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Coping With People You Dislike

As much as most of us wish we could exist in harmony with the people we encounter throughout our lives, there will always be individuals we dislike. Some simply rub us the wrong way while others strike us as deliberately unaware. We may judge others as too mean or abrasive for us to interact with them comfortably. Yet no person should be deemed a villain because their beliefs, opinions, mannerisms, and mode of being are not compatible with your own. You need not embrace the rough traits they have chosen to embody. There may be times in which the best course of action involves distancing yourself from someone you dislike. But circumstances may require that you spend time in the company of individuals who awaken your aversion. In such cases, you can ease your discomfort by showing your foe loving compassion while examining your feelings carefully. ....CLICK & SEE

The reasons we dislike some individuals are often complex and, at first, indecipherable. Often, we are automatically averse to people who are different because they compel us to question our values, spirituality, culture, and ideologies, threatening to undermine our self-assurance. Realistically, however, those you dislike have no power to weaken your life’s foundations. In fact, your aversion to specific individuals may actually be your response to your fear that specific qualities you see in them also exist within you. Their presence may force you to face internal issues you would rather not confront. If you meet someone who inspired an intense, largely negative response in you, ask yourself why your reaction is so laden with powerful emotions. Remember that you control your feelings and, if necessary, you can minimize this individual’s impact on your well-being by choosing how you will respond to them.

Though you may not have an immediate breakthrough, your willingness to consider your dislike rationally can help you better understand the root of your feelings. Your aversion to certain individuals may not wane over time, yet the comprehension you gain through reflection can help you interact with them sympathetically, benevolently, and with a greater degree of kindness. There is nothing wrong with recognizing that you are incompatible with some people. You may never achieve a shared harmony with those you dislike, but you can nonetheless learn to modulate your reactions to these individuals and, ultimately, to coexist peacefully with them.

Source:Daily Om

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Ailmemts & Remedies

Carpal Tunnel Syndrome

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Definition:
Carpal tunnel syndrome (CTS) is a median entrapment neuropathy that causes paresthesia, pain, numbness, and other symptoms in the distribution of the median nerve due to its compression at the wrist in the carpal tunnel. The mechanism is not completely understood but can be considered compression of the median nerve traveling through the carpal tunnel.  It appears to be caused by a combination of genetic and environmental factors. Some of the predisposing factors include: diabetes, obesity, pregnancy, hypothyroidism, and heavy manual work or work with vibrating tools. There is, however, little clinical data to prove that lighter, repetitive tasks can cause carpal tunnel syndrome. Other disorders such as bursitis and tendinitis have been associated with repeated motions performed in the course of normal work or other activities. Though considered a condition of modern times, carpal tunnel syndrome has actually been recognized since the 1880s…...CLICK & SEE

The carpal tunnel is an anatomical compartment located at the base of the palm. Nine flexor tendons and the median nerve pass through the carpal tunnel that is surrounded on three sides by the carpal bones that form an arch. The median nerve provides feeling or sensation to the thumb, index finger, long finger, and half of the ring finger. At the level of the wrist, the median nerve supplies the muscles at the base of the thumb that allow it to abduct, or move away from the fingers, out of the plane of the palm. The carpal tunnel is located at the middle third of the base of the palm, bounded by the bony prominence of the scaphoid tubercle and trapezium at the base of the thumb, and the hamate hook that can be palpated along the axis of the ring finger. The proximal boundary is the distal wrist skin crease, and the distal boundary is approximated by a line known as Kaplan’s cardinal line. This line uses surface landmarks, and is drawn between the apex of the skin fold between the thumb and index finger to the palpated hamate hook. The median nerve can be compressed by a decrease in the size of the canal, an increase in the size of the contents (such as the swelling of lubrication tissue around the flexor tendons), or both. Simply flexing the wrist to 90 degrees will decrease the size of the canal.

Compression of the median nerve as it runs deep to the transverse carpal ligament (TCL) causes atrophy of the thenar eminence, weakness of the flexor pollicis brevis, opponens pollicis, abductor pollicis brevis, as well as sensory loss in the digits supplied by the median nerve. The superficial sensory branch of the median nerve, which provides sensation to the base of the palm, branches proximal to the TCL and travels superficial to it. Thus, this branch spared in carpal tunnel syndrome, and there is no loss of palmar sensatio.

Symptoms
Numbness or tingling in the thumb and the first three fingers.
Shooting pains in the wrist and forearm, which may radiate into the shoulder and neck.
Weakness in the hand; difficulty picking up and holding objects.
Feeling that the fingers are swollen when no swelling is visible.

The main symptom of CTS is intermittent numbness of the thumb, index, long and radial half of the ring finger. The numbness often occurs at night, with the hypothesis that the wrists are held flexed during sleep. Recent literature suggests that sleep positioning, such as sleeping on one’s side, might be an associated factor. It can be relieved by wearing a wrist splint that prevents flexion. Long-standing CTS leads to permanent nerve damage with constant numbness, atrophy of some of the muscles of the thenar eminence, and weakness of palmar abduction (see carpometacarpal joint §?Movements).

People with CTS experience numbness, tingling, or burning sensations in the thumb and fingers, in particular the index, middle fingers, and radial half of the ring fingers, which are innervated by the median nerve. Less-specific symptoms may include pain in the wrists or hands and loss of grip strength (both of which are more characteristic of painful conditions such as arthritis).

Some suggest that median nerve symptoms can arise from compression at the level of the thoracic outlet or the area where the median nerve passes between the two heads of the pronator teres in the forearm, but this is debatable. This line of thinking is an attempt to explain pain and other symptoms not characteristic of carpal tunnel syndrome. Carpal tunnel syndrome is a common diagnosis with an objective, reliable, verifiable pathophysiology, whereas thoracic outlet syndrome and pronator syndrome are defined by a lack of verifiable pathophysiology and are usually applied in the context of nonspecific upper extremity pain.

