Neuritis is essentially the inflammation of nerves in a specific area of the body. Neuritis causes pain and sensitivity in the affected area of nerve inflammation. A few of the most common sites in the body that tend to be frequently affected by neuritis is the eye or optic nerve, the feet and legs, alternately referred to as peripheral neuropathy. Peripheral neuropathy generally affects individuals with diabetes and multiple sclerosis.

The severity of pain associated with neuritis depends largely on the number of nerves affected as well as the location of in the body of the inflamed nerves.

Optic Neuritis

Optic Neuritis, also known as retrobulbar neuritis, is a common site for nerve pain and damage. Nerve inflammation in conjunction with optic neuritis causes pain and discomfort in the eye. When the eye moves, pain occurs due to the over-sensitivity of the optic nerve. Inflammation of the optic nerve can do more damage to the eye and vision than just discomfort. Partial or in some cases complete vision loss may occur with optic neuritis. When the nerves of the eye are inflamed, pressure tends to increase in the area behind the eye socket as well. This added pressure can cause a deterioration of the myelin sheath which acts as a protective layer coating the nerve.

Causes Of Optic Neuritis

The causes of optic neuritis vary, with the most common cause being that of an attack on the immune system which ultimately weakens and destroys the myelin sheath covering the nerve. Due to the uncertainty of why the immune system attacks itself, it is difficult to predict the underlying cause of the problem.

One of the most likely precursors of optic neuritis is multiple sclerosis. This disease unfortunately leads to vision problems in many cases. Optic neuritis and multiple sclerosis often go hand in hand. The rapid deterioration of the myelin sheath causes the nerves in the body, and in the case of optic neuritis, deteriorates the optic nerve.

Infections such as those that are of bacterial in origin, as well as lyme disease, HIV, and herpes have also been suspect as a cause for optic neuritis. A compromised immune system increases the chances of an individual developing neuritis due to the immune system being at the heart of nerve damage.

Additional Causes

Cranial arteritis is also suspect in causing optic neuritis. When the arteries supplying blood flow to the optic nerve and the eye are blocked or damaged, the chances of the nerves sustaining damage increases. Decreased blood flow can further injure an already weakened optic nerve.

Diabetes is also a common disease that increases the likelihood of optic neuritis. When the glucose levels of a diabetic remain constantly high, resulting nerve damage throughout the body, particularly in the extremities and the eyes may occur.

Certain drugs and medications are also potential causes of optic neuritis. An example of a drug that has been associated with optic neuritis as a side effect is ethambutol. Ethambutol is a medication that is frequently used in the treatment of tuberculosis.

Symptoms of Optic Neuritis

The symptoms often associated with optic neuritis are:

• Moderate to severe eye pain and discomfort
• Vision changes such as blurring or focus problems
• Loss of color vision

Very often, the symptoms of optic neuritis are indicators of multiple sclerosis. Individuals who seek medical attention for optic neuritis may subsequently be diagnosed with the condition following an examination and testing procedures.

Risk Factors Associated With Optic Neuritis

There are many risk factors associated with optic neuritis. Age is one of the risk factors of developing the disorder. As the body ages, the optic nerve tends to weaken and naturally lose some of the myelin that protects the nerves. The typical age of onset in optic neuritis is approximately 30 years.

Another risk factor involved in optic neuritis is sex. Women are two times more likely than men to develop this disorder over the course of their lives.

Race may also play a role in the likelihood of developing optic neuritis. Caucasians have a higher tendency than other races and ethnicities to develop the disease. Genetic mutations involving the optic nerve may also serve as a risk factor in this disorder.

Optic Neuritis Complications

One of the complications stemming from optic neuritis may include damage to the optic nerve which in some cases may be permanent. A decrease in visual acuity may also occur in an individual with optic neuritis. Studies indicate that up to ten percent of individuals suffering from optic neuritis will result in some amount of vision loss, usually long-term.

Diagnosis And Treatment Options

Diagnosing optic neuritis begins with a visit to an ophthalmologist who specializes in the internal disorders of the eye. The ophthalmologist may order tests such as an ophthalmoscopy in order to determine the structural soundness of the optic nerve and to detect any swelling and inflammation that may be present.

Pupillary light reaction tests may also be administered to measure the pupil’s response to light. Optic neuritis tends to damage the amount of constriction in the pupil in relation to light levels. Visually evoked potentials tests, as well as MRI scans may also be used to determine the presence of optic neuritis and the damage that may have resulted from the disorder.

A treatment option that may be employed for optic neuritis may include intravenous steroids, which helps quicken the restoration of a certain amount of visual loss that may have occurred due to the disorder. Other possible treatments include prescribing oral steroids such as prednisone may be administered. In certain cases, a procedure known as plasma exchange therapy may be of help in restoring some of the vision loss.

Peripheral Neuritis

The condition known as peripheral neuritis has a direct correlation to diseases such as multiple sclerosis and diabetes. This condition is usually referred to by healthcare professionals as peripheral neuropathy. The typical complaint of peripheral neuropathy sufferers is numbness and pain in the hands and feet. The symptoms are often described as a tingling or burning sensation and a loss of feeling to varying degrees. Peripheral neuropathy usually occurs in intermittent stages. Individuals suffering with the disorder find that the symptoms appear and subsequently disappear. The severity of the neuropathy also varies greatly during its occurrence.

Causes Of Peripheral Neuritis (Neuropathy)

There are several underlying causes of peripheral neuropathy. Some of the following are typical circumstances that surround this disorder are:

• Nerve trauma due to accidents and injury
• Excessive nerve pressure such as a pinched nerve
• Vitamin and mineral deficiencies
• Multiple Sclerosis
• Diabetes
• Viral or bacterial infection
• Heavy metal poisoning
• Autoimmune disorders
• Alcohol or drug addiction
• Kidney disease
• Liver disorders
• Spinal cord tumors

Many of the causes of peripheral neuropathy are diagnosed as a result of treatment being sought for the actual symptoms of neuritis.

Peripheral Neuritis (Neuropathy) Symptoms

The symptoms often associated with peripheral neuropathy include loss of sensation in the feet and/or hands, lack of coordinating extremity movement, numbing sensations that gradually increases over time, enhancement or loss of sensitivity to heat and cold, bowel and bladder incontinence, muscular pain, and possible paralysis.
Burning and pinching sensations are also common complaints in patients with peripheral neuropathy.

Typically with the progression of the disorder, the physical symptoms may spread to the entire length of the arms and legs in some cases.

Risk Factors Of Peripheral Neuropathy

The risk factors of peripheral neuropathy are a medical history of diabetes, autoimmune disorders such as HIV, Epstein-Barr disease, lupus, and multiple sclerosis. Kidney or thyroid disease, high toxin exposure, repetitive physical trauma or accident involving the spinal cord, as well as nutritional deficiencies may also raise the risk level of developing peripheral neuropathy.

Diagnosis And Treatment

Diagnosing peripheral neuropathy will begin with a description of symptoms, blood tests, and physical examination by a healthcare professional. Nerve biopsies and MRI scans are also common diagnostic tools in determining the existence of the disorder.

The typical traditional treatment options available for peripheral neuropathy include:

• Anti-depressants
• Narcotic and non-narcotic pain medications
• Anti-seizure medications which control nerve pain
• Lidocaine patches to the affected area

Natural Cures And Remedies For Neuritis

While both optic and peripheral neuritis have their own individual treatment regimens, both are caused by aggravated nerves which may benefit from similar remedies and natural pain relievers. Some of the best home remedies that lessen the pain and discomfort associated with neuritis include some very benign products that can be obtained from a local grocery or drug store.

Much research has been done regarding the benefits of the B-vitamin family of supplements for treating both types of neuritis. Pantothenic acid, B-12, and B-2 are essential in protecting and optimizing nerve function. Another popular home remedy that is helpful in the reduction of nerve pain is carrot and spinach juice. The vitamins and minerals found in both of the vegetables provide excellent antioxidant support for the nerve and the body as a whole.

Barley Brew

Barley brew is also a potent pain reliever in response to neuritis. Boiling the barley brew and mixing it with buttermilk and lime juice make for a tasty home remedy. Beet juice is also a wonderful vegetable that is filled with many essential vitamins that help promote healing and nerve restoration.

Epsom Salt

A proven remedy for neuritis flareups is the epsom salt bath. Epsom salt baths should be taken three times per week in order to calm aggravated nerves and relieve pain and discomfort associated with neuritis. An effective means of gaining strength and building up bodily endurance during neuritis flareups is exercise. Soya bean milk is another home remedy used in treating neuritis. The natural chemicals found in soya beans help improve nerve function and should be taken once daily, preferably at night before bed.

Exercise

While most people who suffer from this disorder would cringe at the thought of exercise during such bouts of neuritis, moving the body by moderate walking for twenty minutes per day can help lessen nerve pain. Mild to moderate physical activity helps strengthen the body and muscles and relieves discomfort due to the natural hormones that are released by the body during exercise. Proper stretching should be done before and after any exercise routine, even if the exercise is light. This is necessary in order to avoid muscle strain or injury which would only heighten the problems with neuritis.

Things To Avoid During A Neuritis Flareup

There are several things that sufferers of neuritis should avoid in order to lessen pain and discomfort as well as promote speedy healing. Cut back on or avoid the following items:

• Canned meats such as tuna and salted fish
• White refined breads and cereals
• Coffee
• Tea
• Caffeine products

The above items will only add to the complications of neuritis and should be avoided if all possible during a bout with neuritis.

