Female Sterility

Female sterility is also known by the more common name of female infertility. In women, infertility is the inability to conceive a child. Alternative names for female sterility include pelvic inflammatory disease and polycystic ovaries, although these properly refer to only two of the diseases that can be responsible for female infertility.

Popularly, female infertility is known as inability to conceive or unable to get pregnant. Unfortunately, there is a certain stigma associated with this particular medical problem. Both men and women feel that their equipment is inadequate. Counseling may be needed in some cases in order to help a particular couple understand what their options are.

Symptoms and Risk Factors of Female Sterility

The most obvious symptom of this problem is the woman failing to achieve pregnancy after at least one year of sexual intercourse without any form of contraception. There are many other symptoms that couples can use to determine if either the woman or the man is sterile or infertile. Keep in mind that it is entirely possible for a woman to have regular menstrual cycles, a healthy sex life, have none of the risk factors and be healthy in general, and yet still suffer from infertility. This highlights the incredible sensitivity of the reproductive system to even minor changes in a couples’ sexual regimen.

The above notwithstanding, there are several warning signs that couples can use to indicate female infertility before they start trying to get pregnant for a year on their own.

Irregular menstrual cycles

This is the first and biggest warning sign of female infertility or sterility. The irregularity can be either too short or too long, for example less than twenty-four days and more than thirty-five days, respectively. If the woman’s cycles are completely unpredictable, that is the largest warning sign of all. Irregular cycles could be an indication of problems with the woman’s ovaries.

Uncommon bleeding and cramps

Menstrual bloodflow lasting anywhere from three to seven days is completely normal. However, if that bloodflow is extremely light or extremely heavy, or if the woman has intensely painful cramps during discharge, that is another sign of possible infertility. Another sign in this area is if the bleeding changes significantly from month to month.

Age

As the woman ages, the chances of getting pregnant decrease dramatically. This is due to a simple biological fact: the female reproductive system is only able to produce children for a certain period in her life. After the woman reaches thirty-five, it is highly unlikely that she can get pregnant at all. Even after thirty, the odds decrease significantly. This is because the reproductive system gradually begins to enter menopause and cease ovulating. If the woman is over thirty-five and fails to achieve pregnancy after six months of sexual intercourse, the couple should seek out medical advice.

Male impotent and ejaculatory problems

Infertility on the male side is not so obvious to detect; it’s unlikely that the couple will notice it themselves, although they might if the male fails to ejaculate at all. The best way to determine if there are male infertility problems is to get a sperm analysis done on the man’s semen. Sexual dysfunction on the part of the male is a definite red flag for female infertility. It counts as female infertility because the couple acts together as a unit to produce a child; a problem with one is a problem with both.

Weight problems

If either the man or the woman is overweight or underweight, that can lead to infertility problems, as well. Fertility is an intimate part of the body’s homeostasis, and dietary problems can directly affect a couple’s ability to conceive.

Miscarriages

A miscarriage, or spontaneous abortion, is the loss of a gestating infant within the first twenty weeks of pregnancy. In other words, the pregnancy terminates itself. This can be an emotionally devastating event for the couple. If the woman has had three miscarriages in a row, that is a definite sign of fertility issues. According to the American College of Obstetricians and Gynecologists, miscarriage is the most common type of pregnancy termination.

Chronic illness

If either of the partner’s have any illnesses classified as chronic, such as thyroid problems, hypertension or diabetes, this could also be an explanation for infertility. Since the reproductive system is intricately linked to the body’s production of hormones, any problems with any of the hormonal glands as a result of illness will definitely result in fertility being affected in both men and women.

Cancer treatments

If either partner has been treated for cancer, especially cancer relating to any organ near the reproductive system, that could have resulted in complete sterility in one or both partners. Radiation therapy is particularly devastating to both male and female reproductive systems.

STDs

Sexually transmitted diseases are known causes of infertility problems in men and women. Get screened for STDs if either partner has had unprotected sex with anyone else.

Smoking and drinking

Doing either of these things while pregnant is strictly prohibited, as everyone knows. Smoking and drinking while trying to get pregnant is also damaging to fertility, as well.

Causes of Female Sterility and Infertility

• Many symptoms of female infertility are also causes of female infertility, as the previous list demonstrates. That being said, there are definite causes of female infertility that have nothing to do with dietary habits, sexual dysfunction, or anything that either of the partners controls. The two biggest reasons why pregnancy fails to occur is the ovaries not producing eggs, or the fallopian tubes not functioning properly.
• Ovulatory issues account for thirty percent of women’s infertility, and tubal problems account for a further twenty-five percent. The remaining sixty-five percent are due to other issues relating to particular biological or biochemical imbalances and irregularities. For instance, ten percent of infertility problems result from a condition called endometriosis. This is where the lining of the uterus, which ordinarily catches and nurtures the developing embryo, grows so quickly and so fast that the embryo cannot be caught. Sometimes this condition even destroys embryos due to the excessive growth.
• Endometriosis is characterized by heavy, long and painful menstrual periods as the uterus discharges the overly large uterine lining. Sometimes there are no symptoms whatsoever. This is because endometriosis has no link between how severe the condition is and how severe the symptoms are. This makes it very difficult to identify.

Aside from a condition such as this, the causes of infertility as they relate to ovulatory problems are as follows:

Hormonal problems

Fortunately for women suffering from ovulatory irregularities, if the problems are the result of hormonal issues, they can be treated in seventy percent of cases by drugs like Clomiphene and Menogan/Repronex. Hormonal problems result in the failure to produce mature eggs, malfunction of the hypothalamus gland, which operationally leads to the failure to produce mature eggs, and the malfunction of the pituitary gland, which also leads to the failure to produce mature eggs.

The hypothalamus sends a hormonal signal to the pituitary gland, which in turn notifies the ovaries to bring an egg to a mature state. The malfunction of this system results in the inability of the ovaries to product mature eggs, hence leading to infertility.

Damaged ovaries

If the ovaries have been physically damaged, they will likely lose their ability to produce eggs at all, much less mature ones. Damage can result from trauma, invasive surgical procedures or infection from sexually transmitted diseases.

Premature menopause

As of yet, this is an unexplainable condition. There is simply no reason why this should occur, yet it does. A possible hypothesis is that the female runs out of the supply of eggs earlier in life than she should.

Follicle problems

The ovary stores eggs in little capsules called follicles. Ordinarily, a mature egg would be released by the follicle, but when the follicle suffers problems, this does not occur. The egg is not released from the ovary and therefore does not become fertilized by the man’s sperm. If this occurs often enough, pregnancy may be prevented altogether.

The causes of infertility as they relate to tubal problems are as follows:

Infection

This is the most common cause of problems with the fallopian tubes. The infectious agent, which can be either bacteria or viruses, is usually transmitted sexually. There are other diseases, especially those affecting the vaginal canal, kidneys, bladder and other organs surrounding the area that can easily spread to the fallopian tubes. Infection causes the tubes to inflame in an attempt to fight the disease, which leads to scarring and permanent damage if the infection is not countered or treated.

Abdominal diseases

Appendicitis, colitis and other diseases affecting the abdominal region can easily spread to the reproductive system. The same result occurs no matter what the disease: the fallopian tubes inflame to fight the infection, which leads to scarring and permanent damage.

Previous surgery

Pelvic and abdominal surgery can accidentally damage the fallopian tubes, which leads to the same result. Adhesions resulting from surgical instruments can block the tubes to such an extent that eggs cannot travel through them.

Ectopic pregnancy

This is an extremely dangerous and potentially deadly condition for the woman. The egg is fertilized and implanted in the fallopian tube instead of the uterus. If this condition continues, the woman will face an infant growing in a place that cannot accommodate it. The organ will eventually burst under the pressure, which can cause severe internal bleeding and threaten the woman’s life.

Congenital defects

These are extremely rare operationally, but some women are simply born with tubal irregularities that have nothing to do with disease, surgery or reproductive malfunction.

Preventing Female Sterility

Sadly, most causes of infertility cannot be alleviated through preventative measures. On the other hand, this in no way means that couples should not take care when trying to conceive. There are certain lifestyle precautions that must be met. This includes physical and emotional health precautions, since conception involves optimum factors of both sides of a couple’s life.

Some basic lifestyle precautions are:

• avoid excessive exercise as it can lead to menstrual disorders
• do not take any recreational drugs whatsoever
• quit smoking
• minimize caffeine consumption
• use stress-relief methods that do not rely on alcohol
• abstain from sexual intercourse outside of marriage
• maintain a constant body weight
• avoid exposure to environmental hazards, such as pesticides, heavy metals and electrical, electromagnetic, and nuclear radiation
• keep a monthly chart of menstrual cycles, as this is the best indicator of the woman’s health

Researching fertility history on both sides of the couple’s family is an excellent way to prepare for any surprises. For women, the mother’s genetics can play a huge role in determining any congenital defects. For men, their father’s virility can play an equally large role, as well. Look into any medications either partner is taking for implications or consequences for fertility, as certain drugs can alter the body’s normal functionality in terms of reproductive health and other bodily systems.

