Thehealthtime.com

Acne and Isotretinoin: Using Isotretinoin the Right Way
What is isotretinoin?
Isotretinoin (brand name: Accutane) is a medicine used to treat very bad acne. It is usually used for acne that did not get better after treatment with other medicines. It is important for you to take isotretinoin the right way. You should also know about the side effects of isotretinoin. Talk to your doctor if you have any questions about this medicine or if you have side effects when you take it.

Return to top

How should I use and store isotretinoin?
You should take isotretinoin with food. You don’t have to keep the medicine in the refrigerator, but keep it out of sunlight. Don’t keep it in a place that is very warm.

Isotretinoin has been prescribed just for you. Don’t share it with other people. Keep isotretinoin away from children. You may not give blood while you are taking this medicine or for at least 1 month after you stop taking it. You should also not have cosmetic procedures done to smooth your skin (such as waxing) while you are taking isotretinoin and for at least 6 months after you stop.

Tell your doctor if you or anyone in your family has diabetes, asthma, liver disease, heart disease or depression. You should also tell your doctor if you are allergic to any medicines, especially parabens (chemicals used in cosmetics, moisturizers and isotretinoin). Be sure to tell your doctor if you are taking any other medicines, even over-the-counter medicines.

Isotretinoin is like vitamin A, so while you are taking isotretinoin, you should not take vitamin A pills or multivitamins that contain vitamin A. You should also not take any antibiotics without talking to your doctor first.

Return to top

What should I expect during treatment?
Your acne may get worse when you start using isotretinoin. This usually just lasts for a little while. If this happens to you, your doctor may have you use other medicines along with the isotretinoin in this stage.

The dosage of isotretinoin is different for each person. During your treatment, your doctor may change your dosage. Be sure to take isotretinoin just the way your doctor tells you. If you miss one dose, don’t take extra the next time. You will probably take isotretinoin for 15 to 20 weeks.

Be sure you keep all of your appointments with your doctor. Your doctor needs to check on you often. He or she may check your cholesterol levels and your liver.

Return to top

Does isotretinoin have any side effects?
During treatment, you may have some of the following side effects. These side effects usually go away when you stop taking isotretinoin:

•Dry skin and lips–your doctor can suggest lotions or creams to use.
•Fragile (easily injured) skin, itching or rash
•Increased sensitivity to the sun (easily sunburned)
•Peeling skin on your palms and soles
•Thinning hair
•Dry, red eyes–you may find that you can’t wear your contact lenses during treatment.
•Nosebleeds
•Bleeding gums
•Pain in your muscles
•Vision problems such as decreased night vision
A few people have even more serious side effects. If these problems aren’t treated, they could last even after you stop taking isotretinoin. If you have any of the side effects listed below, stop taking isotretinoin and check with your doctor right away:

•Headaches, nausea, vomiting or blurred vision
•Depression or changes in your mood, such as feelings of sadness or irritability
•Unusual tiredness or lack of appetite
•Severe stomach pain, diarrhea or bleeding from your rectum
•Very dry eyes
•A yellow color in your skin or eyes, and dark yellow urine
Return to top

What should I expect after treatment?
Your skin might keep getting better even after you stop taking isotretinoin. Most of the side effects go away in a few days or weeks after you stop taking isotretinoin. If your side effects last for more than a few weeks after you stop taking this medicine, talk to your doctor.

Your acne may not get better the first time you use isotretinoin for 15 to 20 weeks. If you need to take isotretinoin again, you can start taking it 8 to 10 weeks after your first treatment is over. Do not give blood for at least 1 month after you stop taking isotretinoin.

Return to top

Are there special concerns for girls and women?
You must not take isotretinoin if you are pregnant or if there is any chance you might get pregnant while taking this medicine!

Isotretinoin causes severe birth defects, including malformation of the head and face, mental retardation and severe internal defects of the brain, heart, glands and nervous system. It can also cause miscarriage, premature birth or death of the fetus.

In order to prevent pregnancy, you must use 2 forms of birth control at the same time for at least 1 month before you start taking isotretinoin and during the entire time you are taking this medicine. Keep using 2 forms of birth control for 1 month after you stop taking isotretinoin.

Your doctor will make sure you are not pregnant before you start taking isotretinoin. He or she will check again every month while you are taking it. You will be asked to read and sign a consent form to show that you understand the dangers of birth defects and agree to use 2 forms of birth control. If your period is late, stop taking isotretinoin and call your doctor right away.

