Curative Intent Treatment for Colorectal Cancer With Isolated Brain Metastases: A Case Report

Case Presentation

Our patient is a 65-year-old man who presented initially to the neurosurgery clinic in 8/2011 after noticing difficulty with his vision. His past-medical history was positive only for hypertension. He had no previous surgical history, no prior colonoscopies and no family history of colon cancer. His only gastrointestinal complaint was chronic mild constipation, and he denied any melena, hematochezia, changes in bowel pattern or weight loss. On exam, he was noted to have a left lower quadrant visual field loss (left inferior quadrantanopsia). A brain MRI showed an enhancement lesion in the right occipital lobe. Three days after his clinic visit he underwent a right occipital craniotomy with resection of the tumor, with intraoperative concern for incomplete resection. Pathology results were positive for adenocarcinoma with signet ring features. Tumor cells were positive for CK20 and negative for CK7 and TTF1, suggestive of a colorectal primary lesion.

A CT of the chest, abdominal and pelvis, PET and MRI of the liver were obtained, showing a mass in the proximal ascending colon and pericolonic adenopathy but no other evidence of metastatic disease. A colonoscopy demonstrated an ascending colon mass and biopsies of the lesion revealed poorly differentiated adenocarcinoma with signet ring features. CEA was markedly elevated at 140.8 ng / mL. Three weeks after the brain metastasis resection, he underwent a laparoscopic right hemi- colectomy. Pathology confirmed moderately differentiated adenocarcinoma extending into the pericolonic fat. The surgical margins were negative for tumor, and one of thirty-one lymph nodes was involved by adenocarcinoma. The cancer was classified as stage IV disease by virtue of the central nervous system (CNS) metastases (T3 N1a M1a). The patient underwent stereotactic radiosurgery (SRS) targeted to the postoperative intracranial tumor bed (5 isocenter plan to dose of 17 Gy) 6 weeks after the initial neurosurgical operation. This was followed by 12 cycles of systemic chemotherapy (FOLFOX).

Brain MRI at three months after SRS was negative, but at six months from SRS and eight months from initial presentation, there was evidence of tumor recurrence at the occipital surgical site on MRI accompanied by a rise in CEA. He was treated with partial brain fractionated radiation to the operative bed (30 Gy in 10 fractions). Continued surveillance MRI imaging subsequently has shown no evidence of persistent or recurrent disease in the brain.

Following fractated radiotherapy, patient was offered additional chemotherapy or a watch and wait approach, and elected to defer additional chemotherapy at that time. Surveillance CT imaging of the abdomen was normal until 12 months after presentation when there was evidence of local recurrence at the ileocolonic anastomosis and at two abdominal port sites, again accompanied by a rise in CEA to 828.1 ng / mL. These were treated with surgical excision and a new ileocolic anastomosis created. After recovery, he was treated with FOLFIRI with Cetuximab. The patient recovered and is doing well without evidence of any additional recurrence. Continued surveillance is necessary however as there remains a significant risk of local site recurrence (3-15% [8]) and intracranial recurrence (up to 50%) in patients with similar treatments. He continues to be followed closely with serial surveillance imaging (body CT and brain MRI), colonoscopy and laboratory studies including CEA, now 29 months after presentation (Dec 2013). He has no neurologic deficits including no sensory, motor, visual or cognitive impairments.

Discussion

Metastatic colon cancer to the liver or the lung traditionally carried a poor prognosis with a median survival of 12 months. The incorporation of surgical resection of the metastases, neoadjuvant and adjuvant chemotherapy, ablative and targeted radiotherapy have transformed the management in such patients from a palliative to a curative approach [9]. Management of liver and lung metastases with CRC is now well established, with surgical resection for curative intent being the treatment of choice in selected patients with distant metastases and recurrences in whom the primary tumor is well controlled [10,11]. Complete resection can increase 5-year survival to 30-50% in liver metastases and 40% in lung metastases [8]. In contrast, BM in patients with CRC still carries a disqual prognosis, with a median survival of two months from the date of diagnosis [12,13] that extends up to 5.4 months with treatment. This is in part secondary to their late presentation, and presence of concomitant lung and liver metastases when discovered. Management of BM is still unclear and is usually determined by the extracranial disease progression and response to chemotherapy, since most of the patients die from their extracranial disease [14,15]. The management of locoregional recurrent colon cancer is more clearly defined, with surgical resection in appropriate candidates offering an opportunity for curative therapy [16,10].

Treatment goals in presence of BM range from a conservative / palliative approach to an aggressive / curative one. In such cases where few or no randomized trials are available, it is reasonable to make clinical decisions based on the patient's life expectancy, treatment options currently available, and on the main prognostic factors identified in the literature. Among those, the Karnofsky performance status (KPS) (7070), age (6565 years), control of primary tumor, absence of extracranial metastases and number of brain lesions [17]. Recursive partitioning analysis (RPA) has been used to evaluate patient survival when patients were classified in three prognostic classes. RPA Class I patients with KPS of 70 or greater, age 65 years or younger, controlled primary tumor and absence of systemic metastases, had a median survival of 7.1 months [14,18] .Considering these prognostic factors, our patient would be classified as RPA class I and was a good candidate for a curative treatment regimen.

Multiple approaches have been tried to manage BM. Surgical resection has the benefit of providing tissue for diagnosis and prolonging survival in patients with BM from CRC, with the main drawback being neurologic deficiencies [11]. Initial treatment strategies combined surgery with whole brain radiation therapy (WBRT) in efforts to decrease recurrence rates, however studies did not improve overall survival [10,19,20]. In addition, the complications incurred by WBRT included an increase in long-term neurotoxicity and decrease quality of life [21]. These complications of WBRT and enhancement in the field of radiation therapy have led to alternative radiation treatment modalities such as stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (hfSRT) that focus therapy on the tumor bed and spare normal brain tissue from potential toxicity.

In our case, SRS was chosen as an adjuvant therapy due to concern for initial incomplete resection, obtaining the local control benefit of combined radiation and surgery, but avoiding the toxicity of WBRT. To our knowledge, no randomized controlled trials have compared surgery with WBRT to surgery with SRS in patients with BM from CRC. However, several retrospective studies on patients BM and varying primary malignancies treated with surgery and adjuvant SRS are available, and have demonstrated similar results in survival and local intracranial recurrence similar to WBRT although with higher rates of distant brain recurrences [22-24]. In patients who do develop intracranial recurrence, studies shown that salvage SRS provided an extended survival in selected patients in whom the major prognostic factors such as RPA class are favorable [25].