Neuritis can be a debilitating illness that causes nerve pain and discomfort for sufferers. With the proper treatments, both with traditional and natural remedies, a pain free life may be enjoyed once again.

Corns are hardened areas of skin that are the result of constant rubbing and pressure placed on specific areas of the body, most commonly the feet. These areas can become painful and bothersome for some people.

Symptoms

Corns and calluses are skin that becomes thick and hardened. These areas of skin may also appear flaky and dry at times. These hardened, thick skin areas are most often found on a person’s hands, feet and other areas of the body that may suffer from being consistently rubbed or pressed.

Causes

Typically corns and calluses are caused when a person subjects certain areas of their skin to pressure or friction from consistent use. Corns are usually skin that thickens on the top or side of a toe. A common cause for this happening is shoes that do not fit the person’s foot properly. Calluses are areas of thickened skin that develop on the hands or the soles of a person’s feet. This typically occurs from performing physical labor tasks.

The thickening of the skin occurs as a protective reaction to help prevent the development of blisters that can be painful and troublesome. People who have bunions on their feet most times will develop a callus over the bunion due to the bunion sticking out and rubbing against the shoe.

Risk Factors

Whenever a person consistently subjects parts of their body to repetitive rubbing or pressure, the possibility of developing corns or calluses is present. There are certain things that do put people at a higher risk factor for developing a corn or calluses. This includes:

• Age – As a person ages, their feet tend to become wider and flatter. The soles of their feet also tend to lose fat on the padding of their soles. This the feet to fit improperly in the shoe and allows for rubbing to occur. These problems also lead to improper pressure being put on areas of the feet that will cause skin to harden and thicken up.
• Cosmetic Foot Surgery – When a person has cosmetic surgery performed on their feet for situations such as to be able to fit into dress shoes easier, or to reduce the size of a person’s foot, this can lead to foot problems. Since the foot is designed to support a person on various pressure areas of the foot, reducing the size of a foot can throw the body’s sense of balance points off. This will lead to the foot having added pressure points in areas that it is not use to leading to the development of calluses and corns.
• Gender – Studies that have been conducted show that women are at a higher risk of developing corns on their feet. This is normally due to the types of shoes women tend to wear. This is also a result of women wearing a variety of different types of shoes for dress, exercise and causal wear without allowing their feet to adjust to just one or two different pairs of shoes.
• Occupational Risk Factors – The type of job and the environment in which a person works has a lot to do with their risk of developing corns. A person that is on their feet a lot or who perform a great deal of physical labor are at a greater risk of developing corns and calluses than someone who sit’s at a desk for the majority of their work shift. One example of this is a farmer who spends their time tending to their crops. Almost one hundred percent of their job requires physical labor. They develop corns and calluses to help prevent painful blisters from occurring.
• Pregnancy – Pregnant women are at a higher risk of developing corns and calluses because of the additional pressure placed on their feet that is not normal. The feet have specific points that it is used to receiving the majority of the pressure through regular wear and this is thrown off during a pregnancy.
• Sports and Activities – Since the majority of sports and extracurricular activities, such as dancing, require a person to spend a great deal of time on their feet while being active. These activities increase the likelihood of your feet and other parts of the body to experience extensive pressure and rubbing, causing corns and calluses to develop.
• Weigh Gain and Obesity – People who have gained weight or who suffer from obesity are at an increased risk of developing corns and calluses because of the extra pressure that they are putting their feet under to support the extra weight.

Prevention Tips

Corns can be very painful. There are cures to help remove corns that have developed. However, there is no guarantee that corns will not return or develop in another area. The best thing to do is prevent them from occurring in the first place. Here are some tips and techniques to help reduce the chances of developing corns.

Wear socks that are clean and dry. Providing continued moisture to your skin can erode the skin’s natural toughness. This is when corns will develop. Socks lock in moisture to the foot without allowing them to breathe. Wear socks continuously also contributes to foot odor and conditions such as athlete’s feet.

Shoes should not be worn indoors. Unless you are wearing a special corrective foot wear for a orthopedic problem, you should try to go bare foot around your home as much as possible. This gives your feet a break from the constant pressure and rubbing that occurs when wearing shoes.

Shoes With a Natural Curve

Shoes that come to a point, are thin or straight in design or that have a flat foot appearance, are more likely to cause rubbing and unnatural pressure points to your feet when wearing them. This can lead to the development of corns.
Do not wear shoes that are tight in the toes. Shoes that have a tight fit in toe area will definitely rub against the inside of the toe the entire time they are worn. This will result in a corn developing on the toes. Opt for wider toe shoes that allow for comfort and are natural fitting.

Check inside seams of shoes. If shoes have inside seams, make sure that they will not rub against the toe while wearing. Shoes that do not have protruding seams are less likely to contribute to developing corns. The more padding the better. When purchasing shoes, look for styles that have extra padding to help create a buffer for your feet and toes. When your foot settles into this buffer, it will maintain its natural position and result in less rubbing and pressure. You will also want to pay special attention to the ball of the foot and the back of the heel area. This is a common place for corns to develop.

Podiatrist Recommendations

Talk to a podiatrist about inserts. If you are unable to find shoes that fit your feet properly, talk to a podiatrist about getting inserts for your shoes. There are special pads, shoe inserts and wedges that can be specially made to your foot’s natural design to help eliminate the chances of developing corns as well as other painful foot conditions.

Surgery may be necessary. If you are unable to deal with the pain of an existing corn or you have a severe deformity of the foot, you may need to speak with a podiatrist about surgical treatments that are available that can help you deal with painful corns. This should always be a last resort when dealing with corns.

Test and Diagnosis Considerations

When diagnosing a corn, doctors and medical professionals will perform a visual inspection of the area and provide you with treatment options. They may inform you of some medicines or supplies available to treat corns. Doctors may even discuss surgical options that you have to remove the corn.

Treatment Options

There are many treatment options available to help patients deal with corns. There are medicines and over the counter medical supplies, surgical options that can be performed by a surgeon and countless natural remedies and cures available to try. Here are some of the options that a person has to help deal with painful corns.

Medicines and Over The Counter Medical Supplies

Special pads that are designed to place over the corn can be purchased over the counter. These pads can help to prevent future rubbing and pressure to the corn. Some varieties of pads available are medicated, meaning that they have an acid medication designed into the pad itself to help dissolve the hard tissue of the corn. This does help, but the medicine itself can harm good skin as well as the corn if it is not positioned correctly on the corn.

Shoe padding and shoe inserts are available. These products are meant to act as a bunting for your foot, allowing it to cradle around your foot and mold it into place to prevent rubbing and pressure points.

Over the counter acid medications are available. This usually comes in a liquid or gel form and is meant to be applied to the corn to soften the toughened skin. This should not be used by people who have problems that do not allow them good feeling in their feet areas. This is also not a recommended option for a person with pre-existing health problems like diabetes.

There are specially designed tools available to help shave away the tough skin of a corn. These tools are not recommended for people who have a decreased ability to fight off infections or who do not heal well, such as diabetics.

Pumice Stones

Pumice stones are a great over the counter option when trying to eliminate a corn. Soak your feet for approximately 20 minutes. Rub the pumice stone over the corn until you have removed as much dead and dried skin as possible. Continue this method for as many days as needed without making the area around the corn raw. Diabetics should not use pumice stones because of the chances of breaking the skin and causing infection.

Surgical Options

Surgeons can cut off the corn or callused area to help eliminate the pain. If the corn is caused by a toe that is not straight, surgeons can straighten the crooked bone to help reduce the likelihood that it will return. If the corn is the result of a toe that is too long or too short and causes rubbing, surgeons can help to shorten the bone or lengthen the toe using cosmetic surgery on the feet.

Doctors can burn the corn off using a medical acid treatment, similar to the treatment used for the removal of warts.

Natural Cures and Remedies

Fill a basin or tub that can be used to soak your feet in, with as hot of water as you can stand without getting scalded. Pour in about half a cup of Epsom salt into the water filled basin or tub. Soak your feet for 20 to 30 minutes twice a day. Continue this treatment for approximately one week. During the time of treatment, avoid wearing socks and shoes as much as possible.

Dip a cotton swab into castor oil and apply to the corn. Using medical adhesive tape, tape the cotton swab to the corn and allow it set over night. Continue this process for one week and you should begin to notice a big difference in your corn.

Some patients claim that if you tie a slice of lemon over the corn and leave it there over night you will get results.
Grind three or four licorice sticks and mix with half a teaspoon of sesame oil or mustard oil until a paste like substance forms. Apply this paste to the corn and leave on overnight. This will gradually soften the skin and reduce the size of the corn.

Grind chalk into a powder and mix with a small amount of water to form a paste. Apply the paste to the hardened corn and leave on overnight. This will soften the corn and shrink the size of it.

Vaginal Infection is a general medical term referring number of fungal, bacterial, and parasitic conditions that effect, but are not limited to, the vaginal area. Vaginal infections are commonly called, yeast infections, vaginitis, yeast overgrowth, or Candida. Doctors will use more specific terms like, Bacterial vaginosis (BV), candidiasis, genital candidiasis, vulvovaginal candidiasis (VVC), or Trichomoniasis (Trich).

Symptoms

Vaginal Infections cause a wide range of symptoms, including one or more of the following : itching, burning, and irritation in the vaginal area; painful intercourse, abnormal vaginal discharge, white “chunks” that resemble cottage cheese, foul odor, fishy odor, inflammation and swelling of the genital area, and burning during urination. A healthy vagina has a pungent odor unique to every person. Normal discharge is clear to white, turning yellow when exposed to air. The color and amount of discharge varies through the monthly cycled and depends largely on estrogen levels.

