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a) Atrial Fibrillation :
Atrial fibrillation is a disturbance of the heart's normal rhythm. With this medical condition, the upper chambers of the heart, called atria, contract in a rapid, uncoordinated way causing an irregular heartbeat. Sometimes the heart rate becomes very fast, causing symptoms such as dizziness. Atrial fibrillation is often a sign of advanced heart disease and is most commonly caused by prolonged and uncontrolled high blood pressure.
One of the most important aspects of atrial fibrillation is that if it's not treated, it is a risk factor for having a stroke. Many people with long-term atrial fibrillation should be on blood thinners to help prevent this.
Who is Affected by Atrial Fibrillation?
Atrial fibrillation usually occurs in older people; approximately 10 per cent of people over age 75 will be affected. Young, healthy people can, in rare cases, experience short bouts of atrial fibrillation. Often these are caused by situations like alcohol binging or severe stress. These episodes can often be avoided by quitting smoking, good sleep habits, stress management techniques, and avoiding excessive drinking.
Risk Factors for Developing Atrial Fibrillation
You may be at risk of developing atrial fibrillation if you have or have had:
- Coronary artery disease (blocked heart arteries)
- Heart failure
- Heart attacks
- Uncontrolled high blood pressure
- Heart valve damage (usually due to rheumatic fever)
- An overactive thyroid gland
- Pneumonia
- Chronic lung disease
- Chronic alcoholism
- Some medications, such as theophylline
Sometimes no cause for the fibrillation can be found.
Symptoms
The symptoms of atrial fibrillation include:
Irregular heartbeats sometimes known as palpitations
- Fast heart rate
- Weakness and reduced exercise tolerance
- Fatigue
- Shortness of breath
However, some people have no symptoms.
Diagnosis
A doctor diagnoses atrial fibrillation by listening to a patient's story, examining the patient, taking the pulse to look for an irregular heartbeat, and doing an electrical heart tracing called an ECG.
Prevention
Atrial fibrillation can best be prevented by maintaining your heart in as healthy a condition as possible. Since the most common causes of atrial fibrillation are coronary heart disease and high blood pressure, the best way to prevent it is to have a healthy lifestyle that reduces the risk of those medical conditions.
Lifestyle Factors:
- Quit smoking.
- Engage in physical activity such as regular aerobic activity (brisk walking, jogging, swimming, or biking) for a minimum of 30 to 60 minutes, most days of the week. If you're over 65 or have an illness, check with your doctor before starting or increasing your exercise program.
- Keep your weight within normal range. (Your doctor can help you determine what "normal" is for you.)
- Take time to relax and participate in leisure activities.
Nutritional factors:
- Eat foods that are low in fat and cholesterol, and high in fibre.
- Eat a variety of foods and be sure to get at least five servings of fruits and vegetables a day.
- Eat foods rich in folic acid (such as dark leafy greens, dried beans, whole grains, and orange juice).
- Increase your intake of soy products.
- Keep alcohol consumption to a moderate level (no more than two drinks per day to a maximum of 9 drinks per week for women and 14 drinks per week for men.)
Medical issues:
- Have your blood pressure checked once a year
- If you're feeling down or depressed, talk to your doctor
Managing Your Atrial Fibrillation
Atrial fibrillation can be effectively managed and the risk of complications dramatically reduced with proper treatment.
The Goals of Treatment Are:
- To reduce the symptoms of atrial fibrillation
- To reduce the complications that can develop, such as stroke and serious disturbances in the rhythm of the heart
- When needed, to slow the heart rate down or to convert the irregular heart rhythm back to normal
Here are five important steps you can take to help manage your health if you have atrial fibrillation:
1. Educate Yourself
Consider attending a course to learn about diet, exercise, and other lifestyle factors for a healthy heart.
2. Adjust Your Lifestyle
You can make a number of lifestyle modifications with the advice of your doctor and pharmacist to help prevent further heart disease (see the Prevention section above).
3. Understand Your Treatment
Controlling a fast heart rate. If your atrial fibrillation is causing your heart to beat too fast, the rate can usually be controlled through medications or a procedure called cardioversion. Here an electrical shock is administered to your heart while you are sedated; this usually causes your heart to begin beating normally again.
Restoring normal heart rhythm. Most patients with atrial fibrillation are candidates for treatment to convert the irregular heart rate back to a normal heart rate if it does not convert back by itself. This can be done with medications or cardioversion.
Anticoagulant therapy. Stroke, along with blood clots to the limbs and intestines, is a risk for people with atrial fibrillation. When the flow of blood slows down in the fibrillating atrium, the blood may form a clot. Each year, up to 4.5 percent of people with atrial fibrillation may have strokes from blood clots released into the brain if the atrial fibrillation is persistent and they are not treated medically. It is very important for all patients with ongoing atrial fibrillation to be considered for blood thinning medications to protect against this. The decision as to whether to actually use blood thinning medication is based on a person's risk factors such as age, gender, and medical conditions such as diabetes, high blood pressure, and previous stroke.
The most commonly used blood thinning medication is warfarin. As some people cannot take warfarin for medical reasons, their doctors may recommend ASA to thin their blood. Except in special cases when advised by a physician, ASA and warfarin should not be taken together as this may cause bleeding problems. If you are on blood thinners, make sure you understand that you can have bleeding complications, and see your doctor right away if you have symptoms such as any abnormal bruising or tarry, black stools.
4. Use Your Medications Properly
It is important to take your medication exactly as prescribed to receive the full beneficial effect and avoid complications. With warfarin, taking too much can cause bleeding problems and too little is ineffective. If you are having any difficulty with side effects or are uncomfortable with taking medication, talk with your doctor or pharmacist before considering stopping them.
5. Monitor Your Condition
Your doctor will schedule regular visits to monitor your condition. If you are on warfarin you usually need regular blood testing to check medication levels. When to Seek Medical Attention
If you have atrial fibrillation and are experiencing increased weight gain, increased heart rate, increasing shortness of breath with exertion, or decreased exercise tolerance, see your doctor as you may need additional treatment.
Emergency Symptoms and Treatment
If you experience a rapid pulse rate, (your doctor or pharmacist can show you how to tell), feel faint, or have chest pain, seek medical help immediately.
As people with atrial fibrillation are at risk for stroke, it is very important that they and their families know the symptoms of stroke.
Stroke symptoms are:
- Sudden weakness, numbness and/or tingling in the face, arm, or leg
- Sudden blurred or decreased vision, particularly in one eye, or double vision
- Temporary loss of speech or trouble understanding speech
- Sudden, severe, and unusual headaches
- Sudden loss of balance, especially with any of the above signs
- In severe cases, loss of consciousness
Get the person with possible stroke symptoms to an emergency department immediately as the success of treatment depends on how fast medical care is given and every minute counts.
