A lot of things can be done to cope with the initial stages of dementia. A person goes through a wide range of emotions such as fear, denial, frustration, and anger, post the diagnosis. Here is a list of tips that will help a patient with dementia to cope better:

Physical health: For a dementia patient, it is very important to take care of one s health. A good diet along with regular exercise and adequate rest is a prerequisite to manage this disorder.
Regular check-ups: Regular medical check-ups with the doctor are necessary in this condition. Depression and other mental health problems should be discussed with a professional.
Quit alcohol: Alcohol might give momentary pleasure from the misery, but it has long-standing implications. It reacts with the medicine and creates additional health and memory-related complications.
Allocate time for difficult tasks: With time, it can become difficult to perform even the simplest of tasks. The patient should accordingly schedule the time to perform the tasks which may be difficult to carry out. Adequate breaks should be taken while performing a task to avoid getting fatigued.
Redefine work: If a patient is suffering from dementia is still working, it should be ensured that the work is more manageable from a desk. Planning an early retirement may be a good idea in order to cope with dementia.
Be organised: Keeping track of things can get difficult with time. It, therefore, makes sense to organise all belongings systematically. Putting labels on doors and drawers also help.
Continue pursuing your hobbies: Amidst the difficulty and the depression, it is a good idea to continue doing things that are fun. While such activities might require some assistance from the doctor and family members, this helps the patient to be cheerful and healthy.
Maintain notes: Since dementia is involved with forgetfulness, it makes sense to maintain a diary and keep records of phone numbers, people, appointments, etc.
Communication channel: Maintaining a direct communication channel with family, friends, and relatives is a good idea. Sharing feelings will go a long way in maintaining relations with loved ones.
Support group: Joining a dementia support group can be highly beneficial for the patient. It will not only give the patient company but also make sure that the patient gets a lot of useful information about the disorder. It also helps in keeping the morale up.
Getting ready for the future: Things need to be meticulously planned well in advance to ensure that when the disease progresses, the patient has enough people to look after him. Things such as medical arrangements, financial assets, and property details should be carefully handed over as per the patient's wish. This will ensure a smooth run of the patients  life when they can no longer take care of themselves.

Dementia - Easy Tips To Help You Cope With It!

Vertigo is a feeling that your head or your surrounding is spinning. It is an illusion of movement. People with vertigo cannot bend down to pick up stuff, as they may feel the spinning sensation.
There are two types i.e. objective and subjective. Vertigo is said to objective when the surrounding seems to be spinning; subjective is when the person feels their head is spinning. Vertigo can be slightly mysterious to diagnose. There are, however, some causes which can help you understand it better. There are two main types of vertigo: Central and Peripheral. Central vertigo is when there is an issue in the brain that is causing vertigo. Middle ear problems leading to vertigo is known as peripheral vertigo.

Central vertigo:

Paroxysmal positional vertigo (BPPV): Also known as, Benign paroxysmal positional vertigo (BPPV). These episodes are benign and occur in paroxysms or spurts. The person will feel the attack with simple actions like turning over in bed. They do not last long, often about 20 to 30 seconds.
Migraine: Known for the severe headaches, migraine can also cause vertigo.
Head trauma: This type of vertigo usually subsides with time as the person recovers from trauma.
Neck injuries: Injury to nerves and blood vessels in the neck can also lead to vertigo.
Health conditions: General health issues like arteriosclerosis, multiple sclerosis, and diabetes lead to vertigo.
Stroke or blood flow blockage: When blood does not reach the base of the brain, it can result in vertigo.
Peripheral vertigo:

Middle ear infections: Labyrinthitis (either bacterial or viral) a middle ear infection can cause vertigo. Common viruses include herpes, influenza, measles, rubella, hepatitis, and EBV.
Meniere s disease: Another ear problem causing vertigo is Meniere s disease. This is known for its 3 symptoms   vertigo, ringing in the ears (tinnitus) and hearing loss. This can be caused by various factors, some of which can include ear infections, head injuries, or heredity. The exact cause of the condition is not established clearly.
Acoustic neuroma: A tumor of the nerve tissue in the inner ear may cause vertigo. The person can also have hearing loss and ringing sensation.
Other causes of vertigo include:

Pregnancy: During the first trimester, in particular, the various hormonal changes can cause vertigo. The expanding uterus puts pressure on the blood vessels, leading to reduced blood supply to the brain, which can also induce vertigo. As the baby continues to grow, lying on the back can put pressure on the blood vessels to the heart, causing vertigo.
Stress: It is known to worsen vertigo, which a person may already have. Anxiety and panic attacks are known to worsen vertigo.
Travelers: Be it ship, air, or train, some people experience a spinning sensation with any form of travel.


Vertigo In Adults - Why It Happens?

While we all know substance abuse is a social issue and learning that a loved one is affected by the problem can be nearly heart-breaking. It is definitely not something that can be easily accepted. At the same time, the affected individual needs all your love and attention and more importantly support to get through the situation. It is important to not show anger or frustration at the person but to empathize and help them get out of the situation. 

Read on to know some of the ways in which you can play an active role in supporting your loved one under such circumstances. This involves both of you coping with the situation at hand, as well as helping the person come out of the abuse. 

