Archive for June, 2011

KNEE FRACTURE: NONDISPLACED AND DISPLACED FRACTURES

Thursday, June 23rd, 2011
Bone has an amazing capacity to heal itself. After a bone breaks, the process of building new bone begins. Blood rushes to the wounded area, forming a fracture hematoma, or mass of blood that protects the injury. New, immature bone cells begin to form around the injury. In a process that can take between 6 weeks and 6 months, the immature bone cells mature and develop into solid bone, and the broken bones eventually knit back together.
At one time, we used to automatically put the injured limb in a cast to prevent overstressing the fracture while it heals. However, we have since learned that complete immobilization can seriously weaken the leg muscles; therefore, we now try to stress-relieve the wounded area with crutches and a functional cast made of fiberglass that allows for some movement. By doing this, we can prevent weight from being put on the broken bone, but the knee can still have some range of motion, which will prevent the muscles from atrophying.
Displaced fractures are surgical emergencies that can be treated by either closed reduction or open reduction, depending on the type of injury.
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COPING WITH SEIZURES AND EPILEPSY: WHAT DO YOU TELL THE SCHOOL?

Saturday, June 18th, 2011
In the best of all possible worlds, clearly you should tell the school about the seizure. Unfortunately, this is not the best of worlds. Prejudice, misconceptions, overconcern, and fear of seizures still exist. Therefore, there is no simple correct answer to the question. In general, there is no need to tell the school about a single seizure. There is nothing school officials can do, or should do, about your child. They need not watch him more carefully unless he is participating in gymnastics that would place him at heights or is swimming unsupervised. They should not restrict him from playing on sports teams or at recess. He should be allowed to go on field trips and to do everything the other children do. Since there is nothing special school personnel need to do after a single seizure, it’s probably not necessary to let them know about it. What or whether you tell the school about the seizure may depend on your assessment of the teacher, the principal, and the school nurse and how you think they will react to the information. If your son or daughter does have another seizure, and if it occurs in school, you will wish that you had told them if you did not. After a second or third tonic-clonic seizure, or with epilepsy, it’s a different matter, to be discussed later.
This same philosophy applies to day care and to babysitters. Individuals acting as surrogate parents should have the same information and philosophy about overprotection as you have.
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PUTTING THE CARBOHYDRATE ADDICT’S DIET TO WORK: WHAT ABOUT EXERCISE?

Wednesday, June 8th, 2011
Many researchers have reported over the years that there is a relationship between activity levels and weight loss. In general, our findings support their reports, yet we have also observed that a rigorous exercise regime is not essential to the success of the diet, and other scientists have supported our findings.
Do these findings seem odd? They aren’t, really.
The explanation lies in the distinction between exercise and physical activity. Today, the word exercise is usually used to mean a programmatic pattern of activity, a planned regimen of regular running or swimming or other vigorous workouts. On the other hand, physical activity is less well defined: a job that requires considerable walking, for example, involves what we would term physical activity.
Thus, while exercise may make you feel good, look good, and stay healthy, it is not an integral part of the weight-loss component of this diet. At the same time, we do emphasize that you need to maintain a moderate level of physical activity (not necessarily a rigorous exercise plan) to help make the diet work for you.
So run or swim if you wish: there are many health benefits, and it may make1 you look good and feel better. But don’t do it solely to advance your weight-loss goals. Recall that it is a return to normal insulin balance that eventually produces weight loss in the carbohydrate addict.
In short, you don’t have to be in training for the marathon to lose weight: but you also can’t expect reasonable weight loss when you never get out of your easy chair.
As always, follow your physician’s recommendations, too.
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