Test Considerations

Both the man and the woman should be tested for infertility upon failure to conceive, aside from taking all the preparatory measures they can.

Treatment Options

There are three types of treatments for female infertility: herbal remedies, drugs and surgical procedures. Here is an examination of each one in turn.

Herbal remedies

• Banyan roots, jambul or jamun leaves and the herb known as winter cherry are the best at handling female sterility. Banyan roots are tender and should be dried in shade before being crushed and powdered. Banyan roots are best administered in the form of twenty grams mixed with approximately one hundred grams of milk. Take them at night for three consecutive nights after the end of the woman’s monthly cycle. No other food should be eaten for a short while thereafter. Continue administering the roots every month after the completion of her cycle until conception takes place.
• To prepare a remedy using jambul or jamun leaves, pour two hundred and fifty mililiters of boiling water over twenty grams of leaves. Let it steep for two hours, and then take them either with two teaspoons of honey or two hundred mililiters of buttermilk.
• Finally, winter cherry is prepared by powdering it and mixing it in the amount of six grams with one cup of milk. The woman should drink this mixture for five or six nights after menstruating.
• Keep in mind that herbal remedies can have serious side effects, such as heart attacks, strokes and seizures. This danger is especially so when mixing herbal remedies with drugs, since the herbs amplify the effect of the drugs. The cost of herbs is pretty negligible; most of them can be purchased cheaply for five to twenty dollars per container.

Drugs

• As noted above, ovulatory disorders are responsible for about thirty percent of fertility issues. There are two drugs that are used to treat problems of this type: human menopausal gonadotropins such as Pergonal and Fertinex, and clomiphene citrates like Clomid and Serophene. Both of these can be supplemented with other drugs, and there is an increasing variety of drugs that are used with them.
• A typical cycle of clomiphene citrate will cost around fifty to one hundred dollars. Side effects can include hot flashes, mood swings, headaches, nausea and vomiting and even ovarian swelling and cysts. A cycle of hMG will cost eight hundred to one thousand dollars and must be administered by injection. Side effects include fatigue, mood swings, headaches, bloating and weight gain, and most seriously swelling at the site of injection. There is a significant risk that the ovaries will become overstimulated using hMG, and other drugs will probably have to be prescribed in order to keep this from happening.

Surgery

• Surgery is usually called for with problems relating to the cervix, such as structural problems. Abnormalities within the reproductive system, for example in the fallopian tubes, can usually be corrected with surgery. Almost all physical problems can be treated with assisted reproductive technology, which involves such techniques as artificial insemination, a relatively well-known procedure. Surgery can lead to serious problems if not performed with the utmost care, so make sure you locate a specialist that you trust.

Conclusion

Female sterility or infertility can usually be treated. Even if all of the above solutions fail, adoption or surrogacy are always viable options for couples who want children.

Bed Sores

Bed sores are breaks to the skin’s integrity, caused by insufficient blood circulation to affected tissues secondary to sustained pressure. Individuals at risk for developing bed sores are those whose primary diagnosis renders them immobile, the wheelchair bound, for example, or patients confined to a bed. Bed sores occur most often over bony areas like the shoulder blades, tailbone, the hips, the ankles, the heels, or the elbows.

When an individual remain in one position for too long, restricted blood flow can lead to decreased oxygenation to the skin over these body parts. The result? The affected tissues begin to die.

Bed sores are one of mankind’s oldest afflictions. They’ve been found in excavated Egyptian mummies and were first described in the scientific literature in the 18th century. Today between 3% and 10% of all hospitalized patients develop decubitus ulcers.

In nursing homes that figure hovers between 17% and 28%.

It’s been estimated that the treatment of bed sores cost the American healthcare industry over one billion dollars a year.

That is a remarkable figure when you consider the fact that most medical experts agree they can be prevented altogether by changing position every two to four hours

Alternative Names

The term “bed sore” is something of a misnomer since outbreaks are not confined to the bedridden.

More properly the wounds are referred to as “decubitus ulcers” (from the Latin decumbere meaning “to lie down.”)

Occasionally they are also called “pressure ulcers” or “pressure sores.”

Symptoms of Bed Sores

Any person who remains in a single position for a length of time is at risk for developing skin breakdown. The National Pressure Ulcer Advisory Panel, a research and advocacy group, classifies pressure sores into four stages using the depth of the lesion as its criteria. (Note that not all pressure sores follow this progression.)

• Stage I

  The affected area appears reddened and blanches to the touch. (In people with darker skin, the area will seem bluish or ashen.) The affected area may hurt or itch. The skin patch may feel warm and seem hard or spongy. When the pressure source is relieved, these symptoms generally disappear within 24 hours.

• Stage II

  A lesion has appeared on the affected area that resembles a blister or an abrasion. It’s not deep – generally it involves the destruction of only the most superficial layer of skin although occasionally it reaches into the underlying dermis. Surrounding tissues may show some discoloration.

• Stage III

  The lesion develops a crater-like appearance as the damage extends into the subcutaneous fatty tissues.

• Stage IV

  The lesion extends even more deeply, often affecting the fascia, the muscles, the tendons and sometimes even the bones. Wound drainage and foul odors may indicate the presence of secondary bacterial infections.

• Unstageable

  Some decubitus ulcers are so severe they cannot initially be staged: eschar (dead tissue) or other wound detritus obscures the mouth of the lesion, making it impossible to estimate its depth.

Diagnosis in the early stages is not always a simple matter. Caregivers need to familiarize themselves with the first signs of skin breakdown because as a decubitus ulcer penetrates into the deeper skin layers, the chances of complete healing decrease.

Causes of Bed Sores

Bed sores have a single, simple cause: uninterrupted pressure (in excess of the capillary refill reflex) to the affected area. In some cases, irreversible damage may begin to occur after as little as two hours of unrelieved pressure.

Pressure sores do not occur in most people. Ever sat still so long in one position that when you finally moved you ached? The same process is involved in the formation of decubitus ulcers. Eventually you did shift position; and for most people, even when they’re asleep, a complicated set of neuronal feedback mechanisms alert their bodies when it’s time to make a postural adjustment.

But people who are comatose, paralyzed, sedated, restrained or otherwise unable to move volitionally cannot move on their own. This is the population at risk for developing bed sores. For someone who cannot move, something as simple as a wrinkle in a bed sheet can begin the process of skin breakdown.

Pressure Sores

Pressure sores can also develop or be exacerbated as a result of friction when a body is rubbed or dragged across a surface, or when traction is applied to the skin.

Why do pressure sores occur? When pressure interrupts the skin’s capillary blood flow, it also interrupts the supply of oxygen brought to the skin by the blood in those capillaries. Without oxygen tissues begin to die, a process medical scientists call ischemia. The damaged tissues reddens as part of the inflammatory response when, in an effort to increase the blood supply, white blood cells release enzymes that dilate the capillaries. Vasodilatation causes the capillaries to leak, which leads to a build up of plasma fluids around the affected area responsible for the spongy or hard texture of the site.

Secondary bacterial infection is common with bed sores. Not only does infection compromise the healing of shallow sores, but should it spread into the bloodstream it can become life threatening. The actor Christopher Reeve died of sepsis secondary to a bed sore. Secondary bacterial infection can be diagnosed by the presence of pus and an unpleasant odor arising from the lesion site.

Bacterial infections can evince themselves as an acute and painful condition of adjacent connective tissues called cellulitis (which untreated can lead life-threatening complications like meningitis) or infections of the bone (osteomyelitis) and joints (infectious arthritis.)

Risk Factors For Developing Bed Sores

Anybody who is immobilized – even for a brief interval of time – is at risk for developing pressure sores. A number of factors increase susceptibility:

Age

Two thirds of all decubitus ulcers occur in individuals who are over 70 years of age because the elderly tend to have thinner skin than younger individuals and are also more likely to suffer from malnutrition. The speed of healing in general decreases as people age.

Spinal Cord Injuries

Not only are spinal cord injuries immobilizing, they also interfere with the perception of pain and other kinds of discomfort. Since blood flow is decreased to the areas of the body beneath the break, healing occurs much more slowly. The annual incidence of bed sores among this population is estimated at between 5% and 8%, and some studies estimate their likelihood of developing a decubitus ulcer over the course of a lifetime to be as high as 85%.

Weight Loss and Malnutrition

Fat and muscle cushion bony prominences but people who are sick in bed or hospitalized for other reasons tend to lose fat and their muscles atrophy. Inadequate nutrition is a serious problem among the elderly in the United States, and the link between bed sores and malnutrition has been well documented. Dehydration also contributes to skin fragility.

Incontinence

Moisture generally contributes to skin breakdown, and the metabolic wastes in urine can be particularly damaging to fragile skin. Fecal incontinence greatly increases the risk of secondary bacterial infection.

Smoking

The nicotine in tobacco impairs circulation leading to decreased levels of oxygen in the blood and far longer healing times for any type of injury.

