus, calcium and iron. It is especially popular for being rich in vitamin C. The following are some of its great benefits.

1. Reduce the seborrheic keratosis

The vitamin C contained by jujubes is an antioxidant substance, which participates the body’s physiological oxygen reduction and effectively reduces the production of seborrheic keratosis through preventing the chronic sedimentation of melanin in the body.

2. Protect liver

The sugar, fat and protein contained in jujubes are nutrients that can protect the liver. It can promote liver to synthesize protein, increasing the content of red protein and albumin in serum, adjusting the ratio of albumin and globulin, preventing transfusion reactions and lowering the serum alanine aminotransferase level etc.

Use 50 grams of jujubes and 90 grams of rice to make thick porridge, which can benefit a lot to patients with hepatitis. Prepare 30 to 50 grams of jujubes, peanuts and crystal sugar. Boil peanuts first, and then add the jujubes and crystal sugar inside to make soup. Drink the soup before sleeping every day and take 30 days as a treatment period, you will find that it has a certain effect in dealing with acute and chronic hepatitis and liver cirrhosis.

3. Prevent hair loss

Jujube has the function of nourishing spleen and stomach. There is an old saying in China goes like this “Good spleen, good skin”. With radiant skin, the hair can have a sound shelter. So eat more jujubes can prevent hair loss and help you to grow glossy hair.

4. Nourish stomach and brain

Jujube is frequently used in traditional Chinese medicine for nourishing stomach and spleen. In the case of fierce or irritating substances in the drug prescription, jujubes are often equipped to help protect the stomach and spleen. It is also rich in carbohydrate, protein, fat and organic acids, which brings a tonic effect on the brain. The jujube cake made from jujubes and flour is a delicious food with the function of improving stomach and brain.

5. Invigorate the vital energy and nourish the blood

The high vitamin content in jujube makes it beneficial for human capillary. Prepare 20 jujubes, 1 egg, and 30 grams of brown sugar, with water stew served. One time per day. It is especially good for women’s recuperation after producing a baby.

6. Promote sleep

Jujube can nourish spleen and blood, also with a soothing effect. Prepare 1000 grams of fresh jujubes, wash, remove the nuclear, smash and add proper volume of water to boil with slow fire. Filter the juice, mixed with 500 grams of honey. Mix thoroughly into the jujube paste with fire heating, and reserve them in bottles for later use. Eat 15 ml each time for 2 times per day. If continuously served, insomnia can be prevented and cured.

In addition, jujube can also play a role in calcium supplement, emission control prevention and anti-diarrhea. However, jujubes are not appropriate for individuals with a constipation problem for the high content of carbohydrate.

How to Text a Girl – 5 Secret Texting Tips to Create Massive Attraction

Ignoring her, and having TONS of fish on the line

A lot of guys will focus only on one girl and at the same time drive her away, why is this? Imagine you are fishing, and only have one “rod” in the water. You will inherently pay too much attention to the line and jump all over it the second it jiggles. Now imagine you have ten rods in the water, one jiggles but you don’t give it the same level of attention because two others are showing interest at the same time. The more fish you have curious about your bait the higher the chances you are going to catch one, not only because of a numbers game but simply because you physically can’t pay too much attention to only one. This is a type of positive self-sabotage to keep your attention divided. This is one of the stranger things about relationships and is exactly why “when it rains, it pours” is a very true adage.

The Art of Push and Pull

Push and pull I have heard in the PUA world a few times but I have never heard a good explanation as to why it works and I have never heard it applied to how to text a girl. Let me explain how to move this useful tool so there is no doubt as to how to text a girl, perfectly. I liken push and pull to self-stimulation (you get what I mean, right?) as you “work” on yourself, you are creating arousal. If you only “pulled” or only “pushed” there would be no “erecting” attraction and certainly no release. In the texting world it might look like this: You: Hey cutie, did you get that job yet? (pull) Her: Don’t know yet kinda worried You: Well, if you weren’t so under qualified (push) Her: Hey! What’s that supposed to mean!? You: I was talking about us (second push) Her: Whatever, you wish you could date me! € You: Sigh, you are right, I am certainly not in your league (pull) Her: Gawd! I know you… so full of yourself You: Sure am, and that’s why you have the hots for me (push) Her: hahaha, not… You: Okay sweetie, got to run, good luck on the job and let me know if you get it (pull) Her: Thanks! Take care… We have just stimulated the situation and because there was no release we have built up the interest for the second interaction, nicely done. (Let me add something, just read another “textpert’s” advice on how to text women. To my lack of surprise, it was relatively rude and about 80% push. This is the most common PUA mistake, they rarely incorporate enough pull and put themselves at risk of being labeled a jerk, or only create attraction based on temporary negative tension)

Why you should be a pain in the A** over text

Being difficult is a killer tool for creating attraction over text because it forces the other person to play by your rules and not theirs. A lot of guys when texting a girl will take a more passive role, since they believe that if she “likes” you she will choose you. Not that simple, does anyone desire something that is not challenging? This comes down to perception of value, if there are a bunch of hurdles in your particular race it certainly makes it more fun to win. We want to make sure that she values you as much as possible and therefore wants to race. Example: Her: Hey when are you going to ask me out… You: I was going to ask you the same question Her: Girls don’t ask guys out You: Well I guess we aren’t going out, so disappointing… Her: Come on, just say it, and don’t worry, I will say yes You: No, and I know you will say yes, I can tell you got it bad for me! Her: Jeeze… Why do you have to be so difficult? You: Because you like it Her: Maybe I do okay… I am free on This text exchange might take place over an hour or a few days but the point is that you didn’t back down. Women love to push boundaries to test what kind of man you are, this is natural this is normal. Being difficult and not bowing to the will of a woman is incredibly attractive and powerful, when texting a girl.

