A to Z Disease

What Is Weight Loss, or Bariatric, Surgery?

"Bariatric" medicine refers to the medical field associated with the prevention and treatment of obesity. Bariatric surgery involves altering your digestive system to redirect or restrict the amount of food your body can process, which then leads to weight loss.

How Does Bariatric Surgery Work?

Our digestive system allows food to move from the mouth, down the esophagus to the stomach. The normal stomach is designed to hold about three pints of food and will release food particles to the small intestine. In the small intestine, the useful nutrients and calories are absorbed. The food particles that can't be digested are stored in the large intestine until they are eliminated. What bariatric surgery does is change the process or speed of digestion. The changes depend on the type of bariatric surgery that is performed.

Types of Bariatric Surgery

The two major types of bariatric surgery are restrictive and gastric bypass.

Restrictive Surgeries

Restrictive surgeries decrease the size of the stomach. The two most common techniques are called Laparoscopic Gastric Banding, and Vertical Banded Gastroplasty, or VBG.

Laparoscopic Gastric Banding

"Laparoscopic" means the doctor uses a video camera attached to thin tubes that are inserted into the body through small incisions. Because this is considered a minimally invasive procedure, it typically means a quicker recovery, less time in the hospital and less scarring than an open procedure.

During this procedure an inflatable silicone band, is placed around the upper part of the stomach like a belt or wristwatch. This gastric band divides the stomach into a small and large portion, leaving a narrow opening between the two. This controls the amount of food that can be consumed and slows the food as it is moves from the esophagus into the stomach, resulting in a quicker sensation of fullness. Unlike many of the other bariatric surgery options, the gastric band procedure is reversible and once the band is removed, the stomach will return to its original shape. This band is adjustable and allows your doctor to inflate or deflate it using a saline solution that's administered through a thin needle.

Vertical Banded Gastroplasty, or VBG

The second type of restrictive surgery, VBG, is more commonly known as "stomach stapling." In this procedure, a band and staples are used to create the small pouch at the top of your stomach. The effect is similar to the gastric band; the patient will likely eat less food and feel full sooner.

Gastric Bypass Surgeries

"Gastric bypass" surgeries are a combination of both restrictive and malabsorptive procedures. Malabsorptive means the digestive system is changed so that food doesn't travel through part of the small intestine where nutrients and calories are usually absorbed.

The most common gastric bypass surgery involves stapling part of the stomach to create a small pouch about the size of a walnut. This is the "restrictive" part of this procedure and is similar to gastric banding and VBG. Next, part of the small intestine is cut and re-shaped into a "Y" and then reconnected directly to the stomach pouch. This way, when food is digested, it bypasses most of the stomach and parts of the small intestine responsible for absorbing nutrients and calories. Since food doesn't pass through these portions of the small intestine, rapid weight loss can occur.

Gastric bypass can be performed through open surgery or laproscopically. Once gastric bypass surgery has been performed, it can't be reversed.

Who Can Have Bariatric Surgery?

Bariatric surgery is not an option for everyone. It is also something that should be considered after you've tried to lose weight through healthy diet and exercise for an extended period. If traditional methods for losing weight fail, here are some criteria for determining if bariatric surgery is an option:

• BMI Is 40 or Higher. BMI is a number that represents your body fat content relative to your height. You can determine your BMI by knowing your height and weight and using a BMI chart.
• Number of Pounds Overweight. You are at least 100 pounds overweight if you are a man, and 80 pounds overweight if you are a woman.
• Obesity-Related Medical Conditions. These can include conditions like high blood pressure, sleep apnea or diabetes.
• Obesity Interfering with Daily Life. This can include difficulty fulfilling needs for your job or family, or simply walking from one place to another.
• Commitment and Determination. You do not see bariatric surgery as a one-time quick fix. You are dedicated to sustaining the weight loss you achieve through surgery through diet and exercise. You are also aware of potential side effects, complications and necessary lifestyle changes, and will work with your doctor to keep your health on track.

Benefits and Risks of Bariatric Surgery

If you and your doctor decide this type of surgery is right for you, you'll want to know the benefits and risks involved.

• With the restrictive surgeries, like banding, you may lose up to 60 percent of your excess weight over the course of 2 to 3 years. About 80 percent of patients experience some degree of weight loss. With gastric bypass, the majority of the weight loss, as much as 70 percent, will occur in the first 1 to 2 years. Both of these surgeries will likely result in improvements in medical problems, like cholesterol levels, sleep apnea, high blood pressure, and Type 2 diabetes.
• Overall, gastric bypass surgery leads to more weight loss than restrictive surgeries, but can be more invasive and cannot be reversed.
• It isn't uncommon for people who have had these surgeries to see their weight loss plateau and even gain some weight back after a few years. That is why a drastically different lifestyle, especially your diet, is such a critical part of the treatment.
• These surgeries do come with risks. There are potentially serious side effects and complications that you could experience as a result of these procedures.
• You may need to have follow-up operations to correct any complications or abdominal hernias. While you are losing weight, you are advised not to become pregnant.
• For patients who undergo restrictive surgeries, there is the risk of band erosion or the breakdown of the staple line, which will then need to be surgically corrected. In addition, there is a small chance of death with any bariatric procedure.
• After the surgery is performed, your daily lifestyle will change and you should consult your doctor. He or she can help you stay on track with your recovery and weight loss.

How Do The Eyes Work?
To understand how the eyes work, it's helpful to compare the eyes to a camera. Cameras use a lens and film to produce an image, and in a way, so do the eyes.

Light comes in through the cornea, a clear tissue that covers the front of your eye. The pupil is the dark spot in the middle of your eye. It works like a camera shutter, controlling the amount of light that enters our eyes. When it's dark, the pupil dilates, or widens. When it's bright, the pupil gets smaller. Surrounding the pupil is the iris. This is the colored ring of muscle fibers that help the pupil change size.

When you look at an object, light rays enter your eyes. These light rays are bent and focused by the cornea, lens, and vitreous. The vitreous is a clear jelly-like fluid that fills the inside of your eye. The lens' job is to make sure the rays come to a sharp focus on the retina at the back of the eye. Think of the retina as the film in the camera. It's lined with light-sensitive cells, called photoreceptors, that capture, upside-down, the images in our visual field. The sensitive macula, critical for sharp focus, is the most active part of the retina. A healthy macula helps us read small print and see the images in our direct line of vision. When light rays reach the retina, they're converted into electrical pulses that travel through the optic nerve to your brain. It is there that the image gets flipped right-side up.

Vision Screening Guidelines

Guidelines for Adults

• At least one test between ages 20 and 29 and at least two between ages 30 and 39
• Vision tests every two to four years between ages 40 and 65 and every one to two years after age 65.

Guidelines for Children

• Children five years and younger should have their eyes checked each time they see their pediatrician. Teens should be examined once a year.

If you are experiencing any vision problems, it's a good idea to get checked more often.

Protecting the Eyes & Vision
While we can't control the risk factors that make us more vulnerable to vision problems, it's important to exercise caution:

• Know your family's medical history;
• Protect your eyes with sunglasses that absorb 100 percent of damaging ultra violet rays;
• Stay away from cigarettes which contain chemicals that can damage the eyes; and
• Eat a healthful diet.

Types of Vision Problems
It's normal for our vision to deteriorate as we age. Here are some very common vision problems that can usually be corrected with glasses or contacts:

• Farsightedness. This occurs when you can see well at a distance, but not close up.
• Nearsightedness. This is also called myopia. It occurs when you can see well close up, but not at a distance.

There are some vision problems that are much more serious and can even lead to blindness.

If you have a family history of eye disease, you'll have a higher risk of developing vision problems. You may also have other risk factors like previous eye injury, premature birth, diseases that affect the whole body, like diabetes, high blood pressure, heart disease, or AIDS. The only way for you to know for sure if you have serious eye problem is by having an eye exam given by an Optometrist (O.D.) or an Ophthalmologist (M.D.).

• Glaucoma. This occurs when the pressure of the fluid inside your eyes damages the fibers in your optic nerve, and causes vision loss. If left untreated, you can lose your eyesight altogether.
• Cataracts. A cataract means a 'clouding' of all or part of the normally clear lens within your eye, which results in blurred or distorted vision.
• Conjunctivis. This is commonly known as Pink Eye. It is caused by an inflammation of the conjunctiva. This is the thin, transparent layer that lines the inner eyelid and covers the white part of the eye. The inflammation is usually caused by a virus, and will resolve without any treatment. But, sometimes pink eye is caused by a bacterial infection and will require antibiotics.
• Eye Floaters. These may look like small dots or lines moving through your field of vision. They're actually tiny clumps of gel or cells inside the vitreous fluid in the eye. They may be a sign of retinal detachment and you should call your doctor right away.
• Macular Degeneration. This results from changes to the macula portion of the retina. The macula is responsible for clear, sharp vision. This condition can cause a blind spot in the middle of your sight line.
• Retinal Tears and Detachment. These affect the thin layer of blood vessels that supplies oxygen and nutrients to your retina. Initial symptoms are eye floaters. This condition must be treated immediately. If it isn't, it can lead to permanent vision loss.

