medicine2forum

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

2011-06-15T01:08:00.001-07:00

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”

Doctor Says Surgery May Relieve Pain Of Neuropathy

2011-06-15T01:07:00.000-07:00

DENVER -- 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 .

Medifocus Guidebook on Peripheral Neuropathy

2011-06-15T01:00:00.001-07:00

Migraine headache

2011-06-14T22:58:00.000-07:00

تختلف آلام الصداع النصفي (الشقيقة)عن كل آلام الأنواع الأخرى من الصداع. Different migraine pain (migraine) for all the pain of other types of headaches. ويصيب هذا النوع من الصداع جزءا واحدا من الرأس أي بشكل نصفي. Affects this type of headache is one part of the head in any half. ويعاني منه 25% من النساء و8%من الرجال طوال حياتهم. And affects 25% of women and 8% of men throughout their lives. والمرأة أكثر عرضة لنوباته ولاسيما في مرحلة الاياس (سن اليأس) لتغير معدلات الهورمونات الأنثوية لديها. Women are more vulnerable to Nubath, especially at the stage of menopause (menopause) to change the rates of female hormones have. يسبق حدوث الصداع النصفي في ثلث الحالات نوبات من الأورة متمثلة في تخيلات بصرية وصوتية وشمية غير موجودة. Preceded by a migraine in one third of cases, episodes of aura represented in fantasies and audio-visual and olfactory non-existent.

محتويات Contents

[أخف]

causes

ينتج مرض الصداع النصفي عن توسع شديد في الأوعية الدموية خارج القحف (الموجودة في فروة الرأس) مما يؤدي إلى انضغاط على النهايات العصبية المحيطة بالأوعية الدموية مطلقة الألم وهذا يفسر طبيعة الألم النابض. Produces migraines for the expansion of severe extracranial blood vessels (located in the scalp), leading to compression of the nerve endings surrounding blood vessels, an absolute pain and explains the nature of the pain this spring. وهذا أيضا يفسر الألم العيني في أغلب أنواع الصداع النصفي لكون الطبقة الخارجية للعين تأخذ الألياف العصبية من نفس العصب (مثلث التوائم) الذي يحيط بالأوعية الدموية خارج القحف (شريان صدغي سطحي). This also explains the kind of pain in most types of migraine to the fact that the outer layer of the eye takes nerve fibers of the same nerve (trigeminal) that surrounds the blood vessels outside the cranium (superficial temporal artery). في نفس الوقت يحصل تقبض في الأوعية الدموية داخل القحف مما يؤدي إلى حدوث الأعراض العصبية المرافقة للنوبة الألمية. At the same time gets arrested in intracranial blood vessels leading to neurological symptoms associated with heart Alolmip.

Types

الصداع النصفي نوعان صداع نصفي عادي لايشعر فيه المريض بدنو النوبة وتستمر نوبته من 4-72ساعة حيث يشعر بألم في جانب الرأس أو الجانبين وقديكون نابضا أو متوسطا أو شديدا مع القيء وشعور بالغثيان وحساسية للأصوات. وصداع نصفي تقليدي وفيه يشعر المريض بدنو النوبة مرتين علي الأقل سنويا. Migraine types migraine headache plain did not feel the patient approaches the heart and continues his shift of 4-72 hours, where the pain is felt in the side of the head or the sides and Kadikon vibrant, medium or severe, with vomiting, nausea and sensitivity to sounds. and migraine headache traditional and the patient feels approaches the seizure at least twice a year . وقد تستمر النوبة 3أيام ويسبقها توتر عصبي وتشوش الرؤية. The last 3 days and Nubia preceded by nervous tension and blurred vision. فيري الشخص أثناءها الخطوط متعرجة وأضواء مبهرة (كوميض)أو يفقد النظر مؤقتا مع صعوبة في الكلام والشعور بضعف الذراعين والساقين وتنميل بالوجه واليدين وألم في الجبهة والفكين والأذنين وحول العين. Ferry person during the zigzag lines and strobe lights (Comid) or consider temporarily lose with difficulty in speech and feeling weak arms and legs and numbness of the face and hands and pain in the forehead, jaws, ears and around the eye. وقد يظهر الصداع في جانب واحد من الدماغ خلف العينين أو حولهما و تسمى هذه الأعراض بالأورة . Headaches may appear on one side of the brain behind the eyes or around and called these symptoms Baloorp . وقد ينتقل للجانب الآخر أثناء النوبة. The move to the other side during a seizure. والأفضل تحديد أسباب ظهور الصداع النصفي ومحاولة تجنبها للسيطرة علي الصداع والوقاية منه رغم من عدم وجود أسباب محددة لظهور الصداع النصفي, لكن هناك بعض العوامل التي قد تساعد علي ظهوره، وهذه العوامل تختلف من شخص لآخر. And better determine the cause of migraine and try to avoid to control and prevention of headaches, although there are no specific reasons for the emergence of migraine, but there are some factors that may help his appearance, and these factors vary from person to person. ومن بينها الضغط العصبي، وعدم تناول وجبة أساسية أثناء اليوم، أو النوم في أوقات متأخرة ليلاً أو عدم النوم لفترة كافية، والإرهاق أو زيادة التمارين الرياضية. Including stress, lack of basic meal during the day, or sleep in late at night or not sleeping long enough, and fatigue or increased exercise. أو تناول بعض أنواع الطعام والشراب كالجبن والنبيذ الأحمر والخمور والمواد المضافة إلي الطعام مثل ملح النترات في اللحوم المحفوظة كاللانشون والبولوبيف والهامبرجر والسجق وقلة تناول كمية الكافيين المعتاد عليها الشخص والموجود في الشاي والقهوة والكولا والكاكاو. Or eating certain types of food and drink such as cheese and red wine, alcohol and substances added to food such as salt nitrates in meat and saved Kallanhun Albolubev, hamburgers, sausages and the lack of the usual intake of caffeine by the person and who is present in tea, coffee, cola and cocoa. وبالنسبة للسيدات فترة الدورة الشهرية. For the women's monthly period. وهذه العوامل يمكن تجنبها. These factors can be avoided.

Prevention

- عدم النوم لساعات طويلة - الأكل المفيد وتجنب شرب الحمضيات كعصير البرتقال والليمون قبل الأكل - عدم الإكثار من تناول المكسرات - ممارسة الرياضة بانتظام. - Lack of sleep for long hours - useful for eating and avoid drinking citrus orange and lemon juice before eating - not to overindulge in nuts - Exercise regularly. - عدم المكوث في مكان مرتفع الحرارة لفترة طويلة وعدم التعرض للشمس لفترة طويلة - فرد الرقبة والجزء العلوي من الجسم. - Do not stay at a high temperature for a long time and the lack of exposure to the sun for a long time - individual neck and the upper part of the body. ولاسيما ولو كان العمل يتطلب الجلوس طويلا. Especially if the work requires sitting for long. - اترك التدخين. - Quit smoking. - تعلم كيف تسترخي وتنفس بعمق. - Learn how to relax and breathe deeply. عندما يحدث الصداع دون الوقت واليوم الذي بدأ فيه وسجل ماذا أكلت خلال ال 24 ساعة. When headaches occur without the time and the day began and record what I ate during the last 24 hours. وكم من الوقت قضيته في النوم بالليل وفي ماذا كنت تفكر قبل بداية الصداع. How much time I spent in bed at night and at what you are thinking about before the start of a headache. وهل يوجد اجهاد في حياتك؟. Is there stress in your life?. ومدة الصداع.وماذا فعلت لتوقفه. And duration of headaches. And what I did to stop it. ويمكن للصداع أن يخف لو ركنت للراحة وعيناك مغلقتان ورأسك مسنودة. And headache that can hide if you leaned to rest with your eyes closed and head backed. واتباع طرق الاسترخاء تساعد أيضا. And follow the relaxation techniques also help. كما أن التدليك ووضع شيئا ساخنا وراء أعلي الرقبة تفيد في تخفيف الصداع التوتري. The massage and put something hot and neck for the highest benefit in reducing tension headaches. ] Treatment