Thehealthtime.com

Reactive Arthritis
What is reactive arthritis?
Reactive arthritis is an uncommon condition that can make your joints swell and hurt. “Reactive Arthritis” means your immune system is reacting to an infection you already had. One kind of reactive arthritis is called Reiter’s (say: “rite-erz”) syndrome.

_________________

What kinds of infection can cause reactive arthritis?
The same bacteria that cause food poisoning can cause reactive arthritis. So can some sexually transmitted infections (STIs) such as gonorrhea, chlamydia or HIV infection.
_________________

Who gets reactive arthritis?
Reactive arthritis is most common in men between 20 years and 40 years old. Women can also get reactive arthritis, but their symptoms are usually milder.
_________________

How can my doctor tell if I have reactive arthritis?

There’s isn’t a specific test can tell your doctor whether you have reactive arthritis. He or she will make the diagnosis based on how your symptoms and other information they get from you during your appointment. You may have swelling in a knee, ankle or toe. Sometimes your heel or Achilles tendon will hurt. (The Achilles tendon is on the back of your ankle, right above your heel). You may feel pain or burning when you urinate. You may also have a discharge from your penis or vagina. Your eyes might be red and painful, and you may feel a burning sensation. Your vision may be blurry.

Your doctor may also want to test you for an STI, since it’s possible to have an STI without knowing it.
_________________

How is reactive arthritis treated?
Your doctor may give you a medicine for pain and swelling. You may also need antibiotics if you have an STI caused by bacteria. If you have an STI, it’s important that you and your sex partner get tested and treated to keep the STI from coming back.

The good news is that for most people, reactive arthritis goes away in 3 to 4 months. For a few people, the joint pain comes back again and again. If this happens to you, talk with your doctor about what can be done.
_________________

What can I do to get better?
•Take your medicines.
•If you have an STI, have your partner(s) tested.
•Practice safe sex.
•Reduce your risk of getting food poisoning by cooking meat completely, washing utensils and surfaces well and keeping food cold so it doesn’t spoil).
•Do light exercises (ask your doctor what you can safely do).

Thehealthtime.com

Skin Care: Men Who Care About Their Skin Protect It
More and more men are using sun protection while they work and play outdoors. Skin cancer is a threat, but it’s a threat you can do something about. By protecting your skin from the sun, you may lower your chance of getting skin cancer.
Why is the sun bad for my skin?
The sun’s rays, also called ultraviolet or UV rays, damage the skin. The short-term results of unprotected exposure to UV rays are sunburn and tanning. In the long run, unprotected exposure to UV rays can cause skin cancer.

________________

What should I do to protect my skin from the sun?
Follow these “safe-sun” guidelines whenever you are in the sun:

•Stay out of the sun, if you can, from 10 a.m. to 4 p.m., when the sun is strongest.
•If you have to be out in the sun, wear a long-sleeved shirt and long pants to protect your skin. Wear shirts made from tightly woven cloth, like long-sleeved cotton t-shirts. If the clothing fits loosely, you will feel cooler. Special sun-protective clothes are available from several companies, such as Solumbra Sun Precautions.
•Wear sunglasses to protect your eyes from the sun. Sun exposure increases your risk of getting cataracts.
•Wear a wide-brimmed hat to help protect your face, neck and ears from the sun. The best hat to wear in the sun has a brim that’s at least 6 inches all around. Baseball caps and similar hats don’t protect your ears and neck.
•Use sunscreen with a sun protection factor (SPF) of at least 15, even on cloudy days. Clouds don’t protect your skin from sun damage. Only sunscreen can do that. Use lots of sunscreen and rub it in well. Put the sunscreen on 30 minutes before you go outside. Put the sunscreen everywhere the sun’s rays might touch you, including your forehead and face, your ears, the back of your neck and any bald parts on the top of your head. Some sunscreen products say they won’t drip into your eyes. You can try those products on your face if that’s a problem for you.
________________

What else can I do to protect my skin?
It’s a good idea to do a monthly skin check. Ask your doctor about this. If your doctor thinks it’s a good idea for you, pick a certain day each month, like the date of your birthday or the day you pay bills, to check your skin. A monthly skin check can help you find skin cancer early. The earlier skin cancer is found, the better the chance for a cure.

