الأربعاء، 15 يونيو 2011

Howdy Folks:) Sue Relays Asked Me to Post My Results Here


I got to know Sue when she visited the Colorectal Board - she's been a good friend and terrific supporter to me. And since she does not get over to our side very much anymore, she asked me if I would post my results over here so she could see them. I hope you don't mind.
From Sue:
"Will be waiting to see your results. Will you post on the anal board as well??"
This is a long post but covers the past year of my fight, currently at 7-years, Stage IV.
Grab something to drink and you're welcome to read along with Sue. And maybe Joanne will show up here - I miss her to and met her on the other board when she first got here.
Ok, Sue and everybody here we go!
“SUNDANCE vs CANCER” – The Results Post
Faster than a speeding locomotive – Able to leap tall buildings in a single bound – Look! – Up in the air! – It’s a bird! – It’s a plane! – It’s…..it’s……awww $hit, it’s only Sundance:)
LOL:)
The “Betting Windows” are now officially closed, so I hope you got your wagers down – there was sure plenty of time:)
Well, this is finally the post that I have waited for and waited to write. And also the one that many of you have waited for as well. Almost a year in the making and through it all, it has been a “Watershed Moment” in my journey.
I suppose when I reflect back on it, we could say that it’s the most influential battle of my entire campaign. There was much at stake to be won or lost. It carried huge significance as I motored on toward my 7th year of this incredible saga. And all the time, never knowing exactly which way the battle was going to go. Would I win? Or would I begin to slip?
The stakes we were playing for was my very existence, which I believe we can all agree, is worth playing for. The difference is we had to fight like there was never going to be tomorrow – because that’s always in the cards and is the key component that weighs so heavily on all of our minds.
It’s a funny feeling looking back on this past year. In many ways, it still feels like yesterday – and then on the other side, it seems like a lifetime ago.
Cancer played a dirty little trick on me this time. We know he does not play fair and is a dirty fighter. He used the DaVinci tumors the time before, to lull us into a false sense of complacency while he stealthily hid behind my lungs and gathered his forces, before he could again announce his presence in my body for this last year’s fight.
When I was still in the hospital after this lung surgery, I remember a nurse bringing me my pathology report. Even dazed on morphine and with blurred eyesight, I could still make out the words…”Colorectal Mets to Lung.”
And I remember thinking, “Now, you’ve showed yourself, you SOB!” I sat up in bed and thought, “I’ve got you now.” You’ve just kicked the sleeping dog – you just woke up the Gentle Giant. So, once again, it’s “officially back on.”
Strangely though, I felt some sense of comfort in those words, in the fact that I again knew what I was going back up against….there was no guessing anymore, there it was in the report. It was time once more to “get my mind right to fight.”
Once I found out the surgery did not completely remove the malignant tumors, I knew it was going to a really long and hard road, with no shortcuts. I was going to have to go all in and gut this one out for the long haul, if I was to have a chance at any kind of victory.
You all know there were times when it looked like I was beaten. Down and out for the count is what’s ahead for our good old Sundance, folks were probably thinking – put a fork in him, he’s done. But then again, you don’t know Sundance:)
I’ve always said I may “bend or waver” during the fight, but that I would never “break.”
Maybe that’s not an entirely true statement. Perhaps, it depends on what your definition of “break” is. In fact, Cancer had me beaten and on my knees begging for either “Death or Mercy.” It had me beaten at the time, but not broken for the long haul of the fight.
“The CURE” had me beaten as well this time , but I stayed strong enough to complete the entire protocol “by the numbers.” It was really difficult this time to mentally and physically step through all the obstacles that stood in our way. As I’ve said before, it gets a little harder to keep taking the pounding, the longer you stay in the fight.
The mind and heart are still willing – but the body just doesn’t “bounce” like it used to. I think this is the biggest difference in an old veteran fighter vs the newly diagnosed.
While the surgeries and treatments have compromised our bodies, we learn we must adapt and use our experience and smarts to fight on, instead of relying on a new body that is just starting out.
My medical team continuously put the foot on the gas and we were very aggressive in our treatment plan and there was no time to rest. We relentlessly pursued our target and stayed in the attack mode the entire time.
Oh yes, I can be beaten – I can be hurt – I can bleed – I can hurt – I can suffer. I am just a mortal man, composed of blood & flesh..
However, on the other side of the coin, I can also be tenacious – persistent – stubborn – and relentless in my own pursuit. My horoscope is “Cancer, the Crab.” I’m a “July Baby.”
We’re loveable, friendly, and loyal – but when fuc*ed with, we raise our pinschers and will snap you. We’re a very formidable force to reckon with. When we hit back, it hurts too, just like we were hurt. We only fight when provoked though and let’s face it, Cancer does provoke us, doesn’t it?
Here’s the last topic I wanted to discuss. Let’s talk about our roommate – HOPE.
What an interesting fella’ this guy is, am I right?
He’s very elusive and if we’re not real careful, he can just slip out of our fingertips and just be gone. And when he goes, he’s sometimes hard to find again. And when Hope moves out, Depression can move in – then he invites Despair, Hopelessness and Loneliness to the party, and from there our lives can disappear and become nothing but existence.
And that’s a very bad place to be – especially for too long. I know, because I spent 9-months with all of these guys this year. They are not nice “house guests.” They try to rob you of that thing that we call “Our Lives.”
And then it becomes up to us to take back back what was so wrongly taken from us. Each of us must do that and find a way to get Hope moved back in with us, so we can flourish and feel optimism.
What is my definition of Hope?
I’ve come to think of Hope as that “Intangible element of humanity that we cannot see, but one that we feel.”
It’s the single common denominator that every single one of us has inside. It’s the driving force behind our individualism and more importantly, the one thing that we “Cling To” and “Reach For” in times of dire circumstances that beset each of us, somewhere in our lifetime.
As the old saying goes, “Let’s Keep Hope Alive!”
Hey, let’s go down to ringside right now, looks like Michael Buffer is about to announce “The Decision.” Who came out on top? Sundance or Cancer?
“Ladies and Gentlemen! The Winner by KO and still the Undefeated Cancer Champion of the World, with a 3-0 title defense, is……….your very own…….SUNDANCE! “
LOL:)
And the crowd goes WILD……….:) !!!
For any of you that bet against me…….”Suckerzzzz!” LOL:)
That’s right folks – 3 recurrences Up and 3 recurrences Down – just like in baseball, huh?
We did it again. We knocked Cancer “Back into the Shadows” once more. He’s gone back into hiding, licking his wounds, while I lick mine. But, we got Him down right now. You read the BAD in my other post…….and now for something completely different, here is the GOOD:
1. Colon and Rectum = Clear
2. Liver = Clear
3. Lungs = All Clear:)
Many of you might recall in my Thanksgiving Message to my Cancer, that I said, “I am down right now – but when I get up, I’m coming – and He11 was coming with me.
Well, with Big Billy by my side, we “Huffed and we Puffed”…and we “Blew the Doors to the Gates of He11 Wide Open!”
What looked like a highly improbable, if not impossible mission at the beginning of this fight, has come to a successful conclusion. I know how fortunate I am to be on the “positive side of the ledger” right now. It sure could have gone either way, but somehow we are on top right now.
We’re officially back to “Watching and Waiting.” I’ll talk to NED, if I make it “clean” for 5-years, with no further recurrences….. (June 2016).
So, it does not get much better than this….am I right?
I thought the balloons were supposed to fall out of the ceiling about now? Why isn’t the band playing? Where’s the cake and ice cream? Where is Jennie with my margaritas?
LOL:)
Since I can’t get to any of you right now…we’ll just have to have a “Cyber Celebration!” I need some folks to share in this joy with me. It will mean more if I have all of you around me in the “same room.”
So, what’s next for Sundance?
I’m going to Disneyworld!...................................Not!
I’ll be lucky to get to Chicago for CP9 – with this very meaningful victory, it is my sincerest hope that I can make it there and get some lovin’ from my honeys:)
What’s next is instead of escaping Cancer, I’m going to jump back into the deep end of the pool and go back to the beginning of the journey – first chapter titled “The Diagnosis.”
I want to jump on getting this written now, while the wounds are fresh and the feelings raw. I’m excited about making this a reality – now publishing will be another story – coming to an Amazon Kindle near you?
I’ll close this post with these final thoughts…..
On the day that Donna (Shayenne) aka “My Chicky” passed away, I posted on that thread that Her Lion had roared for the final time.
A beautiful chapter in my life and on this board and a real life story of friendship had come to a tragic and painful end. On this day a part of me died with her –Her Lion was dead and gone, and yet the memories still remained, but were now forever buried deep within the archives of the CSN posts.
This is a day where I wished Chicky were still here with us – certainly a story she would have loved to hear about and rejoice in. I will miss not seeing her post in this thread.
In honor of her memory and to bookmark this momentous occasion, Donna’s Lion “ROARZZZZ” one more time:) Miss you, Chicky.
This one was for myself, but also for the Semi;Colon Nation. I stand before you as a living testimony to what Cancer “Can and Cannot” do to us. It will never be easy, but you too can do this. I’ll stand proudly beside each one of you and be with you for each stop in your journey. Don’t be afraid – get mad – get even – and get out there and fight!
I understand less and less as time goes by – have no idea of why I’m still here after 7 years of battling this stuff. Don’t understand why my friends did not make it, but I am still here. I suppose I’ll never know.
And Cancer may indeed catch me one day – but guess what? It won’t be TODAY!!!
All of you know that Sundance is not the kind of guy that “Goes Quietly into the Night.”
I carry all of your hopes and dreams with me in my heart. I have the deepest respect and admiration for each one of you here – both past and present. You are the finest group of people I know and I’m proud to know you all.
All of you are Winners – and Cancer will never, ever take that away from you! With all of the love I can muster, I thank you for staying with me and you are all in my thoughts, in my heart, and in my dreams. Semi;Colons Rock!
I SALUTE YOU!!!
Craig and Big Billy
“Team Sundance”