يمكن بعد اكتشاف نقاط الضغط على الرأس للدكتور علي سلطانه والمقدمه في مؤتمر سان دييغو كاليفورنيا 2001 أن يقوم مريض الصداع النصفي بصنع أقواس الصداع النصفي في منزله واستخدامه عند قدوم النوبة وبذلك يتخلص من الصداع النصفي ويستغني عن استخدام كل الأدوية الضارة التي توصف للصداع النصفي. Possible after the discovery of the pressure points on the head, Dr. Ali authority presented at the conference in San Diego, California, 2001, that the patient migraine making brackets migraines at home and use it when the advent of the Nuba and thus get rid of migraines and is independent from the use of all harmful drugs prescribed for migraine. العلاج الجراحي للصداع النصفي: و للتخلص نهائيا من الصداع النصفي (عملية الدكتور علي سلطانه) باجراء عملية جراحية بسيطة تتم بالتخدير الموضعي وفي فروة الرأس حيث يتم ربط الشريان الجلدي المسؤول عن آلام الصداع النصفي وبذلك يتخلص المريض نهائيا من المرض ويستطيع المريض بعد العملية أن يقوم بجميع الأعمال التي كانت تحرض النوبة لديه وسيشاهد كيف أن النوبة الألمية لن تعود اليه. Surgical treatment of migraine: and to get rid permanently from migraines (the process of Dr. Ali authority) to conduct a simple surgery is local anesthesia in the scalp where the artery skin responsible for migraine pain and thus get rid of the patient's final illness and the patient can after the operation, that is all actions that were inciting the Nuba has and watch how the Nuba Alolmip will not come back to him. يمكن استعمال الأسبرين والأيبوبروفين والباراسيتامول. Can be used as aspirin and ibuprofen and paracetamol. ولا يعطي الأسبرين للاطفال حتي لا يصابوا بحالة رايReye's syndrome. Does not give aspirin to children up to the situation will not get Ray Reye's syndrome. فيمكن للصداع النصفي الاستجابة للأسبرين أو النابروكسين أو توليفة أدوية الصداع النصفي. For migraine headaches could respond to aspirin or naproxen, or combination migraine medications. واسأل الطبيب عن العلاج المناسب. And ask your doctor about appropriate treatment. وأدوية الصداع النصفي هي : ergotamine, dihydroergotamine, ergotamine with caffeine), isometheptene and triptans like sumatriptan, rizatriptan, almotriptan andzolmitriptan. And migraine medication are: ergotamine, dihydroergotamine, ergotamine with caffeine), isometheptene and triptans like sumatriptan, rizatriptan, almotriptan andzolmitriptan. . . كما أن الأدوية التي تخفف الغثيان والقيء تفيد في الأعراض الأخرى من حالات الصداع النصفي..والدواء الشائع في علاج الصداع، الكافايين Caffeine والشخص قد يدمن علي تناوله وقد يكون مخلوطا مع الأسبرين أو أدوية الصداع النصفي كمشتقات الإرجوت مثل الإرجوتامين. The drugs that relieve nausea and vomiting are useful for other symptoms of migraine headaches .. and medicine in the treatment of common headaches, caffeine Caffeine and the person may become addicted to eating may be mixed with aspirin or migraine medication such as Kmstqat Alirjot Alirjuthamin. وعندما ننسحب من تناوله فجأة يسبب صداعا شديدا وغثيان وقيء. When we withdraw from eating suddenly cause severe headache, nausea and vomiting. والكافيين يفرز مع لبن الأم مما يجعل الرضيع قلقا ومؤرقا أثناء النوم. Caffeine is excreted in breast milk, which makes baby concern and Mwrka during sleep. والدواء الثاني الشائع لعلاج الصداع النصفي الإرجوت ومشتقاته كالإرجوتامين و dihydroergotamine ولايستعمل أثناء الحمل. The second medication is common for the treatment of migraine and its derivatives Alirjot Kalirjuthamin and dihydroergotamine Estaml and during pregnancy. فقد يسبب موت الجنين أو الإجهاض. May cause fetal death or abortion. أو في حالة الرضاعة لأنه يسبب ضررا للرضيع. Or in the case of breastfeeding because it causes harm to the baby. لأن هذه الأدوية تفرز مع اللبن وتسبب للرضيع الإسهال والقيء والتشنجات ونبض ضعيف وتغير في ضغط الدم. Because these drugs excreted with the milk and cause of infant diarrhea, vomiting, convulsions, weak pulse and a change in blood pressure. والكميات الكبيرة من هذا الدواء تقلل من افراز اللبن. And large quantities of this drug reduces the secretion of milk. وهذا الدواء يزيد الإحساس بالبرودة لهذا يتدثر الشخص جيدا. This drug increases the feeling of cold Itdther for this person well. لأنها تقلل تدفق الدم بالجسم ولاسيما بالجلد والاصابع ولاسيما بالقدمين وخصوصا لدي المسنين الذبن ما يعانون غا لبا من مشاكل في الدورة الدموية . Because it reduces blood flow to the body, especially the skin, fingers, especially the feet, especially in the elderly Alzbn Ba Ga suffer from circulatory problems. لها عند استعمال هذه الأدوية اسأل الصيدلي علي مكوناتها أو اسأله عن هذه المواد لتتعرف علي دوائك.ويمكن للعلاج الجيد من تخفيف حدة نوبات الصداع النصفي وتسكين آلامه بتناول عقاقير مسكنة. When you have the use of these medicines ask your pharmacist on the components or ask for these materials to learn on your medicine. Can be a good treatment for alleviation of migraine headaches and relieve the pain eating analgesic drugs. وهناك نوعان من أنواع علاج الصداع النصفي. There are two types of treatment of migraine. نوع يقوم بإيقاف تأثير الصداع النصفي بمجرد بدايته وفيها مادة الإرجوتامين وتوصف للأشخاص الذين يصابون بالصداع بشكل غير دوري أو في الأعراض البسيطة حيث تقوم بانقباض الأوعية الدموية.ولايتناولها مرضى القلب، أوالحوامل. Type shut down the impact of migraine as soon as the beginning and a substance Alirjuthamin and described for people who have a headache in non-league or minor symptoms Banaqbad where the blood vessels. Eitnolha and heart patients, Owalhawwaml. والنوع الثاني مغلقات بيتا Beta blockersومغلقات الكالسيوم Calcium channel blocker وتمنع ظهور الصداع النصفي.ويوصف للأشخاص الذين يصابون بالصداع النصفي بشكل دوري ومتكرر.و يمكن وصف الأدوية المضادة للاكتئاب. The second type Mglqat Beta Beta blockers and calcium Mglqat Calcium channel blocker and prevent the emergence of migraine. And described for people who get migraines regularly and frequently. And can be described as anti-depressant medication. وأحيانا قد يجد المصاب فائدة من وضع كمادات من الثلج على الرأس، والجلوس في غرفة مظلمة. And sometimes the patient may find it useful to put packs of ice on the head, and sit in a dark room.

War Veterans Health Resource Initiative

2011-06-14T22:54:00.001-07:00

In recent years, the Afghan and Iraq Wars have increased the prevalence of migraines and headaches in veterans returning to the United States. In one study of 3,621 U.S. soldiers screened within 90 days of returning from a one-year combat tour in Iraq, soldiers were shown to have two to four times the incidence rate of migraine as compared to the general population.
This research and more like it has validated that men and women in the military are returning to civilian life experiencing migraine headaches due to conditions like Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD). Poorly managed migraine translates to a potentially huge impact on a patient's quality of life—from missed or non-productive work days to lost family and personal time.
The National Headache Foundation feels that it is vital to reach out to these men and women who have served our country by providing resources to better understand and manage headache pain.
To do this, the NHF is proud to introduce the War Veterans Program. The program consists of an online resource guide that provides the top resources available to help military men and women cope with neurological trauma effectively. Periodically, the NHF will also provide information about the latest research, statistics and governmental assistance programs set in place during this crucial time.
Military OneSource is provided by the Department of Defense at no cost to active duty, Guard and Reserve (regardless of activation status) and their families. It is a virtual extension of installation services. Visit Military OneSource today at http://www.militaryonesource.com/%20target= or call 1-800-342-9647. www.MilitaryOneSource.com/ChillDrills.

Headaches are very personal.

2011-06-14T22:53:00.001-07:00

No one has the same combination of pain, impairment, triggers, or impact. Therefore, there is no one-size-fits-all solution to getting relief. Experts recommend the following simple tips for finding relief, which all begin with YOU:

Realize that headaches matter, and take your headaches seriously even if others don’t
Learn all you can – be a student of your own headaches
Get the help and care that you deserve: many resources are available right here

Your journey of learning begins here, at Headache U — a place for you to begin educating yourself about your personal headaches, and the many ways you can get help, help yourself and even help others.
This portal will contain a variety of helpful resources and tools, so check back often to see what’s new.
The first of a series of patient education tools that will be available through Headache U is Chart Your Course to Relief: A personal headache care tool. This tool will help you explore your personal experiences with headache, create your own personal headache profile, and get matched with resources that fit your situation

Vasculitis

2011-06-14T22:40:00.001-07:00

Overview, Causes, & Risk Factors

Vasculitis is an inflammation of the blood vessels.

What is going on in the body?

Blood vessels can become inflamed for many reasons. There are different types of vasculitis based on the size and type of blood vessel involved and the pattern of inflammation. Inflammation of blood vessels can lead to serious problems in the body, such as blocking blood flow.

What are the causes and risks of the condition?

Inflammation of blood vessels may occur in response to:

medication.

allergic reactions.

infections.

toxic chemical exposure.

underlying diseases, such as autoimmune disorders. These are conditions in which a person's immune system attacks their own body.

inherited conditions.

smoking.

The primary risk of this condition is that blood flow may be reduced to body tissues. These tissues may then become damaged or destroyed. If the tissue or organ is important, such as the brain, eyes, heart, lungs, or other important organs, serious body damage and disability may result. Death can occur in severe forms of this condition.

Symptoms & Signs

What are the signs and symptoms of the condition?

Most cases involve blood vessels in the skin, but just about any blood vessel in the body can be involved. Exact symptoms depend on the type of vasculitis present. This condition may cause:

tender red or purple bumps on the skin.

open sores on the skin.

depression.

fatigue.

high blood pressure.

damage to the body if blood flow stops in the inflamed blood vessels. For example, vasculitis may lead to a heart attack, loss of vision, kidney failure, lung damage, and other body damage.

Diagnosis & Tests

How is the condition diagnosed?

Clinical history and physical exam often make a healthcare provider suspect this condition. Special tests, such as blood and x-ray tests, and biopsy are often needed to diagnose and categorize the type of vasculitis. A biopsy is a procedure to take a small piece of tissue from an affected area of the body. The tissue can then be studied under a microscope and with other special tests if needed.

Prevention & Expectations

What can be done to prevent the condition?

There is no known way to prevent most cases. Avoidance of smoking can prevent one rare form of this condition.

What are the long-term effects of the condition?

Most long-term problems are related to the areas of the body that are involved, such as the kidneys. Permanent damage can occur to important organs in some cases. Death may occur in severe cases.

What are the risks to others?

There are no risks to others, as this condition is not contagious.

Treatment & Monitoring

What are the treatments for the condition?

The underlying problem that caused the vasculitis needs to be treated first if possible. For example, a medication may need to be stopped.
Oral corticosteroids, such as prednisone, and other medications to suppress the immune system may be needed.
Further treatment may be needed for specific areas of body damage, such as treatment for kidney failure.

What are the side effects of the treatments?

All medications have potential side effects. Side effects will vary depending on which drugs are used.

What happens after treatment for the condition?

Depending upon the cause of the vasculitis, it may completely clear or it may become a chronic problem needing long-term treatment.

How is the condition monitored?

Affected people are asked to monitor their symptoms. Repeat exams, blood tests, and x-ray tests may be needed. The medications used for treatment may also need to be monitored.

Attribution

Author:Lynn West, MD
Date Written:
Editor:Keefe, Sandy, RN, MSN
Edit Date:05/13/00
Reviewer:Adam Brochert, MD
Date Reviewed:05/02/01

Vascular Headaches - Migraine

2011-06-14T22:39:00.005-07:00

Overview, Causes, & Risk Factors

A migraine is a moderate to severe headache affecting one or both sides of the head.

What is going on in the body?

Migraines are believed to be caused by changes in the blood flow in the vessels of the head. Changes in blood flow to different areas of the brain can produce a variety of symptoms.

What are the causes and risks of the condition?

The tendency for migraine headaches is probably inherited. Other factors that put a person at risk for migraines include:

bright lights

certain foods and drinks, such as caffeine, chocolate, or alcohol

head injury or neck injury

hormonal changes in women, especially during menstruation

stress

poor sleep habits

weather changes

Symptoms & Signs

What are the signs and symptoms of the condition?

Signs and symptoms of migraine can include:

confusion

depression

difficulty swallowing

drowsiness

headache that can last for hours or days on one or both sides of the head

irritability

loss of coordination

nausea

numbness or tingling in hands and feet

paralysis anywhere in the body

ringing in the ear

sensitivity to sound, light, or smell

sensory loss, such as loss of smell or taste

trouble remembering things

vomiting

weakness

Diagnosis & Tests

How is the condition diagnosed?

