Friday, November 20, 2009

Control Your Pain

What Is Pain?

Pain has been characterized in a variety of ways. There are physical definitions such as an unpleasant sensation; a warning that something is wrong; or the body's response to a thermal, chemical, or mechanical injury. There are also definitions that attempt to provide a meaning or explanation. For example, pain is a punishment; it lets the body know it is alive; it is a teacher helping to modify future behavior; or it is "all in one's head."

Two definitions have become particularly influential among health care providers, educators, and researchers. The International Association for the Study of Pain (IASP) proposes that pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Margo McCaffery suggested as early as 1968 the widely accepted definition, "Pain is whatever the experiencing person says it is, existing whenever the experiencing person say it does" (McCaffery and Beebe 1989, p. 7). Both definitions point to the fact that pain is much more than tissue damage that triggers a response from the nervous system. The management of pain therefore involves more than treating the tissue injury. The individual's cultural background, present circumstances, and state of mind all require assessment and attention. It has become clear that cultural learning leads to differences in the way that people express pain. Furthermore, it is also becoming increasingly accepted among the medical community that, in contrast to previous medical beliefs, children feel pain even when they are too young to express it effectively. Elderly people may also have different, less obvious, ways of expressing pain, especially if affected by Alzheimer's disease. Health care providers are therefore improving their expertise in recognizing signs of pain across a broad span of patients.

How Does Pain Work?

Research about pain is still limited, but is going forward on many fronts. A major focus is the search for a molecular description of how a pain stimulus is signaled to the brain and how the brain signals its response. Until that process has been firmly identified, caregivers and researchers can utilize the following overview of pain pathways.

Cell damage occurs. Proteins trigger specific channels that set off the pain signal. As chemicals are released the area becomes inflamed and swollen. Identification of the specific pain channels may lead to the development of highly selective local anesthetics with reduced side effects for the rest of the body.

When the tissue damage threshold is reached, nerve fibers in the area carry a message to the spinal column. There are three types of nerve fibers, each of which has a distinctive role in producing pain sensations. Small, myelinated fibers known as A delta carry localized and sharp thermal and mechanical impulses to the neospinothalamic tract. The small, unmyelinated C fibers carry aching, throbbing, burning, dull, unlocalized messages to the paleospinothalamic tract and on to the brain stem and thalamus. A beta fibers, which are large and myelinated, serve to inhibit impulses from the A delta and C fibers, thereby modulating the number and intensity of impulses sent up the spinal tracts.

The physiologist Patrick Wall, one of the world's foremost authorities on pain, describes what happens in the dorsal horn of the spinal cord, "If the input message comes only from the large A beta fibers as a result of touch, the cell fires briefly and then is turned off. If, however, the input volley comes from tissue damage detection fibers, A delta and C, the cell fires more vigorously and exaggerates the output. During all this time, the brain is sending down control messages to amplify, diminish, or ignore the signal" (Wall 2000, p. 40). An example of this occurs when hitting one's shin on a sharp object. The immediate response is to reach down and rub the area. The rubbing message is carried by the A beta fibers closing the gate to messages from the A delta and C fibers.

Once in the spinal cord the messages cross to the opposite side of the spinal column. Next they travel upward through the spinothalamic tract, conveying information about the nature and location of the stimulus to the thalamus, cerebral cortex, and spinoreticular tract. This process activates autonomic and limbic (motivational-affective) responses in the brain stem and thalamus. Messages descend the spinal cord as a result of these responses.

It is in the brain stem and the cerebral cortex that the pain messages are analyzed. Here the body meets the mind. While little research is available, there are theories and some pieces of the puzzle to suggest what is happening.

Endorphins. Endorphins are important pieces of the puzzle. Scientists know something of the body's defenses against pain. Some neuropeptides, such as Substance P, appear to be pain specific transmitters. Other peptides, such as the endorphins and enkephalins, provide profound analgesic (pain-relieving) effects. Morphine and other opioid medications were in use long before the opioid receptor sites in neural tissue were discovered in the 1970s. The word endorphin was coined as a contraction to the terms endogenous (meaning "a natural property of the body") and morphine. Methods to turn on secretion of the endorphins have been studied. Massaging or moving a painful part may owe some of its effectiveness to stimulating endorphin production. The "runner's high," a good feeling as a result of exercise, has also been attributed to endorphin release.

