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Archive for September, 2010

Timelines

A pregnancy is divided into three phases, or trimesters. The first trimester is from conception to the end of week 13. The second trimester is from week 14 to the end of week 26. The third trimester is from week 27 to the end of the pregnancy.

The doctor will examine you and perform a pelvic exam. He or she may also perform blood tests, a urine test, and tests for sexually transmitted disease, including a test for HIV, which is on the rise in teens. (Some STDs can cause serious medical problems in newborns, so it’s important to get treatment to protect the baby.)

The doctor will explain the types of physical and emotional changes you can expect during pregnancy. He or she will also teach you to how to recognize the signs of possible problems during pregnancy (called complications). This is especially important because teens are more at risk for certain complications, such as anemia, high blood pressure, and delivering a baby earlier than usual (called premature delivery).

Your doctor will want you to start taking prenatal vitamins that contain folic acid, calcium, and iron as soon as possible. The doctor may prescribe the vitamins or recommend a brand that you can buy over the counter. These vitamins and minerals help ensure the baby’s and mother’s health as well as prevent some types of birth defects.

Ideally, you should see your doctor once each month for the first 28 weeks of your pregnancy, then every 2 weeks until 36 weeks, then once a week until you deliver the baby. If you have a medical condition such as diabetes that needs careful monitoring during your pregnancy, your doctor will probably want to see you more often.

During visits, your doctor will check your weight, blood pressure, and urine, and will measure your abdomen to keep track of the baby’s growth. Once the baby’s heartbeat can be heard with a special device, the doctor will listen for it at each visit. Your doctor will probably also send you for some other tests during the pregnancy, such as an ultrasound, to make sure that everything is OK with your baby.

One part of prenatal care is attending classes where expectant mothers can learn about having a healthy pregnancy and delivery and the basics of caring for a new baby. These classes may be offered at hospitals, medical centers, schools, and colleges in your area.

It can be difficult for adults to talk to their doctors about their bodies and even more difficult for teens to do so. Your doctor is there to help you stay healthy during pregnancy and have a healthy baby — and there’s probably not much he or she hasn’t heard from expectant mothers! So don’t be afraid to ask questions.

Be upfront when your doctor asks questions, even if they seem embarrassing. A lot of the issues the doctor brings up could affect your baby’s health. Think of your doctor both as a resource and a friend who you can confide in about what’s happening to you.

Changes to Expect in Your Body

Pregnancy causes lots of physical changes in the body. Here are some common ones:

Breast Growth

An increase in breast size is one of the first signs of pregnancy, and the breasts may continue to grow throughout the pregnancy. You may go up several bra sizes during the course of your pregnancy.

Skin Changes

Don’t be surprised if people tell you your skin is “glowing” when you are pregnant — pregnancy causes an increase in blood volume, which can make your cheeks a little pinker than usual. And hormonal changes increase oil gland secretion, which can give your skin a shinier appearance. Acne is also common during pregnancy for the same reason.

Other skin changes caused by pregnancy hormones may include brownish or yellowish patches on the face called chloasma and a dark line on the midline of the lower abdomen, known as thelinea nigra.

Also, moles or freckles that you had prior to pregnancy may become bigger and darker. Even the areola, the area around the nipples, becomes darker. Stretch marks are thin pink or purplish lines that can appear on your abdomen, breasts, or thighs.

Except for the darkening of the areola, which can last, these skin changes will usually disappear after you give birth.

Mood Swings

It’s very common to have mood swings during pregnancy. Some girls may also experience depression during pregnancy or after delivery. If you have symptoms of depression such as sadness, changes in sleep patterns, thoughts of hurting yourself, or bad feelings about yourself or your life, tell your doctor so he or she can help you to get treatment.

Pregnancy Discomforts

Pregnancy can cause some uncomfortable side effects. These include:

nausea and vomiting (especially early in the pregnancy)
leg swelling
varicose veins in the legs and the area around the vaginal opening
hemorrhoids
heartburn and constipation
backache
fatigue
sleep loss

If you have one or more of these side effects, keep in mind that you’re not alone! Ask your doctor for advice on how to deal with these common problems.

