Arthritis

ARTHRITIS comes from the Greek arthron meaning "joint" and the Latin itis meaning "inflammation".  Arthritis affects the musculo-skeletal system, specifically the joints. It is the main cause of disability among people over fifty-five years of age in industrialized countries.

There are over 100 types of arthritis.  Here is a description of some common ones, together with the causes:

 

·                        Osteoarthritis. Cartilage loses its elasticity. If the cartilage is stiff it becomes damaged more easily. The cartilage, which acts as a shock absorber, will gradually wear away in some areas. As the cartilage becomes damaged tendons and ligaments become stretched, causing pain. Eventually the bones may rub against each other causing very severe pain.

·                        Rheumatoid arthritis.  This is an inflammatory form of arthritis. The synovial membrane (synovium) is attacked, resulting in swelling and pain. If left untreated, the arthritis can lead to deformity. Rheumatoid arthritis is significantly more common in women than men and generally strikes when the patient is aged between 40 and 60. However, children and much older people may also be affected.

·                        Infectious arthritis (septic arthritic) - an infection in the synovial fluid and tissues of a joint. It is usually caused by bacteria, but could also be caused by fungi or viruses. Bacteria, fungi or viruses may spread through the bloodstream from infected tissue nearby, and infect a joint. Most susceptible people are those who already have some form of arthritis and develop an infection that travels in the bloodstream.

·                        Juvenile rheumatoid arthritis (JRA) - means arthritis that affects a person aged 16 or less. JRA can be various forms of arthritis; it basically means that a child has it. 

 SIGNS and SYMPTOMS OF ARTHRITIS

The symptoms of arthritis depend on the type of arthritis, for example:

·                        Osteoarthritis. The symptoms develop slowly and get worse as time goes by. There is pain in a joint, either during or after use, or after a period of inactivity. There will be tenderness when pressure is applied to the joint. The joint will be stiff, especially first thing in the morning. The patient may find it harder to use the joint - it loses its flexibility. Some patients experience a grating sensation when they use the joint. Hard lumps, or bone spurs may appear around the joint. In some cases the joint might swell. The most common affected joints are in the hips, hands, knees and spine.

·                        Rheumatoid arthritis.  The patient often finds the same joints in each side of the body are painfully swollen, inflamed, and stiff. The fingers, arms, legs and wrists are most commonly affected. Symptoms are usually worst on waking up in the morning and the stiffness can last for 30 minutes at this time. The joint is tender when touched. Hands may be red and puffy. There may be rheumatoid nodules (bumps of tissue under the skin of the patient's arms). Many patients with rheumatoid arthritis feel tired most of the time. Weight loss is common. 

The smaller joints are usually noticeably affected first. Experts say patients with rheumatoid arthritis have problems with several joints at the same time. As the arthritis progresses it spreads from the smaller joints in your hands, wrists, ankles and feet to your elbows, knees, hips, neck, shoulders and jaw.

·                        Infectious arthritis.  The patient has a fever, joint inflammation and swelling. He will feel tenderness and/or a sharp pain. Often these symptoms are linked to an injury or another illness. Most commonly affected areas are the knee, shoulder, elbow, wrist and finger. In the majority of cases, just one joint is affected.

        Juvenile rheumatoid arthritis.  The patient is a child. He will experience intermittent fevers which tend to peak in the evening and then suddenly disappear. His appetite will be poor and he will lose weight. There may be blotchy rashes on his arms and legs. Anemia is also common. The child may limp or have a sore wrist, finger, or knee. A joint may suddenly swell and stay larger than it usually is. The child may experience a stiff neck, hips or some other joint.

Physical therapy and occupational therapy for arthritis

Physical therapy and occupational therapy help maintain joint mobility and range of motion. How much therapy you need, and what kind of therapy you get will depend on many factors such as the severity and type of arthritis you have, your age, and your general state of health. This has to be decided by you with your physician and physical or occupational therapist. 

Medications for Arthritis

NSAIDs NSAIDs (nonsteroidal anti-inflammatory drugs) are the most commonly prescribed drugs for arthritis patients.

Traditional NSAIDs - these are the largest subset of NSAIDs. As is the case with most drugs, they do carry a risk of side-effects, such as stomach upset and gastrointestinal bleeding.