The “ABCDE” rule can help you look for signs of skin cancer. When you look at moles on your skin, look for the following:
‘ABCDE’ Rule

A for asymmetry: A mole that, when divided in half, doesn’t look the same on both sides

B for border: A mole with edges that are blurry or jagged

C for color: Changes in the color of a mole, including darkening, spread of color, loss of color, or the appearance of multiple colors such as blue, red, white, pink, purple or gray

D for diameter: A mole larger than 1/4 inch in diameter (about the size of a pencil eraser)

E for elevation: A mole that is raised above the skin and has a rough surface
You should also watch for the following changes:
•A mole that bleeds
•A mole that grows fast
•A scaly or crusted growth on the skin
•A sore that won’t heal
•A mole that itches
•A place on your skin that feels rough, like sandpaper
If your doctor tells you to do skin checks, be sure to check your whole body once each month, including your back, your scalp and the bottom of your feet. Use a hand mirror to check the places that you can’t see easily. Have someone help you check the top of your head. You can use a blowdryer on low speed to move your hair so you can see your scalp more easily.

Thehealthtime.com

Concussion in Sports
What is a concussion?
A concussion is an injury to the brain. It’s usually caused by a blow to the head. Most of the time it doesn’t involve a loss of consciousness.

Concussion in sports can happen during drills, practices, and games. Injuries during practice can be just as serious as those that happen during competition.
_______________________

What are some signs of a concussion?
After a blow to the head, talk to your doctor if you have any of the following signs of concussion:
•Headache
•Vision disturbance
•Dizziness
•Loss of balance
•Confusion
•Memory loss (called amnesia)
•Ringing in the ears
•Difficulty concentrating
•Nausea
•Feeling foggy or groggy
•Sensitivity to light or noise
_______________________

How is it diagnosed?
First a doctor will examine you. The doctor will want information from people who were there when the blow to the head happened. This is very important, especially if you’re confused or if you lost your memory. The doctor will test your strength, sensation, balance, reflexes and memory. In more serious cases, your doctor will want to get special x-rays of your head, called computed tomographic (CT) scans or magnetic resonance images (MRI).
_______________________

Does medicine help?
The treatment for a concussion is rest. If you have a headache, you can usually take acetaminophen (brand name: Tylenol). If you’ve had a concussion, always ask your doctor before you take any medicine. If it’s suspected you’ve had a concussion, your doctor may advise against taking aspirin, ibuprofen (brand names: Advil, Motrin) or other nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines may increase the risk of bleeding.
_______________________

What should I watch out for?
Tell your doctor if you have any of the following symptoms:
•Stiff neck
•Difficulty walking, speaking or using your arms
•Severe headache
•Repeated vomiting
•Confusion that gets worse
•Convulsions
•Unusual sleepiness
_______________________

When can I return to sports?
You should never return to play while you have any signs of concussion, like headache or dizziness. If your concussion is very mild, you may be allowed to return to play after 15 or 20 minutes. If you have memory loss or loss of consciousness, you may not be able to return to play for 1 to 2 weeks. After a severe concussion, you may not be able to return to play for a month. If this wasn’t your first concussion, your return to play may take even longer.
_______________________

What are the risks of returning to play too early?
A player returning too early could suffer from “second impact syndrome,” which can be fatal. A second blow to the head, even a minor one, can cause a loss of control of blood flow to the brain. Never return to a sports activity until you are cleared by a doctor.
_______________________

Are there any lasting effects to a concussion?
Most people get better after a concussion without any permanent damage. Some people have signs of concussion for weeks to months. Repeated concussions could cause permanent damage. After several concussions, your doctor may talk with you about changing sports.

Thehealthtime.com

Joint and Soft Tissue Injections
What are joint and soft tissue injections?
Joint and soft tissue injections are shots with a needle into a joint (such as your knee) or a soft tissue space (such as the space between a muscle and a bone). The needle may be used to take out fluid or to put in medicine. These shots can be used to diagnose or treat many different conditions, including rheumatism, tendonitis, carpal tunnel syndrome and bursitis.

Anti-inflammatory medicines such as corticosteroids and pain relievers such as lidocaine (one brand name: Xylocaine) are the most common medicines used for joint and soft tissue injections. Before getting an injection, it is important to tell your doctor if you are allergic to steroids or any other drug.

________________

What will I feel during the injection?
Your doctor will probably give you a local anesthetic (numbing medicine) before the injection so you feel very little pain. You may feel some pain after the anesthetic wears off. Hold ice on the area for 15 minutes several times a day or talk to your doctor about other ways to relieve the pain. He or she may recommend taking an oral pain reliever.

