Hi Everyone,

I decided to make this web page very personal. I consider each and everyone of you very special and I want us to have a personal relationship. In discussing topics envision us sitting in a cafe, sun shining on our faces through a window and we are sipping our favorite beverage. OK? I want you to never think any question is a dumb question.

Exercise improves mood. A brisk 30-minute workout can help calm you down. Physical activity stimulates various brain chemicals that leave you feeling happier and more relaxed. Regular physical activity can help prevent depression.

Exercise can help you lose weight but burning calories and decrease cravings and appetite. It boosts energy levels so you feel like doing more. Productivity increases, along with mood and self esteem.

Exercise promotes better sleep. It also improves your sex life! Just do not exercise too close to bedtime or you will be too energized. 

Exercise promotes health by improving circulation to every organ in the body. You can improve your blood pressure, decrease risk of heart disease and prevent osteoporosis. Cholesterol levels will benefit from regular exercise. The "good" high density lipoprotein will increase while triglycerides will decrease. Certain cancers and type 2 diabetes can be prevented. 

There are many benefits of exercise far too many to mention here but here are ten reasons to start moving now:

  Well today, 23 March 2011, is my 53rd birthday. Really want to tell you how grateful I am to be sharing it with you. I want you to feel like you know me and I want to know you and your stories. I just learned something new this past weekend. I have never heard of the term donut dollies. Richard shared with me the term and told me about one such woman who was brave and adventurous to share her life with soldiers in Vietnam. If I were old enough at that time I think I would have loved to be able to spread some joy to soldiers fighting for our country. If you have a story or remember some donut dollie that made your time a little bit happier I would love to hear about it. Or if you were a donut dollie I would love to hear from you personally. What I remember about Vietnam most is the fear it put in my parents about my brother being drafted. Fortunately for my parents my brother never had to go to war. Unfortunately he was injured in a very serious car accident and suffered serious injuries to his femur bone in his leg. He had friends who went to war and did not come back the same. One such friend lost his leg and suffered many physical and emotional consequences because of Vietnam. Many soldiers suffer from Posttraumatic Stress Disorder which is a very real psychological disorder.

 

I did some research on the history of Posttraumatic Stress Disorder which I found very interesting and would like to share with you.  There are very few scientific  studies done prior to Vietnam on Posttraumatic  Stress Disorder. In the 1800's doctors diagnosed soldiers with "exhaustion" following the stress of battle. Soldiers are programmed to be strong and not show fear but the reality is that soldiers are human and humans are not machines made of steel and bolts. We are emotional creatures and we feel things, like fear, sadness, anger, etc. Through repeated stress and physical extremes soldiers would shut down and become extremely fatigued. This is one of the bodies defense mechanism to protect itself. The treatment would be to remove that soldier from battle for a period of time and then send them back hopefully recharged. 

 

During that same time in England a syndrome known as "railway hysteria" with symptoms resembling Posttraumatic Stress symptoms was exhibited by people who had been in the catastrophic railway accidents.  "Soldiers Heart" referred to Civil War combat veterans exhibiting startle responses, hyper vigilance and heart arrhythmia's. During WWI, those soldiers experiencing overwhelming mental fatigue were diagnosed with "soldier's heart and "the effort syndrome." The term "shell shock" came for WWI and the term "combat fatigue" followed in WWII. The term " Posttraumatic Stress Disorder" did not emerge until 1980 when the third addition of the Diagnostic and Statistical Manual of Mental Disorders was published. This is the book that helps diagnose mental illnesses. 

 

This was just a small history lesson in PTSD, which is a very real disorder. The next time we meet I would like to talk about the symptoms of PTSD and about how clinicians diagnose PTSD. Until then I hope everyone stays well. Remember I want you to ask me questions.. about anything. OK?  Darlene

 

Post Traumatic Stress Disorder (PTSD) (Symptoms)

So this time you ask me about PSA testing. How in the heck do you understand the results of a PSA test? First of all what is a PSA test?

 A PSA test is used to determine information about prostate health. PSA stands for Prostate Specific Antigen. A PSA level is expressed in nanograms per milliliter. and 0 -4 ng/ml is considered a normal reading. An elavated PSA does not always indicate prostate cancer or problems. An enlarged prostate, having sex, certain medications like chemotherapy, prostate biopsy or surgery or even motorcycle riding can elevate the level. If PSA levels increase rapidly over time, it may indicate cancer. Mildly elevated levels (4-10ng/ml) may mean you need to have levels checked regularly for awhile. If levels double in less than 3 years, a biopsy should be done. A digital rectal exam may also verify if cancer is a concern. Many times doctors recommend a "free PSA" blood test. A higher ratio of free PSA means a lower risk of prostate cancer while a lower ratio of free PSA means a higher risk of prostate cancer. 