Causes

Bacterial vaginosis is responsible for at least 50% of vaginal infections. BV is caused by the growth of an unfriendly bacterium called Gardnerella vaginalis that lives in low-oxygen environments. When the vagina loses its natural acidity the Gardenerella bacteria thrives in the altered pH-neutral environment. A bacterial infection with Garnerella causes a fishy odor along with vaginal itching and irritation. Discharge may vary from yellow to grayish white. BV does not cause pain during intercourse and sometimes causes no symptoms at all.

The common yeast infection is caused by the overgrowth of a genus of yeast called Candida Albicans. This fungus–all yeasts are fungi–is present throughout the mouth and digestive tract in nearly 80% of the population, with little noticeable effects. This yeast starts out as a single-celled organism, but in the right conditions it will, literally, go crazy, producing a huge branching structure of filaments, much like a tree with many, many branches. This tangled mass produces a visually identifiable infection called Candidiasis, which is responsible for vaginal yeast infections and mouth infections called thrush. In the most severe cases, Candida can invade the nose, organs, brain, and blood.

Hormones

Hormones are another cause of vaginitis. Atrophic vaginitis, also called Senile vaginitis, can occur in females of any age from fluctuating levels of estrogen. This type of vaginitis causes painful intercourse due to the thinning of the vaginal wall and decreased lubrication associated with low estrogen. Atrophic vaginitis affects postmenopausal and postpartum women as well as pre-pubescent girls with naturally low estrogen levels. There is no unusual odor or discharge associated with this type of vaginal inflammation.

Irritants

Irritant and Foreign Body Vaginitis is caused by the retention of spermicidal sponges, condoms, and tampons or allergies to personal care products, latex allergy, spermicide ingredients, douches, vaginal hygiene products, detergents, fabric softeners, and fragrances. Vaginitis and foul odors caused by a forgotten tampon or lost condom will clear up after the foreign object has removed, no further treatment is necessary.

Vaginitis caused by irritants can be harder to pinpoint, because of the prevalence of these products and sudden onset of allergic symptoms. For persistent or unexplained vaginal irritation switch to a hypoallergenic fragrance-free detergent and discontinue using scented menstrual pads, douches, and other products with ingredients that could cause irritation.

Trich & STD’s

Trichomoniasis, also called trich, (pronounced “trick”) is a sexually transmitted infection which is caused by a parasite Trichomonas vaginalis. This infection is carried by men who are almost always asymptomatic. Because men don’t show outward symptoms it’s imperative that they receive the same anti-parasitic treatment as females to prevent the infection from being passed back and forth. Trich is characterized by foamy greenish yellow vaginal discharge, itching, irritation, and in some cases severe swelling of the vaginal area.

Vaginal infections and irritation can also be caused by sexually transmitted diseases and sexually transmitted infections, like gonorrhea, Chlamydia, mycoplasma, herpes, and campylobacter. Some parasites and improper hygiene, like wiping back to front, can cause similar infections, although these are less common causes.

Risk Factors

Vaginal yeast infections occur most frequently after a course of antibiotics. Medications like penicillin kill all kinds of healthy bacteria, including the good vaginal flora.

Patients on steroidal medications and women on birth control pills or using IUDs are more likely to experience frequent yeast infections. Some women on birth control can develop yeast infection symptoms monthly, which subside at the beginning of the cycle and return again before menstruation.

Diet

Diet is a major influence on the body. Unhealthy food causes imbalances in the vaginal microflora. Diet can influence everything from blood sugar to pH and both are key causes of vaginal infections.

Unprotected Sex

Although yeast infections are not sexually transmitted women who have frequent unprotected sex are at in increased risk this simply because sperm and ejaculate are highly alkaline, making the vagina work harder to correct the acid balance.

Serious medical problems like diabetes, leukemia, and HIV or AIDS can cause in increased occurrence of vaginal infections, particularly yeast infections with Candida. Diabetes alters body chemistry, pH, and causes elevated blood sugar that yeast thrives on. People with compromised immune systems, including patients with HIV or AIDS, are at an increased rick for persistent yeast infections, including oral thrush.

Prevention

After a course of antibiotics take a probiotic supplement to help reestablish the healthy microorganisms and prevent a full-blown infection.

Proper Dieting & Comfortable Clothing

Excellent diet is the key to preventing the reoccurrence and length of infections. Yeast, in particular, feeds on sugars in refined starches. A died heavy in processed foods and empty carbohydrates causes spikes in blood sugar that yeast needs to survive. Limit consumption of potatoes, white flour, breads, crackers, and anything made with starches. Consuming any of these foods, particularly in excessive quantities, only fuels the fire.

Regular consumption of yogurt is extremely effective at balancing the natural healthy flora in the intestines and vaginal area. Using milk supplemented with Sweet acidophilus cultures is another way to correct the natural balance of healthy bacteria in the vagina. Avoid synthetic underwear made from polyester, which can trap air and moisture. Wear cotton undergarments that naturally absorb moisture and promote air circulation.

Hygiene

Don’t use harsh soaps on the vaginal area. Although it may seem counter intuitive, washing thoroughly with water is more effective at maintaining a healthy vaginal balance than using soap. Wear loose clothing. Under certain conditions the combination of tight clothing and undergarments can lead to vaginal infections or cause additional discomfort to an active infection. For comfort and to encourage good air circulation wear loose fitting clothes or skirts.

Change cloths and underwear after working out or getting wet. Bacteria and fungi thrive in this warm and humid environment. Remove underwear during the night for better air circulation. This can be especially comfortable during an active infection.

Tests, Diagnosis, and Considerations

Most women can easily recognize the symptoms of a yeast infection even if they have never had one before. Because the symptoms of different vaginal infections are so similar, women occasionally mistake the symptoms of a bacterial infection for a yeast infection.

At home yeast infection test kits are available. These kits use a basic litmus paper pH test to determine if the infection is caused by Candida or Gardnerella. Users find these at home pH tests to be rather inconclusive because the pH of the vagina usually stays under 4 and both fungal infections and bacterial infections occur in this same range. A healthy vagina has an acidic pH between of 3.8 and 4.2. A pH over 4.5 is on the alkaline side and could indicate one or more the infections are at work.

Specific Testing

The medical diagnosis of vaginal infection is really quite simple. When a patient presents the symptoms of a vaginal infection the doctor will do a pelvic exam with a speculum, just like a pap test, to look at the cervix and vaginal tissue. In some cases the doctor will visually diagnose a yeast infection, other times a sample of the vaginal discharge will be taken on a swab and examined under a high powered microscope. Doctors use several methods to narrow down the true cause of the infection.

First, a doctor may do a pH test. A high pH over 4.5 indicates the infection likely caused by gardnerella. Second, the cells are placed on a slide and mixed with a salt solution or dye to identify “clue cells” distinctive vaginal skin cells covered with speckles the gram-negative Gardnerella bacteria. Doctors will also use a wiff test to identify bacterial vaginosis. A wiff test uses a sample of vaginal discharge combine with 1 drop of potassium hydroxide, an extremely strong alkali (base) that is then sniffed for a fishy odor indicating an infection with the Gardnerella bacteria.

Treatment Options

Pharmaceutical Treatments Prescription and OTC

The usual treatment bacterial vaginosis is 7 day course of antibiotics taken twice a day. Metronidazole is the antibiotic that most often prescribed. It’s a common antibiotic that targets bacteria and protozoa, making it an effective treatment for Trich. Antibiotics are affordable and readily available with a prescription, but they do cause side-effects, including nausea and diarrhea.

For common yeast infections doctors usually recommend an over-the-counter pharmaceutical treatment that contains an anti-fungal drug belonging to the “azole” class, (meaning the active ingredients all end with the suffix azole.) These anti-fungal treatments come in a number of forms from oral tablets to intravaginal suppositories and topical creams. The most popular treatment for yeast infections is a vaginal suppository that contains Miconazole.

These products are sold worldwide under the brand names: Miconazex, Monistat, Femizol and Gyno-Daktarin. As most women know, the feminine care aisle is a veritable jungle of products; even vaginal suppositories come in an amazing and confusing array of varying strengths, most commonly 1-Day, 3-Day, and 7-Day courses. Despite the different duration, these suppositories contain similar total amounts of the medication, but the longer courses are gentler and in some cases more effective.

Side Effects

Mild to severe burning and added swelling and irritation are the most common side-effects caused by applying harsh ingredients on irritated skin. Yeast infections are also known to return after these anti-fungal treatments, because they treat these symptoms not the root cause. Brands like Monistat can be purchased at the drugstore for under $20. Store-brands and generic forms are also available for about half the cost.

Doctors will also prescribe oral anti-fungal medications to control yeast infections. The most common anti-fungal is Fluconazole, which is commonly sold under the brand names Diflucan, Trican, and Alfumet. Many women prefer this oral treatment because it doesn’t cause additional irritation to the vagina like topical treatments can. With generic drug programs this prescription medication can be purchased for under $10.

Brand Name Tips

Brands like Vagisil are constantly marketing their vaginal creams that provide “all day relief.” These medications contain topical pain killers, Lidocaine in the UK or Benzocaine in the US. These products don’t treat the infection, but they are helpful for reducing the symptoms temporarily. Users say the 20% Benzocaine is the most effective for numbing the vaginal area. Side-effects include burning and added irritation from the ingredients and fragrance. Vagisil is available at every grocery store and drugstore for about $6.