Numbness and paresthesias in the median nerve distribution are the hallmark neuropathic symptoms (NS) of carpal tunnel entrapment syndrome. Weakness and atrophy of the thenar muscles may occur if the condition remains untreated

Pain in carpal tunnel syndrome is primarily numbness that is so intense that it wakes one from sleep. Pain in electrophysiologically verified CTS is associated with misinterpretation of nociception and depression.
Causes:
Most cases of CTS are of unknown causes, or idiopathic. Carpal tunnel syndrome can be associated with any condition that causes pressure on the median nerve at the wrist. Some common conditions that can lead to CTS include obesity, oral contraceptives, hypothyroidism, arthritis, diabetes, prediabetes (impaired glucose tolerance), and trauma. Carpal tunnel is also a feature of a form of Charcot-Marie-Tooth syndrome type 1 called hereditary neuropathy with liability to pressure palsies.

Other causes of this condition include intrinsic factors that exert pressure within the tunnel, and extrinsic factors (pressure exerted from outside the tunnel), which include benign tumors such as lipomas, ganglion, and vascular malformation. Carpal tunnel syndrome often is a symptom of transthyretin amyloidosis-associated polyneuropathy and prior carpal tunnel syndrome surgery is very common in individuals who later present with transthyretin amyloid-associated cardiomyopathy, suggesting that transthyretin amyloid deposition may cause carpal tunnel syndrome.

The median nerve can usually move up to 9.6 mm to allow the wrist to flex, and to a lesser extent during extension. Long-term compression of the median nerve can inhibit nerve gliding, which may lead to injury and scarring. When scarring occurs, the nerve will adhere to the tissue around it and become locked into a fixed position, so that less movement is apparent.

Normal pressure of the carpal tunnel has been defined as a range of 2–10 mm, and wrist flexion increases this pressure 8-fold, while extension increases it 10-fold. Repetitive flexion and extension in the wrist significantly increase the fluid pressure in the tunnel through thickening of the synovial tissue that lines the tendons within the carpal tunnel.

Work related:...click & see
The international debate regarding the relationship between CTS and repetitive motion in work is ongoing. The Occupational Safety and Health Administration (OSHA) has adopted rules and regulations regarding cumulative trauma disorders. Occupational risk factors of repetitive tasks, force, posture, and vibration have been cited. The relationship between work and CTS is controversial; in many locations, workers diagnosed with carpal tunnel syndrome are entitled to time off and compensation.

Some speculate that carpal tunnel syndrome is provoked by repetitive movement and manipulating activities and that the exposure can be cumulative. It has also been stated that symptoms are commonly exacerbated by forceful and repetitive use of the hand and wrists in industrial occupations, but it is unclear as to whether this refers to pain (which may not be due to carpal tunnel syndrome) or the more typical numbness symptoms.

A review of available scientific data by the National Institute for Occupational Safety and Health (NIOSH) indicated that job tasks that involve highly repetitive manual acts or specific wrist postures were associated with incidents of CTS, but causation was not established, and the distinction from work-related arm pains that are not carpal tunnel syndrome was not clear. It has been proposed that repetitive use of the arm can affect the biomechanics of the upper limb or cause damage to tissues. It has also been proposed that postural and spinal assessment along with ergonomic assessments should be included in the overall determination of the condition. Addressing these factors has been found to improve comfort in some studies. A 2010 survey by NIOSH showed that 2/3 of the 5 million carpal tunnel cases in the US that year were related to work. Women have more work-related carpal tunnel syndrome than men.

Speculation that CTS is work-related is based on claims such as CTS being found mostly in the working adult population, though evidence is lacking for this. For instance, in one recent representative series of a consecutive experience, most patients were older and not working. Based on the claimed increased incidence in the workplace, arm use is implicated, but the weight of evidence suggests that this is an inherent, genetic, slowly but inevitably progressive idiopathic peripheral mononeuropathy.

Other Associated conditions:
A variety of patient factors can lead to CTS, including heredity, size of the carpal tunnel, associated local and systematic diseases, and certain habits. Non-traumatic causes generally happen over a period of time, and are not triggered by one certain event. Many of these factors are manifestations of physiologic aging.
Examples include:

*Rheumatoid arthritis and other diseases that cause inflammation of the flexor tendons.
*With hypothyroidism, generalized myxedema causes deposition of mucopolysaccharides within both the perineurium of the median nerve, as well as the tendons passing through the carpal tunnel.
*During pregnancy women experience CTS due to hormonal changes (high progesterone levels) and water retention (which swells the synovium), which are common during pregnancy.
*Previous injuries including fractures of the wrist.
*Medical disorders that lead to fluid retention or are associated with inflammation such as: inflammatory arthritis, Colles’ fracture, amyloidosis, hypothyroidism, diabetes mellitus, acromegaly, and use of corticosteroids and estrogens.
*Carpal tunnel syndrome is also associated with repetitive activities of the hand and wrist, in particular with a combination of forceful and repetitive activities
*Acromegaly causes excessive growth hormones. This causes the soft tissues and bones around the carpel tunnel to grow and compress the median nerve.
*Tumors (usually benign), such as a ganglion or a lipoma, can protrude into the carpal tunnel, reducing the amount of space. This is exceedingly rare (less than 1%).
*Obesity also increases the risk of CTS: individuals classified as obese (BMI > 29) are 2.5 times more likely than slender individuals (BMI < 20) to be diagnosed with CTS.
*Double-crush syndrome is a debated hypothesis that compression or irritation of nerve branches contributing to the median nerve in the neck, or anywhere above the wrist, increases sensitivity of the nerve to compression in the wrist. There is little evidence, however, that this syndrome really exists.
*Heterozygous mutations in the gene SH3TC2, associated with Charcot-Marie-Tooth, confer susceptibility to neuropathy, including the carpal tunnel syndrome