Other Medical Conditions

Diabetes, chronic vascular diseases and other conditions that impair circulation increase the likelihood of skin breakdown. Muscle spasms and contractures put individuals suffering from spinal paralysis at risk for developing pressure sores from friction and shearing forces.

Nursing Homes

It’s been estimated that between 17% and 28% of all nursing home residents suffer from decubitus ulcers. There are many reasons for this: the population of these facilities tend to be either medically fragile or elderly. A study by Howard and Taylor found that the incidence of pressure sores in one nursing home in the southeastern United States varied by race and gender. If this is evidence of bias in caregiver decisions, that would be a disturbing trend indeed.

Hospitalization

Slightly fewer than half a million hospitalized patients develop decubitus ulcers in a single year. One study of found that over 36% of 658 patients operated on for hip fractures went on to develop pressure sores within 32 days of their admission to a hospital. Decubitus ulcers are a leading factor in iatrogenic deaths among hospitalized populations, secondary only to adverse drug reactions.

The Braden Scale for Predicting Pressure Ulcer Risk – developed as part of a National Institute of Health proposal – is a tool designed to quantify the process of identifying vulnerable individuals. Using six weighted risk factors, the Braden Scale has proven to be a more reliable predictor of pressure ulcers than subjective assessment.

Bed Sore Prevention Tips

Bed sores are a classic example of the old adage that an ounce of prevention is worth a pound of cure: in the vast majority of cases, bed sores can be prevented by the simple expedients of frequent position shifts and a thorough, routine, daily inspection of the skin to identify potential trouble spots.

If incontinence is a factor, skin barriers like the new, polymer-based protective films should be used in addition to absorbent padding to protect the skin. Improved hydration will make skin less friable, while better nutrition (particularly through foods rich in protein, zinc and Vitamin C) will lead to increase the body’s ability to heal itself should breakdown occur.

Bedridden Individuals

If you are bedridden or immobilized, you will have to rely on the assistance of caregivers; the optimal interval for repositioning is once every two hours and in no event should you go longer than four hours without a postural readjustment.

Special care must be taken with bedridden patients so that pressure is not put on the hips, tailbone, ankles, shoulder blades or elbows. Individuals lying in bed on their side will optimally be positioned at a 30 degree angle (through use of a pillow under the small of the back) so that no weight is directly on the hip bones. Individuals lying on their backs in bed will use foam pads or pillows under their calves to lift their feet from the bed’s surface.

Bony prominences must be prevented from touching one another through the use of strategically placed pillows and foam padding. Raising the head of the bed more than 30 degrees increases the likelihood that you will slip out of a safe position and should therefore be avoided.

If you are bedridden for any length of time, consider a specialized, pressure-relieving mattress. Little known fact: the very first waterbed was invented in 1832 by the distinguished Scottish physician Dr. Neil Arnott as a means of preventing bed sores in invalids. This early model was pretty primitive, consisting of a bath covered with rubberized canvas on top of which bedding was placed. More sophisticated waterbeds are now a first line of defense against bedsores along with air, foam and gel mattresses.

Wheelchair Bound

Pressure-relief wheelchairs are designed to tilt in order to redistribute weight which makes sitting for long periods of time safer and more comfortable. If you do not have a pressure-relief chair and you can move independently, medical experts recommend realigning your weight every fifteen minutes or so. So-called “wheelchair pushups” – using your upper arms to lift your body off the seat – are a great way to relieve pressure if you have enough upper body strength.

If you cannot move independently, your caregiver will assist you in repositioning your body every fifteen minutes or so.

Just as bedridden individuals need pillows and cushions to redistribute their weight, so do the wheelchair bound. No body part susceptible to skin breakdown should ever be positioned directly up against a hard surface.

Routine Daily Skin Inspections

Checking the skin regularly for early signs of skin breakdown is a critical part of bed sore prevention. Stage I decubitus ulcers will often resolve completely within 24 hours after the pressure source is removed. The deeper the lesion however, the longer the healing time and even some Stage II pressure sores never completely heal.

In wheelchair bound individuals, skin breakdown is most likely to begin on the buttocks and tailbone, lower back, legs, heels and feet. Bedridden individuals need to look out for their your hips, spine and lower back, shoulder blades, elbows and heels. These areas of the body may be difficult to visualize even if you have some mobility and can use a mirror, so caregiver assistance is highly recommended here.

If inspection identifies a Stage I pressure sore, pressure to that area must immediately be removed. A protective dressing should be applied to the area after it’s gently washed with soap and water. On no account should a Stage I pressure sore ever be massaged in an attempt to increase circulation as this may lead to a reperfusion injury.

If inspection identifies a pressure sore that’s Stage II or higher, immediate medical attention is indicated.

Bed Sore Clinical Diagnosis and Tests

Bed sores are easily diagnosed by sight. Nurses and physicians use the lesion’s size and depth to develop a treatment plan. Even in cases where the pressure sore is not severe however, blood tests are often ordered at the time of diagnosis to provide insight into an individual’s overall health and nutritional status.

In Stage III and Stage IV pressure sores, further diagnostic tests may be indicated particularly in cases where infection has invaded the tissues. When a lesion does not respond to treatment, a physician may order a tissue biopsy to check for the presence of less common bacteria, fungi or even cancer cells.

Treatment Options for Bed Sores

Most Stage I and Stage II decubitus ulcers will heal on their own over time without surgical intervention. An effective treatment plan will include pressure reduction through frequent repositioning and the use of padding and support surfaces as well as proper cleansing of the affected area and a nutritional consultation. Stage I pressure sores rarely require wound dressings. The treatment of choice for Stage II pressure sores is wound dressings that contain topical antiseptics and antimicrobials. Oral antibiotics are used cautiously if at all due to the potential for producing antibiotic-resistant bacterial strains.

Stage III & Stage IV

Stage III and Stage IV decubitus ulcers may require more aggressive treatment. If infection exists, it must be tackled before surgical intervention is attempted. The presence of infection is often an indication of dead or necrotic tissue around the lesion site, and this must also be removed to decrease the chance of further infection.

Surgical debridement using a scalpel to remove dead tissue is quick but painful. Nonsurgical debridement techniques include autolytic debridement, a technique that uses high-pressure water sprays, and enzymatic debridement, where topical enzymes are applied to the affected areas. Another form of hydrotherapy involves the use of whirlpool baths to keep skin clean and wash away dead tissues.

Surgical Intervention

The goal of surgical intervention is wound closure which may be accomplished through skin grafts, tissue flaps or some other means. Before a surgical intervention takes place, the lesion must be aggressively debrided. Wound closure makes hygiene protocols easier to implement, reduces the possibility of further infection, and raises the affected individual’s own morale. The procedure generally involves the use of tissue – either muscle or skin – harvested from other areas of the individual’s own body to reduce the chance of rejection.

The prognosis for early-stage pressure sores is good if the lesion is identified early enough although healing typically requires weeks. But even when a decubitus ulcer responds to treatment, the reoccurrence rate may be as high as 90% if underlying care issues such as immobility and nutrition are not aggressively addressed.

References

• Christopher Reeve
• Merck.Com

Back Pain

Back pain, sometimes referred to as dorsalgia, is one of the most common ailments amongst people all over the world. The vast majority of the population will experience back pain and one point or another in their lifetimes.

Approximately 90% of all adults will suffer from back pain in their lifetime, and nearly 50% of the working adult population claims to deal with back pain on an annual basis. Low back pain, sometimes referred to as lumbago, ranks amongst the top five reasons for doctor visits annually in the United States and is one of the most common reasons for absenteeism in the work place.

The spine is a column made of 33 different bones which runs the length of the body from the skull to the pelvis. The bones comprising the spine, known as vertebrae, are surrounded by a casing of nerve tissue called the spinal cord.

A layer of cartilage exists between each vertebra and acts as a cushion to help protect the bones. Each of these components, in addition to the muscles, tendons, and ligaments in the back, are susceptible to injuries, strains, and accidents; all of which can lead to mild back pain ranging from mild to severe.

Symptoms of Back Pain

The severity, type, and location of back pain will vary depending upon the root cause of the pain.

Different ailments and conditions can result in similar symptoms.

• Low back pain may progress over time or may happen suddenly. Acute back pain is generally very intense, but rarely lasts more than a few weeks depending on the cause of the discomfort. Chronic back pain is the term used for any back pain that lasts longer than three or four months. At times, lower back pain may also radiate down into one or both legs.
• Pain from injuries, sprains, and strains to the muscles and ligaments of the back are generally localized to the injured area of the back and do not pass along to other areas of the body. Often times, the pain from one of these ailments can be amplified by bending the back.
• A herniated disc can apply pressure to the sciatic nerve, amongst others, causing a number of problems, such as: pain or tingling in the hip or leg, pain that increases when sneezing or coughing, pain that increase when sitting or standing for extended periods of time, pain that radiates down one leg, and sharp pains in one leg accompanied by numbness of the same leg.

Risk Factors of Back Pain

There are a number of risk factors that can lead to back pain. Some of these can be controlled or prevented, but some are a matter of genetics and cannot be controlled effectively.

