CHOOSING A NEW DOCTOR TO TAKE HEALTH CARE FOR OLDER PEOPLE: ACCESSIBILITY AND QUALITY OF THE SERVICES
General Health
HIGH-QUALITY MEDICAL CARE FOR OLDER PEOPLE: SELECTING A NEW DOCTOR
General Health
NORMAL SLEEP PATTERNS: NEWBORN
The newborn sleeps for 18 hours a day or more, usually in spells of 2 to 4 hours at a time, and awakes only if he is hungry, cold, or otherwise uncomfortable. For the first few weeks of life, it is very difficult to ‘read’ the baby’s behaviour and sleep patterns. He is making a huge transition to the outside world and will be affected by such factors as his level of maturity (whether the baby is premature), any drugs given to the mother during labour, the delivery itself, and so on. Mothers often find it difficult to interpret signals from a newborn baby, and it takes some time, varying from days to many weeks, to settle into any sort of pattern or rhythm. This period of being unsettled can last considerably longer if the baby was very premature or has medical problems during the newborn period. A newborn baby tends to sleep very soundly and is not easily awakened by loud noises or body movements in the way that an older child is.
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General Health
GENERAL LACK OF ENERGY/FEELING TIRED ALL THE TIME – NERVOUS TENSION
Nervous tension may be playing some part in producing your lack of energy, especially if you are refusing to acknowledge or express some of your real feelings. It is when you try to force natural feelings like anger, sadness or anxiety underground that they are likely to surface in the form of unpleasant symptoms like extreme tiredness. Don’t force yourself to appear bright, cheerful and optimistic when you don’t really feel like that at all. Talk about and express your feelings—let them out and share them with your loved ones. I am sure that you will all have more energy to deal with what is happening if you can do this.
Try not to burn up energy raging against things that cannot be changed. Use what energy you have positively, to make the most of your situation. If you can no longer manage activities that have been important for you, think about whether you can modify them in some way so that you can manage. Ask for help— obstinately insisting on being independent could mean that you will miss out on some things that you could have managed with a bit of help. Look for appealing alternatives that are within your capabilities. In short, try to make the most of the time and energy that you do have. It is actually quite likely that you will gain energy as a result!
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Cancer
FRACTURES – DESCRIPTION
A fracture is a broken bone; it may be complete or incomplete, as in a greenstick fracture in a child. It is recognised by pain, swelling and loss of function but sometimes this last sign is not present. Just because somebody can still move his fingers does not mean that the wrist has NOT been broken.
Fractures may be complicated by causing damage to arteries and nerves, or compound, that is involving lacerations or exposing the bone. With large fractures there is always marked loss of blood internally (so you can’t see it) and the risk of shock is present.
The essence of first aid treatment is to immobilise the fractured bone. Don’t try to straighten a crooked limb — splint it as it is.
Splints are easily improvised. Strap one leg to another or one arm to the side of the body, or put one arm in a sling. A piece of wood, a stick, even a ruler, bandaged against the broken limb will do to immobilise the ends of the broken bone.
All suspected fractures must be seen by a doctor. FINGERS
These may be splinted with bandages, or by strapping to the adjoining fingers. BONES OF THE ARM
May be immobilised in a sling, or strapped to the side.
CLAVICLE (COLLARBONE)
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General Health
GALLSTONES – TREATMENT
At times, it is necessary to open and explore the common bile duct, as when there is a history of jaundice or if there are indications at operation that a small stone may lie within the duct.
When the duct is explored, it usually extends the stay in hospital to 10 to 14 days.
In the past, quacks often gained a reputation for themselves by claiming to cure gallstones. Their potions usually consisted of one part of oil and another of alkali. These reacted in the bowel to form a soap which collected as one or more pellets.
When these were passed in the motion, the quack claimed he had rid the person of their stones.
While researchers have long sought to dissolve stones, rather than operate, it is only recently that this has become possible.
Chenodeoxycholic acid (CDC) is a naturally occurring bile acid which can be given by mouth in large quantities and can both prevent and dissolve the cholesterol stones.
It only works for these rather than the pigment or mixed stones and, even then, is only effective in about 20 per cent of cases, although up to half the stones may be reduced in size.
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General Health
EXCESSIVE BODY HAIR – GENERAL INFORMATION
Shaving is probably the most used method and can be done by a blade or an electric shaver. While most women seem happy to shave their legs and under their arms, they have a reluctance to shave their faces, perhaps because it seems unfeminine.
