Causes and Treatment of Erythema Nodusum

QUESTION: I have been diagnosed with a disease called "erythema nodusum", a
situation that I find very disturbing and a bit painful to boot. Can you tell
me what causes the disease, and what treatments I should be taking? As of
now, my doctor has done little but reassure me that it will all pass. I need
to know more. Thank you.
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ANSWER: Erythema nodosum can be the sign that alerts a physician to many
possible diagnoses. The typical marks of erythema nodusum are extremely
tender, bright-red nodules that seem to lie just below the skin and are spread
symmetrically over both lower extremities, although they can also appear on
upper extremities. As they fade, they often resemble bruises.
Erythema nodosum is considered to be an immunologic response to a wide
variety of conditions that may be present in the body such as tuberculosis,
sarcoidosis, inflammatory bowel disease and lymphoma. However, the three most
common causes of erythema nodosum are streptococcal pharyngitis, sarcoidosis
and medications (especially birth control pills and sulfonamides), of which
strep throat (pharyngitis) is the most likely cause in children. However, in
a large percentage of cases, despite intensive investigations, no specific
cause can be found. In this case it is labeled "idiopathic erythema nodosum",
and this is the most likely diagnosis in your case.
Many patients with erythema nodosum also suffer from fever, malaise,
arthralgias and arthritis. The disease is diagnosed by obtaining a biopsy of
the lesion and submitting it to a pathologist for evaluation.
In addition, a careful history is a must, as well as a thorough physical
examination. Laboratory testing is part of the process, and the choice of
tests depend upon the situation in which the nodules are found and may include
a complete blood count, chest x-ray and skin test for TB.
When a specific cause can be determined, treatment is focused on removing
the cause. For cases of strep throat, long term treatment with an antibiotic
for as long as 1 year may help.
When the underlying disease is removed, the nodules disappear as well.
In the case of idiopathic disease, complete healing of a lesion usually occurs
within a month or two of its appearance, even without specific therapy. And
that is why your doctor has been reassuring you without particular
medications. Only supportive treatment, such as bed rest, is necessary for
some patients with erythema nodosum. Patients with extremely tender nodules
usually require salicylates or other nonsteroidal anti-inflammatory agents to
help relieve the pain.

Epididymitis

QUESTION: When an intense pain in my scrotum would not pass, I finally
visited the doctor. He prescribed an antibiotic, said that all would clear up
shortly, and it did, and also gave me the name of the disease. He called it
"didi-mite," or something like that, but I was too embarrassed and in too much
pain at the time to ask any questions. I suppose people like me keep people
like you very busy, but can you please tell me what it was I had and why?
Thank you.
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ANSWER: I fully understand your predicament, and at a moment like that it
would be pretty hard to catch the name of a disease as difficult to pronounce
as "epididymitis". Actually, you came as close as most patients.
The epididymis is tightly coiled tube located on the back upper border of
the testicle. Sperm travels from the testicle to the urethra by way of the
epididymis and then through the vas deferens. The epididymis is a collecting
area, where the immature sperm spend up to ten days maturing and developing
the power to move on their own motility before passing into the vas deferens
where the greater majority are stored. Epididymitis is an infection of this
portion of the reproductive system.
The symptoms may unfold gradually, but develop into an intense pain in
the scrotum, accompanied by swelling of the area and a fever, that demands
medical attention. In some cases there is pain on urination or a discharge
from the penis. A urine culture will help to identify the bacteria, or
examining a stained smear of the secretions through a microscope. In most
cases, the bacteria is found to be a gonococcus or chlamydia. Once the germ
that is the source of the infection is found, the appropriate antibiotic can
be prescribed and the results are often apparent in 48 hours as the tenderness
resolves and the temperature drops down to normal. Analgesics, such as
ibuprofen and aspirin, are useful to control the symptoms during the first
days. Since epididymitis is considered to be a sexually transmitted disease
in the majority of cases, it is important that your partner be checked as
well, and receive antibiotic therapy if required.

Endocarditis--Simple Symptoms for a Serious Disease

QUESTION: I suffered with night sweats for some time. Though I felt that I
could endure this, my condition grew worse and I finally gave in and visited
my doctor. He diagnosed a case of SBE (subacute bacterial endocarditis).
With the proper medicines, he saved my life. I think you ought to list these
symptoms, and make people understand how important it is to visit their
doctors even when the symptoms seem trivial. You could help a lot of people.
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ANSWER: You make an excellent point, and though we can use your condition of
subacute bacterial endocarditis (SBE) (also known as infective carditis) as an
example, the principles apply to many other situations. The symptoms of this
disease can be very subtle, offered at a level that seem too trivial to be
concerned about, but they are the first clues that something is wrong. They
include night sweats, low grade fever, weight loss, weakness, lack of
endurance, the patient often being quick to tire. At times painful joints
develop, mimicking arthritis. Yet despite the fact that these may seem like
minor complaints, they all point to SBE.
The heart is lined with a tissue called the endocardium. When infection
strikes, it can affect the valves of the heart, and send clumps of infecting
microbes to other parts of the body through the circulatory system. If left
untreated, it can destroy the valves of the heart, leading to heart failure.
SBE is usually caused by a streptococcus, but is also caused by other
organisms, including Staphylococcus aureus. Often the disease develops after
an infection on the heart valves that provoked no symptoms, and resulted from
infections of the gums that released bacteria into the blood stream. It is
seen in men about twice as often as women, and is diagnosed at around age 40
to 50. The age at discovery is becoming older and older as antibiotics are
used more generally to treat other infections.
Without treatment SBE is almost universally fatal, yet therapy with high
doses of the appropriate antibiotic over sufficient time can eradicate the
infection. Here is another case where listening to the signs of disease your
body generates, seeking medical attention at the earliest possible moment, and
proper treatment can reverse a serious, life threatening situation. Thank you
for asking the question that permits me to restate that most important fact.

How Painful is Delivering a Baby?

QUESTION: I am pregnant, for the first time, and reading everything I can lay
my hands on. I want to know how painful it is going to be, and everyone of my
friends tell a different tale. Sometimes I think they just are pulling my leg
for the fun of it. Even my doctor is less than informative about this, and
she is a woman too. Can you help me? I really want to know.
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ANSWER: Even if I wrote a hundred different answers to your question, and
there are at least that many, I am sure your experience will be different.
And that is the point. Everyone's experience varies, and all I can provide is
a general answer, some averages and a few tips that may help.
As a first time mother, your labor will be longer than for a second or
third birth. As an average, it will be about 13 hours from the time you begin
active labor until the baby arrives. It could be less and it might be more.
See? Just averages.
Some women experience no pain at all, yet it is not called "labor"
without good reason. It is work, and hard work at that. Preparing for
delivery by taking one of the many courses offered by hospitals, birthing
centers and "Y's" can not only prepare you--and your husband--physically, but
mentally as well. The more you understand, the less your anxiety, and that
can lead to less pain. The exercises that form part of the training can help
develop your concentration, focus on meaningful muscular activity, conserve
your energies for the time that activity is most useful, and provide you with
relaxation techniques to use between contractions. All these elements lead to
a delivery that is "less painful". Or for those who are truly successful,
"painless".
Should the labor be protracted and demanding, help can be offered to you
in a number of ways. The use of narcotic pain killers still have a place
during the course of a labor, but have given way to two other techniques.
Both epidural and spinal anesthetics can be used to control pain, while still
permitting you to be alert and cooperate in the process. Finally, a general
anesthetic can be used if it is necessary for you to sleep while a difficult
delivery is accomplished.
Continue your research, learn all you can, take a good course, practice,
and then enjoy the marvel of new life. Good luck.

