Posted: July 27th, 2011 | Author: admin | Filed under: Healthy bones Osteoporosis Rheumatic | Comments Off
Sexual activity after a spinal cord injury is usually more successful if you do some advanced planning. You need to consider mobility issues, such as transferring and positioning, and muscle spasms. More importantly, you probably want to minimize the risk of a bowel or bladder accident during sex. Emptying your bladder before sexual activity will help. If you are on a regular bowel program, the chance of a bowel accident is small. But if your bowels are not regular, you may want to empty them before sex. Protective pads on the bed make quick clean up easier in the event of an accident. Keeping towels on hand is also useful. Avoiding eating or drinking just before sex, or limiting your fluid intake for several hours before sex, can help minimize bladder and bowel accidents.If you use intermittent catheterization, you can catheterize just before sex to empty your bladder. Both men and women can have sex with an indwelling catheter in place. A woman should tape the catheter to her abdomen with surgical tape to avoid dislodging it during sex. A man can fold the catheter back along the side of his penis and cover both with a condom before intercourse. Of course, if you prefer, the catheter can be removed before sex and then reinserted.A woman using a diaphragm for birth control may need help from her partner to insert it. You may want to include this in your sexual encounter, or prepare ahead by inserting the diaphragm yourself or getting assistance.If you have any questions about how to make physical preparations for sex, how to minimize accidents, or how to avoid spasms during sex, ask your doctor. Once you are fully informed, communicate with your partner about the necessary preparations, who will perform them, and the possibility of accidents and how you’ll deal with them. The better you prepare your partner, the more relaxed both of you will be and the greater the likelihood of a pleasurable experience.
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Posted: July 18th, 2011 | Author: admin | Filed under: Anti Depressants-Sleeping Aid | Comments Off
In working with an adolescent, it is wise to avoid obvious authority symbols, such as white coats, framed diplomas dripping off the walls, and a remote clinical attitude. Adolescents are probably already having some degree of difficulty with authority figures anyway, and they don’t need you added to that list. Being somewhat informal in dress and setting can remove one barrier. On the other hand, spiked hair, playing tapes, sitting on a floor cushion, and sucking on a “roach” when they arrive won’t go down very well either. They want you to know about those things, but not be into them; unless, of course, you really are (even then, leave the roach at home). An attempt to fake out the adolescent will fail. They are a hard group to fool, and they place a high premium on honesty. Respect this and honestly be yourself. This means asking for a translation of their vocabulary if you are not familiar with the lingo.Empathy rather than sympathy is the goal. This is true of all therapeutic relationships. Sympathy is feeling like the other person. Empathy is knowing how the person feels, understanding it, but not feeling like he does at the moment. For instance, it is simply not helpful to be depressed along with the person.In general, three types of therapy are done with adolescents. One involves manipulation of the environment. This can include arranging for the father to spend more time with his child, getting the kid who hates Shakespeare into a different school program, or organizing a temporary placement for the child whose parents are nonsupportive at the time. These can be very valuable interventions.Standard insight therapy—psychological, psychiatrically oriented traditional therapy—is not often used. Not many adolescents are ready for, or even could benefit from, this kind of therapy. The ones who can benefit from it tend to be “bright,” advantaged young people, who seem more capable and older than their peers or their chronological age would suggest.The most commonly productive therapy is what could be termed a relational approach. This requires time for you to become well acquainted and for the adolescent to feel comfortable with you. The counselor is supportive of the person without doing it for him. The counselor is a neutral person, available to the adolescent in a very different way than are parents or peers.The issue of confidentiality always comes up. It can be a mistake to guarantee that “nothing you say will ever leave this room.” The counselor does have the responsibility for others as well as the adolescent client. Given blanket protection, what happens when the kid announces he plans to rob the local deli, or another says she plans to drive the family car off the road at the first opportunity? A different approach was suggested by Dr. Hugh MacNamee. His practice was to tell whomever he saw that though most of what they said would be held in confidence, if they told him anything that scared him about what they might do, that would be harmful to themselves or others, he was going to blow the whistle. He made it clear he would not do so without telling them; nonetheless, he would do it. In his experience, adolescents accept this, maybe even with relief. It may help to know that someone else is going to exert some control, especially if they are none too sure about their own inner controls at the moment.In a similar vein, Dr. MacNamee would suggest keeping the adolescent posted on any contacts you have with others about him. If a parent calls, start off the next session by informing the adolescent, “Hey, your Dad called me, and he wanted….” If a letter needs to be written to a school, probation officer, or someone else, share what you are writing with the adolescent. The chances are fairly good his fantasy about what you might say is worse than anything you would actually say, no matter what the problem. Because trust is such an issue with adolescents, it is important that you be willing to say to them what you would say about them behind their backs.Although the aforementioned is a good general approach to the issue of confidentiality, you may need to be aware of other complicating factors. In particular, we refer to the legal issues of a child’s right to care versus parental rights to be informed. There may be circumstances in which an adolescent has a legal right to be seen and treated without parental knowledge or consent. In any case, the ground rules you are following must be clear to the adolescent client.*150\331\2*
Posted: July 8th, 2011 | Author: admin | Filed under: Cardio & Blood- Сholesterol | Comments Off
Who Is Affected by Pulmonary Hypertension? Individuals with previous pulmonary embolism, chronic emphysema, and certain types of congenital heart disease are at higher risk for the development of pulmonary hypertension. Primary pulmonary hypertension is rare; it occurs most often in young adults, but it can occur at any age. It affects about twice as many women as men.How Serious Is Pulmonary Hypertension? Pulmonary hypertension is usually a very debilitating problem; however, the symptoms and life expectancy are extremely variable, even for people with the same degree of pulmonary blood pressure elevation. People with Eisenmenger’s complex seem to be able to endure very severe pulmonary hypertension for years, although they may be limited in their activities. In people with primary pulmonary hypertension, symptoms tend to develop more rapidly and life expectancy is shorter.*214\252\8*