Antidepressants Blog

You may have pins and needles and some pain or discomfort in your chest for a few days. Any numbness or tingling’ sensation under your arm may last several weeks or months. If you have had a mastectomy or auxiliary lymph glands removed, your shoulder will probably also be stiff. The exercises explained above will help you to regain the movement in your arm, and apart from doing these regularly, you should try to use your arm normally as much as possible. However, heavy housework and lifting should be avoided for about 6 weeks, and you should use your other arm to carry shopping etc.

Depression

You are likely to feel tired for at least a few days, and may find you become easily depressed. Many women experience a sense of elation immediately after their operation which then gives way to lethargy and exhaustion as the anxiety they have been feeling starts to be relieved. Mood swings are common, ranging from elation to depression and anger. This is a normal reaction which should settle down in time.

If you have problems sleeping, waking in the night and worrying so that you are exhausted during the day, your GP should be able to prescribe a light sedative which you can take for a few nights. Even three good nights’ sleep can help you to cope again, and stop the cycle of tiredness and anxiety.

If your appetite is poor, it will improve in time, and you should eat what you want when you want until it does so.

Although you should take things easy and rest when you need to for the first few days you are at home, it is important to try to get out and about as much as possible and to return to your normal life as soon as you feel able to do so.

Some women worry that they will be less attractive to their partners, or will be unable to find a partner, after a breast operation, but in the majority of cases these fears are unfounded.

Telling children about cancer

Young children can only understand very simple*’explanations about why their mothers have to go into hospital. By the age of 10, most children can grasp quite complicated details, and it is better to be honest rather than let their imaginations dream up something much worse than the reality. However, it is probably better to give them a little information at a time and gradually build up the whole picture, taking your cue from your children about how much they want to know. All children need reassurance, and a chance to express their own fears and to talk about things if they want to. Older children may find their anxieties difficult to cope with and to express or understand. They should be encouraged to talk about their fears, but not pushed into doing so before they are ready.

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A definite diagnosis of endometriosis is one made when a gynecologist has actually observed endometrial implants or cysts in your pelvic cavity during a laparoscopy (a minor surgical operation using a laparoscope) or, occasionally, a laparotomy (major abdominal surgery).

In general, a laparoscopy is the preferred method of diagnosing endometriosis because it is a simpler and shorter operation and the use of the laparoscope enables better detection of small implants as it magnifies them to several times their actual size.

Classical endometrial implants and cysts can usually be easily recognized and diagnosed by a gynecologist during a laparoscopy. However, atypical implants and microscopic endometriosis can be missed if the gynecologist relies only on a visual impression. An increasing number of gynecologists are using biopsies to diagnose endometriosis in doubtful cases. This involves removing a sample of tissue, known as a biopsy, from any area that the gynecologist thinks may be the site of an endometrial implant for examination and diagnosis under a microscope.

A definite diagnosis is extremely important as it enables an accurate assessment of the severity and extent of the disease to be made and provides a guide as to the likely effect of the condition on your fertility. This is essential information if you are to think about and make informed decisions regarding the management of your endometriosis.

The Commonwealth Department of Community Services and Health, which administers the Pharmaceutical Benefits Scheme, will not subsidize the cost of some of the drugs used in the treatment of endometriosis unless a definite diagnosis has been made.

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Studies in East Africa in the 1930s found that diabetes was rare. Nowadays there are diabetic clinics in all town hospitals.

Diabetes is undoubtedly an ancient disease and Galen, who lived in the second century and was the greatest medical authority in the Roman Empire, certainly described it. What most people do not realize is that he only saw two cases! The condition was further described in the seventeenth century in Europe, but it was rare until the eighteenth century, when it became a common disease among the English aristocracy. Obesity and diabetes emerged together as societies became affluent and ate more fat, oil, sugar, meat, wine and beer, together with refined cereals. In 1971 one researcher reviewing diabetes in the tropics wrote that, ‘The incidence of diabetes is likely to increase with urbanization or as the complexity of civilization takes hold of any racial group.’