Early detection is key to fixing problems with your sight. Don't take your eyes for granted. Get them checked regularly, and tell your doctor if you notice anything unusual.

Overview
We all have our own biological rhythm or internal clock called the 'circadian clock.' It regulates the way our bodies work throughout the day. The circadian clock governs brain activity and hormone production. It's also responsible for making us alert during the day and sleepy at night.

The circadian clock is located in the hypothalamus, located in the brain. It's about the size of a pin head and made up of a tiny bundle of neurons that releases a hormone called melatonin. Melatonin is the hormone that makes us drowsy, so it makes sense that its levels are highest during the night and lowest during the day. That's why some sleep experts call it the hormone of darkness.

Why Do We Need Sleep?
Sleep is important because it helps in maintaining important bodily functions including blood pressure, kidney functions and cell repair. Sleep also plays a large part in keeping our immune systems strong. It helps us to fight off germs and infection, make good judgments and adapt quickly and easily to sudden changes. Basically, sleep is necessary for survival.

The Stages of Sleep
The sleeping process is made up of five phases that cycle throughout the night. The first phase is light sleep, when we can be woken up easily. During the next phases the brainwaves slow down until they reach what is called the delta phase. This is when we sleep most deeply. The last phase is REM sleep, or Rapid Eye Movement sleep. Our eyes dart back and forth beneath closed lids and our muscles temporarily shut down to keep us from acting out our dreams. And we're most likely to remember our dreams if we wake up during this state, since it's the phase closest to being awake in the cycle.

During the night, you will cycle through the stages of sleep as many as five times. You may even wake up between cycles, which is completely normal. The first cycle is about 100 minutes, with only 10 minutes of REM sleep. But in each cycle, you'll start to get more REM sleep so that your last cycle includes about an hour of REM.

Common Sleeping Problems
Here are some common conditions that may prevent you from getting the restorative sleep you need. Some are very serious and should be discussed with your doctor.

* Insomnia. Signs and symptoms of insomnia may include difficulty falling asleep at night, regularly waking up during the night, waking up too early, and waking up feeling tired, even after a full night's sleep.
* Sleep Apnea. Apnea means 'without breath.' When you have sleep apnea, it means you actually stop breathing during sleep. That lack of breath can lasts at least ten seconds, and lead to serious problems including hypertension, heart disease, mood and even memory disorders.
* Bruxism. This is the medical term for clenching your teeth. Some people clench their teeth together during the day without even knowing it, usually when they feel anxious or tense. People with bruxism often grind and clench their teeth during sleep too, and that can cause headaches, jaw pain and earaches.
* REM Behavior Disorder. For most people, dreams are purely a mental activity that occurs when the body is at rest. Even during a vivid or action-packed dream, their bodies are still. But people who suffer from REM behavior disorder, or RBD, may actually act out their dreams. They move their arms and legs in bed, they talk in their sleep or they can get out of bed all together. That's because people with RBD lack the normal muscle paralysis of REM sleep. The disorder usually begins with twitching, jerking and talking during their dreaming for years and then they fully act out their dreams. Sometimes the dreams are violent, and, when acted out, can harm the sleeper or his or her bed partner.
* Restless Legs Syndrome (RLS). This is characterized by an uncontrollable urge to move your legs. It's a neurological condition that, is at its worst when you're resting. Symptoms include burning, creeping and tugging sensations and pain, which can be severe.
* Narcolepsy. This condition is different from other sleeping disorders in that it doesn't impair a person's ability to fall asleep. This is a chronic disorder characterized by overwhelming fatigue and sudden attacks of sleep. It's often mistaken for depression, seizures, and fainting. There isn't a cure, but medications and lifestyle changes can help you cope.

Sleep Hygiene or How to Get Good Sleep
The key to getting a good night's sleep is to practice consistently good sleep hygiene.

Here are some of the steps included in a sound bedtime routine:

* Use Your Bed Only for Sleep or Sex. Avoid eating and watching TV in bed, as it can make it harder to associate your bed with sleep.
* Avoid Caffeine, Nicotine, And Alcohol. These should be avoided mainly in the afternoon or early evening. Caffeine and nicotine are stimulants and they can make it hard to get to sleep. And while alcohol may help you fall asleep, it is noted for disrupting sleep in the early morning hours.
* Exercise. This can help tire the body out, but schedule your workouts at least three hours before it's time for bed. That gives your body time to wind down.
* Create Your Wind Down Routine. Turn the lights down and then off to signal to your brain that it's time to go to sleep. Also, try taking a warm bath to relax your body.
* Design Your Sleep/Wake Cycle. Go to bed and wake up around the same time every day. This will help to reinforce your brain's notion of when it's time to sleep, and time to wake.

If you can't fall asleep after 30 minutes or so of trying, don't stay in bed tossing and turning. Instead, try to do something relaxing like reading or listening to soothing music.

How to Get Good Sleep – Medication Options
If you still can't fall asleep with a good sleep hygiene regimen, it may be time to explore medications. Before taking any medication, you should fully understand potential side effects. Your doctor is the best person to discuss this with.

* Antihistamines. These are over-the-counter medications and can make you drowsy by working against the central nervous system. They're most effective for occasional sleepless night. The more you take them, the less effective they are.
* Benzodiazepine Hypnotic Medications. This is an older class of sleeping pills. They typically leave a 'hang over" feeling, causing drowsiness or headaches the next morning. And, at times, they can be very habit forming.
* Nonbenzodiazepine Hypnotic Medications. These are the newest class of sleeping pills. They quiet the nervous system and they have fewer side effects the next day. They're only meant for short-term or intermittent use.
* Low-Dose Antidepressants. Some individuals have found that these medications help with insomnia, even if they don't have depression.
* Dietary Supplements. Some people have found relief with dietary supplements like melatonin, valerian root, chamomile and kava. It's very important to talk to your doctor about any of these supplements, because they can interact with other medications, which could be dangerous.

What Is A Stroke?

Stroke, sometimes called a "brain attack," is the number one cause of disability in the United States. It happens when the normal flow of blood to the brain is interrupted, having the potential to cause serious damaging effects on the body.

What Happens With A Stroke?

A stroke, or blockage of normal blood flow to the brain, can happen in two different ways:

• Ischemic Stroke. In ischemic stroke, blood clots or plaques build up in the blood vessels carrying blood to the brain. When your brain doesn't get enough blood, your brain cells begin to die rapidly. Ischemic strokes are the most common form of stroke.
• Hemorrhagic Stroke. This is also called a cerebral hemorrhage. It happens when a blood vessel ruptures and blood spills into the brain, killing brain cells. It is usually caused by high blood pressure or an aneurism. An aneruism is a weakened area of the blood vessel that balloons out and can rupture. It is less common than ischemic stroke, but can have devastating effects.

Signs & Symptoms Of Stroke

It's important to understand the signs of a stroke so you can take immediate action to prevent damage to the brain:

• A sudden numbness or weakness in one side of the body, specifically in the face, arm or leg.
• Severe headache with no known cause
• Dizziness and a loss of balance or coordination.
• Sudden confusion, trouble speaking or understanding
• Trouble seeing in one or both eyes

If you or someone you know experiences these symptoms, it may be a stroke or a mini-stroke, also known as a Transient Ischemic Attack (TIA). While this is not a full stroke, it should be taken seriously. One-third of people who have a mini-stroke will go on to have a stroke.

How To Diagnose A Stroke

The National Stroke Association recommends immediate action if you think someone is having a stroke. Here are some simple test for assessing if it is stroke:

• The Face. Ask the person to smile. Does one side of the face droop?
• The Arms. Ask to person to raise both arms. Does one arm drift downward?
• Speech. Ask the person to repeat a simple sentence. Are the words slurred and is the sentence repeated correctly?

If the answer to any of these questions is yes, time is critical. Call 9-1-1 or take the person to the hospital immediately.

Risk Factors For Stroke

While you can reduce your risk for stroke through lifestyle choices, there are certain uncontrollable factors that may put you at higher risk for stroke. These include:

• Age. You're at higher risk if you're if are over the age of 55.
• Gender. Men have a higher risk than women.
• Ethnicity. African American, Hispanic, Pacific Islander, Asian and South Asians are at risk.
• Family History. You should check into any relatives who may have suffered a stroke.
• Your Medical History. If you have had a mini-stroke, or TIA, in the past, you are at higher risk for having a full stroke.

Preventing Stroke

Even if you fall into a high risk group, there are actions you can take to reduce your chances of having a stroke. These include:

• Regular Check-Ups. Have your blood pressure checked every year. High blood pressure, or hypertension, is a major risk factor for stroke.
• Manage Stress. Stress can contribute to high blood pressure, which raises your risk of stroke.
• Diabetes. Get tested to see if you have diabetes. Diabetes accelerates blockages of your arteries and increases your risk of stroke.
• Smoking & Alcohol. Stop smoking and limit your alcohol intake.
• Cholesterol. Know your cholesterol numbers and make sure they are controlled.High cholesterol can clog your arties and keep blood from moving to the brain.
• Healthy Weight. Being overweight increases your stroke risk.
• Birth Control. Birth control pills can increase the risk of stroke, especially for women who are over 35, smoke, have high blood pressure, diabetes, or high cholesterol.
• Hormone Therapy. Women taking hormone replacement therapy may also be at higher risk for stroke.