According to the International Headache Society, migraine is diagnosed when a person has the following:

at least five headache episodes, each lasting 4 to 72 hours

nausea or sensitivity to light and sounds

at least two of the following: one-sided pain, pulsing pain, moderate or severe pain, or pain aggravated by physical activity

There are no blood tests for migraine.
Usually a migraine headache can be diagnosed with a complete physical examination and a medical history that includes information about the person's headache experiences. Doctors seldom use tests to diagnose a migraine. They may order tests to rule out other possible causes of the headache. These tests may include:

biopsy of the arteries in the head. In this test, a doctor collects a small sample of the artery and examines it under a microscope.

a cranial CT scan, which is an examination of the head using a special three-dimensional X-ray

a cranial MRI, which is a special three-dimensional image made using a magnetic field

an electroencephalogram, also called an EEG, which is a recording of brain waves

an electromyogram, also called an EMG. This test is a recording of the electrical activity of selected muscle groups.

skull X-rays

a spinal tap, where a small amount of cerebrospinal fluid is removed from the spine using a thin needle

testing of levels of certain drugs or toxins in the blood

Prevention & Expectations

What can be done to prevent the condition?

A person can help prevent migraine headaches by:

avoiding his or her personal triggers

exercising regularly

limiting stress

A trigger is different from a symptom. A symptom is a condition that accompanies or results from a migraine headache. A trigger is actually something inside or outside the body that can cause or aggravate headache pain. It can be related to something the person does or eats. Other triggers include changes in the weather, fatigue, light, noise, and many other factors.
Triggers can include:

any type of medicine, including prescription medicines, over-the-counter medicines, and herbal remedies

bright or flickering lights

changes in the seasons

changes in the weather

excessive or repetitive noises

high altitudes

jet lag

specific smells

Sometimes a headache is triggered by a combination of food and drink. The National Headache Foundation Listing of Trigger Foods includes:

alcoholic beverages

any pickled, fermented, or marinated food

bananas

broad beans, lima beans, fava beans, and snow peas

caffeinated beverages, such as tea, coffee, and colas

chicken liver or pate

chocolate

citrus foods and drinks

figs, raisins, papayas, avocados, and red plums

foods or beverages that contain aspartame and phenylalanine

freshly baked yeast products

meats that may contain nitrates, such as bacon, sausage, bologna, salami, pepperoni, summer sausage, or hot dogs

monosodium glutamate, also known as MSG, which is found in meat tenderizers, seasoned salt, and soy sauces

nuts or nut butters

onions

pickled or dried herring

ripened or aged cheeses, including cheddar, Emmenthaler (Swiss), Stilton, Brie, and Camembert

sour cream

sourdough bread

Medicines used to prevent a migraine headache include:

anticonvulsants such as valproic acid and gabapentin

beta-blockers such as propranolol and nadolol

calcium channel blockers such as verapamil

cyproheptadine

lithium

methysergide maleate

tricyclic antidepressants such as amitriptyline and nortriptyline

What are the long-term effects of the condition?

Severe and frequent migraine headaches can greatly affect a person's ability to function. A migraine may rarely be linked with a stroke caused by blockage of blood flow in blood vessels.

What are the risks to others?

Although migraines are not catching, 70% of migraine sufferers do have a family history of migraine.

Treatment & Monitoring

What are the treatments for the condition?

Treatment for acute migraine attacks includes:

butalbital/APAP/caffeine

dihydroergotamine

isometheptene/dichloralphenazone/APAP

nonsteroidal anti-inflammatory drugs called NSAIDs, such as ibuprofen and naproxen

other analgesics, such as hydrocodone/APAP

triptans, such as sumatriptan or zolmitriptan

Nonmedicine treatments include:

acupuncture

aromatherapy

avoiding migraine triggers

biofeedback

chiropractic

electromagnetic therapy

exercising regularly

herbal remedies

hypnosis

massage therapy

physical therapy

stress management

Other than avoiding one's triggers, the non-medicine treatments listed above may or may not be effective. A person should always talk with the doctor first before trying any of these treatments for migraine headache.

What are the side effects of the treatments?

Side effects of medicines used to treat migraines include stomach upset, drowsiness, and allergic reactions. Nonmedicine treatments generally have few or no side effects.

What happens after treatment for the condition?

After an effective treatment for migraine is in place, the person will usually feel like resuming normal activities. Rarely, complicated migraines can cause a stroke.

How is the condition monitored?

A person with migraines may be asked to keep a headache diary. Any new or worsening symptoms should be reported to the doctor.

Attribution

Author:Michael Curiel, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:06/15/02
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/05/01

Varicose Veins

2011-06-14T22:39:00.001-07:00

Overview, Causes, & Risk Factors

Normally, tiny one-way valves inside each vein keep blood from flowing backward. When valves are damaged or do not work properly, a vein may start to bulge and twist. This is called a varicose vein.

What is going on in the body?

After blood filled with oxygen is pumped through the body, veins bring oxygen-depleted blood back to the heart. Normally, one-way valves inside veins keep gravity from pulling the blood toward the feet. When valves are not normal or have been damaged, blood pools in the vein. The kinks, bulges, and lumps of varicose veins then occur. Varicose veins are most often noticed on the thigh or calf, where they are close enough to the skin to be seen. Varicose veins can, however, occur in other parts of the body.

What are the causes and risks of the condition?

The cause of this disorder is failure of the valves in the veins to prevent the backward flow of blood. The following conditions increase the risk of this condition:

a family history of this condition

obesity

aging

leg injury

occupations where people stand or sit most of the time

Women are much more prone to varicose veins than men. In fact, one in two women develop varicose veins. This has been linked to changes in hormones that women experience at puberty, during pregnancy, and at menopause.
A woman is more likely to get varicose veins:

if she takes estrogen or progesterone in birth control pills or estrogen replacement therapy

during the first trimester of pregnancy as the uterus expands and more weight is put on the legs. When this occurs during a woman's first pregnancy, these veins often disappear when the baby is born. That may not happen with later pregnancies.

A permanent condition known as milk leg may sometimes occur during pregnancy. It happens when valves in the veins have been destroyed and the pressure of the pooled blood causes swelling.

Symptoms & Signs

What are the signs and symptoms of the condition?

Often, varicose veins close to the skin can be seen. They are often described as swollen, enlarged, snakelike, bluish veins that are most noticeable when standing. They are most commonly seen on the back of the calf or inside of the leg from the ankle to the groin. Other symptoms in the legs include:

pain

itching

swelling

fatigue

heaviness

aching

burning

throbbing

cramping

restlessness

Diagnosis & Tests

How is the condition diagnosed?

A history and physical examination makes the diagnosis of varicose veins. Other tests may be ordered to examine the veins more closely, such as:

ultrasound, a test that uses sound waves to look at tissues, organs, arteries, and blood flow

blood flow studies that can measure changes in the amount of blood passing through a vein

Prevention & Expectations

What can be done to prevent the condition?

Although varicose veins may be partly inherited, making certain lifestyle changes may help prevent this condition. The following activities should be avoided to help prevent this condition:

heavy lifting

standing for long periods of time

sitting with legs crossed for long periods of time

Avoidance of obesity and getting regular exercise is also advised to help prevent this condition.

What are the long-term effects of the condition?

Severe varicose veins can cause eczema, inflammation, or stasis dermatitis, which is skin breakdown in the lower legs.
Inflammation of the deep veins can lead to blood clots. These clots may break off and block the artery that supplies the lungs, known as a pulmonary embolus.

What are the risks to others?

Varicose veins pose no risks to others and are not contagious.

Treatment & Monitoring

What are the treatments for the condition?

Mild varicose veins need no treatment other than for cosmetic reasons. In most cases, people with symptoms can use support hose or heavier elastic knee-high stockings to manage their condition. Frequent rest periods with leg elevation can also help with leg swelling and the feeling of heaviness in the legs. Regular exercise is also advised to improve circulation to the legs.
If symptoms are severe or a person finds the appearance of the veins unacceptable, varicose vein surgery may be an option. A variety of surgery methods are used. These include cutting the veins out, injecting the veins with chemicals to destroy or shrink them, or using lasers or radio waves to destroy shrink the veins.
Treated varicose veins usually disappear with surgery. Problems do not return in the treated veins, but may develop in other veins. Once a varicose vein is closed or removed, nearby healthy veins take over the job of carrying blood back to the heart.

What are the side effects of the treatments?

All the surgical techniques cause some bruising and discoloration, which generally goes away over time. Skin scarring may also occur. As with any surgery, infection, bleeding, and reaction to any pain medicine used may occur.

What happens after treatment for the condition?

After the procedure, a person usually needs to wear a bandage or compression hose, or both. The vein that was treated scars over and causes no further problems. Later, though, people may get varicose veins that need treatment in other parts of the leg.

How is the condition monitored?

A healthcare provider should examine varicose veins periodically.

Attribution

Author:Terry Mason, MPH
Date Written:
Editor:Coltrera, Francesca, BA
Edit Date:06/07/00
Reviewer:Adam Brochert, MD
Date Reviewed:04/09/01

Sources

The American College of Phlebology. Phebology: The Treatment of Leg Veins. 100 Webster Street, Suite 101, Oakland, CA 94607-3724
American Academy of Dermatology. New Treatments Allow Patients to Get A Leg Up on Varicose and Spider Veins, 1999. 930 N. Meachem Road, Schaumburg, IL 60173
Tabers Cycleopedic Medical Dictionary, F.A. Davis Company Philadelphia, PA

Varicose Vein Surgery

2011-06-14T22:38:00.001-07:00

Overview & Description

Varicose veins are enlarged, twisted veins, most commonly located in the legs. There are several ways to remove or treat these damaged veins.

Who is a candidate for the procedure?

Surgery can be done for most people who want to have varicose veins removed. Surgery is usually advised if symptoms are severe and don't respond to other therapy. Many people have surgery because they don't like the way the veins look.

How is the procedure performed?

There are a number of ways to remove or treat varicose veins. The procedure used depends on their location and severity. Surgeons may also have methods they prefer.
The procedure may be done with local anesthesia or general anesthesia. Local anesthesia means that numbing medication is injected under the skin where the cuts will be made. General anesthesia means the person is put to sleep with medications. The surgeon usually decides the type of pain control after talking with the person before surgery.
Procedures used to treat varicose veins include:

surgical ligation and stripping, which is the most complex procedure, used for more severe varicose veins. Certain veins in the leg are tied off, which is called ligation. A small stitch is tied around a vein to block blood flow through it. Stripping is a technique to remove a long portion of a vein using only two small skin cuts. First, a small cut is made at the bottom of the vein. A thin metal instrument is placed into the vein through the cut after it is tied off. The instrument is passed up through the vein. A small skin cut is then made at the top and the device is removed through it. The entire length of vein is pulled out with the device.

phlebectomy, or removal of the vein through cuts in the skin. Phlebectomy is similar to ligation and stripping, except that smaller pieces of vein are removed with a small surgical hook.

sclerotherapy, which permanently closes or collapses the veins with chemicals. Certain irritating chemicals can be injected directly into the varicose veins. This damages the veins and causes them to permanently collapse.

electrodessication, which is the use of electrical current to permanently seal varicose veins

laser therapy and intense pulsed light therapy, which use laser beams or high intensity light to destroy varicose veins

Preparation & Expectations

What happens right after the procedure?