Diabetes is not one simple condition, but a family of conditions. There are, however, two common types. The first (now called Type I diabetes) most commonly first occurs in children but can affect people of any age. Such people need insulin by injection – usually for life. This is a very rare condition among the children of many tropical communities and is also rare in Japanese children. Type II diabetes is the adult-onset type that usually, but not always, occurs in the obese (usually women). In both types genetic and environmental factors are important.

The cause of diabetes is as yet unknown but it has recently been suggested that a high intake of foods rich in high-fibre starch is protective and might even be a good treatment for diabetes. Trials have now shown that slimming on a high-fibre diet can ‘cure’ many cases of adult-onset diabetes completely. Other studies have shown that eating a high-fibre diet can reduce the need for insulin in Type 1 diabetes, and in certain trials patients have been able to stop taking insulin completely when eating the correct diet rich in unrefined starches. Obviously this all has to be done under the watchful eye of a doctor who is expert in diabetes-it is not a do-it-yourself treatment for diabetics.

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Shereen Tate discovered that eating a salad before she hit the party circuit put the brakes on her holiday overeating—and her inevitable 5- to 10-pound weight gain at holiday time.

Normally, the 32-year-old Niskayuna, New York, resident maintained good eating and exercise habits. She limited junk food, made sure she ate lots of fruits and vegetables, and worked out regularly. Even when’ her last pregnancy left her with 20 pounds of “baby fat,” she was able to take off the weight within a year, thanks to her healthy lifestyle.

Still, Shereen couldn’t seem to get through the holidays without picking up a few unwanted pounds. Every year was the same: At holiday soirees, in the presence of savory appetizers, tempting high-fat desserts, and sparkling champagne, Shereen would feel her willpower wane. By the time the New Year arrived, Shereen found herself toting around some of weight she had once worked so hard to lose.

Shereen was able to take off the extra pounds, but she hated having to do it year after year. As yet another holiday season approached, she knew she had to find a way to stop herself from overindulging. Then it hit her: Since she was most likely to eat too much when her stomach was empty, she’d make sure that her stomach was full before she started celebrating.

Shereen got into the habit of eating a pre-party plate of ro-maine lettuce or green leaf lettuce topped with carrots, cucumbers, and a splash of balsamic vinegar. She would leave her home with her tummy politely full. Once at the party, instead of lingering by the buffet table, she’d mingle with other guests. She’d sample a treat or two, but she didn’t feel the urge to overindulge, as she had before.

Shereen’s strategy worked like a charm. She survived that holiday season and seasons afterward without gaining a pound. Now that’s a cause for celebration!

WINNING ACTION

Start social celebrations with a private mini-meal. Before heading to a party, help yourself to a snack to take the edge off your hunger. I like to grab a V8 before party time. It’s easy, it’s quick, and I pick it up at a convenience store on the way. Other good choices include a piece of fruit, yogurt, or even a small plate of pasta.

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The best form of treatment available for post-herpetic neuralgia is the early administration of antidepressant medication such as Prothiaden or Tolvon (particularly useful in the elderly) and Rivotril. Other anticonvulsant medications have also been successfully used.

In recent years the early administration of the anti-viral drug Zovirax also appears to reduce the severity of the rash and subsequent pain in this condition, and the related conditions of Herpes Simplex Type I causing cold sores, and Type II which causes genital herpes.

Another new medication is a cream which contains capsaicin — a derivative of chili peppers — which appears to selectively exhaust substance P, a pain-causing natural chemical in the nerve endings. This cream, known as Capsig in Australia, must be applied at least 3-4 times per day for periods of up to 3 months to be of any long term effect.

Physical therapy may be of use in the early stages of the disease. Accordingly, acupuncture and perhaps TENS may have a role in the early treatment of post-herpetic neuralgia.

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Psychiatrists sometimes also like to play a variation of the game: ‘After you’ve cleared up the physical problem, send him to me for his emotional one!’

Such splitting of the mind and body is impossible, as any successful healer knows.

