Disability also increases the risk of infection, an awareness of the warning signs can help you recognise the symptoms early, and get the infection treated quickly.

General signs of infection:

• Fever – a temperature above 37.5 degrees Celsius, or 99.5 degrees Fahrenheit (please note: a temperature at this level is considered a mild temperature, it ideally should be lower than this)
• Pain
• Inflammation

Urinary tract infections: Some specific symptoms if it is in the urinary tract

• Pain when urinating (could be a burning sensation)
• Needing to urinate more frequently than normal
• Feeling as if you still need to urinate after you just did
• Your urine might appear cloudy, and could have an offensive odour
• Back pain (this is a later symptom)

Respiratory: Some specific symptoms if it is in the ‘chest’

• Viral symptoms don’t resolve in the expected time, and symptoms become worse rather than better
• Sputum (what you cough up) might be a different colour, e.g. yellow or green (it should be clear)
• Difficulty breathing (later symptom, if this happens seek immediate medical attention)

Unhealed wounds:  Some specific signs of an infected wound

• Red skin around the wound – You can draw an outline around the red area to see if it is improving or getting worse each day
• The ooze changes colour – Yellow or green is never a good sign
• Blackened areas – this is serious, it means parts of the skin have died, you need to seek urgent medical attention
• Foul smelling ooze

If you suspect you have developed an infection seek medical attention. Infections left untreated can enter the bloodstream; this is life threatening and needs urgent treatment. The earlier an infection is detected, the easier it is to treat.

If you are prone to infections you might want to consider adding some routine checks into your week, e.g. weekly temperatures, regular at home urine dipstick tests (this is for urinary infections, you will need to get instructions from your GP/nurse on how to conduct an at home urine dipstick test). Most people will not need to do this; people with physical disability are more likely to need these precautions.

If you are put on antibiotics ALWAYS complete the course (i.e. finish the pack) even if you are feeling better. The bacteria if not completely treated by the antibiotics can become resistant. Infections that do not respond to antibiotics are a serious problem; finish ALL the tablets.

Post from: The Recovery Room

Infections

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Sedatives can be useful to break the cycle, but require a prescription from a doctor, and doctors are often reluctant to prescribe them. Sedatives also do not solve the cause of insomnia and may only work temporarily. Also keep in mind sedatives have a half life of maybe 4hrs, this means that after 4hrs its had its strongest impact and is working its way out of your system, so if you wake up through the night the medication will no longer be working and you may not fall back asleep. I recommend trying other more natural methods first before trying medication.

There is also a medication called melatonin available, it may be useful if the cause of insomnia is to do with a disruption in circadian rhythm as can be seen in jet lag, or a low level of melatonin production. Melatonin levels peak at night effectively controlling the sleep-wake cycle. You can read more about this here

The solutions discussed above can be effective, but how effective they are depends on the individual; a bit of trial and error will be necessary to discover the best solution.

In my own experience the best methods are relaxation techniques, such as resting yoga poses, meditation and sleep hypnosis. Some yoga poses that can help can be found here

Some suggested routines are:

-          Don’t work on the computer past a certain hour, around 2hrs before your normal bedtime is a good idea.

-          Don’t read in bed, I know it’s tempting, but it provides a mind association of activity with bed.

-          If you can’t sleep within a reasonable period of time, get back up, do something restful such as read a book (but not in bed) and try again in half an hour.

-          As much as possible create a routine that works for you, following a similar routine every night signals to your mind that you’re going to bed soon.

-          Practice relaxation techniques when you’re not trying to sleep: It’s no good having your first attempt at meditation while you’re frustrated, practice during the day at a time when you don’t need it, and it will be easier to meditate when you need sleep.

-          Exercise during the day (within your ability to do so)

-          Avoid napping during the day – this may be unavoidable, if you must have a nap set an alarm and limit the length of time, an hour nap is unlikely to affect sleeping that night.

-          Try and wake up at a similar time every day, even if you haven’t slept well (This is hard to stick to, but it can improve sleep patterns).