After the surgery, the person will be taken to the surgery recovery room to be watched closely for a short time. Vital signs, blood pressure, pulse, and breathing will be checked frequently. Bandages are usually placed over any cuts. Those who have had more complex surgery may need to stay in the hospital overnight. Most other people will be able to go home a few hours after surgery. If sedatives or general anesthesia were used, someone else must drive the person home.

Home Care and Complications

What happens later at home?

The surgeon or the staff will explain care of any bandages before the person goes home. Swelling and bruising are common when cuts are made. The person will generally have very little pain. Over-the-counter pain medications are usually used for pain, but a prescription pain medication may be given. Most people are able to return to normal activity with 3 or 4 days. While these procedures do cure varicose veins, new varicose veins can appear and need treatment.

What are the potential complications after the procedure?

All surgeries have possible complications. These include bleeding, infection, and reactions to any pain medications used. Small areas of skin numbness can be caused by nerve damage, and these are sometimes permanent. Blood clots may form in the veins, a rare but possibly serious problem. Most people have few or no problems and recover without difficulty.

Attribution

Author:Adam Brochert, MD
Date Written:
Editor:Duff, Ellen, BA
Edit Date:06/23/00
Reviewer:Gail Hendrickson, RN, BS
Date Reviewed:04/09/01

Sources

Vascular Surgery: Principles and Practice, 1994, Veith et al.
American Academy of Dermatology website. www.aad.org

Varicocele

2011-06-14T22:37:00.003-07:00

Overview, Causes, & Risk Factors

A varicocele is the enlargement of the network of veins that drain the testicle in males.

What is going on in the body?

Blood flows from the scrotum and testicles through a complex of veins rather than a single vessel. These veins are prone to becoming enlarged or dilated. This frequently happens when the valves in the veins that keep the blood flowing in the direction of the heart become weakened. A varicocele is more common on the left because of the specific pattern of blood flow on that side. Varicoceles are linked to infertility in males 20 to 40% of the time. This is because the increased blood flow through the enlarged veins raises the temperature of the testicles and affects the development of sperm.

What are the causes and risks of the condition?

Approximately 15% of adult men have a small to moderate size left varicocele. Right-sided varicoceles are uncommon. Typically, the presence of a varicocele does not signal any type of serious disease. However, a large varicocele on the right side that appears suddenly may indicate a mass such as an enlarged lymph node or testicular cancer.

Symptoms & Signs

What are the signs and symptoms of the condition?

Most varicoceles do not have symptoms. They are found by accident during a routine exam or an infertility evaluation. Very large varicoceles may produce a heavy or dragging feeling in the testicles. They rarely are painful.

Diagnosis & Tests

How is the condition diagnosed?

A varicocele is usually diagnosed with a physical exam. It appears as a full but soft mass above the testicle. The mass disappears completely when the man is lying down. The varicocele's appearance has been described as a "bag of worms." Ultrasound is sometimes used to confirm the diagnosis. This is more common during an evaluation for male infertility.

Prevention & Expectations

What can be done to prevent the condition?

There is no known way to prevent developing a varicocele. Routine testicular self examination may alert the man to any new masses, which should be evaluated by the healthcare provider.

What are the long-term effects of the condition?

Varicoceles can be linked to male infertility. If abnormalities show up in a semen analysis, removing the varicocele may improve sperm quality.

What are the risks to others?

There are no risks to others, as a varicocele is not contagious.

Treatment & Monitoring

What are the treatments for the condition?

A varicocele is usually managed conservatively. A scrotal support may be worn to relieve the heavy sensation in the scrotum. However, if the pain continues or if infertility results from a backup of blood in the veins, surgery may be needed.
Removal of the varicocele is called varicocelectomy. This operation can be accomplished with a variety of incisions. The most common is a small cut in the groin or just below it. Several of the veins draining the contents of the scrotum can be tied off through this opening. An alternative procedure is to make a small incision higher up in the flank. Also, the enlarged veins can be blocked with material injected into them through a catheter, or narrow tube.

What are the side effects of the treatments?

Side effects may include bleeding, infection or the accumulation of fluid along the spermatic cord, known as a hydrocele.

What happens after treatment for the condition?

The man will feel some discomfort and a sense of congestion in the testicle for a few weeks following the procedure.

How is the condition monitored?

If the varicocele makes the scrotum feel uncomfortably full, or impairs fertility, the male should follow up with a healthcare provider. Any new or worsening symptoms should be reported to the healthcare provider.

Attribution

Author:Stuart Wolf, MD
Date Written:
Editor:Slon, Stephanie, BA
Edit Date:05/09/00
Reviewer:Gail Hendrickson, RN, BS
Date Reviewed:06/01/01

Sources

The Merck Manual of Medical Information, Home edition, 1997
Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000

Varicella Zoster - Shingles

2011-06-14T22:37:00.001-07:00

Overview, Causes, & Risk Factors

Shingles, or herpes zoster, is a painful rash of blisters that develops due to the virus that causes chickenpox.

What is going on in the body?

A primary, or first time, infection with a virus called the varicella-zoster virus causes chickenpox. After someone recovers from chickenpox, the virus remains quiet, or dormant, in nerves. The infection can reactivate for various reasons later in life and this is called shingles.

What are the causes and risks of the infection?

The cause of this condition is a reactivation of the chickenpox virus. Most people in the US are infected with this virus. Weakness of the immune system may increase the risk of developing shingles. In people with weakened immune systems, infection can be very serious. In these people, the virus can spread all over the body, causing infection in the liver, lungs, and brain.

Symptoms & Signs

What are the signs and symptoms of the infection?

Shingles symptoms are usually limited to a small area of the body. This area is usually a small strip of skin on one side of the chest or abdomen. In some cases, the face can be involved, and this may cause an eye infection. The first symptoms are usually related to sensation. People may experience pain, numbness, tingling, or itching. Pain usually occurs at some point, and can be quite severe. This is usually followed by the development of groups of blisters. The areas around the blisters are often quite painful. The pain can be severe and last for weeks. Pain is usually much less severe in children.

Diagnosis & Tests

How is the infection diagnosed?

Usually the diagnosis of varicella-zoster is made by an interview with the person and a physical exam. The virus can be recovered from the blisters and identified with special tests. Blood tests can also be used to make the diagnosis in some cases if needed.

Prevention & Expectations

What can be done to prevent the infection?

Primary varicella-zoster infection, or chickenpox, can be prevented. If chickenpox is prevented, shingles will not occur. Healthy children and some adults are given varicella vaccine, which prevents chickenpox. People with weak immune systems that have not had chickenpox may be given varicella zoster immune globulin (VZIG) if they are exposed to chickenpox.

What are the long-term effects of the infection?

In most cases, shingles goes away in a week or so and causes no long-term effects. However, some cases result in serious long-term effects. Eye infection may lead to serious eye problems, including blindness. Some people have chronic pain in the area of the blisters that doesn't go away for months or even years. Paralysis in the part of the body that had blisters occurs very rarely. In people with a weak immune system, the virus may cause a serious infection in the body. This may result in liver, brain, or lung damage, and possibly even death.

What are the risks to others?

The virus can be spread to others if they are exposed to the fluid in the blisters. If people who have not received the varicella vaccine or been exposed to chickenpox before are exposed to someone with shingles, they may develop chickenpox.

Treatment & Monitoring

What are the treatments for the infection?

Acyclovir, valacyclovir or famciclovir can be used to treat shingles. Drugs for pain may also be needed. Eye infection usually requires the use of special eye drops to reduce inflammation.

What are the side effects of the treatments?

Headaches and nausea may occur with the drugs used to treat shingles. These are usually taken as pills. People with severe infections may need acyclovir injected directly into the veins, which may cause kidney problems. Drugs for pain may cause stomach upset, allergic reactions or sleepiness. Exact side effects depend on the drug used. Eye drops can cause irritation and allergic reactions in the eyes.

What happens after treatment for the infection?

In most cases, the shingles go away and people can return to normal activities. Pain may remain at the site of the healed blisters. Drugs for pain may be needed. People with eye infection may require long-term eye care from an eye doctor.

How is the infection monitored?

Most cases are monitored by the affected person at home. In severe infections, a person may need to be monitored in the hospital. Further monitoring in this setting would depend on the areas of the body that are affected by the infection. Those with eye infections usually need repeated eye examinations until the infection resolves.

Attribution

Author:Danielle Zerr, MD
Date Written:
Editor:Keefe, Sandy, RN, MSN
Edit Date:05/14/00
Reviewer:Adam Brochert, MD
Date Reviewed:05/04/01

Varicella Vaccine - Chickenpox Vaccine

2011-06-14T22:36:00.001-07:00

Overview & Description

Doctors use the chickenpox vaccine to prevent chickenpox in children and adults. Vaccines contain weakened or dead forms of the germs that cause certain diseases. To fight these germs, the body's immune system creates antibodies. Antibodies are cells that attack foreign substances in the body. A vaccine causes the body to makes antibodies to the weakened germs in the vaccine. Some of these antibodies will stay in the body for long periods of time. How long they remain depends on which vaccine a person gets. If the person is later exposed to the disease, the antibodies multiply to fight it off.
Chickenpox is usually a childhood illness. But it can occur at any age. It is most common in children 6 to 12 years old. The illness usually lasts 4 to 5 days and causes mild symptoms. There is a rash with as many as 250 to 500 itchy bumps, called vesicles. Other symptoms are fatigue and a low-grade fever.
Chicken pox can cause serious, even fatal, complications. People who are at higher risk for these complications include:

teens and adults

children who are given aspirin

infants younger than age 1

newborns and premature babies whose mothers had chickenpox when they were born or have not had chickenpox

people with weakened immune systems

These serious complications include:

severe skin infections

scarring from the pox

pneumonia, which is an infection of the lungs

brain damage

death

The chickenpox vaccine protects against both these complications and the discomfort of mild symptoms. The vaccine can prevent chickenpox in most cases. Anyone who gets chickenpox despite receiving the vaccine usually has only a mild case.

Who is a candidate for the procedure?

The Centers for Disease Control and Prevention, also known as CDC, is the U.S. government agency that makes recommendations about vaccinations. The CDC recommends that the chickenpox vaccine be given to children age 12 to 18 months , or to older children if they have not had chickenpox. Children under the age of 13 should be given one dose of the vaccine. Children who are at least 13 and have not had chickenpox should receive two doses of the vaccine. The doses should be given 4 to 8 weeks apart. Many schools, day care centers, and colleges require the vaccine or a report of a history of chickenpox before enrollment.
Varicella vaccine is recommended for anyone in certain high-risk groups if they have not already had chickenpox. These high-risk groups include:

people who live or work where exposure to chickenpox is likely, such as teachers of young children, day care employees, and residents and staff in institutional settings

people who live or work where outbreaks of chickenpox can occur, such as college students, prison inmates and staff, and military staff

nonpregnant women of childbearing age

teens and adults living in households with children, since the children may pass chickenpox to them

A person in these high-risk groups should talk with his or her doctor about whether he or she should get the chickenpox vaccine. Other people who should consult with their doctors before receiving the vaccine include:

people with weakened immune systems, such as those who have HIV or cancer or who take medicines such as steroids or chemotherapy

people who are allergic to gelatin or the antibiotic neomycin

pregnant women

people who are currently ill

How is the procedure performed?