Natural and Homeopathic OTC Products

There are a host of natural and homeopathic treatments for yeast infections and bacterial vaginitis. These all natural products are aimed at rebalancing the vagina flora. Many of these products contain the healthy Lactobacillus bacteria along with herbal ingredients traditionally used to treat vaginal infections. Prices for these natural remedies are comparable to pharmaceutical over-the-counter treatments, usually $6-$24.

Natural products come in every form conceivable from gel creams to suppositories and oral tablets. YeastGard, AZO Yeast, Nature’s Cure, YeastAway by Boiron, and Hyland’s Vaginitis tablets are all available at most mainstream drugstores. Thursday Plantation has a line of tea tree oil-based suppositories and Yeast Arrest is another vaginal suppository, but it uses boric acid along with a number of antibacterial and anti-fungal botanicals.

Yeast Arrest is a harsh treatment intended for acute and chronic infections. The most common side-effect is burning. Yeast Arrest cures severe infections in 3-14 days.

Home Remedies

Plain yogurt is one of the best home remedies for soothing irritation and restoring a healthy vaginal pH. Yogurt can be frozen in the fingers of rubbers gloves for a home remedy that soothes in two ways or a non-applicator tampon can be dipped and yogurt and inserted overnight for several consecutive nights.

Oils & Other Solutions

Coconut oil is a natural antibacterial used topically in India for centuries. Dip a non-applicator tampon is warmed coconut oil and insert overnight for 4 to 5 consecutive nights. Use all natural coconut oil intended for cooking.

Tea Tree Essential Oil is already approved to treat yeast infections in Italy. 10 drops can be added to a sitz bath or bucket to soak the pelvic area. Alternately, dip a non applicator tampon in olive oil or coconut oil (K-Y jelly is fine too) and apply one or two drops of tea tree oil, insert overnight for 4 to 5 consecutive nights.

Tea tree essential oil is available at health food stores about around $10 depending on the quantity. Check to make sure the oil is not diluted with alcohol. Tea tree oil is a power antibacterial use only a few drops at a time. The most common side effect of tea tree oil is burning.

Wash a diluted vinegar solution to restore the naturally acidic vaginal pH. Mix 1 tablespoon of vinegar with a quart of water. A squirt bottle, like the type used for dish liquid, works great.

About Phlegm

Phlegm is a word that everybody has heard of before, and it is a condition nearly everybody has had to deal with before, at some point in life. It is a viscous liquid mammalians secrete by way of the mucous membranes. However, phlegm itself, and its definition, is specifically limited to the mucus that is produced within the respiratory system, except for those that are found in the nasal passages, and especially that which is sputum, which is what is expelled by way of coughing.

In essence, phlegm is a gel based on water, and it consists of lipids, immunoglobulins, glycoproteins, as well as a few other substances. What each expelled instance of phlegm actually consists of will vary, depending on other factors, such as the condition of the immune system, the genetics of the person in question and what the climate is like outside. In terms of color, phlegm is known to range between a transparent state to that of a pale yellow and green.

Phlegm is known to carry the larvae of several kinds of intestinal parasites, such as hookworm. When phlegm comes out bloody, it may signify a much more serious illness that requires medical attention, such as tuberculosis.

However, it is also often a fairly benign symptom of an illness that is much more minor, such as bronchitis. In the case of the latter, the phlegm will usually have a light streaking of blood. When the amount of blood coughed up is a significant quality, it will require immediate medical attention because this is always a signal of something much more serious.

Symptoms

When a person coughs up a water based gel like substance, of which the color may vary, this is phlegm. Phlegm in itself is a symptom, of which many conditions cite it as one. Some conditions that may cite phlegm as a symptom as a signal of its presence include some of the following:

Allergies

Allergies occur when an immune system overreacts to a certain kind of substance or other kind of allergen. Also known as allergic reactions, this condition is very common, and several kinds of allergies exist. Some of these allergies may include respiratory allergies, food allergies or skin allergies, possibly resulting in cases of contact dermatitis or eczema.

Several special cells make up the immune system of a person, and these cells travel throughout the body so that a person is able to defend against foreign agents that do not belong, such as bacteria and viruses. When a person is prone to allergies, and comes across their allergen, their immune system will react overzealously when they swallow, inhale or touch the allergen, such as dust or pollen. The end result is the system releasing histamine, which causes inflammation, swelling, itching and phlegm.

Nearly any substance is capable of causing allergies, provided the person is sensitive to it. Many people who have allergies are sensitive to more than one substance. The more common allergies that people have include those to mold spores, pollen, animal dander, dust, cockroach droppings, bee stings or dust mite droppings. Other possible allergies might include those to certain plants, certain foods, such as milk or eggs, certain medications, such as penicillin or aspirin, or to chemicals or other substances, such as latex.

Bronchiectasis

Bronchiectasis is a disease which causes damage to occur in the airways, which, in turn, causes them to become scarred, flabby and to widen. The airways are the tubes that are responsible for transporting the air in and out of the lungs. Usually, this condition is due to an infection that ends up injuring the walls in the airways or preventing it from clearing mucus.
Bronchiectasis is known to lead to serious conditions, such as atelectasis, respiratory failure and heart failure. Symptoms for this disease include:

• Bad breath;
• Paroxysmal coughing;
• Coughing foul smelling phlegm;
• Coughing yellow or green phlegm;
• Shortness of breath;
• Fatigue;
• Wheezing;
• Anemia;
• Morning cough;
• Chronic cough; and
• Coughing blood.

Chronic Bronchitis

This condition is an ongoing and progressive disease that embeds itself into the lower respiratory tract within the lungs, and it is a type of COPD, or chronic obstructive pulmonary disease. Its hallmark is its constant wet, loose cough, which produces a rather excessive instance of phlegm. Smokers are at a high risk of developing this at some point in their lifetime.

This disease is a seriously disabling one, and it has the potential of causing major complications, in additional to being potentially fatal. This is especially the case when it is paired alongside with emphysema, which is another very serious form of COPD. COPD is a major cause of disability around the world, and it is the fourth among a list of leading causes of deaths in the United States.

Nicotine Addiction

Nicotine addiction occurs in smokers. Its symptoms include:

• Increased heart rate;
• High blood pressure;
• Weight loss;
• The inability to stop smoking;
• Feeling withdrawal while attempting to quit smoking;
• Strongly craving products with nicotine;
• Avoiding activities where unable to smoke;
• Persistent cough; and
• Increased tolerance to the effects of nicotine.

Rhinitis

Rhinitis is when a person experiences inflammation of the mucous membranes found within the nostrils. Its symptoms include:

• Runny nose;
• Blocked nose;
• Nasal congestion;
• Catarrh;
• Sneezing;
• Nasal secretion crusting; and
• Sinusitis;

The symptoms of vasomotor rhinitis may include:

• A recurring inflammation of the nasal passage;
• Swelling of the nasal membrane;
• Sneezing; and
• A profuse nasal discharge that is watery.

Sinusitis

Also referred to as a sinus infection, sinusitis occurs when the air filled spaced that of which are found within the bones located around and in the nose become infected. These air filled spaces are known as paranasal sinuses. When they become infected, they will become inflamed. What this results in is the mucus membranes lining the sinuses swelling, and this swelling is what causes that familiar pain and pressure around and in the cheekbones and eyes.

This is a common condition that usually stems from a bacterial infection, a viral infection or, though rarely, a fungal infection. There are certain behaviors, injuries and conditions that make a person more susceptible to developing a sinus infection, which includes hay fever, smoking, trauma to the nose, allergic rhinitis, tooth abscess, as well as exposing the depths of the nose to viruses, funguses or bacteria by way of certain activities like picking the nose.

A sinus infection occurs when the immune system within the body is not able to stop any foreign and harmful fungi, bacteria or virus which have made their way into the sinuses and when the immune system cannot stop them from reproducing. The end result is the sinuses becoming inflamed, and it also results in the symptoms, such as a thick greenish mucus becoming discharged out of the nose, in addition to the facial pressure and pain that hallmarks the condition. Other more severe complications may occur, claiming the brain as a potential source of attack. Symptoms include:

• Coughing;
• Sneezing;
• Tiredness;
• Aches;
• Severe headache;
• Runny nose;
• Morning headache;
• Sinus pain;
• Tenderness at sinus region;
• Watering eyes;
• Fever;
• Weakness;
• Tiredness;
• Cough;
• Runny nose;
• Nasal congestion;
• Green nasal discharge;
• Postnasal drip;
• Sore throat; and
• Disturbed sleep.

Causes

There are several reasons which may result in phlegm:

• Allergies;
• Bronchiectasis;
• Chronic bronchitis;
• Chronic rhinitis;
• Cystic fibrosis;
• Hay fever;
• Hemoptysis;
• Nasal polyp;
• Nasopharyngeal carcinoma;
• Nicotine addiction;
• Postnasal drip;
• Rhinitis;
• Sinusitis; and
• Vasomotor rhinitis.

Risk Factors

Those who smoke are at a very high risk for developing phlegm, as well as those who have recurrent lung infections.

Treatment and Prevention

Treatment for phlegm will ultimately depend on what is causing the condition.

Smoking

The obvious treatment to stopping phlegm that arises due to smoking is to quit the habit. It is common enough for people to contract bronchial and lung infections, but they are far more likely in those who smoke on a regular basis.

If a smoker begins to cough up a greyish or a brown tinted phlegm, it is the body’s way of trying to tell them that they are taking the smoking way too far. Quit immediately before the phlegm begins to become streaked with blood, which will only preclude the inevitable diagnosis of lung cancer.