People with atrial fibrillation are also at risk for heart attacks. Any suspected heart attack is an emergency, so call for medical attention immediately.
If you are with a person who stops breathing, start cardio- pulmonary resuscitation (CPR).
b) Heart Failure :
Heart failure is a serious medical condition in which blood is not pumped efficiently from the heart to the rest of the body because of heart muscle damage. The human heart is composed of two main pumping chambers that pump blood, one on the left side of the heart which pumps blood to the body, and one on the right which pumps blood to the lungs to get oxygen. When one or both of these pumps is not working properly, heart failure symptoms can occur.
Who Gets Heart Failure?
Although most of the people with heart failure are over the age of 60, there are conditions that can cause heart failure in people of any age.
Who is at Risk?
Coronary artery disease (blocked heart arteries) and heart attacks are the most common causes of heart failure. People who are at risk of coronary artery disease and heart attacks due to the risk factors below are also at risk for heart failure. These risk factors include:
- Smoking
- Regular exposure to second hand smoke (such as living with a smoker)
- Diabetes
- High blood pressure
- Family history of premature heart disease or stroke (father or brother before age 55; mother or sister before age 65)
- Being physically inactive
- Having high cholesterol
- Being overweight by greater than about 30 lbs (13.5 kg) over ideal body weight or having a waistline greater than 100 cm (40 inches)
- Having chronic stress and/or poor social supports in your life
- Poor dental hygiene
- A history of clinical depression
Other risk factors for heart failure include:
- Heavy drinking (four or more drinks a day)
- Emphysema (usually a smoking-related lung disease)
- Damaged heart valves (can result from rheumatic fever)
- Diseased heart muscles (cardiomyopathy)
- Low hemoglobin (anemia)
- An overactive thyroid gland
Symptoms
Symptoms of heart failure include shortness of breath at rest or with activity, shortness of breath while lying down, awakening at night short of breath, muscle weakness, fatigue, swollen ankles, and either weight loss (losing muscle mass) or gain (water collecting in the body).
Diagnosis
A doctor diagnoses heart failure by listening to a patient's symptoms, doing a physical exam and ordering medical tests. The tests may include an X-ray of the chest to look for fluid in the lungs, and a heart ultrasound to show the size of the heart (heart failure often causes the heart to increase in size). Prevention
Since the most common cause of heart failure is heart disease, most of the prevention strategies are for heart disease.
Lifestyle Factors
- Quit smoking
- Engage in physical activity such as regular aerobic activity (brisk walking, jogging, swimming, or biking) for a minimum of 30 to 60 minutes, most days of the week. If you're over 65 or have an illness, check with your doctor before starting or increasing your exercise program
- Keep your weight in normal range
- Have your blood pressure checked at least once a year
- Take time to relax and participate in leisure activities. Stress and social isolation can worsen the risks of heart disease. Research shows that meditation can reduce high blood pressure
- Any episodes of clinical depression should be identified and treated. If you're feeling down or depressed, talk to your doctor. There are a number of things he or she can suggest to help you
Diet and Supplements
- Eat foods that are low in fat and cholesterol, and high in fibre.
- Eat a variety of foods and be sure to get at least five servings of fruits and vegetables a day.
- Increase your intake of soy products. They help to reduce cholesterol.
- Eat a diet rich in folic acid (such as dark leafy greens, dried beans, whole grains, and orange juice). Folic acid may help reduce heart disease risk.
- If you eat out, ask your local Heart and Stroke Foundation for a list of Heart Smart restaurants in your area.
- Drink moderately (two drinks or less per day to a maximum of nine drinks per week for women and 14 drinks per week for men). Moderate alcohol consumption may provide some protection for people over 35 with heart disease risk factors. However, do not start drinking or increase the amount you drink in order to help your heart.
Medications
- Cholesterol-lowering medications help prevent heart disease in some people
- Taking acetylsalicylic acid (i.e. ASA, Aspirin®) daily at a dose of 80 to 160 mg a day can help prevent heart attacks in many people. Before starting ASA, check with your doctor or pharmacist to make sure it will be safe and effective for you.
Concurrent Medical Conditions
- If you have high blood pressure, diabetes, high cholesterol, clinical depression, or are overweight, work with your doctor and pharmacist to keep these conditions controlled by lifestyle modification or medication.
Managing Heart Failure
The Goals of Treatment Are:
- To reduce the symptoms of heart failure
- To reduce the complications that can develop such as pulmonary edema (fluid in the lungs) and disturbances in the rhythm of the heart
- To control contributing medical conditions such as high blood pressure and coronary artery disease
Here are five important steps you can take to help manage your health if you get heart failure:
1. Educate Yourself
Consider attending a course to learn about diet, exercise, other lifestyle factors, and medication for a healthy heart.
2. Adjust Your Lifestyle
You can make a number of lifestyle modifications to help prevent worsening of heart failure (see Prevention section). In addition to the suggestions in the prevention section above, consider the following guidelines:
- Limit fluid intake to 6 to 8 glasses per day
- Avoid high salt foods, and don't add salt to your food
3. Understand Your Treatment
Medications
ACE (angiotensin converting enzyme) inhibitors (i.e. enalapril, fosinopril, lisinopril, monopril). These are a class of medications that help reduce blood pressure and make it easier for a weak heart to pump blood.
Digoxin.
This is a medication that helps the heart pump stronger. It can have dangerous side effects if too much is taken, so as with all medications, take it exactly as prescribed. Side effects from too strong of a dose can include a slowed pulse, irregular heartbeat, nausea, and visual disturbances, among others.
Diuretics (i.e. furosemide, hydrochlorothiazide).
Often referred to as "water pills," diuretics remove extra water from the body, which tends to collect in people who have heart failure. Diuretics increase the daily amount of urine produced. This makes it easier for the heart to pump and helps prevent water collecting in the lungs, which can give symptoms of shortness of breath.
Beta-Blockers (i.e. atenolol, metoprolol, propranolol).
This class of medications helps reduce the effects of adrenaline in the body. As some people with heart failure will produce too much adrenaline, this will protect the heart from the adverse effects of this exposure.
Surgical Treatments
If medications cannot control heart failure, some people have surgery to improve the heart's functioning. Depending on the reason for the heart failure, some people (albeit very rarely) are treated with a heart transplant.
4. Use Your Medications Properly
It is important to take any medication exactly as prescribed to receive the full beneficial effect. If you are having any difficulty with side effects or are uncomfortable with taking medication, talk with your doctor or pharmacist before stopping them.
Anti-inflammatory medications can increase the risk of hospitalization in older people with congestive heart failure, especially those with coronary artery disease. Talk with your doctor or pharmacist if you regularly take this type of medication to make sure that you need to take it, and are taking the lowest appropriate dose.
5. Monitor Your Condition
Seeing your doctor regularly when you have been diagnosed with heart failure is very important. Your doctor will schedule regular visits to monitor your condition.