________________

What are some common side effects of joint and soft tissue injections?
The most common side effects of joint and soft tissue injections are irritation and swelling of the tissues. This is known as a post-injection “flare” and may last up to 48 hours. Other possible side effects include infection, tendon rupture and muscle damage. In order to reduce your risk of infection, follow your doctor’s instructions carefully and keep the injection site clean. Call your doctor right away if you notice any redness or swelling.

Thehealthtime.com

Shoulder Pain
What causes pain in my shoulder?
A common cause of shoulder pain is soreness of the tendon (a cord that attaches a muscle to a bone) of the rotator cuff (the part of the shoulder that helps circular motion). Another common cause is soreness of the subacromial bursa (a sac of fluid under the highest part of the shoulder). You might experience soreness after activities such as painting, lifting or playing a sport, which require you to lift your arms. Or you may not remember any specific injury.

The main joint in the shoulder is formed by the arm bone and the shoulder blade. The joint socket is shallow, allowing a wide range of motion in the arm. The rotator cuff is made up of 4 muscles that surround the arm bone. This cuff keeps the shoulder steady as the arm moves.

_____________________

How does the rotator cuff get hurt?
The supraspinatus muscle rests on top of the shoulder. Its tendon travels under the bone on the outside of the shoulder (the acromion). This tendon is the one most often injured because of its position between the bones. As the tendon becomes inflamed (sore and swollen), it can become pinched between the 2 bones. The sac of fluid that cushions the tendon can also be damaged.

_____________________

How do I know the rotator cuff is hurt?
If the rotator cuff is involved, the pain is usually in the front or outside of the shoulder. This pain is usually worse when you raise your arm or lift something above your head. The pain can be bad enough to keep you from doing even the simplest tasks. Pain at night is common, and it may be bad enough to wake you.

_____________________

What can I do to help relieve the pain?
Treatment should help relieve the pain and help you restore your shoulder to normal function. Pain relief strategies include active rest (you can and should move your shoulder, but you shouldn’t do strenuous activities like lifting heavy objects or playing tennis). Application of ice, taking nonsteroidal anti-inflammatory medicine such as ibuprofen (2 brand names: Advil, Motrin) or naproxen (brand name: Aleve) and, occasionally, an injection of anti-inflammatory steroids can also help.

Special exercises may also help. The first step of rehabilitation therapy is simple range-of-motion exercises. By bending over and moving (rotating) your shoulder in large circles, you will help to avoid the serious complication of rotator cuff injury, called a frozen shoulder. These range-of-motion exercises are followed by resistance exercises using rubber tubing or light dumbbells. The final step is resistance training with weight machines or free weights.

_____________________

What exercises should I do?
The following exercises may help you (see pictures 1, 2 and 3). Ask your doctor if you should do other exercises, too.

Picture 1 Picture 1. Range of motion. Stand up and lean over so you’re facing the floor. Let your sore arm dangle straight down. Draw circles in the air with your sore arm. Start with small circles, and then draw bigger ones. Repeat these exercises 5 to 10 times during the day. If you have pain, stop. You can try again later.

Picture 2 Picture 2. Rotator cuff strengthening. Use a piece of rubber tubing for these exercises. Stand next to a closed door with a doorknob. Loop the tubing around the knob. With your hand that is closest to the door, bend your arm at a 90° angle and grab the loop of the tubing. Pull the band across your tummy. At first, do 1 set of 10 exercises. Try to increase the number of sets as your shoulder pain lessens. These exercises should be done every day.

Picture 3 Picture 3. Upper extremity strengthening. As your pain goes away, try adding a general upper body weight-lifting program using weight machines or free weights. Lie on your right side with your left arm at your side. With a weight in your left hand and your forearm across your tummy, raise your forearm. Keep your elbow near your side.
_____________________

What else can I do to help this injury heal?
An aerobic exercise program will help improve the blood flow to the tendon or bursa. This helps reduce soreness. Smokers should quit smoking so more oxygen reaches the injured tendon. This will help the injury heal faster.
_____________________

Will I need surgery?
Sometimes an injury that lasts a long time will cause the tendon to tear. This type of injury may need surgery. A tear of the rotator cuff is suspected when the pain goes on in spite of a good rehabilitation program or when there is weakness in certain motions of the arm.

Thehealthtime.com

Ankle Sprains: Healing and Preventing Injury
What is a sprain?
A sprain is a stretched or torn ligament. Ligaments connect one bone to another bone at a joint and help keep the bones from moving out of place.