Glucocorticoids are anti-inflammatory steroids and are very effective at combating inflammation and can be extremely helpful when used properly. The patient needs to consider the potential for undesirable side-effects with this type of drug.

Diet and bodyweight impact on arthritis

Experts say that eating a well-balanced diet is vital when you have arthritis. Not only will you be receiving critical nutrients, you will also be either maintaining or arriving more quickly at a healthy bodyweight. If you are overweight you will be adding extra pressure on weight-bearing joints. Many patients have found that losing just a few pounds made a significant difference to their quality of life. 

For free e-books on arthritis, you may visit Rheumatoid Arthritis.

R. Y. MANABAT, R.N.

Anemia

What is ANEMIA?

Anemia is a condition in which the blood does not supply the body with enough oxygen.  This is because in anemia, either the number of red blood cells circulating in the body is lower than normal or the levels of hemoglobin inside the red blood cells fall below normal.  If hemoglobin and/or red blood cell levels are low, less oxygen is delivered to the tissues by the blood.

Hemoglobin is the iron-containing red pigment that gives the red blood cells their color; and it also gives red blood cells their ability to carry oxygen.

CAUSES OF ANEMIA

There are three general causes of anemia:

• ·               Decreased red cell production by the bone marrow
• ·               Increased red cell destruction, or hemolysis
• ·               Blood loss from heavy menstrual periods or internal bleeding 

 SIGNS AND SYMPTOMS OF ANEMIA

A person with anemia will feel tired and weak. That's because the body's tissues are not getting enough oxygen. In fact, fatigue is the main symptom of most types of anemia. The severity of the symptoms of anemia is in part related to how severe the anemia is. Mild anemia can occur without symptoms and may be detected only during a medical exam that includes a blood test.

• ·               Fatigue
• ·               Weakness
• ·               Fainting
• ·               Breathlessness
• ·               Heart palpitations (rapid or irregular beating)
• ·               Dizziness
• ·               Headache
• ·               Ringing in the ears (tinnitus)
• ·               Difficulty sleeping
• ·               Difficulty concentrating

Common signs include:

• ·               Pale complexion
• ·               The normally red lining of the mouth and eyelids fades in color
• ·               Rapid heartbeat (tachycardia)
• ·               Abnormal menstruation (either absence of periods or increased bleeding)

TYPES OF ANEMIA

There are different kinds of anemia. Some forms of this condition are inherited, while others are brought on by poor nutrition.

1. Iron Deficiency Anemia                

2. Vitamin Deficiency Anemia                

3. Hemolytic Anemia

4. Sickle Cell Anemia

5. Thalassemia

6. Aplastic Anemia

HOW IS ANEMIA TREATED?

The treatment for anemia depends on the type and cause.

 

Iron deficiency anemia is treated with iron (ferrous sulphate) supplements, initially taken three times a day.  If nausea, stomach cramps, diarrhea or constipation occurs, the medication may be taken with a little bit of food.  Treatment should be continued for three to six months in order for the body to fully replenish its iron supply.

Pernicious anemia, or vitamin B-12 deficiency, is treated by a life-long course of intramuscular injections of B-12. Persons with this type of anemia receive a shot of B-12 several times a week when first diagnosed. The treatment may continue for life, with one shot about four times a year.

Folic acid deficiency anemia can be corrected by taking folic acid supplements once a day.

Hereditary hemolytic anemias, such as thalassemia is treated by first eliminating any existing infections and avoiding medications that suppress the body's immune system.

Sickle cell anemia patients may be given oxygen, oral and intravenous fluids and pain-killing drugs to reduce pain and prevent complications. 

Sometimes rare aplastic anemias and autoimmune hemolytic anemias will respond to steroids. Failure to respond to steroids may require removal of the spleen which can become enlarged with defective red blood cells.

For free e-books on ANEMIA, you may visit Cancer Drug.

RICHMOND Y. MANABAT, R.N.

Herpes

What is HERPES?

HERPES IS A VIRUS THAT CAN SPREAD FROM PERSON TO PERSON THROUGH SKIN TO SKIN CONTACT.  IT CAN APPEAR ON MANY DIFFERENT AREAS OF THE BODY AND IS TYPICALLY MARKED BY AN ERUPTION OF A CLUSTER OF BLISTER.

