Friday, July 15, 2011

Medifocus Guidebook on Peripheral Neuropathy


What is Peripheral Neuropathy?
The nervous system controls the smooth functioning of all systems in the body as well as all interactions between the human being and the environment. The nervous system is comprised of millions of neurons that are interconnected and form a communications network within the body that governs many vital functions including:

  • The five senses (sight, hearing, touch, smell, and taste)
  • Voluntary functions (e.g. walking, holding an object)
  • Involuntary functions (e.g. breathing, blood pressure)
  • Cognitive reasoning
The human nervous system has two major components:
  • Central nervous system - includes the brain and spinal cord
  • Peripheral nervous system - includes the nerves that lead from the brain and spinal cord to all parts of the body. An extensive system of specialized nerves makes up the peripheral nervous system which is responsible for a variety of important functions. These specialized nerves include:
    • motor nerves which carry messages from the brain to the body and are responsible for the ability to move any part of the body (e.g., hands, feet)
    • sensory nerves which carry information from organs to the central nervous system where it is processed into sensation (e.g., touch, temperature changes, and vibrations)
    • nerves that control autonomic (involuntary) functions including heart rate, blood pressure, breathing, digestion, and bladder function
Peripheral neuropathy is a term used to describe damage to nerves of the peripheral nervous system which leads to symptoms such as pain, numbness, tingling, burning, and weakness most commonly affecting the hands and feet. Peripheral neuropathy can be caused by a variety of precipitating factors including trauma, infection, diabetes, alcohol abuse, and cancer chemotherapy.
The incidence of peripheral neuropathy is not known with any degree of certainty. It has been estimated that approximately 2 to 3 million Americans have some form of peripheral neuropathy. The prevalence of peripheral neuropathy worldwide has been estimated to range from 2% to 8% of the population. Peripheral neuropathy affects both genders at all ages but symptoms are unique to each individual in terms of frequency, quality, and severity of pain. Idiopathic peripheral neuropathy typically affects adults over the age of 50. Peripheral neuropathy can significantly impact an individual's quality of life and daily activities by causing major disruptions including:
  • Sleep disturbances
  • Mood changes
  • Impairment of social, occupational, and recreational functioning
Knowledge is Critical when Dealing with a Life-Altering Condition such as Peripheral Neuropathy
If you or a loved one has been diagnosed with peripheral neuropathy, it's critical to learn everything you possibly can about this condition so that you can make informed decisions about your treatment. That's why we created the Medifocus Guidebook on Peripheral Neuropathy, a comprehensive 187 page patient Guidebook that contains vital information about peripheral neuropathy that you won't find anywhere in a single source.
The Medifocus Guidebook on Peripheral Neuropathy starts out with a detailed overview of the condition and quickly imparts fundamentally important information about peripheral neuropathy, including:
  • The underlying causes and risk factors for developing peripheral neuropathy, which include:
    • Diabetes
    • Autoimmune disorders
    • Metabolic disorders
    • Hereditary disorders
    • Infectious diseases
    • Alcohol abuse
    • Trauma
    • Cancer chemotherapy
  • The different types of peripheral neuropathy that can occur based on the pattern of nerve involvement and the distribution of pain, which include:
    • Mononeuropathy
    • Mononeuropathy multiplex
    • Polyneuropathy
  • The signs and symptoms associated with peripheral neuropathy based on the specific underlying cause, when known.
  • How peripheral neuropathy is diagnosed based on a variety of factors and diagnostic tests including:
    • Signs and symptoms
    • Patient history and physical examination
    • Pattern of distribution of pain along sensory or motor nerves
    • Special electrodiagnostic studies, such as nerve conduction tests and electromyography (a test which measures the response of muscles to electrical stimulation)
Understanding the Standard Treatments...and the Treatment Options
The primary goals of treatment for peripheral neuropathy include accomplishing the following objectives:
  • Determining and treating the underlying cause of the condition, if possible.
  • Controlling and alleviating pain and other bothersome symptoms associated with the condition.
  • Preserving function of the affected limbs, such as the hands and/or feet.
  • Preventing a significant decrease in the patient's quality of life.
An important aspect for successfully achieving these goals is understanding the treatments - and the treatment options - for peripheral neuropathy. As you read through the section of the Guidebook that focuses on the treatment of peripheral neuropathy, you will specifically learn about:
  • The management of peripheral neuropathy in patients where the underlying cause can be identified, such as diabetes, autoimmune disorders, infectious diseases, nerve compression, and cancer chemotherapy.
  • The major types of medications that are often prescribed to relieve pain associated with peripheral neuropathy, which include:
    • Antidepressants
    • Anticonvulsants
    • Selective serotonin reuptake inhibitors
    • Narcotic analgesics
    • Topical agents such as capsaicin and lidocaine patches
  • The treatment options that are available for controlling pain that does not adequately respond to drug therapy, including nerve blocks with local anesthetics and spinal cord stimulation.
  • The role of physical and occupational therapy in functional rehabilitation of patients with peripheral neuropathy.
  • The role of complementary and alternative therapies in the management of peripheral neuropathy.
  • The impact of peripheral neuropathy on the patient's psychological well-being and quality of life, including aspects such as:
    • Anxiety and depression
    • Social relationships
    • Activities of daily living
    • Employment issues
    • Sleep disturbances
    • Recreational activities
    • Feelings of self-worth
  • Practical tips and suggestions for how to minimize the negative impact of peripheral neuropathy on your quality of life and learn how to better cope with the condition.
  • Important questions to ask your doctor about peripheral neuropathy.
A "One-of-a-Kind" Reference Guidebook on Peripheral Neuropathy that Goes Way Beyond the Fundamentals
Since 1996, when Medifocus was founded, we've learned that many people with Peripheral Neuropathy are seeking more specific information that goes beyond the fundamentals, such as the causes, diagnosis, standard treatments, and treatment options. That's why we developed a "one-of-a-kind" reference Guidebook that goes way beyond the basics and also includes the following sections:
  • A Guide to Recent Medical Literature on Peripheral Neuropathy - This section of the Guidebook contains an extensive bibliography of over 100 references to recently published articles about Peripheral Neuropathy in authoritative, peer-reviewed medical journals with links to the absracts (summaries) of the articles. These articles represent the latest advances in the field and focus on cutting-edge research, new developments, and the lessons learned from recently published clinical trials involving patients with Peripheral Neuropathy. This is the same level of that is used by doctors who treat people with Peripheral Neuropathy to keep abreast of the latest developments and breakthroughs in this specialized field of medicine.
  • Centers of Research for Peripheral Neuropathy - We've compiled a unique directory of doctors, hospitals, medical centers, and research institutions with special interest and, in many cases, clinical expertise in managing people with Peripheral Neuropathy. The "Centers of Research" directory is a valuable resource for quickly identifying and locating leading medical authorities and medical institutions both within the United States and other countries who are considered to be at the forefront in clinical research and treatment of Peripheral Neuropathy. You'd have to spend days - or even weeks - attempting to compile your own list of doctors and medical centers but, with the "Centers of Research" directory, the information is already right at your fingertips. All you have to do is act on the information by selecting and contacting the experts or medical institutions listed in the directory by state and country.
  • Organizations and Support Groups for Peripheral Neuropathy - The Guidebook also includes a directory of organizations and support groups whose goal is to help people with Peripheral Neuropathy by providing access to information, resources, and services. Many of these organizations can answer your specific questions, enable you to "network" with other patients, and provide guidance in areas such as financial, social, or medical-legal issues. This valuable directory of organizations and support groups includes complete contact information, including phone numbers and E-mail addresses.
The Guidebook is a Value-Added Proposition that Comes with a Risk-Free Satisfaction Guarantee so that...You have Nothing to Lose and Everything to Gain
Still not sure if you'll benefit from the Medifocus Guidebook on Peripheral Neuropathy? Still not convinced that the information included in the Guidebook is worth the minimal cost? If that's the case, then please consider the following value-added proposition that comes standard with your purchase of the Guidebook:
  • Free Updates for One Year - With your initial purchase of the Guidebook, you also receive access to free updates for one-full year. The Guidebook is updated with new information every 4 to 6 months, so that you will be able to access the updated information several times during the course of a year for up to one full year after the date of your initial purchase.
  • Free Digest E-Mail Alerts - When you purchase the Guidebook, you will also automatically receive a free subscription to our monthly newsletter - the Medifocus Digest Alert for Peripheral Neuropathy. This is an expertly selected listing of the latest articles published in the medical literature about Peripheral Neuropathy with convenient links to the abstracts of the articles that focus on cutting-edge research, clinical trials, and the latest treatment advances. The Medifocus Digest Alert for Peripheral Neuropathy is automatically delivered straight to your "inbox" monthly and is a valuable resource for keeping up with the latest developments in Peripheral Neuropathy almost as soon as the new information is published in the medical literature.
  • 10% Discount - For a limited time, you can purchase the Medifocus Guidebook on Peripheral Neuropathy at a special 10% discount off the regular list price. Your 10% discount will automatically be applied when you go to "Checkout".
  • Risk-Free Satisfaction Guarantee - Your purchase comes with our RISK-FREE satisfaction guarantee. If, for whatever reason, you are not totally satisfied with the content of your Guidebook, simply contact us within 30-days of your purchase for a prompt, full refund. We are so confident that you will be satisfied with your Guidebook that we offer this RISK-FREE satisfaction guarantee unconditionally - no questions and no hassles

