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Wot's Up Doc??
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The following information is about MY health problems, it could help people cope with similar health problems but as no two cases are the same always consult your doctor for advice and treatment.
My Battle With Rheumatoid Arthritis
What On Earth Is 'Sleep Apnoea'?
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Rheumatoid Arthritis v Dennis Wheatley
From when I left school in the late sixties, I had always been in full time employment and apart from a couple of weeks off in all those years time due to bouts of flu that really hit me hard I had never suffered from ill health. I did have a spell of unemployment in the early eighties but I managed to find a couple of temporary positions during that time and it was one of those temporary positions that led to my big break - a permanent job at a time when unemployment was increasing all the time in our area. At last things seemed to be going right for me, that was until late 1987, as I was saying after my spell of unemployment I had recently been made a permanent employee at a local power tools factory after several spells working for them as a temporary employee and I was overjoyed at the prospect of a secure job. Around the same time my wife had also found permanent employment and so we could at last think about buying our own home, we had lived in council housing since meeting and marrying in the early seventies. I could also consider the possibility of pushing myself forwards within the firm starting with applying to be a machine setter instead of just basic operating, everything seemed to be going great for my family and me....Until!!!
It was around December 1987 when
I started to realise that something was wrong regarding my health
because I started to suffer from aching feet and knee joints, I was
putting the aches and pains down to me being on my feet for most of
the time at work and I carried on as usual. The aches and pains began
to get worse and in August 1988 my wife had to call the doctor out to
our house and he wanted me to take a fortnight off work saying that I
had been overdoing things and he added that the aching joints could be
a spot of Rheumatism, I agreed to one week off work and then tried to
get back into my routine at work, not wanting to risk losing my job.
The week's rest had not eased the aching and I was soon off work again
this time for two days at the beginning of September 1988, I went to
see a different doctor who informed me that I was showing all the
signs of Rheumatoid Arthritis and that he would like me to see a
Rheumatologist. I could not believe what he was telling me and my
thoughts on Arthritis at the time were that it was something that only
old aged people suffer from!! While working a night shift in October
1988 I was sent home from work suffering severe pains in my legs and
my right leg had puffed up like a balloon. A specialist came out to
see me at home the following day and as soon as he saw what state I
was in he confirmed that it was Rheumatoid Arthritis and that I must
be admitted into hospital for treatment and thus began a personal
battle with a very ruthless opponent!!
I was advised by several older people with the same illness whom I usually met at my many visits to hospital for treatment, physiotherapy, hydrotherapy etc. that I must never give in to all the aches, pains and discomfort that comes with this dreadful disease and that I must keep on battling. In February 1989 after loads of treatment, medication and several visits to hospital I managed to get back to work but I had to be satisfied with ‘sitting down’ jobs and so my dreams of becoming a machine setter had gone altogether but at least I was still I was back at work. The illness had appeared to have stabilised and I managed to work on until March 1990 when after one of my bi-monthly visits to see the Rheumatologist I was back in hospital with a progression of the disease!!
It is now 1999 and I have not been able to go back to work since coming out of hospital in 1990, I see two specialists every four to six months, a Rheumatologist and a chest consultant. I also visit my GP regularly and I have blood tests done every couple of months. I am taking medication for both the Arthritis and also a chest problem that has developed, I am taking pain killers to try and ease the pain of aching joints, joints that are destroyed and disfigured. The medication itself has it's drawbacks with side effects and weight gain and who knows what other damage it does to my internal organs but the disease has to be controlled or I will suffer 'flare-up's' which are not nice at all believe me. While coping with R/A for over ten years I have also had to cope with the deaths of my Mother in 1990, my Father in 1993 and my Brother in 1996 so you will probably understand me when I say that I will be very pleased when the 'nineties' are over and done with, but one thing I do know is that I will never give in and will fight this disease to the end......Things Can Only Get Better!!!
Since I first put my WebPages online I have had several people contacting me who had come across my pages while surfing for info on Rheumatoid Arthritis, the only stuff that I know on R/A has come through experiencing and suffering this dreadful disease for the past 12-13 years. I have read a lot of books etc. on the subject but as no two cases of R/A are the same I cannot say what symptoms or complications anybody else who contracts R/A will suffer, I for example cannot stand the cold, if I eat red meat I usually suffer a 'flare-up', other sufferers of R/A might prefer the cold to heat or suffer no reaction to red meat. What I can say to anyone with R/A is, do not let it get the better of you, I know that sometimes the pain, discomfort and mental strain are dreadful but fight it and never let it get the better of you. Apparently the gene that causes R/A is in everybody and a 'trigger' sets it off and your immune system starts to work against you instead of for you. 'Triggers' can be anything from suffering a bereavement, strain caused through work or family problems, even moving home can be stressful enough to be a 'trigger'. If I can help anybody concerning R/A I will, even just a bit of advice may help.
March 2001....
First of all, thanks to all the 'fellow sufferers' who have e-mailed me either to compliment me on my website or to compare ailments. It is now 2001 and my R/A is supposedly in 'remission' (whereas I am in Submission!!) or stabilised as my Rheumatologist prefers to put it. The damage to my joints is extensive and the pain is sometimes unbearable, I know that if it was not for my other problems, Osteoporosis & my chest complaint that the specialist would probably suggest joint replacements but where would they start? If they could replace all my disease ridden joints I would end up resembling the Bionic Man!!
June 2001...
Well I've reached the grand old age of fifty, people have asked me already what it is like to be 50 and I tell them that my body was fifty about ten years ago when the R/Arthritis had set about destroying it and now my age is finally catching up. The R/A is supposedly still 'stabilised' but the constant aches & pains are still with me, I have virtually no grip in my hands at all now and every little task equals pain. The side effects of taking 'Prednisolone' (Steroids) long term seem to have caused yet another ailment, with my eyes now, the eye clinic have said it is probably 'Iritis' a disease linked with R/A (and what is the treatment? Yes more Prednisolone, this time in lotion form!!). Depression is always there in the background, I usually get severe bouts of the 'Why Me' syndrome when I can just sit and cry, all I ever wanted to do was to be able to work and to look after my family but now it is them who look after me especially a wife who is priceless. But life goes on, as they say, 'there is always someone worse off than you', I know this but believe me it does not help and besides as someone once said in the film Blazing Saddles, "I Hate That Cliché". Why is it that governments can spend absolute fortunes on stuff such as sending shuttles, rockets etc. into space, donating millions to useless causes yet medical research, hospitals, clinics etc. are left way behind on their lists of priorities, the once proud health service here in the U/K is becoming a joke and unless you have money you are well and truly f****d.. We are always hearing about these fantastic breakthroughs in the cures for cancer, arthritis etc. then they all seem to fizzle out and nothing is ever heard off them again!! They come up with these fantastic (overpriced) drugs to treat illnesses and then we discover that the long term side-effects are worse than the disease for which we are taking them for!!
My poor old disease ridden hands.
April 2002...
Yet more health problems!! Cellulitis is becoming a common occurrence, I have been treated for it four times already this year. Apparently with my mobility & health problems I am vulnerable to ailments such as Cellulitis so it is even more medication in the form of anti-biotics to treat the infection. I have noticed that with all these other 'side-effects' that are coming along I am becoming more and more depressed and I am really down at this present time, I have learnt to cope with all the aches & pains of the R/Arthritis but with all these other ailments as well, things are getting so bad, my life seems to be all hospitals, doctors, aches, pains & medication!!
July 2002...
I've just come back from a fortnight's holiday in Florida, I always feel better when I am away on holiday in a warm climate, the hot weather seems to suit me more than the usually cold, damp weather of the U/K. At the moment, as well as all the usual aches & pains I am now suffering with an painful, aching right hip, it looks as if the RA has finally spread to my lower back and hips, the pain is unbearable at times and painkillers only seem to ease the pain for a short while. I am fed up with getting up day after day and suffering in some sort of pain, I seem as if the only peace and pain free time I get is when I am asleep. It maddens me when I think of all these lowlife and scum that walk this earth and never seem to ail a thing. Yes I am in one of those 'feeling sorry for myself', depressed and fed-up modes at the moment but the aches and pains of this illness can finally get to the strongest of people and the fifteen plus years of suffering is wearing me down.
A bit of news on the plus side is the problem with the build up of fluid in my legs which was causing the regular bouts of Cellulitis has been eased because I am now being prescribed 'Water Tablets', yet more medication. Apparently the build up of fluid in my legs was causing the problem that led to the Cellulitis and although my doctor was not too keen on the the idea of me taking yet more medication the tablets seem to have done the trick (touchwood!!).
October 2002...
The cold damp Uk weather is kicking in and I hate it, I cannot stand the cold. The aches & pains are always worse during the winter months. I have recently been to see the two consultants who see me regarding the RA and my chest problems, I should say that I have seen their understudies. These six monthly trips to the hospital are getting to be a waste of time, I am not seeing the proper consultants I am seeing people who do not have a clue about my health, they tell me things that I already know and are no help whatsoever, they glance through my medical notes (The Book Of Shadows!!) then they state the obvious like "You are using your inhalers", "Are you on any painkillers". Take the latest trip to see the 'Chest' consultant, I know for certain that my breathing problems are getting worse and my health is deteriorating fast, my inhalers have no effect at all, I can be out of breath just by undressing or dressing, I explain the changes in my health since my last 'consultation' and what am I told, I have to try and exercise a bit more, "try and do a bit of walking!!" , this is brilliant advice for someone who also suffers with severe Rheumatoid Arthritis & Osteoporosis and to someone who is in severe pain just by standing up!! Maybe I'll try for next years London Marathon!! Why is it that when I 'complain' about my health to these people the first thing they suggest is, "maybe we should try increasing the Prednisolone" (steroids)? I do not want to increase the steroids, these are what I blame for the Osteoporosis, the weight gain, the 'moon' face, the thinning skin, the declining eyesight etc etc. The long term use of this drug may control the RA and ease my chest problems but is it worth it in the long run with all these 'side-effects'??
December 2002...