Hypofractionated stereotactic radiotherapy can be an alternative to SRS in large or anatomically challenging lesions allowing higher cumulative radiation doses to the tumor. Although the use of hypofractionated radiation as a salvage therapy has not been rigorously evaluated, there have been similar results between use of SRS and hfSRT as adjuvant therapies in terms of local and distant control, survival and recurrences, and need for salvage therapy [26, 27].

Chemotherapy is indicated for patients with CRC and high-risk features, local or distant metastatic spread [28-30]. Although its benefit in BM was initially thought to be limited because of the anatomical barriers: the blood-tumor and blood-brain barriers, a recent retrospective study showed that administration of chemotherapy after local control of BM in patients with CRC was associated with a statistically significant increase in overall survival, and was the most powerful independent prognostic factor for survival after BM [31]. These results are encouraging, and will hopefully provide additional studies with a prospective design to further clarify the role of chemotherapy in relation to brain metastases beyond the well documented benefit for reduction in risk of systemic metastases.

Conclusion

Significant progress has been made over the last two decades in management of patients with metastatic colon cancer, leading to curative treatment of patients previously terminated to palliative therapies. This has largely been restricted to patients with limited metastatic disease of the abdomen, liver or lungs, however our case demonstrates that with some patients more aggressive therapy can be extended to include patients with brain metastases with excellent outcomes. Prospective studies are still needed to unify the management of BM in CRC patients, particularly in patients with early and isolated BM, and well-controlled primary tumor site. Unfortunately, these studies will be limited by the small number of cases available. For now, the management should be individualized to each patient, considering prognostic factors and patient's preferences. The best patient care will be achieved by a good communication between the multidisciplinary groups involved in the treatment including the gastroenterologist, neurosurgeon, colorectal surgeon, radiation oncologist and medical oncologist, with the goal to achieve control of the primary tumor, any additional systemic disease and the local brain tumor. It is clear however that the diagnosis of isolated brain metastases is no longer a contraindication to curative intent therapy in selected patients.

References

1. Cascino TL, Leavengood JM, Kemeny N, Posner JB (1983) Brain metastases from colon cancer. J Neurooncol 1: 203-209.

2. Sundermeyer ML, Meropol NJ, Rogatko A, Wang H, Cohen SJ (2005) Changing patterns of bone and brain metastases in patients with colorectal cancer. Clin Colorectal Cancer 5: 108-113.

3. Mongan JP, Fadul CE, Cole BF, Zaki BI, Suriawinata AA, et al. (2009). Brain metastases from colorectal cancer: risk factors, incidence, and the possible role of chemokines. Clin Colorectal Cancer 8: 100-105.

4. Temple DF, Ledesma EJ, Mittelman A (1982) Cerebral metastases. From adenocarcinoma of the colon and rectum. NY State J Med 82: 1812-1814.

5. Ruiz-Tovar J, Tartas A, Ramos JL, MiramÃnn J, Limones M (2010) Cranial metastases: first sign of colorectal cancer. Is the resection of the primary non-complicated tumor indicated when the metastases have been resected? ClinTranslOncol 12: 154-156.

6. GÃmemez Raposo C, Mora Rillo M, GÃmemez Senent S, Robles Maruhenda A, Montoya F, et al. (2007) Brain metastases as the first sign of colon cancer. ClinTranslOncol 9: 742-743.

7. Succi L, Urrico GS, Prumeri S, Politi A, Latteri F (2000) Brain metastasis: first sign of colorectal carcinoma. ChirItal 52: 419-420.

8. Akiyoshi T, Fujimoto Y, Konishi T, Kuroyanagi H, Ueno M, et al. (2011) Prognostic factors for survival after salvage surgery for locoregional recurrence of colon cancer. Am J Surg 201: 726-733.

9. Ku G, Tan IB, Yau T, Boku N, Laohavinij S, et al. (2012) Management of colon cancer: resource-stratified guidelines from the Asian Oncology Summit 2012. Lancet Oncol 13: e470-481.

10. Garden OJ, Rees M, Poston GJ, Mirza D, Saunders M, et al. (2006) Guidelines for resection of colorectal cancer liver metastases. Gut 55: iii-8.

11. National Comprehensive Cancer Network (NCCN) (2014) Guidelines for Coloncancer v3.

12. Patchell RA, Tibbs PA, Regine WF, Dempsey RJ, Mohiuddin M, et al. (1998) Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA 280: 1485-1489.

13. Farnell GF, Buckner JC, Cascino TL, O'Connell MJ, Schomberg PJ, et al. (1996) Brain metastases from colorectal carcinoma. The long term survivors. Cancer 78: 711-716.

14. Jung M, Ahn JB, Chang JH, Suh CO, Hong S, et al. (2011) Brain metastases from colorectal carcinoma: prognostic factors and output. J Neurooncol 101: 49-55.

15. Noordijk EM, Vecht CJ, Haaxma-Reiche H, Padberg GW, Voormolen JH, et al. (1994) The choice of treatment of single brain metastasis should be based on extracranialtumor activity and age. Int J RadiatOncolBiolPhys 29: 711-717.

16. Harji DP, Sagar PM, Boyle K, Griffiths B, McArthur DR, et al. (2013). Surgical resection of recurrent colonic cancer. Br J Surg 100: 950-958.

17. Gaspar L, Scott C, Rotman M, Asbell S, Phillips T, et al. (1997). Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J RadiatOncolBiolPhys 37: 745-751

18. Gaspar LE, Scott C, Murray K, Curran W (2000) Validation of the RTOG recursive partitioning analysis (RPA) classification for brain metastases. Int J RadiatOncolBiolPhys 47: 1001-1006.

19. Bradley KA, Mehta MP (2004) Management of brain metastases. Semin Oncol 31: 693-701.

20. Kocher M, Soffietti R, Abacioglu U, Villa S, Fauchon F, et al. (2011). Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of 1-3 cerebral metastases: results of the EORTC 22952-26001 study. J ClinOncol 2011 29: 134-141.

21. Sun A, Bae K, Gore EM, Movsas B, Wong SJ, et al. (2011) Phase III trial of prophylactic cranial irradiation compared with observation in patients with locally advanced non-small-cell lung cancer: neurocognitive and quality-of-life analysis. J ClinOncol 29: 279-286.