Different Types of Herpes

1.  Herpes Simplex  Virus Types 1 and 2 (responsible for cold sores and genital herpes)
2.  Varicella-zoster Virus
3.  Epstein-varr Virus
4.  Human Herpes Virus  (recently discoverd)

 

HERPES SIGNS & SYMPTOMS

The signs and symptoms of herpes can vary widely from full blown outbreaks to no symptom at all. It is very important to educate yourself about genital herpes symptoms as it is a sexually transmitted disease.

Genital herpes (signs & symptoms)

 One  or more of the following symptoms may be experienced if the infection is located in the genital area:

1.     Muscle aches or pain near to area.

2.    A blistr, cut, tear, sore, bump or rash in the infected area.

3.    Vaginal or penile discharge.

4.    Burning sensation or pain when urinating

5.    Flu-like symptoms such as headache, fever and swollen gland.

 

HOW TO TREAT HERPES

Treatment works best if it is started as soon as possible after an outbreak begins. This is especially true for outbreaks that come back again and again (recurrent outbreaks).

Initial treatment:

Most people find some relief and recover more quickly from the first (primary) outbreak of genital herpes by taking antiviral medicines.

Use medicines to relieve symptoms and speed healing of blisters and sores.

Antiviral medicines, such as acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex) are recommended for treating primary genital herpes outbreaks.

Nonprescription medicines, such as ibuprofen (Advil) or acetaminophen (Tylenol), may reduce the pain and fever from genital herpes.

Use home treatment, such as taking warm sitz baths and wearing cotton underwear, to promote healing of herpes sores. For more information, see the Home Treatment section of this topic.

Take steps to prevent the spread of genital herpes. These include avoiding any sexual contact if you or your partner have symptoms or are being treated for genital herpes.

R. Y. MANABAT,  R.N.

Sexually Transmitted Diseases

SEXUALLY TRANSMITTED DISEASES, (also called STDs or STIs -- sexually transmitted infections) are infections that can be transferred from one person to another through sexual contact. According to the Centers for Disease Control there are over 15 million cases of sexually transmitted disease cases reported annually. Adolescents and young adults (15-24) are the age groups at the greatest risk for acquiring an STD, 3 million becoming infected each year.

STDs affect men and women of all ages and backgrounds, including children.  Many countries require that Child Protective Services be notified if children are diagnosed with an STD.

STDs have become more common in recent years, partly because people are becoming sexually active at a younger age, are having multiple partners, and do not use preventive methods to lessen their chance of acquiring an STD. 

People can pass STDs to sexual partners even if they themselves do not have any symptoms. 

Frequently, STDs can be present but cause no symptoms, especially in women (for example, chlamydia, genital herpes or gonorrhea). This can also occur in some men.

COMMON STDs

Chlamydia- is a very dangerous STD as it usually has no symptoms; 75% of infected women and 25% of infected men have no symptoms at all.

Gonorrhea is one of the most frequently reported STD. 40% of its victims contract PID if not treated, and it can cause sterility.

Herpes - Painful and episodic; can be treated but there's no cure.

HIV/AIDS - First recognized in 1984, AIDS is the sixth leading cause of death among young men and women. The virus is fatal involving a long, painful death.

Syphilis - Untreated, can lead to serious damage of the brain or heart.

Tricomoniasis - Can cause foamy vaginal discharge or no symptoms at all. Can cause premature birth in pregnant women.

HOW TO AVOID STDs 

Abstinence is the number one way to avoid contracting an STD.   Faithfulness to your spouse or sticking to one partner is the second best way to avoid the disease. 

 R. Y. MANABAT, R.N.

Diabetes

ALL ABOUT DIABETES

Diabetes (diabetes mellitus) is classed as a metabolism disorder. Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood - it is the principal source of fuel for our bodies.

Diabetes comes from Greek, and it means a siphon. Aretus the Cappadocian, a Greek physician during the second century A.D., named the condition diabainein. He described patients who were passing too much water (polyuria) - like a siphon. The word became "diabetes" from the English adoption of the Medieval Latin diabetes. 

SYMPTOMS OF DIABETES

Frequent urination                Increased fatigue

Disproportionate thirst         Irritability

Intense hunger                      Blurred vision

Weight gain                             Cuts and bruises don't heal properly or quickly

Unusual weight loss             more skin and/or yeast infections

Itchy skin                                Gums are red and/or swollen

Frequent gum disease         Sexual dysfunction among men

Numbness or tingling, especially in your feet and hands

Diabetes can often be detected by carrying out a urine test, which finds out whether excess glucose is present. This is normally backed up by a blood test, which measures blood glucose levels and can confirm if the cause of your symptoms is diabetes.

