Simple Teachings: Depression, The Silent Stalker

Depression is believed to be the number one cause of disability in the world. In the United States alone, more than 17% of the population will experience varying degrees of depression at some point in their lives.

Some of the symptoms for depression are:

• Persistent sad, anxious or empty mood 
• Feelings of hopelessness, helplessness, pessimism 
• Guilt, feelings of worthlessness 
• Loss of interest in previously pleasurable activities, including sports, recreation and sex 
• Constant fatigue, decreased stamina 
• Difficulty in concentrating, downward trend in memory 
• Insomnia, early-morning awakening, oversleeping 
• Loss of appetite, weight loss or overeating and weight gain 
• Suicidal thoughts, suicide attempts 
• Constant restlessness 
• Irritability, anxiety 
• persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain 

There are various kinds of depression as well:

Major Depression: it is manifested by a combination of the above symptoms. It interferes with your ability to enjoy everyday activities. Chronic major depression might require treatment to continue indefinitely.

Dysthymia: This involves long-lasting symptoms that do not disable in any way, but prevent one from functioning at an optimal level or feeling good about oneself. Many people with dysthymia also experience major depressive episodes during their lives.

Bipolar Disorder: This condition is characterized by cycling mood changes. The victim experiences highs and lows, with periods of normal mood in between.

Treatment for depression can vary. Antidepressants are most commonly used. The major types of antidepressants are SSRIs (that alter the amount of serotonin in the brain), SNRIs (that alter both serotonin and norepinephrine), TCAs (that perform the same function as SNRIs, but are stronger) and MAOIs (these are the strongest antidepressants that are legally used).

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The Big V – is Vasectomy for You?

Men who sit down with consultant urological surgeon always have a lot of questions about vasectomy. Chief among them is: ‘It’s reversible, right?’ Here, he addresses some of the myths and uncomfortable truths:

What vasectomy does and doesn’t do

Vasectomy, also known as male sterilization, is a reliable and permanent form of contraception for men who are sure that they don’t want to father any more children.

It doesn’t affect your sex drive or ability to enjoy sex. You’ll still have erections and produce the same amount of fluid when you ejaculate. The only difference is that the fluid will not contain sperm. The testes will still produce sperm, but they can't travel to the penis and are naturally reabsorbed.

Vasectomy doesn’t protect you from contracting or passing on sexually transmitted infections (STIs) or diseases (STDs), therefore you should continue to take appropriate precautions.

The golden rule: speak to your partner

If you’re in a relationship, you need to make this decision together. It goes both ways. You’d be surprised how many men speak with a consultant about vasectomy before they speak with their partner. On the other hand, there are some men who might feel pressured to have a vasectomy by their partner. You should take some time to talk it through long before stepping into a consultant’s office.

Consider it irreversible 

You cannot go into vasectomy with reversal as a fall back option. A vasectomy reversal is a complex procedure, and the success rates of the operation decrease the longer the period after the initial vasectomy.

In some cases it's possible to retrieve sperm surgically from the testicles if your circumstances change. Some men choose to freeze sperm before undergoing a vasectomy. If your future fertility is a central concern, then vasectomy is probably not for you.

I’m starting to have doubts - what are the alternatives?

There are many different types of effective contraception, but things like condoms and the contraceptive pill require constant thought and attention. Couples also have the option of female sterilisation, although this surgical procedure is not as simple to perform, has more risks than vasectomy and requires a general anaesthetic. It’s worth discussing all the options before deciding what to do next.

The awkward bits of the procedure

It’s not unnatural to feel a little vulnerable at the idea of having your testicles felt by a surgeon as they plan to make small cuts in your scrotum. This is a fear you will have to face.

For the surgeon to have unobstructed access, you may have to shave an area of your scrotum. If you prefer, you can do it yourself at home before the operation.

While you shouldn’t feel any pain under the local anaesthetic, you may feel a little exposed as the surgeon feels the testicles to find the vas deferens, tubes that carry sperm to the penis, and makes tiny cuts in both sides of the scrotum. Sometimes it’s just one central incision, or a small hole. The tubes are pulled out through the holes, cut, and sealed off. The tubes are then gently placed back into the scrotum and the cuts closed using dissolvable stitches or adhesive strips. Often there’s no need for a dressing.