And so this is Xmas and what have we done, another year over....Yes here we are the middle of December and another year is nearly over, I hate this time of year, no I am no 'Scrooge' I just cannot get into this Xmas thing, I used to love it when my parents were alive, I was o/k then, looking forward to going to their house on a Xmas morning, all of the family around, those were happy times but these days I am glad when the whole Xmas / New Year thing is over. Another thing about this time of year are the cold dark days, I hate the cold weather I always feel worse in the winter, it has been another year of aches & pains, my health going downhill fast, the doctors and consultants visits this year were a waste of time as usual, always stating the obvious as usual. I am suffering with depression at the moment, I just cannot get interested in anything these days, the only time I feel fine is when I'm asleep, then there is no pain, no aches, no unhappiness. Ill heath is dreadful thing, waking up everyday in some sort of pain, mobility down to a minimum but life goes on...
June 2003...
I Have reached the grand old age of 52, my body feels as if it is 82!! I am still depressed and fed up, sick of waking up to face yet another day in some kind of pain, my knees are just about f****d, the pain when even just standing is unbearable. I get the impression that the doctors & specialists are beat over what to do for the best for me, some of the things that they are coming out with are ridiculous, I was always taught that if something was painful to do then don't do it, I am no masochist!! The depression is really bad at the moment probably because I have recently returned from a three week holiday in the sun over the pond in Orlando, Florida, it was brilliant. How come I always feel 100% better in the sunshine, I know that most people feel a lot better when away from the usual routine of work, pressure etc. but I don't work!! My aches and pains never seem as bad in the sunshine, the feel-good factor is great and I am treated as a normal human being instead of yet another 'thing' in a wheelchair. People were talking to me as well as the people who are with me, I usually get the 'invisible man' treatment over here in the U/K when we are out and negotiating a wheelchair in the U/K is a nightmare what with ignorant people, kerbs, narrow aisles in shops, unfriendly public transport etc. etc. etc. I suppose I am a lot luckier than a lot of disabled folk but a chronic illness really knocks the crap out of you, I can never understand why fit and healthy people are never satisfied with life after all they have the most precious thing on earth...their health.
April 2004...
What a crap year 2004 is turning out to be, it is only April and already I have had to call a doctor out to see me, I have visited the doctors five times, I have been to an urgent care centre at a local hospital and I have seen a consultant (rheumatologist). The health problems seem to be coming thick and fast these days, it is as if my immune system has packed up altogether!! Already this year I have suffered with a chest infection, Cellulitis in both legs and I have been bleeding internally!! The Rheumatologist had X-rays done of my hips and knees and in his words my joints (especially my knees) are completely knackered!! I have been referred to a surgeon but that does not look too promising because of my chest problems, we shall see. The pain in my hips and knees is at times unbearable and very uncomfortable, my mobility is about zero now, it is very painful just standing never mind trying to walk (or shuffle in my case). All this plus no holiday to look forward to is making 2004 a year I wish was over already!! Still life goes on as they say...
August 2004...
2004 still continues to be hell regarding my health. I am still waiting to see a surgeon & anaesthetist regarding possible joint replacements but this still looks doubtful. The pain in my right hip is unbearable at times, my doctor has tried me on some different pain killers but these were useless, I have also been referred to a pain clinic so I am now on a waiting list to see them. The internal bleeding seems to have been solved but a Barium Enema investigation has shown up a small polyp in my bowel. I have been told that it is not cancerous but it will have to be monitored so I now have a 'ticking time bomb' inside of me!! The recurring Cellulitis problem continues having just recovered from the problem in both of my legs. I have been advised to were compression socks (similar to flight socks) to try and curb the problem. What I need right now is a good dose of Florida sunshine but alas it is not to be not for now anyway.
November 2004...
Well after eight months of waiting to see a surgeon regarding possible joint replacements I finally get to see him. I had been warned beforehand by the Rheumatologist what the outcome would be but he still wanted me to see the surgeon so he could explain things. I was told that I needed four major operations, joint replacements of both my hips and both my knees, he explained that this would be an ordeal for a healthy person but for me it would be an extreme health risk. With the complications of my chest problems, asthma, osteoporosis, sleep apnia and being overweight due to immobility and long term steroid use the risk of one operation never mind four would be very risky. He could not guarantee me any decent mobility with the replacements because of the arthritis damage to my feet. The final decision however was mine to make and that if I said yes go ahead then he would be happy to oblige but if I wanted his true medical opinion then it just was not worth the risk. With this in mind and considering my family I have decided it is just not worth it, I have fought this battle for seventeen years now and although the pain is at times unbearable I shall continue the fight. I suppose I was expecting far too much in the hope of regaining some sort of mobility with a couple of operations but it just was not to be.
March 2005....
2005 and yet another ailment to add to my 'collection', Diverticular Disease...After several bouts of internal bleeding and me fearing the worst I have been diagnosed as suffering with Diverticular Disease, I have been reassured that with a sensible high fibre diet this ailment can be kept under control. I was really worried about this one, I have learnt to fight my other ailments but I did not fancy a battle with Mr. Grim Reaper not just yet anyway!! As for my 'other' problems, the pain in my hips especially my right hip is at times unbearable, I have now been supplied with a TENS machine but my first impressions of it is that against chronic pain it is a waste of time, but we shall see.
January 2006...
What a end to 2005, I can honestly say that I have been to hell and back this last two weeks...Whereas most people were looking forward to XBox 360's, PSP's and even just socks for Xmas I was looking forward to Cellulitis and food poisoning!! The Cellulitis I could cope with, been there done that after all but this food poisoning lark this was a new enemy, it started the Tuesday between Xmas and New Year...I felt a strange twinge not long after a mid-day meal, gradually the twinge turned to a sweating, clammy feeling and nausea, I was soon in bed sweating one minute and shivering the next, sick bucket at hand, I do not know why but I had it in my head that I had Rheumatic Fever. The wife wanted to contact an ambulance but I just wanted to go to sleep and hope this feeling went away, there was little sleep that night (or the next three) for the both of us. The doctor was called out and he confirmed that it was almost certainly food poisoning and the only thing to do was to drink plenty of water to 'flush' my system, I could continue with my normal medication for the R/A etc. but unless things got really bad no further medication was needed. It is now the following Tuesday and although I still feel like 'death warmed up' I am up and about and my appetite is very slowly returning, I know that I still not right I am tired and lethargic, I cannot get interested in my usual stuff but hopefully time will get me back to something of a normal routine (for me anyway). I can honestly say that I have never felt this ill, coping with other ailments was a doddle compared to this or the fact could be that I just cannot cope with illness anymore!!! It is now Jan 6th and I am just beginning to feel something like my old self, I am still getting the odd twinge in my stomach but I hope and pray that I am over what has been a lousy couple of weeks, here's hoping that 2006 has a bit more luck for me and my wife than last year.
June 2006...
I never thought the day would come when I struggled with everyday tasks, the aches and especially the pain is getting really bad making simple tasks like having a meal, getting dressed, washing etc. painful chores. Sometimes the pain in my hips caused by just sitting watching television is unbearable, what can be done? well I know the ideal solution is to replace the four major joints causing the most pain and discomfort, my knees and hips. I have been told that this procedure would be very high risk on account of my present state of health, I sometimes wonder if that is the real reason and if the true reason is money!! Even if I was to survive these joint replacements there is no way that my mobility would return because all my joints are affected so my feet and ankles would become a concern!! So would a health authority 'waste' thousands of pounds just to relieve pain when a cheaper solution is to prescribe pain relief and let me suffer in silence!! What maddened me recently is when I was told by the consultant that I should have had joint replacements years ago before my health got the way it is today but all those years ago I was told by consultants that I was too young to have joint replacements!!
Another thing that is really annoying is the way that help from social services these days is practically non-existent, once again this is down to money. When I recently enquired about a 'rising chair' to help me transfer from my chair to my wheelchair I was told that social services did not supply these anymore (this is rubbish) so my wife and I had to fork out nearly a thousand pounds to purchase one ourselves. I have a door intercom fitted so that I can open the door to callers, this has been reported (twice) as broken for over SIX months. Coping with my illness could be made a lot easier with help but the way it appears to be going at the moment is "you have the illness, you deal with it!!", when I come up against these negative appeals for help when the real reason is down to money it makes my blood boil to see all these millions of pounds raised by lotteries etc. going to waste on stupid projects that nobody really cares about anyway. I have always said that things can only get better but I am afraid these days that this is never going to happen, things for me are going to get a hell of a lot worse but I have fought this illness for nearly twenty years now and I am not going to give in now!!
January 2007...
What a lousy end to 2006...December 23rd, Benji the most loyal little companion I had the privilege to know died at the age of nine. Benji was a Yorkshire Terrier that me and my wife bought when he was only five weeks old, he was with us for nine years, nine years giving love, laughter and loyalty. It did not matter to him that I was disabled, he seemed to understand that I could not take him for walks or play with him on the floor yet the loyalty and love he gave me was fantastic, I will never forget him. His death caused through a heart complaint came two days before Xmas, a Xmas that was a blur to me and the 23rd December 2006 is a day that I will never forget, one of the worst days of my life.
August 2007...
Here we are, August already, time is really flying by. It was about this time twenty years ago that the first signs of my illness were raising their ugly heads, twenty years of pain, sadness and disappointment. Don't get me wrong there have been some good times in those years but since this illness started I have lost so much - the ability to walk and do everyday chores, work, drive (I used to love driving), our own home, travelling to watch Man Utd at home, take normal holidays without the fuss and expense of being disabled etc. etc. the list is endless. I have just gone through a period of a really bad bout of depression, these black moods are getting worse, there are times when I just want to go to sleep and not wake up. When I read stories of these so called superstars that have checked into clinics because of depression it makes my blood boil, it must be really hard coping with all that wealth and fame, try twenty years of non stop pain and disability!!
August 2008...
It is hard to believe that it over a year since I added anything to this page, time flies by so quickly these days. Anyway what has happened healthwise since my last entry, well no miracle cures have been found so it is same old same old!! My health continues on it’s downward spiral, the RA is stabilised but the damage to my joints is done so there are still some very painful episodes in doing the simplest of things, even finding a comfortable sleeping position is getting harder. I always said I could cope as long as there was no pain when I was just sitting, relaxing, reading, watching telly etc. but even that is becoming a painful experience due to destroyed hip joints. Apart from the RA problems I now have hearing problems and I have been supplied with hearing aids, Cellulitis is becoming more regular, in fact I am sitting writing this with both my legs bandaged up due to Cellulitis, the feverish feeling that comes along with this infection is awful. The bouts of depression are becoming more regular, so much has been taken away from me, what I could do with is a nice long holiday in the sun, Florida preferably. I think that covers my latest health escapades but apart from all this crap everything is tickety-boo....Yeah Right!!
