What are strengthening physical exercises?(Part 2)

Muscle groups and their corresponding functions

Abdominals[1,2]

The external oblique muscles serve as the cover of the sides of the abdomen. In addition, it helps in the rotation of the trunk and the spine. Serving as further support to the abdominal wall, theinternal oblique muscles are located beneath the external oblique muscles; thus, they also serve as cover of the abdomen at its sides[2].

The internal oblique muscles help in forced respiration, and aid in raising the pressure inside the abdominal cavity. They also rotate and turn the trunk with assistance from other muscles. More importantly, they serve to counteract the actions of the diaphragm[2], resulting in coordinated fashion of regulating the volume of the chest cavity.

The transverse abdominis is the muscle in the side and front of the abdomen. It lies underneath the internal oblique muscles; therefore, it follows that it is the deepest muscle in the front and side of the abdomen. Its main function is to compress the ribs and the abdominal organs. In addition, it stabilizes the thorax and the pelvis. It plays a great role when a pregnant woman delivers her child[3], by pushing the child through and out in the pelvic canal.

Probably unknown to you, there is a back portion of the abdomen, and one of the most prominent muscles in this region is the latissimus dorsi. It is responsible for extending, adducting, and rotating the arms[2]—aside from covering the abdomen at the back.

Strengthening exercises for the abdominals using the body weight

Crunches (Modified sit-ups)[1]

Lie flat on the floor in a supine position, with knees bent and your hands placed over your chest. Slowly raise your head and your shoulders around six inches off the floor. Remain as it is for two seconds then return to the starting point.Exhale as you sit up and inhale as you come down. Do two to three sets of 10 to 20 crunches daily. These exercises are intended and good for your rectus abdominis[1].

Reverse sit-ups[1]

Lie flat on the floor in a supine position, with knees bent and your feet flat on the floor. Place your arms at your side and with the palms down.Keeping your knees still bent, bring your legs up followed by lifting your pelvis towards the chest. Exhale as you gradually lift your pelvis. You can do two to three sets of 10. This exercise is intended for the transverse abdominis muscle[1].

Pelvic tilt[1]

Lie flat on the floor in supine position, with your knees bent and your feet flat on the floor. Simultaneously tighten your butt muscles and your abdominals while raising your pelvis fromthe floor. While raising your pelvis, press your lower back towards the floor. Hold contracted muscles for three to ten seconds while exhaling. You can do this for three to five times[1].

Calf muscles [1]

The gastrocnemius muscle is found at the back portion of the lower leg, andit runs overits entire length. It is connected at the back of the knee and to the heel.When this muscle contracts, your lower leg is pulled towards the upper leg, causing bending at your knees. More importantly, this muscle plays an active role when you walk[2].

The other component of the calf muscles is the soleus. It is located at the back of the lower leg, in close proximity with thegastrocnemius. It is primarily used to push the ground when you walk. In addition, it is very important in dancing and running. To prevent you from falling forward, the soleus will contract to pull your feet against the ground, maintaining your upright posture[2].

(To be continued)

References:

  1. Glover B, Shepherd J, Glover SF. Strengthening. In: The Runner’s Handbook. 2nd revised ed. New York: Penguin Books USA Inc.; 1996:578-597.
  2. http://www.healthline.com/human-body-maps/abdomen-muscles#seoBlock
  3. https://en.wikipedia.org/wiki/Transverse_abdominal_muscle

What are strengthening physical exercises?(Part 1)

Definition

Strengthening physical exercises are movements that you need to do repeatedly in order to develop and improve the strength of a group of muscles. The groups of muscles are abdominals, ankles, arch, back, buttocks, calf muscles, hamstrings, hips/groin, quadriceps, shins, and upper body[1]. As to which group(s) of muscles you would like to develop depends on your purpose. If you would like to be a good runner, then the groups of muscles that you need to strengthen are the calves, hamstrings, and buttocks. If you would like to firm up your abdomen, then you strengthen your abdominals. If you would like to have firm and sturdy shoulders and chest, then strengthen your muscles in your upper body.