Pregnancy and Heart Failure
Heart failure may occur because of pregnancy, but very rarely. Although heart failure is treated if diagnosed, it often gets better by itself.
Children and Heart Failure
Although rare, children can get heart failure because of a heart birth defect.
Warning Signs of Uncontrolled Heart Failure
See your doctor if you:
- Gain 5 lbs in a week or 2 lbs in 2 days
- Have chest pain
- Notice increased fatigue
- Are having increased shortness of breath
- Have difficulty breathing at night
- Notice signs of increased swelling such as swollen ankles or tight clothing
Emergency Symptoms and Treatment
People with heart failure can accumulate fluid in their lungs (pulmonary edema), which causes shortness of breath, and in severe cases a pink froth may come out of the person's mouth. This is a medical emergency, so call for medical attention immediately.
If you are with a person who stops breathing, start cardio- pulmonary resuscitation (CPR). If a member of your family has heart failure or is otherwise at risk for heart attacks, you may want to take a CPR course.
People with heart failure are also at risk for heart attacks. Any suspected heart attack is an emergency, so call for medical attention immediately. Delays in seeking medical treatment for heart attacks cost thousands of lives every year. If there is any doubt, contact medical help as fast as you can as the chances of surviving a heart attack are very good if medical care is accessed quickly.
c) Impotence :
When a man is not able to maintain an erection long enough to have sex, he is said to be impotent. Though impotence may seem to be a permanent condition, it is often curable. As sex is an integral part of life problems with erections have a large emotional impact on both the man and his partner. Almost all men experience a failure to have an erection at some point in their lives because of such things as fatigue or tension, but these isolated events are not cause for concern.
Who is Affected by Impotence?
It is hard to know exactly how many men have suffered from impotence as men hesitate to mention it. Aging is most often associated with impotence. The best estimates are 5% of men by age 40, and 75% of men by age 80.
Physical Factors for Developing Impotence
The following things may cause impotence:
- Alcohol, cigarettes, marijuana and other illicit drugs
- Diabetes (high blood sugar)
- Hardening of the arteries from high cholesterol, high blood pressure, or smoking
- Medications such as blood pressure lowering medications, tranquilizers, and anti-depressive medications
- Various long-term medical conditions such as stroke, liver or kidney failure, multiple sclerosis and others
Psychological Factors for Developing Impotence
Almost one in every three cases of impotence is psychological. Sometimes it can be difficult to separate the emotional from physical causes because men have such negative emotions about impotence. If a man experiences a sudden onset of impotence during a stressful period in his life, the cause is likely emotional. Other signs of a psychological cause of impotence include the ability to have an erection while sleeping or masturbating, but to only sometimes have an erection during sex.
The following are the most common psychological causes of impotence:
- Anxiety over sexual performance may provoke a fear of failure and self-doubt, leading to impotence.
- Anxiety is one of the most common causes of psychological impotence
- Stress caused by a variety of things, such as financial problems or workplace pressures
- Depression frequently leads to impotence. Men who are depressed may have difficulty functioning sexually because of inhibited sexual desire
- Relationship problems sometimes have a direct impact on sexual functioning. It can be difficult for the man to function sexually when there is tension or anger with his partner
Diagnosis
A doctor will first listen to the man's story, looking for clues as to what may be causing the impotence, such as medical conditions, stress, or use of medications or other substances. It helps to be as frank as possible to help the doctor learn how the condition is affecting the man and decide what the most likely cause is. Next, a physical examination and lab tests will show if anything physical is contributing to the problem.
Prevention
A great many cases of impotence are preventable since it is often caused by poor lifestyle choices or medical conditions that can be avoided with good health habits. About one quarter of all cases of impotence can be attributed to medications. If you take medication regularly and experience impotence, talk with your doctor or pharmacist to see if the medication could be the cause.
Quit smoking. Talk to your doctor or pharmacist about the best ways of succeeding.
Don't abuse drugs or alcohol Talk with your doctor if you think you might be drinking too much or have a drug problem.
Have sex. Staying sexually active can help prevent impotence.
Lead a healthy lifestyle. Heart disease, diabetes, and high blood pressure are all associated with impotence. Reduce your risk of these medical conditions by practicing the following lifestyle suggestions:
- Engage in physical activity all or most days of the week
- Eat a low-fat diet
- Eat a high-fibre diet
- Eat at least five to eight servings of vegetables a day
- Avoid excessive alcohol intake (more than 14 drinks per week for men)
- Reduce stress in your life
- Get your blood pressure checked at least every two years
- If you are over 45, get tested for diabetes every three years
The Goal of Impotence Treatment
To restore erections
Four Things You can do to Managing Impotence
Educate Yourself
Understand the causes of impotence - many of them are within your control
Adjust Your Lifestyle
Understand the causes of impotence - many of them are within your control.
Understand your Treatments
Understand how to use medications and other treatments properly can increase the chances of recovering from impotence.
Counselling. As the experience of impotence can be very upsetting, all men with impotence should receive some form of counselling from a healthcare professional who is well versed on the topic. Counselling is helpful whether the cause is emotional or physical.
Sildenafil (Viagra) . Studies of men whose impotence was caused by either psychological, physical, or both factors reported success in 69% of intercourse attempts with Viagra. The medication works only when the man experiences some sexual arousal.
Viagra should not be used more than once a day. No one taking nitrates, such as nitroglycerin ( a heart disease medication) should take Viagra as deaths have been reported in a few men taking the two medications together.
When Viagra is taken as prescribed, side effects reported to date are minor and temporary; they include upset stomach, nasal congestion, headache, and muscle aches. Viagra is taken by mouth.
Injections. The medications papaverine or prostaglandin, when injected with a very small needle in the base of the penis, will produce and erection for most men. Very rarely this has the unwanted effect of prolonging an erection for longer than normal. If the erection goes on more than four hours it is necessary to go the emergency department to have it reversed.
Medical Urethra System for Erection (MUSE). A very small pellet of the medication alprostadil, when inserted into the opening of the penis (the urethra), can produce an erection in 15 minutes. This treatment is easy to use, but it sometimes causes pain in the penis, which may make men less willing to continue the treatment.
Vacuum Devices. There are many vacuum devices currently available for treating impotence. The penis is placed in a plastic tube and an erection is caused by bringing blood into the penis through the use of suction. Once it is erect, a rubber ring is placed at its base to prevent the erection from going away. These devices are generally safe, but the erection should not be maintained for more than 30 minutes because the penis may become cold and painful. Men who are either afraid of injections, or who have tried injections and have not been successful, often prefer vacuum devices.
Penile Prosthesis. These are devices that are surgically placed in the penis to simulate erections. They are often removable and may provide rigidity by inflation (like a balloon) or by inserting a soft but firm implant.