Sinus Infection

Those who are suffering from a sinus infection, influenza or a cold will find solace in a decongestant or a nasal spray. Even though postnasal drip may not necessarily be considered phlegm since it is the mucous produced by the glands that are present within the nasal cavities, it is nonetheless the most likely reason behind chest congestion. Therefore, consider taking a decongestant, such as Claritin, Sudafed or Zyrtec.

Bronchitis

For those who are suffering from a chest cold or some form of bronchitis, it is possible to take an expectorant in order to loosen up the buildup of phlegm. This is not similar to a cough suppressant, because an expectorant cough medicine intends to loosen up the phlegm in the throat and to cause cough, which is also known as a productive cough because it is productive for those who have an infection the bronchial tubes or lungs, or those who are dealing with chest congestion. A couple of common over the counter expectorants include Robitussin and Mucinex.

For those who wish to be rid of phlegm, they should refrain from taking any kind of throat lozenges or cough suppressants. Unless the cough medicine is explicitly labeled to be an expectorant, it will probably only make the problem of phlegm worse. When taking a medication that intends to suppress coughs or to numb the pain that a cough brings on, this usually results in allowing more phlegm and mucous to build up. This is because taking the medication effectively shuts off the parts of the body that are necessary to produce productive coughs.

Prevention

To keep the phlegm from recurring, spit it out after coughing it up rather than swallowing it again. Phlegm is a sticky film that is full of immunoglobulins and glycoproteins that serve to fight against infections, and it is supposed to attach to the linings of the lungs and the bronchial tubes.

In a manner of speaking, once a person begins to cough up their phlegm, it is a sign that the substance has completed its purpose and requires that it be expelled. Instead of swallowing it, spit it into the toilet or into a tissue. Swallowing the phlegm down again may reintroduce it into the pulmonary system again.

Dry, Peeling Skin: Causes, Prevention Tips and Cures

Peeling skin is a fairly common medical affliction that affects millions of people every year, and some are faced with the issue on a long-term basis. Skin may peel or dry skin can occur for a number of reasons and vary greatly in the level of severity. Besides being an annoying and often embarrassing problem, peeling skin can sometimes indicate that serious damage has occurred to the top layers of skin. In more rare cases, it can also indicate serious underlying medical conditions.

The following text is presented for educational and informational purposes only, and is no substitute for a diagnosis by a medical professional. If you are concerned about your skin or are experiencing troubling symptoms, see your doctor.

Here, explore some of the most common causes for peeling skin, and find out ways to both prevent and treat this condition. If the manifestation of skin problems turns out to be just one symptom of a more serious underlying condition, treatment for the related problem will likely help clear up any peeling.

Common Causes of Dry and Peeling Skin

Skin may begin to peel in relation to extreme dryness. In many instances of extreme skin dryness with peeling, sun exposure can be determined to be the main culprit. Sun exposure can cause skin irritation or damage even when sunblock is used.

This lapse in protection can occur when the exposure time is excessive, if the SPF value of the sunblock is less than 30, if the sunblock is not reapplied regularly or in rare cases where a person cannot tolerate any direct sunlight at all.

Sunburn & Heat Exposure

Sunburn is a major cause of sun-related peeling skin. After the initial injury to the top layer of skin cells from intense direct sunlight, the skin cells dry up, die and will eventually peel or slough off. Raw, painful skin may be revealed under the peeling skin if the damage extended beyond the very first layer, also called the epidermis. The “shedding” of old, damaged skin cells from the epidermis is a natural process when the skin is damaged, and may actually be a natural defense mechanism. To protect the body from damaged cells and allow new cells to generate, the old skin must die and fall away.

Heat exposure without sun is another common cause of peeling skin, increased dryness and other skin irritations. Sun and heat exposure can make skin appear red, itchy and feel hot long after the exposure occurs. Skin may blister in response to a severe sunburn or heat burn, and these types of burns should be evaluated by a doctor. After a period of blistering, usually two to five days, the deadened skin will peel away or “shed”.

Chronic Conditions & Chemicals

Certain chronic skin conditions, such as eczemas or types of dermatitis, can also result in peeling skin. Even babies can display scaly, flaking or peeling skin; this affliction is commonly referred to as “cradle cap”, and it is a type of childhood eczema. The condition has a medical name of seborrhoeic dermatitis, which is just a fancy way to describe yellowed, scaly skin that flakes off of an infant’s head. See possible treatments below.

Chemical exposure can also cause dry skin, and this is most evident on the hands of those who work with them on a regular basis. Even frequent hand washing or use of hand sanitizers, which are deemed necessary by most to prevent the spread of germs, are incredibly damaging to skin. This is especially true in people with sensitive skin. Seeking out soap and other products that won’t dry out the hands is a smart solution for those who must wash up more than five to ten times a day on a regular basis.

Fungi

Certain fungi, such as athlete’s foot, ringworm and jock itch, can also cause skin to slough or peel off. Staph infection and eczema also commonly result in the patient experiencing reddened, itchy, peeling or sloughing skin. These conditions should be treated by a doctor with an anti-fungal or antibiotic regimen to clear up the problem. They are unlikely to go away on their own and can turn serious if left untreated.

In many cases where skin irritation occurs without obvious cause, such as fungi, sunburn or other underlying medical conditions, a bit of peeling skin or dry patches may indicate nothing more than a need for a few lifestyle changes. Poor diet, inadequate water consumption, smoking, vitamin deficiencies, excessive alcohol intake, and, ironically, too much exposure to water can all lead to dry skin and other skin problems.

Serious Conditions

Sometimes, though, peeling skin and extreme dryness may be indicative of a much more serious medical condition. Some types of lymphoma and skin cancer will present with a list of symptoms that includes peeling skin, though only a doctor or other trained medical professional can make that determination.

In some rare diseases, such as with Kawasaki disease and peeling skin syndrome, dry skin and peeling can be a typical symptom. These diseases need to be treated and closely monitored by a medical professional.

Solutions For and Prevention of Dry and Peeling Skin

If a serious underlying medical cause can be ruled out, and peeling skin is just a bothersome, nuisance problem, it is likely a condition that can be treated at home. There are many simple ways to help heal damaged skin and actually begin to replenish moisture in skin at home.

Dry skin may be a result of simple dehydration. Getting started on an active regimen of six eight-ounce glasses of water daily for at least two weeks may markedly improve the feel and appearance of the skin. This is an easy and inexpensive way to try and solve problems with dry skin without a trip to the dermatologist.

Maintaining proper hydration is keenly important to the function of all organs of the body, and the skin is the largest organ of all. Furthermore, the skin is the only organ worn on the outside of the body, exposed to all sorts of external toxins and irritants on a regular basis. Air conditioning or incredibly hot weather outdoors in the summer months can cause dry skin, as can turning on the heater in the winter.

Using Moisturizers

Using a good moisturizer will dramatically improve conditions if the skin is already dry and damaged, and help prevent the problem from recurring. For those with sensitive skin, checking the labels of new body products for known irritants in the ingredients list can help them avoid making the problem worse. There are creams and lotions which have collagen and silicone as main ingredients, and these may help improve the condition of dry, chapped, peeling skin on the hands especially.

The Effects of Water

Cold water can help tighten pores and promote healing of skin cells, so turning the water to ‘cool’ toward the end of a shower may help with peeling and dried out skin. blotting skin after showering or swimming, as opposed to rubbing vigorously can help protect skin. Even a bit of olive oil rubbed into the skin once a week can help replenish skin tone, feel and texture, and may reduce itching, peeling and dryness.

Avoid excessively hot water, as well. While an occasional dip in a heated pool or hot tub is fine, taking scalding hot showers every day is not a good idea. Especially in areas with very dry weather, exposure to water of any kind on a daily basis may promote dry skin and peeling. Showering only every other day during a flare-up of dry or itchy skin and limiting the use of body products that may worsen the problem can help the skin’s moisture levels from being stripped each day.

Washing Daily & Oils

Skin produces natural oils, and these oils serve as a protectant as well as a conditioner. For those with overly greasy complexions, these oils may seem like the enemy. For someone with impossibly dry skin, however, the word “oil” is one of the nicest words in the English language. While many people may shudder at the thought of not washing up every single day, our skin wants a break now and then. Not showering doesn’t mean not washing parts that warrant daily washing, and it doesn’t mean not putting on fresh clothes. Especially with the advances of deodorants and perfumes, most people simply do not truly need a daily shower.

Contact a Dermatologist

If the dry skin and peeling is too painful or severe to treat at home, a dermatologist or a family doctor may be able to provide some other options. Some cases of dry, cracking skin are so resistant to less aggressive treatment that powerful steroid-infused ointments and lotions must be used, usually with some good measure of success. Pain medications can also be prescribed to help the patient handle the discomfort of a severe sunburn, chemical burn or heat related burn.

Home Remedies & Creams

At home, those suffering painful sunburns can take over-the-counter anti-inflammatory drugs such as naproxen and acetaminophen, and apply a topical aloe vera gel to the affected areas. Do not apply salves to blistered skin without a doctor’s recommendation.

Medicated steroidal creams, called corticosteroids, can help babies suffering from cradle cap and other types of dermatitis. While these creams have been shown to be effective, many doctors simply recommend washing the hair with baby shampoo and scrubbing the scalp gently with a washcloth every other day. Many doctors and mothers also recommend massaging baby oil into the scalp after washing baby’s hair. Out of baby oil? Try a few drops of olive oil from the pantry or mineral oil from the medicine chest instead.