Diagnosis:
There is no consensus reference standard for the diagnosis of carpal tunnel syndrome. A combination of described symptoms, clinical findings, and electrophysiological testing is used by a majority of hand surgeons. Numbness in the distribution of the median nerve, nocturnal symptoms, thenar muscle weakness/atrophy, positive Tinel’s sign at the carpal tunnel, and abnormal sensory testing such as two-point discrimination have been standardized as clinical diagnostic criteria by consensus panels of experts. A predominance of pain rather than numbness is unlikely to be caused by carpal tunnel syndrome no matter what the result of electrophysiological testing.

Electrodiagnostic testing (electromyography and nerve conduction velocity) can objectively verify the median nerve dysfunction. Normal nerve conduction studies, however, do not exclude the diagnosis of CTS: waiting for nerve tests to become positive may well prejudice the eventual duration and completeness of recovery, particularly of the thenar motor branch is involved.

Clinical assessment by history taking and physical examination can support a diagnosis of CTS.

Phalen’s maneuver is performed by flexing the wrist gently as far as possible, then holding this position and awaiting symptoms.  A positive test is one that results in numbness in the median nerve distribution when holding the wrist in acute flexion position within 60 seconds. The quicker the numbness starts, the more advanced the condition. Phalen’s sign is defined as pain and/or paresthesias in the median-innervated fingers with one minute of wrist flexion. Only this test has been shown to correlate with CTS severity when studied prospectively.

Tinel’s sign, a classic — though less sensitive – test is a way to detect irritated nerves. Tinel’s is performed by lightly tapping the skin over the flexor retinaculum to elicit a sensation of tingling or “pins and needles” in the nerve distribution. Tinel’s sign (pain and/or paresthesias of the median-innervated fingers with percussion over the median nerve) is less sensitive, but slightly more specific than Phalen’s sign.

Durkan test, carpal compression test, or applying firm pressure to the palm over the nerve for up to 30 seconds to elicit symptoms has also been proposed.
Hand elevation test The hand elevation test has higher sensitivity and specificity than Tinel’s test, Phalen’s test, and carpal compression test. Chi-square statistical analysis confirms the hand elevation test is not ineffective compared with Tinel’s test, Phalen’s test, and carpal compression test.

As a note, a patient with true carpal tunnel syndrome (entrapment of the median nerve within the carpal tunnel) will not have any sensory loss over the thenar eminence (bulge of muscles in the palm of hand and at the base of the thumb). This is because the palmar branch of the median nerve, which innervates that area of the palm, branches off of the median nerve and passes over the carpal tunnel. This feature of the median nerve can help separate carpal tunnel syndrome from thoracic outlet syndrome, or pronator teres syndrome.

Other conditions may also be misdiagnosed as carpal tunnel syndrome. Thus, if history and physical examination suggest CTS, patients will sometimes be tested electrodiagnostically with nerve conduction studies and electromyography. The goal of electrodiagnostic testing is to compare the speed of conduction in the median nerve with conduction in other nerves supplying the hand. When the median nerve is compressed, as in CTS, it will conduct more slowly than normal and more slowly than other nerves. There are many electrodiagnostic tests used to make a diagnosis of CTS, but the most sensitive, specific, and reliable test is the Combined Sensory Index (also known as Robinson index). Electrodiagnosis rests upon demonstrating impaired median nerve conduction across the carpal tunnel in context of normal conduction elsewhere. Compression results in damage to the myelin sheath and manifests as delayed latencies and slowed conduction velocities However, normal electrodiagnostic studies do not preclude the presence of carpal tunnel syndrome, as a threshold of nerve injury must be reached before study results become abnormal and cut-off values for abnormality are variable. Carpal tunnel syndrome with normal electrodiagnostic tests is very, very mild at worst.

The role of MRI or ultrasound imaging in the diagnosis of carpal tunnel syndrome is not very clear.

Differential diagnosis:
Carpal tunnel syndrome is sometimes applied as a label to anyone with pain, numbness, swelling, and/or burning in the radial side of the hands and/or wrists. When pain is the primary symptom, carpal tunnel syndrome is unlikely to be the source of the symptoms. As a whole, the medical community is not currently embracing or accepting trigger point theories due to lack of scientific evidence supporting their effectiveness.

Treatment:
Conservative treatments include use of night splints and corticosteroid injection. The only scientifically established disease modifying treatment is surgery to cut the transverse carpal ligament.
Generally accepted treatments include: physiotherapy, steroids either orally or injected locally, splinting, and surgical release of the transverse carpal ligament. There is no or insufficient evidence for ultrasound, yoga, lasers, B6, and exercise therapy.

The American Academy of Orthopedic Surgeons recommends proceeding conservatively with a course of nonsurgical therapies tried before release surgery is considered. Early surgery with carpal tunnel release is indicated where there is evidence of median nerve denervation or a person elects to proceed directly to surgical treatment. The treatment should be switched when the current treatment fails to resolve the symptoms within 2 to 7 weeks. However, these recommendations have sufficient evidence for carpal tunnel syndrome when found in association with the following conditions: diabetes mellitus, coexistent cervical radiculopathy, hypothyroidism, polyneuropathy, pregnancy, rheumatoid arthritis, and carpal tunnel syndrome in the workplace.