Hormone Replacement. Testosterone therapy is usually only offered to men who have medical conditions that cause low testosterone, and not recommended for men with natural testosterone levels.
Use Your Medication Properly
If you decide to take medication to treat your impotence, use it as directed for proper amount of time to receive maximum benefits. If you have concerns about the medications or experience side effects, discuss this with your doctor or pharmacist.
d)BENIGN PROSTATIC HYPERPLASIA(BPH)
Anatomy
The prostate is a walnut-sized gland located beneath the bladder and in front of the rectum. It is surrounded by a capsule of fibrous tissue called the prostate capsule. The urethra (tube that transports urine and sperm out of the body) passes through the prostate to the bladder neck. Prostate tissue produces prostate specific antigen and prostatic acid phosphatase, an enzyme found in seminal fluid (the milky substance that combines with sperm to form semen).
What is benign prostatic hyperplasia (BPH)?
BPH is the non-cancerous enlargement of the prostate, frequently occurring in men over the age of 50. The enlargement can result in a gradual squeezing of the urethra, sometimes causing difficulty in urinating.
Causes
The cause of benign prostatic hyperplasia is unknown. It is possible that the condition is associated with hormonal changes that occur as men age. The testes produce the hormone testosterone, which is converted to dihydrotestosterone (DHT) and estradiol (estrogen) in certain tissues. High levels of dihydrotestosterone, a testosterone derivative involved in prostate growth, may accumulate and cause hyperplasia.
Signs and Symptoms
Common symptoms of benign prostatic hyperplasia include the following:
- Dribbling after voiding
- Feeling that the bladder has not emptied completely after urination
- Frequent urination, particularly at night (i.e., nocturia)
- Hesitant, interrupted, or weak urine stream caused by decreased force
- Leakage of urine (i.e., overflow incontinence)
- Pushing or straining to begin urination
- Recurrent, sudden, urgent need to urinate
- Blood in the urine (i.e., hematuria)
In severe cases of BPH, another symptom, acute urinary retention (the inability to urinate), can result from holding urine for a long time, alcohol consumption, long period of inactivity, cold temperatures, allergy or cold medications containing decongestants or antihistamines, and some prescription drugs (e.g., ipratropium bromide, albuterol, epinephrine). Any of these factors can prevent the urinary sphincter from relaxing and allowing urine to flow out of the bladder. Acute urinary retention causes severe pain and discomfort. Catheterization may be necessary to drain urine from the bladder and obtain relief.
DIAGNOSIS
Digital Rectal Examination (DRE) This examination is usually the first test done. The doctor inserts a gloved finger into the rectum and feels the part of the prostate next to the rectum. This examination gives the doctor a general idea of the size and condition of the gland.
PSA (prostate specific antigen) – to help screen for prostate cancer. This test is also moderately elevated in those with BPH because PSA is a protein produced by cells in the prostate. When evaluating the results, the doctor must consider both the concentration of PSA in the blood and the volume of the patient's prostate.
Urinalysis – to screen for kidney disorders
Urine Culture – to look for signs of a urinary tract infection.
Blood Urea Nitrogen (BUN) and Creatinine – blood tests to evaluate kidney function Ultrasound – to help measure the size of the prostate and evaluate the volume of urine retained in the bladder
Cystoscopy - an evaluation of the urethra and/or bladder using a thin flexible scope
Urine flow and/or pressure studies - to evaluate how fast urine can travel through the urethra and how much pressure is being put on the bladder by urine retention.
Prostate biopsy – collection of one or more small samples of prostate tissue and evaluating its cellular structure under the microscope for abnormal cells and any signs of prostate cancer.
TREATMENT
BPH affects the quality rather than the quantity of life. It is therefore the degree to which the patient's symptoms bother him that will determine the need for therapy; the relative benefits and harms of each treatment option will help to determine their therapeutic preference.
TREATMENT OPTIONS
- Watchful waiting: A strategy of management in which the patient is monitored but receives no active treatment.
- Alpha blocker therapy: Treatment using alpha-1-adrenergic receptor blockers that inhibit contraction of prostatic smooth muscle.
- Finasteride therapy: Treatment using finasteride, an enzyme inhibitor that lowers prostatic androgen levels and can result in some decrease of prostate size.
- Balloon dilation: A catheter with a balloon at the end is inserted through the urethra and into the prostatic urethra. The balloon is then inflated to stretch the urethra where narrowed by the prostate.
- Transurethral incision of the prostate (TUIP): An endoscopic surgical procedure in which patients with smaller prostates (<30 g) have an instrument inserted through the urethra to make one or two cuts in the prostate and reduce the constriction on the urethra.
- Transurethral resection of the prostate (TURP): Surgical removal of the prostate's inner portion by endoscopic approach through the urethra. This is the most common active treatment.
- Open prostatectomy: Surgical removal of the prostate via an incision in the lower abdomen. It usually requires a longer hospital stay.
e) Prostate Cancer :
The prostate is a walnut-sized gland that sits at the base of the tube (urethra) that runs between a man's bladder and the end of his penis. It produces some of the fluid that carries sperm.
Prostate cancer is the growth of malignant cells in the prostate gland. Prostate cancer grows slowly and sometimes causes no symptoms. Men can have prostate cancer for years without knowing it. Prostate cancer can, however, spread to other parts of the body unless it is detected and treated early.
Prostate cancer should not be confused with non-cancerous prostate enlargement, called benign prostatic hypertrophy (BPH), which occurs naturally in older men and does not lead to prostate cancer. '
Who is Affected by Prostate Cancer?
Prostate cancer in the second most common cause of cancer in men (lung cancer is the first). Most prostate cancer is detected between the ages of 65 and 70. One in 8 men will develop prostate cancer. Asian men have the lowest rates of prostate cancer, while men in Scandinavia and United States have the highest.
Fortunately, more than 85% of men diagnosed with prostate cancer can be cured.
Risk Factors for Developing Prostate Cancer
No one knows what causes prostate cancer. You may be at risk if you:
• Have a family history of prostate cancer. Having a brother or father with prostate cancer doubles your risk of developing prostate cancer and increases your chances of developing it earlier
• Are of American, Scandinavian or African descent
• Eat red meat (beef, pork, lamb, processed meats, bacon, and hot dogs) more than five times a week
• Have been exposed to radiation
• Are a smoker
Note: Having had a vasectomy is not considered to increase a man's risk of developing prostate cancer.
Symptoms
- Frequent urination, especially at night
- Difficulty starting urination or holding back urine
- Weak or interrupted flow of urine
- Painful or burning urination
- Blood in the urine
- Painful ejaculation
- Chronic pain in the back, hips or upper thighs
- Difficulty getting or sustaining an erection
Having these symptoms does not necessarily mean you have prostate cancer - other diseases can cause them too. See your doctor if you have any of these symptoms. The first three are also related to benign prosthetic hypertrophy (BPH).