Means of doing strengthening exercises

Using body weight[1]

In this method of strengthening exercises, you do not use any gym equipment and gadgets. You use your own body to do them. Examples are modified sit-ups, reverse sit-ups, pelvic tilt, ankle push, towel sweep[1], and many more. This means that you can do these exercises at home, without even going to the gym.

Using free weights [1]

In contrast to the exercises using your body weight, you may need to report to the gym if you will use the free weights. Generally, there are two kinds of free weights that you can use: (1) handheld dumbbells, or (2) the weight plates on barbells[1]. The need for gym in these exercises is not solely due to the availability of these equipment; more importantly, there are personnel in the gym who could guide you on how to properly use these equipment.

Using machines[1]

Using body weight and free weights will not totally strengthen all of your muscles. In addition, you will use some machines which are intended to strengthen other sets of muscles. Examples of these machines are the biceps curl machine, triceps machine, pull-down machine[1], and many others. When you visit the gym for the first time, you can look around and familiarize yourself with these machines. Each machine has its own use and purpose. Use it (them) if it (they) is (are) what you need. Thus, before using any machine in the gym, consult any fitness adviser around so that you could be guided accordingly.

Muscle groups and their corresponding functions

Abdominals[1,2]

The abdominalsare muscles located in the front section of your abdomen. Their function is to provide you with postural support, protect your internal organs located in the abdomen and pelvic area, and to allow you to perform some movements, such as rotating the spine, bending, breathing, and defecating. The most prominent muscles are the rectus abdominis, external oblique muscles, internal oblique musclesand the latissimus dorsi.The rectus abdominis runs downward from the sternumdown to the pelvic bone, and the external oblique muscles are located at its sides, running downward in oblique direction—hence, the word external oblique. Beneath the external oblique muscles are the internal oblique muscles. Covering the back is the latissimus dorsi muscle[2].POWERTEC

Figure 1.0.Diagrammatic illustration showing the major muscles in the front abdomen.

The rectus abdominis is activated when you do crunches because it is responsible for pulling the rib and the pelvis toward each other. In addition, it curves the back. In terms of bodily functions, it is very important during the delivery of your child, for bowel movements, and for coughing. When you have a bulging belly, the accumulated fat is lying over your rectus abdominis. Thus, when you do periodic physical exercises for the abdominals, the fats will be burned, and you will see the exposed rectus abdominis as a six-pack muscle[2].

References:

  1. Glover B, Shepherd J, Glover SF. Strengthening. In: The Runner’s Handbook. 2nd revised ed. New York: Penguin Books USA Inc.; 1996:578-597.
  2. http://www.healthline.com/human-body-maps/abdomen-muscles#seoBlock

What are the components of your annual medical examination? (Part 7)

Other examinations
Stool examination
Stool examination refers to the laboratory analysis of the material that you move out when you do your bowel movement. The examination is done in two ways: (1) grossly, or (2) microscopically. In gross examination, the stool is observed and analyzed without using any instrument. In the microscopic examination, the analysis is done with the aid of the microscope.The results of the examination—be it grossly or microscopically—would give you an idea of the medical condition of your gastrointestinal tract, andthe following are significant findings if the laboratory technician and examiner could see them in your stool:
Eggs of parasites
If the stool examination would report that there are eggs of worms, then you are infected with them. The most common eggs that are seen in the stool come from the roundworms, specifically the parasite with scientific name Ascarislumbricoides. Roundworm infestation is very common among children who reside in the slums, eating without observing proper sanitation in their foods and dining wares. However, they couldalsobe seen among adults. If your stool examination would reveal the presence of eggs of parasites, then you must consult a medical doctor because you need to take medication(s).
Blood
The presence of blood in your stool could also mean a lot of things. The first that should come to your mind is the presence of any ulceration in your gastrointestinal tract. If the blood can be seen grossly, then the ulceration could be big and quite serious. If seen microscopically, then it is small.
Blood in the stool could also mean a bleeding cancer. Therefore, the moment your stool examination reveals the presence of blood, you need to bear that in mind, and, yearly, you need to have stool examination to find out if the bleeding is worsening or not. If worsening, you need to see your medical doctor because it is possible that you have been having cancer in the gastrointestinal tract—be it in the stomach or in the intestine.