Treating Stroke

There are several different ways to treat a stroke. These include:

Medications

These types of medications are usually prescribed for ischemic strokes:

• Clot-Busting Drugs. These drugs must be given within three hours of the start of a stroke in order to work.
• Anticoagulants, or Anti-Platelet Agents. These medications, like aspirin, may be prescribed to prevent a second stroke from happening.

Surgery

Surgery may be an option if you've had a hemorrhagic stroke. Carotid endarterectomy and angioplasty are two possible surgical procedures. Aneurysm clipping can prevent an aneurysm from re-opening and bleeding into the brain.

Rehabilitation

After a stroke, many of your body's functions may be affected. Rehabilitation can help restore basic abilities. Your plan may include:

• Physical Therapy. This can help with movement, balance and coordination.
• Occupational Therapy. This may be recommended for relearning skills like dressing and bathing.
• Speech Therapy. This may be used for re-learning how to talk.
• Dietician. A professional can help you make healthier food choices to prevent a second stroke.
• Social Worker or Psychologist. These professionals may help you get back on your feet emotionally.

Remember, reducing the damaging effects of stroke can be prevented though healthy lifestyle choices and acting fast if a stroke happens.

Overview

Skin cancer is the most common form of cancer in the United States. The key to successful treatment, though, is early detection which can be achieved through regular skin exams.

When to Perform A Skin Self Exam

You should perform a self skin exam every month. The best time is just after a shower or bath, and the goal is to get to know your body. It's also a good idea to teach young children how important it is that they get to know their bodies too. You'll need to check all parts of your body, even those that don't normally see any sunlight. Skin cancer can develop in areas that are usually covered, and also in people with dark skin. In fact some skin cancer is not always related to sun exposure.

What to Look For

During the exam, remember the ABCDEs. These are guidelines to help you determine whether a spot or bump may be something that should be checked by your doctor.

A. Stands for 'Asymmetry.' - Does your freckly or mole look uneven?

B. Stands for 'Border Irregularity.' - Are the edges irregular?

C. Stands for 'Color Variation.' - Are you seeing multiple colors within the lesion?

D. Stands for 'Diameter.' - Is it wider than 6mm?

E. Stands for 'Enlargement' or 'Evolution.' - Is the color, size or symptom changed?

In addition to the ABCDEs, you should also look for the following:

* A new mole
* Spots that itch, burn or bleed
* Red or dark colored flaky patch that is new
* New firm, flesh colored bump
* A sore that doesn't heal

If you do find a new spot on your body, or see that an existing mole or freckle has changed, it doesn't mean that you have cancer. But, you should get it checked out by your primary doctor or dermatologist.

How to Perform A Skin Self Exam

In order to perform a self skin exam, you'll need both a full length mirror and a handheld mirror for checking hard to see spots.

* Check your head. You should start with your head, checking your face, neck and ears. Be sure to check areas that are most exposed to the sun. It's also important to check your scalp. It may be helpful to use a comb or hairdryer to help part the hair so you can see the skin underneath.
* Look at your upper body. Step back and look at the front of your upper body, checking your shoulders and down to your waist. Then, turn around and look at the upper part of your back with a hand mirror. Again, check from your shoulders down to your waist. Now, lift one arm up and look at your side, including your armpit. Then repeat the process on the other side.
* Examine your arms. Bend your elbows, bringing your hands close to your face. Check your hands, fingernails and palms. Then move up the arm looking at the forearm, and remembering to look at both the top and bottom of the arm. Continue moving upwards to the upper arms (you may need the mirror here). Look at both the outer and under areas of the arms noting any changes.
* Examine your legs. The legs and upper back are the areas most prone to melanoma, the deadliest form of skin cancer, so it's important to be thorough here. In the mirror, look at both the front and back or your legs. Also check the area around the buttocks and genitals. Remember, skin cancers can even develop in areas that don't see much sun.
* Look at your feet. It's probably easier to sit down while you're doing this step. Look at both the top and bottom of your feet, and don't forget to check in the space between the toes. This step is especially important for people of color. Sixty percent of melanoma cases in African Americans occur on the feet.

A monthly skin self exam is easy and could save your life through the early detection of skin cancer.

What Is Skin Cancer?
The term skin cancer is used to describe a number of different cancerous conditions that affect the skin. There are two main categories of skin cancer: melanoma and non-melanoma cancers. Non-melanoma cases are the most common and the most curable types of skin cancer. Melanoma, though also curable w hen caught early, is the deadliest form of skin cancer.

Types of Skin Cancer

There are a few different types of non-Melanoma skin cancers. Melanoma is in a class all on its own.

Non-Melanoma Skin Cancers

Basal Cell Carcinoma. Basal cell carcinoma starts in the lowest layer of the epidermis, the basal layer. It is responsible for three out of four skin cancer cases, usually affecting areas maximally exposed to the sun, like the face. The most common forms look like small firm pale bumps, or a raised spot that is pearly and pink or reddish in color. These cancers spread slowly and respond very well to treatment.

Squamous Cell Carcinoma. This cancer also begins in the epidermis, but in the top layer. These look like lumps, with reddish and rougher surfaces and can start in the same areas of the body as the basal cell cancers.

A big difference between these two skin cancers is that squamous cell is more likely to spread, making it a bigger threat to your overall health.

Melanoma

Melanoma is also related to sun exposure but more so with a history of a bad sunburn in areas like the back and lower legs. This is much less common than basal cell and squamous cell carcinomas, but melanoma is much more serious. What makes it so dangerous is the fact that it is more likely to spread to other organs in the body and can actually lead to death.

Melanoma starts in melanocytes, the cells that produce the color in skin. These cells make you tan or freckle in the summer and often, but not always, turn cancer cells brown or black, which is actually good. This way, you can spot this cancer before it's too late.

Preventing Skin Cancer

The reason the sun is harmful to your skin is because it contains dangerous ultraviolet light, or UV rays. Here are some ways to protect yourself and your children from these rays.

Stay Out Of The Sun For Extended Periods Of Time. This is especially important during the peak hours between 10 AM and 4PM. Remember, the UV rays are just as powerful on cloudy days as they are on sunny days.

Use Sunscreen Daily. Use a "broad spectrum" sunscreen with an SPF of 15 or higher. Fair-skinned people should use SPF 30 or higher. Apply sunscreen 20 to 30 minutes before going outside and re-apply every 2 hours.

Wear Protective Clothing. This can include wide-brimmed hats, sunglasses, and clothing with a tight weave fabric. Also, darker colors will offer more protection.

Get To Know Your Skin. Check your skin for any changes, especially in moles and freckles. There are specific variables you should be aware of, which can be easily identified using the ABCDEs.

What Are The ABCDEs?

This is a simple way for you to remember what to look for in changes in your skin.

A. Stands for 'Asymmetry.' - Does your freckly or mole look uneven?

B. Stands for 'Border Irregularity.' - Are the edges irregular?

C. Stands for 'Color Variation.' - Are you seeing multiple colors within the lesion?

D. Stands for 'Diameter.' - Is it wider than 6 mm?

E. Stands for 'Enlargement' or 'Evolution.' - Is the color, size or symptom changed?

Treating Skin Cancer

The good news is that skin cancer, when detected early, is very curable. This includes melanoma.

If you spot any changes in your skin as described above, you should call your doctor. He or she may perform a biopsy to confirm the presence of skin cancer.

Treatment of skin cancer may include minor or office surgery, or something more extensive like radiation or chemotherapy. It depends on the type and stage of the skin cancer you have.

Some skin cancers are recurrent, even if already treated. So it's important to perform regular self-skin exams, especially if you've been diagnosed with skin cancer in the past.

What Is Restless Legs Syndrome?

Restless Legs Syndrome, or RLS, is characterized by symptoms that can include burning, creeping and tugging sensations felt deep in the leg, usually between the knee and ankle. Despite its name, Restless "Legs" Syndrome, the condition may also affect the arms. There is the same urgent feeling to move, but in this case it occurs between the elbow and wrist.

What Happens When Someone Has RLS?

RLS will make you want to move, stretch or shake your leg. And, when you do, there is temporary relief. This cycle of symptom and relief can continue for long periods and, in some people, may be very painful. Because movement provides relief, people with RLS may pace the floor, move their legs around while sitting and toss and turn in bed. This can keep you awake at night, and result in major daytime fatigue. Some people experience one or two episodes per week. But in severe cases, patients may make uncontrolled and often continuous movements, even while awake.

What Causes RLS?

The cause of RLS is unknown. Researchers believe it might be due to an imbalance of the brain chemical dopamine. This is the chemical that carries the signals between nerve cells that control body movement. When dopamine levels don't function properly, the communication of these signals is disrupted.

Diagnosing RLS

Because it's so hard to diagnose (there is no definitive test), your doctor will rely mostly on the way you describe your symptoms. He or she will also ask about your family's medical history, and any medications you might be taking. Also, make note of the frequency, duration and intensity of your symptoms as well as the time of day they're worst and how they affect you on a daily basis.