Information About Kidney Failure

QUESTION: Just the word "failure" is enough to make me shudder, but I need to
understand a lot more about kidney failure. Just what does this mean, how
does it effect someone's life, or is life possible with kidney failure? We do
not live in the same city as the relative for whom we are concerned, and hope
you can provide us with this information. Please?!
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ANSWER: The word "failure" has many negative meanings, and nowhere is it a
more threatening term than when used to describe the state of the kidney. To
understand what failure means, it is important to appreciate all the important
functions the kidneys perform when they are working normally. While solid
wastes leave the body as feces, and gaseous waste products (such as CO2)
depart by way of the lungs and exhaling, the liquid wastes leave by way of
sweat to a slight degree and through urine for the most part. And it is the
kidneys that control that function.
Many of the chemical processes in the body that lead to the development
of proteins use amino acids. Proteins form more than 10 percent of the
body's weight. Amino acids that remain after the body has used all it
requires are converted into urea by the liver, another waste product that
must be excreted from the body. And the passage out of the body for urea is
through the filtering mechanism of the kidney. Urine is thus composed of
water and urea, with a number of other chemicals as well.
When the kidneys are unable to filter these waste products out of the
blood, the wastes stay within the body, causing the symptoms associated with
kidney failure and impairing the functioning of many body systems. The three
major causes of kidney failure are the interruption of sufficient blood flow
to the kidneys (an obstruction of the renal artery for example), poisoning
with toxic substances that can destroy kidney tissue (heavy metals or some
types of industrial solvents), or infections or inflammations of the kidney
itself (nephritis).
There are two type of kidney failure, "acute" and "chronic". The acute
type is the result of a rapid deterioration of kidney function, often the
result of accidents, severe bleeding and shock or chemical toxins. Immediate
treatment is a must, for this is a life threatening condition. Chronic
failure develops more slowly, sometimes over a period of years, as bit by bit
the kidneys lose tissue, and the ability to perform the filtration function
that is the kidney's responsibility. The patient grows weaker, loses weight,
develops high blood pressure. Often the mental processes become dulled, there
are frequent headaches, and gastrointestinal (GI) symptoms such as vomiting,
stomach cramps, and even GI bleeding can occur. The most common cause of this
form of failure is glomerulonephritis, but long term untreated high blood
pressure can also lead to this serous disease. As the kidney fails the toxins
accumulate in the blood, and both blood and urine tests can provide the signs
necessary to make a diagnosis. This condition is frequently called "uremia"
(urine in the blood), and almost every system in the body is affected when
this occurs.
As the severity of the disease progresses, there are only two possible
therapies that can offer relief. The first is kidney dialysis, where the
blood is cleansed artificially by using a machine to perform the work the
kidneys no longer can do. The other, more preferable treatment is a kidney
transplant. Unfortunately, there are far more people needing this operation
than there are organs. Let this be my plea to all who read this column, to
consider including organ donation when they make their plans for the
inevitable that must come to us all.

Home Ovulation Prediction Kits

QUESTION: My wife and I are trying to conceive our first child, and we're
wondering about the effectiveness of home ovulation prediction kits. What's
the purpose of these kits and how do they work? Do you think they are worth
the price? We appreciate your column and your good advice.
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ANSWER: The purpose of the ovulation prediction kits is to identify the peak
period of a woman's fertility during her menstrual cycle. Fertility
specialists identify this peak as occurring the day preceding and the day of
ovulation. Though the egg released by a woman's ovary can live only 12 to 24
hours, sperm can survive within the uterus for 48 to 72 hours. Couples who
try to conceive will therefore increase the odds of success by having
intercourse during this peak fertility time.
Because every woman's menstrual cycle varies, there was previously no
simple way to predict when ovulation would occur, with the exception of
measuring the ovulating woman's basal body temperature--or waking body
temperature--which tends to rise the morning following release of the
unfertilized egg, due to speeded-up production of progesterone during the
egg-production process. Obviously, becoming aware of the basal body
temperature's rise can only take place in hindsight, after the egg has been
released, which necessarily limits the time in which conception can be
pursued.
Home ovulation prediction kits differ in being able to predict the time
of ovulation through measurement of a chemical change which occurs prior to
release of the egg. A surge in the luteinizing hormone (LH), which starts 24
to 36 hours in advance of ovulation, usually in the early morning hours, is
unaffected by illness, amount of sleep, emotional factors or other things that
can disrupt basal body temperature. Ovulation prediction kits employ a
complex technical process to detect the change in LH through urinalysis.
At present there are at least three different kits on the market.
OvuSTICK, including nine tests in a one-month kit, is a 12-step process
requiring careful attention to instructions. Users collect urine to test
throughout the day; the surge can therefore be detected in its first stages.
The kit is easy to use: a stick immersed in the urine sample turns dark blue
color when the surge has taken place. OvuQuick is another kit that can
usually be found at most pharmacies.
A third brand, the First Response Ovulation Prediction Kit, is even less
expensive and less complicated, though it too requires some attention to
timing and details. Surging is monitored by adding color-changing chemicals
to a series of urine samples. In this test only the morning's urine is
collected, with the goal of identifying the surge's peak rather than its
onset. The kit thus predicts ovulation only 12-24 hours in advance.
Since a fertile couple has only a 10 to 20 percent chance of conceiving
in any given month and it takes average couples several months for the woman
to become pregnant, using any of these kits regularly should not be used as a
diagnostic tool for fertility problems or as a substitute for a fertility
workup. Rather they are an aid to proper timing, which in this case is
essential for success. The average cost of around $40 does not seem excessive
for these methods, which all have been proven to be effective when used as
directed.