The chickenpox vaccine is given by an injection into the muscle of the upper thigh or arm. This vaccination may be given at the same time as other vaccinations but in a different spot on the body.

Preparation & Expectations

What happens right after the procedure?

The site of the chickenpox vaccine injection may sting slightly. A bandage is usually put on it to stop any minor bleeding that may occur.

Home Care and Complications

What happens later at home?

The chickenpox vaccine is very safe. Severe allergic reactions are very rare. But it is important to call a doctor right away to report has any new or worsening symptoms.

What are the potential complications after the procedure?

Chickenpox itself is far more likely to cause serious problems for people at high risk than the vaccine is. Possible side effects of the vaccination include:

mild rash, up to 1 month after vaccination

mild redness, pain, and swelling at the site of the shot for 1 to 2 days

rarely, fever, muscle aches, or another reaction at the site of the shot

rarely, seizures resulting from the fever

very rarely, a severe allergic reaction known as anaphylactic shock, pneumonia, brain damage, or even death

Attribution

Author:Eileen McLaughlin, RN, BSN
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:02/05/02
Reviewer:Melissa Sanders, PharmD
Date Reviewed:02/08/02

Sources

Vaccine information sheets, US Department of Health and Human Services, Centers for Disease Control and Prevention, National Immunization Program, www.cdc.gov/nip/
The Chicken Pox Vaccine: What Parents Need to Know, American Academy of Pediatrics, www.aap.org/family/chckpox.htm
Prevention of varicella: updated recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR 1999;48(RR-06):1-5.
Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR 1996;45(RR-11):1-43.

Varicella - Chickenpox

2011-06-14T22:35:00.001-07:00

Overview, Causes, & Risk Factors

Chickenpox is a disease caused by the varicella-zoster virus (VZV). It is characterized by a blistery rash.

What is going on in the body?

Chickenpox is characterized by an itchy rash that looks like very small blisters on a red base. The blisters look like dewdrops on top of a red pimple. Chickenpox is usually acquired in childhood by inhaling the virus from an infected person. It is also acquired by touching the blisters of the chickenpox rash when there is still fluid in them.
The disease is usually more severe in adolescents and adults. It can be life-threatening in people with autoimmune disorders, pregnant women, and babies born to mothers who have chickenpox around the time of delivery. A fetus can sometimes acquire VZV in the first 6 months of pregnancy. If this happens, the baby can be born with:

scarring of the skin

malformed arms or legs

problems with the central nervous system

eye problems

VZV remains in the body forever. After recovery from chickenpox, the virus usually remains quiet, or latent. But sometimes the virus becomes active again, causing shingles, which is a painful infection along the nerves.

What are the causes and risks of the disease?

Chickenpox is a highly contagious disease caused by the varicella-zoster virus. VZV is a member of the herpes virus family.

Symptoms & Signs

What are the signs and symptoms of the disease?

Symptoms of chickenpox usually appear a little more than 2 weeks after exposure, although anywhere between 10 and 21 days is normal. They include:

blistery, itchy rash

rash appearing on all body surfaces but usually starting on the head and back

fever

Diagnosis & Tests

How is the disease diagnosed?

Chickenpox is usually diagnosed based on the appearance of the rash. However, VZV can be detected and/or cultured from chickenpox blisters during the first few days of the rash. The person's blood can be tested to determine whether he or she has had chickenpox in the past.

Prevention & Expectations

What can be done to prevent the disease?

Chickenpox can usually be prevented with the varicella vaccine. The vaccine is routinely recommended for most children. The vaccine is strongly recommended for adolescents and adults who have never had chickenpox. People at high risk for severe chickenpox may be given varicella-zoster immune globulin.

What are the long-term effects of the disease?

The most common long-term effect is scarring of the skin. Normal chickenpox can leave temporary marks on the skin that take 6 to 12 months to fade.
The most common complication of chickenpox is bacterial infection, such as cellulitis, of the skin. The virus can sometimes cause pneumonia, inflammation of the liver, and an infection of the central nervous system. Chickenpox is a serious disease for adults, people with autoimmune problems, and newborns whose mothers had chickenpox right around the time of delivery.

What are the risks to others?

If a person has chickenpox, it can be highly contagious to a person who has not had VZV. The contagious period begins about 2 days before the rash develops. The person is generally contagious as long as the blisters have fluid in them or until they crust over.

Treatment & Monitoring

What are the treatments for the disease?

Acyclovir is used to treat complicated or more severe cases of varicella. It is not routinely used to treat mild to moderate cases in healthy children.
Home care suggestions are designed to treat the symptoms. These include:

acetaminophen to treat discomfort and fever over 102 degrees. Aspirin should be avoided in a person with chickenpox because of a link between aspirin, chickenpox, and a serious infection called Reyes syndrome.

cool, tepid baths. A cool or lukewarm bath with 1/2 cup of baking soda or oatmeal added to it will decrease itching from the rash. It may help to have several baths a day for the first few days of the rash.

calamine lotion to reduce itching from the rash

diphenhydamine, an antihistamine medication, for itching. The healthcare provider should be consulted before giving this medication to young children.

a soft diet and cool fluids. Avoid salty or citrus foods.

covering the hands of small children with gloves or socks to avoid scratching. Scratching can cause secondary infection of the scabs.

What are the side effects of the treatments?

Acyclovir can sometimes cause damage to the kidneys, or kidney toxicity.

What happens after treatment for the disease?

Most people recover without serious long-term effects. But the virus remains and may reactivate at any time to cause shingles.

How is the disease monitored?

Any new or worsening symptoms should be reported to the healthcare provider. No further monitoring is needed once a person recovers from VZV. If VZV symptoms such as shingles redevelop, a person should contact his or her healthcare provider.

Attribution

Author:Danielle Zerr, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:02/12/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/27/01

Variant Angina - Coronary Artery Spasm

2011-06-14T22:34:00.003-07:00

Overview, Causes, & Risk Factors

The coronary arteries are a pair of blood vessels that carry oxygen-rich blood to the heart muscles. A spasm in these arteries known as a vasospasm reduces blood flow to the heart. This causes a chest pain called angina.

What is going on in the body?

Most often, vasospastic angina occurs while a person is at rest or it wakes a person from sleep. Typical angina is linked with physical activity and caused by fat deposits clogging the arteries, or atherosclerosis. Vasospastic angina differs in that it can happen whether a person:

is active or resting

does or does not have clogged arteries from atherosclerosis

When the spasms occur, blood flow to the heart lessens. This causes the pain and raises the risk of a heart attack.

What are the causes and risks of the condition?

The coronary arteries and other blood vessels may constrict due to:

certain medications, such as vasopressin or ergonovine

cocaine

exposure to cold

high levels of stress

Sometimes, strenuous activity can bring on an attack.

Symptoms & Signs

What are the signs and symptoms of the condition?

Symptoms of vasospastic angina are similar to those of typical angina:

chest pain

shortness of breath

rapid heartbeats called palpitations

These symptoms occur:

at rest

during sleep

with or without physical exertion

Diagnosis & Tests

How is the condition diagnosed?

A healthcare provider may suspect coronary artery spasms based on a person's symptoms. A pattern of chest pain at rest, for example, is suspicious, especially if a person has no history of blocked coronary arteries or heart attack. However, some people with this disease also have blocked coronary arteries.
An electrocardiogram, or ECG may be normal between attacks. During attacks, the ECG may record changes that show a lack of blood flow to the heart. A procedure called a cardiac catheterization can find clogged blood vessels.
Often, vasospastic angina can be diagnosed only after other possibilities have been excluded.

Prevention & Expectations

What can be done to prevent the condition?

Generally, nothing can be done to prevent the condition.

What are the long-term effects of the condition?

A person with coronary artery spasms has a higher risk of:

irregular heart rhythms, or arrhythmias

heart attack

sudden death

What are the risks to others?

There are no risks to others.

Treatment & Monitoring

What are the treatments for the condition?

If a person has severely blocked coronary arteries, surgery may stop the vasospasms. Those who have fewer symptoms and no coronary artery blockages respond well to heart medication.
A person should also:

eat a healthy diet, following the Food Guide Pyramid

exercise regularly

quit smoking

use alcohol in moderation

What are the side effects of the treatments?

All medications have side effects. Medications used to treat coronary artery spasm may cause

headache

fatigue

sleep disorders such as insomnia

dizziness

serious arrhythmias

What happens after treatment for the condition?

Uncomplicated cases are usually well controlled with heart medication.

How is the condition monitored?

Monitoring includes:

blood tests

ECG tests

stress tests, or an ECG of the heart's function during exercise

A person should report any change in the pattern or severity of chest pains to his or her healthcare provider right away.

Attribution

Author:Eric Berlin, MD
Date Written:
Editor:Coltrera, Francesca, BA
Edit Date:06/23/00
Reviewer:Vincent J. Toups, MD
Date Reviewed:06/01/01

Sources

Merck Manual 1999
Current Medical Diagnosis and Treatment 1996
Harrison's Principles of Internal Medicine 1991
Heart Disease: A Textbook of Cardiovascular Medicine, 1980

Valley Fever

2011-06-14T22:34:00.001-07:00

Overview, Causes, & Risk Factors

Valley fever is an infection, usually in the lungs, caused by the fungus Coccidioides immitis. It is called valley fever because the fungus is commonly found in the soil of the valleys of the southwestern US, Mexico, and parts of Central and South America.

What is going on in the body?

Valley fever may cause a range of mild symptoms, and a mild lung infection. Or the infection may be severe and progressive, and spread throughout the body, which can be fatal.

What are the causes and risks of the infection?

Valley fever is caused by a fungus that thrives in the soil. An infection occurs when a person breathes in dust from soil that contains the fungus. The disease is commonly found in California's San Joaquin Valley, southern and central Arizona, and southwest Texas. A person who works outdoors in those areas may be at a higher risk.

Symptoms & Signs

What are the signs and symptoms of the infection?

Many times valley fever causes no symptoms at all. If symptoms do develop, they usually appear 1 to 3 weeks after infection, and may include:

fever

backache and headache

red, spotty rash appearing 1 to 2 days after the fever begins

swelling of the extremities, especially the knees and ankles

chest pain

chills

nasal congestion

cough, which may bring up sputum and even blood

Diagnosis & Tests

How is the infection diagnosed?