Types Of RLS

There are two forms of RLS—primary and secondary. Primary sufferers often have family members who've had it too. Secondary RLS has underlying causes such as chronic diseases like kidney failure, diabetes and Parkinson's disease.

Risk Factors For RLS

RLS can appear at any age. It tends to affect more women than men, partially because some pregnant women experience RLS, especially in their last trimester. Symptoms usually disappear within four weeks after delivery.

Managing RLS

If you do feel the symptoms of RLS, there are several things you can do on your own to manage it:

* Don't Fight The Urge To Move Your Legs. It will only make things worse. Get up and move around or try standing at your desk.
* Try Hot or Cold Baths. Heating pads and ice packs may also ease the discomfort.
* Massage Your Legs. This may help to improve circulation.
* Avoid Caffeine, Alcohol, And Tobacco. These all affect the nervous system.
* Understand Your Medications. Certain medications-such as anti-nausea drugs, anti-seizure drugs, antipsychotic drugs, and some cold and allergy medications-may aggravate symptoms. Talk to your doctor about the possibility of changing medications if you experience medication as a trigger.
* Find A Sleep Pattern That Works. Studies show that maintaining a regular sleep pattern can help. Some people, for instance, have fewer symptoms at certain times of day or night and change their sleep patterns accordingly.
* Exercise Moderately. Moderate exercise routines may also help; excessive exercise, on the other hand, can make your symptoms worse.

Treating RLS With Medication

Here are some medication options you may want to discuss with your doctor:

* Dopaminergic Agents. These are largely used to tame the trembling and shaking that people with Parkinson's disease suffer from, have also been shown to reduce RLS symptoms and are usually the first to be prescribed.
* Benzodiazepines. These are used to treat mild or intermittent symptoms. These drugs may help you sleep better.
* Opioids. These are presribed for more severe symptoms because they can help you relax, as well as target severe pain.
* Anticonvulsants. These can reduce creeping and crawling sensations, but they also may make you feel dizzy and sleepy.

Finding the right medication may take some trial and error. Thus, it is very important that you work with your doctor and have patience to find the right treatment plan for you.

What Is Rheumatoid Arthritis?

Rheumatoid Arthritis, or RA, is an auto-immune disease. It develops when your own immune system attacks healthy parts of the body, like your joints, causing pain and swelling. It differs from osteoarthritis, which is the natural degeneration of joints and surrounding tissue when we age.

What Happens With Rheumatoid Arthritis?

When rheumatoid arthritis strikes, cells from your immune system attack the lining of the joint, which is called the synovium. This attack causes the lining to become inflamed, and swollen. Over time, the lining and other parts of the joint will thicken and lose their natural shape and alignment. If the joint loses its shape, it can become painful and difficult to move. For some people, the pain may come and go. These periods of pain are called flare ups. But, rheumatoid arthritis doesn't just affect the joints. The immune system may also attack muscles, ligaments and organs like the eyes and heart.

Risk Factors for Rheumatoid Arthritis

RA affects one out of a hundred people. It is not known what triggers the immune system to attack the joints, leading to RA, but there are factors that increase the risk of developing it. These include:

• Gender. Women are 75 percent more likely than men to develop it. And, the risk is higher for women who have never been pregnant, or who have just recently delivered a baby.
• Age. It typically develops in people 40 to 60 years old, but can occur at any age.
• Family History. Although RA is not inherited, if someone in your family has RA, you are at higher risk for developing the condition.
• Lifestyle Choices. Smokers are at higher risk.

Signs & Symptoms of Rheumatoid Arthritis

Rheumatoid Arthritis can develop slowly, and the symptoms can be subtle at first. Here are some common symptoms you should discuss with your doctor.

• Joint Stiffness or Pain. Especially for more than an hour or two in the morning, or after sitting down for an extended time. Most normal pain and stiffness will go away after a while.
• Tender Joints. If you feel tenderness when you touch your joints, you should see your doctor.
• Redness and Swelling. Red, swollen hands, wrists, feet and ankles can all be a concern. Typically, rheumatoid arthritis will affect smaller joints farthest from the center of the body first. That's why you may feel early symptoms in these parts.
• Rheumatoid Nodules. These are firm bumps under the skin on your arms.

Other symptoms may include fatigue, loss of energy, low-grade fever, loss of appetite, or weight loss.

While any of these can be a symptom of this disease, you don't need to have all of them to have the condition.

Screening for Rheumatoid Arthritis

A physical examination and some simple tests will help determine if you have Rheumatoid Arthritis. These tests can include:

• Blood Tests. These check for immune system cells and cells that cause inflammation.
• MRIs and X-Rays. These are used to look for joint deformity. In most early forms of Rheumatoid Arthritis, X-rays will not show any difference between diseased joins and healthy joints. But they're good for measuring the progression of the disease as you move forward.
• Joint Fluid Analysis. Your doctor will use a syringe to remove some of the fluid around your joints. It will be checked for inflammatory cells or chemicals that your body is producing.

Coping With Rheumatoid Arthritis

Unfortunately, there is no known way to prevent or cure Rheumatoid Arthritis. It's important to note that an early diagnosis is key to successful treatment of the pain and RA.

Here are some things that might help you cope with a diagnosis of Rheumatoid Arthritis:

• Think Positively. While this is a chronic condition, many people do very well with existing treatment options. A positive mindset will help you be one of those success stories.
• Know Your Limits. You may feel tired or pain quicker than you are used to. Listen to your body and know when to take a rest.
• Use Assistive Tools or Devices. There's nothing wrong with using a cane or special jar opener or asking for help. It'll make your life easier.
• Get Support. Don't be afraid to lean on a few different people in your life.

The best treatment results usually include a number of different therapies used in combination. But that combination will be different for everyone.

Treatment of Rheumatoid Arthritis

Treatment options can be broken down into two categories: medication therapies and surgical options

Medication Therapies

Medication therapies are used to treat the inflammation that causes the swelling and pain from rheumatoid arthritis. The primary role of most of these drugs is to slow down the inflammatory process.

• NSAIDs, or Nonsteroidal Anti-Inflammatory Drugs. Over-the-counter pain relievers like aspirin, ibuprofen and naproxen fall into this group of medicines. These target the enzymes that cause joint inflammation and relieve pain.
• COX-2 Inhibitors. These are the next generation of, or newer, NSAIDs and you need a prescription from your doctor to take them. These drugs are easier on your stomach, but there have been questions about their safety in relation to the heart. It's important to talk to your doctor about whether they're right for you.
• DMARDs, or Disease-Modifying Antirheumatic Drugs. If they are taken before major joint damage happens, they can limit the long-term effects of Rheumatoid Arthritis. DMARDs include immunosuppressants, TNF blockers and corticosteroids.
  • Immunosuppressants. These act to slow the immune response, which drives the inflammatory process. It's important to note that by slowing the immune system, these drugs can actually leave you more susceptible to infection.
  • Corticosteroids are powerful medications used to treat painful flare-ups. These can become less effective and cause problems with long-term use, including ulcers. In addition, the body becomes dependent on them over time—so you need to be slowly taper off of them.
• Antibiologics. These are a class of drugs that are given by injection. They target the proteins that cause inflammation.

Surgery Options

More severe cases of RA may require surgeries such as synovectomy, in which the joint lining is removed. Some people may benefit from replacing an entire joint like a knee or hip. And, there are surgeries to repair tendons that have become damaged from the arthritis.

Many people also find relief from complimentary therapies and relaxation techniques, like hypnosis, deep breathing, and muscle relaxation. Acupuncture, gentle forms of yoga and tai chi can also help. The bottom line is, if it helps and doesn't hurt, give it a try.

Overview

While pregnancy is a special time in a woman's life, and every pregnancy is unique, the basic principles of healthy eating remain the same—plenty of fruits, vegetables, whole grains and lean protein. And of course, now is the time to stop smoking and drinking alcohol. Even small amounts of both can cause damage to your baby, and even cause birth defects.

As the months go by, you're going to gain weight, which is important for you and your baby. But, the term "eating for two," is a little misleading. You actually only need an extra three hundred calories a day. But don't go crazy over counting calories. Instead, use these guidelines to help keep tabs on whether you're gaining too much or too little.

It's common to gain as little as three to four pounds in your first trimester. You'll probably gain the most weight— from half a pound to a pound per week—in your second trimester. Expect about the same for the third trimester, although it may start to taper off.

Essential Nutrients

When thinking about your diet during pregnancy, a prenatal vitamin is a great start. Your doctor can help you choose one that's right for you. But there are some nutrients you should focus on getting through the foods you eat.

Folic acid, or folate, helps to prevent some types of birth defects, like spina bifida. It's also a crucial nutrient for healthy DNA and will decrease the risk of preterm delivery and low birth weight.

Good dietary sources of folate are fortified breakfast cereal, lentils, leafy green vegetables, beans, peas, and orange juice.

Iron is another important nutrient to focus on during pregnancy. When you're pregnant, your body makes a lot more blood to support your baby...and your iron levels need to keep pace. Iron helps avoid anemia, which, though common during pregnancy, can be dangerous. Enough iron can also help prevent fatigue, and ease labor and delivery.

