Being affected with bipolar disorder can not only strain any relationship but also disrupt different aspects of family life. The mood swings stemming from bipolar disorder tend to occur spontaneously without any particular reason. The effects too can be detrimental. Below are some of the best ways one can cope with the impact of a bipolar disorder:

Looking for patterns and signs: You should keep a watch for signs that indicate that you may be entering an episode of mania or depression. Along with a shift in the mood, one should look out for any changes in sleep patterns. It is also essential to keep a track of alcohol or drug usage, energy levels, level of concentration and self-confidence. Since stress is considered a major trigger of bipolar disorder, you should try to simplify life by staying away from any triggers of stress. You may also ask your family and friends to share responsibilities in case your job is too stressful.
Keeping an organized and regular schedule: Sticking to a regular and organized routine can help in controlling mood swings and symptoms of bipolar disorder. People with bipolar disorders generally don t deal well with a lot of changes. Regardless of whether one does errands or work irregularly, it is important to sleep and wake up at a particular time. Also, practising healthy sleeping habits and relax before bed by listening to music, reading books and taking a warm bath is recommended. Make sure that you don t watch thrilling television shows, surf the internet, or play video games since these habits can worsen the mood swings.
Getting regular exercise: Studies show that regular physical exercise can go a long way in improving your mood. You can start by taking a slow walk around your neighbourhood and can gradually increase the intensity of your workouts.
Avoiding alcohol and other drugs: Not just alcohol, caffeine is also a strong stimulant which can make you stay wide awake at night and trigger manic episodes. It is also advised to cut back on soda and other sugary drinks, particularly at night. Alcohol, as well as other drugs, can also affect the impact of the medication which, in turn, can trigger mood swings.
Writing down your feelings: Keeping a journal of the day to day life, stressors and other problems that you may have encountered through the day can be of help. With the passage of time, you will be able to identify the patterns that emerge as triggers which in turn can help you prepare yourself and manage the mood swings better.
These small lifestyle changes and coping strategies can aid in dealing with bipolar disorder effectually. Visiting a specialist can help you get an insight into the exact condition and assist in the management of the triggers.

5 Tips On How To Cope With Bipolar Disorder!

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

HIV/AIDS is a type of sexually transmitted disease which is caused by the Human Immunodeficiency Virus (HIV). The HIV virus attacks the immune system and makes the body vulnerable to other diseases. AIDS is the last stage of the HIV infection; HIV takes about 10 to 12 years to fully culminate into AIDS. AIDS completely destroys the immune system and leads to fatal health conditions and diseases such as cancers and other infections because of AIDS.

Causes-

HIV is a retrovirus that infects the vital organs of the human immune system. The virus progresses in the absence of antiretroviral therapy. The rate of virus progression varies widely between individuals and depends on many factors (age of the patient, body s ability to defend against HIV, access to healthcare, existence of coexisting infections, the infected person s genetic inheritance, resistance to certain strains of HIV).

HIV can be transmitted through:

Sexual Transmission. It can happen when there is contact with infected sexual secretions. This can happen while having unprotected sex, including vaginal, oral and anal sex or sharing sex toys with someone infected with HIV.
Perinatal Transmission. The mother can pass the infection on to her child during childbirth, pregnancy, and also through breastfeeding.
Blood Transmission. The risk of transmitting HIV through blood transfusion is nowadays extremely low in developed countries, thanks to meticulous screening and precautions. Among drug users, sharing and reusing syringes contaminated with HIV-infected blood is extremely hazardous.
Contrary to popular belief, HIV can never spread by means of kissing as the virus cannot survive outside the body.

Symptoms-

The early symptoms of HIV appear within a few weeks of contamination by the virus. The early symptoms include headache, pain in the muscles and the joints, rashes and inflated lymph nodes. These symptoms tend to disappear within 2 to 3 weeks.
The next set of symptoms might appear after a few years and these are persistent. The symptoms include, but are not limited to fatigue, loss of body weight, inflated lymph nodes, fever, a sensation of numbness near the limbs, pain when you try to swallow, sores in the mouth and sweating at night.
If you are diagnosed with HIV, you should:

Try to maintain a daily diet containing vegetables, legumes, and fruits which provide you energy.
Try to include a little bit of fat, carbohydrates (at least 3 servings of vegetable per day), calcium (dairy products) and low-fat protein sources (generally 80-150 gram per day of fish, skinned chicken, low-fat cheese etc.) in your everyday meal.
Maintain a daily calorie intake of 17-25 calories per pound depending on whether the person is losing weight.
Vitamins and minerals are particularly necessary to repair the cells damaged by the HIV virus.
So, it is necessary to intake foods such as eggs, milk, peanuts, green vegetables, meat, beans and broccolis on a regular basis, if you have been diagnosed with HIV.