Nephrotic Syndrome

QUESTION: I am seeking the meaning of a disease called "nephrotic syndrome".
Where does it come from, and what will the future hold for the person who has
this illness? The physician's answers to our questions have been most
confusing, and we are turning to you in the hopes you can straighten this out
for us. I know you will try.
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ANSWER: To begin with the "straightening" process, I must define the word
"syndrome" for you. A syndrome is not actually a disease or illness, but
rather a term applied to a group of symptoms or signs that often appear
together. For purposes of this discussion a symptom is something the patient
experiences or feels subjectively, something unusual or abnormal that they can
report to the physician. Pain is symptom, suffered by the patient but
undetectable during the physician's examination. A "sign" may be observed by
the doctor, it is an objective finding. Fever is a sign, for it can be
measured using a thermometer, and can easily be compared with a normal
temperature.
The "nephrotic syndrome" is composed of the following signs and symptoms:
swelling around the eyes feet and abdomen, large amounts of protein found in
tests of the urine, and increased weight from fluid retained in the body (all
of these are signs), as well as loss of appetite (a symptom). The nephrotic
syndrome may be observed in a number of different diseases. They include
diabetes, multiple myeloma, glomerulonephritis as well as systemic lupus
erythematosus. It can result from an infection, exposure to certain drugs and
toxins, malignancy, or even be the result of an inherited disorder. The
common element in all of these is damage to the glomerulus, a basic structural
element of the kidney. The damage affects the ability of the glomerulus to
retain proteins, so they spill out and are found in the urinary tests.
Because there are so many possibilities, I can't answer your question
completely. When infection is the cause, antibiotics can cure the situation.
When the reason for the syndrome is the use of a drug and the offending drug
is stopped, the syndrome may disappear. The treatment thus depends upon the
cause, and the outcome depends upon the success of the treatment. Now that
you understand the terminology, perhaps your own physician's explanation may
make more sense to you.

Polyps in the Nose

QUESTION: I have been having a problem with my breathing, and after using all
the cold medications on the shelf, I finally overcame my fears and went to see
the doctor. He found "polyps" in my nose, and says I need surgery to remove
them. What would happen if I didn't go through this? What else could I do to
get rid of the problem? I'm just too scared.
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ANSWER: Apprehension is understandable, but there is little to fear here. A
nasal polyp develops when the mucous membrane that lines the nose is
constantly irritated as the result of allergies or recurring infections. They
may grow individually or in clusters, but when they become too large, they
obstruct the flow of air in and out of the nose and cause the breathing
difficulties you are experiencing. Sometimes they dwindle when the infection
passes, and using corticosteroids such as beclomethasone spray may shrink
them, but even then, surgery may be required. It is not a frightening
procedure, but can be performed as an office procedure using local anesthesia
to make the procedure painless. If medications fail, and you choose not have
them removed, they will probably just continue to grow, until you are so
uncomfortable that you have them removed after all.

Changes in Fingernails from Aging

QUESTION: Of late my finger nails are changing, and I am wondering if this is
caused by some hidden disease. The nail now has ridges running down its
length, and though I used to clip them regularly once a month, there isn't
much to cut away now. Is there any explanation for all of this, and could
you please provide it for me?
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ANSWER: While the finger nails' changing appearance can be a sign of an
underlying medical condition, the reason in your case is a bit less
frightening--that is, unless you fear the years that have gradually been
adding up, for the signs you mention are a result of a normal aging process.
The metabolism of the human body slows just a bit as age advances, and so
nails grow more slowly and often show vertical ridges that may cause concern,
but do not signify any health problems. The average growth rate of a finger
nail is about 1/8 to 1/4 inch per month, while the speed of toenail growth is
only one-third to one-half as much. Thus it takes about 5 1/2 months to
replace a fingernail, and well over a year for a toenail to grow in.
Other factors also affect growth rate. It is slower in cold weather,
slower at night, and the shorter the finger the slower the growth. Nail
growth in women is faster during their menstrual periods and during
pregnancies.
Nails may also suffer from local problems like fungus or bacterial
infections. In such cases there may be signs of local inflammation, nail
discoloration, abnormal thickening and even loosening of the nail. However,
your complaints can just be added to some of the others that age brings; a bit
disturbing, but far from serious, at least not in this case

Surgery for Acute Mastoiditis

QUESTION: Back when I was a youth, there was a serious operation that lopped
off a bit of the bone behind the ear. It was viewed with great alarm, but I
can remember several schoolmates displaying that peculiar dimple that resulted
from the surgery. I tried to explain this to my daughter, but can no longer
remember what the illness was, or why the operation was so dreaded. Do you
recall and can you tell me?
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ANSWER: Yes, of course I do, but there are few in this generation that have
experienced the tribulations of a once very serious condition known as "acute
Mastoiditis". The mastoid bone is really a round bump (from the Greek
"mastos" = breast, "eidos" = resembling) on the temporal bone, one of the
bones that forms the skull. It lies just behind the ear, and is easily seen
and palpated. The inner structure of the mastoid is a series of spaces in the
bone, honey-comb-like air cells which connect to the inner ear. The spaces
are lined with a thin layer of cells, the mucous membrane. They may become
infected following a serious infection of the inner ear that goes untreated.
About two weeks after the beginning of the middle ear infection, the
clinical symptoms of mastoiditis begin. An ear ache develops, and the mastoid
area behind the ear becomes red, painful and swollen. Pus may discharge from
the ear (otorrhea), and hearing is lost progressively as the infection
continues. The air cells become filled with purulent fluid, and gradually the
infection eats away at and destroys some of the bony tissue. This can lead
to further complications as the infection, now an abscess, proceeds inward
towards the brain.
In the days of which you write, it was necessary to provide an exit for
the abscess and the pus to prevent a brain abscess from developing. And so
the mastoid bone was opened, and as much of the infected bone was removed as
possible and the pus drained away. This operation is called a "mastoidectomy"
(Now, it all comes back to you now). Today, however, we live in the era of
very potent antibiotics, that have dramatically changed the picture. High
doses of penicillin are continued over a period of several weeks, until all of
the bacterial invaders are killed. In some cases surgery may still be
necessary if the antibiotic therapy is not successful, but the need for this
procedure is relatively infrequent.

Lung Trouble from a Clot in the Leg

QUESTION: I was hospitalized with lung trouble from a clot in my leg. The
explanations I received just don't make sense to me. Could you please tell me
what happened? I have an inquiring mind that wants to know.
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ANSWER: Great line, and it did get my attention. Very likely you suffered
from thromboembolic disease. That is a medical term that means the formation
of a blood clot which obstructs a blood vessel, usually in the legs (as in
your case) or elsewhere in the body. Such clots can be carried by the blood
to a different body site . . . often the lungs or heart.
Such conditions are extremely serious and are major causes of pain and
deaths, and so your hospitalization was really necessary.
Thrombosis, especially when in deep veins (those that run deep below the
surface of the skin), is very difficult to diagnose, often requiring the
services of specialists who use several highly sophisticated diagnostic
methods.
Patients who suffer deep vein thrombosis frequently have been subject to
prolonged bed rest--perhaps following major surgery or congestive heart
failure. Also, certain diseases, among them cancer and polycythemia vera (a
disorder of unknown origin that causes abnormal increases in bone marrow and
red cells in the blood) can cause it. Additionally, drugs such as estrogens
may increase the likelihood of clot formations, as do long periods of time
when portions of the body may be in a cast. However, deep vein thrombosis is
a common problem even in the absence of those conditions.
Physicians often have patients suspected of suffering thromboembolic
disease to rest in bed, elevate one or both legs, soak in warm baths, and take
anti-inflammatory drugs.
There are effective anticoagulant (decreasing the blood's ability to
clot) drugs that can be used, if a physician's diagnosis indicates they are
required. Two of those are heparin and warfarin. As all drugs do, those two
can have side effects. People taking them are watched very closely by their
physicians.
Other drugs can be helpful, and at times surgery is required to
completely correct the condition. All therapy depends upon your particular
condition, and should be discussed fully with your own physician.