Lean red meats, poultry and fish are good sources of iron. Iron-fortified breakfast cereals, nuts and dried fruits are also other options.

Getting enough calcium is important during pregnancy. Calcium is not only for strong bones and teeth. It also helps your circulatory, muscular and nervous systems, and can help prevent those leg cramps we all feel. It's especially important during the third trimester, when your baby's bone mass is developing.

Dairy products like milk and cheese are the richest sources of calcium, but you can also get it from broccoli, fortified fruit juices, and some breakfast cereals...just go for the ones low in sugar.

If you don't eat dairy foods, you may need a calcium supplement.

Smart Food Choices

In order to help your baby develop, it's important to make smart food choices while taking a "vacation" from some foods. What you're trying to avoid are foods that can make you sick, or damage to your baby. Let's walk through some of them:

Store-bought lunchmeats can contain bacteria called listeria that are harmful to unborn babies.

Instead, try egg salad, or chicken and tuna salads made with low-fat mayo. And remember; fully cook all meats and poultry before eating. If you're not sure, use a meat thermometer.

Seafood can be a great source of protein, iron and the omega-3 fatty acids, which can help your baby's brain development.

However, some fish and shellfish contain high levels of mercury. Too much mercury can damage your baby's developing nervous system. So stay away from swordfish, shark, and tilefish.

But 12 ounces a week or about two meals of salmon and catfish is safe. Tuna's fine also, just keep it under 8 ounces a week. And, when you cook fish, make sure it's cooked all the way through.

Raw or undercooked fish and shellfish can also contain bacteria, so it's good to take a break from them while you're pregnant.

Dairy products like skim milk, hard cheeses and cottage cheese can be a healthy part of your diet. And yogurt is great because it has cultures in it that help prevent yeast infections, which can also occur during pregnancy.

Just make sure that every dairy item you eat is fully pasteurized. Soft cheeses like brie, goat and feta aren't fully pasteurized, so you should avoid those during your pregnancy.

Sweets are fine, but try to make healthy choices and stay away from processed foods as much as possible.

Figs have more fiber than most fruits and vegetables, as well as potassium, calcium and iron. A box of raisins packs a good dose of fiber and iron, and it's a great way satisfy that sweet tooth. Soy nuts are a good salty alternative and quick pick me up.

There's no firm verdict on caffeine, though it's best to stay clear of it. Even though a cup or two hasn't shown any harmful effects, it can affect the baby's heart rate and breathing.

Finally, drink lots of water. Not only can it keep your digestive system working smoothly, it also helps your blood carry the nutrients from the food you eat to your baby.

It's tough enough to keep up a healthy diet when you're not pregnant. The do's and don'ts can pretty daunting...and it's hard to say goodbye to foods we love when we are pregnant. But you're not in it alone. Start motherhood off by sharing good health with your baby, it's a huge step towards a great new bond.

Have a safe, healthy and happy pregnancy!

Overview

Pregnancy lasts about forty-weeks, starting with a woman's last menstruation and ends with the baby's birth. Pregnancy can be divided into three trimesters, based on the development of the baby.

The First Trimester (0-14 weeks)

Signs & Symptoms

During the first trimester of pregnancy, you won't see much change in your physical appearance, but you may feel these common symptoms:

• Exhaustion
• Cramping
• Skin breakouts
• Tender breasts
• Spotting
• Other common PMS symptoms
• Frequent urination
• Backaches
• Leg cramps
• Mood swings
• Nausea and vomiting. This is most often referred to as "morning sickness". The term "morning sickness" can be misleading because many women experience these symptoms throughout the day. Taking a vitamin B6 supplement can help ease the nausea. You should also try to avoid fatty, acidic, or hard to digest foods. Also, as long as you stay hydrated and can maintain a healthy diet and weight, the nausea and vomiting should not affect the baby.

Expected Weight Gain In The First Trimester

Most women will not see significant weight gain during this trimester. On average, you should expect to gain about one pound per month during the first trimester. If you are normal weight when you conceive, you should expect to gain a total of 25 to 35 pounds throughout pregnancy.

Diet & Nutrition

There is a common misperception that because you're technically eating for two, you should eat twice as much. Typically, you should plan to eat an extra 300 calories a day throughout your pregnancy.

You should maintain a healthy diet, rich in nutrients, protein and calcium. Anemia is common in pregnant women, so you should make sure to get plenty of foods full of iron. Continue taking prenatal vitamins, which contain folic acid.

There are many foods to avoid, which include:

• Foods High In Mercury. Examples include tuna fish, raw foods like sushi, undercooked meats, and eggs.
• Soft, Unpasteurized Cheeses. Examples include bleu cheese and feta. Pasteurized means food has been heated to destroy potentially harmful viruses and organisms.

Also, consult your doctor before taking prescription and over the counter medications.

What's Happening Inside

This is the time when the baby's cells will organize into what will become organs like the heart and lungs. The umbilical cord, which connects the baby to the placenta, will begin to form. This cord will provide all the nutrients and oxygen the baby will need until birth. Fingers and toes will begin to develop and the ears, upper lip and nose will become more recognizable by week eight.

Common Tests & Procedures

Throughout these first fourteen weeks, you should plan to visit your obstetrician once a month to keep track of your baby's progress. You should also consult your obstetrician before taking any prescription or over the counter medication.

• Ultrasound. By week 10 you'll be able to hear your baby's heartbeat through an ultrasound. An ultrasound uses high-frequency sound waves to scan a woman's abdomen to create an image of the baby on a computer screen. They will be used throughout pregnancy to monitor your baby's heartbeat, movement and breathing, as well as determine your baby's size, due date and gender.
• Genetic Counseling. Along with an ultrasound, your obstetrician will discuss several different procedures that can help determine your baby's progress. In fact, your doctor may recommend seeing a genetic counselor during the first two trimesters if you are 35 years of age or older, or if you have a family history of genetic problems like downs syndrome and cystic fibrosis.
• Chronic Villus Sampling, or CVS. This test is usually performed between weeks 10 and 13. in 99% of cases, CVS will detect these genetic abnormalities. Because there is small chance of miscarriage as a result of this test – approximately 1% - it is not always performed.

A Note About Miscarriage

One of the hardest things to think about is losing the baby, or having a miscarriage. Miscarriage is actually very common, especially during the first trimester. Here are some signs and symptoms that may indicate a miscarriage:

• Mild to severe back pain
• Weight-loss
• Appearance of white or pink mucus
• Painful contractions that occur every five to 20 minutes
• Brown or bright red bleeding
• A sudden decrease in the signs usually associated with pregnancy

Most miscarriages will occur in the first 13 weeks. If you have these symptoms, you should call your doctor. She will advise you on the best course of action. It's important to note that having a miscarriage is common and doesn't necessarily affect your ability to have a baby in the future.

The Second Trimester (15-27 weeks)

Common Symptoms

You may start to feel the baby move and kick, although many first-time moms don't feel this movement until week 20. During the rest of your pregnancy, you can expect to gain one to two pounds per week. This increase in weight happens because your baby is growing quickly.

During this period, many women notice the exhaustion, nausea and vomiting experienced in the first trimester decrease. You may feel more energetic and develop the "glow" of pregnancy as the baby starts to show more significantly.

Diet & Exercise

Here are some guidelines to help you maintain a healthy exercise and diet program that will be healthy for you and your baby:

• Try to find non-weight bearing activities, such as swimming or cycling on a stationary bike.
• You should also avoid over-heated gyms and make sure to continually hydrate your body.
• Continue taking pre-natal vitamins rich in folic acid;
• Eat foods that are full of protein, fiber, nutrients, carbohydrates and iron;
• Avoid unpasteurized foods, uncooked meats or foods that contain mercury.

What's Happening Inside

By the beginning of this trimester, features like eyebrows and fingernails start to grow.

Around week 16, the baby's eyes will be sensitive to light and it will be able to make facial expressions like frowning and squinting. By week 18, it will develop the ability to swallow and hear. Around week 20, your "innie" belly button may "pop" and suddenly become an "outie." But, don't worry, it'll return to normal shortly after the baby's born. By week 24, you may notice an increase in the baby's movement in reaction to touch or sounds.

Common Tests & Procedures

In general, you should plan to visit your doctor once a month during this trimester to keep track of your baby's progress. Here are some tests your doctor may perform during this time:

• Sonogram. At the halfway point, week 20, you'll likely have an ultrasound, also called a sonogram. This test uses high-frequency sound waves to scan a woman's abdomen to create an image of the baby on a computer screen. Your doctor will check the baby's development. This is often the first opportunity to learn the baby's sex and find out if there are multiples. If you are having multiples, you can expect more frequent trips to the doctor. He or she will make sure you and your babies are getting the care and nutrients you need.
• Amniocentesis. If you didn't get a Chorionic Villus Sampling, or CVS test inthe first trimester, your doctor may recommend amniocentesis in the second trimester. This is a diagnostic test where fluid is drawn from around the baby with a needle, using an ultrasound as guidance. This fluid can be tested for genetic problems like spina bifida, downs syndrome and cystic fibrosis. This test is similar to a CVS test which we talked about in our segment on the first-trimester. Usually, an amniocentesis can be performed after 15 weeks and is recommended for women who will be 35 or older on their due date, or couples who have a family history of genetic problems. Because this is an invasive test, it's not recommended for all women, so you should talk it over with your doctor.
• Glucose Screening Test. This test checks for gestational diabetes. This type of diabetes appears in about 4% of pregnant women and then usually goes away once the baby is born. This test is typically done between weeks 24 and 28.

