Medsarticles. Medical Weblog

PLASTIC SURGERY: CAN CHANGING YOUR LOOKS CHANGE YOUR LIFE?

admin — Wed, 16 Jun 2010 13:14:35 +0000

When you look in the mirror, do you like what you see? Too many facial wrinkles? A scar across your cheek? Pits left over from adolescent acne? Not enough hair on you head? Nose too big? Bags under your eyes? Belly hanging out? Thighs jiggling with fat?

Two million Americans each year grow tired of what their mirrors tell them. So they turn to plastic surgeons for an artistic re-sculpting of what nature, careless living, or accident has misformed. Most women and a growing number of men are no longer self-conscious about going for a “nose job” or a tummy tuck or having their face reshaped. Nor do they worry about spending anywhere from 2,000 to 30,000 dollars for the repair job. American plastic surgery is now a 4 billion dollars-a-year industry.

“I love being a grandmother,” says Ila Miles, a homemaker from Tucson, Arizona. “But I don’t want to look like one.” Mrs. Miles spent 5,800 dollars on nose surgery and a complete facelift.

For Timothy Rothrock, 20, a student from Lock Haven, Pennsylvania, plastic surgery totally restored his face after he was trapped in a forest fire. The worst damage, however, was to his neck: he had lost the contour -the curve from his chin line to his neck. Ugly raised scars marked the skin.

Ten operations were required to stretch, lift, and reshape Mr. Rothrock’s skin back to normal. “A few people still stare, and kids can be bothersome,” he says. “But now the scars are not quite as noticeable.”

For people whose faces are their fortunes, plastic surgery is strictly business. The roster of those who have had “repairs” reads like the guest list at a big Hollywood bash: Carol Burnett (chin augmentation), Frank Sinatra (hair transplant), Michael Jackson and Peter О’Toole (noses reshaped), Lana Turner and Phyllis Diller (facelifts), Mariel Hemingway (breast augmentation), and Eileen Brennan (face repair after a car accident).

“I feel blessed,” says Ms. Brennan, now the star of a new ABC-TV series, Off the Rack. “Every bone was broken in the left side of my face. I didn’t think I’d ever appear before a camera again.”

With the increasing demand for reshaping faces and bodies have come spectacular improvements in plastic surgery, making it safer and more daring than ever before. In addition to the facelift, which achieves only surface changes, plastic surgeons today can actually modify the bone structure below the skin through facial sculpting. New methods and materials for chin augmentation and reduction can create facial symmetry where it was lacking (as in Carol Burnett’s case). Techniques for eyelifts and nose surgery have been improved, so that the end result is a less “done,” less artificial look.

Along with common cosmetic repairs, the list of human sculptings now includes replacement of limbs, fingers, and hair torn from their anchors by accident; remolding to normal the faces of infants born with gargoylesque features; and redesigning noses, eyes, ears, chins, hairlines, and more to satisfy the patient’s deep emotional needs.

The rush to reshape nature’s work signals a fundamental change in the American outlook, says Dr. William W. Shaw, chief of plastic surgery at Bellevue Hospital in New York City. “Before the 20th century, people struggled to survive epidemics and famine,” he explains. “Medicine then turned its attention to chronic diseases like cancer, heart ailments – and to death. People now want to do something for themselves against aches, pains, and deformity.”

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ENDOCRINE DISORDERS: ADDISON’S DISEASE

admin — Wed, 16 Jun 2010 13:13:57 +0000

This is a relatively rare, serious disorder of the adrenal gland in which there is insufficient production of one or more hormones. Deficient production of aldosterone leads to excessive excretion of sodium and water in the urine, and increased retention of potassium. These changes lead, in turn, to lowered blood volume, dehydration, and hypotension. Patients may have a craving for salt, thirst, profound weakness, vomiting, diarrhea, and changes in heart rhythm.

Deficient production of other hormones, glucocorticoids, leads to rapid depletion of liver glycogen and to hypoglycemia a few hours after meals. If no food has been eaten for 10 to 12 hours hypoglycemia is severe.

Mild insufficiency is often controlled by increasing the salt intake and by giving five to six meals daily. Cortisone may be prescribed to control hypoglycemia. When the deficiency is severe deoxycorticosterone (DOCA) is prescribed to control the mineral metabolism.

A high-protein, low-carbohydrate diet is essential in order to reduce the stimulation by insulin and the subsequent hypoglycemia. Simple sugars are especially avoided. Midmorning, mid-afternoon, and late evening snacks high in Protein and low in carbohydrate are used.

