Medical Weblog

The aging process can be especially noticeable in the area around your eyes. That’s because the skin around your eyes is thinner and more delicate than on any other part of your body. To slow the aging process in the area around your eyes you must do everything you can to protect the entire area— including your eyelids.

There are several routine factors that cause wear and tear around your eyes. By avoiding or minimizing these factors you can maintain your smooth, youthful skin, and, in effect, a youthful appearance around your eyes.

1) Friction— done often enough, even a minimal amount of rubbing can cause injury to the skin around the eyes. That’s why it is important that you avoid, as much as possible, the common habit of rubbing your eyes, especially when they feel tired or sleepy. Rubbing your eyes in such a manner causes friction and could produce or worsen bags under the eyes because the skin stretches. Often, people who rub their eyes frequently, end up looking weary even when they are not.

2) Applying and removing makeup— the application and removal of certain kinds of eye makeup can also cause stretching, and lead to the appearance of “tired eyes”. Whenever eye shadow or eye liner is applied and whenever makeup remover is used to remove waterproof mascara and liner, the skin is bound to be stretched. Some cosmetic consultants recommend that you use only an eye-brow pencil and non-waterproof mascara on the area around the eye, except on special occasions. Neither product involves the application or removal of cosmetics to and from the skin, and both come off easily at the end of the day with just a little soap and warm water.

3) Squinting— even a natural adaptive response such as squinting can eventually help make you look older. Most people squint instinctively as protection against excessive light. You are also likely to squint when you are trying to focus on something you are not able to see very well. While it may seem rather innocuous, such squinting simply “engraves” squint lines, or crow’s feet, around your eyes.

The best way to prevent squinting and the resulting damage to the skin around your eyes, is to wear tinted glasses to protect your eyes against bright light while you are outdoors, and glasses or contacts indoors or out to correct any vision problems.

Since wind and extremes of temperature compound the damage caused by chronic sun exposure, wearing glasses can also provide a shield against the elements. Even if you wear contact lenses for general use, it’s a good idea to have a pair of tinted or plain glasses on hand to wear whenever you go outside to help prevent the signs of aging around your eyes.

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You don’t have to be an athlete to contact this common skin condition in which the skin between the toes becomes itchy and sore. Sometimes the skin will crack and peal away and, on occasion blister. The culprit is a fungal infection which thrives in warm, moist conditions. Sweaty footwear is often the breeding ground for this painful and annoying foot menace.

Here are some suggestions on how to prevent athlete’s foot and how to treat it once you’ve got it:

1) Buy two pairs of shoes— if possible, never wear the same pair of shoes day after day. It normally takes shoes at least 24 hours to dry out completely. You can also try keeping the insides of your shoes dry and clean with frequent use ol antifungal powder or spray and by wiping them with a disinfectant, such as Lysol, occasionally. Shoes that allow evaporation of moisture are best.

2) Change your socks— if your feet have a perverse tendency to perspire a lot, it’s a good idea to change your socks two or three times a day— cotton socks are best. To prevent the organism from breeding, it’s important that you make its living conditions as inhospitable as possible—clean and dry.

3) Dry your feet— after a shower or a bath, make sure your feet are allowed to dry thoroughly before you put them into shoes and socks. Once you’re sure your feet are dry, apply powder to help them stay that way.

4) Don’t go barefoot in public— you can help reduce the risk of contracting athlete’s foot by wearing slippers and/or shower shoes whenever you are in places where other people often walk around barefoot— swimming pools, health clubs, spas, gyms, locker rooms, and so on.

5) Wash your feet— once you have it, careful hygiene is often treatment enough, without having to resort to drugs. At least twice a day, you should wash the space between your toes with soap, water and a cloth. Be sure to dry the infected area thoroughly with a towel— especially the painful area between the toes. And always put on clean, dry socks.

6) Try aluminum chloride— a twice-daily application of a 30 percent aluminum chloride solution is often effective treatment because of its drying and antibacterial properties. Have your pharmacist make up the solution and use a cotton swab to apply it between your toes at least two times a day. Continue the treatment for two weeks after the condition has cleared up.

7) Use over-the-counter medications— once the infection has cleared up, you should take every precaution to keep it from recurring. One way to do that is to apply over-the-counter antifungal cream or lotion.

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Exercise combined with other healthful lifestyle choices, such as weight control and being a non-smoker, can help raise high-density lipoproteins (HDLs)— also known as “good cholesterol”—and as a result reduce certain health risks, including heart attack.

Medical experts say that even though HDL levels are to some extent genetically determined, they can be raised several ways, without using medication. In studies at Stanford University and Medical College of Virginia, losing excess weight and kicking a smoking habit have both been shown to lead to an increase in HDL levels. Postmenopausal women receiving estrogen replacement therapy also tend to have higher HDL levels.