Third Trimester (28-40 weeks)

Common Symptoms

During the final trimester of pregnancy, your body is getting ready for deliver. You can expect to feel many of the following symptoms:

• General discomfort
• Difficulty getting a good night's sleep
• Pelvic pressure and vaginal discharge, as your cervix opens and prepares for delivery;
• Heartburn
• Swelling of the feet and hands
• Tender breasts
• Hemorrhoids
• Appearance of stretch marks and varicose veins.

Diet & Exercise:

Like the other trimesters of pregnancy, you should maintain a healthy diet. You should continue taking pre-natal vitamins rich in folic acid; eat foods that are full of protein, fiber, nutrients, carbohydrates and iron; and avoid unpasteurized foods, uncooked meats or foods that contain mercury.

Exercising will become increasingly difficult, as your stomach gets bigger, but there are still some things you can do to stay active. Try low-impact exercises like walking or swimming. Avoid overheated rooms or gyms and don't do exercises that require laying on your back or cause bouncing, jumping or sharp movements.

In some cases, doctors will recommend bed rest, which is fairly common. Conditions that may cause bed rest are high blood pressure, vaginal bleeding and premature contractions.

Understanding Contractions

Contractions are a signal that you may be ready to deliver your baby. But there are different types of contractions you should understand. These include:

• Braxton-Hicks Contractions. These premature contractions occur when the muscles of your uterus tighten for anywhere between 30 seconds and 2 minutes. It is your body's way of preparing for actual labor. Sometimes it's hard to determine if what you're feeling is Braxton Hicks or actual labor contractions. Mothers often describe Braxton Hicks as more uncomfortable than painful and they will eventually taper off and disappear. Actual labor contractions will get progressively longer, stronger and closer together. Braxton Hicks shouldn't increase in intensity or frequency. If these premature contractions are uncomfortable, there are a few things you can try:
  • Take a warm bath to help you relax.
  • Take slow, deep breaths and doing breathing exercises.
  • Drink a couple glasses of water.
  • Try changing your activity or position.

If you haven't reached 37 weeks yet, but are experiencing more than four contractions in an hour, or if you have vaginal bleeding or spotting, call your doctor.

• Actual Labor Contractions. Once you've reached the 37-week mark, you should call your doctor when your contractions last 60 seconds each and are five minutes apart. This will be your body's way of telling you it may be time to deliver your baby.

What's Happening Inside

During the final trimester, the baby is using this time to put on weight and strengthen bones. Movements will become stronger and more frequent. The baby is actively breathing and sucking. And you may feel slight spasms in your uterus when the baby gets the hiccups.

Common Tests & Procedures

Because you're in the home stretch, you should plan to see you obstetrician once every two weeks between weeks 28 and 36. You may also be tested for the following conditions.

• GBS, or Group B Strep. This is a specific bacteria doctors check for in the last trimester.
• Anemia. Your doctor will want to make sure you have a healthy red blood cell count.
• STDs. In some cases, you may also be tested again for sexually transmitted diseases.

Delivering Your Baby

Beyond 37 weeks, your baby will be considered full-term and are ready to deliver your baby. It is not uncommon for women to pass their due dates. Only 5% of women deliver on their due date - most have the baby one to two weeks late. You should consider the period past your due date as extra time for the baby to gain strength and for you to prepare for life with a newborn.

What Is Menopause?

Clinically, a woman has reached menopause when she has not had a period for 12 consecutive months. The time leading up to menopause is called perimenopause, and the time after is called postmenopause. The most significant time is the year or two of change leading up to menopause. During this time, a woman's body will make a lot less of the hormones estrogen and progesterone. Many women begin to notice changes and often wonder whether any of the symptoms they are feeling are "normal."

Menopause Symptoms

Menopause affects every woman differently, but there are common signs that the change is happening.

• Hot Flashes. This is a classic symptom, and can range from feeling flush in the face, neck or chest through to perspiring profusely at night (also called 'night sweats').
• Changes in Your Period. The time between your cycles may change, as can the flow or heaviness.
• Abnormal Bleeding or "Spotting." This is very common as you near menopause. But if your periods have stopped for 12 months and you still have spotting, you should visit your doctor. This could be a symptom of a more serious problem.
• Emotional Changes. You may experience mood swings, irritability, depression, anxiety and feeling tired or tense. Sleep problems further contribute to these discomforts.
• Vaginal Changes. The vagina may become dry and thin, making sexual intercourse painful. Some women may also experience an increase in vaginal infections.
• Osteoporosis. Thinning of the bones can lead to loss in height and an increased risk of bone fractures.
• Urinary Incontinence. You may experience leaking, burning or pain when urinating, or leaking when sneezing, coughing or laughing.
• Decreased Libido. Some women also experience a decrease in their sex drive, from less interest in sex to changes in their sexual response.
• Weight gain or Increased Body Fat. This is common especially around the waistline.
• Thinning Hair or Hair Loss.
• Problems with Concentration or Memory.

The best advice is to learn everything you can about menopause and talk to your doctor, and don't be afraid to ask questions. Each woman will experience menopause differently—some will have mild symptoms, others severe.

Although every woman will experience menopause, the experience is not the same for everyone. Each woman has to adapt and accept the changes that come with her personal version of menopause.

Treating Menopause Symptoms

There are so many different ways to treat the symptoms of menopause. Here are some of the most common options:

Medical Options

• Hormone Replacement Therapy (HRT). Many women have had success with HRT, but researchers have found links to increased risk of heart attack, stroke and breast cancer. You and your doctor should discuss if HRT is an option for you. There's no one-size-fits-all recommendation regarding HRT.
• Low-dose Antidepressants. SSRIs, or selective serotonin reuptake inhibitors, may decrease hot flashes by up to 60 percent as well as help with depression. Your doctor can explain any side effects.
• Vaginal Estrogen. This can relieve vaginal dryness. You administer it by inserting an estrogen tablet, ring or cream directly into the vagina.

Lifestyle Choices

• Identify Hot Flash Triggers. These can include spicy foods, alcohol, hot beverages, hot weather or a warm room. Dress in layers and get plenty of exercise to manage hot flashes.
• Relieve Vaginal Discomfort. You can use over-the-counter water-based vaginal lubricants, moisturizers, or vaginal estrogen. Staying sexually active helps too.
• Reduce Sleep Disturbances. Avoid caffeine after lunch and don't exercise right before bed. Try breathing relaxation techniques or even guided meditation. This may help to calm you before bedtime.
• Manage Your Weight. Exercise routinely and eat well. This will help lift your mood and foster a more positive body image.
• Practice Kegel Exercises. You may want to include Kegel exercises as part of your regime; they will help strengthen your pelvic floor and improve some forms of urinary incontinence.

Women who have gone through menopause are at a higher risk of other conditions including cardiovascular disease and osteoporosis. The good news is that many of the treatment approaches to menopause do double duty by helping to either prevent or lessen the affects of these related conditions.

Most importantly, schedule regular check-ups with your doctor and talk to him or her about your symptoms of menopause.

What Are Migraines?

Migraines are severe headaches, and may cause more than just pain in your head. Migraines can also bring on nausea, changes in vision and sensitivity to light and sound. Migraines can last anywhere from a few hours to a few days. While it's not fully understood what causes migraines, researchers are learning more and more about what happens inside the body when these headaches occur.

Migraines don't just affect adults. In fact, people who suffer from migraines usually develop the condition during childhood or adolescence. Those with a family of history of migraines are more likely to develop the headaches, and women are three times as likely as men to suffer.

What Happens When Someone Has a Migraine

It's believed the pain is triggered after a drop in the level of a chemical in the brain called serotonin. The drop in serotonin causes the nervous system to release other chemicals, called neuropeptides, which travel to the outer covering of the brain. These chemicals react with the blood vessels, causing them to dilate, or open wide. The widening of these blood vessels may create the pain associated with migraines. This may explain why many patients say they feel a throbbing pain. And, many times, migraine pain is only felt on one side of the head.

Types of Migraines

• Classic Migraines. With classic migraines, people may feel what's called a "prodrome," or premonition before the migraine attack. Auras are one type of premonition. They cause changes in sight and often come in the form of pulsating light, or blurred vision. They can start 15 minutes to an hour before a migraine, and may linger through and even after the headache. Other premonitions may also be felt in the days and minutes leading up to a migraine. These can include feelings of elation or intense energy, cravings for sweets, thirst, drowsiness, irritability or even depression.
• Common Migraines. These do not come with any premonition or warning sign.

Screening for Migraines

Your doctor will ask about your family and medical history, and may also run some routine tests. These may include an MRI or CT scan, which create images of the brain and other parts of the body.