Doctor Says Surgery May Relieve Pain Of Neuropathy

Medifocus Guidebook on Peripheral Neuropathy

الثلاثاء، 14 يونيو 2011

Migraine headache


تختلف آلام الصداع النصفي (الشقيقة)عن كل آلام الأنواع الأخرى من الصداع. Different migraine pain (migraine) for all the pain of other types of headaches. ويصيب هذا النوع من الصداع جزءا واحدا من الرأس أي بشكل نصفي. Affects this type of headache is one part of the head in any half. ويعاني منه 25% من النساء و8%من الرجال طوال حياتهم. And affects 25% of women and 8% of men throughout their lives. والمرأة أكثر عرضة لنوباته ولاسيما في مرحلة الاياس (سن اليأس) لتغير معدلات الهورمونات الأنثوية لديها. Women are more vulnerable to Nubath, especially at the stage of menopause (menopause) to change the rates of female hormones have. يسبق حدوث الصداع النصفي في ثلث الحالات نوبات من الأورة متمثلة في تخيلات بصرية وصوتية وشمية غير موجودة. Preceded by a migraine in one third of cases, episodes of aura represented in fantasies and audio-visual and olfactory non-existent.

محتويات Contents

[أخف]

causes

ينتج مرض الصداع النصفي عن توسع شديد في الأوعية الدموية خارج القحف (الموجودة في فروة الرأس) مما يؤدي إلى انضغاط على النهايات العصبية المحيطة بالأوعية الدموية مطلقة الألم وهذا يفسر طبيعة الألم النابض. Produces migraines for the expansion of severe extracranial blood vessels (located in the scalp), leading to compression of the nerve endings surrounding blood vessels, an absolute pain and explains the nature of the pain this spring. وهذا أيضا يفسر الألم العيني في أغلب أنواع الصداع النصفي لكون الطبقة الخارجية للعين تأخذ الألياف العصبية من نفس العصب (مثلث التوائم) الذي يحيط بالأوعية الدموية خارج القحف (شريان صدغي سطحي). This also explains the kind of pain in most types of migraine to the fact that the outer layer of the eye takes nerve fibers of the same nerve (trigeminal) that surrounds the blood vessels outside the cranium (superficial temporal artery). في نفس الوقت يحصل تقبض في الأوعية الدموية داخل القحف مما يؤدي إلى حدوث الأعراض العصبية المرافقة للنوبة الألمية. At the same time gets arrested in intracranial blood vessels leading to neurological symptoms associated with heart Alolmip.

 Types

الصداع النصفي نوعان صداع نصفي عادي لايشعر فيه المريض بدنو النوبة وتستمر نوبته من 4-72ساعة حيث يشعر بألم في جانب الرأس أو الجانبين وقديكون نابضا أو متوسطا أو شديدا مع القيء وشعور بالغثيان وحساسية للأصوات. وصداع نصفي تقليدي وفيه يشعر المريض بدنو النوبة مرتين علي الأقل سنويا. Migraine types migraine headache plain did not feel the patient approaches the heart and continues his shift of 4-72 hours, where the pain is felt in the side of the head or the sides and Kadikon vibrant, medium or severe, with vomiting, nausea and sensitivity to sounds. and migraine headache traditional and the patient feels approaches the seizure at least twice a year . وقد تستمر النوبة 3أيام ويسبقها توتر عصبي وتشوش الرؤية. The last 3 days and Nubia preceded by nervous tension and blurred vision. فيري الشخص أثناءها الخطوط متعرجة وأضواء مبهرة (كوميض)أو يفقد النظر مؤقتا مع صعوبة في الكلام والشعور بضعف الذراعين والساقين وتنميل بالوجه واليدين وألم في الجبهة والفكين والأذنين وحول العين. Ferry person during the zigzag lines and strobe lights (Comid) or consider temporarily lose with difficulty in speech and feeling weak arms and legs and numbness of the face and hands and pain in the forehead, jaws, ears and around the eye. وقد يظهر الصداع في جانب واحد من الدماغ خلف العينين أو حولهما و تسمى هذه الأعراض بالأورة . Headaches may appear on one side of the brain behind the eyes or around and called these symptoms Baloorp . وقد ينتقل للجانب الآخر أثناء النوبة. The move to the other side during a seizure. والأفضل تحديد أسباب ظهور الصداع النصفي ومحاولة تجنبها للسيطرة علي الصداع والوقاية منه رغم من عدم وجود أسباب محددة لظهور الصداع النصفي, لكن هناك بعض العوامل التي قد تساعد علي ظهوره، وهذه العوامل تختلف من شخص لآخر. And better determine the cause of migraine and try to avoid to control and prevention of headaches, although there are no specific reasons for the emergence of migraine, but there are some factors that may help his appearance, and these factors vary from person to person. ومن بينها الضغط العصبي، وعدم تناول وجبة أساسية أثناء اليوم، أو النوم في أوقات متأخرة ليلاً أو عدم النوم لفترة كافية، والإرهاق أو زيادة التمارين الرياضية. Including stress, lack of basic meal during the day, or sleep in late at night or not sleeping long enough, and fatigue or increased exercise. أو تناول بعض أنواع الطعام والشراب كالجبن والنبيذ الأحمر والخمور والمواد المضافة إلي الطعام مثل ملح النترات في اللحوم المحفوظة كاللانشون والبولوبيف والهامبرجر والسجق وقلة تناول كمية الكافيين المعتاد عليها الشخص والموجود في الشاي والقهوة والكولا والكاكاو. Or eating certain types of food and drink such as cheese and red wine, alcohol and substances added to food such as salt nitrates in meat and saved Kallanhun Albolubev, hamburgers, sausages and the lack of the usual intake of caffeine by the person and who is present in tea, coffee, cola and cocoa. وبالنسبة للسيدات فترة الدورة الشهرية. For the women's monthly period. وهذه العوامل يمكن تجنبها. These factors can be avoided.