I hope our discussion on PSA level of the prostate clarified some issues. Always ask your doctor questions if you do not understand things. PSA testing is recommended annually after the age of 50. If you have a family history  or are African American you should broach the subject with your physician at age 45. If you have a suggestion for a topic, please let me know. Until the next time we meet..... Love Darlene.


Bipolar Disorder (Overview)

Sorry folks I have been gone for so long. I decided to take Rich's suggestion and not make my discussions so formal. I am going to talk from my heart about my topic.  I am back and I still am waiting for some questions, comments, responses from the gallery. I have a direct e-mail which is apndarlene@gmail.com. I can answer you through your direct e-mail or post the question on the site if you don't mind. I am here for you.. so just use me! I thought today we would talk about Bipolar Disorder. That diagnosis is thrown around a lot lately. The latest celebrity to claim she has Bipolar II disorder is Katheran Zeta-Jones. I was at lunch with some old friends from the Cedarcrest days and one of the nurses asked me if Bipolar II was a new diagnosis because she had only heard of Bipolar I disorder. Bipolar I and Bipolar II have been around a long time. There is also a third category of this illness called "Cyclothymia." Now I can tell you I rarely hear of that. Cyclothymia is a very mild form of Bipolar disorder with less severe symptoms of depression and hyppomanic symptoms.

It all can be confusing to people who are not really familiar with the disorder. In order for a person to be diagnosed they must be free from the influence of any drugs or alcohol. This is often difficult because many people who suffer from these illnesses often "self- medicate with illegal substances or alcohol. Bipolar I is the most severe disorder with periods of elevated mood alternating with periods of depression. When I mean elevated mood I mean over the top mood. It is pretty easy to spot a manic person. They often can appear agitated, restless, have pressured speech, difficulty with focusing and easily distracted. They can be loud, in your face, with extreme forms of behavior. People who are manic can be impulsive, reckless in their behavior. They might spend lots of money, be sexually promiscuous, have little need to sleep and have boundless energy. They can even become psychotic, with strange beliefs and thoughts, have delusions of grandeur. When I worked in the hospital I have to tell you I enjoyed my manic patients but manic symptoms often leads to serious trouble. Often times full blown mania leads to hospitalizations as the behaviors are so extreme people usually end up calling the police or an ambulance.

Depression is the other extreme that people with Bipolar illness suffer from. Often times the depressions can be so severe in Bipolar I, they can lead to suicidal thoughts and even suicidal behaviors. Most people dread the depressions but rather enjoy the mania side of the illness. Depression can be characterized by low mood, appetite disturbances, sleep disturbances, difficulty focusing, decreased energy and motivation. Often depressed people detach themselves from life, avoiding friends and family. Moods can switch quickly in people who suffer from Bipolar or they can be more cyclic in nature. Some people may suffer from more mania, while others can suffer more from the depression side of the illness. Either way this illness can be very disrupting to life. Thank goodness there are some good medications that can help stabilize mood. In my next segment I will talk about some of the medications that are used to help people stabilize their mood. 

Bipolar II disorder is less severe and can present as hypomania and depression. Most people with Bipolar II may never be hospitalized but requires treatment with medications and therapy. 

Well, that's it for now. Hope everyone is keeping healthy and happy. I started eating an apple a day (or at least every other day) Recently heard a study that says people who eat an apple a day have improved their cholesterol level and decreased their LDL (bad fat in the blood) and increase their HDL (good fat in the blood). Also starting walking more - doing at least 2 miles on the track. Another thing I started doing was using a Neti pot daily. People who have chronic colds, sinus infections, allergies should consider this. I am breathing easier through my nose and feeling better. Until next time.. Love, Darlene.

Bipolar Disorder (Treatment)

Hello there. I am back to finish my discussion on Bipolar illness. My first part involved brief discussion on what Bipolar illness is. I talked about the different forms of Bipolar and symptoms. This topic will focus on treatment. I cannot stress the fact that medication therapy also should go hand in hand with psychotherapy - that is "talk" therapy. People who manage medications - physicians and APRN's focus primarily on symptom management and issues related to that. A psychotherapist is someone you can talk to who, who you trust to share your innermost feelings and problems with. They are skilled in helping you identify issues and guide you along the path of emotional strength. Today our focus is on primarily medications. There are some excellent medications approved by the FDA to manage symptoms of Bipolar illness. There are also other medications that can be used "off label" to help in the management of symptoms as well. When I mean "off label" I simply mean that the FDA has not officially approved them but they are being used and successfully manage symptoms of the illness.