Preventing Migraines

• Avoid Migraine Triggers. These can include a sensory stimulus like bright lights, sun glare, loud noises or even certain smells; and changes in the weather.
• Reduce Stress. Some people will get migraines when they are under heightened stress, while others may develop their migraines after going through a stressful period.
• Avoid Trigger Foods And Drinks. Common migraine trigger foods and substances include caffeine, MSG, alcohol (especially wine and beer) and certain seasonings and processed foods.
• Don't Smoke. Smoke has been known to trigger migraines.
• Understand Medications You're Taking. It's possible that these may be the cause of your migraines. Speak to your doctor before starting or stopping any medication.
• Hormonal Changes. This especially affects women. Migraines can occur around the menstrual cycle, during pregnancy and even at the time of menopause. Since birth control pills contain estrogen, these too may trigger migraines in some women. You can't control the natural hormones your body produces, but you can work with your doctor if you take birth control, or use a hormone replacement therapy.

Migraine Treatment

Medical Options

Medical options are classified into three categories: over-the-counter medications, prescription pain relievers and preventative medications. Remember, discuss potential side effects with your doctor.

• Aspirin and Ibuprofen. Aspiring and ibuprofen are considered non-steroidal anti-inflammatory drugs. Other non-steroidal anti-inflammatory drugs can be used also. These work well for occasional migraines, but if they're used frequently they may cause a side effect known as "rebound headaches." These are severe headaches that occur after the initial medication wears off.
• Triptans. These act like the serotonin chemical in your brain and constrict the blood vessels in the brain. These are best used before or just after the start of a migraine. Triptans can be taken as a pill, nasal spray or even an injection.
• Ergotamine Medications. These also constrict blood vessels in the brain, but can cause more side effects than the Triptans. They may only be used in certain patients.
• Preventative Medications can be prescribed if pain relievers don't work, or for people who suffer from frequent migraines. These medications are taken everyday, and come in these three classes:
• Beta Blockers. These are commonly used to treat high blood pressure and heart disease. But, they've been shown to reduce the frequency and severity of migraines.
• Antidepressants. These work by regulating the brain chemical serotonin. They can help individuals with migraines even if they aren't diagnosed with depression.
• Anticonvulsants. Also known as anti-seizure medications, these medications are used to treat epilepsy and bipolar disorder but have shown great success in preventing migraines.

Lifestyle Choices

• BioFeedback. This is a complementary therapy which can help reduce muscle tension and stress.
• Yoga. Yoga is a good option for calming the body, and helping to reduce stress.
• Massage and acupuncture have also been known to help.

Migraines can be treated better today than ever before. Know the signs and triggers of migraines and do your best to take early action against these headaches.

Overview

We all need sleep, especially kids. And, when they don't get it, everyone in the family wakes up exhausted, irritable, and emotionally drained.

Here are some general guidelines for how much sleep children need according to their age:

• Infants: 14 to 16 hours
• Toddler and Preschoolers: 12 hours
• School-age children: 10 hours
• Adolescents: 9 to10 hours

These numbers may sound high, and children vary in their sleep needs, but a lack of sleep can have a serious impact on your child's health, school performance, and behavior, not to mention your family life.

How to Know If Your Child Needs More Sleep

Here are some things you can do to learn if your children aren't getting enough sleep:

Observe Breathing. Once they fall asleep, listen to their breathing. If they snore or breathe through their mouths, or if they breathe irregularly, take notes and talk to your pediatrician.

Watch for 'Night Terrors.' During a night terror, a child may sit straight up, and his or her eyes are wide open. He or she may scream or even thrash around. Although it seems as though they are awake, or that they're having a really bad dream, they won't remember the incident in the morning. So, in fact, it's really important to monitor the episodes because some kids will actually try to get out of their beds or even out of their rooms. And if this happens, just gently help your child get back to his or her bed, and back to sleep.

Listen for Nightmares. These are much more common than Night Terrors and often can be handled with a little TLC or a change in bedtime routine.

Setting Bedtime Routines

It's important to set strict bedtime routines to avoid the vicious cycle of lack of sleep and misbehavior. It is actually the lack of sleep that causes the misbehavior and not the other way around.

For Younger Children

The Ferber Technique

The Ferber technique is named after pediatrician, Dr. Richard Ferber, who wrote "Solve Your Child's Sleep Problems." The idea behind the technique is to extend the time you wait before going back into your child's room when they are resisting going to bed. It can take a couple of days or even a week before your baby gets the message, but once he or she does, and you put him/her to bed and he/she falls asleep, you're going to feel a real breakthrough.

Forming Positive Associations with Sleep

Good sleep starts with a predictable, soothing bedtime routine made up of activities that help a child wind-down and that signal the body that it's time to relax. Find those right relaxation techniques for your child, whether it is a warm bath or a bedtime story. What won't work are activities that keep a child's motor running, like playing an exciting game, rough-housing, or watching TV. Also keep sugar, chocolate and caffeine off the menu before bed. And if your child's taking medications, ask your pediatrician if they might be interfering with his or her sleep.

Weaning Your Child from Your Bed

Many times kids get used to sleeping with their parents in their parents' bed. But sooner or later that habit will need to be broken. Here's a technique to make that transition happen:

Put a mattress on the floor in your child's room, close to his bed and start sleeping there. The following night, move the mattress a little farther away from her bed, until you are basically out of the room and back into your own bed. It may take a week or longer. Gradual weaning often works a lot better with preschoolers than anything else. And remember to reward positive behavior. Tell your child that if she's quiet for 15 minutes, you'll come in and check on her. But be sure you keep your promise. By the third or fourth "check-in", chances are he'll be fast asleep.

For Older Children & Teens

The Dangers of Sleep Deprivation in Kids

Sleep deprivation has a serious effect on a child's ability to concentrate and pay attention, or even stay awake, in class. It also lowers children's immune systems, so they're more prone to illness.

First, make sure your kids have a proper "wind down" time before bed. This means limiting late night hours, which may mean cutting down on late-hour sports practices, and TV and computer time. Also, make sure they avoid caffeine before bed.

If you have teenagers and find that they are having a harder time getting out of bed in the morning, it may be because their sleep/wake cycle changes at puberty. If they have a chance to take a nap in the afternoon when they get home from school, let them. And you should allow them to catch up somewhat on the weekends, but don't let them sleep so late that they feel jet-lagged and can't feel productive during the day.

Parents always want the best for their kids. Making sure they have enough sleep is one of the best things you can do for their health and their ability to learn and grow.

What Is HPV?

HPV, or human papillomavirus, is a common virus spread mainly through sexual contact. There are more than one hundred different strains of the virus. While most strains are harmless and clear up over time, a small number of strains can lead to cervical cancer.

What Happens With HPV?

When a woman is infected with HPV, cells on the surface of the cervix can show signs of a viral infection. In some cases, the infected cells can become precancerous and may eventually become cancer in the cervix. The cervix is the lower, narrow part of the uterus, which is where babies grow and develop inside a mother. It's connected to the top end of the vagina. Most cases of cervical cancer develop in the flat, scaly cells that line the cervix. These are called squamous cell carcinomas. The remaining percent of cases develop in the glands of the cervix.

Signs & Symptoms Of HPV

In many cases there are no outward signs of HPV, but some strains can cause genital warts, which explains the name. "Papilloma" is actually the medical term to describe a wart. In general, here are some signs you should look for:

* Genital Warts. These can appear as single or multiple bumps in the genital areas of men and women. They can be present on the vagina, cervix, vulva, penis, and rectum. Warts themselves are considered low risk and generally won't develop into cervical cancer.
* Common Skin Warts. These may be found on the hands or soles of the feet.
* Abnormal Vaginal Bleeding. Also, vaginal discharge that's yellow in color, low back pain, discomfort during sex and painful urination.

Screening For HPV & Cervical Cancer In Women

Since ouward symptoms of HPV are rare, it's very important that women get screened routinely for both HPV and cervical cancer. Here are common tests you should ask your doctor about:

* Pap Smear. This is the most common routine test for women. During a pap smear, your doctor will remove cells from the cervix using a special swab. In order to do this, a tool called a speculum will be inserted to hold the walls of the vagina open so your doctor can get a clear view of the cervix. You'll feel some uncomfortable pressure while your doctor is removing the cells from your cervix, but it only lasts a few seconds. For the most accurate results, Pap Smears should be performed 2 weeks after menstruation and at least 48 hours after sex. The American Cancer Society recommends that all women begin having annual Pap smears at the age of 18, or when they become sexually active.
* HPV DNA Test. This is a simple blood test that will detect the presence of HPV.
* Colposcopy. After the Pap smear, some gynecologists also perform a colposcopy. This test checks for warts that can't be seen during a pelvic exam. Your doctor will flush a vinegar solution, or acetic acid, into the upper portion of your cervix. That will cause any existing warts to whiten and stand out.
* Biopsy. If any abnormal cells are detected during routine testing, further tests may be necessary. This can include a biopsy, which is a surgical procedure to test cells for cancer.

Screening For HPV & Cancer In Men

HPV is a sexually transmitted infection and right now, there is no way to detect HPV in men.