Safety and comfort then sex

Above we talk a lot about pushing her, being difficult, ignoring her and simply raising your value by not being conventional. At the same time it is incredibly important to communicate that you are a safe guy, that you are friendly, that you are decent, and that sex is not your priority. Fortunately, text is a great place to do this, with text you can craft your response rather the knee jerk you might vomit out in person. Not creating safety and comfort is the number one reason she shuts the sex gates on your advances. If you don’t know how to text a girl properly and you send her something that is overly sexual or mildly aggressive, you will set off her flight response. Do you know why women love gay men? Because they get their male fix with zero sexual threat. I am not asking you to be effeminate around women (but it certainly doesn’t hurt) only to understand that even the smallest sexual physical threat sends women running. How does this translate to texing girls? Simple, keep sex talk to a minimum, keep anger totally wrapped up, and present them the safest guy you can. Now mix that with being push/pull, and you have a guy ALL women will be stupid attracted to. (Note, danger is a form of sexual tension, but this is a tight rope of attraction, one that can take a very long time to master)

Your goal is mastery not a bunch of rules and techniques

I teach a ton of rules and techniques for texting girls but I personally don’t need them anymore. Why? Because I understand the secret of relationship balance, something that if understood will launch you success, not only with texting girls but in all relationships. Make sure you continue below to really master texting.

5 Ways to Poison, Maim, and Kill Yourself

We are so focused on fossil fuel emissions that are poisoning and killing us, that we are blind to the contaminants in our house. There are poisons we are using every day and we don’t even realize they are have invaded our homes. This is an occasion when myopia is a virtue. You and I have been taken for suckers for too long. These are the sources that are poisoning, maiming and killing you.

Take Your Medicines

Pharmaceutical drugs are Poisons although we call them medicines. You and I bought into the story of these instant cure medicines because we became lazy and wanted instant gratification for our maladies, little realizing that the medicines were supposed to be a temporary relief. We forgot that for long term wellness, we had to change our ways.

We forgot that all illnesses are due to our wanton carelessness or carefree lifestyle. Most of us still have wool pulled over our eyes and can’t see through the yarn spun by Big Pharma. If Big Pharma was as successful as they claim, why haven’t their truck loads of heart disease drugs stopped the still accelerating heart disease rates worldwide?

Why do their painkiller drugs kill people? Heard of the rotavirus vaccine causing babies intestines to tangle up and die? How do you maim yourself with drugs? The erection producing drug causes certain heart disease patients to actually get a heart attack. And then there is a anti-diabetes drug causing develop heart disease? And there are tomes more…

Drink Milk

Fortified milk brands are sprouting all over the dairy product aisles, like seeds sprouting after a shower.

Why do we need to fortify milk? When I was young I was told that milk was the perfect food. How do you fortify a perfect food? What is missing that needs to be replenished?

Big Dairy is pumping up food that’s dead. Nutrients have been destroyed while being heated and pasteurized in their factories. Make no mistake, fortified milk doesn’t fortify you. It merely conceals the dead food the chemicals are in.

You can test this yourself. Buy a carton of fortified or any packaged milk and take it to a farm. Take a swig from the milk that comes directly from the udder of the cow and from your carton of milk. You will instantly taste the difference.

Not only does milk from Big Dairy taste flat, the fortifying chemicals are poisoning you slowly. We have no idea what the fancy named fortifying chemicals do in the long term, because unlike the drug industry, the dairy products don’t have any clinical trials to pass.

Eat Your Vegetables and Fruits

Produce from the farms of huge agriculture companies are devoid of minerals that vegetables and fruits are supposed to transfer to us. Modern agricultural methods have depleted the soil. The plow, artificial pesticides and artificial manure have bleached our produce. Discovery of agriculture spelled our doom and caused the explosion of modern day diseases. Our prehistoric ancestors didn’t suffer from our maiming and killer diseases. Every non-infectious disease (and some infectious ones like salmonella, typhoid, hepatitis A and traveler’s diarrhea) is caused by our suicidal eating habits.

You can also taste the difference between produce from big farms versus the organic products.

Always buy packaged foodstuff

Have you noticed that many packaged foods are also fortified? It’s the same reasons as for Big Dairy. Breakfast cereals proclaim their products pack a nutrient-packed punch, when they are only able to deliver a weak stir. Many of them don’t even resemble anything we recognize as foodstuff. Some of them look like the droppings of prehistoric reptiles. And we feed our children this garbage!

Use chemical laced personal care items

Some years back lipsticks were laden with lead and the discovery of the deadly effects of lead, lead to their disuse. Now everyone thinks that lead was the only poison used in the personal care industry. There are many more and they have exotic names that you need a degree in Latin to pronounce.

For example, many shampoos and skin care products have SLF (sodium lauryl sulphate) that damages your immune system. There are many more additives in personal care products whose dangers we still are in the dark about.

Do you feel like a slug living in a cess pool? If you follow my advise here you can still gain radiant health:

– switch as many products to natural alternatives as fast as you can

– detoxify yourself of the accumulated poisons

– avoid processed foods as much as possible and eat the right ones

– do natural exercises

You can achieve breakthrough health if you are disciplined and committed to it.