A healthcare provider may suspect this infection if the person lives in or has recently traveled through an infected area. A history and physical exam may reveal some of the symptoms common to valley fever. A chest x-ray, blood tests, including a complete blood count or CBC, and a spinal tap may also be done. A blood culture will reveal the presence of the infection.

Prevention & Expectations

What can be done to prevent the infection?

Currently there is no way to prevent the infection. A person who lives in the areas where the infection is common should avoid exposure to dust and dry soil as much as possible.

What are the long-term effects of the infection?

Valley fever can form lung abscesses, or pus pockets, which can be difficult to treat. Occasionally the infection spreads throughout the body, causing lesions in the bones and other organs. In those cases, the mortality rate can reach 60%. In rare cases, the disease may recur within a few months. Valley fever tends to be more serious in dark-skinned people, pregnant women, or people with weakened immune systems.

What are the risks to others?

Valley fever may be spread to others through contaminated dressings of infected people.

Treatment & Monitoring

What are the treatments for the infection?

The acute form of valley fever normally clears up without treatment. Bed rest and fever- reducing medications may be recommended. In more severe cases, fungus-killing medications may be used.
A healthcare provider may prescribe amphotericin B to be given through a vein. In cases of recurrence, a medication such as ketoconazole may be prescribed between courses of amphotericin. In severe cases, surgery may be needed to drain abscesses in the lungs.

What are the side effects of the treatments?

Possible side effects of the medications include stomach upset, allergic reactions, and irritation at the site in the vein where the medication is being given. Any surgery poses a risk of infection, bleeding, and allergic reaction to the anesthesia.

What happens after treatment for the infection?

After treatment, valley fever usually goes away. In rare cases, the infection recurs, and further treatment is needed.

How is the infection monitored?

In cases of continued infection, the person may be monitored for recurrent symptoms. Any new or worsening symptoms should be reported to the healthcare provider.

Attribution

Author:John Riddle
Date Written:
Editor:Duff, Ellen, BA
Edit Date:08/25/00
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:08/29/01

Sources

Valley Fever Facts, www.astdhpphe.orginfect/valley.html
Centers For Disease Control and Prevention, www.cdc.gov

Vaginitis

2011-06-14T22:33:00.001-07:00

Overview, Causes, & Risk Factors

Vaginitis is an inflammation of a woman's vagina. It can be caused by bacteria, fungus, viruses, parasites, hormonal changes, or chemicals.

What is going on in the body?

A healthy vagina has a balance of many bacteria and fungi. Normal vaginal discharge is clear, cloudy, or whitish. But the balance in the vaginal environment can be thrown off by many factors. Following are some of the common factors affecting the balance:

change in hormone levels

impaired health

normal aging

sexual activity

stress

What are the causes and risks of the condition?

Candida albicans,\ \Candida tropicalis,\ \Candida glabrata,\ and \Candida parapsilosis.\ ',CAPTION,'Vaginal Yeast Infection');" onmouseout="return nd();">Vaginal yeast infections are a common cause of vaginitis. They are usually caused by an overgrowth of Candida albicans. This type of infection often produces an itchy, whitish vaginal discharge that may look like cottage cheese. Yeast infections are often seen after the woman has taken antibiotics for another infection. The antibiotics interfere with the normal balance of organisms in the vagina.
Bacterial vaginosis occurs when several types of harmful bacteria that live in the vagina grow too fast. No one knows what causes the overgrowth of these bacteria. The harmful bacteria can replace protective bacteria. This makes the vagina less acidic. Half of the time, vaginosis causes no symptoms. Some women may have a grayish-white or yellowish-white discharge.
Trichomonas vaginalis.\ ',CAPTION,'Trichomoniasis');" onmouseout="return nd();">Trichomoniasis is caused by a parasite. It spreads during sexual intercourse. There is a large amount of frothy vaginal discharge. The discharge is usually yellow-gray or green and has an unpleasant odor.
Atrophic vaginitis is associated with low levels of estrogen. The vagina becomes less acidic. This allows harmful bacteria to nudge out healthy bacteria. The vagina is more susceptible to injury and infection. Some women with this condition have no symptoms. Others have vaginal dryness and burning. Usually this condition occurs after menopause. Sometimes it affects nursing mothers or girls before they reach puberty.
Many factors can irritate the vagina or change its acidity, such as the following:

cervicitis, or inflammation of the cervix

chemicals in deodorants, powders, or soaps

chemicals in spermicides, condoms, and diaphragms

douches

an object left in the vagina, such as a forgotten tampon

sex toys

sexual intercourse

sexually transmitted diseases, or STDs

Other factors that increase a woman's risk for vaginitis include the following:

breastfeeding

clothing that holds heat and moisture, such as nylon panties

diabetes

hormone replacement therapy

immunodeficiency disorders, which weaken her response to infection

menopause

oral contraceptives

poor hygiene

pregnancy

stress

Symptoms & Signs

What are the signs and symptoms of the condition?

Many women have vaginitis without symptoms. Often, though, a woman will notice some of these symptoms:

abnormal vaginal bleeding

discomfort or burning during urination

dryness or discomfort during sexual intercourse

a foul or fishy vaginal odor, especially after intercourse

irritation and itching inside and outside the vagina

swelling or redness of the genital area

vaginal discharge that may be lumpy, frothy, or discolored

Diagnosis & Tests

How is the condition diagnosed?

The diagnosis of vaginitis begins with a medical history and physical exam. The healthcare provider will do a pelvic exam. The provider may also take the following steps.

Check the acidity of the vaginal discharge.

Order tests to rule out STDs or other diseases.

Perform a Pap smear.

Take a sample of discharge from the vagina.

Prevention & Expectations

What can be done to prevent the condition?

Vaginitis cannot always be prevented. Following these recommendations can lower a woman's risk for vaginitis.

Avoid douches and other chemicals in the vaginal area.

Consider hormone replacement therapy after menopause.

Control blood glucose, if she has diabetes.

Practice safer sex.

Wear loose-fitting, absorbent underwear.

Wipe front to back after using the toilet.

What are the long-term effects of the condition?

If an infection is treated, long-term problems usually do not arise. Sometimes the cause of vaginitis cannot be cured. Severe STDs may cause chronic pain and infertility.

What are the risks to others?

If the vaginitis is caused by an STD, a woman can transmit the infection to a sexual partner.

Treatment & Monitoring

What are the treatments for the condition?

Treatment options depend upon the cause of vaginitis. Therapy may include the following:

antibiotic medicines, such as ceftriaxone or clindamycin

antibiotic vaginal tablets or creams, such as metronidazole or triple sulfa

antifungal medicines, such as fluconazole

antifungal vaginal creams or tablets, such as miconazole or clotrimazole

hormone replacement therapy

sitz baths, which involve sitting in a few inches of warm water

soothing vaginal creams or ointments

What are the side effects of the treatments?

Antibiotics and antifungal medicines may cause rash, stomach upset, or allergic reactions.

What happens after treatment for the condition?

Vaginitis may take a few days or more to disappear, depending on how long an infection has been present and the cause of the inflammation. If an STD has been diagnosed, the sexual partner or partners should be tested.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

Attribution

Author:Eva Martin, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:04/19/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:09/11/01

Vaginismus

2011-06-14T22:32:00.001-07:00

Overview, Causes, & Risk Factors

Vaginismus is painful, reflex muscle spasm of the vagina and leg muscles, which occurs when sexual intercourse is tried or anticipated.

What is going on in the body?

When a woman has vaginismus, muscle spasms cause the vagina and leg muscles to tighten reflexively. Putting a finger or penis in the vagina is quite painful. Often it cannot be done.
The problem is often linked to past sexual trauma. Other factors, such as fear of pregnancy or venereal disease, may also be present.

What are the causes and risks of the condition?

Some contributing factors are:

past sexual trauma, as a child, teen, or adult

sexual inhibition for religious, cultural or emotional reasons

pain with intercourse in the past

desiring women rather than men, even if the desire is not acted upon

painful pelvic exams

Symptoms & Signs

What are the signs and symptoms of the condition?

The key symptom of vaginismus is vaginal tightness strong enough to make intercourse impossible. The pain may cause a woman to avoid sexual intimacy.

Diagnosis & Tests

How is the condition diagnosed?

A healthcare provider will take a medical history and ask about episodes of vaginismus. A pelvic exam will be done, too. During it, the provider will try to gently insert a finger or fingers into the vagina to see if this causes a painful spasm of vaginal muscles and tightened leg muscles.

Prevention & Expectations

What can be done to prevent the condition?

Sexual abuse is a complex problem. Raising awareness and a healthy suspicion through education, identifying abusers and offering protection are key issues.

By speaking positively about sexuality, parents may help remove, or at least not encourage first-time fears. This may help children accept their own sexual preferences, too.

If intercourse is always painful, a healthcare provider can offer treatment. That may help prevent a worsening cycle of vaginismus.

What are the long-term effects of the condition?

Because sexual activity is painful for a woman with vaginismus, relationships are often avoided, or marred by discord and dissatisfaction. Lingering questions about sexual preference may never be resolved.

What are the risks to others?

A woman's partner may start to view himself as a sexual failure. Problems having an erection or impotence may result.

Treatment & Monitoring

What are the treatments for the condition?

Treatment usually involves counseling to get at the root psychological cause for the vaginismus. Some experts use a program that slowly makes it easier to relax vaginal muscles so that the vagina opens up. A reputable sex therapist or gynecologist familiar with the problem may suggest:

placing the woman's fingers or her partner's fingers in the vagina and learning to relax.

placing dilators of increasing size into the vagina daily. Over many weeks this helps open up the vagina and relax the muscles.

seeking sex therapy with a goal of having intercourse and a healthy, satisfying sexual relationship. Sessions may involve education about female and male anatomy, how sexual response works, and common myths about sex. If a phobia exists, hypnosis and relaxation techniques may be useful, too. Success rates are high. Within 10 to 15 sessions, about 90% of women with vaginismus respond to therapy.

What are the side effects of the treatments?

Until a woman is able to relax her muscles, using dilators in the vagina may be uncomfortable and irritating. Therapy may uncover difficult issues that could trigger deep depression or anxiety.

Attribution

Author:Eva Martin, MD
Date Written:
Editor:
Edit Date:
Reviewer:Sandy Keefe, RN, MSN
Date Reviewed:09/11/01

Vaginal Yeast Infection

2011-06-14T22:31:00.001-07:00

Overview, Causes, & Risk Factors

A vaginal yeast infection is caused by one of a group of fungal organisms known as Candida. These include Candida albicans, Candida tropicalis, Candida glabrata, and Candida parapsilosis.

What is going on in the body?

Candida organisms are normally found in the vagina in small numbers. Their number is kept in check by the normal bacteria that also live there. Certain situations can disrupt this balance and allow a vaginal yeast infection to develop.

What are the causes and risks of the infection?