Placebo response. Less well explained is the "placebo effect." This occurs when a treatment produces an effect primarily because of its intent rather than its specific therapeutic physical or chemical properties (e.g., taking a pill that actually contains no medicine). People sometimes report that they feel better even though they have had only the expectation and appearance of a treatment. The double-blind research technique that pits a new drug against an inactive substance has been developed to offset the placebo effect. The placebo would be expected to produce no effects. In actuality, however, placebo users frequently report positive effects. An important aspect of the placebo effect seems to be that the person trusts the person administering the treatment and believes that the treatment will be effective. The placebo effect can be a useful supplement to therapeutic treatment but its effectiveness differs markedly from person to person and is not entirely reliable.

Both the presence of endorphins and the well-documented placebo response point to the power of the mind-body connection in pain management.

Use of Noninvasive Pain Control Measures

The first methods of pain control probably included stimulation of the skin with heat, cold, massage, and vibration, all of which have the ability to relieve pain without causing injury, at a low cost, and with little experience. Other types of stimulation of the skin include massage with mentholbased lotions, transcutaneous electrical nerve stimulation (an electrical current administered through skin patches), and acupressure (gentle pressure applied to acupuncture points).

Rubbing a bumped shin or applying a cool cloth to a forehead works to relieve discomfort. A parent's kiss to make everything "all better" helps a child through a painful experience. It reminds the individual that the presence of a loved one has a role in relieving pain.

Assisting the patient to focus attention on stimuli other than pain is another effective noninvasive pain control measure. Because the pain stimulus does not go away, but instead becomes "more bearable," this strategy has the advantage of being under the patient's control. It is also inexpensive. Many patients use the distraction strategy without realizing it by watching television, reading, doing crossword puzzles, listening to music, or attending to the company of friends and relatives. Meditation and guided visual imagery are also in this group of therapies. A disadvantage is that the existence of the pain may be doubted by others if the patient can be distracted. Distraction requires concentration and may drain the energy resources of the patient, perhaps leading to increased fatigue and irritability. The method is particularly effective for brief painful episodes.

Freedom from skeletal muscle tension and anxiety produces the relaxation response, characterized by specific physiological responses (decreased oxygen consumption, decreased respiratory rate, decreased heart rate, decreased muscle tension, normal blood pressure, and increased alpha brain waves) and a lowering of the subjective sense of distress. Conscious attempts can be made to interrupt the cycle of pain that leads to anxiety and muscle tension with increased pain as a result. The relaxation response requires active patient involvement. Many patients need specific instruction to invoke the relaxation response effectively. Some techniques include deep breathing exercises, jaw relaxation, review of peaceful past experiences, and a meditative or progressive relaxation script or tape.

Use of medication. While the noninvasive therapies are useful for mild pain, they should be considered supplements to the effective management of moderate to severe pain. Moderate to severe pain are often treated with medication and invasive pain control measures.

The World Health Organization developed the "analgesic ladder" to illustrate a systematic plan for the use of pain medication. Mild pain is treated with medications such as aspirin, acetominophen, and non-steroidal anti-inflammatory drugs (NSAIDs). Maximum recommended doses of these drugs restrict amounts in order to prevent toxicity and damage to the liver and kidneys. As pain increases, opioids such as oxycodone may be used. Severe pain requires morphine or other long-acting opioids. The dose is matched to the pain level. Although there are side effects to these drugs, the amount of drug is not limited. If pain level increases, the route by which the medication is given may change from the slower acting oral route to a faster route, whether transdermal, transmucosal, or intravenous. It is important to avoid routes that actually cause pain, such as intramuscular injection.