 Prevention

- عدم النوم لساعات طويلة - الأكل المفيد وتجنب شرب الحمضيات كعصير البرتقال والليمون قبل الأكل - عدم الإكثار من تناول المكسرات - ممارسة الرياضة بانتظام. - Lack of sleep for long hours - useful for eating and avoid drinking citrus orange and lemon juice before eating - not to overindulge in nuts - Exercise regularly. - عدم المكوث في مكان مرتفع الحرارة لفترة طويلة وعدم التعرض للشمس لفترة طويلة - فرد الرقبة والجزء العلوي من الجسم. - Do not stay at a high temperature for a long time and the lack of exposure to the sun for a long time - individual neck and the upper part of the body. ولاسيما ولو كان العمل يتطلب الجلوس طويلا. Especially if the work requires sitting for long. - اترك التدخين. - Quit smoking. - تعلم كيف تسترخي وتنفس بعمق. - Learn how to relax and breathe deeply. عندما يحدث الصداع دون الوقت واليوم الذي بدأ فيه وسجل ماذا أكلت خلال ال 24 ساعة. When headaches occur without the time and the day began and record what I ate during the last 24 hours. وكم من الوقت قضيته في النوم بالليل وفي ماذا كنت تفكر قبل بداية الصداع. How much time I spent in bed at night and at what you are thinking about before the start of a headache. وهل يوجد اجهاد في حياتك؟. Is there stress in your life?. ومدة الصداع.وماذا فعلت لتوقفه. And duration of headaches. And what I did to stop it. ويمكن للصداع أن يخف لو ركنت للراحة وعيناك مغلقتان ورأسك مسنودة. And headache that can hide if you leaned to rest with your eyes closed and head backed. واتباع طرق الاسترخاء تساعد أيضا. And follow the relaxation techniques also help. كما أن التدليك ووضع شيئا ساخنا وراء أعلي الرقبة تفيد في تخفيف الصداع التوتري. The massage and put something hot and neck for the highest benefit in reducing tension headaches. ] Treatment
يمكن بعد اكتشاف نقاط الضغط على الرأس للدكتور علي سلطانه والمقدمه في مؤتمر سان دييغو كاليفورنيا 2001 أن يقوم مريض الصداع النصفي بصنع أقواس الصداع النصفي في منزله واستخدامه عند قدوم النوبة وبذلك يتخلص من الصداع النصفي ويستغني عن استخدام كل الأدوية الضارة التي توصف للصداع النصفي. Possible after the discovery of the pressure points on the head, Dr. Ali authority presented at the conference in San Diego, California, 2001, that the patient migraine making brackets migraines at home and use it when the advent of the Nuba and thus get rid of migraines and is independent from the use of all harmful drugs prescribed for migraine. العلاج الجراحي للصداع النصفي: و للتخلص نهائيا من الصداع النصفي (عملية الدكتور علي سلطانه) باجراء عملية جراحية بسيطة تتم بالتخدير الموضعي وفي فروة الرأس حيث يتم ربط الشريان الجلدي المسؤول عن آلام الصداع النصفي وبذلك يتخلص المريض نهائيا من المرض ويستطيع المريض بعد العملية أن يقوم بجميع الأعمال التي كانت تحرض النوبة لديه وسيشاهد كيف أن النوبة الألمية لن تعود اليه. Surgical treatment of migraine: and to get rid permanently from migraines (the process of Dr. Ali authority) to conduct a simple surgery is local anesthesia in the scalp where the artery skin responsible for migraine pain and thus get rid of the patient's final illness and the patient can after the operation, that is all actions that were inciting the Nuba has and watch how the Nuba Alolmip will not come back to him. يمكن استعمال الأسبرين والأيبوبروفين والباراسيتامول. Can be used as aspirin and ibuprofen and paracetamol. ولا يعطي الأسبرين للاطفال حتي لا يصابوا بحالة رايReye's syndrome. Does not give aspirin to children up to the situation will not get Ray Reye's syndrome. فيمكن للصداع النصفي الاستجابة للأسبرين أو النابروكسين أو توليفة أدوية الصداع النصفي. For migraine headaches could respond to aspirin or naproxen, or combination migraine medications. واسأل الطبيب عن العلاج المناسب. And ask your doctor about appropriate treatment. وأدوية الصداع النصفي هي : ergotamine, dihydroergotamine, ergotamine with caffeine), isometheptene and triptans like sumatriptan, rizatriptan, almotriptan andzolmitriptan. And migraine medication are: ergotamine, dihydroergotamine, ergotamine with caffeine), isometheptene and triptans like sumatriptan, rizatriptan, almotriptan andzolmitriptan. . . كما أن الأدوية التي تخفف الغثيان والقيء تفيد في الأعراض الأخرى من حالات الصداع النصفي..والدواء الشائع في علاج الصداع، الكافايين Caffeine والشخص قد يدمن علي تناوله وقد يكون مخلوطا مع الأسبرين أو أدوية الصداع النصفي كمشتقات الإرجوت مثل الإرجوتامين. The drugs that relieve nausea and vomiting are useful for other symptoms of migraine headaches .. and medicine in the treatment of common headaches, caffeine Caffeine and the person may become addicted to eating may be mixed with aspirin or migraine medication such as Kmstqat Alirjot Alirjuthamin. وعندما ننسحب من تناوله فجأة يسبب صداعا شديدا وغثيان وقيء. When we withdraw from eating suddenly cause severe headache, nausea and vomiting. والكافيين يفرز مع لبن الأم مما يجعل الرضيع قلقا ومؤرقا أثناء النوم. Caffeine is excreted in breast milk, which makes baby concern and Mwrka during sleep. والدواء الثاني الشائع لعلاج الصداع النصفي الإرجوت ومشتقاته كالإرجوتامين و dihydroergotamine ولايستعمل أثناء الحمل. The second medication is common for the treatment of migraine and its derivatives Alirjot Kalirjuthamin and dihydroergotamine Estaml and during pregnancy. فقد يسبب موت الجنين أو الإجهاض. May cause fetal death or abortion. أو في حالة الرضاعة لأنه يسبب ضررا للرضيع. Or in the case of breastfeeding because it causes harm to the baby. لأن هذه الأدوية تفرز مع اللبن وتسبب للرضيع الإسهال والقيء والتشنجات ونبض ضعيف وتغير في ضغط الدم. Because these drugs excreted with the milk and cause of infant diarrhea, vomiting, convulsions, weak pulse and a change in blood pressure. والكميات الكبيرة من هذا الدواء تقلل من افراز اللبن. And large quantities of this drug reduces the secretion of milk. وهذا الدواء يزيد الإحساس بالبرودة لهذا يتدثر الشخص جيدا. This drug increases the feeling of cold Itdther for this person well. لأنها تقلل تدفق الدم بالجسم ولاسيما بالجلد والاصابع ولاسيما بالقدمين وخصوصا لدي المسنين الذبن ما يعانون غا لبا من مشاكل في الدورة الدموية . Because it reduces blood flow to the body, especially the skin, fingers, especially the feet, especially in the elderly Alzbn Ba Ga suffer from circulatory problems. لها عند استعمال هذه الأدوية اسأل الصيدلي علي مكوناتها أو اسأله عن هذه المواد لتتعرف علي دوائك.ويمكن للعلاج الجيد من تخفيف حدة نوبات الصداع النصفي وتسكين آلامه بتناول عقاقير مسكنة. When you have the use of these medicines ask your pharmacist on the components or ask for these materials to learn on your medicine. Can be a good treatment for alleviation of migraine headaches and relieve the pain eating analgesic drugs. وهناك نوعان من أنواع علاج الصداع النصفي. There are two types of treatment of migraine. نوع يقوم بإيقاف تأثير الصداع النصفي بمجرد بدايته وفيها مادة الإرجوتامين وتوصف للأشخاص الذين يصابون بالصداع بشكل غير دوري أو في الأعراض البسيطة حيث تقوم بانقباض الأوعية الدموية.ولايتناولها مرضى القلب، أوالحوامل. Type shut down the impact of migraine as soon as the beginning and a substance Alirjuthamin and described for people who have a headache in non-league or minor symptoms Banaqbad where the blood vessels. Eitnolha and heart patients, Owalhawwaml. والنوع الثاني مغلقات بيتا Beta blockersومغلقات الكالسيوم Calcium channel blocker وتمنع ظهور الصداع النصفي.ويوصف للأشخاص الذين يصابون بالصداع النصفي بشكل دوري ومتكرر.و يمكن وصف الأدوية المضادة للاكتئاب. The second type Mglqat Beta Beta blockers and calcium Mglqat Calcium channel blocker and prevent the emergence of migraine. And described for people who get migraines regularly and frequently. And can be described as anti-depressant medication. وأحيانا قد يجد المصاب فائدة من وضع كمادات من الثلج على الرأس، والجلوس في غرفة مظلمة. And sometimes the patient may find it useful to put packs of ice on the head, and sit in a dark room.