Fats and undigested materials
If fats are present in your stool, then it is possible that you are not capable of digesting them. You have what is medically known as fat intolerance , and you may need to take some enzymes to help you digest your fats. In addition, some undigested materials could be seen in your stool. This again will indicate that you cannot digest some groups of foods; therefore, you need to see your medical doctor for further test(s) and/or for your medication(s).
White blood cells
Normally, the white blood cells are not found in your stool. However, if they are present, it means that you have ongoing infection in your gastrointestinal tract. Again, you need to see your medical doctor without delay so that you could take the right medication(s), preventing the worsening and spread of the infection.
Some words of caution: it does not mean, however, that if your stool examination does not reportpresence of white blood cells, that you do not have infection in your gastrointestinal tract! If there are other indications that an infection is present in your gastrointestinal tract, your medical doctor will proceed to treat it as a form of infection, even if white blood cells are not present in your stool.
Parting words on “annual medical examination (AME)”
The importance of AME cannot be underestimated. It is needed to serve as basis of preventive measures. Without it, your medical doctor is not properly guided on what preventive measures he could implement for you. Do it without delay!
(Last of a series of 7)

What are the components of your annual medical examination? (Part 6)

Other examinations

Endoscopy

Endoscopy is a medical procedure wherein an instrument—called an endoscope–is inserted in your anal opening, and its end is pushed upward in the hollow space of your intestines. For your additional information, your intestines are divided into: (1) the small intestines, and (2) the large intestines. Your large intestines, in turn, are divided into the following (Refer to Figure 1 below): (1) ascending colon, (2) the transverse colon, (3) the descending colon, and the (4) rectum. When endoscopy is done, the most that it can reach are the parts of the large intestines. Therefore, it is very feasible in looking at the medical condition of the rectum, descending colon, transverse colon, and the ascending colon. This procedure is resorted to when you experience difficulty in moving your bowel, when your abdomen is gradually enlarging and you are losing weight, and when you noticesignificant amount of bloodbeing admixed in your stools!

Ultrasonography

Ultrasonographyutilizes sound to derive a picture of internal organs and structures. For instance, if the result of your urinalysis reveals that there are plenty of red blood cells, then ultrasonography may be resorted to find out the cause of your bleeding in the urinary tract. There are two possible causes of bleeding in your urinary tract: (1) you have stone which has been injuring the lining of your urinary tract, or (2) you have bleeding cancer in your kidney or urinary bladder. If ultrasonography is done, then—by and large—the exact cause of the bleeding can be determined.Ultrasonography can also be used to determine medical problem(s) in the liver or gastrointestinal tract.

Other tests

Alpha- fetoprotein

If ever you had ultrasonographyof the liver and if there was a new growth in it, the determination of the alpha-fetoprotein will be resorted to. If this substance in the blood is very much higher than the normal values, then it is possible that you have been suffering from cancer of the liver medically known as hepatocellular carcinoma. If you are suffering from this liver disease, aside from the positive results from ultrasonography and blood test for alpha-fetoprotein, your medical doctor may find out during the physical examination that your liver is enlarged and your eyes are colored greenish. With all of these findings, very likely, you have hepatocellular carcinoma. To definitely confirm that you have it, your medical doctor may request for biopsy of your liver, wherein a needle is pushed into your liver and sample tissue will be taken from it. The sample tissue will then be examined under the microscope, and it will be known in due time whether or not you have hepatocellular carcinoma.