Doctor Says Surgery May Relieve Pain Of Neuropathy

Millions of Americans suffer from neuropathy, a painful condition that affects legs and feet. For many, medication is the only relief, but that can stop working.
Now a doctor in Colorado is one of just a few surgeons in the country offering another alternative.Gregory Garland says he has a tremendous amount of pain in his foot and leg and is going under the knife to treat it.
"I'm having the tunnels opened up around the nerves in my feet," Garland said.Dr. James Anderson of the Poudre Valley Foot and Ankle Clinic is one a very few surgeons doing a new controversial procedure for people who suffer from neuropathy."Neuropathy is basically a malfunction of nerves. You'll get burning, tingling and numbness. The pain is not sometimes bad in the beginning but it can become very severe," Anderson said.Neuropathy is common in diabetics and is the leading cause for amputations. Until now, there was little that could be done for patients.This new surgery is similar to that commonly done for carpal tunnel syndrome in the wrist."It's a decompression surgery," Anderson said.The tight areas are opened in up in the ankle, giving the nerves more room to pass."If you can release pressure from the nerves, the neuropathy symptoms can go away," Anderson said. "It's like restoring the nerves, basically."Before surgery is considered, the patient undergoes numerous tests. Surgery is not for everyone and recovery can take several months.But many patients are getting permanent relief.Dick O'Grady had the surgery 10 months ago. Before that, his life basically came to a standstill, he said."The pain became so intense that I went into the emergency room and was in the hospital for four days," he said.Now, he can do the things he loves such as working in his yard without pain. "I really feel like a success story," O'Grady said. "To this day I have absolutely no regrets. I am getting my life back and becoming more mobile. I am sleeping at night now without the pain.""We are right at about 85 percent success rate," Anderson said.Currently, the prevailing theory is there is no cure for neuropathy and some doctors adamantly discourage patients from having this surgery. It's important to discuss all the options with your own doctor.If you would like more information on the decompression surgery for neuropathy call (800) 866-4620 or go to .

Nitrogesic

Nitrogesic Descriptions

Many people are suffering from anal fissure, which is a crack or tear in the skin of the anal canal. However, anal fissures may cause painful bowel movements and bleeding as well. There may be blood on the outside of the stool or in the toilet following a bowel movement. Hence proper hygienic measures should be taken with the usage of the best medicine. Nitrogesic ointment is widely used to treat anal fissures.

Glyceryl trinitrate belongs to the class of muscle relaxants. It is an organic nitrate that donates nitric oxide. Nitroglycerin relaxes the anal sphincter muscle and provides immediate symptomatic relief in pain and spasm. To avoid surgery Nitroglycerin ointment is an ideal treatment for anal fissure. It is also used to treat hemorrhoids.

Before applying the Nitroglycerin ointment i.e. Glyceryl trinitrate ointment, please ask your doctor or for a copy of the manufacturer’s information for the patient and read it carefully. Talk to your doctor about the risks of applying Nitrogesic ointment. Do not let anyone else take your medication especially a woman who is or may become pregnant.

How To Use Nitrogesic


Use this ointment exactly as prescribed by your health care professional. Moreover, do not rub the Nitrogesic ointment onto the skin harshly.

However, if you wish to use the medication for your children, please contact your pediatrician.

Nitrogesic side effects


If you notice any of the symptoms, which seem severe or persistent to you, please contact your doctor immediately. The symptoms may be – blurred vision, headache, a feeling of extreme pressure in the head, sweating, nausea, vomiting, dry mouth, skin irritation from application of the ointment, flushing of the face or neck, palpitations i.e. irregular heartbeats, unusual weakness and tiredness, swelling on face, tongue, lips, skin hives, itching, rashes etc.

Inform your doctor if you experience any of these side effects and if they appear too bothersome to you.

Nitrogesic interaction


Inform your doctor if you are allergic to the formulation of this medication or any other medication in any other form and also inform your doctor about any other medication you may be taking in any other form.

Nitrogesic may interact with the heparin, alteplase, foods, varied medications, aspirin medication for mental depression like phenothiazines, chlorpromazine, mesoridazine, prochlorperazine, thioridazine, medication for high blood pressure, medicines for treatment of erectile dysfunctions like Sildenafil, Tadalafil, and Vardenafil, certain migraine medicines like ergotamine or DHE, other medication used to treat angina etc.

Hence, it is necessary to take proper precautions to avoid any reactions.

Nitrogesic Over Dose


In case of overdose call your local poison control center at 1-800-222-1222.
If the suffering patient has collapsed or is not breathing call local emergency services at 911. Canadian residents should call their local poison control center directly.

Nitrogesic notes


Do not allow any other person to use your medication without getting doctor’s prescription themselves and also avoid using this medicine for other health conditions on your own.

It is essential to inform your doctor if you have or have ever had diseases like: liver disease, anemia, previous heart attack, bleeding in the brain, head injury, recent stroke etc. Avoid alcohol during the complete course. Keep the medicine away from the children and pets.

Nitrogesic missed dose


If you miss an application of this medicine, apply it as soon as you remember. And, if it is almost the time of your next application, skip the missed application and continue to your regular dosing. Do not double your applications in any case and consult your doctor for the missed application.

Nitrogesic uses


Ideally, Nitroglycerin ointment is used in the treatment for anal fissure as one can avoid surgery. However, Nitroglycerin relaxes the anal sphincter muscle and provides immediate symptomatic relief in pain and spasm.

However, it may also be used to treat some other medical conditions which may be determined by your doctor accordingly.

Nitrogesic other uses


This medication may be prescribed for other uses also, so ask your doctor or pharmacist for more information about the Nitrogesic medication. Sometimes, the Nitrogesic ointment is used to treat chest pains.

Nitrogesic storage


Nitrogesic medication should be stored at 15-30°C and 59-86°F and at cool and dry place. Check Expiry date without fail. Keep all medicines away from women, newborns, children and pets. Also, keep it away from heat, dampness and direct light. In any case, do not store the Nitrogesic ointments in the bathroom.

Nitrogesic precaution


Following precautions must be taken during consuming generic Nitrogesic:

1. It is very important for the patient to know that before using Nitrogesic they must inform their health care professional if you have or have ever had diseases like: liver disease, anemia, previous heart attack, bleeding in the brain, head injury, recent stroke etc.

2. Also acknowledge your doctor if you need to undergo any kind of surgery, including dental surgery or need an x-ray procedure that uses contrast agents. So, inform your doctor immediately about it, so that the doctor can decide whether to continue taking Nitrogesic or stop it during the surgery.

3. Let the doctor also know if you are in-taking or are planning to take any prescribed or non prescribed medicines, health supplements or any OTC medications, vitamins etc.

4. Do not use the Nitrogesic medication, if you have any kind of allergy to it or to any ingredients of it and tell your doctor or pharmacist about the allergy and get treated.

5. Tell your doctor if you are pregnant or breast feeding before taking Nitrogesic Cream medication or it may result in abortion. Hence, inform your doctor immediately when you plan to conceive, or become pregnant during the course.

6. Do not share the drug with others unless they are prescribed by the doctor themselves. And if your symptoms of side effects do not improve in few weeks or if they become worse and bothersome, check these conditions immediately with your doctor.

7. Please, use the medicine in the prescribed amount and do not overdose it or use it for the longer period of time. Do not discontinue on your own and consult your doctor before doing so to avoid further problems.

8. During the complete course, please avoid alcohol and alcohol containing beverages to achieve good results

Buying Medicine Online

These days, buying prescription drugs from the Internet is easy, but finding a safe source for those medicines is not. More and more people are turning to the Internet for cheaper drugs that are easy to get, but medicines purchased from these Web sites often come with the risk of harming you or your family. Rogue Web sites are all over the Internet selling drugs that are not what they appear to be. These sites may be selling drugs that are counterfeit, contaminated, or otherwise unsafe.
By being informed about the dangers of buying drugs on the Internet you can protect yourself and your family from the risks posed by rogue Web sites. NABP has been working with the state boards of pharmacy since 1999 to combat those sites that put your health and safety at risk. Over the years NABP has seen that the risks of buying from a rogue site don’t stop at the loss of money. Lives have been lost due to people buying medicines from sites that send dangerous drugs without medical oversight that may have been tampered with, expired, or even fake.
Knowing which Web sites are safe and which ones are not can be confusing. To help you make an informed choice, and as part of its mission to protect the public’s health, NABP has reviewed, and continues to review, thousands of Web sites to determine if they maintain safe pharmacy practices. Unfortunately, the majority of Web sites selling prescription drugs do not.
NABP has created two categories to help you make an informed choice:
  • Recommended Internet Pharmacies: NABP recommends that patients use sites accredited through the VIPPS (Verified Internet Pharmacy Practice Sites) or Vet-VIPPS (Veterinary-Verified Internet Pharmacy Practice Sites) program. These sites have undergone and successfully completed the thorough NABP accreditation process, which includes a thorough review of all policies and procedures as well as an on-site inspection of all facilities used by the site to receive, review, and dispense medicine. 
  • Not Recommended Sites: These Internet drug outlets appear to be out of compliance with state and federal laws or NABP patient safety and pharmacy practice standards.