The most common site of sprains is the ankle. An ankle sprain can happen when you fall, when you suddenly twist your ankle too far, or when you force the joint out of its normal position (for example, when you land awkwardly on your foot after jumping). Most ankle sprains happen during sports activities or when walking or running on an uneven surface.

The signs of an ankle sprain can include:

•pain or tenderness
•swelling
•bruising
•coldness or numbness in the foot
•inability to walk or bear weight on the joint
•stiffness
The severity of an ankle sprain depends on how badly the ligaments are stretched or torn. If the sprain is mild, there may not be much pain or swelling, and the ligaments may only be stretched. If the sprain is severe, one of more ligaments may be torn, and the join may be severely swollen. A severe sprain can also be extremely painful.

_____________

How are ankle sprains diagnosed?
Your doctor will usually be able to tell if you have a sprain by asking you some questions about how the injury occurred and by examining your ankle. You doctor may also want to take an x-ray of your ankle to make sure that it’s not fractured or broken.
_____________

How can ankle sprains be treated?
Many doctors suggest using the RICE approach–Rest, Ice, Compression, Elevation–for treating ankle sprains (see the box below).

RICE approach
Rest–You may need to rest your ankle, either completely or partly, depending on how serious your sprain is. Use crutches for as long as it hurts you to stand on your foot.

Ice–Using ice packs, ice slush baths or ice massages can decrease the swelling, pain, bruising and muscle spasms. Keep using ice for up to 3 days after the injury.

Compression–Wrapping your ankle may be the best way to avoid swelling and bruising. You’ll probably need to keep your ankle wrapped for 1 or 2 days after the injury and perhaps for up to a week or more.

Elevation–Raising your ankle to or above the level of your heart will help prevent the swelling from getting worse and will help reduce bruising. Try to keep your ankle elevated for about 2 to 3 hours a day if possible.
_____________

Will I need to wear a brace?
This will depend on how serious your sprain is, if you have other ankle injuries and how your doctor thinks your sprain should be treated. You may need to wear a brace or padded plaster, plastic or fiberglass splint for 10 days to 6 weeks. A brace or splint keeps the bones and injured ligaments from moving, which provides protection, reduces pain and speeds healing.
_____________

How long before I can use my ankle?
This depends on how serious your sprain is. If your sprain is mild, your doctor may suggest that you start trying to use your ankle again fairly soon–from 1 to 3 days after your injury.

Special exercises are sometimes needed to regain strength and to help reduce the chance of ongoing problems. Your ankle may need to be supported by taping or bracing to help protect it from reinjury.

_____________

What about medicine for pain?
If you need medicine to ease the pain, try acetaminophen (brand name: Tylenol) or ibuprofen (brand names: Advil, Motrin, Nuprin).

_____________

What is the best way to use ice?
Putting ice on your ankle can be very helpful, but you also need to be careful. The cold can damage nerves if the ice is left in place too long.

Ice can be left on your ankle for up to 20 minutes at a time. When your skin feels numb, it’s time to remove the ice. Use ice treatments every 2 to 4 hours for the first 3 days after your injury. Ice treatments can consist of ice packs, ice slush baths or ice massages.

To use ice packs, partly fill a plastic bag with crushed ice. Wrap a thin, wet cloth around your injury. Place the ice pack over this and then wrap an elastic bandage around the ice pack to hold it in place.

For ice slush baths, fill a large bucket with water and ice. Place your ankle in the bucket until the skin gets numb.

Ice massages can work well for small areas. Freeze water in 4- to 8-ounce styrofoam (coffee) cups. Tear the top part of the cup away from the ice. Hold the covered end and slowly rub the ice over the sprained area with a circular motion. Don’t hold the ice on one spot for more than 30 seconds.

_____________

How do I wrap a sprained ankle?
Start by cutting out a horseshoe-shaped pad from 1 x 4- to 3 x 8-inch-thick felt. Put this pad around the outside of your ankle joint on both sides of your foot, with the open end facing up.

Then wrap an elastic bandage, such as an Ace bandage, in a basket-weave “figure-of-eight” pattern. Leave your heel exposed. Reinforce your wrap with 21 x 2-inch adhesive tape over the elastic bandage.

Ask your doctor to show you how to do this. The ankle shouldn’t be wrapped so tightly that the blood flow is cut off.
_____________

How soon can I exercise or play sports?
If you’re an athlete, you’ll probably be able to return to your sport in several weeks, depending on how serious your injury is and what sport you’re involved in. When participating in sports, you may need to keep your ankle braced or wrapped for support and protection.