Prostate-specific antigen

The prostate-specific antigen (PSA) is a blood test which is required from men 50 years old and over. It is an indicator of whether or not you have been harboring prostate cancer. Thus, if the level of your PSA is higher than the normal ranges, you need to have the test more often—yearly, at the very least—and you need to have aurologist (medical doctor for this kind of problem) who will follow you up. Ideally, before you submit yourself for this test, a urologist has seen you and has examined your prostateby doing the digital rectal examination, wherein he inserted his finger into your anal opening and was able to touch your prostate, feeling its consistency and its size. If your medical doctor appreciated hard prostate and your PSAvalue is high, then most probably you have prostate cancer.

(To be continued)

What are the components of your annual medical examination? (Part 5)

Laboratory examinations

Blood chemistry analysis

Alanine aminotransferase

Alanine aminotransferase (ALT)is one of the enzymesthat is measured and monitored to find out if you have medical problem(s) in your liver. This enzyme is highly specific for the liver; therefore, if it is elevated, or higher than the normal values, you really have a disorder in your liver. It was formerly known as the serum glutamic-pyruvic transaminase (SGPT).

Blood urea nitrogen and creatinine

Theblood urea nitrogen (BUN) and creatinineare the indices for evaluating the medical condition of the kidneys. If the blood levels ofBUN and creatinine are over the normal values, then it is possible that you are beginning to have problem in your kidneys, or you have been having problem with your kidneys for a long time, if the levels are considerably high. There are two most common causes of kidney problems. These are: (1) diabetes mellitus (DM), and (2) hypertension. Thus, if you have been suffering from DM, even if you have been taking the right medications, you still need to have periodic measurement of both your blood BUN and creatinine.If you have hypertension, take the necessary medication(s), without waiting for the rise in your blood BUN and creatinine.

Chest x-ray

X-ray of the chest is very important part of the annual medical examination (AME), especially if it is your first time to undergo AME. If the results of your first chestx-rayare normal, and if you are over 50 years old, then you can afford to have it every 5 years. However, if there are positive findings that need to be followed up—to find out if it(they) is(are) worsening or not—then you need to have it every year or every two years depending on the nature of the medical finding(s) and on the advice of your medical doctor.

The most important findings that you need to pay attention to in the chest x-ray are the following: (1) any new growth which could be cancerous in nature, (2) any infectious disease, such as tuberculosis or pneumonia, and (3) any abnormality of the heart, such as enlargement. If new growth is found, then further tests need to be done, such as getting a sample of it then examined under the microscope.

Electrocardiogram

The electrocardiogram(ECG) is a tracing on a paper which is produced by the instrument called electrocardiograph. By interpreting the tracings on the paper, the reader could say if you have heart enlargement, if certain part(s) of your heart is(are) not well supplied with blood (myocardial ischemia), if you have problem with the electrical current of your heart, if your heart rate is slow or fast, and if your heart rate is irregular—among other things. Among the medical problems mentioned, the detection of myocardial ischemia is the most helpful and lifesaving because if it was not previously established, it could lead to death if proper management is not immediately done.

Gastroscopy

Gastroscopy is the process of inserting an instrument, called the gastroscope, through your mouth and reaching the inside of yourstomach. Through the gastroscope, the medical observercould now inspect the inner lining of your stomach, and he could find out if you are suffering from stomach ulcer or any new growth. If the new growth is suspicious looking, the medical observer could bite a piece from it using the gastroscope,   and the sample will be submitted to the laboratory for examination. With the aid of themicroscope, your new growth could be classified as either benign or malignant. If benign, then there is no problem; however, if malignant, then you may either undergo surgery or chemotherapy or both. In addition, if you have a bleeding ulcer, using the gastroscope, the medical observer could inject a medication in and around the site to stop the bleeding.