The ‘nobody will touch me’ game sounds as if it’s a patient-directed one. But this has been found to be rare. Despite much talk about doctors wanting their patients back from specialists, neurosurgeons and pain specialists, they do not go about it in a way that will achieve this. Some doctors treat patients who have major neurological problems like lepers. This can often happen with those suffering intractable pain and those who are failures of traditional medical and surgical therapy, and patients with implanted stimulators. (Implanted stimulators include dorsal column stimulation,in which wires are placed inside the vertebral column to directly stimulate the spinal cord to produce pain relief.) This is an extremely expensive, and sometimes painful, procedure which often fails to produce pain relief for more than six months.

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Fight or flight? Stand your ground or cut and run to fight another day.? Fear, stress, pain and suffering have been the companions of homo sapiens since the days of the cave-men. But the terrors of winged dinosaurs, giant cave-bears and lurking sabre-tooth tigers have been replaced by the even more menacing stresses and tensions of the roar of the morning rush hour to start another working day in the twentieth century jungle.

A stress may be congenital, muscular, immunological, infectious, neoplastic, chemical, degenerate, emotional, psychological, or even environmental, such as accident or shock.

Why the pressure’s on

Unlike our ancestors, who picked up a rock and hurled it at a menacing animal, it’s a lot harder for a New Technology tribe member to pick up a computer terminal and hurl it at the menacing deadline pressures, at a tyrannical boss pacing up and down for a late report, to hit back blindly at creative burnout when a sales strategy/adver-tising campaign for a truly awful product is demanded.

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The currently accepted definition of pain from the Taxonomy Subcommittee of the International Association for the Study of Pain — I ASP — in its 1979 report reads: ‘An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.’ In addition it is noted that pain is always a subjective experience — that is to say that pain is only experienced by the person suffering it.’

Each individual learns the application of the word through experiences related to injury in early life. In an earlier definition of pain Dr Harold Merskey, the Canadian psychiatrist working in the pain area, drew attention to the fact that pain was almost always associated with some form of visible or audible behaviour. Califor-nian psychologist Richard Sternbach had already proposed that pain had three components: a component pointing to the pain source as a harmful stimulus signalling possible tissue damage: a pattern of responses permitting recognition of the pain by an observer; and, finally, the subjective or private feeling of hurt.

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There are two forms of urticaria which differ mainly in their timing. The type which troubled Kustner (see p22) is acute urticaria, which comes on very rapidly and usually clears within 24 hours. It is usually accompanied by other symptoms, such as feverishness, faintness or nausea. Chronic urticaria, the other form, is a persistent rash, or one which comes and goes over a much longer period of time.

The blame for acute urticaria can usually be pinned on a food that was eaten just before the attack began, although there are other causes of acute urticaria, including insect stings, drugs (notably penicillin), and, more rarely, something that was applied to the skin. Whatever the cause, the reaction is usually so prompt and unequivocal that the patient easily makes the correct diagnosis.

With chronic urticaria, things are not so simple. Only about 20 or 30 per cent of people with this distressing problem are likely to discover the underlying cause. Two-thirds of those afflicted do not have high IgE levels, nor any other allergic illness, and it is not at all certain what causes their symptoms. However, those that can identify the source of their problem very often find that there are several triggers, including food or food additives. Whether they are acting as allergens, or have a drug-like effect, is an open question.

The subject of urticaria will come up again in Chapter Five, because even when the rash is truly allergic it can be caused in more than one way.

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In cases of varicose veins, the regular taking of Ginkgo drops will counteract the formation of blood clots (thrombosis). Everyone who is reasonably sensible and natural in his approach to nutrition and life-style will be able to achieve a veritable regeneration and rejuvenation when taking a course of these drops.

I have received many encouraging letters from patients who have found Ginkgo biloba to be an excellent remedy for a variety of complaints. In February 1986, one lady wrote:

‘I have been taking this remedy since October 1985. For years I kept getting a pain behind my left eye and when out walking I would involuntarily swerve to the left, often bumping into people. I even feared I had a brain tumour, but neither the eye specialist nor X-rays discovered anything like that. Tests of the throat, nose, ears and sinus were all negative. One doctor said that vascular and circulatory problems were to blame and prescribed Ginkgo biloba, “the best remedy there is,” he added. And that reminded me of your article in Gesundheits-Nachrichten (Health News), where you recommended Ginkgo biloba for the same complaints.’

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