Buyer Beware! That Web Site Might Not Be What It Seems

Many Web sites selling prescription drugs are unlicensed, operating illegally, or operating from foreign countries where medicines shipped to the United States are unregulated. Thus, there is no way of knowing whether the medicine you receive is contaminated, sub-potent, super-potent, expired, or counterfeit, or whether it has been stored and shipped under proper conditions to maintain its effectiveness.
And that Canadian online pharmacy with the cheaper prices? It may be calling itself a “Canadian pharmacy,” but it may actually obtain its medications from countries in Asia, South America, or Eastern Europe, where quality standards are more lax and counterfeit medications more widespread. While counterfeit medications can surface anywhere, they are significantly more common in developing foreign countries. That is the problem with buying medicine from foreign sources – you never know what you’re getting.
While there are some excellent Canadian Internet pharmacy sites, NABP cannot recommend any Canadian site selling drugs to Americans because Food and Drug Administration (FDA) regulations prohibit this activity. Prescription drugs imported from other countries are not FDA-approved and their safety and effectiveness cannot be ensured because they are outside the legal structure and regulatory resources provided by Congress.

What Are Sites Listed as Not Recommended Doing Wrong?

NABP continually reviews Web sites selling prescription drugs to help you see through rogue sites. Of the nearly 7,000 Internet sites reviewed, NABP found that 96% of the sites fall in the Not Recommended category because they appear to be operating in conflict with pharmacy laws and practice standards. Of the sites reviewed, the most common reasons for sites being included on the Not Recommended list were:
  • 83% do not require a valid prescription
  • 42% offer foreign or non-FDA-approved drugs
  • 55% do not provide a physical address
  • 20% are located outside of the United States and selling drugs illegally to patients in the US
Only 4% of the sites NABP reviewed are potentially legitimate in that they appear to meet pharmacy laws and practice standards, based on information obtained by looking at the Web site. NABP highly recommends that you use only those Internet pharmacies that are VIPPS or Vet-VIPPS accredited. Currently, 39 sites, representing more than 12,000 online pharmacies, have received accreditation.

Cancer, brain

Cancer, brain: Cancer of the central information processing center of the body. Tumors in the brain can be malignant or benign and can occur at any age. Primary brain tumors initially form in the brain tissue. Secondary brain tumors are cancers that have spread to the brain tissue (metastasized) from elsewhere in the body.

Wednesday, June 15, 2011

Doctor Says Surgery May Relieve Pain Of Neuropathy

Millions of Americans suffer from neuropathy, a painful condition that affects legs and feet. For many, medication is the only relief, but that can stop working.
Now a doctor in Colorado is one of just a few surgeons in the country offering another alternative.Gregory Garland says he has a tremendous amount of pain in his foot and leg and is going under the knife to treat it.
"I'm having the tunnels opened up around the nerves in my feet," Garland said.Dr. James Anderson of the Poudre Valley Foot and Ankle Clinic is one a very few surgeons doing a new controversial procedure for people who suffer from neuropathy."Neuropathy is basically a malfunction of nerves. You'll get burning, tingling and numbness. The pain is not sometimes bad in the beginning but it can become very severe," Anderson said.Neuropathy is common in diabetics and is the leading cause for amputations. Until now, there was little that could be done for patients.This new surgery is similar to that commonly done for carpal tunnel syndrome in the wrist."It's a decompression surgery," Anderson said.The tight areas are opened in up in the ankle, giving the nerves more room to pass."If you can release pressure from the nerves, the neuropathy symptoms can go away," Anderson said. "It's like restoring the nerves, basically."Before surgery is considered, the patient undergoes numerous tests. Surgery is not for everyone and recovery can take several months.But many patients are getting permanent relief.Dick O'Grady had the surgery 10 months ago. Before that, his life basically came to a standstill, he said."The pain became so intense that I went into the emergency room and was in the hospital for four days," he said.Now, he can do the things he loves such as working in his yard without pain. "I really feel like a success story," O'Grady said. "To this day I have absolutely no regrets. I am getting my life back and becoming more mobile. I am sleeping at night now without the pain.""We are right at about 85 percent success rate," Anderson said.Currently, the prevailing theory is there is no cure for neuropathy and some doctors adamantly discourage patients from having this surgery. It's important to discuss all the options with your own doctor.If you would like more information on the decompression surgery for neuropathy call (800) 866-4620 or go to .

