Another step you may wish to consider is to set up a temporary changing area on the ground floor of your home. This can be as simple as a folded blanket with a waterproof pad placed on a table, in a reclined stroller, or on the floor. This will save you some trips up and down the steps, at least in these first few months when your child needs many changes during the day.
In summary, back pain is quite common during pregnancy and after the birth of a child. Exercise, stretching, weight loss and proper lifting are crucial to lessening back pain in the postpartum period.
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A.Postpartum back pain is a fairly common problem in my practice. Many woman have back pain during pregnancy, as a result of the weight of the fetus and the amniotic sac. You say that your pain started in the postpartum period; this is also fairly common and — as you suggest — is often related to lifting and carrying an infant.
A. The first thing I stress to my patients is to use proper lifting techniques. Lifting a baby from a crib or bassinet often involves bending forward; this is improper body mechanics. If possible, it is best to use your legs when lifting rather than bending forward with your back. Secondly, when carrying a young child, it’s best to hold the child close to your body, not with your arms extended.
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A.I recommend lumbar (lower back) epidural injections to patients with back or leg pain who have signs of nerve compression. The compression can be caused by a herniated disc pressing on a nerve root or by spinal stenosis, which is a narrowing of the area around the nerves. The primary objective of the epidural is to relieve the irritation around the nerves, thereby giving pain relief.
A. The doctor begins by numbing the skin over the spine in the lower part of the back. The doctor then inserts a small needle into the epidural space, which surrounds the spinal cord. Then a local anesthetic and some cortisone is injected into this space. In most cases, the epidural is performed without much difficulty and without significant pain.
The short-term benefit is a lessening of the inflammation around the nerve roots, which reduces the pain. Patients typically experience pain relief within two to three days after the epidural, but it is difficult to predict the duration or degree of pain relief for each individual. In my practice, I recommend that if a patient enjoys considerable relief after the first epidural, he or she should hold off on additional injections. If the patient has only have moderate relief, then I recommend a second and occasionally a third epidural injection. For a patient who gets virtually no relief, I usually recommend other treatment options.
Most epidurals are performed by anesthesiologists in a hospital or outpatient facility. Other physicians, including orthopedists, neurologists, neurosurgeons and physiatrists (rehabilitation specialists), also give these injections. I don’t think it matters which specialist performs an epidural, but the physician should be experienced and perform many epidurals. Some physicians feel most comfortable doing the procedure under X-ray guidance.
The epidural is a fairly low-risk procedure that can give relief and possibly enable the patient the avoid a surgical procedure. In the proper hands, an epidural is safe. However, I do discuss the possible complications with my patients. One complication is the possibility of a headache after the procedure. This is quite unusual, occurring in less than 1 percent of patients. In general, the headaches resolve within a few days. Although the risk of bleeding with an epidural is low, it remains a concern. If, for some reason, a patient has an underlying bleeding problem that has so far gone undetected, that person would be at risk for developing bleeding from the epidural. This could result in paralysis.
I inform my patients that the epidural, in general, does not burn any bridges, meaning that if it fails to give significant relief, they are still possible candidates for surgery. On the other hand, a patient who has surgery but still has persistent pain is very difficult to treat.]]>
At the end of the study, researchers discovered that patients in the Tai Chi group had significantly improved physical function and mental well-being, and decreased arthritic symptoms and tension compared to patients in the non-training group. Patients in the Tai Chi group had improved function in areas such as walking speed, bending ability, arm mobility and household activities.
Researchers believe that Tai Chi training can help older adults to manage their osteoarthritis better, while improving physical and mental health at the same time.
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The potential cancer-fighting attributes of a new class of drugs called “COX-2 inhibitors” (COX-2 stands for the enzyme cyclooxygenase-2) was discussed in the July 21 issue of the “Journal of the National Cancer Institute” (JNCI). The COX-2 inhibitors are able to restrain the development of tumors in animal tests, giving hope that they may soon become another weapon in the struggle against cancer.
Researchers first began their studies when elevated levels of the enzyme, COX-2, were found in tumors. Experiments were then designed to see if reducing the levels of this enzyme would reduce the size of such tumors. It was known that commonly used anti-arthritis drugs and pain relievers, such as aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), actually did lower levels of COX-2. Therefore, scientists used NSAIDs in trials to evaluate the possible anti-tumor effect of lowering COX-2 levels.