Regular exercise is another method of ensuring high HDL levels. Experts say that regular muscle contractions stimulate the production of HDL. And while vigorous exercise produces the greatest effect, studies indicate that even mild exercise is of some benefit in raising HDL levels.

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These infections are caused by one or more types of bacteria invading the bladder, urethra, or other parts of the urinary tract. Common UTI symptoms include a burning sensation on urinating and frequent urination. Backache and fever may also accompany the infection. Doctors say that at least 50 percent of all women will contract a bladder infection, sooner or later. Here are several expert recommendations for reducing the discomfort of UTI.

1) Drink a lot of water or juices— urologists say you should drink plenty of fluids— water and juices—to flush out the bacteria that are causing the inflammation. While there’s no conclusive evidence, some recent studies suggest that cranberry juice may indeed be an effective treatment for UTI.

2) Avoid coffee, tea and alcohol—these fluids may irritate the urinary tract.

3) Soaking in a hot bath— many women find this a good way to get relief from UTI.

4) Try an anti-inflammation drug— both aspirin and ibuprofen may help to reduce the inflammation in the bladder.

5) Get more vitamin C in your system— some doctors say that large doses of vitamin C can acidify the urine enough to disrupt the growth of bacteria. Before you begin taking vitamin C as a treatment for UTI, you should get your doctor’s approval.

6) Urinate before intercourse— an empty bladder can reduce the likelihood of irritation in the pelvis by allowing more space. It also helps get rid of bacteria that may be present in the vagina.

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One of the most important decisions a. mother makes in the months preceding her baby’s birth is how she will feed her baby. According to medical childcare experts, more and more mothers these days are choosing to breast feed. The decision seems to be a wise one because the American Academy of Pediatrics has labeled breastmilk as the “perfect” food for a baby during the first year of life. Moreover, breast milk is easy for the baby to digest, and it provides antibodies until the baby’s body can make them on its own. Breastfeeding also provides a special closeness for mother and baby, and it helps restore the uterus to pre-pregnancy size.

Here are several things a mother can do to ensure successful breastfeeding:

1) Go to breastfeeding classes before the baby is born.

2) Try to nurse the baby as soon as possible in the delivery room. Research shows that babies who begin nursing almost immediately after delivery are more successful at breastfeeding.

3) Nurse your baby as often as 8 to 12 times a day for the first few weeks, and let the baby nurse as long as he or she wants. The more a baby nurses, the more milk a mother will provide.

4) Allow the baby to nurse from both breasts during each feeding. Nurse on one side until it appears the baby is losing interest, then offer your baby the other breast.

The next time you feed your baby, begin with the side you ended with the time before.

5) Don’t give your baby supplemental bottles or a pacifier until you have been nursing successfully for more than three weeks and the baby is gaining weight.

6) The key to success for any breastfeeding mother is to pay attention to her baby, and having the support of those around her in her decision to breastfeed. Some experts even recommend joining breastfeeding support groups.

Any prospective mother considering breastfeeding her baby should consult a pediatrician who is supportive of breastfeeding and can help with any questions or problems that might arise.

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Yes, it is. Prozac has a powerful effect on the frightening bursts of anxiety and rising waves of panic that characterize panic disorder, the symptoms of which include shortness of breath, dizziness, rapid heartbeat, sweaty palms, trembling, choking, chest pain, and fear of going crazy, passing out, or dying. In one study, nineteen out of twenty-five patients who were treated with Prozac for panic disorder and, in some cases, agoraphobia, showed moderate to remarkable improvement in their symptoms. Treatment was most effective when it started at the low level of 5 mg a day.

It is likely that Prozac and other medications, by alleviating panic attacks, can also cause a decrease in the symptoms of agoraphobia, the debilitating fear of open spaces, including going into crowded streets and department stores that often results in patients becoming completely housebound, sometimes for years on end.

Behavioral therapy, typically including exercises aimed at desensitizing the patient to frightening stimuli, also plays an important role in the treatment of both panic disorder and agoraphobia. Patients with panic disorder, agoraphobia, or social phobia, should use a combination of an antidepressant and behavioral therapy.

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The expression “normal mood” is basically an artificial construct. In reality, most people experience mild and transient moodswings. Anyone can feel more down than usual or more up than usual for a few hours or several days; those mild mood fluctuations are part of what we mean by normal. But when the person is always revved up or always down in the dumps, when these up or down feelings become so strong that they go beyond the usual baseline range, psychiatrists begin to consider the mood pathological even if the patient does not

Patients are likely to define the word normal in individual ways that entirely depend on their personal fusion. For people with a life-rime history of minimal depression, normal is for them slightly depressed. To psychiatrists seeing these patients and comparing them with hundreds of other people in the general population, these patients are clearly more depressed than the cultural norm and would be diagnosed as such. These people might be considered hypothymic; their mood is at the bottom of normal or slightly below.