For continuous pain, medical practitioners often maintain that continuous pain medication should be available. This requires drugs that are long acting and given on a continuous schedule. The goal is to keep pain in check, rather than waiting until it is out of control before administering more medication.

Side effects of the drugs should be anticipated and prevented. The most common and preventable side effect of the opioids is constipation. Prevention includes adequate fluid and fiber intake and the possible use of stool softeners and laxatives.

It is important to remember that withstanding pain uses energy. When pain is first adequately relieved with medication, the patient may sleep for an extended period of time. This sleeping does not indicate that too much medication is being taken, it means that the person's body is recuperating and regaining energy. This sleepiness can lead family and caregivers to fear that the disease is progressing or that too much medication is being given. If the person arouses easily, then it is an indication that he or she is not taking too much medication.

Wednesday, November 4, 2009

How To Make a Speech

Some people would prefer to dive over a cliff than make a speech. They conjure up all kinds of nightmare scenarios: What if I freeze? What if the audience hates me on sight? What if no one laughs except in places they shouldn't? Will everyone remember the mistakes I make for the rest of my life?

And yet, by learning a few techniques used by professional speakers -- who are very often the most scared of all -- you can not only conquer your nerves, you can also make a powerful impression and within seconds, actually start to enjoy the whole experience. Here's how.

First, check how you look. Dress appropriately, and be well groomed, so you feel comfortable and smart. Dressing professionally also helps the audience feel you've taken trouble for them and that they are respected. But make sure you don't go too far and unintentionally distract them, for example, with a man's flashy tie or a woman's low neckline.

  1. Opening nerves. Here are some techniques that will help you feel more comfortable and relaxed when you start.
    • Before you go on, chat to people in your audience. It will help create a warmer, more friendly atmosphere.
    • As you're waiting to be announced, repeat your opening sentence three or four times to distract you from your nervousness and to give you the confidence of a sure start.
    • To help relax from head to toe, take three deep slow breaths - in through nose - out through mouth with your hand on your stomach as it expands and contracts.
    • When starting, pause for 1-2 seconds to establish yourself.
    • Stand upright and relaxed.
    • Pleasantly acknowledge a friendly face nearby.
    • Smile. Smiling shows warmth for the audience and is rarely misinterpreted.
  2. Contact.
    • Make eye contact with the audience, momentarily from one to another as a way of showing interest in them.
    • Engage with animated listeners - but not too much.
    • Scan the audience, and don't miss anyone, anywhere, ever.
    • Occasionally start a sentence looking at one section of the audience and finish looking at another section.
    • Too shy to look straight at individuals? Until your confidence grows, try looking at the spaces between them.
  3. Speaking technique.
    • Recall how you talk to your mother, girlfriend or boyfriend, chief financial officer or boss. It's usually different for each. So imagine that someone who loves and appreciates you is listening. Start out by imagining you're talking to them.
    • Successful speakers project energy and conviction. They have to if they are to hold their audience from start to finish. They also know that if they stop concentrating on the words and the thread of their speech, so will the audience.
    • Believe what you say and deliver it with conviction and passion. The audience will sense if you're not sincere.
  4. Delivery. These suggestions may feel unnatural when you first try them, but you can see just how effective they are by listening to the phrasing of top presenters on TV and radio. Notice how they:
    • Emphasize key words in every sentence. So when you go through your speech, you will find it useful to underline a number of verbs and adjectives in each of your sentences to remind you to give them extra ‘punch.'

      • Don't drop your head when reading speech (many speakers type their speech only on the top half of pages).
      • Don't turn your back on audience.
      • Don't play with a pen or pointer.
      • Don't grip table or lectern.
      • Don't bend towards microphone (adjust its height).
      • Don't lean towards your notes.
      • Don't stare fixedly at notes or visual aids.
      • Don't fidget: Touch face, tie, lapel, etc.
    • And when it's all over . . .smile.