War Veterans Health Resource Initiative

In recent years, the Afghan and Iraq Wars have increased the prevalence of migraines and headaches in veterans returning to the United States. In one study of 3,621 U.S. soldiers screened within 90 days of returning from a one-year combat tour in Iraq, soldiers were shown to have two to four times the incidence rate of migraine as compared to the general population.
This research and more like it has validated that men and women in the military are returning to civilian life experiencing migraine headaches due to conditions like Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD). Poorly managed migraine translates to a potentially huge impact on a patient's quality of life—from missed or non-productive work days to lost family and personal time.
The National Headache Foundation feels that it is vital to reach out to these men and women who have served our country by providing resources to better understand and manage headache pain.
To do this, the NHF is proud to introduce the War Veterans Program. The program consists of an online resource guide that provides the top resources available to help military men and women cope with neurological trauma effectively. Periodically, the NHF will also provide information about the latest research, statistics and governmental assistance programs set in place during this crucial time.
Military OneSource is provided by the Department of Defense at no cost to active duty, Guard and Reserve (regardless of activation status) and their families. It is a virtual extension of installation services. Visit Military OneSource today at http://www.militaryonesource.com/%20target= or call 1-800-342-9647. www.MilitaryOneSource.com/ChillDrills.

Headaches are very personal.

No one has the same combination of pain, impairment, triggers, or impact. Therefore, there is no one-size-fits-all solution to getting relief. Experts recommend the following simple tips for finding relief, which all begin with YOU:
  • Realize that headaches matter, and take your headaches seriously even if others don’t
  • Learn all you can – be a student of your own headaches
  • Get the help and care that you deserve: many resources are available right here
Your journey of learning begins here, at Headache U — a place for you to begin educating yourself about your personal headaches, and the many ways you can get help, help yourself and even help others.
This portal will contain a variety of helpful resources and tools, so check back often to see what’s new.
The first of a series of patient education tools that will be available through Headache U is Chart Your Course to Relief: A personal headache care tool. This tool will help you explore your personal experiences with headache, create your own personal headache profile, and get matched with resources that fit your situation

Vasculitis


Overview, Causes, & Risk Factors

Vasculitis is an inflammation of the blood vessels.
What is going on in the body?
Blood vessels can become inflamed for many reasons. There are different types of vasculitis based on the size and type of blood vessel involved and the pattern of inflammation. Inflammation of blood vessels can lead to serious problems in the body, such as blocking blood flow.
What are the causes and risks of the condition?
Inflammation of blood vessels may occur in response to:
  • medication.

  • allergic reactions.

  • infections.

  • toxic chemical exposure.

  • underlying diseases, such as autoimmune disorders. These are conditions in which a person's immune system attacks their own body.

  • inherited conditions.

  • smoking.


  • The primary risk of this condition is that blood flow may be reduced to body tissues. These tissues may then become damaged or destroyed. If the tissue or organ is important, such as the brain, eyes, heart, lungs, or other important organs, serious body damage and disability may result. Death can occur in severe forms of this condition.

    Symptoms & Signs

    What are the signs and symptoms of the condition?
    Most cases involve blood vessels in the skin, but just about any blood vessel in the body can be involved. Exact symptoms depend on the type of vasculitis present. This condition may cause:
  • tender red or purple bumps on the skin.

  • open sores on the skin.

  • depression.

  • fatigue.

  • high blood pressure.

  • damage to the body if blood flow stops in the inflamed blood vessels. For example, vasculitis may lead to a heart attack, loss of vision, kidney failure, lung damage, and other body damage.


  • Diagnosis & Tests

    How is the condition diagnosed?
    Clinical history and physical exam often make a healthcare provider suspect this condition. Special tests, such as blood and x-ray tests, and biopsy are often needed to diagnose and categorize the type of vasculitis. A biopsy is a procedure to take a small piece of tissue from an affected area of the body. The tissue can then be studied under a microscope and with other special tests if needed.

    Prevention & Expectations

    What can be done to prevent the condition?
    There is no known way to prevent most cases. Avoidance of smoking can prevent one rare form of this condition.
    What are the long-term effects of the condition?
    Most long-term problems are related to the areas of the body that are involved, such as the kidneys. Permanent damage can occur to important organs in some cases. Death may occur in severe cases.
    What are the risks to others?
    There are no risks to others, as this condition is not contagious.

    Treatment & Monitoring

    What are the treatments for the condition?
    The underlying problem that caused the vasculitis needs to be treated first if possible. For example, a medication may need to be stopped.
    Oral corticosteroids, such as prednisone, and other medications to suppress the immune system may be needed.
    Further treatment may be needed for specific areas of body damage, such as treatment for kidney failure.
    What are the side effects of the treatments?
    All medications have potential side effects. Side effects will vary depending on which drugs are used.
    What happens after treatment for the condition?
    Depending upon the cause of the vasculitis, it may completely clear or it may become a chronic problem needing long-term treatment.
    How is the condition monitored?
    Affected people are asked to monitor their symptoms. Repeat exams, blood tests, and x-ray tests may be needed. The medications used for treatment may also need to be monitored.

    Attribution

    Author:Lynn West, MD
    Date Written:
    Editor:Keefe, Sandy, RN, MSN
    Edit Date:05/13/00
    Reviewer:Adam Brochert, MD
    Date Reviewed:05/02/01

    Vascular Headaches - Migraine


    Overview, Causes, & Risk Factors

    A migraine is a moderate to severe headache affecting one or both sides of the head.
    What is going on in the body?
    Migraines are believed to be caused by changes in the blood flow in the vessels of the head. Changes in blood flow to different areas of the brain can produce a variety of symptoms.
    What are the causes and risks of the condition?
    The tendency for migraine headaches is probably inherited. Other factors that put a person at risk for migraines include:
  • bright lights

  • certain foods and drinks, such as caffeine, chocolate, or alcohol

  • head injury or neck injury

  • hormonal changes in women, especially during menstruation

  • stress

  • poor sleep habits

  • weather changes


  • Symptoms & Signs

    What are the signs and symptoms of the condition?
    Signs and symptoms of migraine can include:
  • confusion

  • depression

  • difficulty swallowing

  • drowsiness

  • headache that can last for hours or days on one or both sides of the head

  • irritability

  • loss of coordination

  • nausea

  • numbness or tingling in hands and feet

  • paralysis anywhere in the body

  • ringing in the ear

  • sensitivity to sound, light, or smell

  • sensory loss, such as loss of smell or taste

  • trouble remembering things

  • vomiting

  • weakness


  • Diagnosis & Tests

    How is the condition diagnosed?
    According to the International Headache Society, migraine is diagnosed when a person has the following:
  • at least five headache episodes, each lasting 4 to 72 hours

  • nausea or sensitivity to light and sounds

  • at least two of the following: one-sided pain, pulsing pain, moderate or severe pain, or pain aggravated by physical activity


  • There are no blood tests for migraine.
    Usually a migraine headache can be diagnosed with a complete physical examination and a medical history that includes information about the person's headache experiences. Doctors seldom use tests to diagnose a migraine. They may order tests to rule out other possible causes of the headache. These tests may include:
  • biopsy of the arteries in the head. In this test, a doctor collects a small sample of the artery and examines it under a microscope.

  • a cranial CT scan, which is an examination of the head using a special three-dimensional X-ray

  • a cranial MRI, which is a special three-dimensional image made using a magnetic field

  • an electroencephalogram, also called an EEG, which is a recording of brain waves

  • an electromyogram, also called an EMG. This test is a recording of the electrical activity of selected muscle groups.