Some of the most common risk factors include:

• Physically strenuous work, exercise, and activities
• Stress
• Depression
• Family history of back pain
• Obesity
• Smoking
• Old age
• Pregnancy
• Congenital spinal problems
• Poor posture
• Long term use of certain medications, such as corticosteroids
• Lack of exercise

Prenention Tips for Back Pain

There are no sure fire ways to guarantee the prevention of back pain because there are so many different factors that can lead to the problem.

There are, however, some preventative steps that can be taken to help reduce your risk of certain types of back problems.

• Regular exercise can help to strengthen the muscles in your back and your core and can provide additional protection to help prevent injury.
• Be sure to lift properly. The correct steps to lifting heavy items are to bend at the knees, keep your back and head straight, and lift by extending your legs. Bending at the hip and lifting with the back muscles can lead to serious injury.
• Quit smoking. Smoking tightens the arteries and interferes with blood circulation. This leads to a decrease in the amount of oxygen carried by red blood cells which can lead to an increased risk of bone loss and degeneration as well as slow healing for damaged areas of the back.
• Eat a diet rich with protein, calcium, vitamin D, and phosphorous. These nutrients can help to prevent or slow osteoporosis, thus reducing the risk for serious fractures and breaks.
• Try to manage the level of stress in your life the best you can, both at home and at work. In addition to a myriad of other health problems caused by stress, people tend to tense up and tighten their back muscles when they are tense, thus leading to soreness and cramping.
• Maintain a healthy weight through proper diet and exercise. Obesity places additional stress on the back which can often lead to back pain.
• Make an effort to sleep in a position that keeps your spine properly aligned. If you sleep on your back, use a towel or pillow under your knees to relieve your pressure points. If you sleep on your side, place a pillow or a towel between your knees.

Diagnosis and Testing for Back Pain

Some of the methods used to test and diagnose back pain are very similar to those used to test and diagnose a wide array of medical problems. As long as the problem is not crippling, a doctor will generally test a patient’s range of motion and conduct a visual inspection of the area in pain. Blood and urine tests may also be administered to check for infection.

A series of questions aimed at identifying the source, severity, and cause of the problem will often be asked. Some of the more common questions that may be asked are:

• When did the pain start
• Where is the pain located? Is it concentrated in one area, or is it radiating down into the hips and legs?
• Was there an injury, accident, or incident which can explain the onset of the back pain?
• Is there anything that makes the pain seem either worse or better?

A few common, preliminary diagnostic tests include:

• Testing the patient with the straight leg and bent leg tests. When straightening the leg, a pain shooting down the straightened leg is often indicative of a pinched root nerve. When crossing legs, pain going down the non-crossed leg often indicates a herniated disc
• Reflex tests can help identify nerve pressure if certain reflexes are absent
• Weakness in the lower extremities can help identify other nerve pressure and/or damage. The doctor may be able to isolate the location of the problem based on the patient’s discomfort when walking on their toes or in their difficulty raising their big toe.

Testing for the cause of back pain can include a wide array of differing tests to try and identify the root cause of the problem.

• X-rays are one of the most commonly thought of tests when it comes to identifying issues that exist inside the body. X-rays, however, are not very commonly used in the identification of back pain unless the patient has experienced significant trauma, has prolonged steroid use, or suffers from osteoporosis.
• Nerve tests are accomplished by placing small needles into the muscles in the back. The electric activity transferred through the needles is monitored to try and determine if there is nerve root damage or muscle disease. This test is generally reserved for extreme, chronic pain that has been evident for at least several months.
• Magnetic Resonance Imaging (MRI) and Computed Tomographic Scanning (CT scan) are often considered for patients that are likely candidates for surgery as a result of their root back problems. MRI technology is useful for imaging soft tissue, such as herniated discs and tumors, and CT scans are better used for imaging of bone. CT scanning is less expensive and also less sensitive to patient movement, making it much easier for the patient to deal with, both physically and financially.

Causes of Back Pain

Back pain can occur in people for a number of different reasons.

A few of the more common reasons are listed below:

• Spondylosis occurs when there is a stress fracture within the spine. Vertebrae are often moved from their natural position when this happens which is called spondylolisthesis.
• Osteoporosis is a condition which causes a person’s bones to weaken, making them more susceptible to breaks and fractures. Someone suffering from osteoporosis is much more likely to suffer a spinal injury than an otherwise healthy person.
• Spinal stenosis is caused by a narrowing of the area surround the spinal cord or the spinal nerves. Nerves transmit information from the body to the brain and the brain back to the body.
• Lumbar strains and lower back sprains are the most common cause of back pain in adults. A strain occurs when muscle fibers are abnormally stretched and/or torn.
• Herniated discs occur when the cartilage between vertebras slips out from its normal location and protrudes from one side of the spine more than the other. This disc is soft and pliable in young age, but as with most parts of the human body, can become rigid and less elastic with age. When this happens, the disc can rupture, causing the disc to be herniated.
• Discogenic back pain is caused by the gradual wearing out, or degeneration, of the lumbar discs. This is a natural byproduct of the aging process and sometimes does not produce any symptoms at all. One of the positives of discogenic back pain is that patients generally report diminishment of the pain as time passes, even with minimal treatment.
• Lumbar spine arthritis is most commonly seen in older patients, but it can affect all age groups. Arthritis is an affliction of the joints that surround the vertebrae. Vertebrae are connected with the spinal disc in the front of the spinal cord and with two different facet joints behind the spinal cord.

Treatment Options for Back Pain

The options for treatment for back pain can change dramatically based upon the root cause of the problem, the patient’s wishes, and the medical professional that recommends the treatment. Options for treatment can include home and herbal remedies, pharmaceutical remedies, and in extreme cases, surgical remedies.

Home and Herbal Remedies

Home remedies for back pain are extensive and seemingly everyone has an option to offer. One of the basics shared amongst many groups is regular exercise which strengthens the back and allows for a better supply of nutrients to the back. Proper lifting and moving, getting enough rest, sleeping on a quality mattress with proper support, and avoiding sitting for prolonged periods of time are all preventative measures as well as natural remedies for addressing a problem once it has already begun.

Herbal remedies are a popular option for treating back pain as well. The juice of one lemon, mixed with common table salt, taken twice daily as part of a daily routine has proven to be effective for some. Others have stated that the application of garlic oil directly to the source of the problem has helped to relieve back pain. Consumption of garlic on a daily basis, two to three cloves at a time, has also proven to be an effective remedy for some. Chamomile has long been thought to have a soothing effect on smooth muscle tissue and can be taken as a tea, as an extract mixed with water or some other liquid, or in capsule form.

Pharmaceutical Remedies

Prescription drugs are a popular choice used to address back pain. Most often, pain killing, muscle relaxing, and anti-inflammatory pharmaceuticals are prescribed to treat and relieve back pain. Pain killers are available in both over the counter varieties as well as prescription drugs. Aleve, Tylenol, and Advil are amongst the most popular choices for OTC medication. Felxeril, OxyContin, and Percocet are some of the most popular prescription medications used for back pain relief, and should only be used as directed by a qualified physician.

Surgical Remedies for Back Pain

In the most extreme cases, surgery may be the last available option for a patient to consider when trying to manage their back pain. It is not an option that is taken lightly as the complications and possibility for worsening a patient’s condition are very realistic.

A discectomy is performed to remove a herniated disc from the spinal canal. The area of the disc that is removed is the section which is creating pressure on the spinal nerves, causing severe pain for the patient. A small incision in the back allows the surgeon to remove the herniated section of the disc, and once inside, the decision to remove additional sections of discs may take place to prevent future herniations from taking place.

Spinal fusion is an option that may be recommended for those that have abnormal curvature of the spine, injury to the spinal vertebrae, or weak spines as a result of infection or tumors. The procedure consists of fusing two or more vertebrae together to prevent motion from occurring between the individual bones.

In severe cases, a cordotomy may be performed during which bundles of nerve fibers are intentionally severed to prevent the transmission of pain signals to the brain.

What are Spring Ailments?

The most common spring ailments for millions of people are the so-called “spring allergies” more commonly known as “hay fever” or “allergic rhinitis”– a respiratory infection caused by spring pollen that is released into the air as trees and plants start to bloom. The most common symptoms include a a runny nose, sneezing, coughing, and itchy or watery eyes. Some people experience wheezing, and, in more severe cases, full-blown bronchial asthma attacks; children are especially prone to those.

The biological mechanism behind spring allergies is simple: allergies like pollen enter one’s airways, which causes blood cells to process them as antigens, and to produce antibodies. When the antigens and the antibodies come in contact with each other, so-called chemical and hormonal “mediators” are released. One such mediator is called histamine, and it is primarily responsible for the hay fever symptoms.

Non-Medical Options

Non-medical prevention and lifestyle modifications can help minimize the effects of hay fever. It is possible to keep track of the pollen count, which is the measurement of the number of grains of pollen per cubic meter of air as Regional pollen count forecasts are available through several different websites, and sometimes announced on local news.