Many trials are under way in order to evaluate the cancer-fighting potential of COX-2 inhibitors. Among them is one led by Dr. Raymond DuBois. Dr. DuBois is the principal investigator of the first program to receive a grant from the NCI in support of research studying the effect of drugs intended to prevent, rather than to treat, cancer. This concept is embodied in the term “chemoprevention.” Dr. DuBois commented on recent trials of his program, “The use of COX-2 inhibitors for chemoprevention in humans is still in the experimental stages, but results have been encouraging.”
Blocking this enzyme interferes with production of fatty acids (prostaglandins) that are widely distributed in the body. In trials involving the COX-2 inhibitors, researchers monitor the amount of this enzyme, as well as other markers indicative of the presence of a tumor. Participants in the studies include those who have had tumors removed as well as those who are carriers of certain genetic defects responsible for specific cancers.
Since these recent developments, the producers of the two leading COX-2 inhibitor drugs, rofecoxib and celecoxib, (Searle and Merck & Co., respectively) have begun preparations to expand the testing of the drugs into cancer-related research. While long-term use of NSAIDs sometimes comes at the price of ulcers and other gastrointestinal problems, COX-2 inhibitors are promising because studies have shown that they are less likely to cause these serious adverse health effects.
Past research seems to suggest that after years of therapy with COX-2 inhibitors, reduction of tumor recurrence is possible, but there still remains the question of primary prevention. Also, still to be explored is the question of whether the inhibitor drugs would be used for any tumor that is found to have high levels of the enzyme COX-2, or only a specific class of tumors. We must keep in mind Dr. DuBois? cautious optimism in expectations of what future studies will reveal. He notes that “Without more data, it is too early to recommend the use of COX-2 inhibitors as a treatment to fight cancer.”
What is apparent is that we have come to the beginning of a new era in the fight against cancer. Up until now, medicine has only been able to offer slow gains in cancer death rates, due to gradually improving surgical techniques, and more effective chemotherapy. But with the new data on COX-2 inhibitors and the more extensive results from breast cancer trials using tamoxifen, the era of chemoprevention of cancer may be close at hand.]]>
1) One half to two 50 mg pills are usually prescribed for pain, to be ingested four to six hours apart. You may be started at a low dose of tramadol with a gradual increase. This will acclimate your body to the drug so that you will experience few, if any, side effects. 400 mg is the maximum allowable for Tramadol in a 24 hours period.
2) Tramadol can cause drowsiness as well as light-headedness. You may also experience nausea or vomiting, particularly at the inception of adopting the medication. If can be beneficial to begin with a weaker dose and steadily increase the strength, as well as lie down when feeling sick of faint.
3) Tramadol may lead to incidence of seizure. The severe symptoms such as seizures are rare, but your risk may be greater if you have had trauma to the head, epilepsy, or alcohol or drug problems. The possibility of suffering seizures can go up if Tramadol is taken with antidepressants or sedatives.
Interactions with other Medications
4) Do not drink or take other central nervous system depressants/sedatives such as sleeping pills or allergy medications while taking tramadol. Consult your physician about the possibility of negative drug interaction. The effects of these drugs are intensified by tramadol, so combining them can be dangerous, particularly if you are taking high doses.
Who Should Avoid Tramadol
5) Potentially addictive, Tramadol no prescription should be avoided by those with a tendency toward drug or alcohol abuse. Never to be taken by anyone with suicidal tendencies, Tramadol should be used with special care by those using MAO inhibitors. Tramadol should be avoided by pregnant women due to possibility of miscarriage or stillbirth, as well as infant seizure and withdrawal. You should not take Tramadol if you are breastfeeding, because the substance will penetrate breast milk.
A.From a patient’s standpoint, I understand the desire to try alternative forms of treatment. Unfortunately, many of these are quite costly, are of questionable benefit and can occasionally cause harm. In a patient such as your brother-in-law, who has suffered so much destruction of the joints, it is unlikely that any of these alternative forms of treatment are going to rebuild the cartilage or give significant relief.
A.I once had a patient who developed severe arthritis of the hip while she was in her 50s. After evaluating her, I recommended hip replacement. Instead, she sought out various forms of alternative arthritis treatment, including herbal remedies, acupuncture and psychotherapy. She even went to Mexico for special treatments. She spent over a year trying different things and, unfortunately, got no relief. When she finally had her hip replacement, she couldn’t believe the amount of relief that she experienced. Afterwards, she was upset at herself for having “wasted one year” of her life.