Psychiatry is not easy by no means. There are many medications used for depression, Bipolar, and other disorders. Every medication is unique in its composition and prescribers need to understand the mechanism of action on the neurotransmitters of the brain. A general rule of thumb is to do a complete history of the patient and ask about medications used in the past. If a medication worked well to manage symptoms with no side effects by all means return to what works for the patient. Also a family history is important as many psychiatric illnesses have a genetic component. If a patient's mother was diagnosed with Depression and Zoloft worked well, then chances are Zoloft will be successful in treating the patient's depression. Often times people who are diagnosed with Bipolar have a family history of it. 

In earlier discussion I discussed Bipolar II. Bipolar II patient's often suffer with repeated episodes of depression. A medication called Lamictal or lamotrigine is an excellent choice in treating in treating this. Lamictal has been around a long time for treating seizures and has been proven safe over long-term use. It also is one of the few medications that does not cause weight gain. Unfortunately many of the medications used to treat Bipolar I cause weight gain in some people. For those who suffer primarily from the depressive side of Bipolar this is an excellent choice. It prevents cycling of moods but will not prevent manic symptoms. In some people it may cause anxiety, irritability of mood or sleep problems. 

There are three main medications that have been used to treat Bipolar I that target mainly the manic symptoms of the illness. One is Lithium and is often used in classic BIpolar I symptom pattern: euphoric mania and severe depression. In Bipolar I it is very important to realize that suicide risk is a great concern. Lithium is a very inexpensive medication. It is primarily metabolized by the kidneys so it is imperative before using lithium that bloodwork is ordered to rule out any kidney problems. Another test that should be done is Thyroid to rule out thyroid disease. There is an established connection of thyroid dysfunction and bipolar symptoms. Bloodwork is an important piece when first initiating Lithium therapy. In the beginning of treatment the prescriber will want to monitor you closely for the Lithium level in the blood. If a patient is not going to be cooperative with the bloodwork this is not a good medication to use. A therapeutic dose of Lithium can be very close to a toxic dose of lithium and that is why this drug must be monitored closely by bloodwork and any significant side effects. 

Another medication used frequently is Depakote. It is a heavy hitter with manic symptoms and rapid cycling of mood. It can cause people to gain weight. Bloodwork is necessary but not as frequently as Lithium when first started. 

A medication called Tegretol is sometimes used but not as often as the two above. Again it is beneficial with rapid cycling of mood. It also may help in severe sleep problem cases. It can be used in people who have gained significant weight being treated with Depakote. 

Trileptal is an expensive medication but is used to treat milder cases of Bipolar illness. It is an alternative to Depakote and its low long-term risk is appealing.

Seroquel, a medication first established to treat schizophrenia is now used to treat Bipolar I illness. It is an antipsychotic medication that helps in severe agitation, depression and anxiety symptoms. It also helps with sleep. There are 2 forms of Seroquel, the regular dosing which is taken 2 or 3 times through-out a 24 hour period or the extended release which is given once daily. It is not recommended in people with diabetes or a family history of diabetes. Careful monitoring of blood sugar should be done even in those who do not have a diabetes history as many of the "second generation" antipsychotics like Seroquel have caused increases in blood sugar.  Zyrexa and Abilify are some other antipsychotic medications that are used to treat Bipolar as well.

In many patients the depressions are so severe that more than one medication is used to treat symptoms. It is not uncommon to see patient's on mood stabilizing medications such as Depakote and LIthium  and antidepressant medication such as Zoloft, Prozac, and Lexapro. Antidepressants must be used cautiously in patient's that have Bipolar illness as it can trigger a manic episode. Bipolar illness can be managed well with medication. I cannot stress enough that medication management and a connection to a licensed psychotherapists is crucial in treating this mental illness.

If anyone has any questions or wants further information on this illness or any of the medications discussed, please contact me through my email address.  Until we meet again on these pages.. Keep well and try to stay happy. Darlene - apndarlene@gmail.com

Questions and Topics

This is the section for asking me questions and submitting topics for discussion.

Please  submit all of your questions and/or topics to me at:

apndarlene@gmail.com

Love you guys and gals
Darlene

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