January 2009...
The years are flying by, it must be about ten years since I started this version of my website, they were earlier versions but I stuck with this version. Well January 2009 and things are more or less the same, my illness deteriorates of course but that can only be expected, as long as I can get about I will cope. It is four years since we had a holiday and I miss those Orlando days, the sunshine, the fun etc. still I have some great memories. When I think of all the things that I have had to give up on through illness it is no wonder that depression is always knocking at my door, I used to love going down to Old Trafford to see United play, I miss driving too and as working for a living that too went out of the door long ago. A big lottery win could solve a lot of my problems but I suppose that would solve a lot of people's problems, have you noticed how all the wrong people seem to win the lottery!! Being disabled is an expensive affair and the help that people are supposed to get is non existent around here. Well that's enough moaning on for now, happy new year to all who may be reading this and take care.
April 2009...
After eight months free of Cellulitis the
dreaded ailment returned at the end of April, firstly in my right foot
and then spreading to my left foot, it is now in both my feet and lower
legs. I hate suffering with Cellulitis because it is not only the
burning / itchy sensation but also the feverish feelings that come along
with it. I am not sure if it is the effects of the anti-biotics
prescribed to combat the disease but I always feel worse in the first
few days of the onset of Cellulitis, sickly feelings, tiredness through
lack of sleep, loss of appetite etc. I suppose it is just another one of
those things sent to try me.
March 2010...
May 2009 - Sept 2009 was a good period for
me I was feeling a lot better in myself and the aches and pains did not
seem as severe, then around Oct 2009 the weather started to change and
so did my suffering. We had one of the worst winters on record and I was
feeling lousy, the stiffness, aching, pains etc. were at times
unbearable. The Cellulitis was also getting more frequent and nobody
could explain why. It is now March 2010 and the weather is just starting
to pick up and so hopefully will I!! What it must be like to be able to
shoot off to warmer climes for the winter months, I know that it would
do me the world of good as I now dread the winter months.
May 2010...
After years of my Rheumatoid Arthritis being stable it is now
more active than an Icelandic volcano. What has caused this? Well who
knows, at first I was blaming the cold weather and lousy winter that we
have had, then I was blaming the consultant for 'messing' about with my
treatment, reducing dosages etc. It could be a combination of both but I
have gone through hell this past few months, I cannot get a good night's
sleep because of painful joints keep disturbing my sleep, I seem to
sleep in one - two hour periods. At this present moment in time I am
tired, weary and have very painful joints especially my hands, feet,
knees and hips. I see the consultant in July but I am considering
contacting his nurse for any advice. You would think after all these
years of suffering I would be used to it but this past six months or so
has been awful. On top of all this after a recent visit to my optician
for a sight test I get told that a cataract is emerging in my left eye!!
There has just been a mini heatwave here in the UK, just a few days but in those few days I felt great, the heat really eases the painful joints. Why couldn't I be one of these big lottery winners in the UK then I could be off to somewhere nice and warm for three or four months. As for the heatwave well it has long gone and the temperature has dropped right back down to the UK normal for May!!
March 2011...
Wow, it is
nearly a year since my last update, doesn't time fly when you are
having fun!! At this moment in time my illness appears to be stable
but I have noticed more 'deformities' at my left elbow and my
fingers so I suppose the disease is still active when it is causing
this damage. The aches and pains are still there of course and it is
getting more difficult to get a good night's sleep because of pain
and stiffness in joints, I have been sleeping until around the 5 am
mark which was good for me but this last few days I am having to get
up at around 4 am because of pain. The Rheumatologist has
increased the dosage of Methotrexate to see if that helps and it
seems to have eased the illness. He wants me to try another
medication as well as what I am already taking, the new medication
is Adalimumab (Humira), it is one of these anti-TNF drugs.
Apparently there have been good results with tests on people with
R.Arthritis but like all drugs there are side effects so the
treatment has to be monitored carefully. I am willing to try
anything that will improve my quality of life, hopefully this new
treatment will help.
May 2011...
Well I have had
four Humira injections, I do not know if they are helping because
although the pain and stiffness is easing I usually feel better in the
summer months anyway so the injections could be helping, I will give
them a couple of more months before making any verdict on them. The
cataract in my left eye has got so bad that I need an operation to
remove it, I blame the long term use of steroids (prednisolone) for
this. I am not looking forward to this operation because I hate anything
going anywhere near my eyes, I dread opticians doing eye tests etc. One
thing is improving though, I am sleeping better that is one good thing.
July 2011...
I have had seven
Humira injections and I do believe that there is improvement in the RA,
I feel a lot better overall, the pain and stiffness is at the lowest it
has been for years. It is just a pity that these injections were not
available to me years ago before my hips, knees and finger joints were
destroyed. I know that I will probably not walk again and the pain
caused through these joints when using them will always be with me but
at least there is improvement. The problem is will this improvement
last? I remember years ago at the beginning of this disease I was put
onto 'Gold Injections' and they did a great job, in fact I managed to
get back to work but after a while my body rejected the injections and I
was back to the pain and stiffness, I just hope my body does not become
immune to these new injections. What I need now is a good holiday so if
anyone wants to contribute to the 'Get Dennis Back To Florida Fund'
please get in touch!! (Just Kidding... not)
August 2011...
I think that the
Humira a reached a peak now and done as much as it can, I am still
feeling the benefit as far as ease of pain and slightly better mobility
goes but the fact is that my main joints hips, knees, ankles etc. are
destroyed and I have to accept that any pain now is not through
inflammation of the joints but joints that are damaged.
February 2012...
The cataract in my left eye got so bad
(everything was just blurred) that I had to have a operation to remove
it, I had the operation two weeks ago and everything is o/k. Believe it
or not but the worst part of the cataract operation for me was the
waiting around (three hours) and then having to transfer from my
wheelchair to the operation trolley and then having to lie flat on my
back for about thirty minutes, I was breathless by the time I
transferred from my wheelchair and got into the right position on the
trolley. I cannot lie on my back for long because it affects my
breathing and my chest begins to aggravate me, this plus the now aching
joints made it a very uncomfortable experience, the operation itself was
nothing you do not feel a thing and it is all over in twenty - thirty
minutes. The problem now is that I have to go through it all again
because the cataract in my right eye is getting worse so I am back on
the waiting list for another op. The Rheumatologist agrees with me that
it is the long term use of prednisolone that has caused the cataract
operation and we are working together to reduce the dose of prednisolone
gradually over a matter of three month spells. I am presently only on
6mg / 5mg alternate days and we were hoping to go down to 5mg / 4mg not
bad considering I was on a very high dosage at the start of this
illness. But I am not sure if it is the reduction of the steroid that
has caused aches and pains and stiffness of the joints to return despite
taking the Humira. I had to miss a dose of Humira because of the
cataract operation so it could be that causing the recent discomfort or
it could be just the freezing cold weather that the UK is having at this
time.
****************************************
A lot of people believe that copper has a positive effect with arthritis, rheumatism etc. easing the aches and pains. I myself wear a copper bracelet in the hope that it will help ease my aches and pains. I found the following text while researching the effects of copper.
"The benefits of
copper have been known since the ancient Egyptians first wrote about the
healing qualities in the Papyrus papers over 4000 years ago. More
recently however a serious study was carried out at Selly Oak Hospital
in Birmingham on the effects of copper on other germs and super bugs,
over a ten week trial, laboratory tests showed that the metal had a
serious effect on the following; it killed off the deadly MRSA and
Cdifficle super bugs, it also killed off other dangerous germs including
the Flu virus and the E coli food poisoning bug.
Professor Tom Elliot, the researcher and a consultant microbiologist at
the hospital said: "The findings of 90 to 95 per cent killing of those
organisms, even after a busy day on a medical ward, with items being
touched by numerous people, is remarkable. I have been a consultant
microbiologist for several decades. This is the first time I have seen
anything like copper in terms of the effect it will have in the
environment. It may well offer us another mechanism for trying to defeat
the spread of infection.
The Egyptians used it to sterilize wounds and drinking water, the Aztecs
treated skin conditions with the metal.
Copper is present in our diet in trace amounts and plays an important
role in the formation of red blood cells and in keeping our blood
vessels, nerves and bones healthy.
it is thought the metal "suffocates" germs, preventing them breathing.
It may also stop them from feeding and destroy their DNA.
The copper works on wrists by being absorbed through the pores and
entering the blood system, we all need a certain amount to function
properly, you will notice stiffness in joints will disappear after
wearing the bracelet for a short period, but if you stop wearing the
bracelet the symptoms return in a short period of time, I have worn the
bracelet for almost twenty years and have very rarely had a cold.
You do not have to be a believer to see the changes copper makes, in
fact it is sometimes better if you almost challenge the benefits as you
will notice all the little things that copper changes in your well
being."
While looking to purchase a decent copper bracelet
I found that a lot of them on offer were mostly expensive copper plated
bracelets. A lot of the offers were a rip-off charging £10 - £16, I therefore decided to custom make and supply my own. The
bracelets are hand made out of pure copper chain and clasps, they are not just copper
plated like other chains and they are not imported from abroad. I
usually make and sell my bracelets through eBay and to friends. I have sold a few
of these bracelets worldwide and if you are interested in purchasing a
bracelet contact me at (dwheatley@btinternet.com)
or have a look on eBay (I sell under the name of - menniz). Check my
feedback, the quality of the chains are great and the prices are
reasonable. Here is a
selection of my bracelets, custom made to various sizes and clasps.
****************************************
A chronic, progressive disease in which
inflammatory changes occur throughout the connective tissues of the
body. Most characteristically the process attacks joints of the hands,
feet, wrists, knees, hips, or shoulders. Inflammation and thickening
of the synovial membranes (the sacs that hold the fluid that
lubricates the joints) cause irreversible damage to the joint capsule
and the articular (joint) cartilage as these structures are replaced
by scar tissue. Rheumatoid arthritis is three times as common in women
as in men and afflicts between one and three percent of the population
in the developed nations. Its onset is most common between the ages of
25 and 50, but it also appears in childhood and among the elderly. The
outcome of the disease is unpredictable, with minorities of those
afflicted either recovering completely or progressing to crippling
disease.