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TRAVELLING WITH CHILDREN: PLANNING AHEAD

admin — Tue, 19 May 2009 06:49:35 +0000

Planning ahead

It is important to plan ahead when travelling with children. This can make all the difference between an enjoyable holiday and a nerve-wrecking disaster for all.

Make sure when booking that you choose accommodation that is safe for children Check for hazards such as balconies, stairs and swimming pools. Enquire what facilities are available for children. A nearby playground can provide free entertainment when parents need to rest. Make sure the place that you stay in welcomes children, and that your children can run around without bothering other guests.

Children are often fussy eaters. If your child has certain food preferences check in advance the sort of food available where you will be staying. You may like to take some food along with you. If your child requires medication of any sort, be sure to take an adequate supply along with you. If your child uses an asthma pump when he- is unwell, be sure to take it along also. In addition, always have your parent-held record with you in case you need to take your child to the doctor or the hospital while away.

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THE SEXUAL HEALTH EXAM: CAN YOU BE INVOLVED IN A MUTUALLY PLEASING AND FULFILLING SEXUAL EXPERIENCE? THE SWEETHEART

admin — Mon, 18 May 2009 13:02:29 +0000

The Sweetheart: Sweethearts seem to be trying to “sweeten” the disease away by overcompliance to any and all medical suggestions and requests. This same pattern continues in the marital sex, as they attempt to please their partner. “I have never turned him down. Even when I am sick as hell from the chemotherapy, I’ll still do something.” This wife reported a continued effort to be “nice” sexually and in every other way. “The doctor forgot what he told me about the medicine, but he is a very busy man. I am not his only patient. I understand.”

Research in healing indicates that such compliance is as potentially detrimental to coping with disease as is the unrelenting battle of the Hero. Providing sex as a favor, as an obligation to a partner, only serves to alienate the spouse, who in turn may pull away sexually. A balance between compliance and educated, modulated resistance to the disease process seems to be healthiest for any patient, and such a balance is promoted by a continued sexual interaction where there is alternating give-and-take. “I wish she would be a little nasty sometimes, you know. She is so damned sweet I almost feel guilty having sex with her.” This husband’s report points out the need for balance and what can happen to the spouse of the Sweetheart patient.

The Sweetheart patient puts herself or himself at risk. The medical industry can kill you if you fail to represent yourself, fail to ask questions and hold professionals accountable. Being obnoxious in the hospital or when you are being treated will not make you popular, but being too nice might get you ignored. Again, the issue is balance.

There are certainly many other forms of adjustment to illness. Try to understand how you are being ill, your sickness strategy, and you will learn much about how you might get well.

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SUPER LOVE FOR SUPER SEX/LOVE-MAP LANDMARKS: DESCRIBE YOUR SEXUAL-INTERCOURSE DEBUT

admin — Mon, 18 May 2009 11:17:28 +0000

Every person asked this question had » very specific answer. Intercourse is not something we take lightly, even though we talk very crudely about it sometimes. Share your first intercourse experience with your partner. It will be difficult, but again a necessary step for super marital sex. Being happily married does not require the level of disclosure required on this test, but this book is a program for super marital sex, and for this, such vulnerability is necessary.

“I’ll tell you, it was crazy and quick,” reported the husband. “A bunch of the guys got together, got drunk, and went to this place. This woman was there. We all took a turn. What a wild time. I don’t know how I got it done.”

“Mine was after the prom,” said his wife. “I only remember my hoopskirt up in the air like som0 stupid tent. I couldn’t see anything.

To tell the truth, I don’t know if he ever really got in me. It might have been between the seat and my butt. I worried for weeks until I got my period.”

Clearly, these initiations to intercourse become “main roads” on our love map, and unless we study and learn from them, no detours to better routes are possible.

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CHANCROID; DONOVANOSIS

admin — Mon, 18 May 2009 06:03:00 +0000

Soft sore or soft chancre produces a painful ulcer on the genitals.

The pain tenderness and soft feel of chancroid distinguish it from the painless hard chancre of primary syphilis. It responds well to tetracyclines and also the sulphonamides.

Granuloma inguinale or Donovanosis is rarely seen in temperate countries. It is endemic among the Aboriginals of central and northern Australia and is common around Port Moresby in Papua New Guinea. It has an incubation period of one to four weeks. It causes painless blisters or small papules on the skin of the genitals or thighs which then become raised and irregular and may break down and ulcerate. These lesions heal slowly and may leave marked scarring. Penicillin is not effective but the condition responds to the tetracyclines.