If you are pregnant and have bleeding or pain, call the doctor immediately, even if you are not planning to continue the pregnancy.

Things to Avoid in pregnancy

Smoking, drinking alcohol, and taking drugs when you are pregnant put you and your baby at risk for a number of serious problems.

Alcohol

Doctors now believe that it’s not safe to drink any amount of alcohol when you are pregnant. Drinking can harm a developing fetus, putting a baby at risk for birth defects and mental problems.

Smoking

The risks of smoking during pregnancy include stillbirths (when a baby dies while inside the mother), low birth weight (which increases a baby’s risk for health problems), prematurity (when babies are born earlier than 37 weeks), and sudden infant death syndrome (SIDS). SIDS is the sudden, unexplained death of an infant who is younger than 1 year old.

Drugs

Using illegal drugs such as cocaine or marijuana during pregnancy can cause miscarriage, prematurity, and other medical problems. Babies can also be born addicted to certain drugs.

Ask your doctor for help if you are having trouble quitting smoking, drinking, or drugs. Check with your doctor before taking any medication while you are pregnant, including over-the-counter medications, herbal remedies and supplements, and vitamins.

Unsafe Sex

Talk to your doctor about sex during pregnancy. If your doctor says it’s OK to have sex while you’re pregnant, you must use a condom to help prevent getting an STD. Some STDs can cause blindness, pneumonia, or meningitis in newborns, so it’s important to protect yourself and your baby.

Taking Care of Yourself During Pregnancy
Eating

Many girls worry about how their bodies look and are afraid to gain weight during pregnancy. But now that you are eating for two, this is not a good time to cut calories or go on a diet. Both you and your baby need certain nutrients so the baby can grow properly. Eating a variety of healthy foods, drinking plenty of water, and cutting back on high-fat junk foods will help you and your developing baby to be healthy.

Doctors generally recommend adding about 300 calories a day to your diet to provide adequate nourishment for the developing fetus. You should gain about 25 to 35 pounds during pregnancy, most of this during the last 6 months — although how much a girl should gain depends on how much she weighed before the pregnancy. Your doctor will advise you based on your individual situation.

Eating additional fiber — 25 to 30 grams a day — and drinking plenty of water can help to prevent common problems such as constipation. Good sources of fiber are fresh fruits and vegetables and breads, cereals, or muffins that have lots of whole grain in them.

You’ll need to avoid eating or drinking certain things during pregnancy, such as:

certain types of fish, such as swordfish, canned tuna, and other fish that may be high in mercury (your doctor can help you decide which fish you can eat)
foods that contain raw eggs, such as mousse or Caesar salad
raw or undercooked meat and fish
processed meats, such as hot dogs and deli meats
soft, unpasteurized cheeses, such as feta, brie, blue, and goat cheese
unpasteurized milk, juice, or cider

It’s also a good idea to limit artificial sweeteners, and drinks that contain caffeine and artificial sweeteners.

Exercise

Exercising during pregnancy is good for you as long as you are having an uncomplicated pregnancy and choose appropriate activities. Doctors generally recommend low-impact activities such as walking, swimming, and yoga. Contact sports and high-impact aerobic activities that pose a greater risk of injury should generally be avoided. Also, working at a job that involves heavy lifting is not recommended for women during pregnancy. Talk to your doctor if you have questions about whether particular types of exercise are safe for you and your baby.

Sleep

It’s important to get plenty of rest while you are pregnant. Early in your pregnancy, try to get into the habit of sleeping on your side. Lying on your side with your knees bent is likely to be the most comfortable position as your pregnancy progresses. Also, it makes your heart’s job easier because it keeps the baby’s weight from applying pressure to the large vein that carries blood back to the heart from your feet and legs.

Some doctors recommend that girls who are pregnant sleep on the left side. Because of where some of your major blood vessels are, lying on your left side helps keep the uterus from pressing on them. Ask what your doctor recommends — in most cases, lying on either side should do the trick and help take some pressure off your back.