Howdy Folks:) Sue Relays Asked Me to Post My Results Here


I got to know Sue when she visited the Colorectal Board - she's been a good friend and terrific supporter to me. And since she does not get over to our side very much anymore, she asked me if I would post my results over here so she could see them. I hope you don't mind.
From Sue:
"Will be waiting to see your results. Will you post on the anal board as well??"
This is a long post but covers the past year of my fight, currently at 7-years, Stage IV.
Grab something to drink and you're welcome to read along with Sue. And maybe Joanne will show up here - I miss her to and met her on the other board when she first got here.
Ok, Sue and everybody here we go!
“SUNDANCE vs CANCER” – The Results Post
Faster than a speeding locomotive – Able to leap tall buildings in a single bound – Look! – Up in the air! – It’s a bird! – It’s a plane! – It’s…..it’s……awww $hit, it’s only Sundance:)
LOL:)
The “Betting Windows” are now officially closed, so I hope you got your wagers down – there was sure plenty of time:)
Well, this is finally the post that I have waited for and waited to write. And also the one that many of you have waited for as well. Almost a year in the making and through it all, it has been a “Watershed Moment” in my journey.
I suppose when I reflect back on it, we could say that it’s the most influential battle of my entire campaign. There was much at stake to be won or lost. It carried huge significance as I motored on toward my 7th year of this incredible saga. And all the time, never knowing exactly which way the battle was going to go. Would I win? Or would I begin to slip?
The stakes we were playing for was my very existence, which I believe we can all agree, is worth playing for. The difference is we had to fight like there was never going to be tomorrow – because that’s always in the cards and is the key component that weighs so heavily on all of our minds.
It’s a funny feeling looking back on this past year. In many ways, it still feels like yesterday – and then on the other side, it seems like a lifetime ago.
Cancer played a dirty little trick on me this time. We know he does not play fair and is a dirty fighter. He used the DaVinci tumors the time before, to lull us into a false sense of complacency while he stealthily hid behind my lungs and gathered his forces, before he could again announce his presence in my body for this last year’s fight.
When I was still in the hospital after this lung surgery, I remember a nurse bringing me my pathology report. Even dazed on morphine and with blurred eyesight, I could still make out the words…”Colorectal Mets to Lung.”
And I remember thinking, “Now, you’ve showed yourself, you SOB!” I sat up in bed and thought, “I’ve got you now.” You’ve just kicked the sleeping dog – you just woke up the Gentle Giant. So, once again, it’s “officially back on.”
Strangely though, I felt some sense of comfort in those words, in the fact that I again knew what I was going back up against….there was no guessing anymore, there it was in the report. It was time once more to “get my mind right to fight.”
Once I found out the surgery did not completely remove the malignant tumors, I knew it was going to a really long and hard road, with no shortcuts. I was going to have to go all in and gut this one out for the long haul, if I was to have a chance at any kind of victory.
You all know there were times when it looked like I was beaten. Down and out for the count is what’s ahead for our good old Sundance, folks were probably thinking – put a fork in him, he’s done. But then again, you don’t know Sundance:)
I’ve always said I may “bend or waver” during the fight, but that I would never “break.”
Maybe that’s not an entirely true statement. Perhaps, it depends on what your definition of “break” is. In fact, Cancer had me beaten and on my knees begging for either “Death or Mercy.” It had me beaten at the time, but not broken for the long haul of the fight.
“The CURE” had me beaten as well this time , but I stayed strong enough to complete the entire protocol “by the numbers.” It was really difficult this time to mentally and physically step through all the obstacles that stood in our way. As I’ve said before, it gets a little harder to keep taking the pounding, the longer you stay in the fight.
The mind and heart are still willing – but the body just doesn’t “bounce” like it used to. I think this is the biggest difference in an old veteran fighter vs the newly diagnosed.
While the surgeries and treatments have compromised our bodies, we learn we must adapt and use our experience and smarts to fight on, instead of relying on a new body that is just starting out.
My medical team continuously put the foot on the gas and we were very aggressive in our treatment plan and there was no time to rest. We relentlessly pursued our target and stayed in the attack mode the entire time.
Oh yes, I can be beaten – I can be hurt – I can bleed – I can hurt – I can suffer. I am just a mortal man, composed of blood & flesh..
However, on the other side of the coin, I can also be tenacious – persistent – stubborn – and relentless in my own pursuit. My horoscope is “Cancer, the Crab.” I’m a “July Baby.”
We’re loveable, friendly, and loyal – but when fuc*ed with, we raise our pinschers and will snap you. We’re a very formidable force to reckon with. When we hit back, it hurts too, just like we were hurt. We only fight when provoked though and let’s face it, Cancer does provoke us, doesn’t it?
Here’s the last topic I wanted to discuss. Let’s talk about our roommate – HOPE.
What an interesting fella’ this guy is, am I right?
He’s very elusive and if we’re not real careful, he can just slip out of our fingertips and just be gone. And when he goes, he’s sometimes hard to find again. And when Hope moves out, Depression can move in – then he invites Despair, Hopelessness and Loneliness to the party, and from there our lives can disappear and become nothing but existence.
And that’s a very bad place to be – especially for too long. I know, because I spent 9-months with all of these guys this year. They are not nice “house guests.” They try to rob you of that thing that we call “Our Lives.”
And then it becomes up to us to take back back what was so wrongly taken from us. Each of us must do that and find a way to get Hope moved back in with us, so we can flourish and feel optimism.
What is my definition of Hope?
I’ve come to think of Hope as that “Intangible element of humanity that we cannot see, but one that we feel.”
It’s the single common denominator that every single one of us has inside. It’s the driving force behind our individualism and more importantly, the one thing that we “Cling To” and “Reach For” in times of dire circumstances that beset each of us, somewhere in our lifetime.
As the old saying goes, “Let’s Keep Hope Alive!”
Hey, let’s go down to ringside right now, looks like Michael Buffer is about to announce “The Decision.” Who came out on top? Sundance or Cancer?
“Ladies and Gentlemen! The Winner by KO and still the Undefeated Cancer Champion of the World, with a 3-0 title defense, is……….your very own…….SUNDANCE! “
LOL:)
And the crowd goes WILD……….:) !!!
For any of you that bet against me…….”Suckerzzzz!” LOL:)
That’s right folks – 3 recurrences Up and 3 recurrences Down – just like in baseball, huh?
We did it again. We knocked Cancer “Back into the Shadows” once more. He’s gone back into hiding, licking his wounds, while I lick mine. But, we got Him down right now. You read the BAD in my other post…….and now for something completely different, here is the GOOD:
1. Colon and Rectum = Clear
2. Liver = Clear
3. Lungs = All Clear:)
Many of you might recall in my Thanksgiving Message to my Cancer, that I said, “I am down right now – but when I get up, I’m coming – and He11 was coming with me.
Well, with Big Billy by my side, we “Huffed and we Puffed”…and we “Blew the Doors to the Gates of He11 Wide Open!”
What looked like a highly improbable, if not impossible mission at the beginning of this fight, has come to a successful conclusion. I know how fortunate I am to be on the “positive side of the ledger” right now. It sure could have gone either way, but somehow we are on top right now.
We’re officially back to “Watching and Waiting.” I’ll talk to NED, if I make it “clean” for 5-years, with no further recurrences….. (June 2016).
So, it does not get much better than this….am I right?
I thought the balloons were supposed to fall out of the ceiling about now? Why isn’t the band playing? Where’s the cake and ice cream? Where is Jennie with my margaritas?
LOL:)
Since I can’t get to any of you right now…we’ll just have to have a “Cyber Celebration!” I need some folks to share in this joy with me. It will mean more if I have all of you around me in the “same room.”
So, what’s next for Sundance?
I’m going to Disneyworld!...................................Not!
I’ll be lucky to get to Chicago for CP9 – with this very meaningful victory, it is my sincerest hope that I can make it there and get some lovin’ from my honeys:)
What’s next is instead of escaping Cancer, I’m going to jump back into the deep end of the pool and go back to the beginning of the journey – first chapter titled “The Diagnosis.”
I want to jump on getting this written now, while the wounds are fresh and the feelings raw. I’m excited about making this a reality – now publishing will be another story – coming to an Amazon Kindle near you?
I’ll close this post with these final thoughts…..
On the day that Donna (Shayenne) aka “My Chicky” passed away, I posted on that thread that Her Lion had roared for the final time.
A beautiful chapter in my life and on this board and a real life story of friendship had come to a tragic and painful end. On this day a part of me died with her –Her Lion was dead and gone, and yet the memories still remained, but were now forever buried deep within the archives of the CSN posts.
This is a day where I wished Chicky were still here with us – certainly a story she would have loved to hear about and rejoice in. I will miss not seeing her post in this thread.
In honor of her memory and to bookmark this momentous occasion, Donna’s Lion “ROARZZZZ” one more time:) Miss you, Chicky.
This one was for myself, but also for the Semi;Colon Nation. I stand before you as a living testimony to what Cancer “Can and Cannot” do to us. It will never be easy, but you too can do this. I’ll stand proudly beside each one of you and be with you for each stop in your journey. Don’t be afraid – get mad – get even – and get out there and fight!
I understand less and less as time goes by – have no idea of why I’m still here after 7 years of battling this stuff. Don’t understand why my friends did not make it, but I am still here. I suppose I’ll never know.
And Cancer may indeed catch me one day – but guess what? It won’t be TODAY!!!
All of you know that Sundance is not the kind of guy that “Goes Quietly into the Night.”
I carry all of your hopes and dreams with me in my heart. I have the deepest respect and admiration for each one of you here – both past and present. You are the finest group of people I know and I’m proud to know you all.
All of you are Winners – and Cancer will never, ever take that away from you! With all of the love I can muster, I thank you for staying with me and you are all in my thoughts, in my heart, and in my dreams. Semi;Colons Rock!
I SALUTE YOU!!!
Craig and Big Billy
“Team Sundance”

