Isoptin
By P. Javier. McNeese State University.
Once you start looking in on your thoughts you’ll probably notice that most of them seem to be about reliving the past isoptin 40mg visa blood pressure yoga ramdev, or planning for/imagining the future discount 240mg isoptin with mastercard blood pressure medication best time to take. When a thought pops up, I want you to name the time period when it seems to be occurring. The future hasn’t happened and therefore doesn’t exist as yet and the past has already gone by and therefore also doesn’t exist in the here and now. The present, this very moment, is the only time that you have any real control over. If your thoughts tend, as most do, to the future or the past, you’re missing out on a lot of the right now. You’re generally not fully present to the beauty of the only moment in time that truly exists! Another aspect of thought is that it’s largely concerned with judging, comparing and criticizing. Your mind is constantly evaluating every external and internal situation that you encounter. This time you’re going to pick a word that basically describes what the thought is about as it happens. Say something to yourself like 14 • Mindfulness Medication criticizing, or planning, or worrying, or judging, or remembering. The more familiar you are with your own mind, the easier it will be for you to intervene in your stress responses. Now that you’re getting a bit more familiar with your own mind, let’s try a few more experiments. If a different thought arises, other than mentally watching your breath-cycles and counting them, then start right back at the beginning at one. It’s important that you really try to do all of the experiments and practice suggestions in this book. Give this breath exercise a try right now and then return to the book when you’re through. Sometimes I can’t get beyond one or two breath-cycles before another thought pops up! Your mind is constantly thinking and as amazing as it is, you probably can’t even maintain your concentration for ten breaths. It can be very difficult for you to develop the concentration to be mentally present and fully aware of what’s going on in the here and now. Your mind is like a little hummingbird, flitting from one sensation, thought or perception to the next. Your thoughts are very powerful and can easily pull you away from what you’re doing. You can get carried away into your various mental worlds at the drop of a hat, which leads us to the next concept. As it turns out, both Eastern and Western observations confirm that we all have the ability to focus attention on what’s happening in the present moment, right in the here and now, and that when we do so, it silences and calms the mind. Even if you only manage this present-focus for a short period of time, what time you do spend in the present, is time that takes away from the habitual thoughts of the past or future. Contemplating the past and the future also just happens to be where most of your stressful thoughts arise. You probably worry most about either what’s going to happen or what has already happened. What’s happening right now, in this very instant, is likely considerably less stressful. Let’s try an experiment to see if you can bring those pesky, flitting little hummingbird-thoughts back into the present. Close your eyes tightly and bring all of your focus to the sensation of tension around your eyes. Squeeze your eyes even more tightly closed and feel which of your muscles are tightening in your face, between your eyes and in your forehead. Give this exercise a try right now and then return to the book when you’re through.
Nonetheless purchase isoptin 120mg line blood pressure 9058, he directly links enhanced understanding or insight generic isoptin 120 mg visa blood pressure medication ziac, particularly in relation to the “need” for medication to his adherence (“so I take it”). The following extracts compare chronic schizophrenia to physical 103 conditions, both chronic and temporary, in order to normalize having to take medication on a regular basis for an extended period of time: Ryan, 26/09/2008 R: Uh, how do I feel about it? I realise that um, I’ve got a condition like any other health condition that needs to take medication to um, control the symptoms and treat the illness, so I do…But see, I’ve realised uh, I mean it’s like a lifeline, it’s like someone with diabetes has to take their medication. So I just look at it the same way as anyone else that has a, um, uh, health problem, just have to take them... Brodie, 21/08/2008 B: Um, yeah, it’s just like taking a Panadol or something, if you’ve got headache. In the first extract, schizophrenia is directly constructed as the same as “any other health condition” that requires medical treatment and is later likened to a chronic physical health condition, “diabetes”. The comparison between schizophrenia and diabetes facilitates Ryan’s construction of antipsychotic medication as “like a lifeline” and, therefore, necessary in schizophrenia management. In the next extract, Brodie could be seen to minimize medication adherence amongst people with schizophrenia, when he initially likens taking antipsychotic medication to taking pain killers consumed to treat a headache. He acknowledges, however, that he is required to take antipsychotic medication regularly and for an extended period of time (“I think I have to take them for the rest of my life”), thus, 104 departing from similarities to pain killers used to treat a headache. The interviewees’ normalization of requiring medication on a lifelong basis could be seen to reflect acceptance of their illness, the necessity of ongoing medication to treat the illness and a degree of integration of the illness and medication into their lives. Indeed, Brodie evaluates taking antipsychotic medication on a nightly basis neutrally (“you’ve gotta take it every night of the week, which is ok”). The following extract reflects a consumer’s significant insight, not just relating to the nature of schizophrenia and the need for medical treatment but to how the medication works and how the schedule can be tailored to specific circumstances. Travis is talking about how he is presently lowering his dosage of medication in collaboration with his prescriber: Travis, 19/02/2009 T: Yeah, yeah I’m just slowly doing it, you know but um, you know, I’m very in touch now with where I am. In the above extract, Travis states that he has the self-awareness to recognize in vivo when his illness symptoms are worsening (“I’m very in touch now with where I am. He reports an appropriate response to perceived fluctuations in symptoms, involving contacting his doctor to discuss whether his medication schedule should be tailored to his situation, enabling early intervention. The extract reflects a complex understanding of the mechanism