Jumat, 14 Mei 2010

Quitting Smoking: Nicotine Relapse Prevention And Recovery

According to a Statistics Canada report entitled A step Forward, a step back: Smoking cessation & relapse by Margot Shields " Relapsing was strongly associated with the length of time an individual had quit. Approximately 1 in 5 men and women who had quit smoking for two years or less had started again. By contrast, approximately 5% of former daily smokers who had quit for three to five years had started smoking, and among those who had quit for more than five years, the figure was 1%". Conclusion, the longer you stay quit the less chance you have of starting again. Understanding relapse prevention and recovery may help you to avoid relapsing or it may help you to recover quickly.

Instantaneous Relapse

Instantaneous relapse occurs when you start smoking because something unexpected occurs. The unexpected situation can occur while on vacation, in the midst of having a great time, or it can be during a new and unusual stressful situation. An example of this is where you are out with friends having a great time, maybe alcohol is involved and out of nowhere someone offers you a cigarette and you take one. Or you come home from work and find your pet is very ill and needs immediate attention. You remember you kept a pack in the cupboard and light one up.

Planned Relapse

You finally did it; you stopped smoking, got through the craving, withdrawal and habit stages and have been smoke free for some time. But lately and for no apparent reason you have been thinking about cigarettes. Then one day you decide to buy a pack, you know they aren't good for you, but you buy them anyway. In the back of your mind you have convinced yourself that by now you can control it or maybe you convinced yourself a few won't hurt or maybe you will be able to ration them and have a few at a time. You bought the cigarettes and now you are playing a mental tug or war game. Part of you say's don't do it; the other part says a few can't hurt. Finally you lose the tug of war and give in; you have the first one and all bets are off.

Latent Relapse Potential

Latent relapse potential is something you need to be aware of because it can sneak up on you when you are least expecting it. You just found out you are pregnant and you instantly quit smoking and can't believe how easy it was or you stopped smoking before you took a long vacation and you feel great about beating smoking. When something as exciting as a pregnancy occurs you can be so excited you stop instantly but the day after the baby is born some women find themselves right back at it wondering what hit them. The same goes for a long vacation or a hospital stay. While on vacation or in the hospital you didn't miss smoking. You are away from your normal routine and have been smoke free all along, you return home only to find everything was just as you left it. Knowing that latent relapse potential exists will help you to develop your reentry strategy after giving birth or returning from a vacation or a hospital stay.

Relapse Recovery

Relapse recovery is all about stopping again quickly. The sooner you stop again after that first smoke the higher the probability you will return to being smoke free. When you decide to have one you are at a fork in the road and you have a very important and timely choice to make. One fork is where you continue to smoke. The other fork is where you stop right then and don't have another one. If you happen to have one don't panic, don't give in and don't fall into the trap of thinking you can control your intake of cigarettes. Get right back onto that horse don't light up another cigarette and never look back, the sooner you stop again the more likely you will succeed again.

People who convince themselves that they will quit again some time in the future may find they are still smoking a decade later.

Relapse Prevention

When it comes to quitting smoking and relapse prevention an ounce of prevention is worth a pound of cure. To protect yourself against relapse:

Expect the Unexpected

Mentally preparing yourself for unexpected or unusual events and situations can prevent you from relapsing. Weddings, family and school reunions, buck and does are events that don't occur everyday and are events that increase vulnerability. If you are planning to attend one of these events just think ahead or back to what normally happens. At some point smokers will go out for a smoke and you need to have your personal plan in place before you get there. If someone invites you out for a smoke, simply reply, "No thanks I don't feel like one".

You can't control it

The tongue in cheek definition of insanity is doing the same thing over and over again expecting a different result. When it comes to thinking you can have one or that you can manage and control your cigarette consumption, you are deluding yourself. If you are smoking again after quitting you know this to be the case. Some people relapse because they start off with just one cigarette, thinking they can control it, but usually don't stop there. Statistically the odds are against you controlling your smoking to one or two a day.

Get rid of cigarettes.