Laparoscopy--Not Just for Women

QUESTION: I have been experiencing abdominal pain. My doctor has taken
x-rays and done an ultrasound test, but hasn't been able to make a definite
diagnosis. Now he wants to perform something called laparoscopy. I've known
women who've had that test for different female problems. But what would a
man need it? Please explain.
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ANSWER: Laparoscopy is a very useful, relatively safe test that allows your
doctor to look directly into your abdomen to view the organs located there.
During the procedure, a patient is put under a light general anesthesia, and a
small incision is made. The doctor then inserts a long thin tube-like
instrument that functions as a telescope. The physician can angle the
laparoscope in every direction to get a clear view of almost all abdominal
organs. Photographs may also be made during this procedure.
While the test is very helpful in diagnosing "female troubles," such as
endometriosis, ectopic pregnancies, ovarian cysts and problems with the IUD,
it is also a very practical test for determining problems that are common to
both sexes.
The procedure can help diagnose injuries or diseases of the gallbladder,
liver, spleen, and large and small intestines. This makes it as useful a
procedure to help men as it is in diagnosing women's special problems.
Laparoscopy is considered a relatively uncomplicated test. It involves
minimal discomfort for the patient, and is usually done in a hospital
outpatient department or an outpatient surgical clinic, as well as some
specially equipped doctors' offices. Recovery is most often quick and you may
even be able to get back to most of your normal activities the day after
having the test, although it's probably best to avoid strenuous work and
exercise for about a week.
This test rarely has complications. If you, however, experience severe
abdominal pain, unexplained fever, or redness, swelling or oozing after having
laparoscopy, alert your doctor to the situation, and follow through on any
directions you may receive.

Prune Belly Syndrome

QUESTION: My grandson was just born with an abnormally wrinkled stomach, or
so I have been told. My daughter has been informed that he has "prune belly"
syndrome. What is this? Is it dangerous? What must be done to help him?
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ANSWER: Prune belly syndrome (sometimes referred to as Obrinsky's Syndrome or
abdominal muscle deficiency) affects boys almost exclusively, and is caused by
a lack of the muscles in the lower and central portions of the abdomen. It is
also associated with abnormal development of the urinary and genital systems.
The cause is unknown, but may be related to a sex-linked recessive trait.
The skin of the baby's abdominal wall gets severely stretched because of
the absence of abdominal musculature. Because much of the muscle mass is
missing, the skin of the abdomen is severely stretched by the pressure of the
bowel and bladder. When the pressure is relieved, the skin then collapses
back into a mass of wrinkles, looking like the surface of a large prune, thus
the "prune belly" syndrome. Fortunately, as long as your daughter works
closely with a doctor who understands this problem, your grandson can lead a
normal life.
The baby will need proper abdominal support and he'll need diligent
urological care.
The physician will keep an eye on the growth and development of the
bladder, which may be distended in the early stages of this problem. It is
also imperative that the doctor monitor the kidneys continuously, as there are
some cases in which the kidney degenerates. Major complications are usually
avoided with proper care. Good luck to your grandson.

A Small Shock to the Mother Can Hurt Her Baby

QUESTION: It is probably nothing, but my daughter relates that she got an
electrical shock from an exposed wire to a bedroom lamp. She is pregnant, and
I am worried that this might have some effect on the baby, for I believe I
once read something about a similar situation. Can the baby be hurt if a
pregnant mother gets an electrical shock from a bad wire on a lamp?
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ANSWER: I am sure that you probably suspected this, but the answer is "Yes".
The baby is particularly vulnerable to a shock, even a minor one, because he
or she is surrounded by amniotic fluid and blood vessels that have an
especially low resistance to electrical current. A minor shock to a mother
may be a major shock to a baby in her uterus.
A pregnant woman who receives a shock like you describe should
immediately report it to her doctor, even if the incident seems minor. She
should note any decrease in the baby's movement. Her doctor should listen to
the baby's heart rate immediately and continue close observation for the rest
of the pregnancy, even if the initial physical examination reveals no
problems. If a mother has been shocked, she may develop a condition called
oligohydramnios, or scant amniotic fluid, and her baby's growth may be slowed
dramatically. It is uncertain exactly why this occurs, but it has been
observed many times, and is the reason that the answer to this seemingly
simple question has real importance. Not that this occurs in every situation,
but taking all the steps to be sure of continued close medical surveillance is
only prudent.

Will They Throw Me out of the Hospital Too Early?

QUESTION: It looks like I must have a surgical procedure that I have been
trying to avoid for months. It's not the operation that concerns me, but what
happens afterwards. I hear that the new insurance rules require that people
be thrown out of the hospital long before they are ready to go home. What
happens if something goes wrong? It's the stuff that nightmares are made of.
Can you give me some clues?
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ANSWER: Your description "thrown out" is a bit strong, but chances are that
you will return home a few days earlier than you would have several years ago.
It is all done in the name of cost cutting, but there are still many rules
that protect your well being.
To start with, after the surgery and general anesthesia, you will awaken
in a special unit called the "Recovery Room" where you will be closely
monitored to be sure all goes well. Specially trained nurses and the most
modern equipment assure close supervision, and an early detection of even the
slightest variation from normal. Once you are awake, breathing normally, and
over the effects of the anesthesia, you will be moved to another unit. If the
surgery was complicated, as may be the case for cardiac and neurologic
procedures, your next move will be to an "Intensive Care" unit (ICU), where
the level of care is high and the facility is equipped to handle any
emergency. With less complicated surgery, or when your condition in the ICU
permits, you will once again be moved to a general care unit. There your care
may be less intense, but you will be encouraged to begin moving about, taking
the first steps back to normal movement and your food will begin to resemble
your usual fare (well, almost!). When it is clear that the possibilities of
complications are past, you will be discharged, to continue your convalescence
at home. You may still require some help, a home health aide, or a special
diet. Surely you will have a scheduled visit to your surgeon within a few
days of your hospital discharge, when further directions for your
rehabilitation will be provided and your recovery will continue. All in all,
the time from surgery to the return to work will be about the same today as in
the past, but the proportion of time spent in the hospital will be less.