Bicycling, swimming or even running are usually okay to return to right away if they don’t cause pain during or after exercise. But you’ll still need to avoid pivoting and twisting movements for 2 to 3 weeks.

_____________

How can I prevent reinjury?
When your doctor feels you’re ready to exercise again, you can help prevent further sprains and setbacks by wearing a semirigid ankle brace when you exercise for another 1 to 2 months.

Special wraps that use hook and loop fasteners, or air-filled or laced braces may also help prevent reinjury. Wearing high-top tennis shoes may also help prevent ankle sprains if your shoes are laced snugly and if you also tape your ankle with a wide, nonelastic adhesive tape. Elastic tape or braces are usually not helpful because the elastic gives too much around the joint.

Once your sprain has completely healed, a program of ankle exercises will also help prevent reinjury by making the muscles stronger, which provides protection to the ligaments. Try the following exercises:

Ankle Circles
Sit on the floor with your legs stretched out in front of you. Move your ankle from side to side, up and down and around in circles. Do 5 to 10 circles in each direction at least 3 times per day.

Alphabet Letters
Using your big tow as a “pencil,” try to write the letters of the alphabet in the air. Do the entire alphabet 2 or 3 times.

Toe Raises
Pull your toes back toward you while keeping your knee as straight as you can. Hold for 15 seconds. Do this 10 times.

Heel Raises
Point your toes away from you while keeping your knee as straight as you can. Hold for 15 seconds. Do this 10 times.

In and Out
Turn your foot inward until you can’t turn it anymore and hold for 15 seconds. Straighten your leg again. Turn it outward until you can’t turn it anymore and hold for 15 seconds. Do this 10 times in both directions.

Resisted In and Out
Sit on a chair with your leg straight in front of you. Tie a large elastic exercise band together at one end to make a knot. Wrap the end of the band around the chair leg and the other end around the bottom of your injured foot. Keep your heel on the ground and slide your foot outward and hold for 10 seconds. Put your foot in front of you again. Slide your foot inward and hold for 10 seconds. Repeat at least 10 times each direction 2 or 3 times per day.

Step Up
Put your injured foot on the first step of a staircase and your uninjured foot on the ground. Slowly straighten the knee of you injured leg while lifting your injured foot off the ground. Slowly put your injured foot back on the ground. Do this 3 to 5 times at least 3 times per day.

Sitting and Standing Heel Raises
Sit in a chair with your injured foot on the ground. Slowly raise the heel of you injured foot while keeping your toes on the ground. Return the heel to the floor. Repeat 10 times at least 2 or 3 times per day. As you get stronger, you can stand on your injured foot instead of sitting in a chair and raise the heel. Your injured foot should always stay on the ground.

Balance Exercises
Stand and place a chair next to your uninjured leg to balance you. At first, stand on the injured foot for 30 seconds. You can slowly increase this to up to 3 minutes at a time. Repeat at least 3 time a day. To increase the difficulty, repeat with your eyes closed.

Thehealthtime.com

What Is An Adoption Plan?
Sometimes, couples who are expecting a baby but aren’t able to care for the child make an adoption plan. This allows someone else to raise the child.
What is adoption?
Adoption is when a child’s birth parents give up legal rights to the child, and someone else raises the child. Adoption is permanent. Rules about adoption vary by state. To learn about the rules in your state, contact your local family or human services agency, or go to “Infant Adoption Awareness: State Laws.”

The following are the 2 main types of adoption:
•Open: In this type of adoption, the birth parents have direct contact with the adoptive parents before and after the adoption. The birth parents decide how much information they want to know or share. Together with the adoptive parents, they also decide how much contact they want with the adoptive parents and the child.
•Closed: In this type of adoption, the birth parents may be given some non-identifying information about the adoptive parents, such as their ages or their jobs. But the birth parents do not know specific information about the adoptive parents, such as their names or where they live. In a closed adoption, the adoptive parents are given information about the birth parents that might help them take care of the child, such as medical or family history. However, the adoptive parents do not know the names of the birth parents, where they live or any other information that would identify who the birth parents are.
________________

How do adoptions work?
Adoptions are usually handled by adoption agencies. These agencies help place children with adoptive parents. They screen people who want to adopt. This means that they interview them, check their backgrounds and spend time with them to make sure they are ready to raise a child. Adoption agencies also help birth parents with medical care, support and counseling. There are public and private adoption agencies. All of them must be licensed by the government.
________________

Do all adoptions go through an agency?
No. Some adoptions are not handled by an agency. These are called “independent adoptions” and are handled by lawyers. Typically, the adoptive parents and the birth parents each hire a lawyer to represent them. It is important to find a lawyer who has experience handling adoptions. Independent adoptions are not legal in all states, so be sure to check your state’s laws if you are considering this type of adoption.