22. Rwigema JC, Wegner RE, Mintz AH, Paravati AJ, Burton SA, et al. (2011) Stereotactic radiosurgery to the resection cavity of brain metastases: a retrospective analysis and literature review. StereotactFunctNeurosurg 89: 329-337.

23. Karlovits BJ, Quigley MR, Karlovits SM, Miller L, Johnson M, et al. (2009). Stereotactic radiosurgery boost to the resection bed for oligometastatic brain disease: challenging the tradition of adjuvant whole-brain radiotherapy. Neurosurg Focus 27: E7.

24. Jagannathan J, Yen CP, Ray DK, Schlesinger D, Oskouian RJ, et al. (2009) Gamma Knife radiosurgery to the surgical cavity following resection of brain metastases. J Neurosurg 111: 431-438.

25. Kwon KY, Kong DS, Lee JI, Nam DH, Park K, et al. (2007) Outcome of repeated radiosurgery for recurrent metastatic brain tumors. ClinNeurolNeurosurg 109: 132-137.

26. Steinmann D, Maertens B, Janssen S, Werner M, Frühauf J, et al. (2012). Hypofractionated stereotactic radiotherapy (hfSRT) after tumor resection of a single brain metastasis: report of a single-center individualized treatment approach J Cancer Res Clin Oncol: 1523-1529.

27. Fokas E, Henzel M, Surber G, Kleinert G, Hamm K, et al. (2012). Stereotactic radiosurgery and fractionated stereotactic radiotherapy: comparison of efficiency and toxicity in 260 patients with brain metastases J Neurooncol 109: 91-98.

28. Benson AB, Bekaii-Saab T, Chan E, Chen YJ, Choti MA, et al. (2012) Rectal cancer. J NatlComprCancNetw 10: 1528-1564.

29. Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, et al. (2008). Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomized controlled trial. Lancet1007-1016.

30. Riquet M, Foucault C, Cazes A, Mitry E, Dujon A, et al. (2010) Pulmonary resection for metastases of colorectal adenocarcinoma. Ann ThoracSurg 89: 375-380.

31. Baek JY, Kang MH, Hong YS, Kim TW, Kim DY, et al. (2011) Characteristics and prognosis of patients with colorectal cancer-associated brain metastases in the era of modern systemic chemotherapy. J Neurooncol 104: 745-753.

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Why Should You Prefer Herbal Medicines?

Have you been trying to gain or lose weight since quite some time now? Do you find it difficult to handle your current body posture? Do you want to be improved in each and every sense? Are you tired of trying to lose or gain weight?

If you have already experienced the rude and uncouth side effects of allopathic medicines, it is time for you to shift to Ayurveda, a process wherein the researchers use all sorts of natural herbs to help you get rid of your current health related issues. When you are over or under weight, it is certainly a major health related issue. You try your best to do every possible thing to lose or gain weight. However, it seems difficult and almost impossible. Since there are hundreds of side-effects of allopathic medicines that are available in the market to ease your efforts, you do not prefer using them.

Does this mean you would never be able to get the figure that you have always been dreaming of? No, we have a solution and that is the natural pills. Such medicines are manufactured by using the process of Ayurveda, and there are almost no side-effects of the same.

Following are some of the most major reasons why people prefer herbal medicines over other kinds of medicines:

  1. Natural pills take some time to act on the body and since you know that it is working toill the roots of the problem.
  2. When you stop the consumption of herbal medicines, you do not get eaten by the earlier issues for which you began with the intake of the same.
  3. Herbal medicines are best for those who believe in nature and wish to be natural, always!
  4. Such medicines are not too strong and since people belonging to different age groups consume them. For an instance, there are many herbal cough syrups for the infants as well.
  5. You would never get allergic to any of the herbal medicine (unless there are manufacturing defects in the same)
  6. Natural pills are not very expensive.
  7. There are hundreds of different companies that are into the manufacturing of natural medicines and since you get a wide variety to choose from.
  8. No matter what health related problem you are going through, natural things are able to help you get rid of the same.

Some people may think that herbal medicines work slower than allopathic medicines. However, these doctors take some time to cure the problem from its roots so that it does not recur.

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You’ve Been Diagnosed With COPD – What Next?

If you have recently been diagnosed with COPD, or Chronic Obstructive Pulmonary Disease, then you may be struggling with trying to figure out what to expect. Making an appointment with one of the best pulmonary doctors in your area is the first step in understanding what comes next. Here are a few things to help you begin the self-education process about COPD so that you can manage your treatment effectively.

What is COPD?

To understand COPD, it is often helpful to go letter by letter. The term chronic means that the disease does not go away, either symptoms are recurring or never completely subside. Obstructive implications that your air passages are partly obstructed or blocked, making it difficult to breathe. Finally pulmonary refers to the fact that the disease affects the lungs and airways. It is also important to understand that this is a progressive disease. In other words, it will get worn over time. To understand how these works, it helps to understand a bit about the anatomy of the lungs.

Healthy Airways

When a healthy person breathes, the air goes down the trachea into the bronchial tubes which branch into their lungs. These can be thought of as being similar to an upside down tree in shape, with branches that continue to get smaller. At the end of each branch is a cluster of air sacs known as the alveoli.

When you breathe, air is distributed through these progressively smaller branches into the alveoli, which sends oxygen to the bloodstream and exports it with carbon dioxide to be exhaled. What allows this to work is the elasticity of the alveoli. In healthy lungs, they inflate and deflate like very small balloons.

COPD-Affected Airways

When someone suffices from COPD, the flow of air in and out of the airways becomes inhibited for a number of reasons. For one, the alveoli may lose their elasticity due to age or infrequent use, the walls between the individual air sacs may become destroyed, inflamed, or swollen, or the airways may produce more mucus than normal, causing an obstruction in the passes leading to and from the alveoli.

As a result, breathing becomes more difficult and labored because the exchange rate between oxygen going in and carbon dioxide goes out of the body becomes diminished. Your body does not receive the oxygen it needs to function properly, and carbon dioxide, a potentially hazardous substance can build up in the body.

Symptoms

As with any disease, symptoms will naturally vary. However, common symptoms often start months or years before the patient realizes their airflow has been compromised. However, common manifestations include a chronic dry cough, with large amounts of mucus, known as a 'smoker's cough', shortness of breath, wheezing or other sounds from the lungs, and tightness in the chest.

