Jun
28
2011
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EAT YOUR WAY TO HEALTHY BONES: JULIE’S STORY

EAT YOUR WAY TO HEALTHY BONES: JULIE’S STORY
When I went to have my hone density checked, 1 figured the results would come hack telling me I was “at risk”—isn’t every woman over 601 But I was very surprised when it turned out I already had osteoporosis. I’ve always had a pretty balanced diet, and been a generally active person. I’m no athlete, but I am a half-decent weekend skier.
I am small-boned and thin, like my mom, who was very bent over by the time she died, well into her 80s. As I’ve read about the things that have an impact on your bones, I’ve learned more about my risks. I never have soda, but do usually drink a cup or two of coffee each day. I smoked for more than ten years when I was very young, but I stopped as soon as the Surgeon General’s report about the cancer dangers came out. I didn’t have any menopausal symptoms, so I never even really considered hormone replacement therapy. My doctor brought it up again after my scan, but I cut her off immediately. I’m about to be 65, and have no intention of starting that now, if I haven’t needed it otherwise.
When I found out how much bone I had lost, I started taking Fosamax. After two years on it, a second DEXA scan showed I had increased density by 7 percentage points. That puts me on the borderline between osteopenia and osteoporosis, but definitely on the denser side and out of immediate danger. Though I never had any side effects from it, Fosamax is a difficult medication to take because you have to wait a half hour after you take it before you eat, and you have to stay upright during that time, so you can’t exactly crawl back in bed with the New York Times. Besides, I don’t want to be on this or any drug forever. And in fact, I’m not at all certain just what caused the improvement, since I started a strength training program, became a vegetarian, and began taking vitamin and calcium supplements on the same day I started Fosamax!
That’s why I’ve decided to stop taking the drug and rely on diet and exercise. I’m now a vegetarian, but not vegan—I do eat eggs and dairy. I always say, “I don’t eat anything that had a heartbeat.” That was an enormous change for me, because before that I ate meat at least once a day. I certainly always had meat at dinner, and sometimes it seemed like
I was the last woman alive who would admit to regularly enjoying a steak. It’s funny, though, because giving up meat hasn’t really bothered me. Once I got on a roll with it, it just became second nature.
Regular exercise was also a major lifestyle change for me. I’ve never been a couch potato, but I never followed any particular routine before. Now I exercise daily. I do half an hour of aerobic exercise seven days a week—a cross-country skiing machine, though I don’t use the arm part (I read). Plus, twice a week I work out with weights.
My doctor recommended taking a calcium supplement and a multivitamin, so now every day I get 1,000 milligrams of calcium in pills that also contain vitamin D, magnesium, and trace minerals. I also take a common multivitamin to make sure I cover everything.
I’ve been off Fosamax for six weeks now. This is an experiment on my part, to see if I can maintain the changes I’ve made, without the medication. I’ll get another DEXA scan in a year and then reevaluate my situation. If I lose bone, I suppose I’ll go back to the Fosamax, but I believe the healthy changes I’ve made in my life will give me the strong bones I need.
*37\228\2*
When I went to have my hone density checked, 1 figured the results would come hack telling me I was “at risk”—isn’t every woman over 601 But I was very surprised when it turned out I already had osteoporosis. I’ve always had a pretty balanced diet, and been a generally active person. I’m no athlete, but I am a half-decent weekend skier.
I am small-boned and thin, like my mom, who was very bent over by the time she died, well into her 80s. As I’ve read about the things that have an impact on your bones, I’ve learned more about my risks. I never have soda, but do usually drink a cup or two of coffee each day. I smoked for more than ten years when I was very young, but I stopped as soon as the Surgeon General’s report about the cancer dangers came out. I didn’t have any menopausal symptoms, so I never even really considered hormone replacement therapy. My doctor brought it up again after my scan, but I cut her off immediately. I’m about to be 65, and have no intention of starting that now, if I haven’t needed it otherwise.