After the deal is done

Recovery from the operation is often swift, with many men returning to work the next day. It’s best to avoid heavy lifting or vigorous exercise as this can place strain on the healing wounds.

There can be side-effects. If the surgeon has had trouble finding the tubes, there may be severe bruising around the scrotum. Most men will have some mild soreness after the local anaesthetic wears off.

As with any surgery, there can be complications. Complications arising from vasectomy are rare, but can include anything from bleeding inside the scrotum to infection. Very rarely, even when performed correctly, there is a minuscule risk the tubes can rejoin naturally making you fertile again (1 in 2000 men).

Getting back to sex – hold your horses!

Sex can be resumed as soon as it feels comfortable to do so, but another form of contraception must be used until the live sperm that remain in the tubes are gone. This can take a few months. Two semen tests will need to be performed to ensure that the tubes are clear of sperm. One semen sample should be taken to the hospital 12 -14 weeks after surgery and a second sample two weeks later.

When your semen has been shown to have no sperm at all, you’ll be given the all clear to stop using other methods of contraception.

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Should I worry about testicular cancer?

Testicular cancer is relatively uncommon and little understood. Mr David Hendry, Consultant Urologist at Nuffield Health Glasgow hospital, busts the myths and gives you the facts.

Testicular cancer doesn’t get a lot of press. That leaves many men uninformed, vulnerable to late diagnosis and unduly concerned about the condition. Here’s what you should know: 

It’s not that common

Testicular cancer is the 16th most common cancer in men in the UK with only around 2,200 cases diagnosed a year. That’s not a lot compared to other cancers. For example, the most common cancer in UK men, prostate cancer, was diagnosed in 42,000 cases in 2011.

But it’s the most common cancer in younger men

Unlike other cancers, testicular cancer comes earlier in life - usually affecting younger men, aged 25 – 49. So it’s a key cancer to be aware of throughout this life stage. Most cases of testicular cancer are found by accident by the men themselves.

Who’s most at risk?

If you have an immediate family member who’s been diagnosed with testicular cancer then your risk is 10 times higher than average. Men who have low fertility or have had one or both testicles fail to descend naturally into the scrotum also have heightened risk.

Don’t panic – the overwhelming majority survive

Today, more than 95% of men with testicular cancer are cured, compared to less than 70% in the early 1970s. This is mainly because of the introduction of combination chemotherapy which stops the cancer from spreading.

You’ll probably lose a testicle

For obvious reasons, many men are alarmed at this prospect, but it’s a small price to pay. If you have testicular cancer the first step is usually to remove the affected testicle (orchidectomy). This is the most effective way to ensure the cancer doesn’t spread, which could save your life. 

Removing one testicle won’t impact your sex life – you’ll still produce plenty of sperm and testosterone with the remaining testicle. A prosthetic testicle can even be inserted into the scrotum to maintain its appearance. When the cancer is more advanced, chemotherapy andradiotherapy can then be used to prevent the cancer from returning.

How to self-check

Self-checking is especially important if you’re affected by one or more risk factors. But all men can benefit from understanding what feels normal for them. 

Gently roll each testicle between your index finger and thumb to help identify any irregularities. When you are checking your testicles, you may feel a rounded tube towards the back of each testicle that may be tender. This is normal and is called the epididymis. It is part of the male reproductive system. It’s easiest to check your testicles when they’re warm and relaxed – after a shower or bath is ideal.

What to look out for 

• A hard lump on the front or side of the testicle 
• Swelling or enlargement of the testicle 
• Pain or discomfort in the testicle or scrotum 
• An unusual difference between one testicle and the other 
• A heavy or dragging feeling in the scrotum 
• Don’t hesitate to see a specialist

If you are concerned that you have a lump or pain in your testicles, don’t let embarrassment stand in the way of your health. Get it checked out as soon as possible. Many lumps are non-cancerous. If there is no problem (which is most commonly the case) then you will be reassured, and if there are cancer cells found, early detection greatly improves the success of treatment.

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Making time for your health

When was the last time you checked in on yourself? The fact is many women just don’t know the true state of their health. Even a pressing pain or niggle is easy to ignore and it can be tempting to put off more serious issues to deal with them another day.