 

(To be continued)

What are the components of your annual medical examination? (Part 4)

Laboratory examinations

Blood chemistry analysis

Low-density lipoprotein (LDL) cholesterol

TheLDL cholesterolis one of the lipids that needs to be determined when you submit yourself for blood chemistry examination. This type of cholesterol is also known as the bad cholesterol because if its high level in the blood is not checked, it will be deposited in the different organs of the body, such as in the small and large blood vessels, and it will lead to hypertension and diseases of the heart. Hence, there is an urgent need to periodically measure its level in the blood, and if it is elevated—that is, higher than the normal values, you need to take medication(s) that will lower it.

High-density lipoprotein (HDL) cholesterol

The HDL cholesterol is also known as the good cholesterol because it is responsible for the so-called reverse cholesterol transport, wherein it carries back and returns all the cholesterol from the different parts of the body   to the liver for use and elimination. If cholesterol is not returned to the liver, it will be deposited in different parts of the body leading to the development of diseases of the blood vessels and the heart.

If the level of your HDL cholesterol is low, and your LDL cholesterol is low or normal, then there is no problem. Problem arises when your HDL cholesterol is low, and your LDL cholesterol is high! In this instance, you need to lower your LDL cholesterol by taking synthetic medication(s), and, as much as possible, increase your HDL cholesterol by having periodic physical exercises.

Blood uric acid

In one of the biochemical reactions taking place in your body, uric acid is produced as one of the products. If the enzymes responsible for eliminating uric acid from your body is adequate,the said substance will be adequately removed from your systems. However, if you lack the necessary enzymes, you will retain much of the uric acid, and this will be deposited in your joints causing excruciating pain every time you move your legs and hands. If the level of your uric acid in the blood is high and very much above the normal ranges, and if you have been experiencing pain in your joints, you medical doctor will prescribe you with the necessary medication(s). However, if theuric acid level in your blood is high, but you do not experience pain in your joints, then your medical doctor may still refrain from prescribing you with the necessary medication to eliminate your excess uric acid.

In extreme situation wherein some deformities have been formed in your joints resulting from the deposition of too much uric acid, then it can be said that you have been suffering from gout. In addition, elevation of uric acid in the blood for so many years will lead to the destruction of your kidneys. Hence, periodic measurement of your blood uric acid is a must.

Aspartate aminotransferase

Aspartate aminotransferase (AST)is one of the enzymes that needs to be measured every now and then. It is used to find out if you have a medical problem either in your heart or in your liver. However, if the increase of AST is very substantial, it could mean a problem in the heart which could be fatal. Thus, if you have been experiencing chest pain, and if your AST is substantially elevated, then see a medical doctor immediately because, very likely, you must be suffering from a heart attack!In some instances, however, elevation of AST—especially if minimal or moderate in amount—could mean a problem in the liver or in some skeletal muscles.

(To be continued)

What are the components of your annual medical examination? (Part 3)

Laboratory examinations

Urinalysis

Other important findings in the urinalysis that you need to pay attention to are the presence of protein and/or sugar. If sugar is present in your urine, then it is highly possible that you have been suffering from diabetes mellitus (DM); if protein, on the other hand, is present, then you may have problem in your kidney(s), which could be inflammatory in nature. Thus, although it is cheap, your medical doctor could derive valuable information from itregarding your health, and he could start managing your medical problem at the earliest possible time.

Blood chemistry analysis

Fasting blood sugar

Fasting blood sugar is also known as the FBS. This test will let you know whether you have been suffering from DM or not. If your urinalysis reveals that you have sugar in your urine, then it is a must that you have FBS test so that you could confirm if you really have DM. More often than not, if you have sugar in your urine, you will have, at the same time, elevation of your FBS, signifying that you have been suffering from DM.

If your FBS is slightly over the normal values, your medical doctor may not start you at once with synthetic drugs. Instead, he will advise you on the right diet.Frequently, these are the initial and practical changes that you need to effect in your diet: (1) reduce your intake of rice, (2) refrain from adding sugar in your coffee, (3) avoid ice cream, chocolates, and candies, and (4) stop taking soft drinks. In addition, you need to have regular physical exercises.