Vaginal yeast infections are caused by Candida organisms. Some diseases and conditions that increase a woman's risk for vaginal yeast infection include:

diabetes that is poorly controlled

HIV infection

immuodeficiency disorders, which weaken the woman's response to infection

menopause

pregnancy

Other factors that increase the risk for a vaginal yeast infection include:

a diet high in sugar

antibiotic therapy

corticosteroid use

oral contraceptive use

sexual activity, which can change the acid-base balance in the vagina

using feminine hygiene products

wearing tight clothing or nylon underwear

Symptoms & Signs

What are the signs and symptoms of the infection?

The most common symptoms of vaginal yeast infections include:

burning with urination or sexual intercourse

redness and inflammation of the vulva and vagina

vaginal discharge which is typically thick and white, with a "cottage cheese" consistency

vaginal or vulvar itching

Diagnosis & Tests

How is the infection diagnosed?

Diagnosis of a vaginal yeast infection begins with a medical history and physical exam. The healthcare provider may do a pelvic exam and Pap smear to rule out other infections. A sample of the vaginal discharge may be sent to the lab to check for Candida and other organisms.

Prevention & Expectations

What can be done to prevent the infection?

Helpful measures to prevent vaginal yeast infections include:

asking sexual partners to use a condom

controlling blood glucose levels if the woman has diabetes

limiting intake of dietary sugars

limiting time spent in a wet bathing suit

limiting use of feminine hygiene products

using antifungal creams, such as miconazole, clotrimazole, or nystatin when taking oral antibiotics

wearing loose clothing and cotton underwear

wiping the buttocks from front to back after bowel movements

What are the long-term effects of the infection?

With proper treatment, the infection should resolve in a few days to a week.

What are the risks to others?

Vaginal yeast infections are not believed to be transmitted from one person to another.

Treatment & Monitoring

What are the treatments for the infection?

A woman may choose to use an over-the-counter antifungal medicine. These medicines are inserted into the vagina. Some examples include miconazole, clotrimazole, and nystatin. The healthcare provider can prescribe stronger antifungal creams. The provider can also order an oral medicine called fluconazole.

What are the side effects of the treatments?

Vaginal creams may cause vulvar burning. Fluconazole may cause stomach upset or allergic reaction.

What happens after treatment for the infection?

Women should avoid sexual intercourse until the symptoms are gone and the course of treatment has been completed. Douching, bubble baths, hygiene sprays, or scented soaps around the vulva may irritate the skin.

How is the infection monitored?

Women who have repeated yeast infections that persist despite treatment should see a healthcare provider. Any new or worsening symptoms should be reported to the healthcare provider.

Attribution

Author:Eva Martin, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:05/31/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:05/07/01

Vaginal Pouch - Condom - Female

2011-06-14T22:30:00.003-07:00

Overview & Description

A female condom is a method of birth control.

What is the information for this topic?

The female condom became available around 1992. It is basically a sheath made of a material called polyurethane. This means that it's safe for people who have latex allergies. When used correctly, it is thought to be as good as male condoms at preventing pregnancy. This method of birth control is also thought to offer some protection against sexually transmitted diseases (STDs). But very little research has been done on how much protection is provided.
The female condom is meant to be inserted into the vagina before sex. The sheath contains a flexible ring on each end. One ring is inserted into the vagina and helps hold the condom in place. The outer ring stays outside the body. This can help prevent the condom from getting pushed into the vagina. Lubrication is generally provided with the condom, but more may need to be applied.
There are several advantages and disadvantages to the female condom. The advantages include:

It is one of the only birth control methods for women that provides some protection against STDs.

Since part of the external genitals are covered, there may be more protection against STDs than with male condoms.

It can be inserted before intimacy begins, avoiding the need for interruption or for timing with an erection, as with a male condom.

There are no side effects.

No doctor's visit, prescription, or fitting is needed. This is not true for many other forms of female birth control.

Women do not seem to have much of a decrease in sensitivity with this method. A man's sensitivity also seems to be less affected than with a male condom. This may make a partner more willing to use this method.

After ejaculation, a man does not need to withdraw his penis from the vagina right away. With a male condom, the penis must be withdrawn quickly.

Disadvantages of the female condom include:

Its appearance is considered odd or unattractive by many who use it.

It is expensive compared to a male condom. On average, a female condom costs about two dollars.

It may be noisy or may slip, move, or break during use.

It is currently sold as "one size fits all," and may be uncomfortable for some women.

The outer ring may irritate the clitoris or labia.

Information about its effectiveness and safety is limited.

The female condom is disposable and should never be reused. It must be removed carefully to prevent spilling of semen into the vagina. This method of birth control should not be used at the same time as a male condom. Its use for anal sex has not been approved or studied much by researchers.
Women who have used this form of birth control seem to accept it almost as much as using male condoms. The main reason for stopping its use seems to be the appearance of the device itself.

Attribution

Author:Adam Brochert, MD
Date Written:
Editor:Duff, Ellen, BA
Edit Date:05/19/00
Reviewer:Gail Hendrickson, RN, BS
Date Reviewed:09/19/01

Sources

Williams Obstetrics, 1997, Cunningham et al.
The JAMA website

Vaginal Muscle Spasms - Vaginismus

2011-06-14T22:30:00.001-07:00

Overview, Causes, & Risk Factors

Vaginismus is painful, reflex muscle spasm of the vagina and leg muscles, which occurs when sexual intercourse is tried or anticipated.

What is going on in the body?

What are the causes and risks of the condition?

Some contributing factors are:

past sexual trauma, as a child, teen, or adult

sexual inhibition for religious, cultural or emotional reasons

pain with intercourse in the past

desiring women rather than men, even if the desire is not acted upon

painful pelvic exams

Symptoms & Signs

What are the signs and symptoms of the condition?

The key symptom of vaginismus is vaginal tightness strong enough to make intercourse impossible. The pain may cause a woman to avoid sexual intimacy.

Diagnosis & Tests

How is the condition diagnosed?

Prevention & Expectations

What can be done to prevent the condition?

Sexual abuse is a complex problem. Raising awareness and a healthy suspicion through education, identifying abusers and offering protection are key issues.

By speaking positively about sexuality, parents may help remove, or at least not encourage first-time fears. This may help children accept their own sexual preferences, too.

If intercourse is always painful, a healthcare provider can offer treatment. That may help prevent a worsening cycle of vaginismus.

What are the long-term effects of the condition?

What are the risks to others?

A woman's partner may start to view himself as a sexual failure. Problems having an erection or impotence may result.

Treatment & Monitoring

What are the treatments for the condition?

placing the woman's fingers or her partner's fingers in the vagina and learning to relax.

placing dilators of increasing size into the vagina daily. Over many weeks this helps open up the vagina and relax the muscles.

What are the side effects of the treatments?

Until a woman is able to relax her muscles, using dilators in the vagina may be uncomfortable and irritating. Therapy may uncover difficult issues that could trigger deep depression or anxiety.

Attribution

Author:Eva Martin, MD
Date Written:
Editor:
Edit Date:
Reviewer:Sandy Keefe, RN, MSN
Date Reviewed:09/11/01

Vaginal Injuries - Genital Injuries in Females

2011-06-14T22:29:00.001-07:00

Overview, Causes, & Risk Factors

A genital injury to a female is an injury to the reproductive organs of a girl or a woman.

What is going on in the body?

The external genitalia has a rich blood supply. As a result, relatively minor injuries to the area may bleed excessively. This is particularly true when injuries involve the hymen, vagina, or labia. The injury may be the result of childbirth, rough intercourse, sexual assault, or an accident or other trauma.

What are the causes and risks of the condition?

Childbirth is the most likely cause of genital injury. A tear in the vulva or vagina during pregnancy and delivery may occur as a result of:

an episiotomy, which is a cut made in the opening of the vagina during childbirth

tears in the vaginal opening from delivering a large infant

the use of forceps or vacuum suction during childbirth

Accidental injuries can be caused by:

falls

straddle injuries, for example falling on monkey bars, a bicycle bar, or a fence

the amount of body surface area, also called BSA, that is injured\ \the depth of destruction\ \the location of the burn\ ',CAPTION,'Burns');" onmouseout="return nd();">chemical burns or burns from hot objects

pelvic fractures

high-pressure liquid injection, such as from water-skiing or jet-skiing

Injuries related to sex or assault are due to:

rough sex

unusual positions during sex

having sex for the first time

sexual abuse

rape

physical abuse or assault, such as a foreign object forcibly placed into the vagina or anus

child abuse

Symptoms & Signs

What are the signs and symptoms of the condition?

If the injury is to the inside of the vagina, the girl or woman may not have any bleeding or pain. Sometimes these internal injuries affect the bladder, rectum, and other organs in the abdomen. Symptoms may include:

pain in the abdomen

pain inside or outside the vagina

bleeding

swelling

redness and swelling within the vagina

cuts or tears anywhere in the genital region

painful urination

inability to urinate

foul smelling discharge

an object embedded in the vagina

feeling faint

bite marks on the genitalia

shock

bruising of the vulva, the outside of the vagina

bleeding under the skin of the vulva

change in the shape of the vaginal lips, vulva, or other areas

Diagnosis & Tests

How is the condition diagnosed?

It may be hard to do a pelvic exam in woman or girl who has a genital injury. But without a thorough exam, a healthcare provider may misjudge the extent and severity of the injury. Sometimes the exam is done with the woman or girl under general anesthesia.
Other procedures that may be done include:

cystoscopy, an examination of the bladder

anoscopy, examination of the anus

colonoscopy, examination of the rectum

laparoscopy, examination of the abdomen

exploratory surgery of the abdomen

vaginoscopy, which is a visual examination of the vagina

Prevention & Expectations

What can be done to prevent the condition?

Vaginal injuries related to high-pressure water injection can be prevented by wearing protective clothing such as a wet suit while water or jet skiing. Keeping one's feet together when entering the water on a slide will keep water from entering the vagina.
Preventing sexual assault may not be possible, but it is clear that the victim of this brutality should not be blamed. Women should avoid situations that can bring physical or sexual harm, such as:

alcohol or drug use

being in a dangerous environment

having an abusive partner

having group sex

Children should be told that they should not place objects into the vagina. Also, getting rid of sharp objects in the tub that they may fall on can prevent injuries.

What are the long-term effects of the condition?

Genital injuries need to be treated right away to prevent bleeding, complications, and long-term psychological damage. Genital injuries in girls will very likely create a lot of anxiety for the child as well as for her parents.

What are the risks to others?

A genital injury can pose a risk to a fetus if the woman is pregnant. Other risks may occur from some of the secondary effects of genital injury, such as sexually transmitted diseases.

Treatment & Monitoring

What are the treatments for the condition?

Treatment varies according to the severity of the injuries. Treatments may include:

ice packs, pressure to stop any bleeding, and bed rest

draining any large areas of blood

suturing of cuts or tears

surgery to repair any damage to other organs

antibiotics

estrogen creams to help the vagina heal

using a urinary catheter, which is a small tube that allows urine to drain from the bladder

counseling after sexual abuse

What are the side effects of the treatments?

