BURSITIS II

. Tuesday, September 30, 2008
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With names like miner’s elbow, housemaid’s knee and weaver’s bottom, it sounds more like a wildflower from a seed catalog than an uncomfortable, bumpy inflammation. But once you’ve had sinusitis, you won’t mistake this annoying condition for a bed of roses.

There are approximately 150 fluid-filled bursae distributed throughout your body. Essentially, each bursa is a cushion that helps facilitate movement between adjoining parts of your body. On the back of your hand, for example, bursae help the skin glide freely back and forth. You also have bursae on your elbows, knees and the sides of your body, explains Joseph D. Zuckerman, M.D., vice chairman of the Department of Orthopedic Surgery and chief of the shoulder service at the Hospital for Joint Disease Orthopedic Institute in New York City.

When bursae get injured, whether from injuries,, overuse or even poor posture, they become inflamed and begin to swell. That’s bursitis. Naturally, the bursae that get the most abuse and are nearest the surface––those on the knees, elbows and hips––are the ones most likely to get inflamed. “People who spend a lot of time on their knees–maids, for example, or carpet layers––can have a golfball-size or larger swelling on the front of their knee,” says Dr. Zuckerman.

But those in other professions may also get bursitis, says W. Ben Kibler, M.D., medical director of Lexington Clinic Sports Medicine Center in Lexington, Kentucky. “One of my patients is a judge, and he listens to a lot of cases by resting his elbows on the bench,” Dr. Kibler says. “The right one was swollen a couple of months ago, and now the left one is swollen.”

While unsightly, bursitis isn’t always painful. But an infected bursa can prevent you from moving, walking or doing anything at all, according to Clifton S. Mereday, Ph.D., chairman of the physical therapy program at the State University of New York at Stony Brook. “It can be excruciatingly painful,” he says.

Joint Efforts

It’s not always clear why bursae get inflamed, or why some people get bursitis more often than others. Still, there are things you can do to dump the bumps–before they occur.

Change your game. Since bursitis is often caused by repetitive motions––throwing a baseball, for example, or kneeling in a garden––a change of pace can be a joint-saver. So occasionally swap the baseball for a croquet mallet. Work in the house instead of the garden. Hang up your running shoes and take a long walk instead.

Give your knees a break. People who spend their days laying carpet, fixing plumbing or digging up tulips are particularly prone to bursitis. And because bursae on the knee are so near the surface, they’re easily pricked and sometimes get infected, Dr. Zuckerman says. Try to spend more time on your feet than on your knees. Or if your job requires frequent kneeling, invest in a well-padded cushion or some good knee pads. A little protection today can prevent a lot of pain tomorrow.

Straighten up. People who slump in their seats, slouch at parties or inadvertently look for pennies when they walk put all sorts of pressure on bursae in their backs and shoulders. “By walking more erect, your chances of developing bursitis are reduced,” Dr. Mereday says.

Keep yourself strong. Weak muscles lead to poor posture, and poor posture, as we’ve seen, can cause bursitis. A little exercise––lifting weights, having a swim or just taking regular walks––can prevent both these problems, Dr. Mereday says.

Have a good stretch. Because bursae and tendons are so close together, what affects one can also affect the other. So before you hit the track––or the tennis court or soccer field––take a few minutes to warm up and stretch.

Swell Treatments

You tried to stay off your knees, but the geraniums beckoned you thither––and now you have bursitis. What do you do now?

Try the pharmacy. Over-the-counter drugs such as aspirin and ibuprofen can ease bursitis pain and reduce swelling. In some cases, doctors says, this will be the only medical treatment you’ll need. Take daily, as directed, for two or three weeks until the pain and swelling are gone. If there’s no improvement, see your doctor.

Chill out. While you’re resting, go ahead and put the swollen bursa on ice, says Dr. Mereday. Applying colds help reduce the pain and swelling. Wrap ice packs or cubes in a towel or wash-cloth and place on the injury for 10 minutes, several times a day.

Now get moving. Once the pain subsides––this should happen in a day or two––try to get injured part moving again, Dr. Mereday adds. “Not moving is how you develop frozen shoulder, for instance. It’s not the bursitis that causes it but the adhesions [scar tissue] you get later. So you want to get it moving as soon as possible.”

Big-League Help

Most cases of bursitis can be treated at home. But when the pain gets bad, or you suspect you have an infection, it’s time to see your doctor, Dr Zuckerman says.