Most persons with rheumatoid arthritis have a characteristic auto-antibody in their blood, one of the pieces of evidence that suggest that an autoimmune mechanism plays a role in the causation of the disease. (An autoimmune reaction is an immune reaction against the body's own tissues.) This auto-antibody is called the rheumatoid factor. What causes the autoimmune reaction is unknown, but there is evidence that persons afflicted with the disease have a genetic susceptibility to an environmental factor, such as a virus, that may trigger the reaction. Once activated, the rheumatoid factor recognizes another type of antibody as foreign and binds to it. This chemical binding activates the complement system, a series of blood proteins, which then causes the inflammation.
The active inflammation is first seen in the synovial membranes of the joints, which become red and swollen. Later, a layer of roughened scar tissue protrudes over the surface of the cartilage. Under this scar tissue the cartilage is eroded and destroyed. The joints become fixed (ankylosed) by bands of adhesion, which also may cause displacement and deformity of the joints. The skin, bones, and muscles adjacent to the joints atrophy from disuse and destruction. Painful nodules over bony prominences are fairly common manifestations that may persist or regress. Collections of white cells, mostly lymphocytes, in the connective tissue of muscle and nerve bundles cause pressure and pain. The nodular lesions may invade the connective tissue of the blood-vessel walls. (see also Index: synovial tissue)
A gradual onset seems to be most characteristic of rheumatoid arthritis. Pain and stiffness in one or more joints are usually followed by swelling and heat and are accompanied by muscle pain that may become worse, persist for weeks or months, or subside. Joint pain is not always proportionate to the amount of swelling and warmth generated. Fatigue, muscle weakness, and weight loss are common symptoms. Often, before prominent signs appear, the affected person may complain of coldness of hands and feet, numbness, and tingling, all of which suggest compression of the vasomotor nerve.
The most useful drugs in relieving the pain and disability of rheumatoid arthritis are aspirin and ibuprofen, which have anti-inflammatory properties. If large doses of these are not sufficient, small doses of corticosteroids such as prednisone may be used, though these powerful anti-inflammatory agents are themselves potentially dangerous. Physical therapy is helpful in relieving pain and swelling in the affected joints, with the emphasis on heat followed by exercises that extend the range of motion. Rest in the acute phase is important in association with maintaining a good posture to prevent deformity. In cases of severe pain or disability, surgery is used to replace destroyed hip, knee, or finger joints with artificial substitutes. Orthopedic appliances are frequently used to correct or prevent gross deformity and malfunction.
(Britannica Encyclopedia Cd.)
I myself have tried various 'alternative' medicines without success in relieving the pain or stiffness, of course as I have stated previously no two cases of R/A are the same and everybody is different so alternative medicine may be great. One article I did come across that may benefit other R/A & Osteoarthritis sufferers is the following -
MOTHER NATURE CAN HELP YOU PROTECT THOSE JOINTS!
A diet rich in fruit and vegetables, rich sources of natural plant compounds, is an essential way to protect against cellular damage, including damage to joints.One of the easiest and most efficient ways to increase your intake of these compounds is to drink homemade fresh fruit and vegetable juices. So if you suffer from arthritis, treat yourself to a blender and make your own fresh juice. A daily drink of fresh, homemade fruit juice is a delicious way to help you keep healthy! 0ther specific foods especially beneficial in the treatment of all forms of arthritis are flavonoid-rich fruits, such as cherries, blueberries and blackberries. Also important are sulphur-containing vegetables, such as garlic, onions, Brussel sprouts and cabbage.
Nutritional supplementation can of course provide additional help for those with osteoarthritis. Of particular importance is supplying additional antioxidant nutrients (selenium, manganese and Vitamins C and E) and the nutrients important in the manufacture of joint substances. Of these, niacinamide (a form of vitamin B3), pantothenic acid (vitamin BS), vitamin B6 and zinc are especially important. Look out for these in the foods and supplements you buy.
A plant historically used in the treatment of of osteo-arthritis is Boswellia serrata, a large branching tree native to India. Boswellia yields a gum resin known as salai guggul, which has been used for centuries. And a plant native to Africa, devil's claw (Harpagophytum procumbens) has a long history of use in the treatment of arthritis and especially gout. And of course, glucosamine is extremely effective in the treatment of osteo-arthritis.
GLUCOSAMINE THE NATURAL HEALER
Glucosamine is a naturally occurring substance found in high concentrations in joint structures. When taken as a nutritional supplement, it appears to be nature's best remedy for osteoarthritis. The main action of glucosamine on joints is to stimulate the manufacture of cartilage components, that is, the substances necessary for joint repair.
As people age, they lose the ability to manufacture sufficient levels of glucosamine. The result is that cartilage loses its ability to hold water and act as a shock absorber. The inability to manufacture glucosamine has been suggested as the major factor leading to osteoarthritis. In relieving the pain and inflammation of osteoarthritis, numerous studies have shown glucosamine to produce excellent results. These results occur despite the fact that glucosamine sulphate exhibits very little direct anti-inflammatory effect and no direct analgesic, or pain-relieving, effect. By getting at the root of the problem, glucosamine not only improves the symptoms, including pain, it also helps the body repair damaged joints.
The beneficial results of glucosamine are more obvious the longer it is used.. Because glucosamine sulphate is not an antiinflammatory or pain-relieving drug, it takes a while to produce results. But once it starts working, it will produce results. From a clinical perspective, glucosamine is extremely effective if given orally.
PLUS CHONDROITIN
Glucosamine and chondroitin, when taken together in supplement form, appear to provide the first real natural solution to osteoarthritis. Like glucosamine, chondroitin sulphate helps keep the _ cartilage filled with fluid. One of the key glycosaminoglycans (or GAGs), chondroitin sulphate is composed of repeating units, or chains, of glucosamine with attached sugar molecules. Because it acts like a cross between a magnet and a sponge, it plays an invaluable role in attracting water into. proteoglycan molecules, thus helping to nourish and hydrate the cartilage, both of which are vital in keeping it healthy, flexible and strong.
THE FIRST REAL CURE?
Thanks to the discovery of glucosamine and chondroitin, millions of sufferers around the world now have the means to improve the quality of their lives by halting the painful progress of their osteoarthritis. Meanwhile, the rest of us - including those with a hereditary disposition - have our first real opportunity to ensure that our own futures need never be blighted by this painful, crippling condition.
Has the solution to osteoarthritis finally arrived?
MORE EFFECTIVE THAN DRUGBASED THERAPIES?
Complementary medical therapists now routinely utilise supplements containing glucosamine, which is classified as an amino sugar. The scientific explanation is that it combines a molecule of glutamic acid and a molecule of glucose. It is a natural body constituent found in very high concentrations in cartilage, tendon and ligament tissue and it has been described as the glue that holds cartilage tissue together. In many clinical trials, it has been shown to be more effective than drug based therapies, for many people.
(I do not know the source of the above article it was given to me by a friend who thought it may be of use).
Of course all we arthritis sufferers know that there is no such thing as a 'miracle cure' but some of this info may benefit somebody but as always please consult your doctor first before trying any different ways of easing the pain and discomfort of arthritis.
As for Asthma well it is a very emotive and frightening condition for many people around the world. Although there is currently no cure, with the correct medications and education most people should be able to enjoy the quality of life they seek. It is very important to know as much as you can about your condition so that you are in control, home monitoring can help you to achieve this and while browsing the web for helpful info on doing this I came across a PC 'shareware' program that helps you do just that. It is called 'Asthma Assistant' and info on it can be found at - http://www.asthmaassistant.com The following article is from the Britannica Encyclopedia cd
Asthma
Chronic disease characterized by sporadic attacks
of shortness of breath, wheezing, and coughing. The disease is the
result of muscular constriction of the bronchi and swelling of the
bronchial mucosa. (The bronchi are air passageways branching through
the lungs.) Asthma may be caused by an allergic reaction
(extrinsic asthma), infection in persons with susceptible bronchi
(intrinsic asthma), or malfunction of the autonomic nervous system. Asthma
is common, shows a familial incidence, affects all races, and is
of generally equal incidence in males and females.
In an asthma
attack, contraction of the smooth muscle of the bronchial walls is
accompanied by swelling of the bronchial tubes and the excessive
secretion of mucus by the bronchial glands; the mucus in turn
obstructs or plugs the bronchial airways, thus causing the symptoms of
an asthma attack. (The distinctive wheezing sound made by asthma
sufferers during an attack is caused by the passage of air through
narrowed, mucus-filled bronchi.) The release of histamine and acetylcholine
seems to play a role in producing the symptoms of asthma attacks,
since these chemicals stimulate the smooth muscles of the bronchi to
contract. Histamine is in turn released by cells that are affected by
an allergic reaction. Thus, although there seems to be a hereditary
predisposition present in asthma cases, the actual attacks
themselves seem to be triggered by a person's exposure to allergens, i.e.,
substances to which he is allergic.
Asthma attacks
usually last from one-half hour to several hours. A person having an
attack can be treated by inhaling a vapour of epinephrine
(adrenaline), since this substance acts to widen the bronchi and
inhibit the mucous glands. The epinephrine may also be injected. A
person experiencing a prolonged attack that is resistant to treatment
with drugs is said to be in status asthmaticus. Prolonged or frequent
attacks of asthma may become dangerous if the sufferer is
weakened by fatigue and inadequate nutrition, if his oxygen
consumption is too low, or if emphysema develops. The preventive
treatment of asthma is aimed at determining which substances
the patient is allergic to and preventing his further exposure to
them.
Extrinsic asthma
usually begins before age 30, but intrinsic asthma may have
a later onset. Asthmatic patients may be allergic to materials such as
pollen, mold spores, feathers, animal dander, and foods; established
asthmatics may also experience attacks after exposure to sudden
changes in temperature or humidity or both, exertion, emotional
stress, strong odours, or smoke. Some 35-40 percent of childhood asthma
cases improve at puberty; a nearly equal number worsen, however,
so that treatment of all childhood cases is necessary.
Osteoporosis - The Silent Thief
Boning Up on Osteoporosis
Consider an insidious condition that drains away bone--the hardest, most durable substance in the body. It happens slowly, over years, so that often neither doctor nor patient is aware of weakening bones until one snaps unexpectedly. Unfortunately, this isn't science fiction. It's why osteoporosis is called the silent thief.
And it steals more than bone. It's the primary cause of hip fracture, which can lead to permanent disability, loss of independence, and sometimes even death. Collapsing spinal vertebrae can produce stooped posture and a "dowager's hump." Lives collapse too. The chronic pain and anxiety that accompany a frail frame make people curtail meaningful activities, because the simplest things can cause broken bones: Stepping off a curb. A sneeze. Bending to pick up something. A hug. "Don't touch Mom, she might break" is the sad joke in many families.