Your personal relapse prevention strategy should include getting rid of any remaining cigarettes and smoking paraphernalia in your own way. Some plan their quitting by getting rid of ashtrays, detailing their car or work vehicle and smoking the last one the day they stop. Some wrap their cigarettes in shipping tape so they can't get at them. Some bury them in the back yard. Do what feels right for you, but make sure you have a plan to say good-bye once and for all to your cigarettes, cigars or pipe tobacco and smoking paraphernalia.

Manage chronic stress

Sudden and unexpected stress can catch you off guard, while chronic stress can make the job of quitting smoking tougher. Chronic stress occurs where you have something, somebody or a job that is constantly causing you to feel uptight and maybe out of control. When it comes to chronic stress you have two choices, eliminate the cause or learn to cope and manage your stress.

Eliminating the cause is the preferred solution but is not always possible. Chronic stress can cause you to secrete cortisol a stress hormone. Normally a good thing, when cortisol is present over a sustained period of time it can be damaging to your health, compromise your immune system and can lead to serious disease. If you can't change the cause of the stress in your life you will need to find news ways to mange or reduce the effects of chronic stress to your body and mind.

Managing stress involves finding healthy outlets that allow you to temporarily get some relief. For some people this means going to a gym and working out the frustrations with weights and cardio exercise. Some people find yoga, or mediation will give them relief while other people turn to a new hobby or learning to play an instrument. Whatever you choose make sure you enjoy it.

If you wish to further your knowledge on managing stress several books on the subject entitled "The Relaxation Response" by Herbert Benson M.D. and "Natural Highs" by Hyla Cass M.D. may help you to understand and adopt new ways to feel good without cigarettes.
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Tips On Controlling Diabetes

If you have diabetes then you know how important it is to try to keep it under control as best as you possibly can. There are many ways you can manage diabetes, and many things that you can do on your own. If you are on any kind of medication, you should be taking it every time you need to. Even if you are on a fixed income, there are many pharmaceutical companies that can supply you with medication at no cost to you, and the forms are pretty simple and straight forward.

If you are planning a trip, make sure that you plan ahead, and order more medication if needed. Be sure to bring along some kind of insulin pen, that doesn't need to be refrigerated, and travels well. Make sure that you have enough test strips, and make sure that the batteries for your monitoring equipment are fully charged, but bring extras from home in case you are on an extended stay.

Just because you have this disease, doesn't mean you can't eat at restaurants, but you have to be smart about your food choices. Read the ingredients closely, and try to stick with low calorie choices. You can have as many vegetables as you like, but should you choose to order a salad, make sure that you order the dressing on the side, then you can just dip the salad into it instead.

Enjoy your meal slowly, and try to take home any leftovers. You can also avoid over eating by ordering half meals if possible. Make sure that you monitor you levels, thirty minutes before eating, and an hour after meals. Also be careful that you are eating when you are supposed to, because if you aren't eating properly, this could lead to further problems later on.

Get regular exercise; a good cardiovascular work out can be in simple forms, such as walking or riding a bike. It is important that you get at least thirty minutes of exercise a day, whether at a gym, or at home. You need to maintain your weight and eat a healthy diet to prevent heart disease. Read the food labels when buying at grocery stores, check the calorie contents, what the portion sizes are, and stick to these to the letter.

There are many other valuable resources to help you manage your diabetes. You can find many helpful tips and information on the internet, as well as from your doctor. Make sure that you talk with your doctor before you change your diet or exercise routines, and keep in touch with him about your blood sugar levels, as well as your A1c hemoglobin number. This is important in case they need to up your medication dosage, or adjust it in other areas.

You don't have to let diabetes control your life, as long as you are doing what you need to do. Be informed about your diabetes, educate yourself, and those around you who may try to tempt you with things you know are bad for you. One last thing, people with this disease tend to have foot problems due to poor circulation, so you need to check your feet often, like with a mirror, after your bath or shower.
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About the Author

Beverly Mullin is Dietitian and Health Coach, she has done Masters Degree in Public Health. She is providing information of treatments for diabetes


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Known Cerebral Palsy


Cerebral Palsy (CP, Big Brain Paralysis) is a condition characterized by poor muscle control, stiffness, disability and other neurological dysfunction.

