Post herpetic neuralgia is just a fancy name for pain that occurs after an infection with the varicella zoster virus. This is the same virus that causes chicken pox.
Most people acquire chicken pox at some point in their lives. The virus unfortunately does not disappear and has a great affinity for nervous tissue where it hides. Then years later, the virus wakes up or becomes activated and causes shingles. The virus typically travels along the nerve up to the skin and produces the typical rash and blister like reaction.
In most cases, the episode of shingles resolves after about 4 weeks. However, in some people there is continued pain long after the blisters and rash have disappeared.
This pain is called post herpetic neuralgia. The pain is intense and the treatment is never satisfactory.
The typical symptoms of post herpetic neuralgia include the following:
- Severe intense burning or deep pain
- The pain is often continuous
- The area of the skin may be exquisitely sensitive to touch,
pressure, or heat
- One may also feel an itchy sensation
- Headaches are common
- Generalized body ache and fatigue
- Depression
Thursday, March 19, 2009
Wednesday, March 18, 2009
Pneumatic pumps for lymphedema
Once lymphedema has developed, the first choice of therapy should be garment stockings. However, over the past 15 years, some excellent pump devices have been developed. These devices known as intermittent pneumatic pump compression therapy can be used at home or in the hospital. The pumps are compact, lightweight, and easy to use. The pumps include large cuffs (just like the blood pressure cuffs) which are placed on the leg or arm. The machine is switched on and it recycles between compression and deflation 5 -10 times a minute. The sequential pumps act like a physical massage, squeezing the fluid out of the tissues, and moving it back into the blood stream.
The pumps are best utilized at night and in the morning one can wear stockings. This combination is claimed to be the ideal treatment for lymphedema. There is no other treatment, which even comes close to matching the results of pneumatic compression. Pneumatic compression pumps are not painful and one can get used to the sequential compression each night. The majority of individuals who use these pump are satisfied with the results.
If one has broken skin or has heart failure then the pumps cannot be used.
The compression cuffs are made of durable plastic reinforced with polyurethane and can last a long time. The cuffs are specially designed for long-term use and are available from most medical supplies stores. The machine to inflate the cuffs are quiet, have a timer and a monitor showing the pressure.
Many medical insurance companies and Medicare do cover the cost of sequential compression therapy for lymphedema.
Supplies for lymphedema are available at www.medexsupply.com
The pumps are best utilized at night and in the morning one can wear stockings. This combination is claimed to be the ideal treatment for lymphedema. There is no other treatment, which even comes close to matching the results of pneumatic compression. Pneumatic compression pumps are not painful and one can get used to the sequential compression each night. The majority of individuals who use these pump are satisfied with the results.
If one has broken skin or has heart failure then the pumps cannot be used.
The compression cuffs are made of durable plastic reinforced with polyurethane and can last a long time. The cuffs are specially designed for long-term use and are available from most medical supplies stores. The machine to inflate the cuffs are quiet, have a timer and a monitor showing the pressure.
Many medical insurance companies and Medicare do cover the cost of sequential compression therapy for lymphedema.
Supplies for lymphedema are available at www.medexsupply.com
Shingles Vaccine Part 3
Should you get the shingles vaccine?
All consumers should know that one cannot get shingles unless one has first developed chicken pox. In North America, more than 90% of adults and children have had chicken pox and current estimates indicate that about 30% (or one in three) will get shingles in their lifetime. The vaccine decreases the risk of developing shingles by almost 50 percent.
The other factor to consider is age. The vaccine is at present approved for people over the age of 60 because the chances of developing shingles is higher with age. However, there is a downfall- as one gets older the vaccine also becomes less effective against shingles. Actually the best benefit of the shingles vaccine is that it prevent the development of the painful post-herpetic neuralgia in 70% of cases.
The other question regarding the vaccine is should everyone over 60 get it? the answer is no. If one has already got a definite case of shingles early on in life, the chances of getting another one is very unlikely. Therefore, for those who know they had shingles once, discuss with your physician about what to do next.
Cost
The pharmaceutical company, Merck is out to make money. The company charges $150 for the one shot vaccine. Moreover, if you think that is outrageous, the doctors are charging close to $300. in contrast, the standard flu vaccine only costs $ 10-$20. One would think vaccines play a vital role in preventive medicine but unfortunately the health care professional value your money more than your health.