  • skull X-rays

  • a spinal tap, where a small amount of cerebrospinal fluid is removed from the spine using a thin needle

  • testing of levels of certain drugs or toxins in the blood


  • Prevention & Expectations

    What can be done to prevent the condition?
    A person can help prevent migraine headaches by:
  • avoiding his or her personal triggers

  • exercising regularly

  • limiting stress


  • A trigger is different from a symptom. A symptom is a condition that accompanies or results from a migraine headache. A trigger is actually something inside or outside the body that can cause or aggravate headache pain. It can be related to something the person does or eats. Other triggers include changes in the weather, fatigue, light, noise, and many other factors.
    Triggers can include:
  • any type of medicine, including prescription medicines, over-the-counter medicines, and herbal remedies

  • bright or flickering lights

  • changes in the seasons

  • changes in the weather

  • excessive or repetitive noises

  • high altitudes

  • jet lag

  • specific smells


  • Sometimes a headache is triggered by a combination of food and drink. The National Headache Foundation Listing of Trigger Foods includes:
  • alcoholic beverages

  • any pickled, fermented, or marinated food

  • bananas

  • broad beans, lima beans, fava beans, and snow peas

  • caffeinated beverages, such as tea, coffee, and colas

  • chicken liver or pate

  • chocolate

  • citrus foods and drinks

  • figs, raisins, papayas, avocados, and red plums

  • foods or beverages that contain aspartame and phenylalanine

  • freshly baked yeast products

  • meats that may contain nitrates, such as bacon, sausage, bologna, salami, pepperoni, summer sausage, or hot dogs

  • monosodium glutamate, also known as MSG, which is found in meat tenderizers, seasoned salt, and soy sauces

  • nuts or nut butters

  • onions

  • pickled or dried herring

  • ripened or aged cheeses, including cheddar, Emmenthaler (Swiss), Stilton, Brie, and Camembert

  • sour cream

  • sourdough bread


  • Medicines used to prevent a migraine headache include:
  • anticonvulsants such as valproic acid and gabapentin

  • beta-blockers such as propranolol and nadolol

  • calcium channel blockers such as verapamil

  • cyproheptadine

  • lithium

  • methysergide maleate

  • tricyclic antidepressants such as amitriptyline and nortriptyline


  • What are the long-term effects of the condition?
    Severe and frequent migraine headaches can greatly affect a person's ability to function. A migraine may rarely be linked with a stroke caused by blockage of blood flow in blood vessels.
    What are the risks to others?
    Although migraines are not catching, 70% of migraine sufferers do have a family history of migraine.

    Treatment & Monitoring

    What are the treatments for the condition?
    Treatment for acute migraine attacks includes:
  • butalbital/APAP/caffeine

  • dihydroergotamine

  • isometheptene/dichloralphenazone/APAP

  • nonsteroidal anti-inflammatory drugs called NSAIDs, such as ibuprofen and naproxen

  • other analgesics, such as hydrocodone/APAP

  • triptans, such as sumatriptan or zolmitriptan


  • Nonmedicine treatments include:
  • acupuncture

  • aromatherapy

  • avoiding migraine triggers

  • biofeedback

  • chiropractic

  • electromagnetic therapy

  • exercising regularly

  • herbal remedies

  • hypnosis

  • massage therapy

  • physical therapy

  • stress management


  • Other than avoiding one's triggers, the non-medicine treatments listed above may or may not be effective. A person should always talk with the doctor first before trying any of these treatments for migraine headache.
    What are the side effects of the treatments?
    Side effects of medicines used to treat migraines include stomach upset, drowsiness, and allergic reactions. Nonmedicine treatments generally have few or no side effects.
    What happens after treatment for the condition?
    After an effective treatment for migraine is in place, the person will usually feel like resuming normal activities. Rarely, complicated migraines can cause a stroke.
    How is the condition monitored?
    A person with migraines may be asked to keep a headache diary. Any new or worsening symptoms should be reported to the doctor.

    Attribution

    Author:Michael Curiel, MD
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:06/15/02
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:07/05/01

    Varicose Veins


    Overview, Causes, & Risk Factors

    Normally, tiny one-way valves inside each vein keep blood from flowing backward. When valves are damaged or do not work properly, a vein may start to bulge and twist. This is called a varicose vein.
    What is going on in the body?
    After blood filled with oxygen is pumped through the body, veins bring oxygen-depleted blood back to the heart. Normally, one-way valves inside veins keep gravity from pulling the blood toward the feet. When valves are not normal or have been damaged, blood pools in the vein. The kinks, bulges, and lumps of varicose veins then occur. Varicose veins are most often noticed on the thigh or calf, where they are close enough to the skin to be seen. Varicose veins can, however, occur in other parts of the body.
    What are the causes and risks of the condition?
    The cause of this disorder is failure of the valves in the veins to prevent the backward flow of blood. The following conditions increase the risk of this condition:
  • a family history of this condition

  • obesity

  • aging

  • leg injury

  • occupations where people stand or sit most of the time


  • Women are much more prone to varicose veins than men. In fact, one in two women develop varicose veins. This has been linked to changes in hormones that women experience at puberty, during pregnancy, and at menopause.
    A woman is more likely to get varicose veins:
  • if she takes estrogen or progesterone in birth control pills or estrogen replacement therapy

  • during the first trimester of pregnancy as the uterus expands and more weight is put on the legs. When this occurs during a woman's first pregnancy, these veins often disappear when the baby is born. That may not happen with later pregnancies.


  • A permanent condition known as milk leg may sometimes occur during pregnancy. It happens when valves in the veins have been destroyed and the pressure of the pooled blood causes swelling.

    Symptoms & Signs

    What are the signs and symptoms of the condition?
    Often, varicose veins close to the skin can be seen. They are often described as swollen, enlarged, snakelike, bluish veins that are most noticeable when standing. They are most commonly seen on the back of the calf or inside of the leg from the ankle to the groin. Other symptoms in the legs include:
  • pain

  • itching

  • swelling

  • fatigue

  • heaviness

  • aching

  • burning

  • throbbing

  • cramping

  • restlessness


  • Diagnosis & Tests

    How is the condition diagnosed?
    A history and physical examination makes the diagnosis of varicose veins. Other tests may be ordered to examine the veins more closely, such as:
  • ultrasound, a test that uses sound waves to look at tissues, organs, arteries, and blood flow

  • blood flow studies that can measure changes in the amount of blood passing through a vein


  • Prevention & Expectations

    What can be done to prevent the condition?
    Although varicose veins may be partly inherited, making certain lifestyle changes may help prevent this condition. The following activities should be avoided to help prevent this condition:
  • heavy lifting

  • standing for long periods of time

  • sitting with legs crossed for long periods of time


  • Avoidance of obesity and getting regular exercise is also advised to help prevent this condition.
    What are the long-term effects of the condition?
    Severe varicose veins can cause eczema, inflammation, or stasis dermatitis, which is skin breakdown in the lower legs.
    Inflammation of the deep veins can lead to blood clots. These clots may break off and block the artery that supplies the lungs, known as a pulmonary embolus.
    What are the risks to others?
    Varicose veins pose no risks to others and are not contagious.

    Treatment & Monitoring

    What are the treatments for the condition?
    Mild varicose veins need no treatment other than for cosmetic reasons. In most cases, people with symptoms can use support hose or heavier elastic knee-high stockings to manage their condition. Frequent rest periods with leg elevation can also help with leg swelling and the feeling of heaviness in the legs. Regular exercise is also advised to improve circulation to the legs.
    If symptoms are severe or a person finds the appearance of the veins unacceptable, varicose vein surgery may be an option. A variety of surgery methods are used. These include cutting the veins out, injecting the veins with chemicals to destroy or shrink them, or using lasers or radio waves to destroy shrink the veins.
    Treated varicose veins usually disappear with surgery. Problems do not return in the treated veins, but may develop in other veins. Once a varicose vein is closed or removed, nearby healthy veins take over the job of carrying blood back to the heart.
    What are the side effects of the treatments?
    All the surgical techniques cause some bruising and discoloration, which generally goes away over time. Skin scarring may also occur. As with any surgery, infection, bleeding, and reaction to any pain medicine used may occur.
    What happens after treatment for the condition?
    After the procedure, a person usually needs to wear a bandage or compression hose, or both. The vein that was treated scars over and causes no further problems. Later, though, people may get varicose veins that need treatment in other parts of the leg.
    How is the condition monitored?
    A healthcare provider should examine varicose veins periodically.