I do feel that there is a role for some alternative forms of treatment, but I think it is important that a patient be realistic. For some reason, there is a misconception that alternative treatments are harmless. Unfortunately, some of these treatments do have complications that patients are usually unaware of. Furthermore, the supplement industry is very poorly regulated, and there is a great concern about impurity of the products. Also, many of these companies make outrageous claims without having any scientific proof.
A.I tried doing a search for “Nutrajoint” and was unable to find information on this product. I suspect that, with his degree of arthritis, it would be unlikely to give your brother-in-law significant relief. I would recommend that he be evaluated by an orthopedic surgeon who specializes in joint replacement surgery. One point worth mentioning is that when a joint is removed to allow replacement, the arthritis is also removed. Problems can develop down the road with a joint replacement, but that would not be related to arthritis.
The Arthritis Foundation has published a Guide to Alternative Therapies that I think is an excellent resource for patients. You can purchase this by calling toll-free to (800) 207-8633. It explains in simple terms the risks and benefits of many of these forms of treatment.]]>
Later I studied with Jerre and practiced this bodywork. I was constantly amazed at how different clients would respond to the work. It was a powerful therapy that helped people have profound breakthroughs in their lives. My only disappointment was that not very many clients were willing to delve so deeply into their psyches; most preferred relaxation massage, which I also provided.
Nine years went by. I got married, had a son, got divorced. I got out of the massage profession and moved to another state. There I found my way back into bioenergetics therapy, through the back door once again. This time my son was having problems acting out with aggressiveness, a result of the divorce and school environment. A friend recommended a therapist; after discussing my son’s problems with her, she asked if I had had any therapy since the divorce.
Nancy runs groups for both children and adults utilizing bioenergetics techniques. As far as I know, her children’s groups are unique. I can attest to the fact that they are incredibly effective; my son’s behavior has much improved! Children seem to instinctively respond to the physical release of emotions and can also easily relate to the idea of grounding their energy. This is not always so easy for adults.
Nancy’s groups for adults are equally powerful. Sometimes group members just talk about their issues; if they are willing and time allows, Nancy guides them through bioenergetics exercises designed to tap into and release childhood emotions. I found that witnessing others is a very dynamic experience in that it can be highly cathartic for your own issues. The fundamentals of breathing fully and grounding are an integral component of Nancy’s groups. She strives to make participants feel safe. I also worked with her one-on-one at times, which was highly effective as well.
Bioenergetics goes to the root of our problems. By releasing the energy trapped in our bodies where we stuffed our emotions, it frees the mind to more competently deal with the problems of our day-to-day lives. This form of therapy is a highly effective means of reclaiming our aliveness, our joy in life, and our ability to fulfill our dreams.
Bioenergetics therapists are sometimes medical doctors, sometimes psychologists. They go through extensive training, often with Alexander Lowen himself, who is still a vital teacher at age 70. Therapists who use bioenergetics techniques, such as my body worker, can also prove helpful. Bioenergetics is a powerful tool for rejuvenating ourselves: by utilizing the wisdom of the body we can access profound realms of vitality in our lives.
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Most of us have experienced such overwhelming emotions at one point or another in our lives. Unfortunately, in our culture such overt expressions of emotion are generally frowned upon. I say ‘unfortunately’ because in my experience using our voices and our bodies is the most effective way to release these powerful feelings.
Bioenergetics is a type of psychoanalysis that encourages people to express emotions in just this way. Developed by Alexander Lowen, MD, and based on the work of Wilhelm Reich, it is a true mind-body technique in that it uses the language of the body to heal the problems of the mind. Lowen postulated that unexpressed emotions actually become stored in the tissues of the body, and by consciously using the body to release these old emotions, we can heal traumas and approach full functionality.
Bioenergetics could thus be termed the first truly holistic therapy. By working with areas of chronic tension in the body’s musculature, one is able to access long buried emotions. These childhood traumas affect our adult functioning, both in our bodies and our minds. By releasing the emotions associated with trauma, we are able to release not only chronic muscle tension but also the dysfunctional patterns of relating we have developed for the protection of our psyches. The therapist guides this process both with talk and specific body movements.