If you are suffering from HIV, you must maintain the following food safety measures:

You should try to restrict the intake of fat
Restrict your alcohol intake
You should try to avoid fast foods
You should also limit your regular sugar intake and should avoid foods with extra sugar

HIV/AIDS - Diet, Nutrition & Food Safety You Must Follow!

The heart is one part of your body that pumps blood relentlessly; to be grateful to the most important organ, it s your duty to look after its health. Cardiovascular diseases and heart ailments can be prevented by making minor changes in your lifestyle.

Here are a few tips to keep your heart healthy:

Add fiber to your diet: Making fiber a part of your regular diet is a great idea as the heart works best when it runs on natural fuel. You can achieve this by adding more raw fruits and vegetables in your meals as they are an excellent source of fiber and nutrients.
Engage in physical activity: Your heart is a muscle and to make it healthier, you need some form of physical exercise. Engaging in cardiovascular forms of exercise for an hour daily keeps your heart in good condition. Engaging in physical activity also reduces the risk of getting a heart disease and acts as a stress buster.
Cut down on the salt intake: The sodium content in salt disrupts the balance of fluids in your body leading to high blood pressure. This can affect the functioning of the heart; that is to pump blood, which is a major cause of a heart attack. So, cutting down on salt can reduce stress and the risks of heart attacks.
Manage your weight: People on the overweight side run a risk of getting heart diseases more often than fit and leaner ones as they tend to be more inactive and sluggish. The heart diseases caused due to obesity can be avoided by making minor changes to your diet and exercising on a daily basis.
Quit smoking: If you are a regular smoker, quitting is the best thing you can do for your heart. The main reason for coronary heart diseases is nicotine present in the cigarette. Once, you quit smoking completely, you will be 50% less likely to run the risks of a heart attack as compared to a regular smoker.

5 Tips to Keep Your Heart Fit!

Treatment of frozen shoulder varies depending on the stage it is at, and how severe is the pain and stiffness. There is no outright cure and the aim of treatment is to keep the joint as mobile as possible. The most effective treatment is that which maintains a good range of movement until the shoulder starts to heal. 

Treatment may Include the following:

1. Shoulder exercises: Regular, gentle exercise can help to keep the shoulder joint mobile. If your shoulder is very stiff, exercise may hurt, and it should only be carried out with the guidance of your doctor or physiotherapist. If you are able to, continue using your shoulder as normal saving' the shoulder can cause the muscle to waste and may make stiffness worse.
2. Painkillers: Over-the-counter painkillers such as paracetamol or prescription-only drugs such as codeine may be taken to ease pain and you should discuss this with your general physician or pharmacist.
3. Anti-inflammatory painkillers: Such as ibuprofen and diclofenac, are often prescribed to ease pain and inflammation. Any medication that you take should be discussed with your general physician or pharmacist.
4. Steroid injections into or near the shoulder joint may be effective at relieving pain and inflammation for a few weeks. However, injections are not a cure, and symptoms may return.


Treatment of frozen shoulder

Stuttering is a type of speech disorder wherein, a person speaks slower than normal. It is quite  common in the age group of 3 to 8. The relationship between stress and stuttering has been pondered over for decades now. A lot of people seem to believe that stress and stuttering are co-related. On the contrary, recent studies show that stress is more of a consequence rather than a cause of stuttering. If you take the first theory into consideration, then according to that, children would be the greatest victims of anxiety and stress. But it is seen that the level of stress increases proportionately with the increase in age.

Social anxiety in teenagers increases due to stuttering, when they come across individuals who can speak in a normal pace. This in turn can crush their self confidence and lead them to isolate themselves from social groups and people in general. Hence, it is important to deal with stuttering in the early ages or as and when it occurs. 

Sometimes stuttering can develop due to physical or mental trauma.  Most people with stuttering do not seek therapy for it because they might not think of it to be too severe. Little do they realise that a simple process of speech therapy can help them overcome this disability and rejuvenate their level of self-confidence.

It has also come to light, that people with relapse in stuttering post therapy has shown a three-fold increase in anxiety levels than normal. Hence we cannot ignore the strong relationship between stress and stuttering. So from the above evidence, it is safe to conclude that social anxiety or stress develops as a result of chronic stuttering.

How to deal with stress related to stuttering?

Seeking help is a great start to tackle your disability. If your stuttering is prominent enough to warrant therapy, you must seek professional help for the same. You must also learn to control your anxiety by dismissing any anxious thought or make sincere efforts in controlling physical anxiety.

You can also try to increase your social skills by participating in events, such as public speaking that can reduce your stress levels and make yourself more confident about yourself. One must also remember that a person is defined by what he does rather than what he says. So never let a minor disability come in the way of your self worth!

Stress and Stuttering - How to Deal with It?

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