Autosomal Dominant Polycystic Kidney Disease

QUESTION: My brother has been told he has a disease that causes cysts to form
in the kidney. The doctor also told him it was inherited and therefore I
might have it as well. Have you ever heard of this kind of illness, and would
you share some of your knowledge with me? Thank you very much.
------------------------------------------------------------------------------
ANSWER: I believe your brother has been diagnosed with a disease of the
kidney known as "Autosomal dominant polycystic kidney disease" (ADPKD), (also
known as adult polycystic renal disease). ADPKD is a relatively common
familial disorder, affecting approximately one in 500 Americans, and the
possibility that you too may have the same condition without realizing it does
exist, especially if you are younger than he is. Patients with the dominant
gene have an almost 100 percent chance of developing the disease by age 80.
In individuals with ADPKD, the kidneys are abnormal from birth. Small
cysts are present in the newborn and gradually grow larger with age. As the
cysts enlarge, they press on the neighboring kidney tissues, reducing the
blood flow to these cells. The combination of increased pressure and
diminished circulation causes these cells to atrophy and die. This reduces
the ability of the kidneys to perform their functions. But this is a slow
process, often proceeding without causing any obvious symptoms, and in some
cases can go undiagnosed throughout the patient's entire life.
Most patients show no symptoms until their mid-twenties or early middle
adulthood. Because screening of asymptomatic individuals in families with
known ADPKD is recommended, you might wish to consult with your own doctor.
Ultrasound examinations, followed by additional studies in positive cases,
frequently provides a diagnosis before the onset of symptoms. Some of the
symptoms that may be provoked by ADPKD are; blood in the urine, renal colic
due to obstructing clots, pyelonephritis, hypertension, and in advanced
stages, palpable abdominal masses, chronic renal failure with the nephrotic
syndrome, weight loss, or subarachnoid hemorrhage from associated intracranial
aneurysms. Since chronic renal failure often occurs within ten years of the
onset of symptoms, you would be well advised to start your own investigations
now.

Pericarditis Simulating a Heart Attack

QUESTION: Our neighbor had a serious heart attack, but his wife claims it has
nothing to do with arteries or blood pressure. It developed just like one
though, but the diagnosis was called "pericarditis". Can you please explain
the condition for us? Thanks to rapid treatment he is doing well.
------------------------------------------------------------------------------
ANSWER: An attack of pericarditis can often resemble an ordinary heart
attack, as it starts with a chest pain that radiates to the left side of the
chest, shoulder and back, accompanied by shortness of breath. But the
similarity ends there.
While a "heart attack" results from the blockage of one of the arteries
that supplies blood to the heart, pericarditis is an inflammation of the
pericardium. The pericardium is a tough, fibrous sac that encloses the heart.
It can become inflamed following a viral or bacterial infection, often a
respiratory infection. The inflamed smooth inner surface of the pericardium
becomes roughened and rubs against the heart, producing the pain. In some
cases the pericardium produces more fluid than is necessary for lubrication,
and as the fluid accumulates inside the sac, it exerts pressure upon the
heart, so much so that the heart can not fill properly or beat as it should.
This condition is known as "Cardiac Tamponade" and is a most serious
complication of pericarditis. When the condition becomes life threatening, a
surgical approach may be necessary to drain the excess fluid and free the
heart from its constrictive envelope.
Treatment of the underlying infection, analgesics to relieve pain, and
diuretics (water pills) to reduce edema and swelling can produce excellent
results, but complete recovery can take from 2 weeks to three months to
achieve.

Definition of Paresthesia

QUESTION: What does a doctor mean when he uses the term "paresthesia"? I
have tried to look up the word in my dictionary, but I can't find it. Then
again, it is just a small volume. Can you please provide the definition, in
words I might understand?
------------------------------------------------------------------------------
ANSWER: You are right. It isn't in my small Merriam-Webster either. But
then again, I have some bigger tomes, in which the word is included.
According to Stedman's Medical Dictionary a "paresthesia" is "an abnormal
spontaneous sensation, such as burning, pricking, numbness etc". It is
"spontaneous" because it is felt without any provocation by an outside
stimulus, "abnormal" in that the description by the patient does not reflect
the actual situation, and because it signals that something is amiss. There
are a number of conditions in which paresthesias occur, including
fibromyalgia, restless legs syndrome, depression, diabetic neuropathy, and
many more. When a physician uses the term, it is an indication that there is
no apparent reason for the complaints by the patient about sensations and
feelings. And that is a flashing warning light that further investigations
are necessary to find a diagnosis.

An Explanation of Acute Pancreatitis

QUESTION: I need one of your special run downs about a disease. Your stuff
is better than anything in the medical advisors that cost so much to purchase.
Can you explain acute pancreatitis to me? As you might imagine, I and my
family have a real need for this information. Thank you.
------------------------------------------------------------------------------
ANSWER: Thanks for that nice compliment. Acute pancreatitis is inflammation
of the pancreas gland, most commonly resulting from heavy drinking or disease
of the bile ducts or gallbladder. But it can also be the result of trauma,
peptic ulcers or a high level of blood calcium. So there are many potential
causes, and it is difficult to diagnose.
The end result can be mild and self-limiting or severe and fatal,
depending on the amount of cell damage that occurs. This in turn is
reflected in the number of signs and symptoms present. In severe cases,
digestive enzymes in the pancreas, such as trypsin, run amok and attack and
destroy the cells of the gland itself.
Like some other diseases, acute pancreatitis is a "great imitator," as
clinical symptoms vary widely. But the most common are constant ulcer-like
abdominal pain (worsened by eating and lessened by sitting upright), nausea
and vomiting. Mild cases might produce only abdominal pain, while severe
cases include fever, rapid heart rate, bloated belly, and even a
semi-conscious state.
Because it can appear under different disguises, the only sure-fire way
to establish a diagnosis would be to examine the gland at operation. This is
impractical and rarely done, unless bile duct obstruction exists. Instead,
acute pancreatitis can be differentiated from other possible imitators by
laboratory tests and imaging techniques. A high level of amylase in the blood
or urine is one indicator that is highly sensitive but not specific.
To firm up the diagnosis, tests for tripsinogen, hemoglobin level,
leucocyte count, blood sugar and others are often needed. All this tests help
the physician obtain a clearer idea of the exact nature of the disease state.
In addition, x-rays might help reveal suspicious secondary changes in the
small bowel associated with the disease. Ultrasound and CT scans are helpful
in diagnosis and management.
The outcome of acute pancreatitis is uncertain, and the chances of death
increase for those over 55 years with a high white cell count, high blood
sugar, high blood urea nitrogen (BUN), high serum calcium, high hematocrit,
and high levels of various enzymes associated with destruction of the gland.
The anti-ulcer drug, cimetidine, and antacids are used in treatment to
decrease acids and prevent stress ulceration. Analgesics are used to reduce
pain and prevent spasm of the gland. But each case must be diagnosed and
treated individually, according to specific symptoms and life-styles.
Tube-feeding might be required; heart complications might arise, so
oxygen is often given; washing the abdominal cavity to remove toxic material
might be necessary; antibiotics might be needed for associated infections.
Since alcohol only worsens the disease, it should be strictly forbidden,
and that may help prolong your life. With careful medical management the
mortality from acute pancreatitis is slowly decreasing. Anticipating possible
complications and the course of the illness seems to be the best course to
follow at present.