Medifocus Guidebook on Peripheral Neuropathy


What is Peripheral Neuropathy?
The nervous system controls the smooth functioning of all systems in the body as well as all interactions between the human being and the environment. The nervous system is comprised of millions of neurons that are interconnected and form a communications network within the body that governs many vital functions including:
  • The five senses (sight, hearing, touch, smell, and taste)
  • Voluntary functions (e.g. walking, holding an object)
  • Involuntary functions (e.g. breathing, blood pressure)
  • Cognitive reasoning
The human nervous system has two major components:
  • Central nervous system - includes the brain and spinal cord
  • Peripheral nervous system - includes the nerves that lead from the brain and spinal cord to all parts of the body. An extensive system of specialized nerves makes up the peripheral nervous system which is responsible for a variety of important functions. These specialized nerves include:
    • motor nerves which carry messages from the brain to the body and are responsible for the ability to move any part of the body (e.g., hands, feet)
    • sensory nerves which carry information from organs to the central nervous system where it is processed into sensation (e.g., touch, temperature changes, and vibrations)
    • nerves that control autonomic (involuntary) functions including heart rate, blood pressure, breathing, digestion, and bladder function
Peripheral neuropathy is a term used to describe damage to nerves of the peripheral nervous system which leads to symptoms such as pain, numbness, tingling, burning, and weakness most commonly affecting the hands and feet. Peripheral neuropathy can be caused by a variety of precipitating factors including trauma, infection, diabetes, alcohol abuse, and cancer chemotherapy.
The incidence of peripheral neuropathy is not known with any degree of certainty. It has been estimated that approximately 2 to 3 million Americans have some form of peripheral neuropathy. The prevalence of peripheral neuropathy worldwide has been estimated to range from 2% to 8% of the population. Peripheral neuropathy affects both genders at all ages but symptoms are unique to each individual in terms of frequency, quality, and severity of pain. Idiopathic peripheral neuropathy typically affects adults over the age of 50. Peripheral neuropathy can significantly impact an individual's quality of life and daily activities by causing major disruptions including:
  • Sleep disturbances
  • Mood changes
  • Impairment of social, occupational, and recreational functioning
Knowledge is Critical when Dealing with a Life-Altering Condition such as Peripheral Neuropathy
If you or a loved one has been diagnosed with peripheral neuropathy, it's critical to learn everything you possibly can about this condition so that you can make informed decisions about your treatment. That's why we created the Medifocus Guidebook on Peripheral Neuropathy, a comprehensive 187 page patient Guidebook that contains vital information about peripheral neuropathy that you won't find anywhere in a single source.
The Medifocus Guidebook on Peripheral Neuropathy starts out with a detailed overview of the condition and quickly imparts fundamentally important information about peripheral neuropathy, including:
  • The underlying causes and risk factors for developing peripheral neuropathy, which include:
    • Diabetes
    • Autoimmune disorders
    • Metabolic disorders
    • Hereditary disorders
    • Infectious diseases
    • Alcohol abuse
    • Trauma
    • Cancer chemotherapy
  • The different types of peripheral neuropathy that can occur based on the pattern of nerve involvement and the distribution of pain, which include:
    • Mononeuropathy
    • Mononeuropathy multiplex
    • Polyneuropathy
  • The signs and symptoms associated with peripheral neuropathy based on the specific underlying cause, when known.
  • How peripheral neuropathy is diagnosed based on a variety of factors and diagnostic tests including:
    • Signs and symptoms
    • Patient history and physical examination
    • Pattern of distribution of pain along sensory or motor nerves
    • Special electrodiagnostic studies, such as nerve conduction tests and electromyography (a test which measures the response of muscles to electrical stimulation)
Understanding the Standard Treatments...and the Treatment Options
The primary goals of treatment for peripheral neuropathy include accomplishing the following objectives:
  • Determining and treating the underlying cause of the condition, if possible.
  • Controlling and alleviating pain and other bothersome symptoms associated with the condition.
  • Preserving function of the affected limbs, such as the hands and/or feet.
  • Preventing a significant decrease in the patient's quality of life.
An important aspect for successfully achieving these goals is understanding the treatments - and the treatment options - for peripheral neuropathy. As you read through the section of the Guidebook that focuses on the treatment of peripheral neuropathy, you will specifically learn about:
  • The management of peripheral neuropathy in patients where the underlying cause can be identified, such as diabetes, autoimmune disorders, infectious diseases, nerve compression, and cancer chemotherapy.
  • The major types of medications that are often prescribed to relieve pain associated with peripheral neuropathy, which include:
    • Antidepressants
    • Anticonvulsants
    • Selective serotonin reuptake inhibitors
    • Narcotic analgesics
    • Topical agents such as capsaicin and lidocaine patches
  • The treatment options that are available for controlling pain that does not adequately respond to drug therapy, including nerve blocks with local anesthetics and spinal cord stimulation.
  • The role of physical and occupational therapy in functional rehabilitation of patients with peripheral neuropathy.
  • The role of complementary and alternative therapies in the management of peripheral neuropathy.
  • The impact of peripheral neuropathy on the patient's psychological well-being and quality of life, including aspects such as:
    • Anxiety and depression
    • Social relationships
    • Activities of daily living
    • Employment issues
    • Sleep disturbances
    • Recreational activities
    • Feelings of self-worth
  • Practical tips and suggestions for how to minimize the negative impact of peripheral neuropathy on your quality of life and learn how to better cope with the condition.
  • Important questions to ask your doctor about peripheral neuropathy.
A "One-of-a-Kind" Reference Guidebook on Peripheral Neuropathy that Goes Way Beyond the Fundamentals
Since 1996, when Medifocus was founded, we've learned that many people with Peripheral Neuropathy are seeking more specific information that goes beyond the fundamentals, such as the causes, diagnosis, standard treatments, and treatment options. That's why we developed a "one-of-a-kind" reference Guidebook that goes way beyond the basics and also includes the following sections:
  • A Guide to Recent Medical Literature on Peripheral Neuropathy - This section of the Guidebook contains an extensive bibliography of over 100 references to recently published articles about Peripheral Neuropathy in authoritative, peer-reviewed medical journals with links to the absracts (summaries) of the articles. These articles represent the latest advances in the field and focus on cutting-edge research, new developments, and the lessons learned from recently published clinical trials involving patients with Peripheral Neuropathy. This is the same level of that is used by doctors who treat people with Peripheral Neuropathy to keep abreast of the latest developments and breakthroughs in this specialized field of medicine.
  • Centers of Research for Peripheral Neuropathy - We've compiled a unique directory of doctors, hospitals, medical centers, and research institutions with special interest and, in many cases, clinical expertise in managing people with Peripheral Neuropathy. The "Centers of Research" directory is a valuable resource for quickly identifying and locating leading medical authorities and medical institutions both within the United States and other countries who are considered to be at the forefront in clinical research and treatment of Peripheral Neuropathy. You'd have to spend days - or even weeks - attempting to compile your own list of doctors and medical centers but, with the "Centers of Research" directory, the information is already right at your fingertips. All you have to do is act on the information by selecting and contacting the experts or medical institutions listed in the directory by state and country.
  • Organizations and Support Groups for Peripheral Neuropathy - The Guidebook also includes a directory of organizations and support groups whose goal is to help people with Peripheral Neuropathy by providing access to information, resources, and services. Many of these organizations can answer your specific questions, enable you to "network" with other patients, and provide guidance in areas such as financial, social, or medical-legal issues. This valuable directory of organizations and support groups includes complete contact information, including phone numbers and E-mail addresses.
The Guidebook is a Value-Added Proposition that Comes with a Risk-Free Satisfaction Guarantee so that...You have Nothing to Lose and Everything to Gain
Still not sure if you'll benefit from the Medifocus Guidebook on Peripheral Neuropathy? Still not convinced that the information included in the Guidebook is worth the minimal cost? If that's the case, then please consider the following value-added proposition that comes standard with your purchase of the Guidebook:
  • Free Updates for One Year - With your initial purchase of the Guidebook, you also receive access to free updates for one-full year. The Guidebook is updated with new information every 4 to 6 months, so that you will be able to access the updated information several times during the course of a year for up to one full year after the date of your initial purchase.
  • Free Digest E-Mail Alerts - When you purchase the Guidebook, you will also automatically receive a free subscription to our monthly newsletter - the Medifocus Digest Alert for Peripheral Neuropathy. This is an expertly selected listing of the latest articles published in the medical literature about Peripheral Neuropathy with convenient links to the abstracts of the articles that focus on cutting-edge research, clinical trials, and the latest treatment advances. The Medifocus Digest Alert for Peripheral Neuropathy is automatically delivered straight to your "inbox" monthly and is a valuable resource for keeping up with the latest developments in Peripheral Neuropathy almost as soon as the new information is published in the medical literature.
  • 10% Discount - For a limited time, you can purchase the Medifocus Guidebook on Peripheral Neuropathy at a special 10% discount off the regular list price. Your 10% discount will automatically be applied when you go to "Checkout".
  • Risk-Free Satisfaction Guarantee - Your purchase comes with our RISK-FREE satisfaction guarantee. If, for whatever reason, you are not totally satisfied with the content of your Guidebook, simply contact us within 30-days of your purchase for a prompt, full refund. We are so confident that you will be satisfied with your Guidebook that we offer this RISK-FREE satisfaction guarantee unconditionally - no questions and no hassles.

Sunday, June 12, 2011

Retinal - Vitamin A

Overview & Description

Vitamin A is a fat-soluble vitamin which means it can be dissolved in fat. Vitamin A is carried through the body by fat. The body can store this type of vitamin in fat tissue. Getting too much can be harmful.
Information
Vitamin A is usually measured in retinol equivalents, also called RE. The Recommended Dietary Allowance, called RDA, for vitamin A for adult men, from age 11 on, is 1,000 RE per day. Women, from age 11 on, should get 800 RE per day. There is no increase of vitamin A requirements during pregnancy but lactating women need about 500 RE or more per day.
Vitamin A can be stored in the fat tissues of the body. This can pose a problem for people taking extra doses of vitamin A. High doses can be toxic and cause symptoms such as the following:
  • headaches

  • dry and scaly skin

  • liver damage

  • bone and joint pain

  • vomiting or lack of appetite

  • abnormal bone growth

  • nerve damage

  • birth defects

  • In most cases, only levels 10 times the RDA (far more than a person could get through diet alone) have been linked with these symptoms. Vitamin A cannot reach toxic levels unless a person is taking extra doses. Carotenoids are not converted to vitamin A fast enough to increase the amount of vitamin A stored in the body. Beta-carotene is NOT toxic to the body.
    Getting too little vitamin A can cause side effects too. Symptoms of significant deficiency include:
  • lowered resistance to infections

  • problems with getting pregnant

  • poor growth

  • improper tooth formation

  • rough, dry, and pimply skin

  • digestive problems

  • night blindness

  • eye disease, including xerophthalmia (zear-off-thal-me-ah), a condition in which the clear covering of the eye known as the cornea becomes dry and dull

  • Vitamin A is an important fat-soluble vitamin. Eat a variety of fruits, vegetables, lean meats, and fortified dairy products to ensure optimal intake of vitamin A. Read food labels to help choose foods with vitamin A content.

    Functions and Sources

    What food source is the nutrient found in?
    Vitamin A can come from animal sources such as:
  • eggs

  • fortified milk

  • liver

  • oils of some fish

  • This form of Vitamin A is called retinal or retinol.
    Vitamin A is also found in plants. This form is called carotenoids. Substances such as beta-carotene are converted from carotenoids into vitamin A in the body. Beta-carotene is one of the most common carotenoids. Carotenoids are pigments found in deep orange, red, and yellow fruits and vegetables. They are also found in many dark-green leafy vegetables, such as:
  • carrots

  • pumpkin and other squashes

  • sweet potatoes

  • cantaloupe

  • broccoli

  • spinach

  • How does the nutrient affect the body?
    Vitamin A helps develop and maintain healthy growth in the cells and almost all the parts of the body. It is especially key for proper night vision, but is also needed for the health of a person's:
  • teeth

  • skeletal and soft tissue

  • skin

  • mucous membranes

  • Vitamin A plays a key role in the immune system by helping protect from infections. Beta-carotene is an antioxidant. It has been studied for its role in cancer and heart disease protection. Antioxidants help fight free radicals. Free radicals are oxygen by-products produced when body cells burn oxygen. A build up of free radicals can damage body cells and tissues.

