Conditions

Generalized Anxiety Disorder

San Jose Care Resource Guide: Anxiety, few do not have it, but there are levels. Here is a link to a good article on the topic of generalized anxiety disorder published by JAMA, the Journal of the American Medical Association.

Symptoms mentionned in JAMA:

• Fast or irregular heartbeat (palpitations or “fluttering” in the chest)

• Sweating or flushing of the skin

• Muscle tension

• Headaches

• Difficulty sleeping

• Changes in appetite

• Nausea, vomiting, and diarrhea

• Edginess or irritability

Note: Article mentions there can be physical reasons for the anxiety:

•  heart problems,
•  thyroid conditions,
•  or other medical issues

The symptoms look  fairly general, and can probably be everything and anything. Which means, you have to talk to your Doctor…

• Treatments include
• Cognitive behavioral therapy(CBT)
• relaxation techniques
• medication

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Stroke Rehab: Intensive Home Therapy As Good As “High Tech”?

San Jose care Resource Guide:  Good news for the fans, (include us) of  Home Therapy! 

San Jose care Resource Guide: Quoting MedicalNewsToday

“…The results of this study show that the more expensive, high tech therapy was not superior to intensive home strength and balance training, but both were better than lower intensity physical therapy..”

Key word is” intensive”.  What constitutes intensive therapy is not clear. Below is a home  stroke therapy that looks interesting focusing on the arm and hand. video from StrokeSurvivor2008 at YouTube

But it is difficult to understand how a home health rehab can beat  a program for stroke survivers such as NorthwesternU see this YouTube video:

What do you think?

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Chronic shoulder pain: comparison of acupuncture and conventional treatments

San Jose Care Resource Guide: Chronic shoulder pain can have many causes, the next link  Chronic Shoulder Pain: Part I. Evaluation and Diagnosis   will bring you to an detailed article from Kelton  M. Burnank et. al. on the the diagnosis of the various aspects of it.

•  rotator cuff disorders,
•  adhesive capsulitis,
•  shoulder instability,
•  shoulder arthritis

This article is quite technical: as the it  goes into the details of sub-categories of underlying illness or condition, , the complexities of the diagnosis of the causes of shoulder pain become apparent.

The classical treatments of such causes is described in another article by the same author.  Chronic shoulder pain: part II. Treatment.

Those treatments consist of

• Activity modification and analgesic medications
• physical therapy
•  Combined steroid and local anesthetic injections

Then: “…Symptoms that persist or worsen after six to 12 weeks of directed treatment should be referred to an orthopedic specialist…”

Cure or long term relief does not seem  a given.

Then come a method apparently more benign: accupuncture.  Accupuncture seems to have  some good rate of success according to an article in JAAPA   Chronic Shoulder Pain and Acupuncture Treatment. This article concluded:

“… A treatment series of 15 acupuncture sessions produced signifi­cantly greater pain relief than sham acupuncture or conservative treatment in patients with chronic shoulder pain not due to osteoarthritis or rheuma­toid arthritis…..”

Talk to your Doctor

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Home Health Experts Systems

SJCRG: There some online expert systems for the home care community. We will list some here

Warning:

• Those Expert System have not put health providers out of  business yet! They could be used though to help you decide to go see your Doctor. Also, do not forget your own expert system: what your body and gut feel are telling you!
• SJCRG does not endorse the accuracy of the Expert Systems mentionned.

• EasyDiagnosis.   This is an easy to use, simple, system.
• EverydayHealth:  Designed by an MD, Stephen Schueler, MD, is an emergency physician, teacher, and author
• FamilyDoctor.org  

More Expert Diagnosis Systems to come….

Confirm whatever you find out with your Doctor.

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Chronic Fatigue Syndrome: Study Shows Cognitive Behavioral Stress Management improves stress, quality of life, and symptoms of CFS

San Jose Care Resource Guide: Chronic Fatigue Syndrome is not well undrerstood and it’s causes are unclear. Recent work has tried to tie it to a retrovirus [MediNewsDigest], but the the linkage is not necessarily causal.

San Jose Care Resource Guide: So what is one to do? Some drugs are used but they are not necessarily FDA approved for that purpose . Click hear ffor a link to Adienne Dellwo’s article on the CFS drugs

San Jose Care Resource Guide: What about alternative medicine?

• Click here for a link to the Mayo Clinic on alternatives for CFS
• Then there is this study on the benefits of  CBSM or  ”Cognitive Behavioral Stress Management”. This study was published in the Journal of psychosomatic research
  • Conclusions of this study  are positive, quoting: “…Results suggest that CBSM is beneficial for managing distress, improving quality of life, and alleviating CFS symptom severity…’
  • But what is “Cognitive Behavioral Stress Management”. Here is a helpful introduction lecture video by Dr Jason Satterfield, UCSF,  on Youtube/UCtelevision

What this post helpful to you? Click Here to let us know

Talk to your Doctor

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Sleep Remedies and Strategies in Fibromyalgia & Chronic Fatigue Syndrome

San Jose Care Resource Guide: Adrienne Dellwo has an interesting blog on Fibromyalgia, this time the topic is sleep problems  Click Here for link.