Ductal Cancer of the Pancreas

QUESTION: After a brutal illness, my brother-in-law just died of pancreas
cancer. They called it ductal cancer. What does it mean? Do you think there
was anything that could have been done to save him? The family would
appreciate help in finding answers to their questions.
------------------------------------------------------------------------------
ANSWER: When a loved one passes on, the families often search for answers to
questions that, in fact, have no answers. I'll provide some information that
I hope will help. Ductal cancer of the pancreas means that it arose from
cells in the pancreas that carry the secretions rather than cells that make
the secretions. Such tumors are the most common, and about 80 percent occur
in the head of the pancreas, and can cause jaundice by blocking the flow of
bile. Ductal adenocarcinoma is twice as common in men than women, and appears
most frequently between 50 and 60 years of age. It is a silent cancer, and by
the time symptoms are noticed, it has progressed to the point where surgery is
difficult if not impossible. The most common symptom is weight loss and
severe abdominal pain, but these develop late. Routine laboratory tests are
often normal, but ultrasound and CT (computer tomography) techniques may
locate a tumor. However, confirmation would require a biopsy of the tissue,
which can be obtained by guiding a needle to the tumor through the skin.
Treatment with drugs (chemotherapy) is disappointing, neither conquering
the disease nor prolonging life. However, if the cancer has already spread, a
combination of drugs and radiation are used to offer some assistance and
relief. From the material you included with your letter, it would appear that
all that could be done was done to help.

Reasons to Diet

QUESTION: I am about 50 pounds overweight, but my husband says he likes me
the way I am. My doctor, however, says I am obese, and he's always
encouraging me to diet. He says it's bad for my heart and other parts of my
body to be so overweight. Could you tell me the "other" reasons that it is
unhealthy for me to carry around the extra weight?
------------------------------------------------------------------------------
ANSWER: Almost every system of the body suffers when a person is obese.
Doctors consider a person obese who is 20 percent above the recommended weight
for his or her height and build.
When a person is very overweight, the respiratory system may become
overtaxed. The extra physical mass, composed of fat, that rests on the
breathing apparatus is heavier than it should be. The additional weight
putting pressure on the larynx and rib cage makes it difficult for a person to
breath deeply, and fill the lungs to capacity with fresh air. In the
cardiovascular system, fatty deposits may accumulate on the arteries, causing
atherosclerosis. This may eventually impede the flow of blood to the heart.
Obesity can cause high blood pressure and cor pulmonale, the enlargement of
the right ventricle of the heart. Overweight people are more prone to
varicose veins and thromboembolism--blood clots which may move from the veins
to other parts of the body, particularly the lungs--than people who are
slender. The gastrointestinal system is also affected by excess weight.
Obese people tend to have fatty livers and gallstones much more frequently
than normal.
The most common complication of obesity in the musculoskeletal system is
osteoarthritis. Gouty arthritis and chronic destruction of the joints may
occur because of the excess of uric acid frequently found in overweight
people. In the female reproductive system, excess weight can interfere with
the amount of menstrual flow and the timing of periods. That is because being
overweight has an effect on the production and metabolism of estrogen, the
female hormone. Although uncommon in the general population, toxemia (a form
of blood poisoning) frequently occurs when the obese are pregnant or
postpartum.
The endocrine system can be negatively affected in many ways in the
overweight. The changes in the metabolism of testosterone and estrogen in the
obese may lead to excess hairiness.
Overweight people often suffer from diabetes. They also tend to have a
decreased metabolic rate. Another significant health risk to the overweight
is that cancer rates are much higher. The cancer rate in overweight men is
about a third higher, and obese women suffer from cancer over 50 percent more
often than thin women.
So you see, there are many reasons that it is wise to try to maintain a
healthy body weight. Maybe one or more of the health risks I've mentioned
will motivate you to diet. Remember, there is no race to rid yourself of all
the extra pounds you have been carrying around for so long. Don't crash diet,
because you'll probably regain the weight just as quickly, possibly even
gaining more than you lost. Take it slowly and sensibly and make sure your
nutrition does not suffer when you diet. Your best bet is to change the
amounts of food you eat, eating less of the foods you like best. Of course if
you switch from high cholesterol or fatty foods to low cholesterol, you gain
another benefit of reducing risks of heart attack or stroke.

Is Nausea During Pregnancy Harmful to the Child?

QUESTION: This second pregnancy is a great deal different from my first one.
I'm not breezing through this one as before, but experience a lot of nausea
and vomiting. I fear for the baby. Does the morning sickness mean my baby is
in trouble? I would appreciate any information you can provide.
------------------------------------------------------------------------------
ANSWER: It is most probable that your morning problems will have no effect on
the health of the baby. Few women go through a pregnancy without some nausea
and vomiting. In fact, only about ten percent of women sail through a
pregnancy without feeling at least a twinge of nausea, so your last pregnancy
was a bit exceptional.
Studies show that nausea and vomiting are a part of a healthy pregnancy.
Birth weights of babies born to women who have had nausea and vomiting are
higher than birth weights of babies whose mothers had no nausea. Nauseated
mothers also give birth to term babies instead of premature ones, for the most
part. The reason for this is not understood yet, but for now the information
should provide you with some reassurance.
If you are experiencing enough nausea and vomiting to interfere with your
nutrition and weight gain, however, the situation is very different. A
condition called "hyperemesis gravidarum" affects a small percentage of
pregnant women, and these women vomit so much that they often have to be
hospitalized for intravenous feedings. If they are not cared for, they become
dehydrated and their babies suffer.
Be certain to mention your concerns to your physician, who can then take
the extra moment or two to check out any potentials for trouble and help you
correct them.

What Happened to All the Tonsillectomies?

QUESTION: When I was a youngster, everyone had their tonsils removed at an
early age. Now I have 6 grandchildren, and none of them have had this
operation. Why? Have we developed a new breed of humans without tonsils?
Could you please explain what has gone right with our youngsters?
------------------------------------------------------------------------------
ANSWER: In a world where so little seems to be going right these days, I am
happy to provide you with your answer. No, these children do not belong to a
new breed, despite appearances. The major difference is the availability of
antibiotics that effectively kill the bacteria that cause the infection that
is know as tonsillitis. The most common infecting organism is of the
streptococcal variety, and is susceptible to penicillin. Early administration
of this or other antibiotics prevents the bacteria from gaining a foothold in
the tonsils, and reduces the frequency of recurrent infections. When tonsils
are not scarred by frequent infections they gradually dwindle in size over
time. However, when recurrent infections do occur, and tonsils hypertrophy
(grow larger) a tonsillectomy may still be indicated to remove the chronically
infected glands. It seems as though your "new breed" has just been a lucky
bunch, and avoided that problem.

