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Archive for May 8th, 2009

LAPAROSCOPY: ONE WAY TO DIAGNOSE ENDOMETRIOSIS

Friday, May 8th, 2009

Laparoscopy is a fairly simple procedure that yields excellent results when done correctly.

When the modern and very versatile laparoscope was invented in Sweden about twenty years ago, it was the culmination of a long medical quest to look into and observe the living human body. It is fiber optics, or cold light, that made the laparoscope possible and practical to make. The laparoscope is a long rigid tube equipped with thin glass fibers (along which light travels to “spotlight” organs) and a periscopelike attachment that allows doctors to see into the pelvis and

abdomen. Lightweight and flexible (it can be maneuvered into various positions), the laparoscope not only makes it possible to see into the abdominal cavity but can also be used along with surgical instruments, if necessary, for further medical procedures. Therefore, laparoscopy—the technique that employs the tool—can be performed for either a diagnostic or a therapeutic procedure.

The most frequent candidates for laparoscopy are women with fertility problems, but the number of women who are suspected of having endometriosis and are undergoing the technique to confirm it is growing apace. Laparoscopy, it has been found, benefits women with either problem (or both) in this way: since the technique allows a visual inspection of pelvic organs and subsequent diagnosis, it can avert major surgery. For patients with persistently misdiagnosed and undiagnosed pelvic pain, it may finally provide an answer. Doctors can look for signs of endometriosis in its varying stages—from a reddened inflamed appearance of organs to the existence of pepper spots to greater gluelike adhesions to more massive chocolate cysts and tumors. Laparoscopy allows the sighting of such conditions, but remember, it is surgery, though on a lesser scale.

Currently, laparoscopy, familiarly called the Band-Aid procedure, is considered by most doctors to be the only absolute method of detection for endometriosis. Would that it were absolute! As it turns out, laparoscopy is only as good as the practitioner doing the viewing and diagnosing. Endometriosis is sometimes difficult to identify. Endometriosis that is growing on the ligaments behind the uterus or hidden inside tissue can be difficult to spot. To locate such growths, a doctor needs skill and dexterity. The scope must be positioned well below the uterus to catch sight of hard-to-see implants.

Unfortunately, some physicians either are inexperienced or may not fully understand the procedure or the female anatomy, or both. Because of these shortcomings, a number of complications can occur during laparoscopy. If it is not conducted under proper sterile techniques, the procedure can lead to abdominal and pelvic infections. Internal bleeding is a possibility from an incorrectly placed laparoscope; the device can lacerate, perforate, or traumatize the organs. Laparoscopy can cause serious problems like these in the hands of an unskilled physician. Then again, he may be knowledgeable enough about the procedure itself, but lacking as a diagnostician.

Cases of women undergoing this procedure and being told they are free of the disease when, in fact, they are not are not uncommon. One reason, as mentioned, is the surgeon’s skill in detecting it. Another is that the endometriosis may be microscopic and not visible to the eye. This means that evidence of the disease may not be revealed with laparoscopy, although it exists. Otherwise, the disease is officially described at four different stages of severity (I, II, III, and IV), as recently classified by the American Fertility Society.

*40\43\4*

Tags: Women’s Health
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SKIN CARE: TREATMENT OF PSORIASIS

Friday, May 8th, 2009

More recently a relatively new treatment for psoriasis, known as PUVA has been tried. This involves the taking of a photosensitizing drug, Methoxsalen, and following this by exposure to long-wave ultraviolet light (UVA) at 365 nm. This drug is thought to unite with DNA, forming cross linkages and hence reducing epidermal cell turnover. The treatment is usually given two or three times a week initially, and must be maintained from time to time. The advantages of this treatment are that it is usually very effective and has the bonus of providing the patient with a tan. The disadvantages, however, are that serious burns may result if the dosage is incorrect or if the patient does not protect himself from sunlight for eight to ten hours after taking the treatment. Furthermore cataracts have been reported in animals undergoing this type of treatment, and therefore patients must wear suitable goggles for treatment and for at least eight hours after treatment. More important still, it now appears that patients who have received this treatment for some period of time, particularly those who are also exposed to moderately large amounts of normal sunlight, are much more prone to developing skin cancers. Unfortunately these cancers are not always the relatively benign basal cell carcinomas, but are more commonly the malignant squamous cell carcinoma or even melanoma.

