Herbal Health
Herbal Remedies Blog
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GENERAL ANSWERS TO QUESTIONS ABOUT BREAST DISEASES
After a recent needle biopsy of a cyst in my breast, I have extensive bruising and tenderness in the area. Is this a sign of something wrong?
Bruising is caused by blood leaking from tiny blood vessels under the surface of the skin and is likely to occur to some degree following a biopsy whatever the precautions taken to prevent it. There is unlikely to be any cause for concern, and the bruising should gradually disappear over the next few days or weeks. If it does persist, is painful or spreads, ask your doctor’s advice.
I have been referred to a general surgeon at my local hospital to investigate a lump in my breast. My GP said there is no specialist breast surgeon in our immediate area, but, having thought about it again, I would rather see such a specialist even if it means travelling to do so. However, I am nervous about asking my GP to change the arrangement. What should I do?
You are entitled to see a specialist breast surgeon and, in fact, it is a good idea to do so. A consultant who specializes in breast diseases will inevitably have more experience in this field than a general surgeon who does not have a specific interest in breast diseases. If there is no breast specialist in your area, you can ask to see one elsewhere, although you may have to insist. You may prefer to write to your GP requesting a referral to a breast specialist if you are anxious about talking to him or her again. Alternatively, you could contact your local hospital and ask if there is a breast care nurse you could talk to; she may be able to advise you and to support your request for another referral.
Following the recent discovery of a small lump in my breast, an appointment has been made for me to see a specialist. I am 48 years old. What are the chances that the lump is cancer?
Although most types of breast cancer are more common in women around the time of their menopause, approximately only 1 in 10 of those who are referred to a specialist with breast problems are found to have cancer. There are, of course, different types of breast cancer with different prognoses, and treatment of a small lump detected at an early stage of development may have a better outcome than that of one which is detected later.
I frequently have pain in my breasts which does not seem to be related to my periods. I cannot feel a lump. What should I do, and what might be the cause of this pain?
Non-cyclical breast pain can have several causes, most of which are benign. It is not common for breast cancer to be associated with pain in the breast, although it can be. You should make an appointment to see your doctor, having first made sure that you are wearing a well-fitting bra. If you have not been measured for a bra for some time, and particularly if you have lost or gained a significant amount of weight recently, it may be that the bras you wear are too big or too small and are not supporting your breasts properly.
Breast pain that is not related to the menstrual periods can be referred pain from a back or shoulder problem, and your doctor will probably want to investigate this possibility. Sometimes, the cause of breast pain is never discovered, but it does often resolve itself in time.
I am 48, and have recently been able to feel hardness around the edges of both my breasts. What is this likely to be?
The breast tissue changes in women around the time of their menopause, and what you are feeling is likely to be a benign condition called dysplasia or fibrocystic disease. However, it is worth checking with your doctor to rule out any other possible cause.
I am about to have a mastectomy. WM I need to wear special bras after my operation, and will I be able to wear swimsuits and sundresses?
There is no reason why you should need special bras; the bras you usually wear will probably be able to be adapted to hold and conceal a prosthesis. This is also likely to be true for most of your clothes. If there is a breast care nurse at your local hospital, she will be able to arrange this for you. Do discuss it with her or with your consultant. Swimsuits, bras and sundresses can usually have a pocket sewn into them to hold the prosthesis, and this will allow you to take part in all sports and your usual activities without worrying about your prosthesis becoming dislodged. Mastectomy swimsuits are available, but they are expensive, and should be unnecessary if your own can be adapted.
Although the underwiring of strapless bras can damage a prosthesis, it is probably all right to wear one for short periods of time if you want to wear a strapless dress. Low-cut dresses may not conceal your prosthesis, but apart from this, you should have no restriction on the clothes you will be able to wear.