Screening
Screening exams are simple tests to detect prostate cancer. If prostate cancer is found early, it can usually be cured. If prostate cancer progresses to the point where symptoms are noticeable, attaining a cure is more difficult. Therefore, regular screening exams are very important.
Digital Rectal Exam A digital rectal exam is routine procedure where the doctor places a gloved finger into the rectum and feels the prostate gland. The doctor is feeling for irregularities, usually a hard lump that may indicate cancer. This exam is recommended annually for all men over age 40.
PSA (Prostatic Specific Antigen) Test. PSA is a molecule released into the blood by the prostate gland in higher than normal amounts when cancer is present. This test involves having a routine blood sample taken for analysis by a medical lab. The results are then sent to your family doctor. As yet, there are no Canadian guidelines, but men between 50 and 70 may be appropriate candidates for a PSA test.
Discuss the benefits and consequences of a PSA test with your doctor. This test is not always reliable; sometimes it will come out positive when in fact the person is cancer-free. If a test is positive, further testing is always done to confirm the results. You may have to wait up to two weeks for the final results to be ready.
Men who have a family history of prostate cancer (a father or brother with the disease) may consider having a PSA test done annually starting at age 40. Men over 70 should discuss screening tests with their doctors.
Diagnosis
If the doctor finds a suspicious irregularity during a rectal exam or if a PSA test is positive, more tests are done to confirm the diagnosis. Your doctor will likely send you for an ultrasound. Sometimes a small amount of prostate tissue will be taken from the prostate and examined under a microscope. If the sample is cancerous, other tests are usually done to see if the cancer has spread to other parts of the body.
Prevention
Getting Regular Physical Activity
Physical activity may reduce your risk of developing cancer. No specific recommendations exist for reducing prostate cancer risk, but a general guidelines is to get 30 to 60 minutes of moderate to intense aerobic activity (such as running, swimming, hiking or brisk walking) most days of the week. This has the added benefit of reducing your risk of heart attack, stroke, high blood pressure, and high cholesterol.
Watching Your Diet
Vegetables. Increasing the amount of green and yellow vegetables you eat may decrease your risk of prostate cancer. Try to get at least five servings of vegetables daily. One serving equals 1/2 cup cooked vegetables or raw chopped vegetables, or one cup of leafy raw vegetables such as lettuce or spinach.
Tomato-based food Increasing tomatoes and tomato sauce in your diet may reduce your changes of developing prostate cancer. One recent study showed that men who ate 10 or more servings of tomato-based foods per week are 45% less likely to develop prostate cancer, compared to men who ate less than 1 serving per week. Men who ate less than 10 but more than two servings still benefited. Tomatoes contain lycopene, a plant molecule that gives tomatoes their red colour and is though to be responsible for reducing cancer.
High-fibre foods Men who eat more high-fibre foods such as fruits, vegetables, whole grains and beans tend to have less prostate cancer. Soy products in particular may be protective.
Red meat Reducing red meat intake to four servings or less per week may also reduce your chances of developing prostate cancer.
Vitamin E One research study has shown a 40% decrease in prostate cancer deaths amongst male smokers age 50 to 69 who took 75 I.U. of vitamin E a day for 5 to 8 years.
Selenium Increasing your intake of selenium (a trace mineral found naturally in some foods) may help protect against prostate cancer. Supplementation at 200 mg a day may be beneficial for those men at high risk. High selenium foods include fish and shellfish, eggs, whole grains and garlic.
Managing Your Prostate Cancer
If you are diagnosed with prostate cancer, don't panic. Prostate cancer is usually treatable, and the chances of overcoming it and living a normal healthy life are very good. As prostate cancer can progress very slowly, men often live for many years with treatment even if the cancer has spread to other parts of the body. If the tumour is small and has not spread from the prostate gland, your life expectancy can be normal. If the tumour is larger or has spread just outside the prostate gland, the five-year survival rate is 65% or more. However, the key is early detection and treatment.
The Goal of Treatment Is:
- To kill the cancer cells to prevent the cancer from spreading to other parts of the body
Steps for Managing Your Prostate Cancer
Educate Yourself
Understanding prostate cancer will help you understand your choices in treatment and may help give you a greater sense of control in managing your cancer. Find out as much as possible about treatments and treatment options. Read books and articles, talk to your doctor and talk to people who have survived prostate cancer.
Adjust Your Lifestyle
If you have been diagnosed with prostate cancer, avoid any unhealthy activities such as smoking or excessive alcohol intake. If you can keep your physical activity level up and maintain a healthy diet, you may find this contributes to an increased feeling of well being. Getting adequate rest and trying to reduce stress are also important.
Understand Your Treatment
The treatment depends on whether the cancer has spread. If discovered early, prostate cancer can be cured by radiation therapy or surgery. When cancer has spread beyond the prostate gland, treatment focuses on slowing the progress of the disease by using medication, surgery, and radiation therapy.
Use Your Treatment Properly
When undergoing cancer treatment, try to carry it through for optimal effect. If you are having difficulty or have concerns about your treatment, talk to your doctor or cancer specialist.
Monitor Your Condition
After you have been treated for prostate cancer, it is important to continue to see your doctor for regular follow-up examinations. Your doctor will advise on how frequently you should be examined.
f) Diabetes :
Diabetes is a condition characterized by the body's inability to control levels of blood sugar. Two types of diabetes are most common:
Type 1 Diabetes or Insulin Dependent Diabetes is caused by the body's own immune system destroying the cells in the body that produce insulin, the hormone that keeps blood sugar levels normal. It is generally a disease of childhood.
Type 2 Diabetes or Non-Insulin Dependent Diabetes is caused by an inability of insulin to perform its normal function of controlling blood sugars with subsequent high levels of blood sugar. It is most prevalent among overweight adults over the age of 40.
Who Gets Diabetes?
Type 1 Diabetes affects one in 250 people, with most cases occurring in children or young adults under 20. The highest incidence of diabetes is among people of northern European origins and those with a family history of Type 1 Diabetes. It is less common among people of Asian and African descent.
Type 2 Diabetes is the more common form of diabetes, accounting for 90% of all people with the condition. Most cases occur after age 40. About 5% of all people in Canada have been diagnosed with Type 2 Diabetes. Another 5% of people have Type 2 Diabetes and have not yet been diagnosed because they have not had a screening blood test.
Risk Factors for Developing Type 2 Diabetes
You may be at risk of developing Type 2 Diabetes if you have any of the following risk factors:
- Over 65 (18% of people over 65 have diabetes)
- Overweight (20% of more over your ideal body weight)
- History of gestational diabetes
- Family history of Type 2 Diabetes
- First Nations, Hispanic, or African descent
- Previous diagnosis of impaired glucose tolerance
- Diagnosis of sleep apnea
- Possibly long term eating habits that are low in fibre containing foods and high in foods that can raise blood sugar like white bread, high sugar/low fibre cereals and cola beverages
Symptoms & Diagnosis
Type 1 Diabetes
Symptoms for Type 1 Diabetes may appear suddenly and can include excessive thirst and urination, weight loss, excessive appetite, and fatigue. Sometimes the first symptom of Type 1 Diabetes is an altered level of consciousness or coma.