Osteoporosis leads to 1.5 million fractures, or breaks, per year, mostly in the hip, spine and wrist, and costs $10 billion annually, according to the National Osteoporosis Foundation. It threatens 25 million Americans, mostly older women, but older men get it too. One in three women past 50 will suffer a vertebral fracture, according to the foundation. These numbers are predicted to rise as the population ages.
Osteoporosis, which means "porous bones," is a condition of excessive skeletal fragility resulting in bones that break easily. A combination of genetic, dietary, hormonal, age-related, and lifestyle factors all contribute to this condition.
Changing attitudes and improving technology are brightening the outlook for people with osteoporosis. Nowadays, many women live 30 years or more--perhaps a quarter to a third of their lives--after menopause. Improving the quality of those years has become an important health-care goal. Although some bone loss is expected as people age, osteoporosis is no longer viewed as an inevitable consequence of aging. Diagnosis and treatment need no longer wait until bones break.
There is no cure for osteoporosis, and it can't be prevented outright, but the onset can be delayed, and the severity diminished. Most important, early intervention can prevent devastating fractures. The Food and Drug Administration has revised labeling on foods and supplements to provide valuable information about the level of nutrients that help build and maintain strong bones. FDA has also approved a wide variety of products to help diagnose and treat osteoporosis, including several in the last few
years.......Carolyn J. Strange
Another article....(source unknown)...
According to most information available on osteoporosis, it is a bone disease that affects women. Dr. Robert Lindsay, MD, PhD and President of the National Osteoporosis Foundation says that a majority of the 1,000 men recently questioned by a Gallup survey believed they could not have osteoporosis. However, Dr. Eric
Orwoll, a leading medical researcher in the field of osteoporosis in men says that 1.5 million men have osteoporosis and another 3.5 million are at high risk. Men and Osteoporosis places these numbers slightly higher at 2 million with osteoporosis and another 3 million at risk. American men over 50 years of age have a higher risk of suffering an
osteo-related fracture than developing clinical prostate cancer. One-third of the men who suffer hip fracture will die within a year. Men's Knowledge of Osteoporosis The lack of knowledge about osteoporosis and its complications are particularly dangerous because osteoporosis has no early warning. It is called sometimes the silent disease. Education is the key so that an individual can assess risk and seek help. There is no cure for this disease, but it is preventable, detectable and treatable. The National Osteoporosis Foundation is an excellent source for self-educating with a free kit available for men entitled "Bone Wise Strong Bones for Life", NOF, Post Office Box 96616, Dept.
MQ, Washington, DC 20077.
For the individual the real significance of osteoporosis lies in the danger of fractures. Low bone mass may be asymptomatic but it predicts future fractures as well as high cholesterol or high blood pressure predict the risk of heart disease or stroke. As bone mass decreases, fracture risk increases exponentially. Prevention of the first fracture is the goal.
Defining Osteoporosis
Osteoporosis is the loss of bone mass. Bone is living tissue. Specialized cells called osteoclasts break down older bone while other cells called osteoblasts form new bone. Travecular bone, one type of bone which comprises 20% of the skeleton, has lattice-like quality. When more bone is broken down than built, the bones become thinner and more brittle. As the condition continues to be imbalanced, that is more old destroyed than new being built, then the brittle disease of osteoporosis develops. This condition may deteriorate to the point that even everyday stress on the bone may cause fracture. Areas of the skeleton high in trabecular bone such as hip, wrist and spine tend to fracture more often due to osteoporosis. Bone Scan A picture of normal travecular bone and osteoporotic bone may be found at this same site. Children's bodies produce more bone than is removed, so their skeletons continue to grow in size and strength. Bone mass usually reaches peak amounts by the mid 30's. It is at this point that the decline in bone mass begins.
Risk Factors
Women have been the primary emphasis of this illness because it occurs more frequently in them--one in four. But it also occurs in one in eight men over 50. Osteoporosis occurs more frequently in women because of the rapid bone mass loss they suffer following menopause. Women are also usually smaller thus beginning with less bone mass, and they may not do as much weight bearing exercise as men. But by the age of 65 to 70, men and women begin to lose bone mass at the same rate and calcium absorption decreases in both men and women. Osteoporosis and Men According to Ego
Seeman, BSc, MBBS, FRACP, MD, men with back fractures who develop osteoporosis at relatively young ages may have underlying illnesses which should be investigated by a physician. Another problem involving men with this illness is that little or none of the research has studied men. Decisions regarding this illness are based on studies in women even though the pathogenesis in men and women is different. Osteoporosis in Men
Risk factors are similar in men and women with the inclusion of menopause in women.
Advanced Age
Family History
Small or Thin Build
Low Calcium and Vitamin D Intake
Physical Inactivity
Taking Corticosteroids, Thyroid Medications, Anticonvulsants or Anticoagulants
Smoking
Excessive Alcohol
Excessive Caffeine
Chronic Diseases of Kidney, Lung, Stomach and Intestines
Undiagnosed Low Levels of Testosterone
Men of all ethnic groups are affected, however white men appear to be at the greatest risk for osteoporosis. Osteoporosis Facts
Things I Can Do
Educate yourself and as soon as possible begin preventative actions to "head off" this disease. Know whether or not you are at risk and take action. Visit with your private physician about whether or not he feels you are at risk and have testing. The sooner an individual begins preventative measures, the better.
If you smoke, stop.
Get regular exercise.
Get proper amounts of calcium--recommended to be 1000 mg/day for adults, 1000 to 1500 mg/day for postmenopausal women and 1200 mg/day for adolescents. The best sources are skim milk and nonfat yogurt. Adequate Vitamin D, B6, B12 and K are also important. Some recommendations are for 1500 mg/day of calcium for 65 year old males. Get as much of the above recommended vitamins through diet and then supplement. The Nationa Osteoporosis Foundation recommends TUMS as an excellent calcium source.
Limit alcohol intake.
Women should discuss estrogen replacement with their physicians.
Tests for Osteoporosis
Current technology is available for patients to be evaluated if they are deemed to be at risk. There are scans which study bone mineral density and give physicians accurate and precise measurements with low radiation exposure. Radiation dosages are less than typical chest x-rays.
The most widely used technique for the measurement of bone mass is called DEXA for Dual Energy X-Ray
Absorptiometry. Other tests are available, but the low radiation and excellent precision of this test can be used to measure the spine, hip and total skeleton.
Any assessment and testing would need to be discussed and requested by your physician according to your needs. The exam is non-intrusive, painless and usually takes only 5 to 10 minutes.
Low bone mass in an asymptomatic patient predicts future fracture as well as high cholesterol and high blood pressure predict the risk of heart disease or stroke. As bone mass decreases, fracture risk soars. Prevention of even the first fracture is important.
Because of the accuracy of techniques used to measure bone mass, they can be used both for the presence of osteoporosis and for the indication of future fracture. Because fracture risk depends on the amount of bone present, standards for testing in women could be applied to men.
The cost of a DEXA exam varies from state to state. When comparing costs of osteoporosis estimated to be greater than 10 billion dollars, a DEXA is a relatively inexpensive test. And of course the benefits to the individual who may have an early diagnosis before a broken bone are immeasurable. The broken wrists, broken hips and back problems could largely be eliminated with both preventative treatment and treatment after diagnosis. Bone Scans
Treatments Available
Recent developments in medicine address the problem of osteoporosis in those who have had a definite diagnosis. There are drugs available that are non-hormonal and which make significant advances in the treatment of
osteopososis. Previously, only calcium supplements, hormone replacement and exercise were available, and all reduced the progress of the disease, but with aging, the bones continued to become more brittle and porous. Costs of complications of osteoporosis had been expected to skyrocket as the population continues to age and live longer. The new treatments available today should help avert these expenses and enhance life.
Currently available is a drug by Merck called Fosamax. It is already prescribed to many patients with osteoporosis. Another drug called Evista
(raloxifene) has just been recommended by the advisory panel of the FDA for approval. If it does receive FDA approval, the drug may be on the market in six months. It is a selective estrogen receptor modulator that works by mimicking the effects of estrogen, for example, protective effects on bone, while inhibiting bad effects such as increasing cancer risk in some instances. Trials have shown that raloxifene can increase bone density, but less than with traditional hormone therapy with estrogen or rival drug
Fosamax. If approved, this drug would compete with Premarin and
Fosamax. Fosamax is still not approved for men, and Evista would not be a solution for men either. Although Fosamax does not have FDA approval for men, it is being prescribed often now for them too. Early clinical trials were completed on women only, so that is why it was approved for women. It has not been shown to be harmful to men, and tests are underway to prove its effectiveness in men also.
Choices regarding treatment of osteoporosis should be discussed with your physician.
Can anyone tell me just what 'Sleep Apnoea' is? Not being satisfied with having R/A, Asthma, Osteoporosis & a chest complaint my body has decided that I am coping too well with these and so now I am informed that I may be suffering with 'Sleep Apnoea'. I am now awaiting for an hospital appointment to undergo tests to see if I do in fact suffer with 'Sleep Apnoea', all I know is that I am a very restless sleeper but I put this down to the R/A and I usually suffer with headaches when I awake, around the 4.00 a.m. mark!! When my wife recently informed me that I am ceasing from breathing during the night I told her that she must be mistaken but apparently this is one of the signs of 'Sleep Apnoea'. My consultant is convinced that I may have this complaint so I would appreciate any help, advice from any fellow sufferers of this complaint.
I have noticed since searching for info on Sleep Apnia that there are several ways that people spell 'Apnia', these are Apnia, Apnoea & Apnea so please excuse the different spellings on my webpage.
October 2000 - It now looks as though I do indeed suffer with Sleep Apnea or Obstructive Sleep Apnea to give it it's full name, I have recently returned home after a three day stay in hospital where I underwent tests to see if I did indeed suffer this complaint. I knew that I was showing all the signs of Sleep Apnia, over forty, snoring, headaches, weight gain and daytime tiredness and my wife recently informed me that during the night on several occasions I am suffering spells of ceasing from breathing (apnea's). In hospital I underwent a 'Sleep Test' where several electrodes were 'connected' to my body, these recorded my general sleep pattern, breathing, brain activity etc. On my second night in hospital I was given the chance to try out a CPAP (Continuous Positive Airway Pressure) machine just to see if there was any improvement, this too was monitored, apart from the awkwardness of the face-mask I know myself that my breathing during the test with this machine was better and I was informed that there were no episodes of 'apnea' during the night. I return to the hospital in a few weeks for the full results of the tests and until then I have been given the loan of a CPAP machine by the hospital just to see if my quality of life improves any. In the few days since returning from hospital I have used the CPAP machine and I myself feel as if there is improvement to my sleep pattern and my wife says that I am not as 'noisy', snoring & breathing during sleep. I myself can wear the CPAP mask and you get used to the slight 'humming' of the machine but these slight disadvantages are nothing compared to a good night's sleep.