On the days with a high pollen count, it may help to cover one’s mouth and nose with a medical mask while outside, to avoid inhaling the pollen in the air. It is wise to keep the windows closed, and to frequently wipe down windowsills with a wet cloth. In general, pollen count tends to be lower immediately after a rain, as clears the air of pollen.

It is also helpful to wash one’s face after being outside, to remove the pollen from the skin. However, prevention can only help so much. Fortunately, there is a range of treatments available for hay fever. Over-the-counter pharmaceutical offerings, medical interventions, and traditional and home remedies are outlined below.

Pharmaceutical Remedies for Hay Fever

The common medications for hay fever are usually referred to as antihistamines, because they work by preventing the histamine produced in the body in reaction to the allergens from inducing the unpleasant symptoms. Antihistamines usually help with sneezing, a runny nose, and itching eyes.

Antihistamines

Antihistamines usually come in two types: the ones that may cause drowsiness, such as Piriton or Phenegran, or the ones that do not cause drowsiness, such as Benadryl, Clarity, and Allegra-D. Of course, individual reactions to medications may vary, and some people may feel run down and tired even while taking the medications that are labeled as non-drowsy; others have little to none side effects from any antihistamines.

The most common side effects besides drowsiness include headache, constipation, blurred vision, dry mouth, and dizziness. People who suffer from glaucoma, enlarged prostate, and kidney or liver problems should consult their doctors before taking antihistamines, as their side effects can worsen these conditions.

Many antihistamines are available over the counter, but some require a prescriptionuch as Fexofenadine (sometimes sold as Allegra, Tilfur, Telfast, and Fastofen). Some of these pills have to be taken several times a day; others work on an extended release schedule, providing relief for 24 hours after ingestion. The over-the-counter antihistamines vary in prices; generic alternatives to brand names are usually available, so this course of hay fever management does not have to be too costly. Prices on prescription antihistamines depend on one’s insurance plan or participation in pharmaceutical discount programs.

Nasal Sprays

In addition to the pills described above, antihistamines come in the form of nasal sprays, such as the prescription-only Rhinolast. Such sprays are used for fast relief and prevention of nasal symptoms, but does not affect other common hay fever symptoms like itchy or watering eyes. Also available with a prescription are the nasal corticosteroids, such as Beconase and Flonase.

These nasal steroids relieve inflammation in the sinuses, and work well on all nasal symptoms, including sinus blockage. For best effects these sprays have to be used regularly, and in a preventive fashion. Ideally, their administration starts several weeks before the start of the spring allergies season. For young children, whose parents may be reluctant to give them steroids, another alternative is nasal sprays made with Sodium Cromoglicate, such as Rynacrom.

Over-the-counter nasal decongestant sprays, such as Otrivine and Afrin are also sometimes used by hay fever sufferers, but they should not be used for more than a few days in a row, as they can use “rebound congestion” with long-term use.

Eye Drops

For allergy sufferers whose eye problems are not sufficiently relieved by general antihistamine pills, antihistamine eye drops can help. Otrivine Antistin is available over the counter, and Relestat, Zaditen, Opatanol, and other similar eye drops are available with a prescription. They provide fast relief from itchy, red eyes.

People who develop bronchial asthma associated with spring allergies may need to use inhalers like Albuterol (Salbutamol). Albuterol and other similar medications are bronchiodilaters that relieve bronchial spasms as they occur.

Immunotherapy for Hay Fever

Immunotherapy is an effective way to alleviate hay fever, and may be a good option to explore for people who do not find adequate relief with other treatment options. Immunotherapy consists of being given doses of an allergen to which one is allergic over a period of time—in case of hay fever, the allergen is pollen.

Traditionally immunotherapy is done through a course of injections that are designed to gradually desensitize one’s body to the trigger pollens. This therapy is long-term—it may last for several years. The injections are given weekly at first, then administered once every two weeks, and over time continue to be spaced further and further apart, building up to a cycle of one injection every six weeks, with a gradual increase of the allergen introduced into the body.

Over time the body adjusts to the allergen, and stops treating it as a threat to the immune system. This leads to the alleviation of histamine production, and the elimination of hay fever symptoms.

Side Effects

Side effects include local reactions at injection sites on some of the patients (including redness, hives, and itching), and, rarely, systemic reactions that may include sneezing, hives, asthma, or even anaphylactic shock. As immunotherapy is a medical procedure done in a clinical setting, its costs may vary depending on one’s health insurance and doctor-set rates.

Recently a new form of immunotherapy for hay fever has emerged: Grazax is a grass pollen vaccine in tablet form, that has been shown to significantly improve hay fever symptoms and reduce the need for medication in allergy sufferers. It is already commercially available in Europe, but is not yet on the market in the United States, where it is still undergoing clinical trials. No serious side effects have been observed with Grazax, although some people using it experienced itching in their mouths.

Traditional, Naturopathic, and Home Remedies

There is a lot of folk and home remedies for relieving the symptoms of spring allergies. Some of the most common ones include fenugreek tea, butterbar, and a diet heavy in carotenoids (found in orange and green vegetables, like collard greens, pumpkin, carrots, and apricots), omega-3 fatty acids (available in fish oil and flaxseed oil), and quercetin (a natural antihistamine found in red grapes, red onions, and black tea).

A home version of immunotherapy for hay fever involves eating local honey. Because it contains the same pollens as the ones that trigger one’s allergic reaction, eating or drinking honey regularly can help desensitize one’s organism to these pollens.

Holistic Approach

Because hay fever symptoms are produced by responses of the immune system to allergens are in and of themselves harmless, naturopathic doctors, who practice a holistic approach treat hay fever primarily as an immune system disorder, as well as weak adrenal and digestive functions.

Natural treatments are designed to support and strengthen these functions in order to treat the roots of the hay fever problem. In terms of symptom relief, common herbal treatments include stinging nettles, gingko, and milk thistle.

Standard homeopathic remedies prescribed for hay fever symptoms include Allium cepa, Eophrasia, Natrum muriaticum, Nux vomica, and Wyethia. These naturopathic courses of treatment are usually augmented with a restricted diet, from which dairy and wheat products, and other allergy-triggering and mucous-producing foods are eliminated.

As with all herbal and natural supplements it is important to be aware of the potential interactions between naturopathic medicines and other medicines one may be taking, and to make sure they are appropriate for people with underlying health problems, and pregnant and nursing women.

Chiropractic Treatment

Chiropractic medicine views hay fever as a problem stemming from subluxations—misalignments of spinal vertebrae which can be caused by physical, emotional, or environmental stresses, and which can affect all body systems. Chiropractors offer alternative treatment designed to balance body chemistry and heal the immune system, thus healing hay fever by addressing the underlying causes.

Traditional Chinese Approach

Traditional Chinese Medicine is another holistic field of diagnostic and treatment. According to its practitioners, the causes of illness can be traced to a external “pernicious influences” (wind, cold, heat, dryness, dampness, summer heat) and internal emotions (anger, joy, sadness, fear, shock, and pensiveness).

In a healthy bodies these energies and elements are balanced, but in a sick body one or more elements are out of balance. Hay Fever is considered to be primarily a “wind” illness. For Chinese medicine practitioners there are two main goals in hay fever treatment: strengthening the immune system to reduce its hypersensitivity to environmental agents like pollen, and clearing wind to address the symptoms.

Acupuncture

Acupuncture is a Chinese Medicine technique that is commonly used as an alternative treatment for hay fever and associated bronchial asthma.

Acupuncture involves penetrating the skin with thin needles in specific places on the body for pain relief or immune system support. From the Chinese Medicine perspective acupuncture balances the flow of energy (known as qi) within the body to ensure good health; from the perspective of Western medicine acupuncture works by stimulating the central nervous system in therapeutic ways.

Hay fever sufferers may need acupuncture for varying lengths of time, but 6-8 sessions is a common course of treatment. Acupuncture may be alternated or replaced with moxibustion, which involves a small cone of moxa (mugwort) being placed directly on top of or held over the acupuncture points and burned.

Additional Natural Treatment Options

Ayurvedic medicine, traditionally practiced in India, has its own prescriptions for fighting hay fever. According to Ayurvedic practitioners, hay fever sufferers should eat light, easily digestible foods, minimize the amount of processed foods consumed, drink herbal teas containing cinnamon, ginger, turmeric, cumin seeds cleanse sinuses of mucous, dirt, and pollen with traditional neti pots, and practice a form of breathing called Pranayama, known to many as “yoga breathing.”

Finally, a natural way to treat bronchial asthma associated with hay fever in Russia is the so-called Buteyko Breathing Method, that is becoming gradually better known in the West as well. The Buteyko Breathing Method focuses on breath control, and shallow, nasal breathing, designed to slow down breathing and reduce the volume of oxygen intake. Reduced breathing has been demonstrated to alleviate asthma attacks when they occur by retraining the body to comfortably manage the breathlessness that results from a bronchial spasm.

The home remedies described in this article are usually cheap and easy to administer. Naturopathic courses of treatment with certified practitioners may be expensive; some health insurances cover alternative medicine, while others do not. Pranayama and Buteyko breathing methods can be practiced at home, alone or in a group, at no cost; that is also the case for dietary modifications suggested by holistic practitioners.