How Supplements Can Help
Several studies have suggested that a vitamin B6 deficiency can make you susceptible to the numbness and pain of carpal tunnel syndrome. This vitamin is important in maintaining healthy nerve tissue, relieving inflammation, and improving circulation. It also may increase the brain’s production of the nerve chemical GABA (gamma-aminobutyric acid), which helps control pain sensations. If you don’t notice any improvement after taking vitamin B6 for three weeks, switch to pyridoxal-5-phosphate (P-5-P), a form of the vitamin that the body eventually produces as it breaks down vitamin B6. Some people find this form works better for them.
Taking vitamin C supplements may leave you vulnerable to carpal tunnel-unless you also get enough vitamin B6. One study involving 441 participants found that those deficient in B6 who took vitamin C daily were more likely to develop carpal tunnel syndrome than those who were B6 deficient but did not use vitamin C supplements.

In addition to B6, bromelain, a powerful anti-inflammatory enzyme found in pineapple, is very effective in treating the inflammation and any resulting pain. The combination of bromelain and vitamin B6 works better than either supplement alone. Turmeric, a member of the ginger family, is another useful herb. When turmeric is taken with bromelain, they enhance each other’s anti-inflammatory properties and together may help relieve the pain of carpal tunnel syndrome. Though turmeric is safe to use over the long term, cut the dose in half once your symptoms subside. (This herb can be expensive.)

What Else can be done:
Take frequent breaks when performing any repetitive hand activity, such as typing, knitting, or playing an instrument. Stop at least once an hour to flex your fingers and shake your hands.
Apply ice to your wrists when pain strikes. Use a flexible ice pack — or even a bag of frozen peas — and put it on for 10 minutes every hour to ease the pain and reduce the inlammation.
Elevate your wrists with a pillow when you lie down.
Salt promotes water retention, which can contribute to swelling and may aggravate the symptoms of carpal tunnel syndrome. Try reducing the amount of salt in your diet and see if it helps.

Supplement Recommendations
Vitamin B6
Bromelain
Turmeric

Vitamin B6
Dosage: 50 mg 3 times a day until symptoms subside.
Comments: 200 mg daily over long term can cause nerve damage.

Bromelain
Dosage: 1,000 mg twice a day during acute phase. Reduce to 500 mg twice a day when symptoms subside. Take between meals.
Comments: Provides 8,000 GDU or 12,000 MCU in acute phase.

Turmeric
Dosage: 400 mg 3 times a day.
Comments: Standardized to contain 95% curcumin. Should be used with bromelain.

Prognosis:
Most people relieved of their carpal tunnel symptoms with conservative or surgical management find minimal residual or “nerve damage”. Long-term chronic carpal tunnel syndrome (typically seen in the elderly) can result in permanent “nerve damage”, i.e. irreversible numbness, muscle wasting, and weakness. Those that undergo a carpal tunnel release are nearly twice as likely as those not having surgery to develop trigger thumb in the months following the procedure.

While outcomes are generally good, certain factors can contribute to poorer results that have little to do with nerves, anatomy, or surgery type. One study showed that mental status parameters or alcohol use yields much poorer overall results of treatment.

Recurrence of carpal tunnel syndrome after successful surgery is rare. If a person has hand pain after surgery, it is most likely not caused by carpal tunnel syndrome. It may be the case that the illness of a person with hand pain after carpal tunnel release was diagnosed incorrectly, such that the carpal tunnel release has had no positive effect upon the patient’s symptoms

Resources
Your Guide to Vitamins, Minerals, and Herbs
http://en.wikipedia.org/wiki/Carpal_tunnel_syndrome

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Alcoholism

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Abstinence is the best course for those who can’t control their drinking. Although not a cure, various supplements may help heavy drinkers overcome their craving for alcohol, support them during the taxing withdrawal process, and set them on the road to recovery.

Symptoms
Constantly seeking opportunities to drink; being unable to cut intake; putting alcohol before family, friends, and work.
Needing more and more alcohol to achieve the same effect.
Reacting indignantly to criticism of drinking; adamantly denying the problem.
Experiencing withdrawal signs (tremors, seizures, and hallucinations) if drinking is stopped.

When to Call Your Doctor
If you drink before breakfast.
If binges last 48 hours or more.
If you have blackouts or falls.
If you routinely turn to alcohol to relieve stress or pain.
If your drinking is ruining your personal relationships.
Reminder: If you have a medical condition, talk to your doctor

What It Is
An intense physical and psychological dependence on alcohol is the hallmark of alcoholism — which many consider a chronic disease, like diabetes or hypertension. Though alcohol appears to protect the heart when taken in moderation, excessive drinking over time can damage the liver, pancreas, intestine, brain, and other organs. It can also cause malnutrition when empty alcohol calories replace a nourishing diet.

What Causes It
Drinking has a social component: It makes most people feel talkative and relaxed. Precisely why some people pursue alcohol to excess remains a mystery; psychosocial factors play a role, but there seems to be a strong genetic component as well. Indeed, children of alcoholics are at high risk for the disease, even when raised in nondrinking households.

How Supplements Can Help
The recommended supplements, all of which can be taken together, can play several important roles in weaning problem drinkers from alcohol and helping them through the initial recovery period, which may last for weeks or even months. In addition to supplements, prescription drugs are usually needed to help weather withdrawal symptoms.
Most heavy drinkers are deficient in important nutrients, including B vitamins, vitamin C, and amino acids (protein), because they do not consume a healthy diet and because alcohol has toxic effects; it may be beneficial to continue therapy for several months, or longer, to help restore depleted nutrients. Vitamin C can help to strengthen the body during this difficult period, clearing alcohol from the tissues and reducing mild withdrawal symptoms; it is most useful when taken with vitamin E. The B-complex vitamins, the amino acid glutamine, and extracts from the kudzu vine appear to reduce the craving. Researchers at the University of North Carolina noted that in monkeys (considered good stand-ins for humans), kudzu cut alcohol intake by about 25%. Harvard scientists found that in a strain of golden Syrian hamsters that preferred alcohol to water (and could drink the equivalent of a case of wine a day), kudzu cut consumption in half.