The end result is that your everyday activities, such as bathing, cooking meals, dressing, or brushing your teeth become more difficult. Patients often have to rest for several hours to recover from a fairly benign outing, or simple tasks like doing dishes. Your tolerance to both activity and other infections is greatly reduced. COPD sufferers are more likely to contract the cold, flu, or pneumonia, causing further implications of the illness.

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Understanding a Diuretic And Anti-Inflammatory Pill

A diuretic and anti-inflammatory pill is an herbal remedy that was injected by Lee Xiaoping, a Chinese doctor. The pill has been invented to be effective in curing many male diseases that affect the genitourinary system.

Some of the diseases that the pill cures include: prostatitis, orchitis, epididymitis, vesiculitis, chlamydia, and male infertility that is caused by oligospermatism and necrospermia.

Ingredients

The pill contains different ingredients that work together in ensuring that you heal from the disease that you are suffering from. The most unique thing about the pill is it contains varying amounts of Chinese active ingredients.

Some of the most important elements are: Plantago seed, Dianthus superbus, talcum, Houttuynia cordata, Polygonum aviculare, herba laminariae, pangolin, saffron, semen persicae, honeysuckle, lignum aquilariae, etc

Formulas

There are many active ingredients in the pill. The most common ones are:

Plantain seed : it's sweet in flavor and easily enters the kidney, bladder, lungs, and liver. The herb is used in alleviating water retention, improving eyesight, clearing away heat, and eliminating phlegm.

It's usually recommended when you are suffering from hematuria, urinary stoppage, morbid leucorrhea, damp diseases, phlegmatic cough, conjunctival congestion and arthritis.

Pink herb : this one is bitter and easily enters the heart, small intestine, kidney, and urinary bladder. It's used in removing blood stasis, alleviating water retention, and dredging meridian. It's recommended in treating gonorrhea, edema, swelling, acute eczema, corneal opacity, and conjunctival congestion.

Peach seed : it has a bitter taste and just like the other herbs, it easily enters the heart, liver and large intestine. It's used in expelling stasis, activating blood stagnation, and moisturizing pathogenic dryness.

It's usually indicated in amenorrhea, wandering arthritis, traumatic injuries, blood stasis, febrile diseases, and blood dryness.

Chinese angelica : it has a sweet but pungent flavor and easily enters the heart, liver, and spleen meridian. It's used in regulating menstruation, relieving pain, nourishing blood, moisturizing pathogenic dryness, and adjusting spirit.

It's usually prescribed when you are suffering from vertigo, intensive dryness, dysentery, tenesmus, carbuncle, furuncle, and hemastasthenic headache.

Cowherb seed : it's bitter in flavor and enters the liver and stomach meridians. It's used in promoting blood circulation, lactation, and astringing sores. It's prescribed when you are suffering from dystocia, swelling, amenorrhea or lactation disturbance.

Conclusion

This is what you need to know about a diuretic and anti-infection pill. When buying the pills you need to be cautious. As rule of thumb you should ensure that you buy them from official websites.

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Things to Know About Cord Blood Banking

Patients who suffer from serious blood disorders can benefit from the stem cell transplants. Read on the article to find more information about it.

Umbilical cord and plaque which was once considered as medical waste and discarded after the child birth has gained lifesaving status these days. Researchers found out that the blood remained in the umbilical vein is rich in stem cells. This led to the practice of banking for stem cell research and transplants purposes. If you are an expectant parent who does not know much about this banking, here is a simple guide to help you out. Go ahead and take a look.

  1. What is cord blood?

    The primary function of an umbilical vein is to carry oxygenated and nutrient rich blood from the plaque to the fetus. Blood present in the umbilical cord and placenta is termed as cord blood (CB) which contains all essential elements of blood along with the stem cells. After the childbirth, this blood is discharged from the umbilical vein.

  2. Why bank cord blood?

    Umbilical cord blood has been used to treat more than 80 disorders. However, the clinical application of CB in regenerative medicine and stem cell research has been offering promising results to fight neurological diseases and injuries in near future. Cord tissues consist of Mesenchymal Stem Cells (MSCs), while it is enriched with haematopoietic stem cells (HSCs). Both the tissue and blood is used for standard therapies, clinical trials and experimental treatments. It enriched with blood forming cells makes it a safer alternative to bone marrow transplants. Families with a medical history of genetic inherited diseases can definitely benefit from the services.

  3. Where is cord blood stored?

    You can store at public bank or at privately owned facilities. If you wish to donate CB for medical research or lifesaving transplants, public banking is the right choice. The service which is available at free of cost in public banks does not provide any link between your baby and the donated.On the other hand, if you wish to store your newborn's cord blood for future purpose, contact a private bank. They can store it solely for the use of the donor and his family at a competitive cost.

These are some of the basic factors you need to know before deciding whether or not to opt for cord blood banking. Although, it is strongly recommended to have a brief discussion with your doctor when taking the decision regarding the CB banking.

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Common Facts About Psoriasis Skin Condition

Psoriasis is a skin ailment that is responsible to the person who acquires it and is considered by dermatologists to be an immune system disease. Although persons who have this disease usually have red marks on the skin and lesions, the disease is not in any way contagious. The condition occurs when the immune system is triggered causing skin cells to reproduce at an abnormal rate. The abnormal growth rate of skin cells coupled with certain immune reactions causes the flaky skin that persons with psoriasis usually have.

Given that, the condition is unique to each individual that has it and only genes and immune reactions play a role in its occurrence it is there before impossible for one individual to transfer it to another. It can occur in any individual at any age but is more precalent in Caucasians than dark skinned people and in persons between the age of 9 and 35.

Psoriasis can occur on any part of the body but is most common on the chest, knees and elbows and on the scalp. Other regions include the palms and soles, genitals and the face. A common indicator that the skin condition is psoriasis is the fact that the inflammation and lesions usually occur symmetrically. This means on similar regions but on the right and left sides of the body. One can identify the condition given the skin's appearance but a test by a dermatologist is mandatory for positive diagnosis of the condition.

Usually the doctor takes a piece of skin from the affected patients and examines it under a microscope. The condition can not be identified through any other method so be wary of doctors who may require you to do additional tests. This may be a method to extort money from you or is an indication they may be quacks. Ensure you make an informed decision before consenting to take a blood test or any other test.