Blood cholesterol

High level of cholesterol in your blood has been linked with the development of atherosclerosis and arteriolosclerosis (deposition of fatty plaques in the big and small blood vessels, respectively). When this happens over several years, the opening of your big blood vessels become narrow and their walls become inelastic, leading to the development of hypertension, or elevation and rise of your blood pressure. Thus, to prevent hypertension from taking place, the moment you find out that your blood cholesterol level is above the normal values, you need to consult your medical doctor, and take the medicine(s) that he will prescribe for you. Take it(them) daily so that hypertension will not set in.

If the deposition of fatty plaques takes place in the smaller blood vessels, such as those that nourish the heart muscle, then it is possible that you will have significant reduction in the amount of blood that goes to your heart, otherwise and medically known as myocardial ischemia, and you could be a victim of heart attack! Depending on the extent and amount of heart muscle that is deprived with blood, you may survive or die from it!

Blood triglycerides

Blood triglycerides are forms of fat (lipid) substances. They could be considered as “cousins” or “close relatives” of   blood cholesterol. Being “close relatives”, elevation of triglyceride level in the blood will also lead to the development of hypertension and diseases of the heart. In short, the adverse effects of elevated triglyceride level in the blood is the same as in cholesterolelevation; and when the two substances are simultaneously elevated, the development of diseases in the heart and blood vessels will develop faster than when only one is elevated. Thus, elevation of both the cholesterol and triglyceride levels in the blood is a bad sign! You need to consult your medical doctor soonest so that he could   prescribe you with the necessary medication(s) and advise you on the right diet and physical exercises.

 

(To be continued)

What are the components of your annual medical examination? (Part 2)

Laboratory examinations

Complete blood count

Complete blood count (CBC) is a very simple laboratory procedure, but it could reveal a number ofongoing and persistingmedical problems. One important value that is shown in yourCBC is the hemoglobin content of your blood cell.If the hemoglobin value is below the normal ranges, then you are suffering from anemia;since anemia could only be a tip of an iceberg—so to speak—you might need other laboratory procedures which will help your medical doctor determine what has been causing it.

The other value included in the result of your CBC is the number of red blood cells (RBCs). As mentioned in the previous articles of Powertec, the RBCs transport the oxygen from the lungs and bring carbon dioxide to the lungs. If the number of RBCs is reduced, then you will have a problem in the transfer of both oxygen and carbon dioxide, and you will get tired so easily. You cannot participate in very strenuous activities. Similar to the hemoglobin value, reduction in the number of your RBCs means a lot; it could mean a serious disorder in the blood.

The number of white blood cells (WBCs) is also shown in your CBC. If the number is very much higher than the normal values, then it is possible that you are having infection. If very much lower than the normal values, then it could mean a disorder in the bone marrow—an organ of your body responsible for the production of the different cells of your blood.

The platelet count is also included. To let you know, the platelets are the cellular components of your blood which are needed for producing a clot when any one of your fingers or toes is cut. If your platelet count is low, you are prone to have excessive and prolonged bleeding; but the problem does not stop there; a low platelet count could mean a possible disorder in the bone marrow. In addition, if you have been experiencing moderate to high fever for the last few days, and if your platelet count is low, then it is possible that you are suffering from dengue fever, especially if you come from tropical countries.

If your RBC, WBC, and platelet count are all below the normal values, then the possibility of having problem in the bone marrow is very high. You need to consult a hematologist—an expert in the diseases of the blood.

 

Urinalysis

When urinalysisis done, you need to collect your urine, and it will be submitted to the laboratory for examination within one hour from the time of collection. This laboratory procedure is very cheap and can be done in a short time; however, a lot of information can be gleaned from it.

Normally, RBCs are not found in the urine. However, if they are present, then a number of possibilities could be considered. One important problem that you may have is the presence of stone either in your kidney(s) and/or urinary bladder. However, your medical doctor will ask you more questions to firm up the consideration of this problem.