of medication, as well as early warning signs for relapse and 105 Travis’ initiation of an intervention response. It almost goes beyond acceptance or awareness of the need for lifelong medication and towards integration into everyday life and an attempt to gain the most from the medication schedule. This level of insight, current insight in particular (as opposed to retrospective), was uncommon amongst interviewees. The following extract is also from the interview with Travis and, again, reflects insight beyond an awareness of the need for lifelong medication to treat schizophrenia. The extract is in the context of Travis talking about what he thinks is the best approach to lowering medication dosages. Travis, 19/02/2009 T: Well you know, I’m not a doctor but I think that the best way to do it is to slowly reduce it and feel where you’re at, you know. If you start feeling a bit panicky, just stop it there for a while and let it set in a bit and then, I’m feeling alright now. Like with me, I just lowered my tablets, 50mg, it took me about two months just to get my panicking down, you know, so it’s a lot easier for me because I’m experiencing this and I know what’s going on but if you’re someone who’s just become ill, or even two years of being ill, you know, these things are hard to accept and that can very easily make you get annoyed and just go off the rails and chuck it altogether. Travis states that when he first had his medication dosage decreased, his symptoms, particularly anxiety, became worse and it took him two months to adapt to the lower dosage and stabilise. Travis indicates that whilst he was able to deal with the instability for two months, other consumers, especially those who are newly diagnosed or have not been ill for 106 long, may find such experiences “hard to accept” and become “annoyed”. Travis suggests that a frustrated response to setbacks, such as symptom fluctuations in response to lowering medication dosages, could potentially influence consumers to become non-adherent (“chuck it altogether”) and “go off the rails”. Travis’ personal account seems to reflect not only an acceptance of having a mental illness which requires ongoing medication, but also an acceptance of the limitations of medication. There is perhaps scope for service providers to have a role in communicating the limitations of medication to consumers upon diagnosis, such as that it may not work immediately, it may not eliminate symptoms altogether, it is not a cure and it may cause side effects.
Injuries to the collecting system of the kidney usually are due to significant trauma order isoptin 40mg fast delivery blood pressure 9040, except in the pediatric population for the reasons mentioned above buy isoptin 40 mg online blood pressure for 12 year old. Administration of intravenous contrast often is nec- essary to document these injuries, since they usually are not seen on a plain abdominal x-ray or ultrasound examination and urinalysis may be normal (Table 38. Thus, a normal urinalysis in the trauma setting does not exclude serious urologic injury. Renal Artery Emboli Renal artery emboli can result secondary to mitral valve disease, atrial fibrillation, acute myocardial infarction, endocarditis, and cardiac tumors. In addition, atherosclerotic aortic disease and thrombi originating in renal artery aneurysms have been known to cause renal artery emboli (Table 38. Ureteral and renal pelvic injuries from external trauma: diagnosis and man- agement. The use of indwelling ureteral stents in managing ureteral injuries due to external violence. Ureteral and renal pelvic injuries from external trauma: diagnosis and management. The use of indwelling ureteral stents in managing ureteral injuries due to external violence. Patients who present with renal artery emboli usually are med- ically unstable or recently have suffered a cardiac event. Surgical Number of Operative outcome (%) mortality Institution patients Cured Improved Failed (%) Bowman Gray 152 15 75 10 1. Renal artery angiogram demonstrating normal right renal vascu- lature and abrupt cutoff of left renal artery due to emboli. For bilateral renal artery emboli or emboli to a solitary kidney, streptokinase catheter embolectomy or surgical treatment may be necessary. Nonurologic Causes Other problems that cause flank pain that should be considered by the clinician include intraabdominal pathology that secondarily results in flank pain. Since the kidneys are related anatomically to the colon, pancreas, spleen, ovaries, and psoas muscle, pathology involving these organs can produce flank pain. Usually, the abdom- inal symptoms are the primary complaint of the patient in these situations. Musculoskeletal causes of flank pain are not uncommon and also need to be considered. Most patients with a musculoskeletal cause of flank pain present with pain of long-standing duration (12 weeks or more). In contrast to flank pain secondary to a urologic cause, muscu- loskeletal pain tends to be localized more medially, below the costal margin and above the inferior gluteal folds, with or without leg pain (sciatica). Barone Psychological If the evaluation of a patient with flank pain is normal and the patient continues to complain of pain and seeks narcotic medication for relief of symptoms, consider drug-seeking behavior or Munchausen syn- drome. These patients are well aware of the clinical presentation of stone disease and have been known to put a drop of blood from a pricked finger in the urine to simulate microscopic hematuria. Such patients may have an “allergy” to all nonnarcotic analgesics and some- times indicate the narcotic that works best for them. Such patients also have brought in small stones that they recently have “passed” in the urine. Patients with drug-seeking behavior or Munchausen syndrome should not be given narcotics; however, psychiatric evalua- tion is recommended. History and Physical Examination History The history is the most important component of the evaluation of the patient with flank pain. Long-standing, dull pain is more typical of an infectious, malignant, or congenital problem. Acute, severe pain is characteristic of renal colic and most commonly results from an acute obstruction of the urinary tract due to a calculus, as seen in the case presented. It is not uncommon for patients with renal colic to complain of prior stone episodes, since calculi tend to reoccur in up to 60% of patients. These symptoms are due to irritation of the peri- toneum and distention of the renal capsule. Nausea and vomiting, therefore, can occur with most causes of flank pain; however, it is most severe when the flank pain is acute and severe, such as from a renal calculi. Associated urinary frequency and urgency are common with many causes of flank pain and are due to pain that is referred to the bladder area.