Clinical specialist and lead physiotherapist for women’s heath, Rachel Bromley, says spending time and getting to know your body can help you get the most out of life. Here, Rachel outlines the issues she sees many women living with, and gives advice on reducing risk to your health.

Stress

Everyone experiences and deals with stress in different ways. It can affect our physical health and sleep patterns, leaving us potentially more vulnerable to developing illness. Make sure you make time for relaxation and spend time away from the things that stress you out. If you feel you’re not coping, see your GP.

Diabetes

Over half a million people in the UK have diabetes without knowing it. With a simple blood test and urine analysis, you can diagnose diabetes. This will help you manage your glucose levels through exercise, nutrition and other lifestyle changes.

Heart Disease

Knowing your blood pressure and cholesterol can establish any heart disease risk you may have. Make sure you know your numbers and have these tests annually.

Anaemia

Anaemia occurs when a person has a decrease in amount of red blood cells or haemoglobin in the blood. This lowers the ability of the blood to carry oxygen. The main symptom is tiredness which can be a problem for all of us who lead busy lives. A simple blood test will check for anaemia and the ability to fight infection, so you know you have the energy to live life to the full.

Breast Cancer

There is growing scientific evidence supporting screening for breast cancer, the most common non-skin cancer and second deadliest cancer in women. Screening on the NHS starts at 50. We believe certain women would benefit from a start at 40. Women should self-check regularly and know how to look for the signs.

Colorectal cancer

Risk of colorectal cancer increases with age, so be aware of any changes in bowel motions, any blood in the stool, weight loss and abdominal pains.

Osteoporosis

Osteoporosis is the most common bone disease in the world. It causes your bones to gradually lose density and the risk increases with age. You can help reduce risk by keeping active, having a diet rich in calcium and Vitamin D, not smoking and reducing alcohol and caffeine intake.

Urinary incontinence

Leaking urine is a very common condition affecting women of all ages. It’s estimated that 1 in 3 women experience urinary incontinence during their lives, causing leaking of urine when coughing, laughing or running, or when rushing to the toilet. Although it is a common problem it should never be classed as being ‘normal’ and there are many treatments, including physiotherapy, that can improve or cure urinary incontinence and other intimate problems such as vaginal prolapse or painful sex.

Uterine and Ovarian cancers

These account for 7% and 5% respectively of cancers affecting women aged 50-74. Uterine cancer usually presents with postmenopausal bleeding. You should report any bleeding, however small, or any unusual discharge or pelvic pain to your GP. Ovarian cancer has many symptoms but they are often dismissed as not significant – if you are suffering from constant bloating, abdominal pain, eating less or feeling full, or are feeling unusually tired don’t keep these symptoms to yourself.

Lack of Exercise

Regular exercise is an important part of a healthy lifestyle. It can help improve both physical and mental health. Ideally, aim for 30 minutes a day. Regular exercise substantially helps to reduce cardiovascular disease, colorectal cancer and breast cancer risk. It is effective in lifting mood and helping us deal with stress.

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Understanding Attention Deficit Hyperactive Disorder (ADHD)

One of the most common disorders observed in children is ADHD (Attention Deficit Hyperactivity Disorder), which can continue from adolescence through to adulthood. Some symptoms are: difficulty in staying focused, difficulty controlling behavior, difficulty in paying attention and over activity (hyperactivity).

3-5% of school aged ADHD children are diagnosed every year and Attention deficit Hyperactive Disorder is diagnosed more often in boys than in girls. Studies suggest that the brains of children with ADHD are unique from other children. This shows that even though the cause of ADHD isn’t clearly defined as yet, it sets into motion early on in the child’s life. A combination of factors like brain injury, genetics, social environment and nutrition might contribute to children with ADHD. Although lack of sleep, tic disorders, learning disabilities, and depression and behavior problems may appear with ADHD, do not confuse it solely with ADHD.

Diagnosing ADHD

Diagnosing ADHD is often hard, as factors such as the child’s maturity, personality, temperament and energy level often vary and those sometimes these normal factors may be mistaken for ADHD. ADHD symptoms usually appear early on in life, between the ages of 3-6. A single test cannot determine if you have children with adhd, instead a thorough study of the child, its behavior and the environment it takes place in must be studied. The specialist will also closely monitor the child’s behavior in different situations and may subject the child to a series of highly structured and not so structured situations, to test their behavior. The child may also be tested on intellectual ability and its behavior in social situations will be assessed, along with tests on the child’s intellectual ability.