    Attribution

    Author:Terry Mason, MPH
    Date Written:
    Editor:Coltrera, Francesca, BA
    Edit Date:06/07/00
    Reviewer:Adam Brochert, MD
    Date Reviewed:04/09/01
    Sources
    The American College of Phlebology. Phebology: The Treatment of Leg Veins. 100 Webster Street, Suite 101, Oakland, CA 94607-3724
    American Academy of Dermatology. New Treatments Allow Patients to Get A Leg Up on Varicose and Spider Veins, 1999. 930 N. Meachem Road, Schaumburg, IL 60173
    Tabers Cycleopedic Medical Dictionary, F.A. Davis Company Philadelphia, PA

    Varicose Vein Surgery


    Overview & Description

    Varicose veins are enlarged, twisted veins, most commonly located in the legs. There are several ways to remove or treat these damaged veins.
    Who is a candidate for the procedure?
    Surgery can be done for most people who want to have varicose veins removed. Surgery is usually advised if symptoms are severe and don't respond to other therapy. Many people have surgery because they don't like the way the veins look.
    How is the procedure performed?
    There are a number of ways to remove or treat varicose veins. The procedure used depends on their location and severity. Surgeons may also have methods they prefer.
    The procedure may be done with local anesthesia or general anesthesia. Local anesthesia means that numbing medication is injected under the skin where the cuts will be made. General anesthesia means the person is put to sleep with medications. The surgeon usually decides the type of pain control after talking with the person before surgery.
    Procedures used to treat varicose veins include:
  • surgical ligation and stripping, which is the most complex procedure, used for more severe varicose veins. Certain veins in the leg are tied off, which is called ligation. A small stitch is tied around a vein to block blood flow through it. Stripping is a technique to remove a long portion of a vein using only two small skin cuts. First, a small cut is made at the bottom of the vein. A thin metal instrument is placed into the vein through the cut after it is tied off. The instrument is passed up through the vein. A small skin cut is then made at the top and the device is removed through it. The entire length of vein is pulled out with the device.

  • phlebectomy, or removal of the vein through cuts in the skin. Phlebectomy is similar to ligation and stripping, except that smaller pieces of vein are removed with a small surgical hook.

  • sclerotherapy, which permanently closes or collapses the veins with chemicals. Certain irritating chemicals can be injected directly into the varicose veins. This damages the veins and causes them to permanently collapse.

  • electrodessication, which is the use of electrical current to permanently seal varicose veins

  • laser therapy and intense pulsed light therapy, which use laser beams or high intensity light to destroy varicose veins


  • Preparation & Expectations

    What happens right after the procedure?
    After the surgery, the person will be taken to the surgery recovery room to be watched closely for a short time. Vital signs, blood pressure, pulse, and breathing will be checked frequently. Bandages are usually placed over any cuts. Those who have had more complex surgery may need to stay in the hospital overnight. Most other people will be able to go home a few hours after surgery. If sedatives or general anesthesia were used, someone else must drive the person home.

    Home Care and Complications

    What happens later at home?
    The surgeon or the staff will explain care of any bandages before the person goes home. Swelling and bruising are common when cuts are made. The person will generally have very little pain. Over-the-counter pain medications are usually used for pain, but a prescription pain medication may be given. Most people are able to return to normal activity with 3 or 4 days. While these procedures do cure varicose veins, new varicose veins can appear and need treatment.
    What are the potential complications after the procedure?
    All surgeries have possible complications. These include bleeding, infection, and reactions to any pain medications used. Small areas of skin numbness can be caused by nerve damage, and these are sometimes permanent. Blood clots may form in the veins, a rare but possibly serious problem. Most people have few or no problems and recover without difficulty.

    Attribution

    Author:Adam Brochert, MD
    Date Written:
    Editor:Duff, Ellen, BA
    Edit Date:06/23/00
    Reviewer:Gail Hendrickson, RN, BS
    Date Reviewed:04/09/01
    Sources
    Vascular Surgery: Principles and Practice, 1994, Veith et al.
    American Academy of Dermatology website. www.aad.org

    Varicocele


    Overview, Causes, & Risk Factors

    A varicocele is the enlargement of the network of veins that drain the testicle in males.
    What is going on in the body?
    Blood flows from the scrotum and testicles through a complex of veins rather than a single vessel. These veins are prone to becoming enlarged or dilated. This frequently happens when the valves in the veins that keep the blood flowing in the direction of the heart become weakened. A varicocele is more common on the left because of the specific pattern of blood flow on that side. Varicoceles are linked to infertility in males 20 to 40% of the time. This is because the increased blood flow through the enlarged veins raises the temperature of the testicles and affects the development of sperm.
    What are the causes and risks of the condition?
    Approximately 15% of adult men have a small to moderate size left varicocele. Right-sided varicoceles are uncommon. Typically, the presence of a varicocele does not signal any type of serious disease. However, a large varicocele on the right side that appears suddenly may indicate a mass such as an enlarged lymph node or testicular cancer.

    Symptoms & Signs

    What are the signs and symptoms of the condition?
    Most varicoceles do not have symptoms. They are found by accident during a routine exam or an infertility evaluation. Very large varicoceles may produce a heavy or dragging feeling in the testicles. They rarely are painful.

    Diagnosis & Tests

    How is the condition diagnosed?
    A varicocele is usually diagnosed with a physical exam. It appears as a full but soft mass above the testicle. The mass disappears completely when the man is lying down. The varicocele's appearance has been described as a "bag of worms." Ultrasound is sometimes used to confirm the diagnosis. This is more common during an evaluation for male infertility.

    Prevention & Expectations

    What can be done to prevent the condition?
    There is no known way to prevent developing a varicocele. Routine testicular self examination may alert the man to any new masses, which should be evaluated by the healthcare provider.
    What are the long-term effects of the condition?
    Varicoceles can be linked to male infertility. If abnormalities show up in a semen analysis, removing the varicocele may improve sperm quality.
    What are the risks to others?
    There are no risks to others, as a varicocele is not contagious.

    Treatment & Monitoring

    What are the treatments for the condition?
    A varicocele is usually managed conservatively. A scrotal support may be worn to relieve the heavy sensation in the scrotum. However, if the pain continues or if infertility results from a backup of blood in the veins, surgery may be needed.
    Removal of the varicocele is called varicocelectomy. This operation can be accomplished with a variety of incisions. The most common is a small cut in the groin or just below it. Several of the veins draining the contents of the scrotum can be tied off through this opening. An alternative procedure is to make a small incision higher up in the flank. Also, the enlarged veins can be blocked with material injected into them through a catheter, or narrow tube.
    What are the side effects of the treatments?
    Side effects may include bleeding, infection or the accumulation of fluid along the spermatic cord, known as a hydrocele.
    What happens after treatment for the condition?
    The man will feel some discomfort and a sense of congestion in the testicle for a few weeks following the procedure.
    How is the condition monitored?
    If the varicocele makes the scrotum feel uncomfortably full, or impairs fertility, the male should follow up with a healthcare provider. Any new or worsening symptoms should be reported to the healthcare provider.

    Attribution

    Author:Stuart Wolf, MD
    Date Written:
    Editor:Slon, Stephanie, BA
    Edit Date:05/09/00
    Reviewer:Gail Hendrickson, RN, BS
    Date Reviewed:06/01/01
    Sources
    The Merck Manual of Medical Information, Home edition, 1997
    Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000

    Varicella Zoster - Shingles


    Overview, Causes, & Risk Factors

    Shingles, or herpes zoster, is a painful rash of blisters that develops due to the virus that causes chickenpox.
    What is going on in the body?
    A primary, or first time, infection with a virus called the varicella-zoster virus causes chickenpox. After someone recovers from chickenpox, the virus remains quiet, or dormant, in nerves. The infection can reactivate for various reasons later in life and this is called shingles.
    What are the causes and risks of the infection?
    The cause of this condition is a reactivation of the chickenpox virus. Most people in the US are infected with this virus. Weakness of the immune system may increase the risk of developing shingles. In people with weakened immune systems, infection can be very serious. In these people, the virus can spread all over the body, causing infection in the liver, lungs, and brain.