Here are a couple of articles on the subject (source unknown)....
Sleep Apnia Defined
The Greek word "apnea" literally means "without breath." There are three types of sleep apnea: obstructive, central, and mixed; of the three, obstructive sleep apnea
(OSA) is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.
Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed sleep apnea, as the name implies, is a combination of the two. With each apnea event, the brain briefly arouses sleep apnea victims from sleep in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.
Sleep apnea is extremely common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.
Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues.
What is Sleep Apnea?
Sleep apnea is an abnormal physical condition affecting the ability to breathe during periods of sleep. In fact this disorder is defined by the
interruption of normal breathing after a person who suffers from the condition falls asleep.
Apnea is a medical term that was generated from the Greek word for breath
'ponia.' The Romans modified it to 'pnea'
(the source of words like pneumonia, and pneumatic). In Latin, an 'a' preceding
any term indicates a lack or absence of the item. So, a ponia or apnea means the
absence of breath. People who suffer from this disorder stop breathing for periods as short as twenty seconds and as long a two minutes after falling asleep. They only begin to breathe again when the oxygen in their blood stream decreases to the point of suffocation. See "Describe the Sleep Apnea Cycle."
Describe The Sleep Apnea Cycle:
-
Sleep in an individual who suffers from Obstructive Sleep Apnea is cyclic. This cycle may repeat itself over a hundred times an hour.
-
You fall asleep.
-
The muscles in your throat as well as the rest of your body relax.
-
The relaxed muscles allow the air passage in your throat to constrict or collapse in upon itself. Air flow is restricted or blocked.
-
The restricted air flow causes labored breathing accented by loud snoring or snorts. A complete closure may be the cause of pauses in breathing rhythm.
-
The amount of oxygen in your bloodstream begins to drop. Your body is continuing to use it, but it is not being replaced by breathing. The carbon dioxide level in the bloodstream begins to rise.
-
You continue sleep, struggling for air. This struggle may last 10,20,40 seconds between breaths.
-
Your pulse (heart rate) slows.
-
A center in your brain detects the altered blood chemistry (i.e. high carbon dioxide, low oxygen). This state is called hypoxia.
-
In order to prevent suffocation, the brain triggers a release of a chemical messenger, adrenalin. This chemical shocks the consciousness centers of the brain and causes a partial awakening.
-
The awakening causes the muscles to open the airway, the heart rate races in response to the adrenalin and causes a spike in blood pressure.
-
Several breaths are taken, blowing off the carbon dioxide and restoring oxygen to the blood. The blood chemistry returns to near normal.
-
The brain allows you to return to sleep.
-
The cycle repeats.
Treating Obstructive Sleep Apnea and Its Lesser Twin, Snoring
Patients as well as health care professionals should be alert to the interaction of several factors when considering treatment strategies for snoring and obstructive sleep apnea. Careful diagnosis and effective treatment of obstructive sleep apnea
(OSA, Sleep Apnea Syndrome) and snoring require attention to lifestyle, medical factors, and anatomical problems, as well as to the age and sex of the person with snoring and/or apnea. Phantom Sleep NewsletterTM from
Sleepwell®
by Gila Lindsley, Ph.D., A.C.P.
What is wrong with this picture?
Thanksgiving dinner, or perhaps it is Christmas dinner, or Passover. Uncle Charlie (or perhaps it is Aunt Charlene) has fallen asleep, as usual, on the overstuffed chair in the living room. and everyone chuckles fondly to see him (or her) snug in front of the fire,
his (her) arms resting gently on his (her) belly. Snoring up a storm.
Familiar picture? Probably. Endearing, sweet Norman Rockwell scene? No. The association of this picture to a potentially life threatening disorder called Obstructive Sleep Apnea has been known for about a decade. It is only over the past several years, however, that there has been enough media coverage for the disorder called sleep apnea to have reached public awareness. By this time, the message that loud snoring can be serious -- not humorous -- has been sent into the living room by network television shows such as 20/20, 60 Minutes, the Phil Donahue Show, and even the half-time show of the Super Bowl where the players wore band-aid like devices (designed to help control snoring) on their nose to help their breathing. The full picture of what to do when sleep apnea (or an incipient sleep apnea condition such as loud snoring) is diagnosed has been less well publicized.
The signs and symptoms of apnea are described in other materials. It is more likely in men and perimenopausal or postmenopausal women than in premenopausal women. It certainly can occur in children. If you snore you should become aware of the kinds of personal discomfort,
jeopardy when driving, and decreased function as well as possible medical jeopardy in which this places you.
The treatment of obstructive sleep apnea or snoring
The most important point to make about the treatment of Obstructive Sleep Apnea or Snoring Syndrome is that effective treatment requires several related problems to be treated simultaneously. At least the following need to be addressed:
Lifestyle factors
The impression is growing that to a large extent many cases of obstructive sleep apnea and snoring may be a concomitant of Western culture. The risk of significant obstructive sleep apnea increases with the numerous factors described below, many of which are problems endemic to our society. Correction of obstructive sleep apnea
(OSA) generally requires that these factors be eliminated. At times, elimination of these factors completely resolves the problem.
Weight
Excessive weight brought about by a sedentary life style, too many rich foods, or by medically related situations such as retention of weight after delivering a child or thyroid problems are probably the leading factors contributing to
OSA. Bedpartners almost invariably make the observation that the larger their snoring spouse became, the louder the snoring bellowed, and the more often they hear snoring pauses followed by snorts and a resumption of breathing (i.e., apneas--episodes of obstructed breathing). Conversely, in a large percentage of patients weight loss, aided by exercise if medical conditions don't counterindicate doing exercise, down to an ideal weight has reversed the process.
Smoking
Smoking has numerous undesirable effects on the body as Surgeon General Koop's report has by now made well known. Most pertinent to OSA are the obstructions to the airway which cigarette smoking causes: swelling of the mucous membrane in the nose, swelling of the tissue in the throat, blockage of the small vessels in the lung.
Alcohol
It is the partial collapse of the airway (breathing tube between nose/mouth and lungs) which is the immediate cause of snoring, and its complete collapse which is the immediate cause of apnea. Alcohol relaxes the imbiber, but also causes too great a relaxation of the airway during sleep. This, and other effects of alcohol on the body, mean that alcohol (in patients otherwise at risk) can either cause or greatly contribute to the development of loud snoring and apnea.
Organization of sleep and wakefulness across the week
There are two periods of sleep which, given the right circumstances, are especially vulnerable to the development of unstable breathing. These are Stage 1 sleep, which should only occur when a person is first falling asleep but which can occur many times during the night if sleep is poor); and REM sleep which is the time when dreaming most frequently occurs.
If a person, for instance, goes to bed at 10 PM and awakens at 5 AM each workday, but then waits until several hours later to go to sleep and wake up on on-work days, both Stage 1 sleep and REM behave oddly. This problem with REM and Stage 1 is also true if on some days of the week a person just does not get enough sleep, and then on other days of the week s/he makes up for it by sleeping much longer.
The result in both cases can be the development of very significant respiratory instability during sleep. It is not unusual in the sleep laboratory when recording the sleep of people with irregular sleeping hours to discover that all of their apnea is confined to Stage 1 and/or REM sleep. In our experience for these people correction of this problem minimally requires stabilizing bedtime hours across the week. Sometimes, this is all that is required.
Other factors affecting quality of nighttime sleep can lead to apnea
A disruptive bedpartner, a baby or child waking you up, aggravation from the day, sleeping during conventional hours (e.g. 11 PM - 6:30 AM) when the body's preference is to sleep a night-owl's schedule, excessive use of caffeinated products -- all of these things can also lead to the instability of Stage 1 and REM sleep. In turn, such instability can lead to an OSA tendency.
Medical problems
Anything which can lead to a blockage of the nose, the throat, or the lung potentially play a role in the development of
OSA.
Pertinent nasal problems include allergies to air-borne particles such as animal dander, dryness of the nose because of a wood burning stove, or a septum (structure separating the left and right sides of the nose) so deviated it completely blocks the flow of air through one side. Often in that case, other structures in the nose called turbinates grow larger on the unaffected side. The result can be almost complete blockage of nasal breathing. That, in turn, increases the effort the sleeper must make to breathe because of increased resistance to airflow -- and it is that increased resistance which can then create
OSA.
Factors which can block the throat include large tonsils, large adenoids, excessive amounts of fatty tissue, at times elargement of some of the complex tissue at the back of the throat.
Pertinent lung problem range from childhood asthma through emphysema. Apnea can also be a symptom of diabetes or hypothyroidism.
Specific forms of treatment
Addressing lifestyle issues
Addressing lifestyle issues is essential no matter what other factors might be involved. Here is an admittedly extreme example from our own case log which exemplifies the problems. In lesser form, the problems described are common among many OSA sufferers.
Mr. K is a 52 year old man who runs his own small business. The stress of overseeing his 25-some odd staff members, meeting deadlines, carrying out negotiations and so forth has led over the years to his having extremely poor sleep hygiene. Sleeping hours are very erratic. When he is worried, when he has to meet a deadline, or when he feels he simply cannot stop a task until it is absolutely finished, his nightly quota of sleep often is less then 3 or 4 hours. He catches up by sleeping for upward of 12 hours on his recovery days. He keeps himself going with up to 2-quarts of coffee and 3 packs of cigarettes per day. He rarely gives himself time for meals, but rather grabs food (generally junk food) on the run while sitting at his desk. At 5'7" his weight vacillates between 250 and 300 lbs. He does not use alcohol (but did in the past). When studied in the sleep laboratory, which in his case was necessary, an average of 45 apneas per hour of sleep was observed -- when he was able to sleep at all. That is, about once every 1 1/4 minutes he stopped breathing.