Nausea and vomiting are two of the most common symptoms, very often complained about by a number of different people, and this is because these two symptoms can be caused by a whole wealth of different conditions. More often than not, when a person experiences nausea and vomiting, it is because they are experiencing viral gastroenteritis, which is a condition that is often mistakenly referred to as a “stomach flu,” or they are experiencing morning sickness during the earlier weeks of pregnancy.

There are many different medications that are known to cause a bout of nausea and vomiting, and it is even possible for general anesthesia used for surgery to cause it. Very rarely do just nausea and vomiting by themselves signal any kind of life-threatening or even serious problems.

Causes of Nausea and Vomiting

It is possible for both nausea and vomiting to happen to a person either individually or in conjunction with one another.

A few of the more common causes include:

• Chemotherapy
• Gastroparesis
• General anesthesia
• Migraine
• Motion sickness
• Overdose on toxic substances, alcohol or illicit substances
• Rotavirus
• Vertigo and
• Viral gastroenteritis (stomach flu).

Some of the other potential causes, though less common, of nausea and vomiting include:

• Addison’s disease
• Alcoholic hepatitis
• Anaphylaxis
• Anorexia nervosa
• Appendicitis
• Benign paroxysmal positional vertigo, or BPPV
• Brain arteriovenous malformation
• Brain hemorrhage
• Brain infarction
• Brain tumor
• Bulimia nervosa
• Congenital adrenal hyperplasia
• Crohn’s disease
• Cyclic vomiting syndrome
• Depression, major (major depression)
• Diabetic ketoacidosis
• Dizziness
• Ear infection in the middle ear
• Food poisoning
• Frontal lobe seizures
• Gallstones
• Generalized anxiety disorder
• Gastroesophageal reflux disease, or GERD
• Head injury
• Heart attack
• Heart failure
• Hirschsprung’s disease
• Hydrocephalus
• Hyperparathyroidism
• Hyperthyroidism, or an overactive thyroid
• Hypoparathyroidism
• Intestinal ischemia
• Intestinal obstruction
• Intracranial hematoma
• Intussusception
• Irritable bowel syndrome
• Kidney failure that is chronic
• Liver cancer
• Liver failure
• Meniere’s disease
• Meningitis
• Milk allergy
• Nonulcer stomach pain
• Pancreatic cancer
• Pancreatitis
• Peptic ulcer
• Porphyria
• Pseudotumor cerebri
• Pyloric stenosis
• Radiation therapy
• Retroperitoneal fibrosis
• Social phobia, or social anxiety disorder
• Stomach obstruction
• Strep throat
• Temporal lobe seizure and
• Traumatic brain injury.

When to See a Doctor

It is vital to immediately seek emergency medical assistance or to call 911 should the nausea and vomiting also be accompanied by any of the following warning signs

• Blurred vision
• Chest pain
• Cold, pale, clammy skin
• Confusion
• Fainting
• Fecal odor or fecal material within the vomit
• High fever with a stiff neck or
• Severe cramping or abdominal pain.

Have someone make the drive to the emergency room should any of the following situations become true

• The nausea and vomiting are being accompanied by some kind of pain or some kind of severe headache, especially if it is a new kind of headache that has never been had before.
• Eating or drinking is not possible for about twelve hours or the child is unable to keep down liquids for about eight hours.
• The symptoms or signs of dehydration are occurring, such as infrequent urination, dry mouth, excessive thirst, dizziness, dark colored urine, weakness or lightheadedness upon standing up.
• The vomit resembles coffee grounds, has blood in it or is green.

Call the doctor and make an appoint if any of these circumstances should arise

• The vomiting has recurred for longer than two days in adults, over 24 hours for children under the age of two or over 12 hours for young infants.
• The instances of nausea and vomiting have recurred for longer than a month.
• Unexplained weight loss is experienced and accompanies the bouts of nausea and vomiting.
• Preparing for the Appointment with the Doctor
• When first making an appointment with the doctor, he or she may be the family doctor or be a general practitioner. However, in some instances, when a person calls the office in order to set up an appointment, the person may immediately be referred to an ENT specialist, who is a doctor specializing in disorders that occur within the ear, nose and throat.
• Because the amount of time spent in appointments have a tendency to be shortened and brief, and because there is usually a wealth of ground that must be covered, it is recommended to be fully prepared for the appointment. This section serves as a small guide to offer tips in order to better allow a person to be fully prepared for the appointment with the doctor and offer ideas with regards to what they should expect from the doctor.

What Can Be Done

Be aware of any restrictions before the appointment. Whenever calling the doctor to make the appointment, it is important to ask if there is anything that may need to be done in advance before coming in.

Take a notepad and write down all of the experienced symptoms, even if they appear to be unrelated to the reason for which the call is being made in the first place.

Write down a brief, recent life history involving all key information about personal life, which should include recent life changes or any major stresses.
Because the side effects of many different medications may be the cause of the nausea and vomiting, it is important to make a list of the different medications that are being taken, including any supplements or vitamins.

If possible, try to recruit a friend or a family member to tag along. Because there is a wealth of information that might be provided in a single appointment, it might be difficult for one person to take it all in. When another person joins for the appointment, they may be able to help remember or recall things that the patient forgot or did not catch.

Write down some questions that will be asked to the doctor. Preparing a list of questions, because the time that is to be spent with the doctor is so limited, will make the process go quicker and reserves the rest of the time for more beneficial activities other than thinking of missed questions. When writing down the questions, list them from the more important once to those that are not quite as important, in case time happens to run out. For nausea and vomiting,

Some basic questions that may be asked to the doctor might include:

• What is the most likely cause for the nausea and vomiting?
• Are there any other likely causes for the nausea and vomiting?
• What kind of tests are necessary?
• Is the nausea and vomiting likely to be temporary or chronic?
• What is the recommended course of action?
• What are some of the alternatives to the primary approach that is being suggested?
• These are some other health conditions that are present. How can these conditions and the nausea and vomiting be managed together?
• Are there any restrictions that might need to be followed for the nausea and vomiting?
• Should a specialist be seen? How much will a visit cost and will this kind of insurance cover seeing this specialist?
• Is there any generic alternative to the medication that is currently being prescribed?
• Do any Web sites come recommended regarding the nausea and vomiting? Are there any printed materials, such as brochures, that can be taken home for further reading?
• Do not shy away from taking the time to ask any other questions that come to mind in the event that information is passed that goes by not understood, in addition to the questions that have already been prepared to ask the doctor.

What to Expect From the Doctor

The doctor will probably also have a list of questions to ask, so be prepared to answer them so that more time can be reserved to go over points that may require more time before the information is understood.

The doctor may wish to ask some of the following

• When did the nausea or vomiting begin to happen?
• Has the nausea or vomiting been a continuous experience or occasional?
• How severe is the nausea and vomiting?
• If anything, what appears to improve the symptoms?
• If anything, what seems to worsen the symptoms?
• Any allergies or a cold?
• Treatment Options for Nausea and Vomiting

There is no actual cure for nausea and vomiting, though it is possible to soothe the symptoms and try to ease the nausea so that vomiting does not occur.

These self-care measures can be done in an attempt to feel better and to subside the nausea:

• Try to take it easy. When a person undergoes too much activity and does not get enough rest at night, it can make nausea much worse.
• Always stay hydrated. Vomiting can lead to dehydration rapidly, and drinking large sips can trigger nausea as well. To remedy this, take small sips of clear, cold, sour or carbonated drinks, such as lemonade, ginger ale or water. Another helpful drink may be mint tea.
• Try to avoid coming into contact with strong odors and other similar triggers. Cooking and food smells, smoke, perfume, heat, humidity, stuffy rooms, driving and flickering lights are all among the possible triggers for nausea and vomiting.
• Eat bland foods. In the same way that strong odors can trigger nausea and vomiting, too complex a taste can do the same. Start off by taking in foods that can easily be digested, such as crackers, gelatin and test. When these can be kept down with ease, try to graduate to rice, cereal, fruit, salty foods or foods high in carbohydrates or high in protein. Try not to eat foods at are fattening or spicy. Try not to eat solid foods until six hours have passed since the last instance of vomiting.
• Over the counter medications that treat motion sickness may be helpful, as well. For those who are planning to go on a trip, there are some over the counter motion sickness drugs, including Bonine and Dramamine, that can be helpful for calming the queasy stomach on a trip. When going on a longer journey, such as on a cruise, the doctor should be contacted for requesting information on prescription patches for motion sickness.
• If the nausea and vomiting is due to pregnancy, try to nibble on a few crackers, preferably unsalted, prior to getting out of bed in the morning.

What is Conjunctivitis?

Conjunctivitis is the inflammation of the transparent layer of the eye that lines the eyelid, known as the conjunctiva. This inflammation causes the blood vessels in the conjunctiva to become irritated and give off a pink or red color in the whites of the eyes. Conjunctivitis can be referred to as Madras eye, but is most commonly known as pinkeye. Both humans and animals can experience pinkeye.