Preventing HPV & Cervical Cancer

There are a number of ways to prevent coming in contact with the HPV virus:

* Practice Safe Sex. Unless you're in a monogamous relationship with a partner who's free of STDs, or sexually transmitted diseases, use a condom every time you have sex.
* Get The HPV Vaccine. While this is controversial subject, many girls and young women have chosen vaccination to protect themselves from HPV and cervical cancer. The national Advisory Committee on Immunization Practices recommends routine vaccinations for girls 11 and 12 years old. This is the age when the body responds best because it's building up the immune system. The vaccine is most effective if given before girls become sexually active, so it is also advised that girls as young as 9 and women up to 26 years old be vaccinated if they haven't already received it. This vaccine doesn't offer protection from all types of HPV, or other sexually transmitted diseases.
* Quit Cigarette Smoking. It is known that cigarette smoking increases the risk of both precancerous changes and cancer of the cervix.

Treating HPV

Since HPV is a virus, there is no cure, but there are ways to alleviate symptoms like warts:

If you have small warts, your doctor can remove them by one of three methods:

* Freezing, or cryosurgery
* Burning, or electrocautery
* Laser treatment.

If you have large warts that have not responded to other treatment, you may need to have surgery to remove them.

It's important to remember that no one treatment is best, and warts can return, especially during the first 3 months after treatment. Antiviral drugs may be prescribed if treatments don't stop the warts from coming back. If you are pregnant, genital warts can cause problems and may need to be removed for a safe delivery of the baby.

Treating Cervical Cancer

According to the National Cancer Institute, cervical cancer is curable if caught early. Treatment usually involves surgery, radiation or chemotherapy.

Surgery Options

There are a number of surgery options available.

* Laser Surgery. This is used to kill and remove early stage cancer cells through heat. In early stage cancers,
* Cryosurgery. This may be used to kill and remove early stage cancer cells through cold. may be used to kill and remove cancer cells with heat or cold.
* Conization. During this type of surgery, your doctor will remove a cone shape sample of the cervix. This can be used to test for the presence of cancer, or if the cancer is small, remove it all together.
* Hysterectomy. This type of surgery is used in late stage cancers when it has spread and is performed to remove the uterus and cervix.

Radiation Therapy

Radiation therapy is used to kill cancer cells or shrink the size of a cancer growth. During this therapy, strong x-rays or beams of other high energy radiation are directed to the area affected by the cancer.

Chemotherapy

Chemotherapy treatments use drugs to kill cancer cells. These therapies affect the entire body, and not just the area where the cancer is. They do cause side effects, but they are very successful in treating cancer.

It's important to know that cervical cancer is a "worst case scenario" with HPV. Most of the time your immune system will prevent the virus from becoming serious.

Hosted by Brad Staggs, Home Improvement Expert

Did you know over a third of people over age 65 fall each year and over two-thirds of those falls occur right in the home? There are some simple home improvements you can make now to make your home easier to live in later in life.

Floors & Furniture

* Remove any rug not permanently tacked down. If you decide to keep throw rugs, put a good non-slip pad underneath so it doesn't move or catch someone's foot.
* Consider putting down wall-to-wall carpeting if you have linoleum or ceramic tiles, The carpets shouldn't be too thick or plush.
* Remove any low-standing furniture or decorative items that might cause someone to trip. These are things like baskets, plants, footstools or coffee tables.
* Replace chairs that have wheels on the bottom. If it's difficult to get in and out of a chair, consider installing a lift chair or adding height to your couch.
* Place sturdier risers underneath the legs of furniture to give them extra height.

The Bathroom

* Install grab bars round the tub, shower and toilet. You need to find a bar that's designed to hold at least 250 pounds. Remember always install grab bars directly into the wall studs.
* Elevate toilet seats.
* If your bathroom has the space, consider a walk-in shower or a walk-in bathtub, with a door and built-in seating.
* Use non-skid mats in front of the sink and toilet and outside the tub if you don't put down low-pile carpeting.
* Cover the bottom of the tub with a suctioned safety mat or some sort of permanent rough coating.
* Replace faucet knobs with lever handles to make it easy to turn water on and off.
* Have outlets installed at a level that is easily accessible.

The Kitchen

* Make sure everything in the kitchen is within easy reach. You don't want to have to use a step stool or a ladder, which means you may have a little rearranging to do in your cabinets.
* Put all of your loved one's important information on a piece of paper on the refridgerator: this should include their name, any medications they're taking, any allergies, and the contact information for their doctors and family members. Make sure to keep it up-to-date.
* Consider raising the front of the refrigerator 1/4 inch so the door closes automatically.

Other Tips

* Make sure staircases have hand rails on at least one side.
* Keep flashlights throughout the house, especially close to the bed.
* Program your phones so that emergency numbers only require one-button dialing.
* Replace doorknobs with lever handles so you don't have to grip and turn the knob to open the door.
* Make sure that your water heaters thermostat is kept at no more than 120 degrees Fahrenheit to prevent scalding.
* Consider putting a ramp at places like the garage or the front door to make it easier to get in and out.

Depending on your house, your budget and your own situation, you can make your home comfortable and safe for years to come.

Home First Aid Kit

Creating a home first aid kit is very important and easy. You can either make the items in the kit, or find them at any pharmacy and most supermarkets.

• Emergency Numbers List. These should include your doctor, local ambulance, fire department and poison control center. .It's also a good idea to have numbers for your pharmacy, and a person who will act as your emergency contact.Acetaminophen, Ibuprofen And Aspirin Tablets. These are used for fevers, aches and pains. In some cases, aspirin should be taken during a heart attack. Talk to your doctor about whether this is something you need to think about. One important point—aspirin should not be given to children with flu symptoms, as they can develop Reye's Syndrome, a potentially fatal disease.
• Cough Suppressant. Keep cough suppressants around for unexpected coughs, and colds.
• Antihistamines and Decongestants. These agents are useful for treating symptoms of allergies, especially stuffy noses.
• Thermometer. Keep this to check for fever.
• Oral Medicine Syringes. These are used to give children oral medications, like cough syrup or antibiotics. You can also use these to flush and clean cuts and wounds.
• Emergency Eye Wash Solution. Use this solution to wash out debris, or chemicals from the eyes.
• Bandages (in different sizes and shapes). For cuts and scrapes.
• Elastic Wraps. You'll need these for sprains from a twisted ankle or wrist.
• Gauze and Adhesive Tapes. Use these to dress larger cuts when other bandages won't do. Gauze also acts as a good compress to help stop a bleeding cut.
• Sharp Scissors with Rounded Tips. These will help you remove bandages, or clothing from the skin without cutting or damaging the skin even further. Hydrogen Peroxide and Antiseptic Wipes. These are both good for cleaning scrapes and cuts.
• Antibiotic Ointment. To prevent infection.
• Instant-Activating Cold Packs. For sprains, bumps and bruises.
• Tweezers. Use these to pull splinters or clean cuts and scrapes.

Be sure to keep your emergency first aid kit away from children since it contains sharp objects and medications.

Preventing Accidents in the Home

Here are some helpful tips for staying safe in each main room of the home. If you are injured and in doubt about whether you need medical attention, err on the side of caution and keep your emergency numbers list handy.

The Family Room

• Cover Sharp Furniture Edges. Little ones can fall and bump their heads or other body parts. It's a good idea to put soft covers on sharp edges.
• Tape Down Rug Edges. Prevent slips and falls on rugs by making sure they aren't "turned up" or bulging.

Trips and stumbles can cause sprains and bruises. If this does happen, remember the R.I.C.E. method of treatment: Rest, Ice, Compress and Elevate. .

The Bathroom

• Put down a non-slip mat. To prevent slips and falls, place a rubber or non-slip mat on the floor and in the tub.
• Be safe with Electrical Devices. Keep devices like hairdryers and electric shavers away from water.

The Kitchen

• Store Knives. Avoid skin cuts by putting knives in their proper place, like a drawer or wood block.
• Cut Carefully. Always chop or cut away from you.
• Let It Fall. If you drop a knife, don't reach for it. Let it hit the floor.
• Empty The Sink. Don't leave knives in dirty or cloudy dish water where you can clearly see them.
• Position Hot Pots. Make sure pot handles are turned inward when on the stove to avoid knocking them over.
• Store a Fire Extinguisher. Always keep one handy in case of a stove or oven fire.

Treating Injuries in the Home

Treating Sprains & Bruises

Remember RICE: Rest, Ice, Compress and Elevate. This method is effective for relieving swelling and pain from minor injuries.

Treating Cuts

If you experience a cut, flush it with water and apply constant pressure with gauze or a clean cloth for about 15 minutes. If it is still bleeding after 15 minutes, you need to see your doctor. Use your judgment here. Some bad cuts require a trip to the emergency room.

Treating Burns

If you do get a burn, run it under cool – NOT cold - water, and then apply a clean bandage. To administer proper first aid for burns, you will need clean dish or hand cloths, and a few cold compresses. Keep those in the refrigerator or freezer. You will also need bandages for burns. After that you will want to put on a cold compress. Wrap one of the cold compresses in a towel and then apply it to the burn. Never apply ice or the compress directly to the burn.

You will need to see a doctor for burns that blister, or don't heal after 10 to 14 days. If burns become filled with pus or you develop a fever, you need to seek immediate medical attention.