If, in addition to RBCs, you have pus cells in your urine over the normal values, then it is possible that you have infection in the kidneys and/or urinary bladder or both.This consideration is highly probable if bacteria are found in your urine. Again, your medical doctor may ask some more questions and/or require other tests to confirm and establish that you really have infection.

 

(To be continued)

What are the components of your annual medical examination? (Part 1)

Importance of the annual medical examination

There are three important factors that play vital roles in your health maintenance: (1) adequate physical exercises, (2) well-balanced diet, and (3) submission to annual medical examination (AME). In previous Powertec articles, the first two factors have been well covered and adequately discussed that now the third factor needs to be given the same treatment and attention as the previous two.

The AME could be likened to a scanner which is used to examine and view the whole forest. The forest is composed of different trees, and you really do not know, at a certain time, which tree, or trees, has (have) problem(s). If you scan the whole forest, then you could find out the problematic trees, and, therefore, you could implement preventive measures which will slow down the worsening of their condition. By the same token, your body is composed of different parts and organs, and, at certain time, you really do not know which of your organs have problems. There are times when, without feeling any unpleasant experiences, some of your organs have been having problems. But because they are at the earliest stages of a disease, you do not feel anything bad, and you still feel good and alright.

Following the principles of preventive medicine, you need to have the AME so that your medical doctor will be properly guided on how to implement preventive measures for your health.Without the AME and without its results, your medical doctor will have a hard time knowing your future medical problems; he is lost in the jungle, so to speak; thus, he cannot implement preventive measures at the earliest possible time.

Parts of annual medical examination

History taking

If you will meet your medical doctor for the first time, this part of AME may take some time because he will build up your baseline data from zero. He will get general data from you, such as your name, age, address, place of work, and so on. This is followed by your past history, which is concerned with your past illnesses, previous hospitalizations and surgical operations; your personal history, which is concerned with your personal lifestyle and habits, such as drinking liquor, smoking cigarettes, and other practices and preoccupations which have detrimental effects on your health. Subsequently, your family history will be looked into, searching for the diseases which have been common in your family members, such as hypertension, diabetes mellitus, bronchial asthma, and other diseases. You will asked about the cause(s) of deaths of thedeceased members of your family.

Physical examination

After takingdown your medical history, the medical doctor will then physically examine you. Through inspection, he will look at you, and note down all abnormalities. He will observe how you walk and smile; he will note the color of your skin, eyes, and your tongue. After inspection, he will do palpation wherein he places his hand over your chest,  abdomen or any part of your body, and he will feel for any abnormalities. This is followed by percussion wherein the medical doctor taps any part of your body through the use of his fingers, and feel for any change(s) in the sound emitted by the percussed organ(s). Through auscultation, he will listen to your heart, lungs, and abdomen by using his stethoscope. At the end of the four processes, he will collate all the data that he collected, and he will establish a working impression and tentative conclusion—whether you are totally okay or you have a medical problem.

(To be continued)

 

Basic description and management of pain(Part 5)

Drugs used to control “pain”

In the management of pain, there are several methods being used, and one of them is synthetic drugs. In the ensuing part of this paper, the different classes of drugs being used to control pain are introduced and discussed. This is meant to give you an overall view of what drugs could be used to control your pain. Before you use any one of these drugs, however, you need to consult a medical doctor who will guide you on how to approach your problem in terms of knowing what is causing your pain and what drug to use in controlling it.

Non-opioid analgesic[1]

The frequently used members of this group are the following: paracetamol or acetaminophen, aspirin or acetylsalicylic acid, and the non-steroidal analgesic drugs (NSAIDs). Taken as a group, the following generalizations can be applied to each and every member: (1) by taking the drug(s), you will not develop addiction to it (them), (2) there is a “ceiling” to their analgesic effect—that is, upon reaching a certain dose, increasing it will not lead to further relief of yourpain, (3) the capacity to reduce your body temperature, provide relief of yourpain, and control whatever inflammation you have been experiencing varies from one drug to another within the group, and (4) they provide you withpain relief by preventing the formation of prostaglandins[2].