In an independent adoption, the adoptive parents usually pay the birth mother’s hospital and medical bills until the baby is born. Some also pay for her living expenses during the pregnancy. States that allow independent adoptions have strict laws about what the adoptive parents can pay for and what they cannot.
________________

Can relatives adopt?
Yes, but they have to go through the same evaluations as other adoptive parents.
________________

Can birth parents see the baby after the birth?
Birth parents are usually allowed to see the baby in the hospital. They should check with the adoption agency or lawyer handling the adoption before the baby is born.
________________

How soon is a baby placed in the adoptive home?
It is different from state to state. In most states, there is usually a waiting period of at least 48 hours. The birth parents are then asked to sign a form that ends their rights as parents. After they sign the form, the baby is given to the adoptive parents. In some states, the adoptive parents and the birth parents have a certain amount of time to change their minds about the adoption. But once the adoption is legally approved, it is permanent.

Thehealthtime.com

Pain Control After Surgery: Pain Medicines
What are the benefits of taking pain medicine after surgery?
People used to think they just had to suffer through severe pain after surgery. Today, your nurses and doctors can do many things before and after surgery to prevent or relieve your pain. Treatment of pain can help you in the following ways:
•You can feel more comfortable, which will help your body heal.
•You can get well faster. If you feel less pain, you can start walking and get your strength back more quickly. You may even be able to leave the hospital sooner.
•You may have fewer complications after surgery. People whose pain is well-controlled seem to do better after surgery. For example, they don’t have as many problems such as pneumonia and blood clots.
Many types of medicines are available to help control pain. Some of these include nonsteroidal anti-inflammatory drugs (called NSAIDs), opioids and local anesthetics.
________________

When are NSAIDs used?
For mild pain after surgery, you might be given NSAIDs. These medicines reduce swelling and soreness, and relieve mild to moderate pain. Some examples of these medicines are aspirin, ibuprofen (some brand names: Advil, Motrin) and naproxen (one brand name: Aleve).
________________

What are the benefits of NSAIDs?
You won’t get addicted to these medicines. Depending on how much pain you have, these medicines can take it away or at least lessen your need to take a stronger medicine, such as morphine.
________________

What are the problems with NSAIDs?
NSAIDs may cause nausea, stomach bleeding or kidney problems. Most NSAIDs interfere with blood clotting, and they can also make high blood pressure worse and affect the way blood pressure medicines work. If your pain is strong, you will usually also have to take an opioid to relieve it.
________________

When are opioids used?
Opioids (such as morphine and codeine) are the medicines most often used for acute pain, such as short-term pain after surgery.
________________

What are the benefits of opioids?
Opioids work well for severe pain. They don’t cause bleeding in the stomach or other parts of the body. It’s rare to become addicted to an opioid after surgery if it’s used as prescribed by your doctor.
________________

What are the problems with opioids?
Opioids may cause drowsiness, nausea, constipation or itching. They can also interfere with breathing or urination.
________________

What about local anesthetics?
Local anesthetics (such as procaine) can be given in a shot near your incision or through a small tube in your back. These medicines block the nerves that send pain signals to your brain.
________________

What are the benefits of local anesthetics?
Local anesthetics, or shots at the incision, will block pain only at that area of the body. There is little or no risk of drowsiness, constipation or breathing problems when you use a local anesthetic. Local anesthetics reduce your need for opioids.
________________

What are the problems with local anesthetics?
Several shots are usually needed to make pain relief last, but too much of a local anesthetic can cause problems. Even average doses may cause you to feel dizzy or make your legs feel weak.
________________

How is pain medicine given?
Medicines can be given by mouth (liquid or pill) or through the rectum (suppository), or they can be injected into the skin, a muscle or a vein.
________________

What are the benefits and problems of oral medicines?
Aspirin, ibuprofen or codeine can be taken by mouth. Pills and liquids cause less discomfort than shots into a muscle or the skin. They can work just as well as shots. They are inexpensive and easy for you to take when you go home from the hospital. On the other hand, these medicines can’t be used if you aren’t supposed to take anything by mouth or if you’re nauseated or vomiting. (Some of these medicines also come in a rectal suppository, so you can take them even if you’re nauseated.) There may be a delay in pain relief with oral medicines, because you have to wait for your body to absorb the medicine.
________________

What are the benefits and problems of injected medicines?
Medicines given in shots into the skin or a muscle can work even if you’re nauseated or vomiting. However, the injection site usually hurts for a short time.