Any Treatment?

ADHD is most commonly treated with a “stimulant”, which may seem like it has an oxymoron, but it instead it has a calming effect on ADHD children. These medicines reduce hyperactivity and impulsivity while improving the child’s ability to focus, learn and work on tasks, as well as improving physical co-ordination. It must be noted that one approach does not work for all children and patients must be monitored carefully and closely in order to be safe from side-effects. Such as decrease in appetite, sleep problems, change in personality and tic disorders.

Psychotherapy is also used to cure ADHD children. Behavioral therapy though teaching the child how to monitor his or her behavior and learning how to give oneself rewards for acting in a desired manner is another goal achieved through behavioral therapy. Social skills, such as asking for help, sharing toys, being polite are taught by the therapists.

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What should you expect when you visit the ENT?

ENT doctors, or otolaryngologists, are trained in the medical and surgical treatment of patients with diseases and disorders of the ears, nose, throat (ENT), and head and neck.

But for whatever reason you may have to see an ENT doctor, having organized a consultation, it can be quite daunting thinking about what may take place at this appointment.

So what can you expect to happen when you’re there?

Ears:

The physician will use an otoscope to examine the ears and the ear drum. There is a light source, with a small magnification as an attachment that allows the surgeon to identify pathology. This is a fairly no invasive diagnostic procedure that can be used for patients in all age groups. Sometimes, tuning forks are used to measure hearing. This along with a microscopic study of the ear and ear drum can be considered as a full examination.

Nose:

To diagnose the nose the doctor only needs a simple speculum again with a light source attached to it. This helps in understanding the anatomy and possible pathology.

In case you have undergone nasal surgery, a flexible endoscope is typically used to inspect the nose.

Throat :

A typical examination begins with an external check of the neck area, feeling for any swollen glands. Next, the oral cavity will be examined used a tongue depressor and light to illuminate the tongue and tonsillar areas of the mouth. Using a flexible nasolaryngoscope to examine the larynx and the nasal cavity, is not an uncommon practice anymore.

This nasolaryngoscope is a fiber optic cable that gets inserted through the nose. As discomforting as it sounds, it is really the best way for the surgeon to examine areas that are harder to see. The entire procedure gets over in minutes and is usally a part of a typical ENT examination.

What About It?

It is easy to understand, the trauma associated with this type of examination as it involves various non invasive and invasive techniques of diagnosis. But without these measured steps, it would never be a thorough examination and that means missing out on a problem that may need fixing. We know that is not acceptable in today’s society. So now you have an idea of what to expect at an ENT consultation. If you feel the need to get examined, go ahead. Don’t let a little bit of discomfort come in the way of your good health.

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The Wonders Of Magnetic Therapy

Magnetic therapy is a method of medicinal therapy that involves placing magnets of different sizes and strengths on the human body, with the purpose of relieving pain and treating various diseases. Although there are anecdotal reports of healing with magnetic therapy, available scientific evidence does not support these claims. The U.S. Food and Drug Administration (FDA) considers magnets harmless and of no use for medical purposes.

Magnet therapy involves using magnets to cure illnesses, by attaching thin metal magnets to the body (either alone or in groups). They are sometimes used in magnetic therapy necklaces or magnetic therapy bracelets, or are attached to sticky patches that hold them in place. There are even magnetic shoe soles, blankets and slumber pads. Magnetic jewelry is also gaining popularity as a healing method.

This use of magnets to cure diseases is a lot older than one would imagine. A physician in the 16thcentury named Paracelsus started this, because he thought that magnets would attract and eliminate various diseases from the body due to their magnetic properties. Although this is a little far-fetched, modern doctors have noticed that positive and negative magnetic charges had different effects on human biological systems.

Magnetic therapy has been tested scientifically, but sporadically. To test the claim of improved blood flow, one study compared magnets and otherwise identical nonmagnetic disks on the arms of healthy volunteers. The researchers measured blood flow and found no difference between the real and fake magnets.

Magnetic therapy is generally considered safe. However, implanted medical devices like pacemakers or pumps can be affected by magnets. This means that a thorough medical examination should be conducted before magnetic therapy is undertaken to cure an illness.

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