    Symptoms & Signs

    What are the signs and symptoms of the infection?
    Shingles symptoms are usually limited to a small area of the body. This area is usually a small strip of skin on one side of the chest or abdomen. In some cases, the face can be involved, and this may cause an eye infection. The first symptoms are usually related to sensation. People may experience pain, numbness, tingling, or itching. Pain usually occurs at some point, and can be quite severe. This is usually followed by the development of groups of blisters. The areas around the blisters are often quite painful. The pain can be severe and last for weeks. Pain is usually much less severe in children.

    Diagnosis & Tests

    How is the infection diagnosed?
    Usually the diagnosis of varicella-zoster is made by an interview with the person and a physical exam. The virus can be recovered from the blisters and identified with special tests. Blood tests can also be used to make the diagnosis in some cases if needed.

    Prevention & Expectations

    What can be done to prevent the infection?
    Primary varicella-zoster infection, or chickenpox, can be prevented. If chickenpox is prevented, shingles will not occur. Healthy children and some adults are given varicella vaccine, which prevents chickenpox. People with weak immune systems that have not had chickenpox may be given varicella zoster immune globulin (VZIG) if they are exposed to chickenpox.
    What are the long-term effects of the infection?
    In most cases, shingles goes away in a week or so and causes no long-term effects. However, some cases result in serious long-term effects. Eye infection may lead to serious eye problems, including blindness. Some people have chronic pain in the area of the blisters that doesn't go away for months or even years. Paralysis in the part of the body that had blisters occurs very rarely. In people with a weak immune system, the virus may cause a serious infection in the body. This may result in liver, brain, or lung damage, and possibly even death.
    What are the risks to others?
    The virus can be spread to others if they are exposed to the fluid in the blisters. If people who have not received the varicella vaccine or been exposed to chickenpox before are exposed to someone with shingles, they may develop chickenpox.

    Treatment & Monitoring

    What are the treatments for the infection?
    Acyclovir, valacyclovir or famciclovir can be used to treat shingles. Drugs for pain may also be needed. Eye infection usually requires the use of special eye drops to reduce inflammation.
    What are the side effects of the treatments?
    Headaches and nausea may occur with the drugs used to treat shingles. These are usually taken as pills. People with severe infections may need acyclovir injected directly into the veins, which may cause kidney problems. Drugs for pain may cause stomach upset, allergic reactions or sleepiness. Exact side effects depend on the drug used. Eye drops can cause irritation and allergic reactions in the eyes.
    What happens after treatment for the infection?
    In most cases, the shingles go away and people can return to normal activities. Pain may remain at the site of the healed blisters. Drugs for pain may be needed. People with eye infection may require long-term eye care from an eye doctor.
    How is the infection monitored?
    Most cases are monitored by the affected person at home. In severe infections, a person may need to be monitored in the hospital. Further monitoring in this setting would depend on the areas of the body that are affected by the infection. Those with eye infections usually need repeated eye examinations until the infection resolves.

    Attribution

    Author:Danielle Zerr, MD
    Date Written:
    Editor:Keefe, Sandy, RN, MSN
    Edit Date:05/14/00
    Reviewer:Adam Brochert, MD
    Date Reviewed:05/04/01

    Varicella Vaccine - Chickenpox Vaccine


    Overview & Description

    Doctors use the chickenpox vaccine to prevent chickenpox in children and adults. Vaccines contain weakened or dead forms of the germs that cause certain diseases. To fight these germs, the body's immune system creates antibodies. Antibodies are cells that attack foreign substances in the body. A vaccine causes the body to makes antibodies to the weakened germs in the vaccine. Some of these antibodies will stay in the body for long periods of time. How long they remain depends on which vaccine a person gets. If the person is later exposed to the disease, the antibodies multiply to fight it off.
    Chickenpox is usually a childhood illness. But it can occur at any age. It is most common in children 6 to 12 years old. The illness usually lasts 4 to 5 days and causes mild symptoms. There is a rash with as many as 250 to 500 itchy bumps, called vesicles. Other symptoms are fatigue and a low-grade fever.
    Chicken pox can cause serious, even fatal, complications. People who are at higher risk for these complications include:
  • teens and adults

  • children who are given aspirin

  • infants younger than age 1

  • newborns and premature babies whose mothers had chickenpox when they were born or have not had chickenpox

  • people with weakened immune systems


  • These serious complications include:
  • severe skin infections

  • scarring from the pox

  • pneumonia, which is an infection of the lungs

  • brain damage

  • death


  • The chickenpox vaccine protects against both these complications and the discomfort of mild symptoms. The vaccine can prevent chickenpox in most cases. Anyone who gets chickenpox despite receiving the vaccine usually has only a mild case.
    Who is a candidate for the procedure?
    The Centers for Disease Control and Prevention, also known as CDC, is the U.S. government agency that makes recommendations about vaccinations. The CDC recommends that the chickenpox vaccine be given to children age 12 to 18 months , or to older children if they have not had chickenpox. Children under the age of 13 should be given one dose of the vaccine. Children who are at least 13 and have not had chickenpox should receive two doses of the vaccine. The doses should be given 4 to 8 weeks apart. Many schools, day care centers, and colleges require the vaccine or a report of a history of chickenpox before enrollment.
    Varicella vaccine is recommended for anyone in certain high-risk groups if they have not already had chickenpox. These high-risk groups include:
  • people who live or work where exposure to chickenpox is likely, such as teachers of young children, day care employees, and residents and staff in institutional settings

  • people who live or work where outbreaks of chickenpox can occur, such as college students, prison inmates and staff, and military staff

  • nonpregnant women of childbearing age

  • teens and adults living in households with children, since the children may pass chickenpox to them


  • A person in these high-risk groups should talk with his or her doctor about whether he or she should get the chickenpox vaccine. Other people who should consult with their doctors before receiving the vaccine include:
  • people with weakened immune systems, such as those who have HIV or cancer or who take medicines such as steroids or chemotherapy

  • people who are allergic to gelatin or the antibiotic neomycin

  • pregnant women

  • people who are currently ill


  • How is the procedure performed?
    The chickenpox vaccine is given by an injection into the muscle of the upper thigh or arm. This vaccination may be given at the same time as other vaccinations but in a different spot on the body.

    Preparation & Expectations

    What happens right after the procedure?
    The site of the chickenpox vaccine injection may sting slightly. A bandage is usually put on it to stop any minor bleeding that may occur.

    Home Care and Complications

    What happens later at home?
    The chickenpox vaccine is very safe. Severe allergic reactions are very rare. But it is important to call a doctor right away to report has any new or worsening symptoms.
    What are the potential complications after the procedure?
    Chickenpox itself is far more likely to cause serious problems for people at high risk than the vaccine is. Possible side effects of the vaccination include:
  • mild rash, up to 1 month after vaccination

  • mild redness, pain, and swelling at the site of the shot for 1 to 2 days

  • rarely, fever, muscle aches, or another reaction at the site of the shot

  • rarely, seizures resulting from the fever

  • very rarely, a severe allergic reaction known as anaphylactic shock, pneumonia, brain damage, or even death


  • Attribution

    Author:Eileen McLaughlin, RN, BSN
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:02/05/02
    Reviewer:Melissa Sanders, PharmD
    Date Reviewed:02/08/02
    Sources
    Vaccine information sheets, US Department of Health and Human Services, Centers for Disease Control and Prevention, National Immunization Program, www.cdc.gov/nip/
    The Chicken Pox Vaccine: What Parents Need to Know, American Academy of Pediatrics, www.aap.org/family/chckpox.htm
    Prevention of varicella: updated recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR 1999;48(RR-06):1-5.
    Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR 1996;45(RR-11):1-43.