Many still believe shaving tends to increase hair growth and to make it coarser. Tests have shown that hairs cut across by shaving have a stubbly appearance and feel, but do not become thicker or harder.
Chemical means of removing hairs are available and effective. They may irritate sensitive skins and have little benefit over shaving, except that the regrowth does not feel as rough as after shaving.
Plucking the hairs is the most popular means of reducing the number in the eyebrows and is effective elsewhere. It is painful and may lead to irritation of the follicles.
Electrolysis or burning out the hair follicle by an electric current is a popular method of treatment. If the hair follicle is destroyed, there should be no regrowth and permanent cure results, but this is not easy to achieve.
Repeated treatments are usually necessary and some hairs in their “resting” stage may not be destroyed. This method may lead to inflammation and even to scarring or an increase in pigmentation.
So there is no one satisfactory method of clearing those unwanted and unsightly hairs.
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General Health
EXPRESSIONS USED TO DESCRIBE EFFECTS OF TREATMENT – WHAT YOU NEED TO KNOW TO MAKE THE BEST DECISIONS (PART 3)
What can we conclude now? You have cancer and that is bad news, whichever way you look at it. There are probably difficult times ahead of you, whatever you do. If you meekly accept all your practitioner’s recommendations, it is likely that life will be much less pleasant for you than it could be. If you try to make your own decisions, it is likely that you will have difficulty getting the cooperation and information you need from your practitioner. Seek support from family, friends, nurses, social workers, or other practitioners. Trust your own judgement and gut feelings about what is right for you. Don’t let your practitioner talk you out of your decisions with medical jargon, scientific explanations, bullying or sweet-talking. These are techniques that authority figures such as fathers and teachers use with children. Switch to a practitioner who doesn’t do this, if possible. If not, just remember that you are not a child and that they can only hold a position of power and authority over you if you let them.
Here is a thought that might help you a little. Every time you refuse to let a practitioner treat you like a helpless child, you make it that tiny bit easier for the next patient to do the same. It is only through pressure from patients like you that doctors and other practitioners will be forced to change their approach, I believe this is the most important way in which you can use your disease to help future patients.
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Cancer
THE G.I. FACTOR AND WEIGHT REDUCTION: THE NEED FOR EXERCISE
A ‘fast metabolism’ is not necessarily a matter of luck. Exercise, or any physical activity, speeds up our metabolic rate. By increasing our kilo-joule expenditure, exercise helps to balance our sometimes excessive kilojoule intake from food.
Exercise also makes our muscles better at using fat as a source of fuel. By improving the way insulin works, exercise increases the amount of fat we burn. A low G.I. diet has the same effect. Low G.L foods reduce the amount of insulin we need which makes fat easier to burn and harder to store. Since body fat is what you want to get rid of when you lose weight, exercise in combination with a low G.L diet makes a lot of sense!
Why exercise keeps you moving. The effect of exercise doesn’t stop when you stop moving. People who exercise have higher metabolic rates and their bodies bum more kilojoules per minute even when they are asleep!
The body loves to store fat. It is a way of protecting us in case of famine. In the midst of plenty we are building up our fat stores.
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Diabetes
FAT LOSS: COUNTERACTING ENERGY SPARING ADAPTATIONS
The loss of body fat can lead to a range of physiological outcomes which, in turn, affect the further loss of body fat. Physiological adaptation to weight and fat loss can be divided into predictable changes (such as the decline in RMR in response to the loss of lean mass) and adaptive changes (where the body actively works to reduce the rate of weight loss). Dr Rudy Leibel and his colleagues from Rockefeller University in New York have tried to quantify the adaptive changes in lean and obese people as they lose weight. For a 10 per cent weight loss, they found that total energy expenditure declined by about 450kcal, of which about half could be explained by the changes in body composition and half could be considered adaptive.
The main way of counteracting the adaptive reductions in energy expenditure is through physical activity. This has been shown in several studies to counteract the energy sparing effects of dietary restriction. It does this by increasing energy expenditure both during and after exercise and by maintaining lean body mass. Studies examining exercise, however, have not always been convincing, possibly due to the difficulty in getting people to comply with the exercise regimens that have been set for them. There is still enough evidence to suggest that exercise can help with those who do comply and indeed may be the most effective form of continuing fat loss in the maintenance stage. There is little argument amongst scientists that diet appears to have the most immediate effect on fat loss, but it is now also becoming increasingly clear that exercise should be the mainstay in any fat loss maintenance program
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Weight Loss