    Attribution

    Author:Clare Armstrong, MS, RD
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:09/27/02
    Reviewer:Kathleen A. MacNaughton, RN, BSN
    Date Reviewed:09/26/02

    Sources
    Mahan, K, MS, RD, CDE & Escott-Stump, S., MA, RD, LDN. (2000). Krause's Food, Nutrition, & Diet Therapy (10th ed.). Pennsylvania: W.B. Saunders Company.
    Somer, E., MA, RD. & Health Media of America. (1995). The Essential Guide To Vitamins and Minerals (2nd ed.). New York: HarperCollins Publishers, Inc.
    Duyff, R., MS, RD, CFCS. (1996). The American Dietetic Association's Complete Food & Nutrition Guide. Minnesota: Chronimed Publishing.

    Relapsing Urinary Tract Infection - Recurring Urinary Tract Infection

    Overview, Causes, & Risk Factors

    Recurring urinary tract infection (UTI) involves repeated infections of the kidneys or bladder even after proper treatment.
    What is going on in the body?
    UTIs are usually caused by bacteria. In most cases, the bacteria enter the body through the skin around the genitals and anal area. The bacteria travel up toward the bladder or kidneys. If the bacteria are not killed by the person's immune system, an infection can occur.
    What are the causes and risks of the infection?
    Recurrent UTIs can occur for many reasons, including:
  • problems with the immune system

  • the use of a urinary catheter to empty the bladder

  • abnormalities in kidneys, ureters, bladder or urethra can cause repeated infections. The ureters are tubes that carry urine from the kidneys to the bladder. The urethra is a tube that carries urine from the bladder to the outside of the body.

  • damage to part of the urinary system

  • sexual intercourse, which seems to trigger UTI in some women

  • poor hygiene, such as wiping from back to front after a bowel movement or not changing the underwear often.


  • Symptoms & Signs

    What are the signs and symptoms of the infection?
    A UTI may cause any of the following symptoms:
  • fever

  • the need to urinate frequently

  • painful urination

  • pain in the abdomen or on the sides of the back below the ribs

  • nausea and vomiting

  • incontinence, or involuntary loss of urine

  • a sensation of fullness in the lower abdomen

  • blood in the urine


  • Diagnosis & Tests

    How is the infection diagnosed?
    A history of the symptoms is taken by a healthcare provider. A urine sample may be sent to a lab for a urinalysis and a urine culture. Infected urine often contains bacteria and white blood cells, the infection-fighting cells of the body. Normal urine contains little or no bacteria or white blood cells.

    Prevention & Expectations

    What can be done to prevent the infection?
    Prevention of recurring urinary tract infections can involve several steps:
  • A woman who develops UTIs after sexual intercourse may take antibiotics, such as sulfamethoxazole/trimethoprim, before signs of infection occur.

  • A person who has a urinary catheter in the bladder needs to have the device changed or cleaned often.

  • Good hygiene is important for everyone, but especially for those who are bedridden and incontinent.

  • A person should drink 8 glasses of water every day.

  • A person should urinate when the urge is felt, rather than holding urine in the bladder for long periods of time.

  • What are the long-term effects of the infection?
    Recurring UTIs can damage the urinary system. A UTI can spread to the blood, causing sepsis. That can cause severe illness and even death.
    What are the risks to others?
    UTIs are usually not contagious. However, infections of the urethra are generally spread through sexual contact.

    Treatment & Monitoring

    What are the treatments for the infection?
    A person who has an abnormality in the urinary system may be able to have surgery to correct the problem. Otherwise, antibiotics, such as sulfamethoxazole/trimethoprim or nitrofurantoin, are given to treat the UTI. A person may need to take these medications for a week or more in difficult cases of recurrent infection.
    A person who has an artificial device, such as a urinary catheter, in the bladder should have the device changed or cleaned regularly.
    What are the side effects of the treatments?
    Antibiotics may cause allergic reactions and stomach upsets. Other side effects vary depending on the medication used.
    What happens after treatment for the infection?
    The person can usually go back to normal activities once the symptoms have gone away.
    How is the infection monitored?
    Often, a person with recurring UTIs is asked to give a urine sample after treatment is completed. A urinalysis and urine culture can be done to check that the bacteria are gone from the urinary tract.

    Attribution

    Author:Adam Brochert, MD
    Date Written:
    Editor:Coltrera, Francesca, BA
    Edit Date:04/14/00
    Reviewer:Gail Hendrickson, RN, BS
    Date Reviewed:07/27/01

    Sources
    Principles and Practice of Infectious Diseases, 1995, Mandell et al

    Recommended Dietary Allowances (RDA)

    Recommended Dietary Allowances (RDA)

    The Recommended Daily Allowances, known as RDAs, are recommendations for nutrients. They were developed by the Food and Nutrition Board of the National Academy of Sciences/National Research Council. They are updated as new research findings surface. The RDAs state the amount of a nutrient that is needed for most people to stay healthy. They are different for children, adults, males, and females.
    The Dietary Reference Intakes, known as DRIs, are an umbrella group that includes the following other nutrient measures:
  • RDAs

  • Adequate Intakes, known as AI

  • Estimated Average Intakes, known as EAR

  • Tolerable Upper Intakes, known as UL

  • DRIs are slowly becoming the more accepted form for nutrient recommendations. Experts expect that DRIs will take the place of the RDAs in time.
    Information
    United States Recommended Dietary Allowances (RDA)
    Recommended Dietary Allowances: National Academy of Sciences;10th ed., 1989
    Dietary Reference Intakes: National Academy of Sciences, 1997
    CompoundunitsAdultAdultChildrenInfantsPregnantLactating+


    Males (25+years)Females (25+years)4-8 years6-12 mos.

    Biotinmcg30*30*12*6*30*35*
    Calcium (Ca)mg1200*1200*800*270*1000*1000*
    Chloride (Cl)mg750750600300750750
    Chromium (Cr)mcg50-20050-20050-20020-6050-20050-200
    Copper (Cu)mg1.5-31.5-31-20.6-0.71.5-31.5-3
    Fluoride (F)mg4*3*1*0.5*3*3*
    Folatemcg400*400*200*80*600*500*
    Iodine(I)mcg15015012050175200
    Iron (Fe)mg10(25-50y) 15

    (51+y) 10
    10103015
    Magnesium (Mg)mg420**320**130**75*350-400**310-360**
    Manganese (Mn)mg2-52-52-30.6-1.02-52-5
    Molybdenum (Mo)mcg75-25075-25050-15020-4075-25075-250
    Niacinmg16**14**8**4*18**17**
    Pantothenicmg5*5*3*1.8*6*7*
    Phosphorus (P)mg700**700**500**275*700**700**
    Potassium(K)mg20002000160070020002000
    Proteing635028146065
    Selenium (Se)mcg705530156575
    Sodium (Na)mg500500400200500500
    Vitamin AmcgRE*10008007003758001300
    Vitamin B1(Thiamine)mg1.2**1.1**0.6**0.3*1.4**1.5**
    Vitamin B2 (Riboflavin)mg1.3**1.1**0.6**0.4*1.4**1.6**
    Vitamin B6 (Pyridoxine)mg1.7**1.5**0.6**0.3*1.9**2.0**
    Vitamin B12 (Cyanocobalamin)mcg2.4**2.4**1.2**0.5*2.6**2.8**
    Vitamin Cmg606045359590
    Vitamin Dmcg(51-70y) 10*

    (71+y) 15*
    (51-70y) 10*

    (71+y) 15*
    (1-8y) 5*5*5*5*
    Vitamin Emg

    alpha TE*
    108741211
    Vitamin Kmcg806530106565
    Zinc (Zn)mg15121051519
    g =grams
    mg = milligrams (0.001 g)
    mcg = micrograms (0.000001g)
    IU = International Units
    RE = Retinol Equivalent
    Alpha TE = alpha Tocopherol equivalent
    + Generally the higher number was reported.
    * AI (Adequate Intake) from the new Dietary Reference Intakes, 1997: Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Values have changed from previous RDA.
    ** RDA (Recommended Dietary Allowance) from the new Dietary Reference Intakes, 1997: Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Values have changed from previous RDA.

    Radial Nerve Damage - Radial Nerve Injury

    Overview, Causes, & Risk Factors

    A radial nerve injury involves damage to the radial nerve, which allows sensation and movement in part of the arm. The radial nerve attaches to the skin and muscles of certain areas of the arm, forearm, and hand. It is responsible for muscle movement and sensation in these areas. Someone with an injury to the radial nerve lose function in these areas.
    In most cases, the radial nerve is damaged by trauma, repeated use of the nerve, or by the nerve being compressed by other structures. The injury may be permanent.
    What are the causes and risks of the injury?
    Radial nerve injury can be caused by a number of activities, including:
  • the improper use of crutches, usually when a person rests his or her weight on the armpits rather than the hands

  • hanging the arms over the back of a chair for too long or lying on an arm for too long. This is sometimes called "Saturday night palsy," because it often happens in those who are very drunk or intoxicated.