    Varicella - Chickenpox


    Overview, Causes, & Risk Factors

    Chickenpox is a disease caused by the varicella-zoster virus (VZV). It is characterized by a blistery rash.
    What is going on in the body?
    Chickenpox is characterized by an itchy rash that looks like very small blisters on a red base. The blisters look like dewdrops on top of a red pimple. Chickenpox is usually acquired in childhood by inhaling the virus from an infected person. It is also acquired by touching the blisters of the chickenpox rash when there is still fluid in them.
    The disease is usually more severe in adolescents and adults. It can be life-threatening in people with autoimmune disorders, pregnant women, and babies born to mothers who have chickenpox around the time of delivery. A fetus can sometimes acquire VZV in the first 6 months of pregnancy. If this happens, the baby can be born with:
  • scarring of the skin

  • malformed arms or legs

  • problems with the central nervous system

  • eye problems


  • VZV remains in the body forever. After recovery from chickenpox, the virus usually remains quiet, or latent. But sometimes the virus becomes active again, causing shingles, which is a painful infection along the nerves.
    What are the causes and risks of the disease?
    Chickenpox is a highly contagious disease caused by the varicella-zoster virus. VZV is a member of the herpes virus family.

    Symptoms & Signs

    What are the signs and symptoms of the disease?
    Symptoms of chickenpox usually appear a little more than 2 weeks after exposure, although anywhere between 10 and 21 days is normal. They include:
  • blistery, itchy rash

  • rash appearing on all body surfaces but usually starting on the head and back

  • fever


  • Diagnosis & Tests

    How is the disease diagnosed?
    Chickenpox is usually diagnosed based on the appearance of the rash. However, VZV can be detected and/or cultured from chickenpox blisters during the first few days of the rash. The person's blood can be tested to determine whether he or she has had chickenpox in the past.

    Prevention & Expectations

    What can be done to prevent the disease?
    Chickenpox can usually be prevented with the varicella vaccine. The vaccine is routinely recommended for most children. The vaccine is strongly recommended for adolescents and adults who have never had chickenpox. People at high risk for severe chickenpox may be given varicella-zoster immune globulin.
    What are the long-term effects of the disease?
    The most common long-term effect is scarring of the skin. Normal chickenpox can leave temporary marks on the skin that take 6 to 12 months to fade.
    The most common complication of chickenpox is bacterial infection, such as cellulitis, of the skin. The virus can sometimes cause pneumonia, inflammation of the liver, and an infection of the central nervous system. Chickenpox is a serious disease for adults, people with autoimmune problems, and newborns whose mothers had chickenpox right around the time of delivery.
    What are the risks to others?
    If a person has chickenpox, it can be highly contagious to a person who has not had VZV. The contagious period begins about 2 days before the rash develops. The person is generally contagious as long as the blisters have fluid in them or until they crust over.

    Treatment & Monitoring

    What are the treatments for the disease?
    Acyclovir is used to treat complicated or more severe cases of varicella. It is not routinely used to treat mild to moderate cases in healthy children.
    Home care suggestions are designed to treat the symptoms. These include:
  • acetaminophen to treat discomfort and fever over 102 degrees. Aspirin should be avoided in a person with chickenpox because of a link between aspirin, chickenpox, and a serious infection called Reyes syndrome.

  • cool, tepid baths. A cool or lukewarm bath with 1/2 cup of baking soda or oatmeal added to it will decrease itching from the rash. It may help to have several baths a day for the first few days of the rash.

  • calamine lotion to reduce itching from the rash

  • diphenhydamine, an antihistamine medication, for itching. The healthcare provider should be consulted before giving this medication to young children.

  • a soft diet and cool fluids. Avoid salty or citrus foods.

  • covering the hands of small children with gloves or socks to avoid scratching. Scratching can cause secondary infection of the scabs.


  • What are the side effects of the treatments?
    Acyclovir can sometimes cause damage to the kidneys, or kidney toxicity.
    What happens after treatment for the disease?
    Most people recover without serious long-term effects. But the virus remains and may reactivate at any time to cause shingles.
    How is the disease monitored?
    Any new or worsening symptoms should be reported to the healthcare provider. No further monitoring is needed once a person recovers from VZV. If VZV symptoms such as shingles redevelop, a person should contact his or her healthcare provider.

    Attribution

    Author:Danielle Zerr, MD
    Date Written:
    Editor:Ballenberg, Sally, BS
    Edit Date:02/12/01
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:07/27/01

    Variant Angina - Coronary Artery Spasm


    Overview, Causes, & Risk Factors

    The coronary arteries are a pair of blood vessels that carry oxygen-rich blood to the heart muscles. A spasm in these arteries known as a vasospasm reduces blood flow to the heart. This causes a chest pain called angina.
    What is going on in the body?
    Most often, vasospastic angina occurs while a person is at rest or it wakes a person from sleep. Typical angina is linked with physical activity and caused by fat deposits clogging the arteries, or atherosclerosis. Vasospastic angina differs in that it can happen whether a person:
  • is active or resting

  • does or does not have clogged arteries from atherosclerosis


  • When the spasms occur, blood flow to the heart lessens. This causes the pain and raises the risk of a heart attack.
    What are the causes and risks of the condition?
    The coronary arteries and other blood vessels may constrict due to:
  • certain medications, such as vasopressin or ergonovine

  • cocaine

  • exposure to cold

  • high levels of stress


  • Sometimes, strenuous activity can bring on an attack.

    Symptoms & Signs

    What are the signs and symptoms of the condition?
    Symptoms of vasospastic angina are similar to those of typical angina:
  • chest pain

  • shortness of breath

  • rapid heartbeats called palpitations


  • These symptoms occur:
  • at rest

  • during sleep

  • with or without physical exertion


  • Diagnosis & Tests

    How is the condition diagnosed?
    A healthcare provider may suspect coronary artery spasms based on a person's symptoms. A pattern of chest pain at rest, for example, is suspicious, especially if a person has no history of blocked coronary arteries or heart attack. However, some people with this disease also have blocked coronary arteries.
    An electrocardiogram, or ECG may be normal between attacks. During attacks, the ECG may record changes that show a lack of blood flow to the heart. A procedure called a cardiac catheterization can find clogged blood vessels.
    Often, vasospastic angina can be diagnosed only after other possibilities have been excluded.

    Prevention & Expectations

    What can be done to prevent the condition?
    Generally, nothing can be done to prevent the condition.
    What are the long-term effects of the condition?
    A person with coronary artery spasms has a higher risk of:
  • irregular heart rhythms, or arrhythmias

  • heart attack

  • sudden death


  • What are the risks to others?
    There are no risks to others.

    Treatment & Monitoring

    What are the treatments for the condition?
    If a person has severely blocked coronary arteries, surgery may stop the vasospasms. Those who have fewer symptoms and no coronary artery blockages respond well to heart medication.
    A person should also:
  • eat a healthy diet, following the Food Guide Pyramid

  • exercise regularly

  • quit smoking

  • use alcohol in moderation


  • What are the side effects of the treatments?
    All medications have side effects. Medications used to treat coronary artery spasm may cause
  • headache

  • fatigue

  • sleep disorders such as insomnia

  • dizziness

  • serious arrhythmias


  • What happens after treatment for the condition?
    Uncomplicated cases are usually well controlled with heart medication.
    How is the condition monitored?
    Monitoring includes:
  • blood tests

  • ECG tests

  • stress tests, or an ECG of the heart's function during exercise


  • A person should report any change in the pattern or severity of chest pains to his or her healthcare provider right away.

    Attribution

    Author:Eric Berlin, MD
    Date Written:
    Editor:Coltrera, Francesca, BA
    Edit Date:06/23/00
    Reviewer:Vincent J. Toups, MD
    Date Reviewed:06/01/01
    Sources
    Merck Manual 1999
    Current Medical Diagnosis and Treatment 1996
    Harrison's Principles of Internal Medicine 1991
    Heart Disease: A Textbook of Cardiovascular Medicine, 1980