Be sure to take extra thiamin to help ease withdrawal symptoms.

The herb milk thistle, the amino acid NAC (N-acetylcysteine), and phosphatidylcholine (500 mg three times a day) strengthen the liver, helping it rid the body of toxins. Studies confirm the protective effects of the herb milk thistle. When people with cirrhosis (liver scarring), a dangerous late-stage complication of alcoholism, took milk thistle, 58% were alive after four years, compared with only 39% who did not use the herb.

The mineral chromium should be taken to prevent fatigue caused by low blood sugar (hypoglycemia), a common problem in alcoholics. Evening primrose oil provides the fatty acid GLA (gamma-linolenic acid); this substance stimulates production of a brain chemical called prostaglandin E, which works to prevent withdrawal symptoms such as seizures and depression. It also assists in protecting the liver and nervous system. The herb kava and the amino acid GABA (gamma-aminobutyric acid) are both natural sedatives that can aid sleep.

What Else You Can Do
Join a support group, such as Alcoholics Anonymous (AA).
Try acupuncture. It may reduce the craving for alcohol.


Supplement Recommendations
Vitamin C/Vitamin E
Vitamin B Complex
Amino Acids
Kudzu
Milk Thistle
Chromium
Evening Primrose Oil
Kava

Vitamin C/Vitamin E
Dosage: 1,000 mg vitamin C 3 times a day; 400 IU vitamin E daily.
Comments: Vitamin C helps boost the effects of vitamin E.

Vitamin B Complex
Dosage: 1 pill, plus extra 100 mg thiamin, each morning with food.
Comments: Look for a B-50 complex with 50 mcg vitamin B12 and biotin; 400 mcg folic acid; and 50 mg all other B vitamins.

Amino Acids
Dosage: Mixed amino acid complex (see label for dosage amount), plus L-glutamine (500 mg twice a day), NAC (500 mg twice a day), and GABA (750 mg twice a day).
Comments: For best absorption, take on an empty stomach.

Kudzu
Dosage: 150 mg 3 times a day.
Comments: Standardized to contain at least 0.95% daidzen.

Milk Thistle
Dosage: 250 mg 3 times a day between meals.
Comments: Standardized to contain at least 70% silymarin.

Chromium
Dosage: 200 mcg twice a day.
Comments: Take with food or a full glass of water.

Evening Primrose Oil
Dosage: 1,000 mg 3 times a day.
Comments: Can substitute 1,000 mg borage oil once a day.

Kava
Dosage: 250 mg 3 times a day.
Comments: Standardized to contain at least 30% kavalactones.

Source:Your Guide to Vitamins, Minerals, and Herbs (Reader’s Digest)

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Migraine

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What are Migraines?
Migraine is a biologically based disorder. Its symptoms are the result of changes in the brain, not a weakness in character or an inappropriate reaction to stress. For many years, scientists believed migraines were linked to the dilation and constriction of blood vessels in the head. They now believe migraine is caused by inherited abnormalities in certain cells in the brain. People with migraine have an enduring predisposition to attacks triggered by a range of factors. Specific, abnormal genes have been identified for some forms of migraine.

………………………....CLICK & SEE THE  PICTURES

Symptoms:

People who get migraine headaches appear to have special sensitivities to various triggers, such as bright lights, odors, stress, weather changes or certain foods and beverages.If you get a migraine, you may experience an aura 10 to 30 minutes before the attack. An aura may cause the sensation of seeing flashing lights or zigzag lines, or you may temporarily lose vision. Other classic symptoms include speech difficulty, weakness of an arm or leg, tingling of the face or hands and confusion. About 20 percent of migraine victims experience an aura prior to an attack. Even if you don’t have an aura, you may experience a variety of vague symptoms beforehand, including mental fuzziness, mood changes, fatigue and unusual retention of fluids.

The pain of a migraine is described as intense, throbbing or pounding and is felt in the forehead, temple, ear, and jaw, around the eye or over the entire head. It may include nausea and vomiting, and can last a few hours, a day, or even up to three or four days.

Migraines can strike as often as several times a week, or as rarely as once every few years. Some women experience migraines at predictable times–near the time that menstruation begins or every Saturday morning after a stressful workweek.

In addition migraine can take several other forms:

Hemiplegic migraine: Patients with hemiplegic migraine have temporary paralysis on one side of the body, a condition known as hemiplegia. Some people may experience vision problems and vertigo-a feeling that the world is spinning. These symptoms begin 10 to 90 minutes before the onset of headache pain.

Ophthalmoplegic migraine: In ophthalmoplegic migraine, the pain is around the eye and is associated with a droopy eyelid, double vision and other sight problems.

Basilar artery migraine: Basilar artery migraine involves a disturbance of a major brain artery. Preheadache symptoms include vertigo, double vision and poor muscular coordination. This type of migraine occurs primarily in adolescent and young adult women and is often associated with the menstrual cycle.

Status migrainosus: This is a rare and severe type of migraine that can last 72 hours or longer. The pain and nausea are so intense sufferers often must be hospitalized. The use of certain drugs can trigger status migrainosus. Neurologists report that many of their status migrainosus patients were depressed and anxious before they experienced headache attacks.