And order 120 mg isoptin with mastercard blood pressure factors, unfortunately quality isoptin 120 mg blood pressure kidney, most people aren’t aware of when and how these underlying assump- tions can derail the most serious and sincere efforts for making changes. The quizzes in this section are designed to help you discover whether any change-blocking beliefs create obstacles on your road to change. After the quizzes, you can find an exercise that assists you in ridding yourself of these beliefs through careful, honest analysis of whether each belief helps or hurts you. Detecting beliefs standing in your way People resist change because they are afraid, feel they don’t deserve something better, and/or view themselves as helpless to do anything about their circumstances. Unknowingly holding any of these beliefs will inevitably impede your progress toward change. So take the following three quizzes to see which, if any, of these barriers exist in your mind. Put a check mark next to each statement in Worksheets 3-1, 3-2, and 3-3 that you feel applies to you. Part I: Analyzing Angst and Preparing a Plan 32 Worksheet 3-1 The Fear of Change Quiz ❏ 1. Doing something about my problems would somehow discount the importance of the trauma that has happened in my life. Now that you’ve taken the quizzes, you can probably see if any of these beliefs dwell in your mind. If you checked two or more items in The Fear of Change Quiz, you probably get scared at the thought of changing. If you checked two or more items from The Underlying Undeserving Belief Quiz, you may feel that you don’t deserve the good things that could come to you if you were to change. Chapter 3: Overcoming Obstacles to Change 33 If you checked two or more items from The Unfair, Unjust Belief Quiz, you may dwell so much on how you’re suffering that you have trouble marshalling the resources for making changes. If, by chance, you checked two or more items in two or more quizzes, well, you have a little work cut out for you. People pick up on these ideas as children or through traumatic events at any time in their lives. And some change- blocking beliefs have a touch of truth to them; for instance, Life is often unfair. You can succeed in the things you do, and you can move past the bad things that have happened to you. Even if you’ve experienced horrific trauma, moving on doesn’t diminish the significance of what you experienced. Lately, she’s been sleeping poorly; her youngest child has asthma, and Jasmine finds herself listening to the child’s breathing throughout the night. Her oldest son is an exchange student in another country and rarely calls home, so images of him being hurt or kidnapped float through Jasmine’s mind throughout the day. Her doctor is concerned about her rising blood pressure, so Jasmine decides to work on her anxiety and stress. She takes the three change-blocking beliefs quizzes (presented earlier in this section) and discovers a variety of change-blocking beliefs, although the fear and undeserv- ing beliefs predominate. She then fills in her Top Three Change-Blocking Beliefs Summary, which you can see in Worksheet 3-4. Next, Jasmine jots down her reflections on both this exercise and the change-blocking beliefs she’s identified in the summary (see Worksheet 3-5). Worksheet 3-5 Jasmine’s Reflections I can see that I do have some of these change-blocking beliefs. But now that I reflect on it, I guess I can see how these beliefs could get in the way of doing something about my problems. Part I: Analyzing Angst and Preparing a Plan 34 In the next section, Jasmine sees what she can do about her problematic beliefs. But before jumping to her resolution, try filling out your own Top Three Change-Blocking Beliefs Summary in Worksheet 3-6. Go back to the three change-blocking belief quizzes and look at the items you checked. Then write down the three beliefs that seem to be the most trou- bling and the most likely to get in the way of your ability to make changes. Worksheet 3-7 My Reflections Blasting through beliefs blocking your path After completing the exercises in the last section, you should have an idea of which change- blocking beliefs may be holding up your progress.