When I found out how much bone I had lost, I started taking Fosamax. After two years on it, a second DEXA scan showed I had increased density by 7 percentage points. That puts me on the borderline between osteopenia and osteoporosis, but definitely on the denser side and out of immediate danger. Though I never had any side effects from it, Fosamax is a difficult medication to take because you have to wait a half hour after you take it before you eat, and you have to stay upright during that time, so you can’t exactly crawl back in bed with the New York Times. Besides, I don’t want to be on this or any drug forever. And in fact, I’m not at all certain just what caused the improvement, since I started a strength training program, became a vegetarian, and began taking vitamin and calcium supplements on the same day I started Fosamax!
That’s why I’ve decided to stop taking the drug and rely on diet and exercise. I’m now a vegetarian, but not vegan—I do eat eggs and dairy. I always say, “I don’t eat anything that had a heartbeat.” That was an enormous change for me, because before that I ate meat at least once a day. I certainly always had meat at dinner, and sometimes it seemed like
I was the last woman alive who would admit to regularly enjoying a steak. It’s funny, though, because giving up meat hasn’t really bothered me. Once I got on a roll with it, it just became second nature.
Regular exercise was also a major lifestyle change for me. I’ve never been a couch potato, but I never followed any particular routine before. Now I exercise daily. I do half an hour of aerobic exercise seven days a week—a cross-country skiing machine, though I don’t use the arm part (I read). Plus, twice a week I work out with weights.
My doctor recommended taking a calcium supplement and a multivitamin, so now every day I get 1,000 milligrams of calcium in pills that also contain vitamin D, magnesium, and trace minerals. I also take a common multivitamin to make sure I cover everything.
I’ve been off Fosamax for six weeks now. This is an experiment on my part, to see if I can maintain the changes I’ve made, without the medication. I’ll get another DEXA scan in a year and then reevaluate my situation. If I lose bone, I suppose I’ll go back to the Fosamax, but I believe the healthy changes I’ve made in my life will give me the strong bones I need.
*37\228\2*
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Written by admin in: Healthy bones Osteoporosis Rheumatic |
Jun
17
2011
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SURGICAL APPROACHES TO EPILEPSY: SURGERY FOR PARTIAL (FOCAL) SEIZURES – RISK-BENEFIT DISCUSSION WITH YOUR PHYSICIANS

SURGICAL APPROACHES TO EPILEPSY: SURGERY FOR PARTIAL (FOCAL) SEIZURES – RISK-BENEFIT DISCUSSION WITH YOUR PHYSICIANS
Discussion of the possibility of surgery and its risks and benefits should be an ongoing process. Having identified a focus and its location, surgery can become a more serious consideration, and a more detailed discussion of its risks and benefits is possible. The risks will depend on the area to be removed. Surgery is most often performed to remove a focus from the frontal or temporal lobes of the brain, areas from which large amounts of tissue can usually be safely removed without major complications.
As with any operation, there is, of course, a risk of dying or suffering major complications of anesthesia. While the consequences of such a complication could be great, the chances of a major anesthetic complication’s occurring are in the range of less than one per one thousand. Infection also is always a risk; so is bleeding or clotting of a blood vessel. All these are potentially serious and capable of causing additional brain damage. Fortunately, these complications occur infrequently.
Generally, as noted, frontal and temporal lobe removals are considered by neurologists and neurosurgeons to be “safe” procedures, but as with any decision-making process, the risks and their magnitude must be weighed against the possible benefits and the chances of those benefits occurring. What are the benefits of the focal operations? The maximum benefit would be freedom from seizures for your child—freedom from taking anticonvulsant medicine and freedom from neurologic deficit due to the surgery. This is everyone’s goal. What are the chances of that occurring? Surprisingly, it is difficult to give numerical answers to this question. Surgical centers often quote 60-75 percent “good outcomes.” This means that perhaps 50 percent will be cured of their seizures, another 10—25 percent will have substantial decrease in the frequency of their seizures, and about 25 percent—one in four—will not be helped at all.
*157\208\8*
Discussion of the possibility of surgery and its risks and benefits should be an ongoing process. Having identified a focus and its location, surgery can become a more serious consideration, and a more detailed discussion of its risks and benefits is possible. The risks will depend on the area to be removed. Surgery is most often performed to remove a focus from the frontal or temporal lobes of the brain, areas from which large amounts of tissue can usually be safely removed without major complications.