Type 2 Diabetes
Symptoms for Type 2 Diabetes usually occur more gradually that with Type 1 Diabetes. Like Type 1 Diabetes, the symptoms can include excessive thirst and urination, excessive appetite, and fatigue. Other symptoms can include the slow healing of cuts, skin infections, bladder infections, blurred vision, and numbness or tingling in the hands or feet.
Often there are no symptoms in the early stages of Type 2 Diabetes.
Diagnosis
Both types of diabetes are diagnosed by a blood test that measures blood sugar levels. Often people with no symptoms of the disease are diagnosed by routine blood screening. New guidelines suggest that everyone over 45 years of age be tested every 3 years. Those people who have a parent or sibling with diabetes, are of First Nations, Hispanic, Asian or African descent, are overweight or have high cholesterol may consider being tested sooner or more frequently. Annual testing is suggested for those with a diagnosis of impaired fasting glucose (high blood sugar but not high enough to be diabetic), high blood pressure, coronary artery disease, a history of diabetes during pregnancy or having given birth to a baby over 4 kg.
Prevention
Type 1 Diabetes
Currently, ways to prevent Type 1 Diabetes are unknown, but research is ongoing.
Type 2 Diabetes
Measures can be taken to help prevent Type 2 Diabetes:
- Maintain a healthy body weight (ask your doctor what a healthy weight is for you)
- Participate in physical activity on a regular basis
- Just maintain a healthy diet. Diet in itself may not prevent diabetes, but a healthy diet will help keep weight down, which also reduces your risk of other health problems
Managing Your Diabetes
High blood sugars can cause health problems over time if not corrected. People may not even notice any symptoms. This is why diabetes management is so important.
The Goals of Treatment Are:
- To keep blood sugar levels as close to normal as possible
- To prevent the complications of diabetes, which can include stroke, heart attack, kidney damage, blindness, nerve damage, infections, skin ulcers, and foot problems. These complications occur more often in people with severe diabetes or those who don't adequately control their blood sugar
Steps You can Take to Help Manage Your Diabetes
Educate Yourself to Help Manage Your Diabetes
The more you know about diabetes, the more active role you can take in controlling it. Ask your doctor or pharmacist to help you get in touch with a diabetes education group.
Adjust Your Lifestyle to Manage Your Diabetes
Although treatment for all people with Type 1 diabetes and many with Type 2 diabetes involves medication, significant lifestyle changes are also required. People with diabetes are at a higher risk for heart attack and stroke, so lifestyle changes that reduce the risk of cardiac disease are extremely important.
Maintain a health diet. All people with diabetes should talk with a dietician to learn how to modify your diet for diabetes. A low-fat, high-fibre diet will improve weight control and reduce your risk for having a heart attack. Try for gradual but progressive changes to your diet.
Participate in regular physical activity. Getting regular physical activity (such as brisk walking, jogging, or cycling) will help improve blood sugar levels, lower cholesterol levels, help you achieve a healthy weight, and reduce your risk of heart attack and stroke. Start slowly and work up to 60 minutes most days of the week at moderate intensity. Before you start an exercise program, check with your doctor.
Quit smoking. Smoking increases the risk of heart disease and stroke. It also increases the risk of damage to small blood vessels, which can cause poor circulation in the lower limbs, an increased risk of infection, and sometimes even the need for surgical amputation.
Control your weight. If you are overweight, you are at a greater risk for heart attack. Talk to your doctor about the best way to lose a pound a week. Some people can control Type 2 diabetes through weight loss alone.
Control cholesterol levels. Many people with diabetes have high cholesterol. Lifestyle measures such as good Nutrition, exercise, and weight loss may be sufficient to lower cholesterol. If not, cholesterol- lowering medication may be needed.
Control high blood pressures. In a person with diabetes, high blood pressure increases the chances of early death by four to five times, if it's not controlled. Exercise, adequate diet, weight control, limited alcohol intake, and medication can all help control high blood pressure.
Restrict alcohol consumption. Excessive drinking can worsen high blood pressure or increase the fats in blood. Do not drink more than two alcoholic beverages per day. Alcohol is also high in calories, which can increase blood sugar levels even more.
Have regular check-ups. Visit your doctor at least three times a year for check-ups and monitoring of blood sugar control. Your eyes should be checked yearly.
Understand how to perform regular foot checks as people with diabetes can have serious foot problems such as infections or skin ulcers and not notice unless they do regular checks.
Understand Your Medication to Manage Diabetes
All people with Type 1 Diabetes and some people with Type 2 Diabetes need daily insulin injections. Research has shown that for people with Type 1 Diabetes, taking insulin several times each day more closely controls blood sugar levels and will decrease the likelihood of some long-term complications.
People with Type 2 Diabetes also use oral medications that lower blood sugar levels.
Use Your Medication Properly to Manage Diabetes
Proper medication use is important to avoid side effects, symptoms of poor blood sugar control and future complications of diabetes. Speak with your pharmacist or doctor whenever you have questions about your medications.
Monitor Your Diabetes to Manage Your Diabetes
Check your blood sugar levels regularly to ensure they are controlled. You can monitor your own blood sugar levels with a fingertip pinprick, which takes a small sample of blood. Factors that affect blood sugar control include: timing of meals, a change in diet, meal composition, timing after exercise, stress, illness (even cold), and choice and style of delivery of diabetes medication. Some medications used to treat other conditions and over-the- counter medications can affect blood sugar levels. If you monitor your blood sugar levels, check with your pharmacist before taking any medication.
Your doctor may order a glycosolated hemoglobin test every three to six months. This blood test measures blood sugar control in the months previous to the test.
Pregnancy and Diabetes
Parents of children with diabetes need to be thoroughly educated both about the disease and how to integrate a diabetes treatment plan into family, school, and social life. Sticking to the plan, although trying at times, is vitally important to the child's health. Sharing ideas with other parents in a family support group may be helpful. Support is also available through your doctor, local diabetes clinic and local Canadian Diabetes Association office.
Children and Diabetes
Parents of children with diabetes need to be thoroughly educated both about the disease and how to integrate a diabetes treatment plan into family, school and social life. Sticking to the plan, although trying at times, is vitally important not the child's health. Sharing ideas with other parents in a family support group may be helpful. Support is also available through your doctor, local diabetes clinic and local Canadian Diabetes Association office.
Complementary Treatments for Diabetes
Vitamin E, at a dose of 1200 IU a day, may help counteract nerve damage cause by high blood sugars.