CP is not a disease and not progressive (getting worse).
In infants and premature babies, part of the brain that controls muscle movement are particularly vulnerable to CP injury occurs in 1-2 from 1000 infants, but 10 times more often found in premature infants and more frequently found in very small infants.


Cerebral Palsy can be caused by a brain injury occurs when the baby is still in the womb, the birth place, newborn and children younger than 5 years. But not most the cause is unknown.

10-15% of cases occur due to birth injury and reduced blood flow to the brain before, during and immediately after birth. Premature infants are particularly vulnerable to CP, probably because the blood vessels to the brain has not developed comprehensively, and easy bleeding or because the oxygen can not flow in sufficient quantities to the brain.

* Brain injury may be caused by high levels of bilirubin in the blood (often found in newborns), can cause kernikterus and brain damage.
* Severe disease in the first year of baby's life (eg encephalitis, meningitis, sepsis, trauma and severe dehydration)
* Head injury due to subdural hematoma
* Injury of blood vessels.


Symptoms usually appear before the 2-year-old child and in severe cases, can appear at 3-month-old child.

Symptoms vary, ranging from the irregularities that are not apparent until severe stiffness, which causes changes in the form of arms and legs so the child must use a wheelchair.

CP is divided into 4 groups:

1. Spastic type (50% of all cases of CP), the muscles become stiff and weak.

Rigidity is happening can be:

* Kuadriplegia (both arms and both legs)
* Diplegia (both legs)
* Hemiplegia (arm and leg on one side of the body)

2. Type Deskinetik (Koreoatetoid, 20% of all cases of CP), muscular arms, legs and body spontaneously moves slowly, writhing and uncontrollable, but can also arise rough movements and twitching. Outburst causes worsening situation, the movement would disappear if the child slept

3. Type Ataxic, (10% of all cases of CP), consisting of tremors, unsteady steps with both legs far apart, interference coordination, and abnormal movements.

4. Mixed type (20% of all cases of CP), is a combination of 2 types above, which is often found is a combination of spastic and koreoatetoid type.

Other symptoms can also be found in the CP:

* Below normal intelligence
* Mental retardation
* Seizures / epilepsy (especially in spastic type)
* Sucking or eating disorders
* Breathing irregular
* The development of motor skills disorders (such as reaching for something, sit, roll over, crawl, walk)
* Disturbance speaking (disartria)
* Disturbance of vision
* Hearing loss
* Joint contractures
* Movement is limited.


In the examination will be found in delayed development of motor skills.

Infantile reflexes (eg sucking, and surprise) still exists even supposed to have disappeared.

Muscle tremors or stiffness was clearly visible, and children tend to fold his arms to the side, his legs moving like scissors or other abnormal movements.

* Various laboratory tests can be done to rule out other causes: MRI of head showed structural abnormalities or congenital abnormalities
* CT scan showed the head of structural abnormalities and congenital abnormalities
* Check hearing (to determine the status of auditory function)
* Check vision (to determine the status of visual function)
* Muscle biopsy.


CP is incurable and is a disorder that lasts a lifetime. But many things can be done to enable the child to live independently as possible.

Treatment usually depends on the symptoms and can include:

* Physical therapy
* Braces (buffer)
* Glass eye
* Hearing aids
* Education and special schools
* Anti-seizure drugs
* Drugs to relax the muscles (to reduce tremors and rigidity)
* Occupational therapy
* Orthopedic surgery
* Speech therapy to clarify speech and to help children overcome eating problems
* Treatment (for severe cases).

If there is no physical disturbance and severe intelligence, many children with CP will grow normally and go to regular school. Another child requires extensive physical therapy, special education and always need help in living their daily activities.

In some cases, to free the joint contractures due to deteriorating muscle rigidity, may need surgery. Surgery is also necessary to install the feeding tubes and to control reflux gastroesofageal.


The prognosis usually depends on the type and severity of CP. More than 90% of children with CP survived to adulthood.
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Reference: Cerebral Palsy in Children - Medical Online Media
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