Once a positive diagnosis is given, the doctor and the patient embark on treatment variations to find the one that works for the patient. This is because there is not single treatment for the condition. Since it is unique to each person that acquires it with regard to triggers, the treatment methods also differs. The good news is there are many treatment options available from ointments to natural remedies. Although the condition has no cure, once you find a treatment option that works, the psoriasis can clear after some time. Once this happens the patient will be placed on a regiment of treatments to prevent it being triggered back.

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All Natural Remedies – Let’s Get a Second Opinion!

At one time, natural remedies were the primary method people used in the treatment of various aches or pains, along with many other ailments.

Then, along came technology and the advancement of chemical science. Medical researchers are developing fast-acting, synthetic compounds to treat our health problems, faster than you can blink. These pharmaceuticals are easily prescribed to treat our symptoms and alleviate our discomfort.

Yes, in most cases, they do bring speedy relief. However, they usually leave the actual ailment untreated, plus … many of these synthetic substances very often have dangerous side effects, which can require additional substances to treat the side effects.

Natural remedies, as we know, are found in nature. They do not require any type of synthetic process to create them and they usually address the real cause of a specific ailment, by using all natural processes.

There are many problems that can be eliminated, just by making slight adjustments to your current lifestyle. These could include your habits and the way you exercise. By changing the way you perform these few things, are often the number one solution to the cause of the ailment.

In many other cases, using a natural remedy, could be the most effective way to bring a body back to a natural state of balance.

Very few people will find a sure-fire relief for their problem, by looking to the medical world alone. So, it's really better if you discuss “all” options with your doctor.

Our government protects the drug company monopolies and dismisses the use of natural treatment options!

Why, you ask? It could possibly be the fact that there's very little profit in using a natural treatment, since natural remedies are often self-administered and a lot less expensive, while synthetic drugs are a multi-billion dollar industry.

During the recent Ebola panic, we've never heard very much about any natural ways to fight against this disease.

Also, what hospital will treat an ailment or disease with an all natural product? Where's the profit in that?

Now, I'm not saying that every ailment can be treated with natural remedies, but … If the ailment can be treated this way, should not it be presented as an option to drugs?

Surely, it's not all about the money … is it?

Another problem that many people find disturbing, is the high cost of insurance.

Many elderly people, that need the care of a special physician. The problem is they just can not afford the co-pay.

There are stories of patients that have been admitted to the hospital for a problem. The insurance took care of the majority of the bill, yet canceled the insurance shortly after. Is this right?

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How to Buy Ayurvedic Products Online

Buy Ayurvedic Products Online

With each passing year, the popularity of Ayurveda is growing by leaps and bounds. Now, Ayurvedic products can be bought online too. The global business of Ayurveda is pegged at a whopping at $ 100Billion and the markets are growing. What has made Ayurveda so popular? The idea of ​​holistic healing and safe medicines, most of which is herbal and natural substances has appeared to the new found 'Back to Nature' idealism sweeping the globe.

An ancient science

Ayurveda is a 5,000 year old system of medicine from India. Ayurveda concentrates on health and wellness. Ayurveda, literally means the science of life (In Sanskrit, Ayur means Life and Veda means Science). Ayurveda developed and evolved into what it is today from several ancient treatises. Ancient Vedic literature is testimony to the scientific aspect of Ayurveda. The sages has clearly laid out instructions to maintain health as well as fighting illness through therapies, massages, herbal medicines, diet control and exercise.

Modern relevance

Ayurvedic therapies are fashioned for healing and wellness. The procedures include steam bath, medications, oil massage, dry massage, herbal packs etc. which rejuvenates both body and mind. With the mind and body cleansed and toned, Ayurveda makes one feel lighter, younger and generally more energetic. The most attractive feature about Ayurveda is that being natural; it has no side effects at all.

For the same reason, more and more people are turning to organic way of life and herbal medicines. Today, Ayurveda has spread to different corners of the world. People still flock to Ayurvedic centers in the Indian subcontinent for authentic Ayurveda treatments. Some come just to try the new way of wellness and are so impressed that they tell their friends and send them to these centers. Authentic Ayurveda has made inroads overseas too with clinics and Ayurvedic practitioners in major cities. People who can not get it in their vicinity can turn to the online stores for Ayurvedic products.

Buying Ayurvedic Products online

Buying ayurvedic products online has to be done with caution. Some ayurvedic medicines have been found to have impermissible levels of hard metals like Arsenic and lead. Look for the GMP stamp on the products from India. This quality standard by the Government of India ensures that a host of quality parameters are met in the manufacturing process like hygiene, safety and standard operating procedures with stringent quality checks at different stages of production. Some packs may not display the stamp and yet may be GMP certified. So, look the manufacturer up before you make a decision.

Quality standards

Generally, ayurvedic products are made through long processes which have been stamped in the ancient texts. Charaka Samhita an Ayurveda text had given impetus to standardization and quality control. The quality control processes were in place for each and every aspect of procurement, storage and preparation of medicines. The ancient sages wave ampteen importance to the origin of the raw materials used. There were specific seasons to collect the herbs and other organic stuff like honey. The people who collected the herbs from forests also had a key role and importance. The Acharyas (ancient Gurus) knew that all these had to be followed if the medicine were to have the desired result. With time some quacks and irresponsible Vaidya (Doctors) did not comply with these standards and the markets had a lot of poor quality medicines. To check this, the Indian government has laid out the quality standards to be maintained by Ayurvedic production units. It is advisable to buy ayurvedic products only from GMP manufacturers to be on safe side.

How Ayurveda treats you

Ayurveda believes that the human body is afflicted with health problems due to the imbalance of doshas (humours) in the body. The three doshas are Vata (Air), Pitta (Bile) and Kapha (Phlegm). A person is assessed by the Vaid (Ayurvedic Doctor) to know his / her Prakriti (constitution). A person's Prakriti is defined by the balance of the three Doshas. One can consult an Ayurvedic doctor online to know the Prakriti if one can not have a face to face consultation. The medicines try to put the balance back in order. There are four main classifications of management of disease in Ayurveda:

• Shodan, or cleansing

• Shaman or palliatiive

• Rasayana, or rejuvenation

• Satvajaya, or mental hygiene

The metabolism of the body is center to the Ayurvedic treatment. Most diseases are the effects of poor digestion and absorption of nutrition by the body unless caused by an external virus or bacteria. Purgation, therefore is part of Ayurvedic treatment and so is perfecting digestion. Ayurvedic treatment may involve diet restrictions for a better effect of the medicines. Exercises or Yoga with Ayurveda is also advised in some cases.