  • a bone fracture involving the upper arm bone, or humerus

  • Rarely, no cause can be found for the nerve damage. In these cases, the injury may come from certain repeated motions of the arm, known as a repetitive stress injury.
    A radial nerve injury may be permanent, causing lifelong weakness and numbness, and sometimes chronic pain. In some people, the muscles can shrink and cause the arm to become deformed over time. In other people, some or all of the arm's function may be regained over time.

    Symptoms & Signs

    What are the signs and symptoms of the injury?
    Symptoms of a radial nerve injury depend on where the nerve injury occurs, but may include:
  • numbness or tingling of the skin on the back of the arm, forearm, and hand

  • pain in the same areas as the numbness or tingling

  • muscle weakness, which usually affects the ability to straighten the elbow, wrist, and fingers

  • muscle shrinkage or wasting, which takes a long time to develop

  • deformities in the hand or forearm, usually due to muscle wasting

  • Symptoms may also result from the injury that caused the nerve damage.

    Diagnosis & Tests

    How is the injury recognized?
    A radial nerve injury can often be diagnosed with a history and physical exam. Tests may be ordered to help figure out the cause of the nerve injury. An x-ray of the arm is commonly done to look for a break or other bone injury. A test called a nerve conduction velocity (NCV) study may be done to determine the location of the nerve injury. This test involves attaching wires to the skin. Small shocks are used to stimulate the nerve and measure its function.
    Blood tests or a nerve biopsy are sometimes needed in unusual cases. A biopsy is a procedure to remove a small piece of tissue from the body. A special tool or needle can be inserted through the skin and into the nerve. A small piece of the nerve can be removed with the tool. The piece can then be sent to the lab for further examination and testing.

    Prevention & Expectations

    What can be done to prevent the injury?
    Most cases of radial nerve injury cannot be prevented. Avoiding injury, overuse of the arm, and improper use of crutches can prevent some cases.

    Treatment & Monitoring

    What are the treatments for the injury?
    When the radial nerve injury is caused by a broken bone, fixing the bone may reverse the nerve injury or make it better. This may involve surgery or the use of a cast. Other treatments may include:
  • pain medications, such as aspirin

  • other medications to help with nerve pain, such as amitriptyline or gabapentin

  • physical therapy to help improve arm use and strength

  • occupational therapy to help the person improve his or her ability to perform daily activities

  • What are the side effects of the treatments?
    Surgery may cause bleeding, infection, or allergic reaction to anesthesia. Aspirin and other pain medications may cause stomach upset, allergic reactions, or kidney damage. Other side effects depend on the specific medication used.
    What happens after treatment for the injury?
    Treatment for a radial nerve injury may or may not be able to reverse the lost function in the person's arm. Someone who does not recover fully often benefits from long-term physical therapy and occupational therapy. Deformity of the hand and muscle shrinkage can occur in severe cases. Some people may recover completely and need no further treatment.
    The healthcare provider can help people monitor the injury by measuring the strength and sensation in the affected areas. Some of the medications used to treat pain may also need monitoring, which can include blood tests. Any new or worsening symptoms should be reported to the healthcare provider.

    Attribution

    Author:James Broomfield, MD
    Date Written:
    Editor:Duff, Ellen, BA
    Edit Date:10/09/00
    Reviewer:Adam Brochert, MD
    Date Reviewed:07/01/01

    Sources
    Harrison's Principles of Internal Medicine, Fauci et al, 1998

    RA - Rheumatoid Arthritis

    Overview, Causes, & Risk Factors

    Rheumatoid arthritis, also called RA, is an inflammation in the lining of the joints and other internal body organs. RA belongs to a group of diseases called autoimmune disorders, in which the body makes antibodies against its own tissues. It is a fairly common form of arthritis.
    What is going on in the body?
    In RA, for reasons unknown, the body's immune system malfunctions and begins making antibodies against its own tissues. Antibodies are proteins that help the body to fight infection. These antibodies are made by the immune system in response to a trigger called an antigen. This trigger is often a substance that the body sees as "foreign." These foreign substances can include things like bacteria and viruses. This immune reaction causes an inflammation of the synovial membrane lining the joints.
    This chronic inflammation produces enzymes that can invade and damage cartilage and bone within the joint. Sometimes this form of arthritis is mild, but 70% of people who have it develop chronic problems, and 15% have severe crippling disease. Young children can have a form called juvenile RA.
    What are the causes and risks of the disease?
    The causes of RA are not yet fully understood. Experts suspect that some type of virus can trigger RA in people who have certain genes that give one a tendency to develop the disease.
    RA affects 2.1 million people in the U.S. and can develop at any age. Most often, it starts in middle age, but it is also common in people in their 20s and 30s. More than 70% of the people who have RA are women.
    There is currently research into a number of factors that may trigger RA, including:
  • certain abnormal genes found in some, but not all, people who have RA

  • certain viruses or bacteria that trigger the autoimmune response of RA

  • hormone imbalances


  • Symptoms & Signs

    What are the signs and symptoms of the disease?
    Joint pain, swelling, and stiffness that is especially severe and prolonged in the morning are the most common symptoms of RA. The same joint on both sides of the body is usually involved, and RA most often starts in the hands or feet. However, the problems may move from one joint to another. Usually many joints throughout the body are affected at the same time.
    Because RA is a disease that can affect the whole body, the person may have other symptoms:
  • fatigue

  • a vague feeling of illness called malaise

  • occasional fever

  • loss of appetite

  • loss of energy

  • lumps of tissue under the skin called rheumatoid nodules, often over bony areas exposed to pressure (especially near the elbow)


  • Diagnosis & Tests

    How is the disease diagnosed?
    Observing the person and his or her pattern of symptoms, along with a medical history and physical exam, helps the doctor to diagnose RA. A blood test for the rheumatoid factor is positive in about 80% of cases but does not mean the person has RA.
    Other blood tests, such as a complete blood count, called CBC; C4 complement components; C-reactive proteins, called CRP; and antinuclear antibody, called ANA; tests may be done. People with RA are often anemic and have a low number of red blood cells in their blood count. Joint aspiration, which means removing joint fluid with a needle under local anesthesia, might be done. Synovial fluid that is cloudy, milky, or dark yellow and that contains many inflammatory cells will help detect RA.
    Joint X-rays may also be ordered to help diagnose RA. It is important to rule out other diseases and conditions, such as other types of arthritis, as well as condition such as systemic lupus erythematosus and Borrelia burgdorferi.\ It is passed to humans through tick bites. ',CAPTION,'Lyme Disease');" onmouseout="return nd();">Lyme disease.

    Prevention & Expectations

    What can be done to prevent the disease?
    RA can't be prevented.
    What are the long-term effects of the disease?
    RA may be progressive and can affect many joints. This can make walking very difficult and can interfere greatly with the function of the hands. Disability can be severe and may cause depression.
    Rheumatoid arthritis can cause deformities such as misshapen fingers, bunions, hammertoe, and knock-knees. The affected joints are swollen and warm.
    Other body parts can also be affected by rheumatoid arthritis. The rheumatoid process can involve the eye, known as episcleritis, and the lungs, known as interstitial disease. There may be an inflammation of blood vessels or the lining around the heart, known as vasculitis or pericarditis. Osteoporosis, which is the loss of bone density, is also more common in people who have RA than in the larger population.
    What are the risks to others?
    RA poses no risk to others.

    Treatment & Monitoring

    What are the treatments for the disease?
    People who have RA should learn all they can about self-care and managing their disease. There are many treatment approaches.
    Overview
    Early treatment is the key. Effective self-management of RA will focus on the following goals:
  • relieve pain

  • decrease inflammation in the joints

  • slow down or stop damage to the joints

  • improve joint function and ability to do daily activities

  • increase feelings of general well-being

  • Specific self-care measures may include:
  • managing one's stress

  • applying splints to rest acutely inflamed joints

  • using assistive devices, such as zipper pulls, to decrease strain on joints

  • Medicine
    Symptom control and disease management may be enhanced when medicines are started early in treatment. A wide variety of highly effective medicines are used to treat RA. Most fall into one of two groups, including medicines that relieve symptoms and medicines that actually modify the disease process. These two types of medicines are sometimes used in combination. Examples of medicines that relieve symptoms include:
  • anti-inflammatory medicines, called NSAIDs, such as aspirin, naproxen, and ibuprofen

  • COX-2 specific inhibitor NSAIDs, such as celecoxib and rofecoxib

  • corticosteroids, such as prednisone, which can be taken orally or by injection into the joint

  • analgesics, such as acetaminophen or propoxyphene

  • Examples of medicines that modify disease include:
  • immunosuppressant medicines, which alter the body's immune response, such as methotrexate, azathioprine, and cyclophosphamide

  • anti-inflammatory medicines, such as infliximab and etanercept, which block the effects of a key protein involved in the rheumatoid process

  • antibiotics, such as doxycycline and minocycline

  • medicines that slow down joint destruction, such as d-penicillamine, sulfasalazine, hydroxychloroquine, and gold

  • Diet and Nutrition
    All people should be sure to eat a healthy diet, following the food guide pyramid. It's important to get the right amount of calories, protein, and calcium.
    The findings of some studies have shown that symptoms of RA improve with high doses of omega-3 fatty acids. These substances occur naturally in certain fish and in some plant seeds. However, it is hard to get enough of these acids to affect the disease, and some people cannot tolerate the high doses.
    There has been a great deal of interest in the last few years in the use of glucosamine and chondroitin, dietary supplements that may decrease the joint pain linked with another form of arthritis called osteoarthritis. People who have RA should discuss the value of such supplements with their doctors before taking them.
    Exercise
    Exercise is a key strategy in the treatment of arthritis, but the person with RA needs to be careful to balance exercise and rest to conserve energy. The exercise program should consist of a combination of aerobic exercise, strengthening (joint protection) exercises, and flexibility (or stretching) exercises.
  • For aerobic exercise, 30 minutes of moderate exercise a day can help prevent complications of arthritis, as well as heart disease, stroke, and diabetes. Exercise should be kept to a level where the person can talk without shortness of breath and is comfortable with the pace of the activity. The 30 minutes a day can be done in one session or broken up into several shorter segments. Walking and water aerobics are exercises that keep joint stress to a minimum.