Though some people may also claim petroleum jelly will help cure dermatitis of the scalp, the greasiness can actually contribute to the problem. If the condition appears to make the child fussy due to itchy or painful eczema, petroleum jelly will provide soothing relief. In cases where the scaly, yellow patches of crusty skin extend beyond the scalp or behind the ears, such as when they may appear on the child’s face, bother the child excessively, or if the condition has been getting worse over time, it is prudent to see a doctor.

When To Worry About Skin Conditions

Whenever skin is burned so badly that it blisters, if there is an unexplained rash that persists for more than a few days or gets worse, when unusual, new growths are noted or when severe pain accompanies any of the aforementioned, it is time to seek immediate medical attention from a qualified professional.

When possible, go to a skin doctor, or dermatologist, for any serious skin concerns, as this is their primary area of expertise. After all, a person wouldn’t go to a foot doctor for a tooth ache. Most general family practitioners are qualified to handle skin conditions, and you may need to visit one initially to satisfy the referral requirements to see a specialist under your medical insurance, but a dermatologist will likely be more up-to-date in the skin care field and in their knowledge of available treatment options.

A dermatologist will also likely be able to diagnose the root cause of any peeling skin from the onset, and this will help promote speedy but accurate treatment. If skin cancer is determined to be the cause of the symptoms, a skilled dermatologist will likely be able to immediately coordinate a treatment plan, and may refer the patient to an oncologist who specializes in the treatment of that particular cancer, if necessary.

Bruises are the visible result of a trauma that damages or burst the blood vessels under the skin. There are number of traumatic injuries which can cause bruising, most common are blunt or sharp force instrument traumas. Bruises can also appear as a result of a fracture of an extremity or surgical procedure.

Bruises are usually called contusions, when referenced by a physician or medical professional. The mechanism of a bruise is the bursting of capillaries or veins under the skin which allows blood to travel into the subcutaneous tissue and cause discoloration. Anytime the injury, or force trauma, is sufficient to break the skin it is then called a hemorrhage and no longer considered a contusion. In the case of severe injury, a hemorrhage will sometimes cause a bruise around the break in the skin.

Mechanics of a Bruise

In patients with normally functioning circulatory systems, it can take significant trauma to produce a bruise. In patients with blood disorders, certain cancers and other clotting problems bruises may appear with minor traumas. The trauma leading to a bruise can often cause pain; however, a bruise by itself is generally not a medical emergency. In certain situations bruising can be indicative of a fracture or severe internal injury and may require immediate professional medical attention.

The size and shape of a bruise does not always indicate the type of trauma or instrument that caused the injury. There are several factors that may affect the size, shape and extent of bruising:

• Gender. Women naturally carry more fat cells under their skin, subcutaneously, than men and are generally more prone to bruising.
• Age. As human age, skin tends to lose thickness and elasticity. Thinner skin is more susceptible to bruising to due even minor impact trauma.
• Location. In areas of softer tissue, and areas with a more extensive capillary system, bruising is often more prominent. Soft tissue can allow blood to spread further under the skin causing larger bruises. Areas, such as the face, bruise more extensively due to the number of capillaries that can be broken on impact.
• Genetics and skin color. Those with naturally lighter complexions tend to show bruising more noticeably.

Treatments for Bruising

Most minor bruising in normally healthy patients can be treated at home without the intervention of a physician or hospital visit. As with any home treatment of an injury, bruising must be treated correctly or it can be exacerbated. Bruising, even from minor trauma, can appear quite colorful as it deepens and then begins to heal. Some bruising injuries are not even felt by the patient and are only noticed when the area starts turning the characteristic black and blue of a fresh bruise.

Diagnosing the Bruise

The nature of bruises and the process by which they heal are the cause of the rainbow of colors that can be seen as a bruise appears and then subsides. The deep purplish red and blue coloration of a fresh bruise is caused by the gathering of blood under the skin. Prior to the broken blood vessel sealing itself and the blood flow coagulating, swelling can often be seen along with the deep coloration. As coagulation begins under the skin, the deepening of the bruised color will subside and begin to lighten.

Once the blood that has been released to the subcutaneous tissue decays, it will breakdown into its basic components and be removed through the bodies normal healing process. These basic components of blood are what cause the yellow, green and even gold of a healing bruise.

In normal instances of bruising, the fading colors do not indicate whether the blood vessel is healed or not. Usually the damage caused by the trauma has been repaired within the body well ahead of the color changes seen on the outer surfaces of the skin.

Treatment Options

There are several treatments that can be used to treat minor, normal, bruising. Standard rest, ice, compression and elevation can significantly reduce the extent of swelling and bruising to an injury. Ice should be applied, while the area is elevated, in twenty minute intervals, with twenties minutes between applications. Ice should never be directly applied to an injured area; it should always be in the form of a cold pack or ice wrapped in a kitchen or hand towel.

Instant Treatment

The immediate application of cold to the injury can cause injured blood vessels to constrict and the blood flow to coagulate, reducing the severity of the bruising. Compression should be used sparingly, as bandages are often applied to tightly to allow the natural swelling of an injury. Most recommendations indicate bandages should only be used to lightly hold an ice pack in place. Elevation can alleviate the speed of the blood flow into a bruised area and assist in the coagulation process inside the blood vessels.

If the injury is extremely painful within thirty minutes, exhibits significant swelling or immediate dark bruising the patient should be taken to their physician or the emergency room for an examination of the injury. This type of extreme swelling, bruising and pain may indicate a severe sprain or fracture of the injured body part.

Watch Out for Fractures

Fractures will cause immediate swelling and bruising, but not immediate pain. The pain from a fracture will generally make itself known within thirty minutes of the injury. This delay of pain is due to the body’s release of endorphins in response to a severe injury. Not all fractures will display immediate bruising, but most will. Severe sprains will also cause immediate swelling; however, unlike most fractures, sprains will be severely painful almost immediate following the injury.

Rest and Over the Counter Medicines

Once the immediate swelling has subsided, it is imperative the patient rest the area that has been damaged in order to prevent re-injury and more serious damage. Heat can be applied to ease any remaining pain in the area, though it should not be applied for more than twenty minutes at a time and not until at least three days after the occurrence of the injury. If even gentle heat is applied prior to the blood vessels healing themselves internally, additional blood can flow into the injured area and cause more extensive and painful bruising.

Over-the-counter pain medications are often helpful in alleviating the immediate pain of a traumatic injury. Patients should not use standard aspirin to alleviate the pain, as aspirin is a natural anti-coagulant and will cause blood flow to an injury to increase. The increased blood flow can irritate any bruising or swelling in an injury. Over-the-counter NSAIDS are safe to take to alleviate the pain of a bruising injury as they do not affect the body’s natural ability to coagulate blood.

Normal bruising, due to minor trauma or injury, is easily treatable in the home without a visit to a physician. Even with the ease of home treatment, patients with bruising should be watched for significant changes in the severity of the bruising or increasing pain in the injured area.

Effectiveness of Treatment

Bruising on the extremities will generally take longer to heal, due to the decrease in capillary and blood vessels in these areas. Additionally, bruising on the legs can sometimes seem to travel downward, toward the feet. This is due to simple gravity affecting the flow of the blood from an injury and causing it to travel downward.

While home treatment is often recommended, especially with bruising from minor trauma, bruises can take a significant amount of time to heal. It is rare for a physician to recommend any treatment beyond rest, ice, compression and elevation for a simple bruise. Depending on the patient’s natural ability to heal internally, bruising can take between two and four weeks to completely subside. During the healing process, the patient should take care not to re-injure the bruised area as this can cause additional risk internal damage.

Other Causes of Bruising

There are several medical situations that may cause bruising that is not related directly to a traumatic injury:

• Medication. Aspirin regimens and blood thinner are intended to prevent blood from coagulating and clogging arteries in the heart, brain and extremities. Dosages of these medications may need to be adjusted by the treating physician if the patient is experiencing excessive bruising. This can indicate the blood is not clotting at all and can be dangerous.
• Chronic inflammatory disease. Diseases that affect the circulation, such a lupus, can cause a patient to experience excessive bruising.
• Cirrhosis of the liver. The liver is a major part of the circulatory system and any defect or damage to the liver can affect blood vessels and cause excessive bruising.
• Cancer. Cancers that affect the circulatory system can cause blood to not clot normally and patients may experience excessive bruising.
• Malnutrition. Deficiencies in certain types of vitamins in the diet can cause excessive bruising and affect blood clotting.

Patients with unexplained bruising that occurs without significant injury or without the knowledge of the patient should talk to their physician about possible blood disorders. Children who appear to bruise easily or cannot easily explain how bruising occurred should be watched closely for other signs of possible abuse. Bruising in areas such as arms, face, upper back and neck can be an indication of abuse and not normal childhood injury.

Bruise Prevention

It is extraordinarily rare for anyone to go through life without experiencing an injury significant enough to cause a bruise. There are some who bruise more easily than others and some who are rarely seen with any type of bruising. Most daily activities bring the human body into contact with some object which can cause a bruise and most people don’t even notice small, minor bruises resulting from a bump or scrape with an encountered object.

Children are often the recipients of minor bruising injuries as they grow and learn coordination and object avoidance. In general, children receive minor injuries during normal play activities at school, at home and playing with other children. People who practice what is considered risky behavior such as participating in extreme sports or playing for professional or amateur sports teams tend to encounter circumstances that will cause injury and bruising.

Paying attention to surrounding and objects will usually allow a large segment of the population to avoid encountering injury that will cause bruising.