Throughout your pregnancy, but especially toward the end, you may wake up often at night to go to the bathroom. While it’s important to drink enough water while you’re pregnant, try to drink most of it during the day rather than at night. Use the bathroom right before going to bed. As you get further along in your pregnancy, you might have a difficult time getting comfortable in bed. Try positioning pillows around and under your belly, back, or legs to get more comfortable.

Stress can also interfere with sleep. Maybe you’re worried about your baby’s health, about delivery, or about what your new role as a parent will be like. All of these feelings are normal, but they may keep you up at night. Talk to your doctor if you are having problems sleeping during your pregnancy.

Emotional Health

It’s common for pregnant teens to feel a range of emotions, such as fear, anger, guilt, confusion, and sadness. It may take a while to adjust to the fact that you’re going to have a baby. It’s a huge change, and it’s natural for pregnant teens to wonder whether they’re ready to handle the responsibilities that come with being a parent.

How a girl feels often depends on how much support she has from the baby’s father, from her family (and the baby’s father’s family), and from friends. Each girl’s situation is different. Depending on your situation, you may need to seek more support from people outside your family. It’s important to talk to the people who can support and guide you and help you share and sort through your feelings. Your school counselor or nurse can refer you to resources in your community that can help.

School and the Future

Some girls plan to raise their babies themselves. Sometimes grandparents or other family members help. Some girls decide to give their babies up for adoption. It takes a great deal of courage and concern for the baby to make these difficult decisions.

Girls who complete high school are more likely to have good jobs and enjoy more success in their lives. If possible, finish high school now rather than trying to return later. Ask your school counselor or an adult you trust for information about programs and classes in your community for pregnant teens.

Some communities have support groups especially for teen parents. Some high schools have child-care centers on campus. Perhaps a family member or friend can care for your baby while you’re in school.

 

Find More Health Pregnancy Articles

FREQUENCY OF DEPRESSION IN MIGRAINE HEADACHE

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AUTHOR:BHURGRIGHULAMRASOOL,BILAWAL,SHAMIM-UR-REHMAN,RAJ KUMAR,ANISREHMAN.

SUMMARY:

In this prospective study migraineous patients were enrolled who wre manifested the symptoms of depression.There was considerable psychiatric morbidity there was necessay find out all migranes aand treated them symptomatically.It proved that we should not bypass the chaces of dpression in cases of migraine especially female patients.

Key words:migraine, depression,psychiatry,males, females,cluster ,tension.

INTRODUCTION:

“Migraine is a mysterious disorder characterized by pulsing headache (feeling of weightage,fullness over forehead),usually restrictedto one side,which comes in attacks lasting 4-48hours and is often associated with nausea,vomiting,sensitivity of light, and sound, vertigo,loosemotions and other symptoms.”(Tripathi-2006)

“Migraine is very common type of headache,with a prevalance of 10-12%,migraine ranks 19th among disease” (cephalalgia 2004)

“migraine is a complex disorder inwich many psychological,inviromental,biochemical,neurophysiologic,and genetic factors play a role to tiger attacks. The diagnosis is based on headache characetrized and associated symptoms specified internationl headache society” (westermanCJetal 2003)

“The typical headache is unilateral,throbbing and may be severe.If untreated, the migraine attacks typically lasts 4 to 72 hours. The attacks are usually associated with nausea,vomitting, or sensitivity to sound,light and or movement.In addition to this, migraine with aura is characterized by transient focal neurological symptoms,which are usually visual,and may precede,accompany, or flow the headache attacks.”(stewart WF et al 1994)

“Thereare two types of migraine headaches.The first migraine without aura(previously called common migraine) is severe,unilateral,pulsating headache that the typically lasts from 2 to 72 hours.These headaches are often aggrivated by physical activity and accompanied by nausea,vomiting,photophobia(hypersensitivity to light) and phonophobia (hypersensitivity to sound.Approximately 85% of patients with migraine do not have aura.In the second type migraine with aura (previously called classic migraine),the headache preceded by neurological symptoms called auras which can be visual, sensory,and or cause speech or motor disturbances. Most commonly these prodromal symptoms are visual, occuring, approximately 20 to 40 minutes before headache pain begins. In the fifteen percent of migraine patients whose headache is proceded by aura,the aura itself allows diagnosis.The headache itself in migraine with or without auras is similar.For both typesmigraines,woman are three folder more likely thanmen to experience either type of migraine.