THREE MAIN TYPES OF DIABETES

Diabetes Type 1 - You produce no insulin at all.

Diabetes Type 2 - You don't produce enough insulin, or your insulin is not working properly.
 

Gestational Diabetes - You develop diabetes just during your pregnancy. 

5 ESSENTIALS DIABETES TIPS

• READ UP ON DIABETES
• TEST AND RECORDS YOUR BLOOD SUGAR
• PICK A GOOD DIET FOR YOUR DIABETES
• INCLUDE SOME ACTIVITY EACH DAY
• TALK ABOUT YOUR DIABETES 

TREATMENT

The major goal in treating diabetes is to minimize any elevation of blood sugar (glucose) without causing abnormally low levels of blood sugar.

Type 1 diabetes is treated with insulin, exercise, and a diabetic diet.

Type 2 diabetes is treated first with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugars, oral medications are used. If oral medications are still insufficient, treatment with insulin is considered.

Weight reduction and exercise are important treatments for diabetes. Weight reduction and exercise increase the body's sensitivity to insulin, thus helping to control blood sugar elevations.

 R. Y. MANABAT, R.N.

For reading references, visit Free Diabetes E-books.

Depression

Feeling sad, or what we may call "depressed", happens to all of us. The sensation usually passes after a while. However, a person with a depressive disorder - clinical depression - finds that his state interferes with his daily life. His normal functioning is undermined to such an extent that both he and those who care about him are affected by it. 

 What is DEPRESSION ?

Depression is "a mental state or chronic mental disorder characterized by feelings of sadness, loneliness, despair, low self-esteem, and self-reproach; accompanying signs include psychomotor retardation (or less frequently agitation), withdrawal from social contact, and vegetative states such as loss of appetite and insomnia."

Different Types of Depression

Major depressive disorder (major depression)

Major depressive disorder is also known as major depression. The patient suffers from a combination of symptoms that undermine his ability to sleep, study, work, eat, and enjoy activities he used to find pleasurable.

Dysthymic disorder (dysthymia)

Dysthymic disorder is also known as dysthymia, or mild chronic depression. The patient will suffer symptoms for a long time, perhaps as long as a couple of years, and often longer. However, the symptoms are not as severe as in major depression, and the patient is not disabled by it.

Psychotic depression

When severe depressive illness includes hallucinations, delusions, and/or withdrawing from reality, the patient may be diagnosed with psychotic depression.

Postpartum depression (postnatal depression)

Postpartum depression is also known as postnatal depression or PND. This is not to be confused with 'baby blues' which a mother may feel for a very short period after giving birth. If a mother develops a major depressive episode within a few weeks of giving birth it is most likely she has developed PND.

SIGNS and SYMPTOMS

Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows.

Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.

Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.

Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.

Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).

Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.

Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.

Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.

Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.

Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

TREATMENT

Antidepressant medications

Selective serotonin reuptake inhibitors (SSRIs) are medications that increase the amount of the neurochemical serotonin in the brain.

Electroconvulsive therapy (ECT)

In the ECT procedure, an electric current is passed through the brain to produce controlled convulsions (seizures). ECT is useful for certain patients, particularly for those who cannot take or have not responded to a number of antidepressants, have severe depression, and/or are at a high risk for suicide.

Psychotherapies

Many forms of psychotherapy are effectively used to help depressed individuals, including some short-term (10 to 20 weeks) therapies. Talking therapies (psychotherapies) help patients gain insight into their problems and resolve them through verbal give-and-take with the therapist.

HOW TO AVOID BEING DEPRESSED:

1.    Offer goodwill to others.
2.    Learn to Detach from Thoughts
3.    Keep Busy.
4.    Avoid Feelings of guilt.
5.    Live a Balanced Life.
6.    Don’t Base your Happiness solely on other people.
7.    Share Problems
8.    Cultivate Happiness.
9.    Have Low Expectations.
10.  Don’t Dwell On the Negative.

"Happiness will follow you if your heart remains Undisturbed by trifles." (Sri Chimoy)

R. Y. MANABAT, R.N. 



For references, visit Anxiety and Depression.