Treatment for Mr. K involved a short term interim measure which will be described below (nasal
CPAP), but of necessity also had to involve addressing these numerous lifestyle issues. In his case, because his lifestyle was so ingrained, we referred him to a behavioral psychologist to help out.
The overnight sleep study
The overnight sleep study provides some clues regarding treatment. The study can reveal disturbances of Stage 1 and REM sleep. Identification of these leads to further questions about lifestyle.
We may discover that the OSA is present only when the patient is sleeping supine (on the back). Gently turning the patient onto his or her side or stomach reduces the OSA. If we are not concerned that the patient is in immediate medical jeopardy, we may try to actually train the patient to stay off of his or her back during sleep. Please note that currently there is a debate about the safety of trusting the results of this kind of intervention.
The overnight study might demonstrate that OSA develops only when the person reverts to breathing through the mouth (vs breathing through the nose), so-called obligate mouth breathing. Otolaryngological evaluation (by an ear-nose-throat specialist) might demonstrate this to be caused by allergies (which should be evaluated by an allergist) or other causes that may restrict air flow through the nose. One current approach to correcting this problem is the use of rings which are placed inside the nostrils at night. Another device looks like butterfly band-aids that keep the nasal airway open if the problem is not too severe. There is yet insufficient evaluation of the rings and the Breathe-Right® "bandaids" to know how effective these treatment approaches are for OSA.
Nasal CPAP
CPAP (Continuous Positive Airway Pressure) is in most spheres considered to be the treatment of choice. The CPAP unit consists of an air compressor and mask which delivers pressurized air through the nose when a person is sleeping, and which then can open up the airway from the inside almost as if the air were an internal splint. The correct pressure for the individual is determined in what is called a titration trial in the sleep laboratory. If the nasal airway will admit the flow of air, CPAP has in many cases offered immediate relief. Some people opt to use CPAP indefinitely. Others use it to support their breathing during sleep until some of the measures which take more time to accomplish (e.g. weight loss, smoking cessation, correction of sleep-wake rhythms) have produced the desired effect. Not everyone opts to follow through with CPAP either short term or long term once they've experienced it. Some find the way they look when wearing the nasal CPAP mask to be offensive. Others feel claustrophobic with it, and yet others find that the compressed air causes dryness of their nose or -- in some cases -- sinus infections. In the majority of cases these problems can be rectified, but neither is this universally true.
For more extensive coverage, the reader is referred to Phantom of the Night by T.S. Johnson, M.D. and Jerry Halberstadt (New Technology Publishing, 1995) Phantom of the Night. It is delightfully written. It offers two vantage points on CPAP--one, from a respected pulmonologist, the other from a man who suffered from apnea for years before it was diagnosed. The information provided is useful, easy to understand, and covers the ground from the symptoms and biology of sleep apnea, thtrough the effective use of nasal CPAP. It is an honestly written book, and well worth the reading.
Surgery
Youngsters with demonstrated apnea during sleep usually have shown signs at home of poor concentration, of either withdrawal or aggressiveness, and of generally feeling poorly. For many of these young people, large tonsils which actually meet at the midline are the demonstrated cause. For the majority of these, a tonsillectomy may correct the problem.
In some people the lower jaw is set too far back. This also displaces the tongue backward which in turn blocks what is called the posterior air space (behind the tongue down into the throat). During the night, the combination of normal airway relaxation with the already limited airway diameter leads to the development of OSA. New surgery has become available for repositioning the jaw. Long term results are not yet in.
Repair of a previously fractured nose which has led to severe obstruction of the nasal airway is a cause which can be surgically corrected.
There are some forms of surgery in use now which are more controversial since they are promoted to stop snoring, but not necessarily the underlying apnea disorder; and since they are not necessarily for the purpose of correcting an obvious anatomic abnormality. Among these forms of surgery are:
straightening the septum in patients whose septal deviation is congenital and does not produce significant blockage of the nasal airway or induce obligate mouth breathing;
turbinectomy to correct enlarged turbinates;
uvulopalatopharyngoplasty (UPPP)
Called by some an internal face lift, a recent study reported a 79% success rate for UPPP treatment for an unselected group of patients with diagnosed OSA. Successful response was not defined as elimination of the apnea, but rather a decrease in apnea rate by half or more from the presurgical rate. To provide a more concrete sense of what was meant by success, the mean apnea rate after UPPP was still an average of 30 apneas per hour of sleep (compared to a normal range of 0-5). Thus the patient would still require treatment for apnea. A post-surgery sleep study should be done after this surgery.
There are therefore continued efforts to develop diagnostic strategies to fine tune decisions about which patients with diagnosed apnea are most likely to derive significant benefit from the UPPP. We add that attention must also be paid to the numerous other factors which also must be addressed when treating patients with obstructive sleep apnea.
LAUP surgery, which involves removal or shortening of the uvula (the structure which hangs down from the roof of the mouth, toward the back), removal of tonsils if present, and in some cases a shortening of the soft palate. It has been heavily promoted as a treatment for snoring. Success in treating snoring may, however, cause the patient to overlook obstructive sleep apnea, and this operation has not been demonstrated to be effective in treating apnea. Therefore, the possibility of apnea should be eliminated before this surgery.
Tracheostomy In very severe cases, when a person's breathing during the night is so impaired that his or her heart is highly dysfunctional and blood oxygen levels become perilously low, guaranteed immediate correction of the sleep-related breathing problem is critical. However, if s/he cannot tolerate nasal CPAP, a life-saving tracheostomy can be performed. This is the creation of an opening in the lower part of the throat, below the level where the airway collapses. Plugged during the day so that normal speech is possible, the tracheostomy is open for breathing during the night.
Oxygen
Oxygen is rarely used alone because of the way the brain uses information about how much oxygen is in the blood. That is, oxygen administration during sleep in some cases can paradoxically lead to significant worsening of the apnea. This becomes especially problematic when a person with apnea also has a chronic lung disease that requires oxygen. Oxygen at the correct flow rate when used in conjunction with nasal CPAP, however, in many cases corrects this problem. It is essential for the appropriate oxygen flow rate and appropriate nasal CPAP pressure to be determined while the patient is being monitored during nighttime sleep in a qualified sleep disorders center or apnea laboratory.
Medical interventions
In the case of an underactive thyroid gland, the obesity which untreated hypothyroidism can create eventually can also cause OSA. However, current data suggest that an underactive thyroid gland can lead to apnea even before the individual begins gaining weight. The mechanism is unknown. Thyroid hormone supplementation might lead to significant correction of the apnea if this is the sole problem. Because of this finding it has become common for routine thyroid function testing to be recommended if there is any suspicion whatever (including family history) of hypothyroidism.
For unclear reasons, uncontrolled diabetes can also lead to apnea. Control of blood sugar levels has, however, in our experience had at best a moderate effect in controlling the diagnosed obstructive sleep apnea.
Certain medications which increase respiratory drive are helpful in some patients. Progesterone (often marketed as Provera in the synthetic form), a female hormone secreted at a high rate during the third trimester of pregnancy when the growing uterus has pushed hard against the diaphragm and decreased the space lungs have to operate in, has been used with some degree of success in men and women alike. For perimenopausal and postmenopausal women, addition of exogenous progesterone might be the first treatment effort.
Dental appliances
Dental appliances worn during sleep, many of which gently move the lower mandible fortward, are increasingly being evaluated with respect to their efficacy in treating obstructive sleep apnea, with positive results in at least a subset of the patients studied. More studies clearly need to be conducted, but the current findings are promising, according to a recent consensus report by the American Sleep Disorders Association.
Conclusion
The actual cause of OSA is not known. There are many people who can violate the majority of the described lifestyle factors or who have blatant obstruction of the upper airway, but who still do not develop obstructive apnea, or even loud snoring. However, for people with clearly diagnosed apnea, all of the foregoing can be pertinent in developing a treatment plan. We would like to underscore that neither nasal CPAP nor surgery can be expected to have the intended effect if too many of the other factors described above are not corrected as well. On the other hand, for some patients, correction of these lifestyle factors may eliminate the problem without further treatment.
What Is Bronchiectasis?
Aiir is carried into the lungs through a series of branching tubes. The medical name for these tubes is 'bronchi'. The bronchi contain tiny glands that produce a small amount of mucus which helps keep the tubes moist and trap dust and germs that we breathe in. The mucus is then normally wafted away by the beating of tiny hairs called cilia which line the tubes. When the bronchial tubes get damaged, they can no longer clean themselves and the mucus accumulates in the tubes, spilling over to adjacent tubes. These tubes are then prone to infection by bacteria causing inflammation which leads to damage called 'bronchiectasis'
What Is The Cause?
There are several known causes including:
- Underlying genetic disease such as cystic fibrosis, where the mucus in the bronchial tubes is too thick, and primary ciliary dyskinesia, where the cilia lining the bronchial tubes do not beat properly
- Mechanical obstruction of the bronchial tubes by inhaled foreign bodies, for example, peanuts
- Healing of the tubes resulting in puckering and scarring causing obstruction
- Inhaling stomach acid which has been regurgitated back into the gullet
- Too little immunity to infection, for example after infantile pneumonia from whooping cough or measles, or lack of antibodies which occasionally occurs after a virus infection in adult life.
However, over half the patients with bronchiectasis in the UK have no obvious cause for it.
How Does It Develop
Almost all causes of bronchiectasis reduce the ability of the bronchial tubes to clear mucus. If live bacteria persist in the tubes, inflammation occurs and white blood cells are recruited from the blood to kill the bacteria. If, for a variety of reasons, these cells fail to eliminate the bacteria so that inflammation continues relentlessly, the chemical that the blood cells produce can damage surrounding healthy tissue leading to further infection.
What Are The Symptoms?
The most common symptom is coughing up phlegm, often in large quantities, every day, which is very tiring and many people find socially embarrassing. Even taking this into account, there is often excessive tiredness with lack of concentration.
These symptoms frequently result in the patient being accused of smoking. In fact, 80 per cent of patients have never smoked and most of the remainder have stopped. Eighty per cent of patients also have wheezy shortness of breath and a runny nose and one third suffer from chronic sinusitis.
Less common symptoms are coughing blood (haemoptysis), chest pain and joint pain. There may uncommonly be additional symptoms of associated conditions, for example bloody diarrhoea from ulcerative colitis, rheumatoid arthritis, and infertility (mainly in men). The doctor may hear crackles in the chest due to retained mucus.
How Is It Diagnosed?