Suggestions for Living with Tinnitus

QUESTION: You have to do something to help me. I have this constant, high
pitched noise in my ear that's driving me crazy, and my doctor tells me there
is nothing that can be done for it. What do you say?
------------------------------------------------------------------------------
ANSWER: The name of this condition is "tinnitus", a persistent ringing or
buzzing in one or both ears. My doctor tells me the same thing, that there is
no real treatment for you, me or the other 36 million people estimated to
suffer from this problem.
Of course there are a lot of causes for ringing in the ears, from wax in
the ear to allergies or low and high blood pressure. And you should have a
thorough examination to be sure that all the possible causes have been sought
out and corrected. However, if the cause is damage to the nerve that carries
sound from the ear to the brain, for the time being we are going to have to
learn how to live with it. I am happy to share with you some of the things
that I do to cope with my constant ringing companion.
First: I no longer fear it, or that I will lose my mind. I direct my
attention to other things and activities, which seem to make the sound less
intense.
Second: I keep music on, in the background, wherever and whenever
possible. This includes my clock radio, which plays for an hour while I am
falling asleep, and then turns itself off.
Third: I have been advised to cut back on caffeine, nicotine and
chocolate. I do pretty well with the chocolate advice, don't smoke, but still
haven't been able to cut out the coffee. Maybe you can.
Fourth: I know that fatigue is a stress that can increase the intensity
of my problem, so I try to avoid overfatigue, and rest when the opportunity
presents itself. I'm not overly successful with this either, but perhaps you
can do better than I do.
I will make you one sincere promise. If research provides a better
answer to our problem, you can bet it will appear in this column as soon as I
find out about it.

Is an Eyelid Twitch Dangerous?

QUESTION: There are some times, when for nor reason I can find, my eyelid
begins to twitch. I can put my finger on it, to try to hold it, but that
doesn't stop the twitches. Then as suddenly as it started, it just stops.
Where does this come from and what can I do about it? Is it dangerous? I
know this is some silly little thing, but perhaps you will answer me anyway.
I would be most thankful.
------------------------------------------------------------------------------
ANSWER: A twitching eyelid is a form of tic, or tiny uncontrollable movement
of a muscle. A tic is usually caused by an irritation of the nerve that sends
signals to the muscle. Several nerves control the muscles of your face,
including the tiny muscles that make up your eyelid. The twitch could be due
to a minor irritation of the oculomotor nerve (which controls the muscles that
move your eyes) or the facial nerve (which controls the muscles of your face).
If your eyelid twitch ever persists or gets worse, it should be examined
by your physician. A worsening facial tic can be caused by a tumor growth or
a cyst near the nerve. This situation is rather rare, however. In most
cases, the reason for your twitch may never be found. In that case, you may
get some relief by trying a few simple measures. Try applying either hot or
cold compresses on your eye lid or try gently stretching your eyelid, by
gently pulling it either up or down. These simple tricks often put an end to
the tic.
When no cause is found, a twitching eyelid is not dangerous, but it is a
nuisance. Try the simple physical measures I have outlined to get quick help.
If they don't work, you may simply have to wait until it disappears by itself,
and console yourself with the knowledge that you have nothing serious to worry
about.

How To Get A Good Night's Sleep!

Do you remember when you were little and it seemed as though sleep overcame you as soon as your head hit your pillow? And you slumbered through the night until morning time? They call it the sleep of the innocent, but don't you wish you could sleep like that again?
Adult responsibilities, stress, lifestyle and other worries often result in poor sleep habits and once the cycle of tossing and turning begins, it is difficult to return to a decent night's sleep. Many adults rely on prescription drugs to fall asleep and quite a few are addicted to them! Others 'self medicate' and use alcohol and other recreational drugs to try and fall asleep. If you are regularly struggling to sleep well, then you probably need to learn to fall asleep again!
So let’s go back to basics!
And who better to consult than babies! After all babies are the experts at sleeping so why not learn a little from them! Apart from their age and body clock, there are specific reasons that babies fall asleep so well. Let’s have a look at a few of them and see if we can’t borrow some of the tricks!
ROUTINE: Most parents try very hard to get their children into a routine. Regular bedtimes, bath times and mealtimes are something to strive towards. Of course, one cannot be too rigid, but a child on a regular routine will feel secure and will be able to ‘predict’ his environment more easily. It also helps his body clock to start the process of winding down before he actually gets to bed. He knows that after supper comes his bath, a story, a prayer and a good night kiss. When his head hits the pillow, he is ready to meet the sandman!
So try and follow this example. Start a night time routine. Make your evenings more or less predictable along the lines of supper, bath and bed. For at least three weeks try and follow this simple routine and go to bed at the same time each night – about 8 hours before it is time to get up. Wear soft comfortable and cozy nightwear, specifically for sleeping (remember flannel pyjamas?)
EXERCISE: This is something kids do lots of! They don’t stop running around for a minute! Now I am not suggesting that you start running around wherever you go, but regular exercise is one of the best sleep aids around! It’s also free and healthy and has lots of good side effects. Take up a sport, go to the gym or start regular walks. You won’t regret it!
HAVE PEACEFUL EVENINGS: How many times don’t you hear parents saying to their kids “Calm down now, it’s nearly bed time”. Or “You’d better stop running around – you won’t be able to fall asleep!” Perhaps you say this to your own children – with good reason! Do you follow your own advice? Or do you sit up watching thrillers (or even worse the news!) or finishing off the day’s work that you brought home from the office? Sound familiar? Try a different approach. Never watch TV while trying to fall asleep. Rather dim the lights while you get into a hot bath and put on some soothing music. Use aromatherapy in your home – in particular lavender for it’s soporific properties. Be quiet and peaceful for the hour before you go to bed and your body will start to get the message!
OTHER HINTS: Avoid all products with caffeine or sugar after 6pm. That means coffee, cola chocolate and all 'soda pops' (fizzy drinks). Also stay away from heavy meals at night. Your tummy will be too busy digesting to allow you to sleep well! Don't eat red meat, refined products or lots of cheese. Go for pastas, grains, pulses, potatoes and rice. Good evening or bedtime drinks are warm milk, lettuce extract and chamomile tea (sleepy tea) - all safe and proven sleep aids. If you are really struggling, some herbal remedies to aid sleep are Valerian, Passiflora and Kava Kava. Try to put these simple hints to the test for three weeks only. You will be surprised at the difference they make! Should you do this faithfully and still struggle to sleep, consult your doctor or request an online consultation at www.feelgoodcounseling.com/onlinecounsel.htm
Good night!

About The Author
Michele Carelse is a qualified Clinical Psychologist and Licensed Counselor. Her website at www.feelgoodcounseling.com offers Online Counseling, free Support Groups, Recommended Reading and lots of interesting articles.

