SURGERY TO RELIEVE ARTHRITIC PAINS
We have just explained that surgical operations on organs or glands cannot solve the question of arthritis. But can a doctor “operate” on actual arthritic bones and relieve your pain? The answer is “Yes.”
After deformity has set in, there are a number of orthopaedic operations which are helpful. More surgery will undoubtedly be devised in the future. Meanwhile, some of the operations now being used successfully for deformed arthritics only are known as synovectomy, arthrodesis, arthroplasty, etc.
Operations can be performed to remove any flesh-like tabs clinging to joint linings. These are frequently found in osteo-arthritis and sometimes they impede joint mobility. Surgery can also cut away some bone-spurs or extraneous deposits of cartilage or bone called “joint mice.”
But before allowing your arthritis to reach the stage where surgical help is needed, wouldn’t it be far better to practise the dietary and oil regime in this book? Prevent deformity by sane eating habits, and escape the surgeon’s knife.
If a knee swells up to twice its normal size, and the trouble is a diseased lining, it is true that the joint membrane can be removed surgically. Joint linings will then regenerate, and your body will build new ones. At that time you may decide to straighten out your diet, to protect your “second set” of linings. Why not eat correctly now? You’ll save yourself a trip to the surgeon and a long convalescence.
One type of deformity is “fusion.” When a joint becomes fused, it is said to be ankylosed. An ankylosed joint is frequently free from pain. The operation known as arthrodesis is primarily designed to give the fused joint some degree of service … at least enable it to bear some weight. An arthoplasty operation will improve ball and socket joint mobility, by inserting a metal cup in your joint. Again, we say, however, stop your arthritic advancement by diet, before you need to undergo these major measures.
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SIDE-EFFECTS OF HRT/ PROGESTOGENSIS :WHAT ADVERSE EFFECTS CAN PROGESTOGENS CAUSE?
These can be physical or psychological; numerous side-effects have been attributed to progestogens and those that we encounter most frequently are shown below. Because too few data on the frequency and severity of the symptoms are available for meaningful conclusions, they are presented in alphabetical order.
Physical and psychological side-effects associated with administration of progestogen
PHYSICAL:
Abdominal ‘cramps’
Accident-prone
Acne
Backache
Breast tenderness
Clumsiness
Dizziness
Flatulence
Fluid retention
Generalized aches and pains
Greasy skin
Headaches
Hot flushes
Poor sleep
Tiredness
Weight gain
PSYCHOLOGICAL:
Aggression
Anxiety
Apathy
Confusion
Depressed mood
Difficulty making decisions
Emotionally labile
Forgetfulness
Irrational
Irritability
Panic attacks
Poor concentration
Restlessness
Tearfulness
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TREATMENT OF CELLULITIS
Cellulitis should be treated with systemic antibiotics. Limited disease of the torso and extremities can be treated with oral antibiotics. Treatment choices include penicillinase-resistant penicillins, first-generation cephalosprins, amoxicillin-clavulonate, broad-spectrum macrolides, second-
generation fluoroquinolones, or clindamycin. Some clinicians administer an initial dose of intravenous antibiotics (i.e., cefazolin, ceftriaxone) to reduce the risk of progression before starting oral medication.
A recent study demonstrated the effectiveness of home-administered once-daily intravenous cefazolin plus oral probenecid. Close follow-up is important once treatment is started. At the initial visit, the margin of the rash should be traced with a marker. Patients should be seen within 24 hours for reassessment. Most cases will improve after 1 day of treatment, but sometimes it may take several days to see regression. As long as the cellulitis does not progress, it is reasonable to continue the initial antibiotic and monitor patients closely. Once the infection has demonstrated significant regression, patients can be instructed to finish their antibiotics and return as needed.
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