Be prepared to try new things to improve your sleep patterns, what works for a while may all of a sudden stop working. From my experience this is true of relaxation techniques, medications, and herbal remedies. It may be necessary to rotate a few of the more effective methods, as even though one method may stop working, revisiting that method it may work again for a while.

Post from: The Recovery Room

Insomnia: Management

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-         Valerian (herbal remedy): I had good results with this the first few times I tried it, then it stopped working altogether, I’ve found for me it’s effective if used occasionally.

-         A warm bath before bed: This is relaxing and certainly enjoyable, it’s improved my success on occasion but isn’t reliable.

-         Warm milk: Tastes good. I have slept better if I got up in the middle of the night, had this and gone back to sleep, but there’s nothing to say I wouldn’t have slept then anyway.

-         Chamomile tea: Soothing, but ineffective for me, just makes it more likely I’ll need a bathroom visit through the night.

-         Lavender oil on my temples: I have had some success with this occasionally; in the least it’s relaxing and smells good.

-         Pain medication: Failsafe when it’s been pain that’s kept me awake.

-         Getting back up before I get too frustrated: Simple solution, I’ve had great success simply by getting back up if I’m not asleep within an hour. Usually I stay up an hour with a warm cup of tea and a good book, or some mindless internet activity. Most of the time if I do this I sleep when I go back to bed. (Note: a non-caffeinated tea is the most sensible, but ill confess to having regular black tea; also, computer activities are stimulating, reading a book or watching television is a better solution)

-         Meditation: Very effective if I can manage to meditate, sometimes my mind is too busy for this to work. Meditation can aggravate the problem sometimes, leading to more frustration and less sleep.

-         Sleep hypnosis recording: I have a sleep hypnosis recording on an mp3 player; I tried 2 different recordings, one works great, the other not at all. This has been my most effective solution; I have fallen asleep using this even when in pain. The problem with this is I got sick of the recording and stopped using it after a while; it could become expensive and tedious to find a new recording every so often. I no longer use it for this reason.

-         A resting yoga pose before bed: This works reasonably well, but it does require thinking about preparing for bed before going to bed, usually I just want to go to bed.

-         Temazepam (sedative): This works great sometimes, and then not at all others. Taking this medication has occasionally left me angry because there are times nothing happens at all and I am left lying awake staring at the walls. It works best if I take it maybe once a month when my insomnia is at its absolute worst, but even then it can fail me.

Post from: The Recovery Room

Insomnia – A review of treatments

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“Erosion of the tissue lining, usually in the stomach (gastric ulcer) or the upper small intestine (duodenal ulcer). These are generally referred to as peptic ulcers”  [1] From glossary G-19

Why does an ulcer develop?

Ulcers can occur either because there is excessive acid which erodes the stomach tissue and/or because the protective mucus layer of the stomach has deteriorated.

Some possible causes of this happening are:

·         Acid-resistant bacterial infection (Helibacter pylori [H.pylori)

·         Heavy use of aspirin and related NSAIDS medications

·         Stress

·         Disorders that cause excessive acid production in the stomach

·         Smoking and alcohol

·         Genetics [1]

Symptoms:

·        Pain after eating – “Stomach acid acting on a meal irritates the ulcer after most of the meal has moved from the site of the ulcer” p93 [1]

Less common symptoms:

·         Nausea and vomiting

·         Loss of appetite/weight [1]

More on pain – burning or gnawing abdominal pain

“This is a typical symptom of duodenal ulcer, although many people with duodenal ulcers don’t have the typical symptoms. The pain can occur one to 2 hours after meals, or sometimes in the middle of the night or early morning. It usually occurs when the stomach is empty. You may feel pain in the area between your navel and your breastbone. The pain may last from between a few minutes to several hours, and can often be relieved by eating, drinking milk or taking antacid medicines. With stomach ulcers, pain can be caused by eating rather than relieved by it.” [2]

Risks:

·         The ulcer could erode all the way through the stomach wall, leading to an infection

·         If a blood vessel is eroded there could be massive blood loss [1]

If you suspect you have an ulcer, see your doctor for diagnosis and treatment. Do not ignore the symptoms.