What are the Symptoms of Conjunctivitis?

Many symptoms can accompany conjunctivitis.

• Red or pink coloring in the whites of the eye is the most obvious symptom
• Watery eyes is also a common symptom
• The feeling that there is something in the eye, or a gritty irritation is also common
• Itchiness, burning, and sensitivity to light may also be symptoms of conjunctivitis
• Green, yellow, or white discharge from the eye is typical, and they eyes may be sealed shut after sleeping due to the mucous-like discharge
• Blurred vision may also be present

What Causes Conjunctivitis?

Viruses, bacteria, allergies, or foreign objects or chemicals in the eye can all attribute to pinkeye symptoms.

Viral conjunctivitis often results from viruses similar to those that cause colds. Other cold symptoms may be present such as a sore throat or runny nose, and the eyes often will have watery discharges or those filled with a mucous-like substance. This type of conjunctivitis is very contagious, and usually runs its course within a week.

Bacterial conjunctivitis is also often associated with the common cold, but is caused by bacteria. Often a thick yellow or greenish colored mucous will be present in the affected eye. This material may cause the eyelids to stick together after sleeping as well.

Those with bacterial conjunctivitis may have a gritty feeling in their eye, or feel the need to try and remove foreign materials from the eye, although there may not actually be anything to remove. This type of conjunctivitis is also extremely contagious, and is more common in children.

Allergic Conjunctivitis

Allergic conjunctivitis often affects both eyes and is triggered by allergens, often during seasonal changes with pollen and other substances present in the air.

Hay fever, asthma and eczema are also common causes of allergy related pinkeye. In response to the allergens the body releases histamines, which can cause a red or pink color to the whites of the eye. Allergic conjunctivitis is not contagious.

Conjunctivitis caused by foreign chemicals or objects is also not contagious, and can be caused by a number of things. Any type of foreign object entering the eye can irritate it, causing it to become pink or red and even produce a discharge. Chemicals such as bleach that may splash in the eyes can also cause conjunctivitis. This is the shortest-lived conjunctivitis, and usually only lasts for a day at most.

What are the Risk Factors of Conjunctivitis?

Those that have eyes easily irritated by certain allergens can expect conjunctivitis when exposed to those elements, unless measures are being taken to prevent it. Likewise, whether or not a foreign object or chemical will affect a person depends upon the situation and person. However, for viral and bacterial conjunctivitis, merely being exposed to someone with this type of pinkeye can trigger the symptoms. It has also been found that those that wear contacts may have an increased risk of contracting conjunctivitis.

What are some Prevention Tips for Conjunctivitis?

Good hygiene is perhaps the best way to prevent the spread of conjunctivitis. Washing your hands frequently and not putting your fingers in your eyes are good tips to follow. You should never share eye cosmetics or personal care items with another person, and contacts, glasses, washcloths, and towels should never be shared from person to person.

Taking proper care of your contacts is also a good idea. For allergic conjunctivitis, avoiding allergens that trigger pinkeye is a good idea if possible. If you or someone in your family contracts conjunctivitis, it is important to take measures to prevent the spread of it throughout the family.

Discarding eye makeup and not wearing makeup are good ideas. Changing pillowcases and washing sheets and blankets in hot water will also be helpful.

Choosing to wear glasses instead of contact lenses may also help. You should use a cotton ball or tissue to wipe away discharge from the eye, which should be immediately thrown away and not used again. If eye drops are used to control the conjunctivitis, they should not be shared, nor should you use the same eye drops from an infected eye into an non-infected eye.

Staying home from school or work may also be necessary to prevent the spread of conjunctivitis.

What are the Test and Diagnosis Considerations for Conjunctivitis?

If you suspect that you or someone you know has conjunctivitis, a medical professional can easily diagnose it. Generally, taking a look at the eyes in a brief exam can tell a doctor if a person has pinkeye. The doctor may take a sample of the discharge from the eye that can be sent to a laboratory to diagnose exactly what type of conjunctivitis a person is suffering from.

A young child with reoccurring episodes of pinkeye may be referred to an eye specialist to try and determine what the cause may be.

What Treatment Options are Available for Conjunctivitis?

Different treatment options are available for the different types of conjunctivitis. Both home remedies and pharmaceutical treatments are available depending upon the situation. If you are unsure of what to do, it is important to contact your doctor first.

The most common home remedies for conjunctivitis include putting either warm or cool clean washcloths over your eyes. For conjunctivitis caused by allergies, cool compresses are recommended, but for bacterial or viral conjunctivitis, warm washcloths may feel better. While this method will not cure the conjunctivitis, it will provide relief. Bacterial and viral conjunctivitis usually resolve without any treatment at all, although it may be unpleasant to endure.

Marigold Plant

Another home remedy is to put the leaves of a marigold plant into cold water and to use it as eyewash. This is said to provide quick relief to the eyes. Placing cool, wet chamomile tea bags over your eyes has also been recommended as a way to decrease the redness in the eyes. Washing the eyes with chamomile flower tea has also been suggested as a way to provide relief.

Spinach and Carrot Juice

Spinach and carrot juice mixtures are also recommended during the duration of conjunctivitis. Drinking the juice of Indian gooseberry and mixing it with honey has also been suggested as a home remedy as well. Eating foods rich in Vitamin A and B2 may also be helpful in the treatment of conjunctivitis. Even using a cotton ball and placing baby shampoo over the closed eyes has been determined to provide relief for those suffering from conjunctivitis.

Each of these home remedies can be inexpensive, easy ways to provide comfort for those suffering from pinkeye, with relatively no risks to the eye when using them. However, if the home remedies and solutions do not seem to provide relief, pharmaceutical options may be necessary.

Traditional Medicine

For those suffering from allergy related conjunctivitis, seeking the help of a doctor is probably the best option. Although cool compresses and maybe even artificial tears may provide some comfort, for those with severe cases, antihistamines or other anti-inflammatory medications may need to be prescribed. Eye drops may be necessary, which can include steroids or decongestants.

Over the counter eye drops usually cost between $5-10, but they may not work as well as eye drops prescribed by your doctor. However, often these prescription eye drops can cost around $50 or $60 for a thirty-day prescription.

There is really nothing that can be done to treat viral conjunctivitis, except to let it run its course. While over the counter eye drops and warm compresses may provide some relief, time is the ultimate healer. Usually within a week viral conjunctivitis will go away on its own, although its not uncommon for it to last up to two weeks. Maintaining good hygiene is of utmost importance for those suffering from viral conjunctivitis.

Bacterial Conjunctivits

Bacterial conjunctivitis can go away on its own as well, however if the symptoms are not improving within three days, antibiotics, eye drops or ointment may be needed to cure the conjunctivitis. Ointments may be easier to administer to young infants or children, however they may blur vision for a brief time following being used. Whether it is a pill form or eye drop or ointment, prices will vary.

Generic versions are available for most options, which will decrease prices and make the treatment more affordable. Insurance should cover these treatments as well, which will help keep prices lower in most cases.

If you have contacted pinkeye from some sort of chemical or irritant, the first thing to do would be to try and wash out your eye. If water doesn’t seem to be helping the situation, or it was a harsh chemical that came in contact with your eye, a doctor will be necessary to help the situation. A saline solution rinse may be needed in order to clean the eye. This is a fairly inexpensive method.

Irrigation with Ringer’s lactate, which is saline, potassium, and calcium formula, may also be needed in the case of chemical irritants. Since permanent damage could be done to your eyes depending upon what has irritated it, seeing a doctor is advised. If nothing more, the doctor will be able to determine if you have damage or need additional assessments.

Getting Rid of Conjunctivitis

If you think you have conjunctivitis, the first thing to do is consider how you may have contracted it. Did you come in contact with something that could have irritated it? Are you allergic to something in the air? Were you around someone that had pinkeye? Do you have a cold? After answering those questions it can help you determine what type of conjunctivitis you may have. Unless a chemical has come in contact with your eye, most doctors would suggest letting the conjunctivitis run its course for a few days.

If the symptoms are too severe or you feel the need to contact a doctor, by all means do so. However, depending upon the type of conjunctivitis, there may be nothing that the doctor can do. Trying home remedies may provide relief without having to pay for a doctor visit. It is important to use good hygiene and even stay home for a day or two if you think you may be contagious. While it’s not a pleasant thing to get, conjunctivitis is not fatal, although if your eye has come in contact with some sort of chemical, there could be lasting damage. Although it can be pesky and annoying, conjunctivitis is a simple problem to fix with often minimal effort.

Chlamydia

The CDC estimates that more than two million people between the ages of 14 and 39 are infected with Chlamydia, also referred to as Chlamydia Trachomatis. Many people do not seek treatment because they do not realize they have fallen victim to this silent infection. There is also a certain level of under-reporting because of the social stigma that is attached to this disease. The CDC currently estimates that more than three million Americans become infected with Chlamydia every year.

Concerns for Women

Chlamydia will cause damage to a woman’s reproductive organs. Chlamydia has the ability to cause serious, even irreversible damage before the woman even realizes there is a problem.