Migraine-there is chance for family tenency,females are more affected than male,it develops unilateral,variables in onset,characterized by pulsating,throbing.Cluster-ther in family chance,males are more than females it develops during sleep,at behind or around head,characterized by sharp,steady.

Tension-Type-there is family history,it develops understress,bilateralcharacterized by dull,persistentent type.(Richard D etal 2006)

” Depression may means the symptom of feeling of said, meloncholic or low in spirit, or it may mean the syndrome of depression as characterized by low mood,lack of enjoyment, reduced energy and changes in appetite, sleep and libidpolic.(A.W.CLARE 1998)

“Clinically significant depression is often reffered to is as major cause of disability and of succide.Medically unexplained symptoms that may result from depression include chronic fatigue,chronic wide spread pain,weight loss and conginitive impairment (deprssive pseudodementia).Dpression comorbid with a medical condition magnifies any associated disability,diminishes adherence to medical treatment and rehiltation, and may even shortet life expectancy.Recent research suggests that patients who have a major depressive disorder soon after myocardial infarction or stroke die sooner than who do not even when disease severity is controlled.(lloyd& sharpe MC 2002).

“It is widely accepted that the limbic system has a role in control and expression of emotion.These structures from a reverbrating (papez) cercuit inwhich inputs from various cortical areas,especialy those involving in perception, are fed in together with other inputs from the brain system and spinal cord.Output is mainly from the hypothelmus,through releasing hormone, and the reticular formation and autonomic nuclie of the brain stem. The hypothelmus plays a part in hormonal disturbabce in depression.The reticular formation and autonomic nuclie contol aroused and autonomic function,both of which are often altered in depression.The limbic system also contains sructures involved in the control of memory,depressed patients often express their disorder in terms of adversely disorted recollection of past events.The limbic system may act as a regulatory system for emotional states.Noradrenergic and 5HT neurones abuond in these areas of the brain,and the system’s close link with the LHRA axis provides a pictures how disturbance of these systems might be linked in depression.”(cantopher1991).

‘Types of depression.Major depression-It is probably one of the most common forms of depression,lack of interest,walk around with weight of world on his or her shoulder, hopeless atate,lack of interest in sexual activity and less appetite and weightloss.

Atypical Depression-individuals somtimes experience of happiness, but fatigue,oversleeping,overeating weightgain.typical depressio can last for months or a suffer may live with it forever.

Psychotic Depression-Individual of psychotic dpression begin to hear and see imajinory things-sound,voicesand visual that donot exist.

Dysthymia-Individual characterized by sad,blue,or meloncholic.it is a condition that people are not even aware of but just live with daily,feel life is unimportant,dissatisfied,frightened and simply donot enjoy their lives.

Manic depression:It is highly exuted,emotional disorder people who suffer from manic depression have an extremely high rate of succide.”(Any Berhman 2004)

METHODS:

We interwiewed after informed consent one hundred and two patients reporting atMedical and the psychiatric outpatients Department at Muhammad Medical College Mirpurkhas sindh,between March 2007 to to April 2008.These patients were screened for presence of depression symptoms in concomittently with migraine/half headache in head.Depressive symptoms were measured through depression scale and clinical interview,weeping,lonlelessness,sadness,confusion main questions were asked during interviewed in cases of migraine.

RESULTS

:There were thirty seven males (36.27%)and sixty five females (63.72%)who were examined during attacks of headache,17(45.9%)patients were manifested depressive symptoms and 43 (66.1%)females were developed symptoms of depression in cases of migraine.