Types of Ayurvedic Medicines

Ayurvedic medicines come in various forms like tablets, powders, pastes, ointments, oils, creams, tonics etc. Some Ayurvedic drugs are for wellness while others are for treatment of specific diseases or disorders. Some Ayurvedic products like Triphala or Chavanaprash may be taken daily for maintaining good health. Ayurveda has been proved to be very helpful in the treatment and management of lifestyle disorders like Diabetes, High Blood Pressure (Hypertension) and Obesity. Chronic ailments like Constipation, Pile and Arthritis; Skin problems like Psoriasis and leucoderma have effective solutions in Ayurveda. Preventive and restorative Ayurvedic products are now being used by people across the world. Cosmetic care by Ayurveda has taken the imagination and fancy of the fashion and health conscious. Turmeric one of the most popular herbs is now being cultured in different parts of the world to meet the rising demand.

Modern Clinical trials and studies

Ayurveda has stood the test of time. New research and studies on Ayurveda by institutions around the world are waking up to the efficacy of Ayurvedic Medicines. Various studies have shown that Ayurveda is really helpful in combating Diabetes and High Cholesterol. Neurological problems also have better results when treated with Ayurvedic medicines.

Advantages of Ayurveda

• Ayurveda is holistic and therefore improves physical, mental and psychological conditions.

• Ayurveda is natural remedy with 75% herbs and organic matter

• Side effects for Ayurvedic medicine are few and far between

• Ayurveda delivers effective cure for many chronic diseases

• Ayurvedic therapies provide relief from stress and rejuvenating the body

• Ayurvedic drugs are largely cheaper

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Kidney Stone Treatment Using Natural Ways

When we talk about the best home treatment for kidney stones, this is definitely available for sufferers who need to eliminate the triggered pain and discomfort. However, it is very important to learn that home remedies are excellent when the stones are still in moderate condition.

In most cases, sufferers want to discover the best treatment when they reveal the symptoms after discussing with doctor. When diagnosed with this kind of problem, the common symptoms may include vomiting, fever, nausea, difficulty when urinating with blood, severe lower abdominal pain and a sufferer may chill. These particular signs are indicating that the stones are huge already.

The usual natural treatment to reduce the pain includes drinking enough of water because this helps the kidneys to pass out the stones without extreme pain. Remember that there are cases involving patients who suffered from kidney stones due to dehydration. This condition happens because the body lacks fluid and so the stones can easily develop. To avoid this kind of concern, it is best to drink at least 10-12 glasses of water daily than the usual 6-8 glasses. This is very important to keep the urine clear and advances the development of kidney stones effectively.

Although we can discover various types of natural treatments, people who are suffering from heart ailments or liver problem must consult to a doctor before taking any step. On the other hand, we can still say that the available home remedies for gout are very effective, safe and affordable to consider. By simply following the exact guidelines when treating kidney stones naturally, it is definitely possible to eliminate them without undergoing expensive medical treatment.

Another effective kidney stone treatment can likewise include the available over the counter (OTC) medicines. However, it is very important to learn these medicines can only provide temporary relief. Taking medicines can reduce the pain when passing out the stones, but not permanently. In most cases, the available OTC drugs may include Aspirin, Ibuprofen, Advil and Motrin. While taking any of these pain relievers, it is also necessary to eat the right kinds of foods. Keep in mind that a person who is suffering from this type of health condition needs to follow a proper diet regimen to live a normal life again.

Choosing the exact kidney stones treatment can help a sufferer to relieve the chronic pain, especially when passing out the stone with extreme pain. Again, there are different types of home remedies for kidney stones and they may benefit a particular sufferer in preventing or curing the problem effectively and without spending more money.

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An Introduction to Ayurvedic Treatment

Introduction to Ayurveda

Ayurvedic medicine, also known as Ayurveda, is one of the world's oldest holistic healing systems. It was developed thousands of years ago in India. It is based on the principle belief that health and wellness depend on a delicate balance between the mind, body, and spirit.

The prime aim of Ayurveda is to achieve good health, rather than fighting the disease.

Ayurveda Concepts

According to Ayurveda everything in the world, living or not, is connected. Good health can only be achieved when your mind, body and spirit is in harmony with the universe. In Ayurveda anything that may affect your physical, spiritual and emotional well being may cause you to be out of balance with the universe. Some things that can cause a disruption include:

  • Genetic or birth defects
  • Injuries
  • Climate and seasonal changes
  • Age
  • Emotions

How your body works to keep you healthy and your unique physical and psychological characteristics combine to form your body's constitution, or Prakriti. Your Prakriti is believed to stay the same for your entire life. However, how you digest food and eliminate waste can influence it.

Every person is composed of five basic elements found in the universe

  • Space
  • Air
  • Fire
  • Water
  • Earth

These elements combine to form Doshas, ​​the three life forces or energies. The Doshas controls how your body works. The three Doshas are

  • Vata (Space and air)
  • Pitta (Fire and water)
  • Kapha (Water and earth)

Everyone inherits a unique combination of these three Doshas. One Dosha is usually more dominant. Each Dosha serves as means to control different body functions. The chances of getting sick are linked to the balance of your Doshas.

Vata Dosha

Vata Dosha is thought to be the most powerful of the three Doshas. It controls very basic body functions such as cell division. It also controls the mind, breathing, blood flow, heart function and waste ejection in the intestines.

Things that cause disruption to this Dosha are fear, grief, staying up too late, consumption of dry food and eating too soon after a previous meal.

If Vata Dosha is more dominant in your body, you are likely to develop anxiety, asthma, heart diseases, nervous system disorders, skin problems and Rheumatoid arthritis, a disease affecting the joints.

Pitta Dosha

Pitta Dosha controls digestion, metabolism and certain hormones that are linked to appetite.

Things that throw pitta Dosha out of control are eating sour and spicy food, fatigue and prolonged exposure to sun.

If Pitta Dosha is more dominant in your body, you are likely to develop anger and negative emotions, heart disease, heart-burn few hours after eating, high blood pressure, infections and Crohn's disease, a chronic inflammatory disease.

Kapha Dosha

Kapha Dosha controls muscle growth, body strength and stability, weight and the immune system.

Things that disrupt this Dosha are daytime sleeping, eating after your stomach is full, consuming too much sweet, salty and water like foods, and greed.

If Kapha Dosha is more dominant in your body, you are likely to develop asthma and other breathing disorders, cancer, diabetes, nausea after food and overweight.