Similarly, hyperthymics who have been energetic, driving, and productive all their lives usually see this as their normal mood. However, experts in mood disorders know that these people are more energetic and active than are most people in the population. These people lead lives at the top of normal or slightly beyond—although they describe themselves as “normal.”

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Because 15% of patients with bipolar manic depression ultimately commit suicide and the rates for unipolar depression seem to be similar, it would appear that suicidal thoughts are very common.

Between 40% and 60% of patients undergoing an acute episode of major depressive disorder have suicidal thoughts, and an even higher percentage may have a history of suicidal thoughts or wishes. Many other psychiatrists and psychophannacologists would go even further, believing mat as many as 90% of patients who appear in the psychiatrist’s office for the treatment of acute or chronic depression have at some time at least expressed the thought that “I sometimes wish I were dead,” or “My family would be better off without me,” or “I wish I could go to bed and never wake up,” or “I just wish I’d get hit by a car.”

In 1991, a total of 30,810 people killed themselves, making suicide the eighth leading cause of death in the United States. Provisional data indicate that fewer people killed themselves in 1992, dropping suicide a notch on the ladder of death. As of this writing, suicide appears to be the ninth leading cause of death, right behind a new entry in the top eight HIV infection.

But regardless of the precise figures, the likelihood is strong that far more people than reported actually died by their own hands. Because there is still a stigma against suicide, not all self-inflicted deaths are so labeled, and many forms of suicide, such as single-car accidents and death through drug abuse, are neither acknowledged nor identified as such.

Moreover, the number of people who attempt suicide without success is thought to be fully eight to ten times larger than the number of those who succeed.

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Depressed patients are first required to have a complete physical exam, an EKG, and a blood chemistry profile that measures, among other substances, the level of thyroid hormone. Because an amount below the normal range is sufficient in itself in some cases to cause depression, patients with underactive thyroids may need first and foremost to take thyroid medication. If the depression has not begun to disappear on thyroid hormone alone after seven to ten days, a trial of an antidepressant is initiated. However, if patients are already in a major depression superimposed on hypothyroidism, they may need an antidepressant as well as the thyroid hormone.

Fortunately, studies have shown no important interactions between Prozac and thyroid hormone. The two medications can be taken simultaneously. Thyroid hormone is usually given as levothyroxin. Cytomel or T3 (triiodothyronine) is given to boost the action of tricyclic antidepressants and used as a step-up treatment with Prozac if the antidepressant is not doing the job on its own.

To date, no clear-cut warning has been given regarding any important adverse effects of Prozac on the thyroid. Very infrequent cases of hypothyroidism have been reported with patients on Prozac. Even more rarely, goiter and hyperthyroidism have been reported, although they probably are not related to the Prozac treatment.

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Prozac is usually taken in the morning after breakfast, which seems to produce fewer side effects, particularly nausea and insomnia. But some patients have been able to tolerate it with other meals or at other times of the day, including bedtime, without adverse side effects. Many patients take Prozac at a time when it is most convenient for them or simply easy to remember, whether in the morning, after dinner, or at bedtime.

Can you overdose on Prozac? Not easily. During preclinical trials with Prozac up to 1993, no deaths occurred in patients receiving Prozac in normal doses. Two deaths were reported during comparative clinical trials, but in both cases other drugs were involved, so the role of Prozac is not clear. Another thirty-two patients recovered after overdose without any lasting harm, including one who reportedly took 3000 mg of Prozac, which is over thirty-seven times the recommended maximum dose of 80 mg.

In contrast, it is easy to overdose with other antidepressants such as the TCAs and MAOIs due to the toxic effects of high doses on the heart. With Prozac, even in large amounts, the risk of serious cardiovascular or neurologic harm is very small. Prozac should be considered one of the safest of all the antidepressant drugs.

If I will take a capsule by mistake, will it hurt me? No. A single dose of Prozac should not hurt a healthy person. The possible side effects and risks of using Prozac in small doses in conjunction with tricyclic and tetracyclic antidepressants appear to be minimal. However, the use of Prozac with MAOI antidepressants such as Nardil, Parnate or Marplan is considered dangerous. Prozac taken by mistake with an MAOI could conceivably cause a toxic reaction with elevated blood pressure, nausea, vomiting, or shock. Immediate transport to an emergency ward is indicated if such symptoms follow. A patient switching from an MAOI to Prozac must wait at least two weeks. A patient switching from Prozac to an MAOI must wait at least five weeks. Failure to observe these precautions can result in severe toxic reactions and even death.

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