Pharmacy Links
- Canadian Pharmacy
- Cheap Tramadol Without Prescription
- Compare prescription drug prices and save your money.
- Holland Online Pharmacy
Tags
Categories
- Allergies
- Anti Depressants-Sleeping Aid
- Anti-Infectives
- Anti-Psychotics
- Arthritis
- Asthma
- Cancer
- Cardio & Blood- Сholesterol
- Diabetes
- Epilepsy
- Gastrointestinal
- General Health
- HIV
- Men's Health-Erectile Dysfunction
- Pain Relief-Muscle Relaxer
- Skin Care
- Weight Loss
- women's health
Over the course of a year, I’ll see 5,000 or more patients who come to me for treatment. Of all the symptoms my patients tell me they have, malaise, or a general sense that they’re not feeling as well as they could, is one of the most common complaints I hear. Unfortunately, whenever a patient tells me she is feeling weak and unwell, it opens the door to the possibility of every single medical problem on earth. This can be frustrating and overwhelming to the physician as well as to the patient, so if she simply says she doesn’t feel quite right, I ask her to be as specific with her complaints as she can. It’s important to keep in mind that age and activity levels have a lot to do with how people define malaise. For instance, the malaise of a 20-year-old athlete who cannot run 10 miles every day because of an injury is much different from the 50-year-old executive who can’t seem to find the energy to go to work or the 65-year-old grandmother who just feels too tired to do chores around the house.
If you have been feeling weak and out of sorts lately, answering the following questions will help your physician zero in on the possible causes:
1. How long have I been feeling unwell? A week, a month, or longer?
2. Has there been a change in my appetite or thirst? In my urination or bowel habits?
3. Have I gained or lost a significant amount of weight in the last few weeks or months?
4. For women, if I am still menstruating, has my cycle or flow, or both, changed recently?
5. Have I recently had a fever, night sweats, or a physical intolerance to hot or cold temperatures?
6. Have I recently traveled abroad or to a different region of the country?
7. Do I have a symptom such as a rash, arthritic pain, or swollen glands?
8. Do I think I might have been bitten by a tick recently?
9. Have I been undergoing problems in my personal life lately?
10. Do I have a past history of a serious illness that was cured or went into remission? Have I begun to take a new form of medication recently?
11. Has my urine darkened in color recently?
12. Do I have a history of blood transfusion, sharing a hypodermic needle, drug abuse, or even one unsafe sexual encounter?
13. Do I feel a general ache in my bones?
*566\167\8*
A complete medical history and physical exam as well as a series of specific diagnostic tests will help your doctor determine the necessary treatment for your unexplained weight gain.
As with any medical treatment, the risks must be weighed against the benefits when you and your doctor decide about your specific treatment. If your doctor has prescribed steroids to treat another medical condition, you should realize that the short-term use of steroids for a week or even up to a month has not been found to cause any permanent weight or health problems. You’ll lose the extra pounds once you stop taking the steroids.
Water pills, or diuretics, can help reduce a weight gain of a few pounds that comes before menstruation and is caused by water retention—if they’re used judiciously. However, they do not help reduce the body’s stores of fat and are dangerous to use on a reduced-calorie diet since they can cause potassium depletion and dehydration.
Since most cases of weight gain are caused by eating too much and/or moving too little, what I’m going to say next is going to sound boring, but I’m going to say it anyway. If your weight gain is the direct result of too many calories and not enough exercise, you’re going to have to change your lifestyle if you want to lose weight. A sensible weight-reduction plan should include a low-fat, low-calorie diet and regular physical exercise. Your doctor is the best person to advise you about the best course of action for you.
*570\167\8*
In an elderly person, weight loss can have certain causes a doctor would never consider to be a problem in a younger person. For one, your elderly aunt may not be able to obtain nutritious food because she’s unable to make it out of the house to go shopping and there’s no one else around to do it for her. Poorly fitting dentures can make it uncomfortable for her to eat, or she may be experiencing increasing senility due to Alzheimer’s disease, cancer, or an underlying infection and has lost her appetite.
As with younger people, I consider weight loss in an elderly person to be serious if she loses more than 10% of her body weight over the course of a month or two. If this happens, I’ll order a blood test to determine if there is evidence of malnutrition. Lower serum protein levels, albumin levels, and lymphocyte counts ate all signs that the immune system is beginning to deteriorate, making an elderly person more prone to infections, bedsores, falls, and other health problems. These can depress the appetite even mote.
The treatment for your elderly relative will depend on the cause. Using Meals on Wheels, taking food supplements, and getting new dentures, as well as possibly going into a nursing home are some of the steps that might be considered by the doctor and the patient’s family.
*574\167\8*
High-risk groups. Skin protection from ultraviolet light for persons with frequent exposure to sunlight.
Discussion of aspirin therapy for men who have risk factors for myocardial infarction (e.g., high blood cholesterol, smoking, diabetes mellitus, family history of early-onset coronary artery disease) and who lack a family history of gastrointestinal or other bleeding problems or other risk factors for bleeding or cerebral hemorrhage.
Discussion of estrogen replacement therapy for perimenopausal women who have an increased risk for osteoporosis (e.g., Caucasian, low bone mineral content:, bilateral ovary removal before menopause, early menopause, slender build) and who are without known contraindications (e.g., history of undiagnosed vaginal bleeding, active liver disease, thromboembolic disorders, hormone-dependent cancer).