Headache-free migraine: This type is characterized by such migraine symptoms as visual problems, nausea, vomiting, constipation or diarrhea. Patients, however, do not experience head pain. Headache specialists have suggested that unexplained pain in a particular part of the body, fever and dizziness could also be possible types of headache-free migraine.

Causes:
Because migraine headaches are believed to have a genetic component, it might help your doctor in making a diagnosis to review your family history even if you are not aware that a relative suffered from migraines, consider information you may know about, such as past illnesses and lifestyles. Keep in mind that the term “migraine” was not used much until the 1950s, and even then many migraines were not diagnosed or referred to as “migraines.”
Triggers:
Migraines may be induced by triggers, with some reporting it as an influence in a minority of cases and others the majority. Many things have been labeled as triggers, however the strength and significance of these relationships are uncertain. A trigger may be encountered up to 24 hours prior to the onset of symptoms.

Physiological aspects:
Common triggers quoted are stress, hunger, and fatigue (these equally contribute to tension headaches). Migraines are more likely to occur around menstruation. Other hormonal influences, such as menarche, oral contraceptive use, pregnancy, perimenopause, and menopause, also play a role. These hormonal influences seem to play a greater role in migraine without aura. Migraines typically do not occur during the second and third trimesters or following menopause.

Dietary aspects:
Reviews of dietary triggers have found that evidence mostly relies on self-reports and is not rigorous enough to prove or disprove any particular triggers. Regarding specific agents there does not appear to be evidence for an effect of tyramine on migraine, and while monosodium glutamate (MSG) is frequently reported as a dietary trigger, evidence does not consistently support this.

Environmental aspects:
A review on potential triggers in the indoor and outdoor environment concluded the overall evidence was of poor quality, but nevertheless suggested people with migraines take some preventive measures related to indoor air quality and lighting.

Pathophysiology:
Migraines are believed to be a neurovascular disorder with evidence supporting its mechanisms starting within the brain and then spreading to the blood vessels. Some researchers feel neuronal mechanisms play a greater role, while others feel blood vessels play the key role. Others feel both are likely important. High levels of the neurotransmitter serotonin, also known as 5-hydroxytryptamine, are believed to be involved.

Aura:
Cortical spreading depression, or spreading depression according to Leão, is bursts of neuronal activity followed by a period of inactivity, which is seen in those with migraines with an aura. There are a number of explanations for its occurrence including activation of NMDA receptors leading to calcium entering the cell. After the burst of activity the blood flow to the cerebral cortex in the area affected is decreased for two to six hours. It is believed that when depolarization travels down the underside of the brain, nerves that sense pain in the head and neck are triggered.
CLICK & SEE
Pain:
The exact mechanism of the head pain which occurs during a migraine is unknown. Some evidence supports a primary role for central nervous system structures (such as the brainstem and diencephalon) while other data support the role of peripheral activation (such as via the sensory nerves that surround blood vessels of the head and neck). The potential candidate vessels include dural arteries, pial arteries and extracranial arteries such as those of the scalp. The role of vasodilatation of the extracranial arteries, in particular, is believed to be significant
Diagnosis:
The diagnosis of a migraine is based on signs and symptoms.[5] Neuroimaging tests are not necessary to diagnose migraine, but may be used to find other causes of headaches in those whose examination and history do not confirm a migraine diagnosis.[57] It is believed that a substantial number of people with the condition remain undiagnosed.[5]

The diagnosis of migraine without aura, according to the International Headache Society, can be made according to the following criteria, the “5, 4, 3, 2, 1 criteria”:

*Five or more attacks—for migraine with aura, two attacks are sufficient for diagnosis.
*Four hours to three days in duration
*Two or more of the following:
*Unilateral (affecting half the head);
*Pulsating;
“Moderate or severe pain intensity”;
“Aggravation by or causing avoidance of routine physical activity”

*One or more of the following:
*Nausea and/or vomiting;
*Sensitivity to both light (photophobia) and sound (phonophobia)

If someone experiences two of the following: photophobia, nausea, or inability to work or study for a day, the diagnosis is more likely. In those with four out of five of the following: pulsating headache, duration of 4–72 hours, pain on one side of the head, nausea, or symptoms that interfere with the person’s life, the probability that this is a migraine is 92%. In those with fewer than three of these symptoms the probability is 17%

When checking family history these questions  are to be asked:

  • When growing up, do you recall a family member who was sick much of the time?
  • If so, did he/she exhibit any of the following symptoms: head pain that interfered with daily activities, nausea or vomiting, sensitivity to light or sound, numbness or speech difficulty?
  • To what did he or she attribute symptoms of their headache: menstrual cycle, over-work, fatigue, stress or something eaten or drunk?
  • Be prepared to discuss with your health care professional both the symptoms of relatives’ headaches and their methods for coping.Diagnosing a headache relies on ruling out other problems, such as tumors or strokes. Experts agree that a detailed question-and-answer session with a patient can often produce enough information for a diagnosis. Some women have headaches that fall into an easily recognizable pattern, while others require further testing to determine if symptoms are due to secondary causes such as dental pain, hemorrhage or tumor.You may be asked:
  • How often do you have headaches?
  • Where is the pain?
  • How long do the headaches last?
  • When did you first develop headaches?

Your sleep habits and family and work situations may also be discussed.

Take a migraine Test
Classification:
Main article: ICHD classification and diagnosis of migraine
Migraines were first comprehensively classified in 1988. The International Headache Society most recently updated their classification of headaches in 2004.[3] According to this classification migraines are primary headaches along with tension-type headaches and cluster headaches, among others.