Antibiotics can cause stomach upset, rash, allergic reaction, and other side effects. Surgery poses a risk of infection, bleeding, and allergic reaction to anesthesia.

What happens after treatment for the condition?

Bed rest, ice packs, and antibiotics may be needed for some time depending on the extent of the injuries. Not having sex for a while will allow the tissues to heal.

How is the condition monitored?

A woman or girl should notify her healthcare provider if she notices any of the following:

fever

pain or swelling in the affected area

bleeding

nightmares, sleep disorders, depression, or thoughts of suicide after sexual abuse

Attribution

Author:Eva Martin, MD
Date Written:
Editor:Smith, Elizabeth, BA
Edit Date:08/22/00
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/02/01

Sources

Understanding Your Body, Felicia Stewart, Felicia Guest, Gary Stewart, and Robert Hatcher, 1987
Maternity and Gynecological Care, The Nurse and the Family, Irene Bobak, Margaret Jensen, Marianne Zalar, Mosby Co., 1989

Vaginal Inflammation - Vaginitis

2011-06-14T22:27:00.001-07:00

Overview, Causes, & Risk Factors

Vaginitis is an inflammation of a woman's vagina. It can be caused by bacteria, fungus, viruses, parasites, hormonal changes, or chemicals.

What is going on in the body?

change in hormone levels

impaired health

normal aging

sexual activity

stress

What are the causes and risks of the condition?

cervicitis, or inflammation of the cervix

chemicals in deodorants, powders, or soaps

chemicals in spermicides, condoms, and diaphragms

douches

an object left in the vagina, such as a forgotten tampon

sex toys

sexual intercourse

sexually transmitted diseases, or STDs

Other factors that increase a woman's risk for vaginitis include the following:

breastfeeding

clothing that holds heat and moisture, such as nylon panties

diabetes

hormone replacement therapy

immunodeficiency disorders, which weaken her response to infection

menopause

oral contraceptives

poor hygiene

pregnancy

stress

Symptoms & Signs

What are the signs and symptoms of the condition?

Many women have vaginitis without symptoms. Often, though, a woman will notice some of these symptoms:

abnormal vaginal bleeding

discomfort or burning during urination

dryness or discomfort during sexual intercourse

a foul or fishy vaginal odor, especially after intercourse

irritation and itching inside and outside the vagina

swelling or redness of the genital area

vaginal discharge that may be lumpy, frothy, or discolored

Diagnosis & Tests

How is the condition diagnosed?

The diagnosis of vaginitis begins with a medical history and physical exam. The healthcare provider will do a pelvic exam. The provider may also take the following steps.

Check the acidity of the vaginal discharge.

Order tests to rule out STDs or other diseases.

Perform a Pap smear.

Take a sample of discharge from the vagina.

Prevention & Expectations

What can be done to prevent the condition?

Vaginitis cannot always be prevented. Following these recommendations can lower a woman's risk for vaginitis.

Avoid douches and other chemicals in the vaginal area.

Consider hormone replacement therapy after menopause.

Control blood glucose, if she has diabetes.

Practice safer sex.

Wear loose-fitting, absorbent underwear.

Wipe front to back after using the toilet.

What are the long-term effects of the condition?

If an infection is treated, long-term problems usually do not arise. Sometimes the cause of vaginitis cannot be cured. Severe STDs may cause chronic pain and infertility.

What are the risks to others?

If the vaginitis is caused by an STD, a woman can transmit the infection to a sexual partner.

Treatment & Monitoring

What are the treatments for the condition?

Treatment options depend upon the cause of vaginitis. Therapy may include the following:

antibiotic medicines, such as ceftriaxone or clindamycin

antibiotic vaginal tablets or creams, such as metronidazole or triple sulfa

antifungal medicines, such as fluconazole

antifungal vaginal creams or tablets, such as miconazole or clotrimazole

hormone replacement therapy

sitz baths, which involve sitting in a few inches of warm water

soothing vaginal creams or ointments

What are the side effects of the treatments?

Antibiotics and antifungal medicines may cause rash, stomach upset, or allergic reactions.

What happens after treatment for the condition?

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

Attribution

Author:Eva Martin, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:04/19/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:09/11/01

Vaginal Infection - Vaginitis

2011-06-14T22:26:00.003-07:00

Overview, Causes, & Risk Factors

Vaginitis is an inflammation of a woman's vagina. It can be caused by bacteria, fungus, viruses, parasites, hormonal changes, or chemicals.

What is going on in the body?

change in hormone levels

impaired health

normal aging

sexual activity

stress

What are the causes and risks of the condition?

cervicitis, or inflammation of the cervix

chemicals in deodorants, powders, or soaps

chemicals in spermicides, condoms, and diaphragms

douches

an object left in the vagina, such as a forgotten tampon

sex toys

sexual intercourse

sexually transmitted diseases, or STDs

Other factors that increase a woman's risk for vaginitis include the following:

breastfeeding

clothing that holds heat and moisture, such as nylon panties

diabetes

hormone replacement therapy

immunodeficiency disorders, which weaken her response to infection

menopause

oral contraceptives

poor hygiene

pregnancy

stress

Symptoms & Signs

What are the signs and symptoms of the condition?

Many women have vaginitis without symptoms. Often, though, a woman will notice some of these symptoms:

abnormal vaginal bleeding

discomfort or burning during urination

dryness or discomfort during sexual intercourse

a foul or fishy vaginal odor, especially after intercourse

irritation and itching inside and outside the vagina

swelling or redness of the genital area

vaginal discharge that may be lumpy, frothy, or discolored

Diagnosis & Tests

How is the condition diagnosed?

The diagnosis of vaginitis begins with a medical history and physical exam. The healthcare provider will do a pelvic exam. The provider may also take the following steps.

Check the acidity of the vaginal discharge.

Order tests to rule out STDs or other diseases.

Perform a Pap smear.

Take a sample of discharge from the vagina.

Prevention & Expectations

What can be done to prevent the condition?

Vaginitis cannot always be prevented. Following these recommendations can lower a woman's risk for vaginitis.

Avoid douches and other chemicals in the vaginal area.

Consider hormone replacement therapy after menopause.

Control blood glucose, if she has diabetes.

Practice safer sex.

Wear loose-fitting, absorbent underwear.

Wipe front to back after using the toilet.

What are the long-term effects of the condition?

If an infection is treated, long-term problems usually do not arise. Sometimes the cause of vaginitis cannot be cured. Severe STDs may cause chronic pain and infertility.

What are the risks to others?

If the vaginitis is caused by an STD, a woman can transmit the infection to a sexual partner.

Treatment & Monitoring

What are the treatments for the condition?

Treatment options depend upon the cause of vaginitis. Therapy may include the following:

antibiotic medicines, such as ceftriaxone or clindamycin

antibiotic vaginal tablets or creams, such as metronidazole or triple sulfa

antifungal medicines, such as fluconazole

antifungal vaginal creams or tablets, such as miconazole or clotrimazole

hormone replacement therapy

sitz baths, which involve sitting in a few inches of warm water

soothing vaginal creams or ointments

What are the side effects of the treatments?

Antibiotics and antifungal medicines may cause rash, stomach upset, or allergic reactions.

What happens after treatment for the condition?

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

Attribution

Author:Eva Martin, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:04/19/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:09/11/01

Vaginal Hysterectomy for Uterine Prolapse

2011-06-14T22:26:00.001-07:00

Overview & Description

A vaginal hysterectomy may be done to correct a condition known as uterine prolapse. A uterine prolapse is a condition in which the uterus drops from its normal position at the top of the vagina. A vaginal hysterectomy involves the removal of the uterus and cervix through a small incision in the vagina. The ovaries and fallopian tubes may also be removed during the procedure.

Who is a candidate for the procedure?

When menopause occurs, a woman's body starts to make less estrogen. Without estrogen, the female pelvic muscles lose tone. The vaginal walls thin out and the uterus may drop from its normal position. The woman is at higher risk for the following conditions:

the feeling that something is falling out of the vagina

loss of bowel or bladder control

low backache

more frequent or painful urination

pelvic or vaginal heaviness or pressure

pulling or aching in the lower stomach

urinary tract infections

If the bladder or rectum is protruding through a tear in a muscle or tissue, it can be fixed during the surgery. The ovaries and tubes may also be removed.

How is the procedure performed?

Before surgery, several things are usually done.

The abdomen and vulvar area, which is the area between the legs, are sometimes shaved.

An anesthesiologist meets with the woman. He or she will discuss the anesthesia options and allergies to medicines.

An intravenous line, or IV, is placed in a vein, usually in the hand or arm. The IV can be used to replace fluids and give medicine or a blood transfusion.

Medicines, such as sedatives, are given.

A urinary catheter is placed in the bladder to drain urine.

In the operating room, the woman is given either local or general anesthesia. The skin around the vagina is cleaned with a soapy solution to remove any bacteria. A cut is then made in the upper part of the vagina to expose the tissue, such as blood vessels, that surrounds the uterus and cervix. These tissues must be cut and tied off before the uterus is removed. Sutures are placed in these deep structures. These will heal during the weeks following surgery and do not need to be removed. The uterus is removed from the top of the vagina, and the vagina is closed at the top.
The surgery usually takes 60 to 90 minutes. At times, the ovaries and tubes may be removed. Other organs may be repaired or removed at this time if necessary.

Preparation & Expectations

What happens right after the procedure?

The woman usually stays in the hospital for 1 to 3 days. She may be asked to sit up in bed and walk a short distance the first night after surgery. The urinary catheter is usually removed the next morning. The IV is usually removed if there is no evidence of fever or infection and the woman is drinking fluids.

Home Care and Complications

What happens later at home?

Women having this surgery are advised to follow certain tips at home.

Antibiotics and pain medicines should be taken as directed if needed.

A balanced diet with iron replacement should be followed to promote healing.

Exercise programs should be followed as directed.

Heavy lifting should be avoided for 4 to 6 weeks.

Intercourse should be avoided for 4 to 6 weeks after surgery to allow the vagina and internal structures to heal.

Stool softeners, such as docusate, should be used. Eight glasses of fluids should be taken in each day. This helps prevent constipation and straining and damage to the incision.

Walking every day is recommended.

After a hysterectomy, a woman cannot become pregnant. If the ovaries are removed along with the uterus and cervix, hormone replacement therapy with estrogen is often advised. This helps prevent symptoms and other health problems of menopause.

What are the potential complications after the procedure?

Surgery may cause bleeding, infection, or allergic reaction to anesthesia. Any new or worsening symptoms should be reported to the healthcare provider.

Attribution

Author:Eva Martin, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:06/30/01
Reviewer:Adam Brochert, MD
Date Reviewed:06/11/01