When you have red, painful swelling that doesn’t go away, you probably have an infected bursa, Dr. Zuckerman says. For this you need antibiotics, which in most cases will quickly eliminate the infection. To relieve painful swelling, however, your doctor may drain the bursa as well.

In some situations, when the pain of bursitis has not improved with rest, ice and anti-inflammatory medications, asteroid injection can be beneficial. This approach is used very sparingly, and it’s important that there be no infection present, Dr. Zuckerman says.

Occasionally bursitis will be so painful and long-lived that your doctor will recommend surgery to remove the swollen bursa. But this is rare, Dr. Kibler says. Most of the time, self-care––and perhaps drugs––will do the trick.

MENINGITIS

. Sunday, September 28, 2008
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Justify FullYou’ve never before hurt so much. Your forehead is hot enough to roast chestnuts. You’ve just vomited what seems like your last eight meals. And inside your head, a battalion of cackling gremlins is driving needles into your most sensitive nerve endings. Could it be the flu? Or could it be something worse, like meningitis?

Meningitis, an ugly but fortunately rare disease, often starts off with the same symptoms as the common flu. But along with the fever, nausea and headaches, you might also experience a stiff neck, an oversensitivity to bright light and, occasionally, a deep red or purplish rash.

What these symptoms may mean is that your meninges, the membranes that cover your brain and spiral cord, have become infected and inflamed. The cause is usually an invasion by either viruses or bacteria. Sometimes these organisms are carried to the meninges by the bloodstream from another part of the body, such as the lungs. Sometimes a head injury, like a skull fracture, or an infected sinus or ear can open the door to such an invasion.

The Essential Diagnosis

The symptoms of both types of meningitis, viral and bacterial, are the same. But the bacterial kind is much more dangerous––in fact, potentially deadly if not treated quickly. That is why it’s important to act on these symptoms immediately by going to your doctor or a hospital emergency room.

There’s only one way to tell the two kinds of meningitis apart, says Bradley Perkins, M.D., a specialist in meningitis with the federal Centers for Disease Control (CDC) in Atlanta. That one way is with a spinal tap. Doctors remove a dose of spinal fluid for analysis to tell what kind of organism may be at the source of your woes.

If that organism is a virus, you can breathe a sigh of relief. You’ll feel rotten for a while, but you’ll probably be well in two or three weeks.

The Viral Variety

The kind of meningitis caused by viruses is not only the less dangerous of the two, it’s also the more common. These viruses usually spread from person to person and tend to spread quickly among groups, much like a flu. The favorite victims if viral meningitis are children and young adults. “Their immune systems are usually strong enough that they get better without medication,” Dr. Perkins says. “Antibiotics don’t work against a virus, and antiviral drugs have so many side effects that it’s usually not worth giving them.”

In other words, if you have viral meningitis, you simply need to tough it out as you would a flu. What can you do to feel better? The same things you’d do if you had the flu.

Stay home and rest. Let your body devote its energy to fighting the infection, Dr. Perkins says. “You won’t feel like getting out of bed anyway.”

Drink plenty or fluid. Fever dehydrates you. And you’ve got to keep elimination system well watered to flush out the debris of the war in progress between your immune system and the virus.

Reach for the bottle. Take aspirin, ibuprofen or acetaminophen as needed for the pain, says Dr. Perkins. But don’t give aspirin to anyone under 21 because of the risk of Reye’s syndrome, a serious neurological disease.

Darken the room. Your eyes are probably hypersensitive to light, and that can make your headache worse.

Keep eating. It’s essential to keep up your strength.

Take an antinausea medication. How can you eat if you’re nauseated and throwing up? Try an over-the-counter preparation recommended by your doctor or pharmacist.

Take it easy. Don’t go out and run races or dance till dawn right after you’ve recovered––that’s risking a relapse. Again, think of yourself as having had the world’s worst flu, and act accordingly. Give yourself time to regain your strength.

The Bacterial Blight

Even though bacterial meningitis is extremely dangerous, it’s much less common than it used to be, and if caught early, it is usually highly curable, Dr. Perkins says. Bacterial culprits include very common bacteria like streptococcus pneumoniae and hemophilus influenzae type b (Hib). “Most of us carry these bacteria around, but we don’t get sick, because our immune systems keep them in check,” says Dr. Perkins. “The people most susceptible are probably those with some kind of immune deficiency or those who have gotten some new strain of bacteria that they haven’t developed an immunity to” Babies, the elderly and people traveling through certain nations with epidemic diseases are most at risk.