Prostaglandins are hormone-like substances which participate in the performance of your different body functions, such as the contraction and relaxation of your muscles, the dilation and constriction of your blood vessels, and the modulation of inflammation [3]. By modulating inflammation, it could worsen yourpain; thus, the prevention of its formation would lead to the relief of yourpain.

Paracetamol or acetaminophen[2]

Generally, paracetamolor acetaminophen is used to reduce your body temperature. Thus, when you are having fever, this drug is prescribed to you and to othersby a relatively large number of medical doctors. Aside from this, however, youcan use it to control yourpain. This drug is relatively safe, cheap, and very effective; hence, you are encouraged to use this as the first line drug to control yourpain. However,if you have a history of stomach ulcer and hyperacidity (too much acid in the stomach), you are advised to be more cautious in using it; if none, this medication is generally safe and largely deprived of any life-threatening reactions to your body.

To avoid confusion, you should remember that this drug has two generic names: paracetamol or acetaminophen. In some countries, drug dispensers know paracetamol, but they are not aware of acetaminophen; in other places, however, acetaminophen is well-known as the generic name of this drug.

Aspirin or acetylsalicylic acid[2]

Aspirin or acetylsalicylic acid has the same actions as paracetamol. The main difference is on the possible side-effect. Aspirin is notorious for causing possible bleeding from your stomach when it is used for a long time. Thus, you should exercise extreme caution   when using it. To play safe, useparacetamolif you are not allergic to it, instead of aspirin.

Non-steroidal analgesic drugs (NSAIDs)[2]

If acetaminophen (paracetamol) or aspirin will not be able to relieve your pain, then you can shift to using the NSAIDs. Examples of NSAIDs arediclofenac,ibuprofen, naproxen, celecoxib, mefenamic acid, etoricoxib, and indomethacin[4,5].If you use thesedrugs on a short-term basis, they could be considered as generally safe; however, you need to be more careful if you use them for a long period of time, bearing in mind always their possible side-effects on the kidneys and the inner lining of the stomach [1].

Weak opioids [1]

When the non-opioid analgesics or NSAIDs could not fully control your pain, then the so-called weak opioids, such as codeineandtramadol[6], could be added or could be used as replacement. The purpose of adding the weak opioid is to avoid maximizing or increasing the dose of the non-opioid analgesics or NSAIDswhich could be detrimental to your health[7].

Strong opioids [1]

Strong opioidsare the ultimate treatment for moderate to severe pain. When everything has been tried on you and yet no palliation of pain is observed, then the strong opioids will be resorted to. Examples of strong opioids are morphine[6]and oxycodone.

(Last of a series of 5)

 References:

[1]Mercadante S, Fulfaro F. World Health Organization guidelines for cancer pain: a reappraisal. Annals of Oncology 16 (Supplement 4) 2005: iv132-iv135.

[2] Melmon, Kenneth L., Howard F. Morrelli, Brian B. Hoffman, and David W. Nierenberg. Clinical Pharmacology, Basic Principles in Therapeutics. McGraw-Hill, Inc., Health Professions Division: New York, 1992.

[3] MedicineNet.com. http://www.medicinenet.com/script/main/art.asp?articlekey=16461

[4] NSAID (List of non-steroidal anti-inflammatories).

http://cdn.dupagemedicalgroup.com/userfiles/file/patientForms/nsaid-list.pdf

[5] eMedExpert, Non-steroidal anti-inflammatory drugs comparison.

http://www.emedexpert.com/compare/nsaids.shtml

[6] WHO analgesic ladder: which weak opioid to use at step two? http://www.bpac.org.nz/BPJ/2008/December/docs/bpj18_who_ladder_pages_20-23.pdf

[7] United States. U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 9, Management of Cancer Pain, Rockville, March 1994.