Educate yourself: When you are trying to help a person, you should know in detail about the substance that was being used and its ill effects. This gives you greater credibility, unlike the person who got carried with the happy feeling it gave and got into abuse. 
Ensure safety: This is both for the affected individual and yourself. With the required substance not being available, the person could look at harming either self or others, especially ones who are trying to get them out of the abuse. Though the intent is to help, they are looked at as people who are depriving the feel-good feeling produced by the substance, which is no longer easily available. Therefore, ensure safety. 
Talk openly: In the beginning, be a good listener. Once you get their confidence, make them understand that the entire situation is making you upset and perhaps angry or frustrated too. Get them to focus on your proposal of getting out of the habit together. If they are willing then this can ensure greater success in quitting the habit. Get to understand how exactly the habit developed including the people responsible for it, the circumstances leading to it, and the various chemicals that were used. The duration and frequency are also important. Tell them it is okay and that you will both get out of it with each other s support. 
Participate in therapy sessions: Individual counseling will work effectively for the primary client, but it is also important for family members to get involved. The counselor also would need support beyond the few counseling hours for completely getting rid of an individual s habit. Therapy can help you learn how to manage the issues back at home. 
Find your  me-time : With all that is going on, you will need some time for yourself to just be. Eat well, stick to your workouts, sleep well, keep your friends, and make time for your hobbies. These will ensure you are in good shape to support the affected individual. It is not possible for you to help another person when you are not in great shape yourself.

Substance Abuse - How Should You Cope With Someone Going Through It?

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

Masturbation is considered as a good way of pleasuring oneself and leading to a more qualitative sex life. Masturbation is a sexual activity that is at par with sexual intercourse that will create a basis for an improved sex life. This will ensure that the need for sex is one that is based on respect and love, rather than a mere bodily function. Let us find out how it helps in having a better sex life:

Awareness: masturbating is also a great way to know more about your own sexual preferences and what you like in terms of sexual activities. This awareness helps in better understanding and channelling ones sexual appetite for even better gratification during intercourse.

Staying healthy: masturbating can help in releasing even more dopamine and oxytoxin, both of which have a favourable effect on your brain and mood. These hormones can also help in improving your immune system in the long run.

Knowing your partner: masturbating alone and with your partner can help in knowing your partner and his or her sexual preferences. This can help in pleasuring your partner in a better way which will further fortify the relationship.

Excessive masturbation is strongly recommended as it has its long-term side-effects:

1. The use of sex toys and other accessories can further your satisfaction level. For instance, realistic vaginas can prove to be pretty handy in maximizing your sexual potency. Other credible sex toys are also available which are as helpful. Another effective technique of masturbating better is via porn or r-rated movies. By simultaneously watching movies while masturbating, your imagination gets fueled up with all kinds of sexual fantasies, providing you with more immediate satisfaction than usual.

2. A change in position is also pretty effective in heightening your senses and providing a better feel whilst masturbating. Keeping your hand still and only moving your body is such a way. While doing this, you can masturbate while kneeling or standing or sitting or even swapping hands. The more the variety, the better. Moreover, interchanging positions in between has also been proved to be very effective.

Masturbation: For A Better Sex Life

Anger and temperamental issues are a very common part of a person s identity. It is there from birth and is thought to mirror the hereditary qualities. It can be permanently present or could be triggered in certain situations. Some people have a hot temperament than others. However, there are a few ways with which temperamental issues can be dealt with effectively. These are as follows:

Psychotherapy

Individual or group therapy sessions can be useful. A commonly utilised sort of treatment, psychological behavioural treatment treats people or groups with discontinuous unstable issues.
Distinguish which circumstances or practices may trigger a forceful reaction
Figure out how to overcome anger and control wrong reactions utilising procedures, for example, relaxing preparing, re-thinking circumstances (psychological rebuilding) and learning adapting attitudes.
Medicine
Distinctive types of medications may help in the treatment of temperamentally unstable issues. These medicines may incorporate certain antidepressants (particularly specific serotonin reuptake inhibitors or SSRIs), anticonvulsant mind-set stabilisers or different medications if necessary.

Controlling your outrage
Some portion of your treatment may include:

Unlearning issue conduct.
Adapting admirably to anger.
Rehearsing the systems you learn in treatment to help you perceive what triggers your fits and outrage and how to react in ways that work for you rather than against you.
Building up an arrangement. Work with your specialist to build up an arrangement of activity for when you feel yourself getting irate. For instance, in case that you think you may lose control; try to expel yourself from that circumstance. Go for a walk or call a trusted friend to attempt to quiet down.
Dodging liquor and other substance use. These substances can build forcefulness and the danger of harmful temperamental outrages.
Consider taking these actions before a crisis emerges:

Call someone at home or someone you trust for help and guidance.
Keep all guns away or covered up. Try not to give the abuser the key or use the gun.
Gather a crisis pack that includes things you will require when you leave, for example, additional garments, keys, individual papers, medicines and cash. Conceal it or leave the pack with a trusted friend or neighbour. Try to go away from the situation so hat you do not do something regrettable.
Educate a trusted neighbour or friend regarding your condition so that he or she can call for help if needed.
Know where you will go and how you will arrive back in case that you feel angry, regardless of the possibility that it implies you need to leave during the night. You might need to work on escaping your home securely.
Decide on a code word or visual flag that implies you require the police and tell it to your friends, family or your children.

Temperamental Issues - How To Deal With Them Effectively?

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