Warning Signs of Diabetes and Emergency Treatments
It is possible for people with diabetes to react to their medication, especially if they exercise more than normal or eat less food than normal. This may lower blood sugar to dangerous levels. If this happens, people with both types of diabetes may experience, among other symptoms:
- Sweating
- Irregular heart beat
- Tremors
- Fatigue
- Confusion and weakness
This is a medical emergency as it may lead to unconsciousness, seizures, and brain damage if it is not treated immediately. At the first signs of these symptoms, give the person sugar (such as a soft drink, fruit juice, a small candy or plain sugar) immediately and call for medical assistance. If the person is unable to swallow, place a teaspoon of sugar syrup in their cheek every 10 minutes.
Glucagon is an emergency medication that may be appropriate for some people with diabetes. Glucagon is injected, and since you need training to administer it discuss this emergency medication with your doctor.
If you have diabetes, make sure your family and friends know how to help you if you have a reaction.
g ) High Blood Pressure (Hypertension) :
Hypertension is the medical term for high blood pressure. Blood pressure is the force of your blood pressing against the walls of your arteries as your heart pumps. It is like the water pressure in your household pipes or garden hose. When the pressure gets too high in your arteries, it can cause disease.
Risk Factors for Developing Hypertension
You may be at risk of developing hypertension if you have any of the following risk factors:
- A family history of hypertension
- Have severe hardening of the arteries (as diagnosed by your doctor)
- Are over 65 years of age
- Have kidney disease
- Are pregnant
- Are of African descent
- Have another chronic disease or long-term illness. Ask your doctor if it increases your risk of hypertension
- Are you a smoker
Risk increases for Developing Hypertension
If You
- Have more than two drinks of alcohol per day
- Do not exercise
- Use large amounts of salt
- Do not get enough calcium
- Have chronic stress
Other Factors That Can Raise Blood Pressure
Some drugs and other products may cause an increase in blood pressure, including:
- Birth control pills
- Estrogens
- Steroids
- Thyroid hormones
- Large amounts of black licorice (more than two ounces daily for more than two months may raise blood pressure)
- Some decongestants in cold/allergy medicines
- Some anti-inflammatory drugs (e.g. ASA, ibuprofen)
- Other drugs. Ask your pharmacist which other prescription or over-the-counter medications can affect your blood pressure.
High Blood Pressure Symptoms
Hypertension is called a "silent killer" because you usually do not notice any symptoms until it causes damage to your organs. Severe high blood pressure can cause headaches, vision problems, temporary weakness, breathing difficulty, or temporary paralysis from small strokes. Seek medical help immediately if you experience these symptoms.
High Blood Pressure Diagnosis
Even if you are healthy and rarely see a doctor, have your blood pressure checked at least once every two years.
A typical blood pressure reading is 120/80. Blood pressure is measured with a special cuff inflated around your arm. The first, higher number (in this case, 120) is called "systolic." This is the pressure in your arteries when your heart is in its pumping phase. The second, lower number (in this case, 80) is called "diastolic." This is the pressure in your arteries between heartbeats. Coffee will temporarily raise blood pressure but does not cause chronic high blood pressure. Make sure you have not had coffee or smoked in the half-hour before having your blood pressure taken.
Blood pressure is usually considered too high it if is over 140/90. New guidelines, however, suggest that even a blood pressure as low as 130/85 in people who have other risk factors, including smoking, high cholesterol, a family history of heart disease, over age 60 or menopausal, diabetes (high blood sugar), stroke or heart disease and other medical conditions should be lowered further to reduce the risk of stroke.
Fluctuations in blood pressure are normal, but if your blood pressure is consistently high, you will need to be examined by your doctor to determine if there is a treatable cause. Your doctor or pharmacist will also review your medications to see if they may be contributing to high blood pressure
High Blood Pressure Prevention
Hypertension can often be prevented by:
- Limiting yourself to two drinks of alcohol a day or less, with a maximum of 9 drinks a week for women and 14 drinks a week for men
- Maintaining a healthy body weight. Losing as little as 10 pounds may reduce your blood pressure. Ask you doctor what a healthy weight is for you
- Maintaining a low-fat diet. Get less than 30% of your total calories from fats or oils
- Limiting added salt at the table to no more than half a teaspoon per day. Salt raises blood pressure in 10 to 15% of people. Avoid high salt foods such as chips, picked foods, luncheon meats, soy sauce, fast foods, and canned soup. Read food labels to check for salt; monosodium glutamate (MSG), sodium chloride, and baking soda all contain salt.
- Participating in a moderately intense physical activity for 50 to 60 minutes at least 3 or 4 times a week.
- Moderate physical activity includes brisk walking, jogging, swimming, and biking. Check with your doctor before starting an exercise program
- Stopping smoking
- Getting 1000 mg of calcium per day. Sources include dairy products (use low-fat), broccoli, nut pastes, molasses, canned salmon with bones, tofu made with calcium, kale and figs
- Getting 2500 to 3000 mg of potassium per day. Sources include fresh and frozen vegetables and fruit, low-fat dairy products and nuts
- Getting 350 to 400 mg of magnesium per day. Sources include dark green vegetables, nuts, legumes, soybeans, seafood, and whole grains
- Reducing stress. If you're at risk of hypertension, consider relaxation, yoga, or meditation, which may help prevent or lower high blood pressure
- Stopping daily coffee intake may reduce blood pressure slightly
- Ensuring adequate sleep. Not getting enough sleep can further raise blood pressure in people who already have hypertension
The best way to get vitamins and minerals is through your diet. If this is not possible consider calcium or potassium supplements. Consult your doctor or pharmacist before starting either supplement. Magnesium supplements are not useful in preventing or reducing high blood pressure.
Managing Your Hypertension
Unfortunately this easily treated medical condition is only well controlled in one out of six people, mostly because people either do not know they have it or they do not make lifestyle changes and take proper medications. New research shows that managing high blood pressure is especially important for people with diabetes (high blood sugar) as it increases their risk for heart disease or stroke by 2 1/2 times. The diastolic pressure for people with diabetes should optimally be 80 mmHg or less.
If high blood pressure cannot be lowered by lifestyle factors, then medications are essential in preventing complications of hypertension.
The Goals of Treatment Are
- To keep blood pressure in the normal range or as close to this as possible
- To control other risk factors (like smoking and diabetes among others) that worsen the long-term health effects of hypertension
- To decrease the long-term health risks of hypertension
Important Steps for Managing Hypertension
Educate Yourself
Understanding the causes and effects of hypertension will help motivate you to make healthy lifestyle changes and, if necessary, stay on medication.