*68/39/5*
Cancer Cancer
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SURGICAL TREATMENTS OF ENDOMETRIOSIS: AFTER LAPAROTOMY
After your operation you will have an intravenous drip in your arm to provide you with fluids so that you do not become dehydrated as you will not be allowed to drink. You will usually have a catheter draining your bladder for the first day or two if you have had a hysterectomy. You may also have a tube coming out of the surgical wound to drain any excess fluid and debris from the area of the operation.
For the first twenty four hours after your operation the nurses will observe you closely. They will chart your pulse, breathing rate, blood pressure and temperature frequently, and check your wound and record any vaginal bleeding. During this time your gynecologist will come and discuss the operation with you.
The physiotherapist may visit you again to help you with your breathing and foot and leg exercises.
You may experience some nausea and/or vomiting immediately after the operation. To help relieve this you may require an injection.
You will usually feel drowsy and experience pain for the first few days following your surgery, particularly from your wound. The tube that was placed in your throat may give you a sore throat for the first day or so. Two to four days after your operation you will probably experience wind pain which can be very unpleasant and uncomfortable.
For the first day or two you will either be given painkilling drugs continuously through your intravenous drip or you will be given painkilling injections every four to six hours. You will then progress to painkilling tablets.
When you first start to drink again you will be allowed only to suck ice and sip small quantities of fluid. Once you are able to cope with fluids and any nausea and vomiting has ceased your intravenous drip will be removed. When you have passed wind you will be able to progress onto a light diet of semi-solids and then onto a normal diet if you have no problems. You will probably not open your bowels for the first two to four days after your operation but if constipation becomes a problem you may be offered suppositories.
You will sit out of bed for a short time on the day after your operation and you will be encouraged to move around a little more each day as your condition improves.
When you return home you will then require another three to five weeks of recuperation if you have had a conservative laparotomy, or another three to seven weeks if you have had a hysterectomy. It is important that you do not just rest in bed but that you move and walk around each day and gradually increase your activity level as you recover and feel better.
You may tire quickly for the first week or two, so you will need some help with household tasks for the first one to three weeks, especially if you have children. When you start to do the household jobs again you should do a little at a time and still have plenty of rest. Do not try to be a superwoman as it will only slow down your recovery in the long-term.
For the first week or two after you return home you may still have some discomfort or pain so a mild painkiller such as Panadeine or Panadol may be necessary. The vaginal discharge, if you have had it, usually persists for about two weeks after surgery but it may last for up to six or eight weeks following a hysterectomy.
Most of the healing of the wound occurs in the first two weeks after surgery. After that you can lift light loads but it is probably best to avoid lifting heavy loads if possible for the first month or so. You can drive the car again when you are fit enough to do light gardening and walk up stairs quickly, generally about three to six weeks after surgery. You can have sexual intercourse again when your doctor has examined you about six weeks after your operation.
You should notify your gynecologist immediately if you develop any of the following symptoms:
• a fever
• your wound becomes tender, swollen and red
• a discharge appears from your wound
• severe abdominal pain or cramps
• urinary frequency and scalding when passing urine
• pain or bleeding when using your bowels
• your vaginal discharge develops an unpleasant odour
• your vaginal discharge persists beyond six to eight weeks
• tenderness and/or swelling in your calf muscles
• increasing soreness of the calf muscles when walking
• shortness of breath, chest pain or pain when breathing.
*50/41/5*
Women's Health Women’s Health
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ANOREXIA NERVOSA: BEHAVIORAL TREATMENT
Having a contract reduces the “arbitrariness” of treatment and makes it easier to accept. The rules are codified, written down, and stored away someplace-somewhat like the Constitution. The patient might argue about how to interpret those rules, or how they should be enforced, but she can’t dispute that they exist.
Of course, it’s important to work with patients to help them overcome their fears and anxieties. I tell them, “Look, I know this whole situation is pretty scary. But we want to help you. Of course we want you to gain weight, but that’s really your responsibility. We’re not going to be spies and monitor every mouthful you eat. But if you find you’re having trouble, we’ll have someone sit with you and help you get through the fear. Yes, we need to give you enough calories so that you begin to gain weight, but we don’t want to go too fast. We’re not here to just fatten you up and send you on your way. We want to help you gain weight in a healthy and calm manner, so that we can begin to find out what’s really troubling you deep down inside.”