Web site Offers Skincare and Beauty Advice to Meet Unique Needs of Teens With Darker Skin

Web site Offers Skincare and Beauty Advice to Meet Unique Needs of Teens With Darker Skin
 by: ARA Content

(ARA) - Acne-prone teens with dark complexions have skincare and makeup problems unique to their darker skin tones, and also have difficulty finding skincare information that speaks directly to their needs. Now, teens with complexions ranging from the darkest shades of black skin to lighter olive-colored skin, can get expert skincare and makeup advice on www.pimpleportal.com.
Jeanine Downie, M.D., a dermatologist based in Montclair, N.J., recognizes the frustration darkly complected teens experience. "People with darkly complected skin, which can include persons of African-American, Asian, Latino, Mediterranean and Native American heritage, must cope with controlling their acne and are also more prone to scarring. Furthermore, they often have difficulty finding skincare information that addresses darker skin, and don't know that a dermatologist can provide treatment to help with their specific needs."
Celebrity makeup artist Michael Criscuolo, whose high-profile client roster includes supermodels Naomi Campbell and Tyra Banks, also knows that darkly complected skin requires a bit of extra attention when it comes to finding the right shade of foundation and cover-up. "Women with dark complexions sometimes have difficulty finding a natural shade of makeup to conceal blemishes and scars," says Criscuolo. "However, new lines of makeup that cater specifically to those with darker skin tones allow the skin to appear flawless, and best of all, natural."
Named one of 2000's "Best of the Web" by Access Magazine and awarded a Gold Triangle Award by the American Academy of Dermatology for furthering public understanding of dermatological issues, www.pimpleportal.com provides information for teens to help them cope with, cover-up and conquer breakouts and other skin problems. Dr. Downie and Michael Criscuolo offer teens with dark complexions the following advice:
Dermatologist Jeanine Downie's professional advice includes:
HANDS OFF - No matter what your skin color, adopt a strict "hands off" policy since picking leads to permanent scars. Darker skin is more prone to scarring and hyperpigmentation (a dark spot that remains on the skin after the pimple is gone).
AWAY WITH ASHINESS - Since dark skin can be extra sensitive, teens undergoing acne treatment often experience dry skin or ashiness. To avoid this condition, use a non-comedogenic, oil-free moisturizer all over the face in addition to your daily zit-fighting regimen.
TREATMENT X 2 - Black skin undergoes a two-step process during acne treatment. First, a dermatologist will probably prescribe a treatment to reduce and prevent breakouts. After existing acne is under control, some African-Americans require additional treatment for hyperpigmentation. Dr. Downie advises her patients to start each morning by washing with a cleanser containing alpha hydroxy acids and applying a bleaching agent like hydroquinone to treat dark spots. At night, Dr. Downie's patients treat skin with a pimple-fighting product like RETIN-A MICRO (tretinoin gel) microsphere, 0.1%, to prevent future breakouts, and again apply hydroquinone cream to even out skin tone.
Celebrity Makeup Artist Michael Criscuolo's expert advice includes:
GET EVEN - Darker skin tones tend to have more variations in shading than lighter skin tones. For those who lack an even complexion, match your foundation as close to your natural color as possible, then, using a large blush brush, swirl (almost like a car wash buffer) powder over your entire face for the appearance of evenness.
YOU GLOW, GIRL - If you suffer from oily skin, counteract oil slicks by applying a light layer of loose powder over your makeup. Keep your powder puff with you for touchups during the day.
BROW BEATER - Some African-American women have coarse or uneven eyebrows, so they choose to trim the hair and define the brow line. To create natural looking brows, use a brow pencil in your natural hair color and draw in brows. Be sure to use feather-like strokes so the line doesn't appear too bold or unnatural. If your brows are a bit thicker, apply an oil-free hair gel to hold hairs in place.
Visitors can log on to www.pimpleportal.com for additional skincare and makeup information. In addition, teens can subscribe to "What's Popping," a free monthly e-mail newsletter in which dermatologists and other skincare experts share information and "tricks of the trade" in dealing with a variety of skincare and makeup issues.
RETIN-A MICRO starts working in as little as two weeks, with full results after seven weeks. Unprotected exposure to the sun or tanning lights, extreme wind or cold, or use of irritating skin-care products may aggravate the skin. The most common adverse reactions to RETIN-A MICRO were limited to mild or moderate irritation of the skin. For specific questions pertaining to RETIN-A MICRO, visit www.retinamicro.com.

About The Author

Courtesy ARA Content, www.ARAcontent.com; e-mail: info@ARAcontent.com

This article was posted on January 17, 2002

Seniors on Muscle Beach? You're Never Too Old to Get Fit

Seniors on Muscle Beach? You're Never Too Old to Get Fit
 by: ARA Content

(ARA) - If you think you're too old to benefit from a fitness regimen that includes weight training, think again.
Seven years ago, Beatrice Maullin read about the Crown Valley Senior Olympics competition in her hometown of Pasadena, Calif. She had been working out at a local gym doing aerobics, machine weights and free weights. Thinking that there was no sport in which she could compete, she called to volunteer for the Senior Olympics. But when she saw that one of the events was powerlifting, an exercise in which she had become interested, she decided to enter the competition, despite having only two weeks to practice the proper form.
In April 1995, Beatrice won her first powerlifting gold medal. By the way, at the time she was 74.
Today, at 80, Beatrice has won 25 gold medals, holds the powerlifting world record for her age group (82.5 pounds), and is the oldest woman in the United States to compete in the bench press. She has won the "best overall" title in weight lifting for the past six years and has been featured locally and nationally in newspapers, magazines and television, advocating weight training for women of all ages.
Beatrice was not a fitness enthusiast all her life. "I took dance as a young girl, raised two boys, and ran my own businesses, but it's not the same as working out," she said. "I don't know why I waited this long to finally do something just for myself. There must have been some magic plan waiting for me to take that first step. I can't believe all this excitement and fuss started when I was in my 70s," she says. "I've never had so much fun."
Studies consistently show that weight training for seniors is beneficial in many ways. Increased strength can help improve balance, reduce blood pressure, stabilize blood sugar levels and lower cholesterol. A separate study also shows that women who take up weight training increase their metabolism for a longer period of time -- and therefore burn more calories -- by training with weights, as compared to jogging or other aerobic exercise.
And increasingly, fitness clubs are catering to seniors, who often are their most committed members and are by far the fastest growing segment of the health club market. For example, Gold's Gym offers discounts to seniors, including 25 to 50 percent off enrollment fees, and many instructors take special training to accommodate the needs of the older fitness club members, says Derek Barton, vice president of Public Relations and Communications for Gold's Gym International.
"Our mission at Gold's is to help all of our members fulfill their human potential," Barton says, "and that includes seniors. We want them to go for it. We not only have a growing number of seniors enrolling in our clubs, but also a growing number of seniors doing great things, like Beatrice."
Beatrice says that although the recognition and gold medals are nice, those aren't what keep her coming back to the weight room.
"I feel healthier, more exuberant, happier about the time I spend in the gym," she says. "I love meeting people of all ages at the gym, because they understand the dedication it takes to stay in good health. Of course, going to the gym to work out, you must allow extra time to exercise your jaw muscles, too!"
Beatrice has no plans to retire any time soon. In fact, she tries to get out and speak to women's groups as much as possible to spread the word about the benefits of weight training, even though she realizes it may create some competition in her age bracket.
"These new baby boomers are in for a big surprise when it comes to getting older if they have not been keeping fit by exercising," she says. "If they have not, the fit seniors will beat them mile for mile."

About The Author

Courtesy ARA Content, www.ARAcontent.com; e-mail: info@ARAcontent.com

EDITOR'S NOTE: For more information, contact Connie St. John, The St. John Group, (415) 454-2243, e-mail: constjohn@aol.com

This article was posted on January 17, 2002