Pain relief medicines can be injected into a vein through a small tube called an intravenous (IV) catheter. The tip of the tube stays in your vein all the time that the medicine is being used. Medicine given this way goes through your body fast, so it starts to work quickly. This method of pain relief works well for brief pain.

With a patient-controlled analgesia (PCA) pump, you can control your own doses of pain medicine. When you begin to feel pain, you push a button to inject medicine into your vein; a small tube must first be put into your vein. If you use the PCA pump, you have to learn how when to use it.

Pain medicine can also be put into your back through a small tube called an epidural catheter. This method works well when you’re having surgery on your chest or your stomach. It takes a specially trained doctor (called an anesthesiologist) to put the small tube in your back. This person also watches you for problems that can happen several hours after the pain medicine is given.
________________

Adapted from Pain Control After Surgery: A Patient’s Guide. AHCPR Pub. No. 92-0021. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, 1993.

Thehealthtime.com

High Blood Pressure Medicines
What is high blood pressure?
Imagine that your arteries are pipes that carry blood from your heart to the rest of your body. High blood pressure (also called hypertension) occurs when your blood moves through your arteries at a higher pressure than normal.
_______________

How is high blood pressure treated?
High blood pressure medicines (also called antihypertensive medicines) can help lower your blood pressure. The goal of treatment is to reduce your blood pressure to normal levels with medicine that is easy to take and has few, if any, side effects. Your doctor may also talk to you about the benefits of lifestyle changes, such as eating a healthy diet, being physically active and losing weight if you’re overweight.
_______________

What are some common medicines to treat high blood pressure?
There are several types of medicine used to treat high blood pressure. Your doctor will decide which type of medicine is right for you.

Diuretics (water pills) help your body get rid of extra sodium (salt) and water so your blood vessels don’t have to hold so much fluid.

Beta-blockers make the heart beat slower so that blood passes through your blood vessels with less force.

Angiotensin-converting enzyme inhibitors (also called ACE inhibitors) keep your body from making angiotensin II, a hormone that causes blood vessels to narrow. This relaxes your blood vessels.

Angiotensin II receptor blockers (also called ARBs) relax your blood vessels by blocking the effects of angiotensin II, a hormone that causes blood vessels to narrow.

Calcium channel blockers (also called CCBs) help keep your blood vessels from constricting (becoming narrow) by blocking calcium from entering your cells.

Alpha-blockers help relax your blood vessels by reducing nerve impulses. This allows your blood to pass through more easily.

Alpha-beta blockers not only reduce nerve impulses, but also make the heart beat slower so the blood passes through the vessels with less force.

Centrally acting drugs affect your brain and central nervous system to reduce the nerve impulses that can increase your heart rate and cause your blood vessels to narrow.

Direct vasodilators relax the muscles in the blood vessel walls. This causes the blood vessels to widen.
_______________

Do these medicines have any side effects?
All medicines have side effects. Some common side effects of high blood pressure medicines include the following:

•Headache
•Dizziness or lightheadedness
•Nausea
•Vomiting
•Extreme tiredness, weakness, drowsiness or lethargy (lack of energy)
•Diarrhea or constipation
•Unintended weight loss or gain
•Nervousness or increased anxiety
•Chest pain, heart palpitations (the feeling that your heart is racing) or arrhythmia (irregular heartbeat)
•Cough, fever, congestion, upper respiratory tract infection or “flu-like” symptoms
•Skin rash
Tell your doctor as soon as possible if your side effects become severe or bothersome.

_______________

What is a drug interaction?
If you use 2 or more drugs at the same time, the way your body processes each drug can change. When this happens, the risk of side effects from each drug increases and each drug may not work the way it should. This is called a “drug-drug interaction.” Vitamins and herbal supplements can also affect the way your body processes medicine.

Certain foods or drinks can also prevent your medicine from working the way it should or make side effects worse. This is called a “drug-food interaction.” For example, people taking certain CCBs may need to avoid eating grapefruit or drinking grapefruit juice.

Be certain that your doctor knows all of the over-the-counter and prescription medicines, vitamins and herbal supplements you are taking.

Also, ask your doctor whether you need to avoid any foods or drinks while using your blood pressure medicine.