Adjust your Lifestyle
New research shows that proper nutrition alone can be very effective in treating high blood pressure in some people. A diet that includes 8 - 10 servings of fruits and vegetables, 2-3 servings of low fat dairy products and is low in total fat can lower blood pressure as much as some medications. One serving is one medium size piece (apple, banana, carrot or potato), half a cup of fresh vegetables, 1 cup of salad or half a cup of juice. A typical serving size of dairy products is 250 ml (1 cup) of milk, 50g (2 oz) cheese or 175 ml (3/4 cup) yoghurt.
If you have hypertension, follow the "Prevention" suggestions indicated above very closely. Of these measures, losing weight is the most effective at lowering high blood pressure. For some people, weight loss alone is all the treatment they need to normalize their blood pressure.
Heart disease risks
Since high blood pressure is a risk factor for heart disease (along with smoking, excess weight, diabetes, lack of exercise, high cholesterol, and a family history of heart disease or stroke), it is particularly important to reduce as many other heart disease risk factors as possible. For example, stop smoking, lose weight, and reduce cholesterol. These risk factors are all interrelated, and if more than one is present, they amplify each other's negative effects.
Understand Your Medication
If your blood pressure is above normal, and lifestyle changes have not lowered it enough, you may need one or more blood pressure-lowering medications. Keep up with the lifestyle measures as well because they can still help, and will reduce your risk for other diseases.
Many kinds of blood pressure medications are available. The best drug for you depends on a number of things:
- The severity of your high blood pressure
- Other health conditions you may have
- Other medications you are taking
- Possible side effects
- Personal preferences
Sometimes one medication is not adequate and a second or third may be added. Your pharmacist can help by explaining the drug choices available to you.
Although ASA (half an adult 325 mg tablet per day) and Vitamin E (200 to 400 I.U. per day) do not reduce blood pressure, your doctor may advice you to take these medications since they have been shown to reduce the risk of heart attack.
Monitor Your Blood Pressure
Monitoring blood pressure at home can be useful, particularly for people who have abnormally high blood pressure only when they are in a medical setting, for those who have variable blood pressure, and for those who have unusual risk factors. Your pharmacist can help you choose suitable home monitoring equipment.
Pregnancy and Hypertension
Blood pressure can become elevated for a minority of women during pregnancy and can cause problems for mother and baby if not adequately treated. Attending regularly scheduled prenatal care appointments will ensure that this is screened for and treated if it occurs
Children and Hypertension
Children who eat more fibre and calcium in their diet tend to have lower blood pressure as adults. Children who have a high fat intake or are overweight are more likely to have high blood pressure as adults.
It is uncommon for children to have high blood pressure. When it does occur, it is usually caused by another disease such as kidney disease or blood vessel abnormalities. Although no precise guidelines exist in Canada for checking blood pressure in children it is reasonable to ask for your child to be checked every year or two, after age three, when your child routinely sees their doctor.
Warning Signs of Uncontrolled Hypertension
Symptoms from high blood pressure are quite uncommon, as blood pressure must be very high to cause symptoms. These symptoms, which may be also caused by other conditions, include:
- Restlessness
- Excessive sleepiness
- Confusion
- Blurred vision
- Headache
- Nausea and vomiting
If a person previously diagnosed with high blood pressure develops any of these symptoms, they should seek medical care.
h ) Pain Management :
Pain is the sensation of discomfort or distress you feel when special “pain sensor” nerves are activated in the body. Pain serves several important purposes. It tells you if you are in danger, thereby protecting you from more serious harm. For example, if you cut yourself, you feel pain and pull your finger away before the cut goes deeper. Pain is also your body's way of warning you of an impending problem, damage or disease.
Pain can come from any part of the body where the pain sensor nerves are found, but occurs most commonly in the head or in muscles, ligaments, tendons, bones, joints, and teeth.
Lifestyle Modifications to Prevent Pain
Headaches.
Numerous factors can trigger a headache, including foods, changes in weather, stress, anxiety, and hormonal changes. If you have frequent headaches, keep a daily diary to help figure out what may be triggering the headache, then eliminate the trigger. Some pain relievers, when used regularly (more than four days per week) can also trigger headaches.
Arthritis or Joint Pain.
If you have osteoarthritis, regular physical activity will maintain or improve the muscle strength around the joints, as well as improve your general sense of well-being. Walking and swimming are examples of low-impact exercise that will not jar your joints or worsen joint damage. Physical therapy may also help to relieve arthritis and joint pain.
Glucosamine sulfate is a nutritional supplement that has gained attention for possibly relieving the pain of arthritis. It appears to be effective in some people. Research is ongoing so talk to your pharmacist about the latest developments.
Managing Pain
Pain can be managed in many ways.
Managing Pain with Non-drug Treatments
Headaches.
Once a headache occurs, rest in a quiet dark room, try to sleep, or apply an ice pack to your forehead or the back of your neck.
Muscle or Joint Injury.
During the first 24 to 48 hours after a muscle or joint injury, several important non-drug measures should be taken. One of the best ways to treat muscle and joint injuries is with rest, ice, compression, and elevation (remember it as RICE). Rest is important as continued activity can extend the injury. Ice, compression, and elevation will help reduce the swelling and pain.
Here are some tips to help speed your recovery:
- Do not use heat right after an injury has occurred.
- Start RICE as soon as possible.
- Apply an ice pack, ice chips, ice cubes, or frozen peas in a plastic bag (wrapped in a towel) over the injured area.
- Wrap the injured area firmly with an elastic bandage.
- Leave the pack and bandage on for 20 minutes.
- Unwrap the area and remove the ice for about 15 minutes.
- Continue for 12 to 48 hours, depending on the extent of the injury.
- After 48 hours, replace the ice with a heating pad, hot water bottle, or Magic Bag (a bag of beans that you heat in the microwave).
Arthritis or Joint Pain. In addition to regular physical activity, either a hot or cold pack may help to relieve symptoms. If you weigh more than 20% over your ideal body weight, losing weight may relieve pain in your hips and knees by reducing pressure on those joints.
Managing Pain with Non-prescription Pain Relievers
If non-drug measures are ineffective or only partially effective, safe and effective over-the-counter products are available to help relieve pain. Brand names can be confusing due to “sound-alike” names, so always check a product's ingredient list before you buy. Some cold and allergy products may also contain pain relievers. If you need assistance, ask your pharmacist.
Three types of over-the-counter pain relievers are acetaminophen, anti-inflammatory medications, and combinations of these medications with codeine.
Acetaminophen relieves aches, pains, and fever, but will not affect swelling. The following products all contain acetaminophen as a single ingredient: Tylenol and Pharmasave's Acetaminophen.
Anti-inflammatory medications relieve aches, pains, and fevers, and may also reduce swelling. The following non- prescription medications have anti-inflammatory effects:
· Acetylsalicylic acid (ASA) such as Aspirin, Entrophen, Anacin, and Pharmasave's ASA
· Ibuprofen, such as Motrin, Advil, and Pharmasave's Ibuprofen
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