When a doctor sees a patient with a persistent cough, producing infected sputum, there are three categories of tests which should be carried out:
· A test to determine whether the symptoms are due to bronchiectasis and, if so, its distribution and severity. This is done by high-resolution computerized tomography (CT) scanning which is painless
· Tests to see if it has affected lung function, to determine what bacteria are present by sputum culture, and to determine whether the inflammation is active by white cell scanning
· Tests to detect known causes of bronchiectasis, blood tests, a simple test of mucus clearance in the nose, measuring the speed of beating of the cilia and how much salt is present in sweat. A fibreoptic bronchoscopy may be necessary to exclude a mechanical obstruction. In men, tests of the number of sperm and their motility may be required.
How Is It Treated?
If there is no underlying cause which might cause bronchiectasis to recur, and the bronchiectasis is localised to a single area of the lung which could be removed without impairing breathing, then removal by operation IS a cure.
-
The cause, if determined, must be treated (for example, antibody replacement for deficiency)
-
Regular daily self-administered physiotherapy utilizing gravity to drain the infected tubes
-
Improvement of airflow through the bronchial tubes by anti-asthma treatment
-
Treatment of nose or sinus infection and runny nose using nasal drops and sprays
-
Antibiotics to treat infections, administered at regular intervals or continuously, by intravenous or inhaled routes
-
Treatment of any associated disease.
What Can Go Wrong?
The most important complication to avoid is progression of the disease by modifying ineffective treatment. Other complications are haemoptysis (seldom requiring treatment) and rare lung abscess or spread of infection via the blood to another site in the body.
Taken from the British Lung Foundation leaflet on Bronchictasis.
Cellulitis (or
Cellulites)
Question: What causes cellulitis and what is the treatment?
Answer: Cellulitis is a condition where there is significant and widespread inflammation of any part of the body, usually due to infection by bacteria. The term is more commonly used, however, to refer to inflammation (again, usually due to infection) involving the soft tissues (skin, as well as fat beneath the skin) and not the internal organs of the body. There may be areas of purulent material ('pus') within the areas of swelling or redness.
The involved area of skin and subcutaneous (meaning below the skin) tissues is painful, red, warm, and if left untreated, can steadily spread to other areas.
Causes of cellulitis are quite diverse. Essentially, any break in the skin's defense can become infected. This includes burns, swelling and stretching of the skin, lacerations, bruises, abrasions, animal bites, scratches, or even insect bites (although insect bites get infected less commonly). The specific appearance, behavior, and treatment of a given cellulitis varies with the infecting organism, and the immune defense of the individual patient. In severe cases, untreated cellulitis can progress to skin death (necrosis).
Although many bacteria can cause this disease, the most common causes of cellulitis are bacteria known as the Staphylococcus, and more specifically, Staphylococcus, Epidermis, Pyogenes, or Aureus. In the commonly seen cases of injury to a patient's foot due to stepping on a sharp object while outdoors, or injury while swimming, other bacteria may also be causing the infection. Specific locations on the body are prone to infection with certain organisms, such as fungal infections of the fingernails and/or toenails, for example.
Treatment of this disease involves draining any areas of purulent fluid, and sending this fluid for culture. Antibiotics should be started as soon as possible, using one that would treat the more commonly seen bacteria in the particular situation. For example, is the patient suffering from diabetes mellitus (high blood sugar), do they have a problem with their immune system, or a problem with their blood vessels supplying the area of infection? Depending on the severity of infection, as well as the patient's overall medical history and condition, a physician decides whether the cellulitis warrants intravenous antibiotics in a hospital, or rather with oral antibiotics with office visit follow-up. On occasion, surgery is required as part of total treatment (with antibiotics) for severe cases. If you are concerned about the possibility of having a cellulitis contact your physician, so that appropriate therapy can be started. (source unknown)
********************
THE WINDOW
A great note for all to read it will take just 37 seconds to read
this
and change your thinking.
Two men, both seriously ill, occupied the same hospital room. One
man
was allowed to sit up in his bed for an hour each afternoon to
help
drain the fluid from his lungs. His bed was next to the room's
only
window.
The other man had to spend all his time flat on his back. The men
talked
for hours on end. They spoke of their wives and families, their
homes,
their jobs, their involvement in the military service, where they
had
been on vacation.
Every afternoon when the man in the bed by the window could sit
up, he
would pass the time by describing to his roommate all the things
he
could see outside the window.
The man in the other bed began to live for those one-hour periods
where
his world would be broadened and enlivened by all the activity and
colour
of the world outside.
The window overlooked a park with a lovely lake. Ducks and swans
played
on the water while children sailed their model boats.
Young lovers walked arm in arm amidst flowers of every colour and
a fine
view of the city skyline could be seen in the distance.
As the man by the window described all this in exquisite detail,
the man
on the other side of the room would close his eyes and imagine the
picturesque scene.
One warm afternoon the man by the window described a parade
passing by.
Although the other man couldn't hear the band - he could see it.
In his
mind's eye as the gentleman by the window portrayed it with
descriptive
words. Days and weeks passed.
One morning, the day nurse arrived to bring water for their baths
only
to find the lifeless body of the man by the window, who had died
peacefully in his sleep. She was saddened and called the hospital
attendants to take the body away.
As soon as it seemed appropriate, the other man asked if he could
be
moved next to the window. The nurse was happy to make the switch,
and
after making sure he was comfortable, she left him alone.
Slowly, painfully, he propped himself up on one elbow to take his
first
look at the real world outside. He strained to slowly turn to look
out
the window beside the bed.
It faced a blank wall. The man asked the nurse what could have
compelled
his deceased roommate who had described such wonderful things
outside
this window.
The nurse responded that the man was blind and could not even see
the
wall. She said, "Perhaps he just wanted to encourage you."
Epilogue: There is tremendous happiness in making others happy,
despite
our own situations. Shared grief is half the sorrow, but happiness
when
shared, is doubled. If you want to feel rich, just count all the
things
you have that money can't buy.
"Today is a gift, that's why it is called the present."
********************
On a lighter note........
Actual Doctors' Notes On Patient's Charts:
- Patient has chest pain if she lies on her left side for over a year
- On the 2nd day the knee was better and on the 3rd day it disappeared completely.
- She has had no rigors or shaking chills, but her husband states she was very hot in bed last night.
- The patient has been depressed ever since she began seeing me in 1993.
- The patient is tearful and crying constantly. She also appears to be depressed.
- Discharge status: Alive but without permission.
- Healthy appearing decrepit 69 year-old male, mentally alert but forgetful.
- The patient refused an autopsy.
- The patient has no past history of suicides.
- Patient has left his white blood cells at another hospital.
- Patient's past medical history has been remarkably insignificant with only a 40 pound weight gain in the past
three days.
- Patient had waffles for breakfast and anorexia for lunch.
- Between you and me, we ought to be able to get this lady pregnant.
- Since she can't get pregnant with her husband, I thought you might like to work her up.
- She is numb from her toes down.
- While in the ER, she was examined, X-rated and sent home.
- The skin was moist and dry.
- Occasional, constant, infrequent headaches.
- Patient was alert and unresponsive.
- Rectal exam revealed a normal size thyroid.
- She stated that she had been constipated for most of her life, until she got a divorce.
- I saw your patient today, who is still under our car for physical therapy.
- Both breasts are equal and reactive to light and accommodation.
- Exam of genitalia reveals that he is circus sized.
- The lab test indicated abnormal lover function.
- The patient was to have a bowel resection. However, he took a job as a stockbroker instead.
- Skin: Somewhat pale but present.
- The pelvic examination will be done later on the floor.
- Patient was seen in consultation by Dr. Blank, who felt we should sit on the abdomen and I agree.
- Large brown stool ambulating in the hall.
- Patient has two teenage children, but no other abnormalities
********************
Perks of being over 50...
1. Kidnappers are not very interested in you.
2. In a hostage situation you are likely to be released first.
3. No one expects you to run into a burning building.
4. People call at 9 PM and ask, "Did I wake you?"
5. People no longer view you as a hypochondriac.
6. There is nothing left to learn the hard way.
7. Things you buy now won't wear out.
8. You can eat dinner at 4 P.M.
9. You can live without sex but not without glasses.
10. You enjoy hearing about other peoples operations.
11. You get into heated arguments about pension plans.
12. You have a party and the neighbors don't even realize it.
13. You no longer think of speed limits as a challenge.
14. You quit trying to hold your stomach in, no matter who walks into
the room.
15. You sing along with elevator music.
16. Your eyes won't get much worse.
17. Your investment in health insurance is finally beginning to pay
off.
18. Your joints are more accurate meteorologists than the national
weather service.
19. Your secrets are safe with your friends because they can't
remember them either.
20. Your supply of brain cells is finally down to manageable size.
21. You can't remember who sent you this list.
********************
Drunk In Charge!!
A drunk goes to his doctor complaining of tiredness
and headaches.
"I feel tired all the time, my head hurts, and I'm not sleeping.
What's wrong with me Doc?"
The doctor examines him thoroughly and says, "I can't find anything
wrong.
It must be the drinking."
"Fair enough Doc," replies the drunk.
"I'll come back when you're sober!"
********************
Have you noticed the way drugs always have to have long medical sounding names? Is this why Viagra is now to be known as 'Mycoxafloppin'??
The Inside of Me
When
I look into the mirror, I see the same eyes,
But I see an outside me that's like a disguise.
Still I cannot fight what other eyes see,
What I've always been is still inside of me.
I can't speak my thoughts, like I did before,
Though I think the same way, maybe now even more.
Nothing has changed from my point-of-view,
Even if I can't do things like I used to do.
Something wicked is defeating my age,
And I don't have the strength to express my rage.
Nevertheless, my brain is okay,
As my body gets weaker and weaker each day.
I wish you'd remember me the way that I was,
When I lived my life like everyone does.
Don't talk to me like I'm just a tot;
My body is sick. My inside is not.
I'm feeling alone here while I'm sick,
But even now I like a good flick.
Bring one by to watch it with me,
Or we could just sit and watch some tv.
Maybe you could read some Scripture aloud.
By comforting me, I know God would be proud.
I need you, Friend, though I cannot ask,
For this illness is such a challenging task.
Please rest assured, I don't have the plague.
Tell me your memories of me aren't that vague.
The outside is different; I know what you see,
But I'm still the same on the inside of me.
**********************************
Last Updated: 7th February 2012