In some cases, the cost of the shingles vaccine may not be covered by Medicare or insurance. Know as Zostavax, please check with your insurance plan or Medicare if they do cover it
All consumers should know that one cannot get shingles unless one has first developed chicken pox. In North America, more than 90% of adults and children have had chicken pox and current estimates indicate that about 30% (or one in three) will get shingles in their lifetime. The vaccine decreases the risk of developing shingles by almost 50 percent.
The other factor to consider is age. The vaccine is at present approved for people over the age of 60 because the chances of developing shingles is higher with age. However, there is a downfall- as one gets older the vaccine also becomes less effective against shingles. Actually the best benefit of the shingles vaccine is that it prevent the development of the painful post-herpetic neuralgia in 70% of cases.
The other question regarding the vaccine is should everyone over 60 get it? the answer is no. If one has already got a definite case of shingles early on in life, the chances of getting another one is very unlikely. Therefore, for those who know they had shingles once, discuss with your physician about what to do next.
Cost
The pharmaceutical company, Merck is out to make money. The company charges $150 for the one shot vaccine. Moreover, if you think that is outrageous, the doctors are charging close to $300. in contrast, the standard flu vaccine only costs $ 10-$20. One would think vaccines play a vital role in preventive medicine but unfortunately the health care professional value your money more than your health.
In some cases, the cost of the shingles vaccine may not be covered by Medicare or insurance. Know as Zostavax, please check with your insurance plan or Medicare if they do cover it
Shingles Vaccine Part 2
The Shingles vaccine is a live vaccine and is administered as a single injection in the upper arm. While the vaccine is relatively safe, most individuals do develop transient side effects like redness, swelling localized tenderness and swelling at the site of the injection. in most cases, these side effects resolve in 2-7 days.
Who should not receive the shingles vaccine?
- Anyone who is allergic to the components of the vaccine
such as neomycin or gelatin
- Individuals who have HIV or AIDS.
- Individuals who are presently being treated with
chemotherapeutic drugs
- Individuals who are on long-term corticosteroid therapy
- Individuals who are receiving intravenous immunosuppressant
drug therapy to treat rheumatoid arthritis, Crohn disease,
or psoriasis
- Those who have an active cancer like Hodgkin’s or leukemia
- Individuals who are presently being treated for active
Tuberculosis
- Females who are pregnant
Who should not receive the shingles vaccine?
- Anyone who is allergic to the components of the vaccine
such as neomycin or gelatin
- Individuals who have HIV or AIDS.
- Individuals who are presently being treated with
chemotherapeutic drugs
- Individuals who are on long-term corticosteroid therapy
- Individuals who are receiving intravenous immunosuppressant
drug therapy to treat rheumatoid arthritis, Crohn disease,
or psoriasis
- Those who have an active cancer like Hodgkin’s or leukemia
- Individuals who are presently being treated for active
Tuberculosis
- Females who are pregnant
Shingles Vaccine
The shingles vaccine has been available for some time but is not recommended for all individuals. The current recommendations by the Centers for Disease Control suggest that the shingles vaccine is best for individuals over the age of 60, irrespective whether or not they have acquired shingles in the past.
At the moment, shingles vaccine is not recommended for adults under the age of 60. Other individuals who should not receive the shingles vaccine include those who have HIV, are on long-term corticosteroid therapy, are on chemotherapeutic drugs, or have low immunity.
The shingles vaccine is not 100% effective and there is no guarantee that one will not acquire shingles after being vaccinated. However, there is a benefit from the vaccine even if you acquire shingles.
Individuals who do get vaccinated generally develop a very mild version of the infection. In addition, the duration and intensity of symptoms are also reduced. Another benefit of the shingles vaccine is that one has a very low chance of developing the dreaded and painful post herpetic neuralgia syndrome.
The current efficacy of the shingles vaccine stands around 50%, but it also reduces the risk of developing post herpetic neuralgia by 70%
At the moment, shingles vaccine is not recommended for adults under the age of 60. Other individuals who should not receive the shingles vaccine include those who have HIV, are on long-term corticosteroid therapy, are on chemotherapeutic drugs, or have low immunity.
The shingles vaccine is not 100% effective and there is no guarantee that one will not acquire shingles after being vaccinated. However, there is a benefit from the vaccine even if you acquire shingles.