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EUTHANASIA – DISCUSSING EUTHANASIA

admin — Fri, 15 May 2009 08:54:29 +0000

The mature doctor will accept that death is inevitable, and will help his patients to approach it. But actively to push the patient across that threshold is another thing altogether.

Most doctors would accept the principle that one should not use extraordinary means to prolong life if that life has lost its “quality.”

But here the definition becomes obscure. For what is “quality” of life?

In the U.S. the medical profession has been confused by the always-present threat of a malpractice suit.

Fortunately, this is rare in Australia.

When you discuss euthanasia, either in support of it or not, you will need to consider who it is who makes the final decision — the patient, the patient’s family, the patient’s doctor, a panel of doctors or lay people, or perhaps a concensus of all of these.

But you will also need to discuss who will do the deed — the patient’s own doctor, or a specially licensed doctor — who carries out this procedure when requested.

God help him.

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YOUR CANCER, YOUR LIFE – SCREENING FOR CERVICAL CANCER (CONCLUSION)

admin — Tue, 12 May 2009 13:08:57 +0000

A lot of research has gone into screening for breast cancer. There is some evidence that yearly screening with clinical examination (feeling the breast) and mammography (special X-rays) in women over forty-five may improve the survival for breast cancer, but it doesn’t make a dramatic difference. I believe the best way of ensuring that breast cancer is diagnosed as early as possible is by examining your own breasts regularly and reporting to a doctor when you detect any lump or thickening. Breast cancer diagnosis is often delayed because women who know they have a lump ‘keep an eye on it’ themselves for some time before seeking attention. What I say about this applies to every symptom that may be due to cancer. If it is not cancer, having tests right away will put your mind at rest and save you a lot of unnecessary worry. If itis cancer, the earlier it is diagnosed, the better your chances. Pretending it isn’t there won’t make it go away—it will only live it mote time to grow and spread.

Cancer of die cervix is the only type of cancer where a screening procedure has been shown to influence the mortality of the disease;; You could think through possible screening procedures fof other: types of cancer yourselfI think that the examples I have given are enough to show you the difficulties involved. If only there was a simple blood test for cancer!

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CENTRAL NERVOUS SYSTEM METASTASES – CONCLUSION

admin — Tue, 12 May 2009 13:00:34 +0000

Thus, a deposit starting in the bones of the spine or between the bone and meningeal covering can cause pressure on the spinal cord. Because the outside part of the meninges is called the dura, these deposits are called extradural lesions (‘extra’ meaning ‘outside of). Symptoms depend on the location. They often include pins and needles, loss of feeling and loss of strength in the feet and legs, and partial or complete loss of control of bowel and bladder. Extradural lesions cannot be seen on a plain X-ray. They do show up on a CT scan. Another way of ‘seeing’ them is with a myelogram. Here a liquid contrast material is injected into the spinal fluid through a lumbar puncture needle. Because the liquid is heavier than the spinal fluid, it ‘settles’ in the lowest available location. The person can be safely tilted up and down at different angles on a special ’tilt table’ to get the contrast material to the trouble spot.

I have discussed in detail how we can look for secondary deposits in the common sites: the lungs, liver, bone and central nervous system. The same type of approach applies to whatever part of the body is suspected of containing secondary lesions. Suspicions based on symptoms, findings on clinical examination or blood tests may be followed up by appropriate X-rays, scans, biopsies etc. Ask your doctor for an explanation if you don’t understand why certain tests are recommended. You have every right to refuse tests, for example, if you can’t see what difference the results would make to your care.

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WHOOPING COUGH – TREATMENT

admin — Tue, 12 May 2009 12:40:58 +0000

Being a bacterial illness it responds to antibiotics, although the organism is resistant to penicillin.

Pertussis vaccine is present in the triple antigen and is given to children starting at eight weeks of age. The greatest threat to children from whooping cough is to those under 12 months old.

Older children tolerate whooping cough much better, but may be affected by severe side effects from the vaccine.

The whooping cough part of triple antigen is usually not given to those over 12 months old. When immunisation is necessary, the CDT (combined diphtheria and tetanus) vaccine is used instead.

Cough suppressants are of little use trying to control whooping cough, but the child will usually respond fairly quickly once antibiotics are given.

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