Migraines are divided into seven subclasses (some of which include further subdivisions):

*Migraine without aura, or “common migraine”, involves migraine headaches that are not accompanied by an aura

*Migraine with aura, or “classic migraine”, usually involves migraine headaches accompanied by an aura. Less commonly, an aura can occur without a headache, or with a nonmigraine headache. Two other varieties are familial hemiplegic migraine and sporadic hemiplegic migraine, in which a person has migraines with aura and with accompanying motor weakness. If a close relative has had the same condition, it is called “familial”, otherwise it is called “sporadic”. Another variety is basilar-type migraine, where a headache and aura are accompanied by difficulty speaking, world spinning, ringing in ears, or a number of other brainstem-related symptoms, but not motor weakness. This type was initially believed to be due to spasms of the basilar artery, the artery that supplies the brainstem.

*Childhood periodic syndromes that are commonly precursors of migraine include cyclical vomiting (occasional intense periods of vomiting), abdominal migraine (abdominal pain, usually accompanied by nausea), and benign paroxysmal vertigo of childhood (occasional attacks of vertigo).

*Retinal migraine involves migraine headaches accompanied by visual disturbances or even temporary blindness in one eye.

*Complications of migraine describe migraine headaches and/or auras that are unusually long or unusually frequent, or associated with a seizure or brain lesion.

*Probable migraine describes conditions that have some characteristics of migraines, but where there is not enough evidence to diagnose it as a migraine with certainty (in the presence of concurrent medication overuse).

*Chronic migraine is a complication of migraines, and is a headache that fulfills diagnostic criteria for migraine headache and occurs for a greater time interval. Specifically, greater or equal to 15 days/month for longer than 3 months.

Abdominal migraine:
The diagnosis of abdominal migraines is controversial. Some evidence indicates that recurrent episodes of abdominal pain in the absence of a headache may be a type of migraine or are at least a precursor to migraines. These episodes of pain may or may not follow a migraine-like prodrome and typically last minutes to hours. They often occur in those with either a personal or family history of typical migraines. Other syndromes that are believed to be precursors include cyclical vomiting syndrome and benign paroxysmal vertigo of childhood.

Differential diagnosis:
Other conditions that can cause similar symptoms to a migraine headache include temporal arteritis, cluster headaches, acute glaucoma, meningitis and subarachnoid hemorrhage.[11] Temporal arteritis typically occurs in people over 50 years old and presents with tenderness over the temple, cluster headaches presents with one-sided nose stuffiness, tears and severe pain around the orbits, acute glaucoma is associated with vision problems, meningitis with fevers, and subaracchnoid hemorrhage with a very fast onset. Tension headaches typically occur on both sides, are not pounding, and are less disabling.[11]

Those with stable headaches which meet criteria for migraines should not receive neuroimaging to look for other intracranial disease.[57] This requires that other concerning findings such as papilledema (swelling of the optic disc) are not present. People with migraines are not at an increased risk of having another cause for severe headaches.

Treatment:

Medication:
Preventive migraine medications are considered effective if they reduce the frequency or severity of the migraine attacks by at least 50%. Guidelines are fairly consistent in rating topiramate, divalproex/sodium valproate, propranolol, and metoprolol as having the highest level of evidence for first-line use. Recommendations regarding effectiveness varied however for gabapentin. Timolol is also effective for migraine prevention and in reducing migraine attack frequency and severity, while frovatriptan is effective for prevention of menstrual migraine.

Amitriptyline and venlafaxine are probably also effective. Angiotensin inhibition by either an angiotensin-converting enzyme inhibitor or angiotensin II receptor antagonist may reduce attacks. Botox has been found to be useful in those with chronic migraines but not those with episodic ones
Alternative Therapy:
While acupuncture may be effective, “true” acupuncture is not more efficient than sham acupuncture, a practice where needles are placed randomly. Both have a possibility of being more effective than routine care, with fewer adverse effects than preventative medications. Chiropractic manipulation, physiotherapy, massage and relaxation might be as effective as propranolol or topiramate in the prevention of migraine headaches; however, the research had some problems with methodology. The evidence to support spinal manipulation is poor and insufficient to support its use. Of the alternative medicines, butterbur has the best evidence for its use.

Some Herbal Medicines for Migraine:

1. Betel leaves can be applied with beneficial results over the painful area to releave intense headache.

2. Seeds of bishop’s weed (ajwaine) are useful in the treatment of migraine. They should either be smoked or sniffed frequently to obtain relief.

3. A paste of clove and salt crysrals in the milk is a common household remedy for the headache.

4. Ginger oinment made by rubbing dry ginger with a little water on a grinding stone should be applied to the forehead.

5. Henna (mehndi) flowers cure headachs caused by the heat of the sun.Headache is relieved by a plaster made of henna flowers in vinegar and applied over the forehead.

Mysterious migraine in Ayurveda and Mygraine treatment in Homeopathy

For different kinds Home remedies of migraine visit link 1 and link2 and link3

One may try this Magic Drink to stop headache instantly:
All you need is lemon juice and salt. Not many people know of this remedy, but it can be used by anyone with a migraine. You need high-quality salt, like Himalayan salt. Himalayan salt contains about 84 healthy elements. Salt increases the levels of serotonin in the blood, which will save you from headaches.

Get fresh lemons and squeeze the juice out of the lemons and add about 2 teaspoons of salt to the juice. Stir this mixture and then add water.
When the water has been added you can drink it immediately. You must drink the whole thing in order for it to work, don’t sip on it. It may not taste too great, but it will definitely get rid of your migraine.