Individuals who do get vaccinated generally develop a very mild version of the infection. In addition, the duration and intensity of symptoms are also reduced. Another benefit of the shingles vaccine is that one has a very low chance of developing the dreaded and painful post herpetic neuralgia syndrome.
The current efficacy of the shingles vaccine stands around 50%, but it also reduces the risk of developing post herpetic neuralgia by 70%
Thursday, March 12, 2009
Bed Wetting and Treatment with Oxybutynin (Ditropan) Part 2
One of the anti cholinergic drugs widely used to treat bed wetting is called oxybutynin (Ditropan). It is available as a pill and a syrup. The drug has to be taken 2-3 times a day for 4-6 weeks. Only in a few cases, does bed-wetting completely stop with Oxybutynin. Data indicate that less than 1/4th of patients with bed wetting respond. When higher doses of the drug are used, side effects become a problem.
The experts claim that oxybutynin works by reducing bladder contractions and decreasing irritability of bladder muscles. This leads to a delay in the urge to urinate.
Oxybutynin has been used to treat both children and adults who have daytime bed wetting problems from an overactive bladder. By relaxing, the bladder muscles oxybutynin has been used to control both night and day time bed-wetting.
The most common side effects of Ditropan include:
- Dry mouth
- Hot dry skin
- Stomach upset
- Runny nose
- Facial flushing
- Blurry vision
- Sensation of dry eyes
- Constipation
- Mood changes
So does this drug work? For the consumer, it is important to understand that anticholinergic drugs are not the first choice of medications for bed-wetting. Because of their side effects, they are generally the last choice.
The majority of reports indicate that the side effects of Ditropan are worse than the bed wetting it self. Its success rate is less than 20%. For the individual who has bed-wetting, this is definitely not the drug to use.
The experts claim that oxybutynin works by reducing bladder contractions and decreasing irritability of bladder muscles. This leads to a delay in the urge to urinate.
Oxybutynin has been used to treat both children and adults who have daytime bed wetting problems from an overactive bladder. By relaxing, the bladder muscles oxybutynin has been used to control both night and day time bed-wetting.
The most common side effects of Ditropan include:
- Dry mouth
- Hot dry skin
- Stomach upset
- Runny nose
- Facial flushing
- Blurry vision
- Sensation of dry eyes
- Constipation
- Mood changes
So does this drug work? For the consumer, it is important to understand that anticholinergic drugs are not the first choice of medications for bed-wetting. Because of their side effects, they are generally the last choice.
The majority of reports indicate that the side effects of Ditropan are worse than the bed wetting it self. Its success rate is less than 20%. For the individual who has bed-wetting, this is definitely not the drug to use.
Bed Wetting and Treatment with Oxybutynin (Ditropan) Part 1
Besides vasopressin and the tricyclic antidepressant (imipramine), other medications are also used to treat nocturnal enuresis. This includes the anticholinergic drugs. Over the past 40 years, many different anti cholinergic medications have been developed and some have found use in treatment of bed wetting.
In some individuals who wet the bed it has been observed that the bladder muscle is hyperactive. Any minor stimuli causes it to contract which then results in bed-wetting. The anti cholinergic medications act by relaxing the bladder muscles.
There are also some individuals who have a very small bladder and are not able to retain urine. Some features of a hyperactive and small bladder include:
- Sudden need to urinate
- Urinate more often than normal
- Persistent dribbling of urine or having wet pants or underclothes
- Leakage of urine when the urge to urinate comes on (unable to control urine flow)
- Pain on urination
By decreasing the incidence of muscle spasms in the bladder, the bed wetting episodes decrease- at least that is how it is in theory.
In some individuals who wet the bed it has been observed that the bladder muscle is hyperactive. Any minor stimuli causes it to contract which then results in bed-wetting. The anti cholinergic medications act by relaxing the bladder muscles.
There are also some individuals who have a very small bladder and are not able to retain urine. Some features of a hyperactive and small bladder include:
- Sudden need to urinate
- Urinate more often than normal
- Persistent dribbling of urine or having wet pants or underclothes
- Leakage of urine when the urge to urinate comes on (unable to control urine flow)
- Pain on urination
By decreasing the incidence of muscle spasms in the bladder, the bed wetting episodes decrease- at least that is how it is in theory.
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