Bruises can be uncomfortable, painful and even unsightly. Even with the noticeable coloration and attendant pain, bruises are generally not life threatening and do not usually indicate a more serious underlying medical condition. If a patient is unable to avoid a situation that causes a minor injury resulting in a bruise, standard home injury treatment can alleviate the pain, discomfort and swelling. Care must be taken not to exacerbate the injury, or the bruising, and within a few weeks the bruising will subside and disappear.

Basic Description and Alternative Names

Lethargy is a persistent condition characterized by constant tiredness. Normally it is also defined as a physical state of sluggishness, where the patient is unable to summon the energy to do any tasks involving even minimal physical labor. This condition is also marked by a persistent inability to feel rested, even though the patient may be able to sleep. Lethargy is also called fatigue, exhaustion, languidness, languor, lassitude and listlessness. Lethargy is to be distinguished from boredom, however, as boredom does not involve the low energy levels that this syndrome does.

Weakness, however, is different from lethargy because lethargy may not involve excessively low energy levels. This is part of the confusion surrounding the term. Lethargy often is used simply to mean that the person in question is tired, but it can be a symptom of a much larger and serious problem that needs medical attention.

Variety of Causes

Whether the symptom in question is weakness or fatigue, both are symptoms and not diseases in themselves. Lethargy can be a physical or a mental condition, depending on the conditions that led to it. It is important to understand that the presence of lethargy merely indicates the presence of something deeper that is severely out of harmony with the patient’s physical and mental system.

Lethargy can arise out of many different sources, both within the body and external to the body. A certain organ may be out of balance, or perhaps the lymphatic or nervous systems are overtaxed. In many cases the patient simply needs rest from the intense nature of modern life.

The stressful conditions many unfortunate individuals find themselves in account for many cases of fatigue where they simply use up all their energy and begin to collapse.

Symptoms of Lethargy & Fatigue

It is confusing to identify lethargy because the word is used as shorthand for many different symptoms, some of which have nothing to do with the condition itself. To specify what set of symptoms to refer to, throughout the rest of this article the word ‘fatigue’ will be used instead as that word is more specific. Even that term runs into definition problems, but for the purposes of this article it will suffice.

The distinguishing factor is time. If fatigue lasts longer than two weeks, it probably requires a visit to the doctor. Fatigue can involve other symptoms even though it is itself usually a symptom of something else. Common symptoms include:

• Fainting or the feeling one is about to faint
• Heart palpitations
• Dizziness and vertigo
• Shortness of breath
• Irritability
• Depression
• Appetite loss
• Digestive problems
• Susceptibility to other illnesses

Many of these conditions overlap with one another in terms of the diseases that may be responsible for them. Therefore, it can be very difficult to identify which are indications of fatigue or lethargy and which are indications of some other disorder. The problem is exacerbated by the fact that fatigue is notoriously difficult to pin down in terms of what is the best course of action to alleviate it.

Often times the only thing that can be done is help the patient recover as much as possible until the subjective feeling of fatigue lifts. Once that is accomplished, the patient may go on to develop other symptoms that then indicate what the true source of the problem is. Depending on the seriousness of the problem, the patient may need medical attention for an extended period of time. It is extremely important to discover what the fatigue is hiding within the patient’s bodily system. Otherwise, the patient could become extremely ill.

Causes of Fatigue

Fatigue is a persistently low level of what might be called subjective energy. In other words, fatigue is the loss of the ability to fully participate in life. The patient may be getting seven or eight hours of sleep per night and still not feel rested or feel as if they have enough energy to do normal activities. Their work and personal lives will likely be disrupted by this condition. It is in the patient’s best interests to recover from this state as soon as possible, in order to restore a healthy confidence and optimism about life and its many interests.

The causes of fatigue are multifaceted and can be and often are very confusing in that the same purported ’cause’ is responsible for multiple ‘effects’. It is easier and more convenient to think of fatigue as simply a condition that unfolds from the presence of certain factors. Some of these factors are psychological, others are physical. They include:

• Allergic reactions that operate beneath the level of normal awareness. Reactions of this type can be slow, like asthma and not involve violent symptoms, like sneezing, coughing, etc.
• Anemia may be the responsible factor, although this condition does not always result in fatigue. Anemia is most commonly the cause of fatigue in women, especially during the conclusion of the woman’s menstrual cycle.
• Depression can and does easily lead to fatigue in both men and women. This intense psychological condition leads to fatigue because the associated neurochemistry changes the homeostasis of the hormonal and muscle systems. The loss of energy can be directly attributed to the depression of the body through the neuro-psychological correlates in the brain and nervous system.
• Pain can also lead to low energy as the nervous system becomes overtaxed and the body partially shuts itself down in order to survive and cope.
• Sleep disorders, with their concordant exhaustion of the entire body, are the most common factors resulting in fatigue.
• Thyroid problems can also lead to low energy and fatigue, especially if the thyroid gland is operating at too high a level or too low a level. Either case leads to significant changes in the body’s energy level.
• The use of alcohol and recreational drugs. These sedatives and stimulants directly affect all the major organs of the body, especially those of the digestive system. This leads to fatigue as the body processes the major toxicity out of the organs.

Risk Factors Associated With Fatigue

When it comes to fatigue, risk factors for fatigue can often be the factors that contribute to the presence of fatigue. Paradoxically, this makes risk factors for fatigue harder to identify because fatigue is so hard to define in terms of definite results. Unreported factors by patients may in fact be the key to identifying the source of fatigue. Even if physical testing is carried out, the results may not be accurate enough to come up with an effective diagnosis. Nevertheless, there are definite factors that can be identified and used to guess at the source of fatigue.

In particular, factors that put one at risk come from physical, mental and environmental sources. They include:

• Whether the patient is a woman, since women are more likely to talk with their doctor about feeling fatigued than men.
• Whether the patient drinks alcohol in any amount, or takes recreational or hard drugs such as cocaine, heroin, etc. This is the most serious condition resulting in fatigue, as well as other symptoms like cognitive impairments and psychological disorders.
• Environmental factors such as exposure to electric, electromagnetic or nuclear radiation, toxic chemicals, and other pollutants and toxins.
• Psychological disorders and mental illnesses.

Risk factors for a loosely-defined condition such as fatigue can be any number of things that make up the everyday life of a patient. In many cases, it may simply be that the patient is not happy with his or her life. In that case, minor or major changes may need to be made to effect a change in the condition itself. Social factors may also contribute to fatigue, as well as neurochemical abnormalities and even common diseases like the cold and flu.

The presence of any one of these factors could indicate a risk for fatigue. The patient is strongly recommended to do as much research as possible into the factors in their everyday lives, as altering these may be the best way to alleviate fatigue.

Tips for Preventing Fatigue

The best way for patients to prevent fatigue from even happening is to increase their energy levels. They can do this by changing their dietary habits as well as by changing their daily routine. The easiest thing they can do is make sure they never skip breakfast in the morning. When people wake up in the morning, the prolonged state of inactivity during the night leaves their body with low blood sugars in the morning.

In addition, when the body goes without food for too long, it starts to rely on internal food stores in order to survive. Therefore, it is important to eat breakfast every morning in order to keep the body’s energy levels high.

If the patient suffers from any form of anemia, it is important for them to check their iron levels on a daily basis. Anemia often results in fatigue since there is not enough blood to carry oxygen and carbon dioxide from the lungs to the body and vice versa, respectively.

Keeping Organized

Psychologically speaking, the best way to prevent fatigue is to keep one’s life organized as much as possible. Plan out everything in advance and keep everything harmonized with personal preferences and styles as much as possible.

Many times things are simply out of whack due to circumstances that clash with personal lifestyle, especially if one feels forced to do something one does not want to do freely.

Exercise can also give patients the energy boost they need. Many times this can be as simple as going for a walk on a daily basis. Find an enjoyable physical activity that gets the heart pumping. Exercise also releases endorphins in the brain which help to change the neurochemical components of the patient’s mental state. This, in turn, helps prevent other conditions such as depression from occurring.

Diagnostic Considerations

As noted above, fatigue is a notoriously hard symptom to ascribe to any one disease or factor or source. For this reason, testing involves running an entire battery of examinations on the patient in order to determine what the precise source of the symptom is. This process is complicated by the fact that many of these tests trigger certain responses in the body that can mask or mimic other diseases, so the true origin of fatigue may not even be identified. That combined with the expense from tests and many patients are likely to give up before even identifying what the true source of their disorder is.

The biggest difficulty in identifying fatigue is in making sure that the patient is actually suffering from fatigue. They could be suffering from another disease manifesting itself in tiredness, low energy, etc. Or they could be suffering a serious disease known as chronic fatigue syndrome. CFS is even more notorious than fatigue because, while being easier to identify, it is known for being harder to get rid of.

Treatment Options

The best treatment for fatigue is to develop healthy lifestyle habits. These consist of mostly behavioral do’s and don’ts, but some are psychological, as well. For instance, avoiding heavy metal rock music or punk rock or any of the currently popular music styles that are considered ‘heavy’, ‘metal’ or ‘dark’ is a good way to make sure that your overall mental state remains positive and not depressed, angry or fearful. These three emergency emotions are responsible for draining a significant portion of the body’s energy, resulting in fatigue and other symptoms like weakness and the inability to wake up feeling restful despite heavy sleep.