As with any operation, there is, of course, a risk of dying or suffering major complications of anesthesia. While the consequences of such a complication could be great, the chances of a major anesthetic complication’s occurring are in the range of less than one per one thousand. Infection also is always a risk; so is bleeding or clotting of a blood vessel. All these are potentially serious and capable of causing additional brain damage. Fortunately, these complications occur infrequently.
Generally, as noted, frontal and temporal lobe removals are considered by neurologists and neurosurgeons to be “safe” procedures, but as with any decision-making process, the risks and their magnitude must be weighed against the possible benefits and the chances of those benefits occurring. What are the benefits of the focal operations? The maximum benefit would be freedom from seizures for your child—freedom from taking anticonvulsant medicine and freedom from neurologic deficit due to the surgery. This is everyone’s goal. What are the chances of that occurring? Surprisingly, it is difficult to give numerical answers to this question. Surgical centers often quote 60-75 percent “good outcomes.” This means that perhaps 50 percent will be cured of their seizures, another 10—25 percent will have substantial decrease in the frequency of their seizures, and about 25 percent—one in four—will not be helped at all.
*157\208\8*
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Written by admin in: Epilepsy |
Jun
08
2011
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LIVING WITH DIABETES: MARRIAGE AND CHILDREN

LIVING WITH DIABETES: MARRIAGE AND CHILDREN
Should people with diabetes marry? Can they hope to raise families of their own? Marriage to someone with diabetes requires some special adjustments that many people have made successfully. It is a matter of being willing to make the effort. The couple should have frank and open discussions beforehand, about what the treatment of the disease entails and the possibility that complications might develop in the future.
Should people with diabetes marry each other? Specialists used to say no, believing there was a high risk that children might inherit the disease. But most young diabetes patients who are thinking about getting married and having children have Type I rather than Type II diabetes. Now that studies have indicated that heredity does not play the major role in this form of the disease it was formerly thought to have, there seems little reason to discourage such marriages. In fact, some counselors suggest that if two people with diabetes marry each other, they will find it easier to adjust, because both of them already know what living with the disease involves.
Is it safe for people with diabetes to have children? There is no reason why a man with diabetes should not father a child. For a woman the problem is a bit more complicated. Modern treatment methods have greatly increased the chances for a woman with diabetes to bear a normal, healthy child. But the rate of death of babies both before and soon after their birth is still somewhat higher than normal. The disease itself also becomes more difficult to control during pregnancy—the body’s need for insulin increases, and the woman must be carefully watched by her doctor to avoid possible complications that might threaten her or her child. Doctors recommend getting the blood sugar level under strict control well before becoming pregnant, and monitoring it carefully during the pregnancy. A pregnant woman with diabetes may have to undergo frequent and expensive tests to determine how well her baby is growing and when it should be delivered.
*40\268\2*
Should people with diabetes marry? Can they hope to raise families of their own? Marriage to someone with diabetes requires some special adjustments that many people have made successfully. It is a matter of being willing to make the effort. The couple should have frank and open discussions beforehand, about what the treatment of the disease entails and the possibility that complications might develop in the future.
Should people with diabetes marry each other? Specialists used to say no, believing there was a high risk that children might inherit the disease. But most young diabetes patients who are thinking about getting married and having children have Type I rather than Type II diabetes. Now that studies have indicated that heredity does not play the major role in this form of the disease it was formerly thought to have, there seems little reason to discourage such marriages. In fact, some counselors suggest that if two people with diabetes marry each other, they will find it easier to adjust, because both of them already know what living with the disease involves.
Is it safe for people with diabetes to have children? There is no reason why a man with diabetes should not father a child. For a woman the problem is a bit more complicated. Modern treatment methods have greatly increased the chances for a woman with diabetes to bear a normal, healthy child. But the rate of death of babies both before and soon after their birth is still somewhat higher than normal. The disease itself also becomes more difficult to control during pregnancy—the body’s need for insulin increases, and the woman must be carefully watched by her doctor to avoid possible complications that might threaten her or her child. Doctors recommend getting the blood sugar level under strict control well before becoming pregnant, and monitoring it carefully during the pregnancy. A pregnant woman with diabetes may have to undergo frequent and expensive tests to determine how well her baby is growing and when it should be delivered.
*40\268\2*
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Written by admin in: Diabetes |

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