Case Processing Summary

 

Cases

Included

Excluded

Total

N

Percent

N

Percent

N

Percent

Total cases of study * Presence of depression in migraineous female patients

43

42.2%

59

57.8%

102

100.0%

Femal patients in study * Presence of depression in migraineous female patients

43

42.2%

59

57.8%

102

100.0%

Male patients in study * Presence of depression in migraineous female patients

37

36.3%

65

63.7%

102

100.0%

Total cases of study * Presence of depression in migraneous male patients

17

16.7%

85

83.3%

102

100.0%

Femal patients in study * Presence of depression in migraneous male patients

17

16.7%

85

83.3%

102

100.0%

Male patients in study * Presence of depression in migraneous male patients

17

16.7%

85

83.3%

102

100.0%

DISCUSSION:

It was proved that females were more than male in our study.There were 66.1% females,45.9% male depressive symptoms in diagnostic cases of migraines.Majority females patients were malnourished and weeping during taking history and these were main parameters considered depressive symptoms in cases of migranious patients.From summary tables and diagrames it was proved that females were more affected than male in this study.It means that depressive symptoms were more presence in females during interview in this stydy.

“A recent research findings indicated that treatment for both migraine and major depression may benefit patients with both disorder.Astudy was conducted on people with migraine or sever headahes aged between 25to 55.When their psychiatric combordity was assed,resaercher found that the risk of migraine in individuals with pre-existing mjor depression was three times highet than in individuals with no history of major depression.More ever major depression the risk of major depression in people with pre-existing migraine was more than fivefold hiher than in people with no history of headaches.However there were no relation between major depression and other types of severe headaches”(MrMARY Ayres2003)

“Many migraines sufferes have noticed that at times,migraine and depression seems to go together and there is strong evidence to support this,However it is not known whether treating migraine affects depressive symptoms or treating depression affects migraine symptoms”(MMA2008)

“Throbbing migraine headaches and major depression may be related.Infact having one may increase the occurance of other.Migraine sufferers were five times more likely that the headache-free individuals to develop major depression in the study conducted by the Henrry ford Health system.Those who started the study with depression were three times more likely to develop migraines.With major depression was more at risk of suffering a first time migraie than non-dopressed individuals. And people who live with migrains seems to br more at risk for an initial bout of depression.Both disorders are biological linked,possibility with brain chemical or hormones.”(PT Staff 2007).

“The overall frequency of recurrent headaches didnot very significantly with age, but girls had headaches are common soatic complaints among Norwegian adolescents,especially among girls”(ZwartJA etal 2004).

“Researchers survey 949 woman with migraine about their history of abuse,deprssion and headaches characteristics,forty percent of woman had chronic headache more than 15 headaches in month,and 72%reported very severeheadache related diability.Physically and sexually abuse was reported in 38%of the womanand 12%reportedboth physical and sexual abuse in the past.The association between migraine and depression is well established, butthe mechanism is un certain.The study found woman with migraine who had major deprssion were twice as likely as a child.If thebabuse coninued age 12 ,the woman with migraine were five times more likely to report depression”(science dily2007).

“Major depression increased the risk of depression,migraine as well same.This bidirectional association,with each disorder increasing the risk for onset of other,was not observed in relation to other severe headaches,both were considered direcly proportional to eachother.”(NBreslaw,et al 2003)

It was proved that migraine type of headache bases of depression if it untreated,same mechanism follow the severe cases of depression could lead to migraine type headache.Females were more affected than males.No doubt migranous corelated to depression.

REFERENCES:

Any Behrman (2004)electroboy:a memoir of mania;published by Random House ,16sep2004 types of depression,medical review board.

Nbreslau,schultz,stewart,RBS lipton (2000)’headache and major depression is association specefic to migraine? Neurology 2000 54,308.American Academy of neuology.

Mrs marry ayres ;to relieve the burden of headache by facilitating informed awareness and encouraging resaerch’

Mary kay betz ;having headache-advisor.

N breslau RB lipton stewart 2003,;comorbidity of migraine and depression investigating potential etiology and prognosis,neurology 2003,60-13-12 American Acadamy of neurology.

Science daily(sept-6-2007)’childhood abuse is more common in woman with migraine who suffer depression than in woman with migraine alones’American Acadamy of Neurology.