      (Unless the occasion's not appropriate....) It tells the audience that you've done your best, that you've enjoyed your talk and are confident they've enjoyed it too, that they're a great audience who've responded well. All that from just a smile? Sure, but it's what's behind the smile (learning and using the above) that's the real secret

Friday, October 9, 2009

I am a Warrior

Within each one of us there is a warrior waiting to be unleashed, most of us get the same idea when we say the word warrior, it became a popular commodity representing famous action figures and wide screen heroes but, we never think about what that specific word means and the idea that could change our lives radically, the idea that we are all nothing less than warriors.
We grew up on tales of heroes and great leaders who gave every thing including their own lives for a great cause, some of us witnessed war, death, fear, courage and epics, some of us are heroes by the common meaning of the word, army men, police men, front line soldiers or extraordinary people who did magnificent deeds.
We all appreciate and admire those warriors who fought for what they believed in and didn't back up and never surrendered, the ones we hope our children would be as great or even close in a way or another but, that doesn't mean that a warrior's place can only be a warfare battlefield, in fact we are all warriors and we all have our battlefields, doctors and scientists fight diseases every single day, teachers and professors fight ignorance every single day and many examples that tends to infinity.
I believe that you don't have to be a soldier, a teacher, a doctor, or a politician to be a warrior, deep inside every one there is a warrior fighting every day, the battlefields may vary but, still they are all battlefields.
A warrior is the real definition of sacrifice and ever lasting immortality, a warrior is a creature defined by higher laws and codes, driven by his passion to a cause, distinguished among others by his devotion and loyalty to that cause and by his ability to go on and never give up.
Every one of us is a warrior as long as he believes in his cause, his sword is his devotion and commitment, his spear is his knowledge and wisdom, his armor is his hope and faith, his shield is his unbreakable determination and his cause is his home to die for, the one that he believes that struggling for is a great virtue, a virtue fit for saints and kings, a virtue worth fighting for.
I encourage every one to awake the warrior within, you are already in the fight, so get up and make your stand, be noticed, be recognized, be remembered and be for ever alive in the eyes of those who witnessed your fight, be for all times the true figure of a warrior.
Fight for what is right, for what is beautiful, for what is great and for what is important, fight for yourself and for your loved ones, fight your bad habits, fight smoking, fight your addiction, fight your greed, fight your dark side and let your inner light prevail, help yourself and others who need help, break your limits, fight for the weak and the needy as certainly some day others will fight for you.
So that you can say " I am a warrior"
This is how I see it, this is my cause.
This article is from:

Thursday, October 8, 2009

Know What's Important

We all have eyes, we all can see but can we really see through? Can we penetrate the walls of deception?
Every day we blindfold ourselves, we become unable to see what's really important and what's not, most of us became shallow and inconsiderate.

We keep ourselves from loved ones, the most important people in our lives, family and friends, brothers and sisters, wives and daughters, the ones that really matter. We blindfold ourselves with formality and keeping all the time busy trying to succeed, demonstrating the true essence of selfishness and being the center of the world.

Some people think that career comes before family, I say who gave you the right to think that way? If it weren't for your family, you wouldn't have had a career, you wouldn't even be there, a man without a family, is a plant without roots, easy to be broken, nothing to support it.
We were created on Earth as successors of God, to spread his word and multiply, to fill the land with goodness and prosperity. That's our role in our lives, to be a family.

So, take a moment and think, when was the last time you saw your parents? When was the last time you checked on your daughter? Did you even attend your son's birthday? Did you even see your grandson?

All of those and many more questions which I ask to children, parents and grandparents.
Can you really handle being alone? A question for the son who never calls his old man, can you handle being neglected by your children; because believe me, you will get old and tired and you might end up all alone just like your old man, as they say "What goes around comes around."

On the other hand, I am dying to know why would a parent abandon his child? I mean what did that weak creature do to deserve this? Why were you threaten by his presence?
How could a human be that selfish?
Humans are distinguished among other creatures by on thing; humanity!
If we don't take care of our own, then we become animals and savage, living for the purpose of surviving.