Ayurvedic treatment

The first step to Ayurveda treatment is to determine your dominant Dosha and the balance among the other non dominant ones.

Ayurvedic treatment depends on your unique Prakriti, your dominant Dosha and the balance between all the three of them. The main goal of Ayurvedic treatment is to cleanse your body of the undigested food. This cleansing process is called Panchakarma.

Panchakarma is a Sanskrit word that means “five actions” or “five treatments”. It reduces any symptoms and helps to re-establish harmony and balance in the body. Panchakarma includes three parts.

Poorva Karma consists of:

  • Paachan (Digestion)
  • Snehan (Internal and external oleation)
  • Swedan (Fomentation)

Pradhan Karma consists of:

  • Vaman (induced vomiting)
  • Virechan (induced purgation)
  • Vasti (Medicated enema)
  • Nasya (Nasal medicine)
  • Rakta Moesha (Artificial bloodletting)

Pradhan Karma is the main method in the process of panchakarma.

Pashchat Karma

This consists of Sansarjan Krama (Specific dietetics), Dhuma-Pana (Herbal fumigation) and some rules to follow while doing specific activities.

Pashchat Karma includes the post-curing measures.

Benefits of Panchakarma

  • Removes the root cause of disease
  • Balances the bodily Humor Vata, Pitta and Kapha
  • Improvements Immunity
  • Balance the Nervous system, Blood circulatory system, Digestive system and also as well as Physiological equilibrium
  • Remove the To toxins located at the week point of body
  • Increases Mental and Physical efficiency
  • Increases skin glow
  • Reduces extra fat
  • Remove insomnia, anxiety and mental problem
  • Increases loss of vigour and stamina
  • Increases joint mobility

Ayurvedic Medicine

The herbs commonly used in the manufacture of Ayurvedic medicines are highly nutritive with a lot of healing properties. Today, Ayurveda and its herbal treatment flourish side by side with homeopathic and Western conventional medicine. Ayurvedic drugs are said to have no side effects. Each herb is unique in its medicinal properties and has a good aroma and flavor. It acts as a perfect mechanism in bringing a balanced harmony between the mind and spirit. When compared to other synthetic drugs, Ayurvedic herbal medicines do not cause any side effects. It works effectively fighting against various infections and diseases and theseby provides quick and easy recovery.

Ayurvedic science focuses on both the external and internal features rather than simply focusing on curing a disease. They renew the whole system rather than the focus being concentrated towards a specific organ of the body.

Benefits of Ayurvedic medicine

  • Building Immunity
  • Better Healing
  • Reducing Stress
  • Cleansing the Body
  • Achieving Overall Balance

The Ayurvedic approach is holistic, so thereafter after an Ayurvedic treatment, the patient will experience an improvement in the physical, mental and psychological conditions. The ingredients used in Ayurvedic medicines are mostly derived from herbs, plants, flowers, fruits etc. making it a remedy close to nature. Ayurveda has been found to be an effective cure for many chronic diseases and has practically no side effects. Compared to other methods of treatment, Ayurvedic approach can bring out wellness to the entire body, and is found to be effective for a prolonged time period. It is based on the fact that “Prevention is better than cure”.

Ayurvedic medicines are effective even for healthy people as they areorative in nature and helps in nourishing the body and enhancing the mental abilities. Ayurvedic therapies can give relief from stress and rejuvenating the body. Ayurvedic treatment is affordable and is comparatively cheaper compared to other systems of medicine.

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Is A Poinsettia Plant Really Dangerous?

The myths and rumors about how toxic the poinsettia plant is are very common late in the year, around the holiday season, when the popular red leaved plants take center stage as festive holiday decorations. While the genus otherwise known as the (Euphorbia) to which the poinsettia plant loves does have some highly toxic plants, the popular plant poinsettia itself is not a toxic plant. Some sources say that the rumor about the dangers of poinsettia leaves to a case of poisoning in 1919 that led to the death of a young two year-old child. At the time, the cause of the poisoning was incorrectly determined to be a poinsettia leaf.

The primary resource used by the major of poison control centers nationwide state that a child who weighed 50 pounds would have to eat well over 500 poinsettia leaves to reach an even potential toxic dose of compounds in the poinsettia plant. Doctors conducted a study of 22,793 reported cases of poinsettia exposures, the majority of reported cases (93%) of which occurred in children and found that 92% of those who were exposed did not even develop any symptoms at all. 96% of those who were exposed were not even treated in a health care facility. Furthermore, no deaths resulting from the poinsettia ingestion have ever been documented. There has been some false determinations, but these were later corrected.

Even though an accidental ingestion of poinsettia plant leaves will not damage your body or kill you, it could still lead to nausea and vomiting in some rare cases. Since the taste of the poinsettia plant leaves is reportedly very unpleasant, it is very unquestionably that a child or an animal who attempts to eat or chew the plant leaves will continue to do so after the first taste. While ingestion of any house plants is never a very good idea some popular plants can be extremely dangerous when eaten. Parents and care givers of young children can be assured that the poinsettia plants leaves are not a dangerous risk in the home.

So in conclusion, the answer to is it fact or fiction that poinsettia plant leaves are dangerous, the answer would be no. It is that time of year again, so have no concerns about setting out a poinsettia plant as part of your holiday decorations. This study was conducted by doctors at the Children's Hospital of Pittsburgh and the Pittsburgh Poison Center.

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Creating a Better System of Communication in Healthcare

One of the biggest challenges that the health industry as a whole currently is faced with is creating a system of communication that is transparent and does not have so many barriers.

It's been said that one of the main reasons why patients file a medical malpractice claim is the lack of communication. This could either be a break in communication between doctor and patient or a communication failure between all medical professionals involved in the patient's care.

There is already a lack of trust in the medical profession due to reports about hospitals overcharging patients for procedures. There are also media stories regarding medical errors that are not being reported. It's time to regain back that trust and bring back the human touch to healthcare.

With all the different technologies and apps that are being used now, that adds another layer of challenges for effective communication between people. Many people now prefer to communicate digitally, which creates issues of security and privacy between medical professionals and patients. This is especially the case for electronic health records (EHR) where there is always the potential for hackers or third parties to gain access to people's information.

So what can be done to improve communication in the healthcare industry so that patients receive better care?

Offer communications skills training – It's typically not a class you would see as part of a healthcare professional's ongoing education curriculum, but communication happens every day between people. Whether it's verbal, non-verbal, or written, communication skills are vital and can be the difference between a patient receiving quality care and a patient who is not satisfied and files for malpractice.