Home Remedies

The majority of treatments for fatigue involve home remedies, and there are not many pharmaceutical treatments available for common fatigue as there are for CFS. The key is to make sure that the patient remains at peace with their external circumstances and not get involved in any potential conflicts. Avoiding conflicts in their personal and professional lives will lead to a greater sense of well-being and provide a stable emotional foundation for the patient to draw on. This will, in turn, create a greater sense of self-reliance and increase the patient’s confidence in himself.

When this happens, energy levels rise significantly since the patient stops relying on external circumstances to give him guidance and purpose. When people realize the source of power is within themselves rather than external to themselves, that denotes the beginning of true recovery from fatigue. It is remarkably easy to do so, but fatigue itself is not the problem: uncovering the attitudes, belief systems and decisions that form the psychological underpinnings of fatigue reveals that the problem has always, in fact, been the patient himself.

Conclusion

Fatigue, like so many other symptoms, is indicative of a larger problem within the patient’s life. Uncovering this problem and addressing it enables the patient to regain lost energy levels and return to participating in life.

Each year thousands of people suffer from heat related illnesses. Some of these illnesses can be treated by taking time to rest and drink fluids, but heat stroke, the most serious of these conditions, may require intense medical treatment. Heat stroke should not be confused with other heat disorders that are less severe. To understand heat stroke, it is necessary to define related heat disorders.

Conditions that may be confused with heat stroke

Heat stroke is not to be confused with heat cramps which are the result of strenuous activity during hot weather. Excessive sweating leading to loss of salt and fluid causes heat cramps. Heat cramps are felt as muscle pain or spasms in the abdomen, legs or arms. Usually resting and drinking fluids such as sports drinks will help an individual recover from heat cramps.

Heat exhaustion is usually a condition that is seen in older adults, especially those with high blood pressure. However, people who work in settings where the temperature is hot and those who do strenuous exercise in hot weather can also suffer from heat exhaustion. Heavy sweating, muscle cramps, weakness and dizziness are all symptoms of heat exhaustion. Some people also experience nausea and vomiting. Heat exhaustion that is not treated can lead to heat stroke.

Heat Stroke

Heat stroke is sometimes called sun stroke or hypothermia. “Hypo” means high or excessive and “thermia” means heat, thus hypothermia means excessive heat. Heat stroke is the most severe of the heat related illnesses. When a person suffers a heat stroke, the core body temperature rises to dangerous levels. When the body temperature rises higher than 40 degrees Celsius or 104 degrees Fahrenheit a person is diagnosed as having a heat stroke. When an individual suffers heat stroke, the body is not able to give off heat fast enough, which causes the temperature to increase.

Usually heat leaves the body through perspiration or sweat, which evaporates. When temperatures are extreme or humidity is high and the body does not have enough fluid for sweating to occur, it can become overheated. Adults lose about ten cups of water per day through sweating, breathing, and urination. Diarrhea and vomiting also cause fluid loss. In extreme heat conditions profuse sweating can cause additional fluid loss. Certain medications, especially those with diuretic effects can lead to dehydration. All of these modes of fluid loss can impair the body’s ability to dissipate heat by sweating.

Being exposed to high heat environments while working; doing yard work on very hot days, living in a house without air conditioning, or being inside of a hot car can all cause heat stroke. The body’s response to heat becomes more severe as people grow older. In extreme conditions, a seventeen year old might suffer heat cramps, but in the same situation, a sixty year old may suffer a heat stroke due to age.

Types of heat stroke

There are two categories of heat stroke. Heat strokes may be caused by exertion. This type of heat stroke is generally experienced by younger persons who exercise, work or play sports for long periods of time under extreme heat conditions. This type of heat stroke is known as exertional heat stroke or (EHS).

The other type of heat stroke is non-exertional or (NEHS). Young children, older adults and those with chronic illness usually suffer this class of heat stroke. Non-exertional heat strokes occur in extremely hot weather or heat waves which may be unusual for an area. Both types of heat stroke can be deadly if not treated immediately.

People who are at high risk for heat stroke

Anyone can be at risk for heat stroke. Older adults, young children, people on certain types of medications, sick persons, those who work outside during the summer and people who engage in strenuous exercise in hot weather are all at risk. Obese persons and those who are not physically fit and those who suffer from chronic illness are among those who are at high risk for non exertional heat stroke.

Symptoms of heat stroke

Knowing the symptoms of heat stroke can help individuals prevent the condition or save someone’s life. The symptoms of heat stroke include increased body temperature, red, flushed skin, rapid heart beat, difficulty breathing, confusion, odd behavior, disorientation, seizures, coma and in children, fussiness and sleepiness in children.

Cures and remedies for heat stroke

Heat stroke is a medical emergency. If heat stroke is suspected, 911 should be contacted immediately. Failing to get immediate help for heat stroke can lead to serious health problems including permanent organ damage and death. Rapid cooling of the victim’s body should begin right away. While waiting for medical help to arrive, heat stroke victims should be put in a cool place or in a shady area. The victim should be cooled down by removing the clothes and using a cloth or sponge to apply cool water liberally to the skin.

If a garden hose is available cool water can be sprayed on the individual’s body to cool them down. Other options include wrapping the victim in cool wet sheets or placing them in a bathtub of cool water. Ice packs under the armpits or in the groin are also recommended to speed cooling. Medications such as aspirin and acetaminophen should not be used.

While these are used to treat fevers, they are not effective in cooling down a person who has suffered a heat stroke. Temperature should be monitored using a thermometer. Emergency medical personnel can provide guidance to help keep the person with heat stroke safe until they can arrive.

Once an individual arrives at the hospital other measures can be used to reduce body temperature to a safe level, including giving intravenous fluids and hemodialysis. A fan is sometimes used to help cool the body.

Prognosis

Heat stroke can be treated successfully with many people enjoying full recovery. The risk of death from heat stroke depends on several factors including age–how old or young the victim is; whether the victims has conditions such as heart and lung problems, and whether there are issues with the kidneys or liver.

The body temperature level and how long the body temperature remains high can impact whether a person will recover fully. It should be noted that in about 20% of people who suffer heat strokes, there can be permanent damage. Brain function can be impaired leaving a person with poor coordination, inability to perform some tasks, and personality changes. The kidneys can also suffer permanent damage.

Preventing heat stroke

Hundreds of deaths occur each year due to heat stroke, but these deaths can be prevented. During heat waves or extreme hot weather, family members and friends should make a point of checking on elderly neighbors to make sure they have a cool environment as well as food and drinks to provide adequate hydration.

Get adequate amounts of fluid

Staying hydrated is a key factor in preventing heat stroke. Drinking plenty of water or sports drinks during strenuous activity can help keep the body cool in very hot environments. The best choices are caffeine free, alcohol free and low-sugar drinks since those with caffeine and sugar can cause fluid loss.

Lack of thirst is not an indicator of whether an individual needs to drink fluids. Adequate fluids should be consumed even when a person is not thirsty. Three to four cups of water per hour or low-sugar/sugar free sports drink can keep the body hydrated in extreme heat. Eating plenty of fruits and vegetables can also provide fluid. Foods like lettuce, watermelon, broccoli and apples are good choices since they are 80-95% water.

Other preventive measures

Listen to weather reports. In extreme weather conditions, television meteorologists usually provide warnings concerning heat conditions that could be risky.

Anytime the body works hard more heat is generated, so working outside in extremely hot conditions adds to the chance of a person developing a heat related illness.

Hot, humid, muggy, and high ozone conditions increase the likelihood of heat related illness. When working or exercising in hot weather, wear light-weight, light colored clothing.

Clothes made with special fibers designed to wick moisture away from the skin are good choices. A hat and sunglasses will also help keep the body cooler.

Take rest breaks in the shade. When working with others make sure that there is an emergency plan in place for dealing with heat stroke. Schedule strenuous activities for a cooler part of the day. When going to amusement parks, make sure that there is plenty of water to drink, especially in situations where much walking and long lines require waiting in the hot sun. When vacationing in tropical climates the same precautions to avoid heat stroke should be taken.

Keep an eye on young children who play outdoors during hot weather. Like adults, children need to take rest breaks and drink enough fluids to prevent heat related illness. Sunburn can contribute to a rise in the body temperature so using a good quality sunscreen is essential when spending time outside during hot days.

Air Conditioning

According to the Centers for Disease Control, “Air-conditioning is the number one protective factor against heat-related illness and death.” In homes without air conditioning in temperatures of 90 degrees or higher, fans may do little more than stir up hot air and may not effective in preventing heat stroke when the weather is extremely hot. Residents should find places where they can cool off on very hot days. Some cities open heat relief shelters or special places where people without air conditioning can go to stay cool during heat waves. Going to a library or shopping mall to cool off during the hottest part of the day can help, as well as taking a cool shower or sponge bath.

Keeping Cars Cool

Never leave children, adults or pets in cars. The temperature inside of a car can reach a dangerous level quickly, even on cooler days. Temperatures can rise about 20 degrees Fahrenheit within 10 minutes in a car where the windows are slightly open. Children or adults left inside will be at serious risk of heat-related illnesses. When a child is left unattended in a hot car, it is very likely that a heat related death can occur.

When traveling with infants and young children remember that they should never be left in a parked car even if the windows are cracked open. The Centers for Disease Control recommends leaving a stuffed animal in the car seat. When the child is buckled in, place the stuffed animal in the front of the car with the driver. This serves as a reminder that a child is buckled in the car seat. Always check the care to make sure all passengers are out including children and pets. Never leave a child in the car awake or sleeping, while running a “quick” errand.

Heat stroke and other heat related illnesses can be prevented. Taking time to practice heat stroke prevention strategies can mean the difference between life and death or disability.