On a brighter note it is worth remembering that research la progressing and new treatments are being developed. One of the more exciting drug groups currently being investigated are the ‘retinoids’, which are based on vitamin A; these may have a great future.

*68\44\4*

Tags: Skin Care
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NUTRITIONAL ASPECTS OF APPETITE CONTROL: CHOCOLATE

Friday, May 8th, 2009

This food deserves special mention as it is commonly the typical object of food cravings. There is now some scientific evidence to explain the anecdotal need for a ‘chocolate fix’. Chocolate contains phenyiethylamine, an addictive substance that affects the brain to produce a pleasure response. This mild ‘high’ involves the same opiate chemicals or endorphins which respond to some illegal drugs. It is hypothesised that uncontrollable eating binges experienced by some individuals are triggered by an imbalance in the opiate system.

Preliminary experiments which have blocked the action of opiates point to sugar-fat mixtures as the predominant foods of desire. A chocolate addiction may also have something to do with its sensory (‘party in your mouth’) properties or its frequent use as a special gift or reward.

In line with the belief endorsed throughout this book that for success, lifestyle changes must be those that are enjoyable, there should be no suggestion that chocolate (or any food) be ‘banned’ from the diet of someone wanting to lose fat. On the contrary, if it is eaten, only the very best (and most expensive) chocolate should be eaten—and savoured—but in small quantities! However, keep in mind that clients who regularly binge on chocolate or other ‘bliss point’ snacks may require more specialised attention.

Myth-information. Appetite-control lozenges generally have an anaesthetic ingredient which numbs the tongue and throat. This makes eating uncomfortable. It does not suppress the appetite.

*121\186\4*

Tags: Weight Loss
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FEELINGS AND EMOTIONS IN CASE OF ENDOMETRIOSIS: SUE’S STORY

Friday, May 8th, 2009

I’m out and about and then I get the standard question: ‘How are you?’. I give my usual answer: ‘I’m surviving, thank you’. A twitch of an eyebrow. Of course they were expecting and only wanted to hear: ‘Fine, thank you’. But, I don’t like to lie and I also don’t wish to give a ‘case history’, so ‘surviving’ is honestly how I feel. It is also somewhere in between feeling good (‘normal’) and being sick enough to justify being in bed — mind you, often I’d love to be curled up in bed!

Then, you get ‘Oh, but you look fine’. I almost scream with frustration. They’re fishing for an explanation. So, should I explain or not? Well…in the interests of helping them to understand (hopefully), here goes with the justification speech yet again! I spiel off: ‘Well, I’ve got endometriosis (only some know what it is and even less understand the implications) and it is caused by… and it makes you have…symptoms, etc. etc.’. I would usually like to add, but prudently don’t, ‘I look “fine” because…

I have become determined to beat it!’.

I have my outward “facade” on today, which is a fake expression, accompanied by make-up, that says “I’m fine, I have no pain or problems at all’”;

the fact is I don’t venture out when I’m really feeling dreadful so you don’t see the real evidence of endometriosis’, or

I’ve taken a painkiller!’

You come away feeling guilty because you don’t look sick enough for them to believe or understand.

*110\83\2*

Tags: Women’s Health
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TREATMENT OF ENDOMETRIOSIS: DANAZOL AND HOW DANAZOL WORKS

Friday, May 8th, 2009

It is thought that Danazol eradicates endometrial implants in several ways. The net result is that the production of oestrogen is suppressed and the levels of oestrogen in the body decrease to the low levels found in women following the menopause. Hence, Danazol treatment is sometimes referred to as pseudomenopausal treatment because it mimics the hormonal condition of menopause.

The low levels of oestrogen mean that the endometrial implants are no longer stimulated to grow and break-down each month. Therefore, they become inactive and begin to gradually waste away.

Ovulation and menstruation usually cease by the end of the second month of treatment though this may depend on the dosage being taken. The symptoms of endometriosis usually begin to decrease by the end of the second month of treatment and then continue to improve throughout the course of treatment.

*52\83\2*

Tags: Women’s Health
Posted in Women's Health | No Comments »

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