Breathing is fundamental to bioenergetics. One of the first physiological responses to anxiety and stress is shallow breathing. Often as children, as we go through traumatic experiences, we get into the habit of shallow breathing; sometimes the muscles of the abdomen and thorax actually become chronically tense so that full breathing seems impossible. During a bioenergetics session, the therapist will keep the client focused on deep, abdominal breathing. Sometimes merely breathing in this manner will bring up emotions.
Grounding is another basic bioenergetics technique. Often our physical experiences as children are so painful that we disown our bodies, tending to live only in our minds. When the emotions we feel seem overwhelming, if we consciously connect our energy to the earth, we are able to feel safer. Thus during a bioenergetics sessions, grounding through specific exercises is vital as we release intense and long repressed emotions.
My first exposure to bioenergetics came at a time in my life when I was not only experiencing a lot of back pain but also was feeling very stuck. I wanted to write, but my creativity seemed inaccessible. I also felt a general sense of emotional numbness. Because the physical pain was foremost in my consciousness, I looked for a body worker to help ease me out of the pain. The woman I found used deep tissue massage similar to RolfingTM combined with the breathing and grounding techniques of bioenergetics.
I went to this woman weekly for about three months. What an intense time that was for me! As Jerre would do the massage strokes, I breathed deeply, exhaling with sound. Often anger or sorrow would bubble up, turning these sounds I was making into yells or wails. Sometimes Jerrre would have me pound my fists or kick my feet on the massage table, wring a washcloth, or just shake my head from side to side. Every bodywork session began and ended with grounding exercises.
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Tramadol has been in use as an analgesic since the late 1970s, and was a very popular analgesic in Germany. International interest in the medication resurfaced when researchers discovered that Tramadol acts similarly to opioids, but inhibits the re-uptake of serotonin and noradrenaline.
How Tramadol Works
Tramadol is a special medication that acts in a unique way. It can be distinguishable from other opioids due to its method of action and its safety profile. It possesses both opioid and non-opioid qualities, and is considered to be an atypical analgesic that acts centrally. Tramadol is a synthetic form of codeine, and does not have strong opioid agonist qualities. Similarly to antidepressant medications, it inhibits norepinephrine and serotonin reuptake.
The antidepressant venlafaxine is similar in structure to Tramadol. Some patients who suffer from chronic pain could experience an antidepressant effect from this drug.
As far as side effects are concerned, Tramadol does not cause many side effects; nausea and vomiting seem to be the most common side effects. When patients on Tramadol are given similar dosages to those of morphine and pethidine, respiratory depression does not normally occur. Respiratory effects of other medications can be increased when taking large doses of Tramadol. It has a low occurrence of cardiac depression and, unlike morphine, does not cause side effects such as dizziness and drowsiness.
The potential for abusing Tramadol or becoming dependent on it is not very high due to its weak opioid effect. Post-marketing data indicates that Tramadol does not have a high potential for abuse.
Urinary disorders, such as micturition difficulties and urinary retention, seem to be common in both Tramadol and other opioids.
People who have epilepsy should not take Tramadol, and people who take medication that lowers epileptic seizure thresholds should approach Tramadol with caution.
Uses of Tramadol
Tramadol can successfully treat moderate to severe pain, as well as neuropathic pain. This medicine possesses an efficacy whose dose-dependency is somewhere between dosages of codeine and morphine, with a parenteral strength that can be compared to that of pethidine.
Research indicates that more successful results can be obtained in controlling post operative pain when patients are given Tramadol instead of NSAIDs. Tramadol can be successfully combined with NSAIDs, because Tramadol’s method of action does not coincide with the mode of action in NSAIDs. Fewer side effects occur when the patient uses a combination of Tramadol and NSAIDs; the combination enables the dosage amount of Tramadol to be lowered.
Tramadol online can be especially useful in treating elderly people who suffer from osteoarthritis, because even though nonsteroidal anti-inflammatory medications can aggravate high blood pressure and cardiovascular symptoms, Tramadol does not possess this trait, nor does Tramadol cause peptic ulcers.
Tramadol has been successfully used, without the necessity of respiratory depression of the neonate, for managing labor pains. It can effectively treat pain that is caused by myocardial ischemia, renal colic or acute trauma.
Tramadol should be taken every 4 to 6 hours with a dosage between 50 and 100 mgs; the dosage of Tramadol should not exceed 400 mg per day; one single oral dosage of 100 mg of Tramadol has an analgesic effect for approximately 6 hours.
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