San Jose Care Resource Guide:  Here is a link to a study showing some help from  pregabalin (Lyrica)

San Jose Care Resource Guide: On an alternative note Hydrotherapy seems to also help sleep for FS patients, click here for link to Brazilian article in sciencedirect

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Medicare: Lawsuit charges government with denying care to thousands of chronically ill

San Jose Care Resource Guide: Yes,  we sometimes have to sue Medicare, i.e. our government, to get proper care.  Here is a link to the article in the  Chicago Tribune. This article was brought to our attention by Ernest A. Wahrburg, BA(PSY), MSW, LCSW (NC & NY)/LinkedIn

Quoting the Chicago Tribune: “…The  Center for Medicare Advocacy, which filed the lawsuit with Vermont Legal Aid on behalf of the National Multiple Sclerosis Society, Parkinson’s Action Network, Paralyzed Veterans of America, National Committee to Preserve Social Security and Medicare, and American Academy of Physical Medicine and Rehabilitation…”

So what is the Center for Medicare Advocacy? Seems like a large well organized pro-Obamacare health care advocacy site. In fact one one their article’s title is “HEALTH CARE REFORM DOES NOT CUT MEDICARE BENEFITS” ….

So why are they suing Medicare, A.K.A, the (Obama) government?

Quoting the Tribune, quoting them,

“…Under the law, Medicare is obligated to provide health care and therapy that are “reasonable and necessary for the diagnosis or treatment of illness or injury,” according to the legal complaint. Yet through the years, program administrators have decided that services will only be reimbursed if patients show signs of getting better, the complaint notes…..”

San Jose Care Resource Guide: This Medicare policy, of course, choose to ignore that , for many  chronically ill, not getting worse is the name of the game!

San Jose Care Resource Guide: Fact is, bombast or not, liberal government will cut and/or weazzle out of social obligations like anybody else….Particularly when the group targeted for cuts does not seem politically significant. I.e. the disabled….The Obama admistration will rather spend our healthcare money on worthy  causes like

See our previous posts on the topic

• With Medicaid waiver, California dives into health care reform (stateline)
• Multiple sclerosis and it’s Financial Burden: Comments on the Guardian’podcast
•  HealthCare: California’s Gov. Brown’s proposed steep healthcare cuts
• Ways The New Health Law May Affect You in 2011 (KHN)
• Health Care Law Should Help With Jail Inmate Treatment (thecrimereport)
• Medi-Cal and Gender Reassignment Procedures

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Sleep: The Importance of Body Clock and Metabolism Regulation (Mercola)

SanJose Care Resource Guide: Dr Mercola has a clear, straightforward, and convincing appeal for a normally simple behavior which as probably as important,nay, more important than all the supplements we are gobling down…Sleep and aiding and abetting your Circadian rhythm. Click Here for a link to his post

Quoting Dr Mercola, 

• Short term memory
• Creativity and learning performance
• Weight gain/loss
• Diabetes and heart disease risk
• Immune system
•  a stronger immune response
• Cancer risk

In addition:

• Parkinson disease (PD)
• Alzheimer disease (AD)
• Multiple sclerosis (MS)
• Gastrointestinal tract disorders
• Kidney disease
• Behavioral problems in children
• Stress response related issues: Headaches,Indigestion,Insomnia ,Increased anxiety,Depression,High blood pressure

You name it, sleep is part of the remedies.    So, yes, sleeping enough can be a good investment of your time…

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Aging: Pain and worry about health in older men and the CHAMP study

San Jose Care Resource Guide: Pain and health worry seem to be a common issue for older people. Here is a link to a study on a group of  1217 community-dwelling men in australia, aged 70years or older the CHAMP study, published in the pain journal. 

Results are interesting,quoting :

•  12.5% had persistent and intrusive pain,
• 22.4% were worried about their health,
• and 6.3% had anxiety.

Let us us rephrase this:

       Of the men studied,

•  87.5% did not have persistent and intrusive pain,
• 77.6% were not worried about their health,
• and 93.7% did not have anxiety

Remarkable! The Australian sun?

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Depression: Bright Light Treatment in Elderly Patients With Nonseasonal Major Depressive Disorder

San Jose Care Resource Guide: Study shows that “..Three weeks of 1-hour early-morning Bright Light Treatment [ BLT]  (pale blue, approximately 7500 lux) can lift someone out of Major Depression. The study followed Eighty-nine outpatients 60 years or older who had MDD underwent 3 weeks of treatment (T1), and were evaluated  and 3 weeks after the end of treatment (T2).

The study concludes that :”..  In elderly patients with MDD, BLT improved mood, enhanced sleep efficiency, and increased the upslope melatonin level gradient. In addition, BLT produced continuing improvement in mood and an attenuation of cortisol hyperexcretion after discontinuation of treatment. 

That does sound like a substantial treatment achievement. Click here for article in the Archives of General Psychiatry

• Notes: The “elderly men” are 60+….
• That the  depression is not season related is counter intuitive, but also consider another study with similar results for Seasonal Depression: “Phototherapy for seasonal major depressive disorder: effectiveness of bright light of high or low intensity.”  With these differences:
  • The patients are not elderly
  •  The treatment is from 8 p.m. to 10 p.m. ( using light at 2000 lux, as opposed to 7500lux  for the nonseasonal case.)

Talk to your psychiatrist

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