*578\167\8*
Diet and Exercise
Fat (especially saturated fat), cholesterol, complex carbohydrates, fiber, sodium, calcium. Caloric balance. Selection of exercise program.
Substance Use
Tobacco cessation. Alcohol and other drugs. Limiting alcohol consumption.
Driving/other dangerous activities while under the influence. Treatment for abuse.
Injury Prevention
Prevention of falls. Safety belts. Smoke detectors.
Smoking near bedding or upholstery. Hot-water heater temperature. Safety helmets.
High-risk groups. Prevention of childhood injuries for persons with children in the home or automobile.
Dental Health
Regular dental visits, tooth brushing, flossing. Other Primary Preventive Measures
Glaucoma testing by eye specialist.
High-risk groups. Discussion of estrogen replacement therapy for women who have an increased risk for osteoporosis (e.g., Caucasian, low bone mineral content, bilateral ovary removal before menopause, early menopause, slender build) and who are without known contraindications (e.g., history of undiagnosed vaginal bleeding, active liver disease, thromboembolic disorders, hormone-dependent cancer).
Discussion of aspirin therapy for men who have risk factors for myocardial infarction (e.g., high blood cholesterol, smoking, diabetes mellitus, family history of early-onset coronary artery disease) and who lack a family history of gastrointestinal or other bleeding problems or other risk factors for bleeding or cerebral hemorrhage.
Skin protection from ultraviolet light for persons with frequent exposure to sunlight.
*582\167\8*
Players: Husband and wife.
Activist: Husband, without wife’s knowledge, or both. Setting: Any bedroom.
Aim: Husband deliberately uses dirty language that wife consciously finds repugnant but unconsciously fantasizes about, thereby making conscious that which was formerly unconscious.
Game Plan: Some evening (or morning or afternoon, as the case may be) while the husband is making love to the wife, he suddenly looks at her and says,
“You slut.”
“You slut. You dirty little slut.”
“Why are you saying that?”
“Because that’s what you are—a dirty little slut.”
“I am not.”
“You are, and you know it. And don’t pretend to be shocked by this language. You know you like it. A dirty little slut like you always likes dirty talk. And dirty sex, too—right?”
*102/196/1*
The success of this game depends on getting both members out of their customary mode of relating, in which the depressed spouse negates both himself and his mate, and the nondepressed spouse continually tries either to soothe him or expresses resentment toward him. In this game, both accept and go along with the depression and the underlying feelings of hopelessness. Further, mirroring the depressed spouse’s hopelessness gives him a glimpse of how he is acting. If they can both accept the depression and allow themselves to have hopeless sex, then they can move on and actually have hopeless sex. Then, ironically, they will find that the sex becomes less hopeless. It may also lead to getting more in touch with the hopelessness and letting go of it.
*77/196/1*
Players: Passive spouse (audience), aggressive spouse (actor), and dummy.
Activist: Aggressive spouse, without the knowledge or cooperation of mate.
Setting: Living room with makeshift stage or room with real stage.
Aim: To shock passive into awareness and allow aggressive to discharge rage.
Game Plan: This game is a take-off on the play within a play from Shakespeare’s Hamlet in which he notes that “The play’s the thing, wherein I’ll catch the conscience of the king.”
The aggressive spouse announces to the passive spouse one night after dinner, “Darling, I have a little surprise. I’ve made up a little play just for you. You like theater, don’t you, darling?”
The aggressive spouse turns the lights down and prepares to act out a scene from their sex life. On the stage is a sofa or bed on which lies a life-size “dummy” (or doll) which will be the surrogate for the passive spouse. The aggressive spouse, having stripped down, enters the scene naked, and lies beside the dummy. (Let’s generally refer to the passive-spouse “dummy” as the dummy, and to the aggressive spouse as simply the spouse.)
*52/196/1*
It is crucial for the wife to never, never give up. She must regard this as a battle—which it is! Her husband has maintained his defenses against spontaneity and intimacy for a good reason (let’s say, for example, he had a very intrusive mother), and he may fight almost to the death to protect himself against vulnerability. The wife must therefore be prepared to fight this battle until he finally gives in, never taking any of his refusals or insults personally, never insulting him back or in any way losing her temper, but always sticking firmly and seductively to the game plan.
Once he gives in to the seduction, the rest of the game is easy. Having lured him out of his defensive posture (of being boring), and herself out of her own defensive posture (of being bored or frustrated), there will most likely be a newfound passion for one another, as well as a newfound interest in sex.
*27/196/1*
“Doc, I don’t understand women today,” he said. “Why not?” “They’re weird.” “What happened?”
“I was at my summer share this weekend and I went out with one of the women in my house, and we had sex—sort of.”
“Sort of?”
“Right. See what you make of this. Doc.” “Go on.”
“I really don’t understand it, but maybe you can.” “I’m listening.”
He paused to find the words, sighing and sitting back in his chair. He was a successful young man in his early thirties who had lived in Manhattan for several years, was buying a condo in the East Thirties, and had just broken up with another woman who had angrily accused him of having a fear of intimacy. He had rented a room in a summer house in the Hamptons, hoping to wash out the bitter taste from this last relationship with a lot of salt air, ocean, and, most important, more noncommittal sex.
*1/196/1*