Is it so hard to pick up the phone and say hi to your son? You will never experience the pleasure of living unless you have lived for a purpose, so why can't this purpose be your family?
we all know that every one is a king in his house, a Sheppard responsible for his followers, for his family, so you must be up to the task and support your family by all means, besides it's so fulfilling and comfortable to go to bed knowing that your family are safe and sound because you did your contribution even if it was very small, it might not be that small in the eyes of your loved ones.

Take care of your own, watch each others' backs, feel the warmth of a family, your family.

Monday, September 28, 2009

Start Making a Difference

In our lives we witness sorrow and joy sadness and depression ups and downs, we witness a new tragedy unfold in front of our eyes every single moment, but what do we do? How would we act?

Is it so hard to take a stand and do your part? I don't think so. In fact there are a lot of people who gave their lives helping the needy, the poor and the sick, man or woman, elder or infant.

Some how there always seem to be a way out, like it was already written and meant to be. Some how God created those people to be the saviors of those who need to be saved, never the less that will never be enough, those who need your help can't depend on the very few that made their stand.

All of us need to speak to ourselves to the inner good that we were basically born with, the kind of instincts that drives us towards doing what we were meant to do, our purpose in life which is:

"Standing up for each other"

We can take it step by step until we can do our part, until each and every one of us can get the satisfaction of sleeping at night knowing that he did something good, that he supplied a need or even drew a smile on a child's face.

Step 1:

The first thing you need to do is to look at the mirror thoroughly and think: "What do I have that I can give up? When can I spare some time for the cause? Am I really committed of it's just a fling?

You will have to break your limits and get out of your shell.

Step 2:

Ask your questions, get your answers and switch from looking at yourself to looking around you, see things with new eyes, look deep into your surroundings, I assure you that you will definitely find someone who needs your help, the old neighbor, the little kid, the homeless guy or even your own family a near or distant relative.

Step 3:

Choose the best way you can be of help depending on your expertise and skills and give it your best shot. Start with something small, something you can commit to and perform on regular bases, but nothing big for starters.

Step 4:

Like we mentioned before the key word to this thing is commitment, you don't want to fail someone depending on you, so I say hold your horses and don't involve yourself in something you can't handle as it is a huge responsibility, now hold on I didn't mean to scare you away, on the contrary I am warning you because I know the overwhelming warm satisfying feelings you will get after doing your first good deed, the feelings that will drive you to make others an others and that's in fact the goal we seek to achieve, but it must be taken step by step; for you not lose your commitment.

Step 5:

Now that you took your stand and made it clear that every body must do his part, you need to ask other people to join your case and you need to spread the word, the life style we seek and our own utopia that many have dreamed of over the ages, the one we have a chance to create and live in.

We need to be their for each other, so start doing it

This article is from:

Thank you,


Friday, September 25, 2009

Boundaries of Mind

People are faced with decisions all the time, in work, in home, during meals or between them, what to wear, what to do etc.

Most of life’s greatest challenges are in fact our own creation, we often set the shape of our limits and live by the line we drew according to our custom laws of I can and I can’t.

We differ a lot from each other, in so many ways even identical twins have different habits, ideas, life styles and the way they see things and how they act upon it so, we also differ in limits some people just can’t do some things while others can easily do them without even thinking.

If I told you that I have a wooden bar 2 feet wide and 100 feet long and I had this bar safely fixed along a corridor at a height of 2 feet and I asked from any one to run along that bar for a 100$ How many of you would do it?!

I would for a 100$ I’d do it with one leg.

What if I move the same bar and put it between two skyscrapers?

Will you do it then?

But why? Why won’t you do it?

Your mind put too many boundaries for you, to stop you from doing it.

You fear of falling, getting hurt or maybe dying, but fear isn’t the only Line you need to skip, some times being intelligent can make you very confused and hesitated. In our case you can think of the wind, the gravity, the stability of the bar and its ability to break, some of us may think about the sum of money before all of that.

The bottom line is all of us have doubts about many things in our lives, but we can’t keep putting boundaries to our abilities thins are more complicated as they are so, no need for hesitation we have to know who we are and what we can do.

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