No matter the specific bacteria, treatment is the same hospitalization and intravenous antibiotics. “You should be in the hospital for a minimum of 7 days, and often up to 14 days,” Dr. Perkins says. “You’ll usually get dramatically better very fast.” When you’re discharged, you may take oral antibiotics for another couple of weeks. Treatment is essential; without it, bacterial meningitis is fatal at least 70 percent of the time.

Although some forms of meningitis will probably be with us for some time, the kind caused by the bacteria Hemophilus influnzae type b may be on the wane. This number one cause of bacterial meningitis in American children is the target of an immunization plan by the CDC. It recommends every child get a first vaccination for Hemophilus influenzae type b at two months of age. “We expect a dramatic reduction in Hib meningitis,” says Dr. Perkins.

BURSITIS

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What to do When Pain Strikes

Despite its quaint nicknames-housemaid’s knee, student’s elbow and clergyman’s knee-bursitis is no laughing matter.

This painful condition occurs when your bursae, the tiny fluid-filled sacs that serve as cushions in and around the joints, become swollen. The most common cause is overuse of certain joints, especially in activities that are out of the ordinary for you. This cloud be taking on your teenager in yet another round of one-one basketball, painting the kitchen or playing too many sets of tennis. As bursae rub against muscles, tendons and each other, they become irritated, swollen and painful.

Bursitis can also be caused by pressure-hence those descriptive nicknames. Kneeling to scrub a floor or roof a house puts pressure on the bursae of the knee, for example. A shoe that’s too tight can cause a swollen bursa, called a pumpbump.

Most commonly, bursitis strikes the shoulders, says Patrick Guiteras, MD., clinical faculty member at the University of North Carolina at Chapel Hill School of Medicine. Other common site are he elbows, hips and knees. Fortunately, the condition usually passes within a few days to a week or two.

When bursitis hits, the first thing to do is stop the activity that caused the problem. Then attend to pain with the following treatments.

Chill it. Immediately apply an ice pack or ice wrapped in a towel to the trouble joint to bring down swelling. Leave it on for ten minutes, several times a day.

Apply moist heat. After the swelling has disappeared, warm up the area by taking a shower or bath, apply hot towels or relaxing in a heated whirlpool. Heat increases blood circulation to the affected area, which helps it heal.

Take on OTC. An over-the counter medication such as aspirin or ibuprofen will help reduce swelling and pain. Check with your doctor first if you have a history of stomach ulcers or irritation.

Keep Moving. Although you don’t want to repeat the activity that caused the bursitis, its important that you don’t stop moving, particularly if your shoulders are injured. Otherwise, the joint will become stiff and can “freeze.”

Eliminate the pressure. Try to keep pressure off the affected area. If the bursitis is in your shoulder or elbow, for example, try to sleep on your back or on the side opposite that joint.

To be continue……………….

Troubleshooting Lip Problems

. Saturday, September 27, 2008
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Here’s a checklist of list problems. Answers Yes or No to each.
  1. Do you a lot of time outdoors?
  2. Do you lick your lips?
  3. Are you lips so chapped that they’re cracked?
  4. Do you always have trouble getting your lipstick to go on evenly?
  5. Does your lipstick bleed?
  6. Do you dislike your lips line?
  7. Have you ever tried a lip pencil and found that it made a mess?
  8. Does your lipstick fade?
  9. Do you bite your lips?
  10. Do your lips problems refuse to improve or go away?
Interpreting your answers
  1. If you answered Yes to any of these question, here are some solution to your problems.
  2. Use a sunscreen to protect your lips from sun damage.
  3. This is an indication that your lips are too dry. Moisturize with a lip balm a medicated lip balm and apply a drop of water first.
  4. You need a medicated lip balm with sunscreen.
  5. Apply a lip conditioner, then a foundation base. This will help your lipstick go on evenly.
  6. Use a lip pencil to define the line.
  7. Get out that lip pencil again. Use it to make minor improvement in your lip line.
  8. The pencil was probably too soft. When you shop for a lip pencil, try it out on the back of your hand first before you buy it.
  9. Chances are you’re not applying it often enough. It’s important to find a lip product with a “feel” you like. That way, you’ll have no problems reapplying it often, especially after meals, before going outside and at bedtime.
  10. Stop! Biting your lips is even worse than licking them. It removes protective skin.
  11. Time for a visit to your dermatologist. Persistent. Persistent problems may require medical care.

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