Devices and surgery:
Medical devices, such as biofeedback and neurostimulators, have some advantages in migraine prevention, mainly when common anti-migraine medications are contraindicated or in case of medication overuse. Biofeedback helps people be conscious of some physiological parameters so as to control them and try to relax and may be efficient for migraine treatment. Neurostimulation uses implantable neurostimulators similar to pacemakers for the treatment of intractable chronic migraines with encouraging results for severe cases. A transcutaneous electrical nerve stimulation device is approved in the United States for the prevention of migraines. Migraine surgery, which involves decompression of certain nerves around the head and neck, may be an option in certain people who do not improve with medications

Prevention:
Preventive treatments of migraines include medications, nutritional supplements, lifestyle alterations, and surgery. Prevention is recommended in those who have headaches more than two days a week, cannot tolerate the medications used to treat acute attacks, or those with severe attacks that are not easily controlled.

The goal is to reduce the frequency, painfulness, and/or duration of migraines, and to increase the effectiveness of abortive therapy.  Another reason for prevention is to avoid medication overuse headache. This is a common problem and can result in chronic daily headache

Click to see:..> Prevention of migraines

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
http://en.wikipedia.org/wiki/Migraine
http://www.prevention.com/tab/0,7199,s1-1-196-779-0-0—13,00.html

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Metamucil-a wonderful fiber supplement

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Pronounced: MET-uh-MEW-sil . Generic ingredients: Psyllium, Senna (Overnight Relief Perdiem only)Other brand names: Konsyl Powder, Konsyl for Kids Perdiem.

Constipation or any other type of bowel disorder is very hurmful for everyone. These are caused by the deficiency(lack) 0f particular neutrients and this dificiency prevents the bowel muscles from functioning the way they should function (neutrients are vitamins,minerals,enzymes etc. etc.) One should get rid of these problems just by taking some fibre supplement, and Metamucil is one of them.I myself used it and am very much satisfied with its effect.Metamucil is a bulk-producing laxative and fiber supplement manufactured by Proctar & Gamble.

What this drug is used for

Metamucil, Konsyl, and Perdiem, all of which are based on bulk-producing psyllium fiber, are used for constipation.

Metamucil and Konsyl Powder relieve chronic constipation and irritable bowel syndrome. Doctors also use them, along with other medications, to ease bowel movements in people with hemorrhoids and to treat the constipation that may accompany diverticular disease (a pouch in the wall of the bowel), occasional constipation during pregnancy, constipation during convalescence, and constipation in the very old. Metamucil is available in regular and smooth-texture powder form, as well as in wafers, in a variety of flavors. Konsyl Powder is sugar- and sugar substitute-free.

Perdiem products and Konsyl for Kids are used only for occasional constipation. Fiber Therapy Perdiem and Konsyl for Kids contain psyllium alone. Overnight Relief Perdiem also contains senna, a natural stimulant. Perdiem products come in granule form. Konsyl for Kids is a powder.

How should you take this medication?

Take these products with at least 1 full glass (8 ounces) of water or other liquid. Most produce results in 12 to 72 hours. Overnight Relief Perdiem acts in 6 to 12 hours.

* ADULTS AND CHILDREN 12 YEARS AND OVER
Metamucil
The usual dose is 2 wafers or 1 rounded tablespoonful, rounded teaspoonful, or packet (depending on the variety). Mix powder with 8 ounces of liquid. If mixture thickens, add more liquid and stir again. Wash down wafers with at least 8 ounces of liquid. Can be taken up to 3 times daily, if needed.

Konsyl
Place 1 rounded teaspoonful in a dry shaker cup or container that can be closed. Add 8 ounces of liquid and shake, don’t stir, for 3 to 5 seconds. Drink promptly. If the mixture thickens, add more liquid and shake again. Follow with an 8-ounce glass of liquid. Take this dosage 1 to 3 times daily. To avoid bloating and to help your body adjust, you may wish to start with half-teaspoonful doses for several days, then increase the dose gradually over several more days.

Konsyl for Kids
Add 2 rounded teaspoonfuls to at least 8 ounces of cool water, stir briskly for 3 to 5 seconds, and drink promptly. If the mixture thickens, add more water and stir again. Follow with more liquid. May be taken 1 to 3 times daily.

Perdiem
Take 1 to 2 rounded teaspoonfuls once or twice daily, in the evening and/or before breakfast. Put the granules in your mouth and wash them down with a full glass of cool liquid. Do not chew them.

* CHILDREN UNDER 12
Metamucil
Use half the adult dosage. For children under 6, consult your doctor.

Konsyl
Use half the adult dosage. For children under 6, consult your doctor.

Konsyl for Kids
Use 1 rounded teaspoonful 1 to 3 times a day. For children under 6, consult your doctor.

Perdiem
The usual dosage is 1 rounded teaspoonful once or twice daily. For children under 7, consult your doctor.

* STORAGE
Store at room temperature in a dry place.

Do not take this medication if…

Avoid these products if you have trouble swallowing, or have ever had an allergic reaction to psyllium. Also avoid them if you have an intestinal blockage or impacted stool. Check with your doctor before taking them if you have stomach pain, nausea, vomiting, or rectal bleeding, or have noticed a sudden change in bowel habits lasting 2 weeks or more.

Special warnings about this medication

Be sure to take each dose with at least 1 full glass of water. If you don’t use enough liquid, the product could choke you.

If you have chest pain, vomiting, or difficulty in swallowing or breathing after taking one of these products, see your doctor immediately.

If you are still constipated after 1 week or notice rectal bleeding, stop taking the medication and call your doctor.

When handling Metamucil powder, spoon it into a glass according to the directions on the label in order to keep psyllium dust from escaping into the air.

Do not take one of these products less than 2 hours before or after taking a prescription drug. If you must avoid phenylalanine, do not use the smooth-texture, sugar-free, orange-flavored variety of Metamucil.

Extracted from:http://www.pdrhealth.com/drug_info/otcdrugprofiles/drugs/fgotc146.shtml

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