  • Strengthening exercises can be done with light weights or a resistance band. The goal is to build strength and tone in the muscles around the joints affected by RA, rather than to build big muscles. Improving muscle strength and tone can help protect the joint and prevent further joint damage. Most people with RA should talk with a doctor or physical therapist to set up a program that is right for him or her.

  • Stretching exercises will help maintain flexibility and should be done each day. They can be done while lying in bed or in various positions or at different times during the day.

  • Surgery
    Surgery may be performed when pain cannot be controlled or when significant function is lost. Several types of surgery may be done, such as:
  • arthroscopy, a procedure that uses a small scope and instruments to get inside the joint without opening it

  • arthrotomy, which means opening the joint through a larger incision

  • synovectomy, which is the removal of the lining of the joint

  • osteotomy, which realigns the bone next to the joint

  • arthroplasty, which is the partial or total replacement of the joint. People with severe arthritis are often candidates for a knee joint replacement or a hip joint replacement.

  • Prosorba Therapy
    The Food and Drug Administration has approved a blood-filtering treatment called Prosorba for moderate to severe cases of RA that have not responded well to disease-modifying medicines. In this procedure, blood is drawn from the arm and then separated into two different parts called the plasma and the red blood cells. Next, the plasma is filtered through a special cylinder the size of a soup can that is filled with a sandlike substance. This is called a Prosorba column, and the filtering sand in it is coated with protein A, which removes certain antibodies from the plasma. These antibodies contribute to pain and inflammation in the joints. The plasma is then combined again with the red blood cells and put back into the person's body.
    Therapy is given once a week for 12 weeks as an outpatient procedure. Each session lasts 2 to 2.5 hours. This therapy can bring remission from RA symptoms, but it will take up to 12 to 16 weeks before the person begins to feel the benefits. Once remission is reached, it may last as long as a year and a half.
    What are the side effects of the treatments?
    Medicines used to treat RA may cause stomach upset or bleeding , allergic reaction, less resistance to infection, and other side effects. Surgery may cause bleeding, infection, or allergic reaction to anesthesia. Nearby bones, ligaments, tendons, nerves, or blood vessels can also be injured by accident.
    What happens after treatment for the disease?
    Treatment of RA is lifelong. There is no cure for the disease, but careful management can help to reduce some of its effects.
    How is the disease monitored?
    A doctor will watch the person's level of comfort and function of the joint. Any new or worsening symptoms should be reported to the doctor.

    Attribution

    Author:John A.K. Davies, MD
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:09/28/02
    Reviewer:Kathleen A. MacNaughton, RN, BSN
    Date Reviewed:09/25/02


    GUANIDINEHYDROCHLORIDETablets

    DESCRIPTION

    Chemically, guanidine (aminomethanamidine) hydrochloride is a crystalline powder freely soluble in water and alcohol. The aqueous solution is neutral.
    The structural formula is:
    Each tablet contains 125 mg of guanidine hydrochloride with no color additive in the base. It also contains the following inactive ingredients: colloidal silicon dioxide, magnesium stearate, mannitol, and microcrystalline cellulose.

    CLINICAL PHARMACOLOGY

    Guanidine apparently acts by enhancing the release of acetylcholine following a nerve impulse. It also appears to slow the rates of depolarization and repolarization of muscle cell membranes.

    INDICATIONS AND USAGE

    Guanidine is indicated for the reduction of the symptoms of muscle weakness and easy fatigability associated with the myasthenic syndrome of Eaton-Lambert. It is not indicated for treating myasthenia gravis. The Eaton-Lambert syndrome is ordinarily differentiated from myasthenia gravis by the usual association of the syndrome with small cell carcinoma of the lung, but myography may be necessary to make the diagnosis.

    CONTRAINDICATIONS

    Guanidine is contraindicated in individuals with a history of intolerance or allergy to this drug.

    WARNINGS

    Fatal bone-marrow suppression, apparently dose related, can occur with guanidine.
    Safe use of guanidine hydrochloride in pregnancy has not been established. Therefore, the benefits of therapy must be weighed against the potential hazards. Because guanidine is excreted in milk, patients on this drug should discontinue breast-feeding.
    Since there is inadequate experience in children who have received this drug, safety and efficacy in children have not been established.

    PRECAUTIONS

    Baseline blood studies should be followed by frequent red and white blood cell and differential counts. The drug should be discontinued upon appearance of bone-marrow suppression. Concurrent therapy with other drugs that may cause bone-marrow suppression should be avoided.
    Renal function may be affected in some patients receiving guanidine. Patients should therefore have regular urine examinations and serum creatinine determinations while taking this drug.
    Physicians should be given adequate precautions pertaining to the gastrointestinal side effects and the possibility of induced behavior disorders.
    Treatment should not be continued longer than necessary.

    ADVERSE REACTIONS

    Anemia, leukopenia, and thrombocytopenia resulting from bone-marrow suppression attributable to guanidine have been reported. Other adverse reactions that have been observed are:
    General: sore throat, rash, fever.
    Neurologic: paresthesia of lips, face, hands, feet; cold sensations in hands and feet; nervousness, lightheadedness, jitteriness, increased irritability; tremor, trembling sensation; ataxia; emotional lability; psychotic state; confusion; mood changes, and hallucinations.
    Gastrointestinal: dry mouth; gastric irritation; anorexia; nausea; diarrhea; abdominal cramping. Gastrointestinal side effects may preclude the use of guanidine as a desired form of therapy.
    Dermatologic: rash, flushing or pink complexion; folliculitis; petechiae, purpura, ecchymoses; sweating; skin eruptions; dryness and scaling of the skin.
    Renal: elevation of blood creatinine, uremia; chronic interstitial nephritis, acute interstitial nephritis, and renal tubular necrosis.
    Hepatic: abnormal liver function tests.
    Cardiac: palpitation, tachycardia, atrial fibrillation, hypotension.

    DOSAGE AND ADMINISTRATION

    Initial dosage is usually between 10 and 15 mg/kg (5 to 7 mg/pound) of body weight per day in 3 or 4 divided doses. This dosage may be gradually increased to a total daily dosage of 35 mg/kg (16 mg/pound) of body weight per day or up to the development of side effects. As individual tolerance is highly variable, the dosage must be carefully titrated. Once a tolerable dose has been established, it should be continued. Occasionally removal of the primary neoplastic lesion may result in improvement of symptoms, permitting the discontinuance of guanidine.

    OVERDOSAGE

    Mild gastrointestinal disorders, such as anorexia, increased peristalsis, or diarrhea are early warnings that tolerance is being exceeded. These symptoms may be relieved by atropine, but nevertheless note should be taken of these symptoms and dosage reductions considered. Slight numbness or tingling of the lips and fingertips shortly after taking a dose of guanidine has been reported. This per se is not an indication to discontinue treatment and/or reduce dosage.
    Severe guanidine intoxication is characterized by nervous hyperirritability, fibrillary tremors and convulsive contractions of muscle, salivation, vomiting, diarrhea, hypoglycemia, and circulatory disturbances. Administration of intravenous calcium gluconate may control the neuromuscular and convulsive symptoms and provide some relief of other toxic manifestations.
    Atropine is more effective than calcium in relieving the G.I. symptoms, circulatory disturbances, and changes in blood sugar.

    HOW SUPPLIED

    Guanidine hydrochloride tablets: 125 mg, white, round tablet; impressed with the product identification number "KEY 74" on one side. Guanidine hydrochloride tablets are available in bottles of 100 (NDC 0085-0492-01).
    Store at 25°C (77°F); excursions permitted to 15–30°C (59–86°F) [see USP Controlled Room Temperature].

    Manufactured by
    Schering Canada, Inc.
    Pointe Claire, Quebec, Canada for
    Key Pharmaceuticals, Inc.
    Kenilworth, NJ 07033 USA
    27051812
    81-483544
    Copyright © 1987, 1992,
    Key Pharmaceuticals, Inc.,
    Kenilworth, NJ 07033
    USA. All rights reserved.