Zwart JA,Dyb,Hotman TZ,Stovener LJ,SandT 2004’The prevalences of migraine and tension-type among adolsent in Norway.Cephalalgia2004 May,24(5).373-9

K.Dtripathi2003’migraine drug therapy,essentials of medical pharmacology,5th edition,

DP Headache classification subcommittee of the international headache society.2nd edition cephalalgia 2004,24:1-160

Western CJ,Rosina AF,Deveris vde coteau pa,’The prevalences and manifestation of hereditory hemmorrhage telangiectasia,a family screening.AM J Genet A2003 116 324-28.

Stewart WF, Schechter,AR rasssmussin BK’migraine prevalence, a review of population-based studies-neurology 1994-44 817-23.

Richard .Dhowland,marry j,mycek,2006’drugs used in treatment of migraine’,pharmacology,lipponcottes illustered.

A.W,Clare 1998’clinincal medicine,parveen kumar 4th edition psychological medicine

Lloyd GG SHRPEMC Davidson’s priniples and practics of medicine 19th edition 2004 affective mood disorder

T Cantopher Neurology of depression neuroanatomy of depression medicine digest 1998 7-8.

 

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Of all the topics I write about, weight-loss surgery is by far the most difficult for me. I like to consider myself a “survivor” of a recent Gastric Bypass surgery nightmare, a nightmare that I never seem to wake up from, and one I want to keep my readers from ever having to live through.

I had Gastric Bypass surgery seven years ago and three more related surgeries since. I’m scheduled for a forth later this year to repair a hernia along the incision line and to try and resolve the matter of reoccurring ulcers due to staple line leakage.

I want to spare you the nightmare of not only the physical anguish you may likely go through, but the mental torture as well. You see, should you have problems resulting from your surgery, it is extremely difficult to find a surgeon willing to go back in and operate to correct another’s mistakes. Most surgeons do not consider it worth the risk.

In fact, when I had a complete break down of my staple line from the original surgery, it took more than a year to find a doctor willing to help me. During this time, acid leakage from my old stomach nearly ate a whole through my new stomach causing the most excruciating pain you could imagine.

I vomited several times a day and got so dehydrated and sick that I had to have a permanent line inserted into my veins to administer fluids and pain medication at home. I was a walking zombie most of the time and life became very, very close to one no longer worth living.

The sad part of this whole matter though, is the fact that I wasn’t obese or even a good candidate for the surgery. I was no more than fifty pounds over weight at the time but vanity got the best of me.

If you look hard enough, you can always find someone willing to do what’s best for their bank account and turn a blind eye to what’s best for your heath. I found such a person and have been paying for that fateful decision ever since.

The irony of it all is that before I had gained my weight, which is a natural and common occurrence as we age and have children, I always thought my very best attribute was my rock solid, and very sexy stomach. A stomach I had long lost site of and very much wanted back.

After my surgery, I did lose the weight but the scar was absolutely hideous. Add three more surgeries to the same area and the subsequent muscle loss and added scar tissue, and a bikini is forever out of the question!

It goes so much further, however, than vanity for me these days. I am always in pain and gripped with the fear of yet another surgery. I nearly died after my first revision because of a lung infection from the anesthesia. I was intubated for two weeks and suffered permanent memory loss because of oxygen deprivation.

I hope that I have at least “scared” you enough to do some research into weight-loss surgery, BEFORE you go under the knife. It is a decision that may haunt you for the rest of your life and one that should not be made in haste or because of vanity.

If your health is at risk, I understand how lucky we all are to have options in this day and age and this radical surgery cold certainly save your life and drastically increase your quality of living. But please explore your options and do your research.

A point about research, though. You need to find an independent source for your information. The problem with this lies in the fact that the people who know the most about weight-loss surgery are those that actually perform it. It certainly would not be in their best interest to advise you against something that is responsible for the large majority of their income, and I do not blame them one bit for not focusing on the negative side of this issue. I am certainly not implying any wrong doing and have amazing faith actually in our overall health care system, but you need the complete and unbiased story.

I would like to point you to the only source I have found for quality information that is neither biased nor incomplete. In fact, I believe that this information should become required reading for anyone considering any type of weight-loss surgery. You owe it to yourself and to those who love you to get this valuable information…information that could save your life.

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