Treatments:

“In the past, milk and cream therapy – the so called Sippy diet – was used to help cure ulcers…milk and cream are two of the worst foods a person with an ulcer could eat. The calcium in these foods stimulates stomach acid secretion and actually inhibits ulcer healing.” p93 [1]

Medications:

·         Antibiotics –to treat H.pylori infection if its present

·         Acid blocking medications e.g. omeprazole

·         Antacids e.g. Zantac

Both antacids and acid blocking medications block acid secretions in the stomach but work in different ways. [1]

Lifestyle changes:

·         Stop smoking or at least keep it to a minimum

·         Avoid aspirin and related NSAIDS where possible (discuss alternatives with your GP)

·         Avoid foods that cause pain – this might include foods like curries and spicy foods, acidic fruit like tomatoes pineapple and oranges, dairy foods. Keep a diary to work out what aggravates your symptom’s, it could be 2hrs after eating before you react.

·         Avoid alcohol, coffee and tea

·         Eat enough fiber

·         Chew food thoroughly (improves digestion)

·         Lose weight if overweight [1]

·         Take Probiotics to improve digestive health, dairy free supplements are more appropriate than yoghurt until the ulcer/s are healed. Probiotics will also replace the lost bacteria if on antibiotics, and can help reduce H.pylori bacteria by providing a better balance of good bacteria.

Diet changes are considered of minor importance in relation to ulcers, however individuals may find improvements avoiding trigger foods and taking probiotics.

References:

1. Wardlaw G & Hampl J. Perspectives In Nutrition. 7^th ed. 2007. McGraw-Hill, New York.

2. mydr.com.au

Peptic ulcers: What are the symptoms?

http://www.mydr.com.au/gastrointestinal-health/peptic-ulcers-what-are-the-symptoms

Post from: The Recovery Room

Ulcers: A quick guide

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The loss of freedom

The loss of self esteem

The loss of regular social outings

The loss of life plans

The change in my relationships

The inability to eat and drink like everybody else does

The list goes on……….

Some of the losses were just perceived losses but it all felt the same to me, real or imagined.

No matter what type of chronic illness you have there would have been some sort of loss. For some the losses may be small, for others the losses are major and can lead to feelings of anger, depression, and withdrawal from people and activities.

So how do you cope with such feelings when these losses aren’t being recognised by those around you, and likely aren’t even being recognised by yourself? Like all grief it takes time and support.

Support from others in a similar situation can ease the burden of loss, allowing not only the ability to vent about the issues without being judged, but recognition that you’re feeling this way and that these feelings are normal and ok.

Keeping a diary can also be helpful, writing down how you feel is similar to talking to others in that it eases the burden.

It takes time but learning to accept the loss is the first step to moving on from it. Once you’ve come to terms with your loss, thinking about what’s positive in your life is important. It might help to just write down 10 positive things in your life, it’s ok if you have to think hard on it, the process will help to clear your mind of negative emotions, put the list somewhere you can see it every day.

Find something positive and enjoyable, something that’s all about you and make time for it on a regular basis. Make it a priority to fit that positive and enjoyable thing into your day.

It’s important to remember that it’s perfectly normal to feel as you do, and that no one is an emotional rock. If how you feel is overwhelming, seek professional help; depression is a common side effect of chronic illness and cant always be managed without help.

In Australia if a GP refers you for counseling, it’s covered by Medicare, leaving only a small gap to pay.

For further information and help with depression:

http://www.beyondblue.org.au/index.aspx?

http://www.limelight.org.au/

“And when it rains on your parade, look up rather than down. Without the rain, there would be no rainbow.”

Jerry Chin

Quote courtesy of people stuff

http://www.peoplestuff.com.au/index.php

What’s your rainbow?

Post from: The Recovery Room

Grieving for loss with chronic illness

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