Chlamydia can cause pelvic inflammatory disease in 40% of women who are not treated. This disease can permanently damage reproductive organs and the surrounding tissues.

Pelvic pain, infertility and ectopic pregnancies can all result from Chlamydia.

Women who have Chlamydia are five times more likely to become infected with HIV if they are exposed to it than women who do not have Chlamydia.

Concerns for Pregnant Women

Pregnant women with Chlamydia are at a higher risk for premature delivery. The babies are at risk for getting the infection in their eyes and respiratory tracts. Babies who contract this infection also commonly develop infant pneumonia and conjunctivitis, or pink eye.

Concerns for Men

Men who are infected with the disease do not typically suffer any complications. The infection can spread to the epididymis. This is the tube that carries sperm. In this event the result can be pain, fever and sterility. However, this is a rare event.

Another rare result of this infection is the development of Reiter’s Syndrome. This can cause arthritis along with skin lesions and the inflammation of the eye and urethra.

Symptoms

Part of what makes Chlamydia so dangerous is the incredible lack of symptoms. This disease can progress unchecked because roughly 75% of women and 50% of men will not experience any symptoms.

For those people who do show symptoms, they are typically seen between one and three weeks after the initial exposure.

Possible symptoms are listed here.

In Women

• Vaginal discharge
• Burning sensation when urinating
• Lower abdominal or back pain
• Fever and/ or nausea
• Painful intercourse
• Breakthrough bleeding between periods
• Eye infections

In Men

• Penile discharge
• Burning and itching around the penile opening
• Testicular pain
• Eye infections

If the infection is in the rectum, symptoms can also include rectal pain, discharge or bleeding. Chlamydia can also infect the throat area of people engaging in oral sex.

Causes

Chlamydia is caused by bacteria known as Chlamydia Trachomatis. This bacterium is transmitted through all sex acts, including oral sex and anal sex.

Risk factors

• Having sex with multiple partners is the number one risk factor. The more people a person is engaging in sex with, the more likely it is they are infected with Chlamydia.
• Teenage girls and young woman have a cervix that is not fully mature, and is therefore more prone to infection. This makes them at a higher risk of becoming infected with Chlamydia if they are sexually active.
• Men who have sex with other men are also at a high risk for becoming infected.

Prevention tips

• The most effective and fool-proof prevention for Chlamydia is to not engage in any form of sex. This includes anal, oral and vaginal sexual activities.
• If you are sexually active, keep any sexual relations limited to long-term, monogamous relationships.
• If you are faithful to your partner, but he or she is having sex with other people, you can become infected with all forms of sexually transmitted diseases.
• Condoms do more than prevent pregnancy. They will reduce the risk of becoming infected with Chlamydia; however, they are not 100% effective at preventing the spread of it.
• Remember that most other forms of birth control; such as the pills, shots and implants; are only designed to prevent pregnancy.
• Good communication is important. Make sure to tell your partner that you will insist on the use of a condom. If he or she balks or refuses, do not have sex with them. The condom will protect both partners from Chlamydia and most other STD’s.



• Your partner has a right to know if you have Chlamydia or another other STD.
• Be honest with your doctor. If you are having unprotected sex, tell your doctor.
• If you have an STD, don’t let embarrassment stop you from telling your doctor. And if you suspect that you might have Chlamydia, ask for a test.

Test and diagnosis considerations

Women and girls under the age of 25 who are sexually active should be screened annually for Chlamydia. Older women with a new partner or multiple partners should also be screened. Pregnant women should always be screened, due to the potential risk to the baby.

Testing is done through lab work. The urine can be tested, or the doctor may want to take a specimen from the penis or cervix.

Treatment options

• Antibiotics
• Single dose azithromycin
• This antibiotic is available in generic, as a tablet or in a suspension. To prevent upset stomach it should be taken with food, although it will be just as effective on an empty stomach. It will typically be taken once a day for five days.
• Aluminum or magnesium based antacids should not be taken when on this antibiotic. The antacids can bind to the azithromycin and prevent its absorption. There are not enough studies on this medication to know how safe it is for pregnant and nursing women.
• Side effects include diarrhea, nausea and abdominal pain, as well as vomiting. Less common side effects include allergic reactions, nervousness and abnormal liver tests.
• The cost will typically be about $30 for 15 pills. However, it is covered under most insurance plans and there is a generic option available for a greater cost savings. This antibiotic is known to be highly effective at curing Chlamydia.
• Doxycycline taken twice daily for a week
• The antibiotic doxycycline is available in a delayed-release tablet that is taken orally.
• This antibiotic is extremely effective at curing Chlamydia and is relatively inexpensive. The one week supply that is required for treatment can typically be obtained for less than $20.
• Long-term or repeated use of Doxycycline has been found to cause secondary infections. Any signs of a second infection should be immediately reported to your doctor.
• Most people do not have any side effects from the use of this medication. However, side effects can include loss of appetite, sensitivity to light, nausea and vomiting.

Serious side effects include:

• Severe allergic reactions; including hives, itching, difficulty breathing, chest tightness, swelling of the lips, face, mouth or tongue, and unusual hoarseness.
• Bloody stools
• Chest pain
• Dark urine or decreased urination
• Fever, chills, sore throat
• Severe diarrhea
• Unusual sunburn
• Headache that is persistent or unusually severe
• Stomach pains or cramps
• Throat irritation, trouble swallowing
• Unusual bruising and/or breathing
• Joint pain
• Exhaustion
• Vaginal irritation or discharge
• Vision changes and yellowing of skin or eyes.
• Diarrhea that is accompanied with stomach pains, cramps or bloody stools, you doctor should be contacted immediately. People taking this medication may be prone to sunburns.
• The sun, tanning booths and sunlamps should be avoided during this time. Doxycycline can impair the effective of hormonal based birth control such as the pill.
• Lab tests can be affected by this antibiotic; if you are having lab tests done be sure to inform your doctor and the lab workers that you are taking it.
• Children under age 8 should not take this medication as the teeth may become permanently discolored. Pregnant and nursing mothers should not take this medication.

Home Remedies

Each of these home remedies is effective due to the ability of the ingredients to boost your immune system. During these treatments, you should absolutely abstain from engaging in any sexual activity.

• Olive Tree Extract

  This can be taken orally, or rubbed on the location that is infected. The olive tree extract has oleuropein, which will help kill off the bacteria and reduce inflammation. It will also boost your immune system. It can be found as a liquid concentrate, powder, capsule or dried leaf tea. This extract has been shown to lower blood pressure and blood glucose.

• Raw Garlic

  Consuming a few cloves of raw garlic before or during every meal will help you get rid of Chlamydia. The chemicals that are found in the garlic have medicinal properties that will help kill the bacteria and clear up the infection.

  This treatment can cause problems with blood clotting for diabetics, so consult with your doctor ahead of time. You may also find that the garlic consumption gives you bad breath, or a bad body odor. Consuming too much garlic can result in nausea, vomiting or diarrhea.

• Curd

  Curd has bacteria that will help your body fight off infectious microbes and boost your own immune system. Eating homemade, unsweetened curds can help you treat the Chlamydia naturally. Yogurt can be used instead of curds.

• Sage Leaves

  Chop up 50 mgs of sage leaves and boil them in 250 ml of water. The mixture can be stores so that you can drink a little three times a week to cure Chlamydia. Sage leaves are found to be very safe, with no noticeable side effects.

• Precautions for Infected People

  If you have been diagnosed with Chlamydia, it is important that you notify all your sexual partners so that they can be tested. It is also imperative that you refrain from all forms until you complete the antibiotic round. To prevent re-infection, be sure that your current sexual partner is tested and treated. You should also be re-tested in three to four month to be sure the infection is completely gone.

Keep in mind that Chlamydia can be passed through all forms of sexual activity, including oral sex. Condoms can be used to prevent transmitting the disease, and should be used at all times unless you are in long-term, monogamous relationship.

Myths Surrounding Chlamydia

The Myth

If you don’t have any, you don’t have any diseases.

The Truth

Chlamydia can be asymptomatic, meaning that you can have it, and spread it, without showing any symptoms.

The Myth

Chlamydia is incurable

The Truth

Chlamydia responds very well to antibiotics and can be completely cured.

The Myth

Chlamydia is mainly spread through kissing, not oral sex.

The Truth

Chlamydia is transmitted through any form of sexual activity, especially anal, oral and vaginal sex.

The Myth

Don’t be alarmed if it burns when you pee, it could be nothing.

The Truth

Anytime you feel burning when urinating, it could be a sign of something serious. Stop having sex immediately, and contact your doctor.

The Myth

You’ll know just by looking at someone if they have an STD.

The Truth

People with STD’s do not look any different than anyone else. Never assume that someone is free of diseases just because they are very “clean”.

The Myth

Use two condoms for ultimate protection from STD’s.

The Truth

Using two condoms actually increases friction and the likelihood of them both failing.

The Myth

If I do have an STD, I’ll know it right away.

The Truth

Most STD’s have no symptoms, and can easily be passed along from one person to another because no one realizes they are infected.