The food journal provides clues about strategies that might work. Anorexics might not be ready to fill out such sheets, especially at first. They dwell on food constantly anyway; writing it all down might just make them more anxious (that can be true for bulimics, too). If they feel that way, I don’t push it. Sometimes keeping a journal focusing just on feelings and events (not food) can be useful.
A journal can provide a vivid record of the patient’s thoughts and feelings about her situation. By examining these thoughts, we can often reveal distortions in the way the patient perceives and interprets events in her life. Cognitive therapy, which I will discuss in just a moment, is a good method for correcting such distortions.
In the final phase, we concentrate on helping the patient maintain her weight within the target range. We reinforce normal eating habits and look ahead to her continued recovery as an outpatient.
Before sending her home, we work out a plan to monitor her weight. We agree on who should do the weighing-a doctor, a nurse, her parents. She understands that if her weight drops below a certain limit, she will have to come back to the hospital.
A word about outpatients: It is possible to set up a contract with anorexics treated outside the hospital, even though they are not being monitored twenty-four hours a day. Usually such contracts set lower goals for weight gain-say, between one and two pounds a week. In family therapy sessions we work out the system of rewards and penalties. The parents may agree, for example, that if the patient fails to meet her target, they will suspend her allowance or ground her.
*75/35/5*
Weight Loss Weight Loss
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STIMULATE YOUR DETERMINATION: SHE PUT FITNESS FIRST AND LOST 155 POUNDS
With a family, a home, and a part-time job, Sandie Howe doesn’t have a lot of free time. But no matter how busy she is, the 34-year-old Stockton, Missouri, resident sets aside 30 minutes a day, just for herself, to exercise. Her no-excuses attitude toward fitness helped her lose 155 pounds and 10 dress sizes.
Sandie never had a weight problem when she was younger. But once she and her husband decided to start a family, she gained between 35 and 40 pounds with each of her four babies. By age 32, she weighed 300 pounds.
“My mom took a photo of me that Christmas, in 1997,” Sandie recalls. “When I saw it, I was so ashamed that I wanted to cry. I made up my mind right then and there to lose weight.”
The trouble was that she didn’t even know where to start. “In the past, I had made some half-hearted attempts to lose weight, but without much success,” she says. “I really didn’t know what to do.”
She knew from experience that dieting didn’t work. So this time, she decided to combine a sensible eating plan with regular exercise. She began by counting calories and grams of fat and exercising for 30 minutes at least three times a week. “I really struggled through my workouts at first,” she recalls. “Whether I was walking outside or doing aerobics to a Pdchard Simmons video, I was pretty winded by the time I was done.”
As the pounds came off, though, she felt stronger and better. She noticed that her feet and knees, which had bothered her when she was at her heaviest, no longer hurt.
Over time, Sandie expanded her exercise program so that she was working out for at least 30 minutes every day. She continued to monitor her calorie and fat intake, too. Within 2 years, she lost 155 pounds. She’s now a fit and trim 145 pounds.
“When it comes to exercising, the biggest excuse is not having time. I know—I used to tell myself that, too,” Sandie says. “I learned ST that I can make time, if I really want to. Some days, I get up a half hour early so I can squeeze in my workout before things get hectic. j §
Other days, I exercise while my children are napping or playing at friends’ homes. If all else fails, my husband is great about watching j the kids so I can go walking for 30 minutes. I |
“Somehow I always find the time I need,” Sandie adds. “You can, too.”
WINNING ACTION
Make yourself a top priority. No matter how busy a family life you have, follow Sandie’s example and demand a half-hour a day for yourself. If your family objects, explain to them how important it is to you and that they’ll benefit, too—by having a happier, healthier wife and mom. Out of 24 hours in a day, you deserve 30 minutes!
*129\89\8*
Weight Loss Weight Loss