Simplifying technology surrounding electronic health records (EHR) – Patients have a right to view their health records, but gaining access to them can be a challenge. Other issues with EHRs include:

  • Not being able to access the EHR via the Internet
  • Cumbersome technology that is time-consuming for medical professionals
  • Inaccurate information about patients because of template-based notes

Be thorough during patient handoffs – The transfer of responsibility for a hospitalized patient from one resident to another can often be interrupted or rushed, which can contribute to miscommunication and errors. Sign-outs are often done via email, text, or written notes. Aim for handoffs that are face-to-face or via phone. Sometimes there are important details about a patient that can come up in conversation that would not otherwise have been communicated.

Developing a system of consistent communication and trust will take time and commitment by everyone within an organization. Is it possible? Yes, but it will require a change in mindset and habits.

What other tips would you add to improve communication in healthcare?

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5 Reasons Why You Shouldn’t Ignore A Possible Bacterial Infection

The human body is full of bacteria. Most bacteria inside and outside are beneficial and friendly to the human body and its various functions. For example, there are friendly and necessary bacteria that live in the digestive system and help to break down food and aid in digestive process. Some bacteria though are not beneficial and an occurrence may lead to a bacterial infection.

Understanding Bacteria

Bacteria are living organisms. They are one-celled organizations that are so small that hundreds if not thousands fit onto a fingernail. Depending on the bacteria, it may be in a shape of a rod, ball, or spiral. As mentioned above, most bacteria are friendly to the human body and its functions. Bacteria aid in digestion, help to kill disease, and even assist in vitamin absorption.

Nearly 99% of bacteria are good or friendly bacteria. The one percent that can cause infection however, can truly wreak havoc on the unlucky person. Common ailments caused by bacteria are the common cold, strep throat, and urinary tract infections.

Types Of Bacterial Infections

Bacterial infections can be found to affect almost any part of the human body and its functions. There are bacterial infections of the eye, stomach, respiratory system, even skin and blood. Sometimes the infection is spread through social contact, poorly prepared food, or through an open or untreated wound. Some infections may only last a short duration; the body's immune system is able to effectively fight off the non friendly bacteria. In other instances, the infection may linger and continue to worsen until a doctor is able to diagnose and treat the infection. This may be through home treatment or antibiotics.

Risks Of Bacterial Infections

Unlike a virus, which needs a host in order to survive, a bacterium is an independent organism that can thrive in near environment. Because of this, when an illness producing bacteria enters the human body, there is a strong chance that it will thrive and reproduce. What create the infection are the toxins that are given off by the bacteria. These toxins damage tissue and extremely lead to the symptoms of the possible infection.

Antibiotics Are not Always The Answer

When it comes to treating a bacterial infection, antibiotics are often the course of treatment. There are different classes of antibiotics to treat the varying scope of bacterial infection, from pervasive to localized. However, there are some conditions such as meningitis or pneumonia that can be viral or bacterial. Tests for the cause are necessary, as for viral conditions; antibiotics are not always the answer. When an infection of any sort is suspected, it is recommended to visit the doctor's office for appropriate tests, diagnosis, next steps and treatments, whether antibiotics are prescribed or not.

Trusted Medical Professional

Having a trusted doctor or nurse to turn to when signs of a possible bacterial infection are at hand is a good thing. Not only is it beneficial for obtaining the necessary tests, treatments, and education on preventing or stopping the spread of the infection, but also provides someone who has a detailed medical file. This knowledge helps to effectively diagnose and treat illness.

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Marijuana Can Benefit Millions In Pain

Amendment 2 or the right to Medical Marijuana would make the use of medical marijuana legal under certain health conditions. Patients or caregivers with an issued license by a physician would also be allowed to attend registered marijuana treatment centers (Ballotpedia 2014). Not just anyone can get a medical marijuana license though. Individuals must be diagnosed with a “debilitating medical condition” such as cancer, HIV or glaucoma. The Florida Department of Health would be responsible for regulating medical marijuana and it would also issue identification cards and develop procedures for treatment centers. In the following passes I will discuss the pros and cons of marijuana, how poor people can obtain it if they can not afford it and how I personally feel about amendment 2 and the legalization of marijuana.

Medical marijuana has many health benefits such as relieving chronic pain due to an illness or relieving stress after a long or busy day. The evidence is proven by research that marijuana can provide certain types of pain, nausea, vomiting, and other debilitating symptoms caused by such illnesses as cancer and AIDS in patients all around the globe (ProCon 2014). Sanjay Gupta, MD, Chief Medical Correspondent for CNN stated that marijuana does not have a high potential for abuse and there are very legitimate applications. Also “Sometimes marijuana is the only thing that works”, said Gupta. Arthritis is another common disease, usually in older adults, with no current cure and marijuana has been proven to help alleviate the symptoms of this disease as well. Rheumatology reported in 2006 that “In comparison with the placebo, the CBM [cannabis-based medicine] produced statistically significant improvements in pain on movement, pain at rest and quality of sleep (ProCon 2014). , there are still those who disagree and argument that the legalization of medical marijuana would be harmful to society.

The ones who are against Amendment 2 and the legal use of marijuana argument it may be detrimental to society by causing an increase in crime. Bishop Ron Allen claimed that marijuana would increase crime and poverty in Berkeley and he explains, “Research tells us that marijuana has the same effects on the pleasure central system in the brain as heroin and crack cocaine.” (OpposingViews 2014) Supporters of marijuana like Mason Tvert, of the Marijuana Policy Project disagree with Allen, stating that Allen did not know what he was talking about and marijuana has been proven to be less toxic and less addictive than other drugs. “The fact is that Medical associations across the country and more than 80% of Americans think marijuana can help seriously people people (Opposing Views) states Tvert.” A study conducted by the University of Texas at Dallas found that legalized marijuana may reduce crimes like robbery and homicide (Ferner 2014).

Another downfall of marijuana is that it is said to be a gateway or stepping stone to other harmful drugs such as cocaine or heroine. The Eagle Forum mentioned in a statement that “Since THC is continuously in the body the” high “from pot typically diminishes so pot smokers typically take other drugs to get a kick (ProCon 2014).” Sue Rosche, Founder and President of the National Families in Action says, “This issue received intense press coverage and California's teens got the message, their past month marijuana use increased by nearly one-third that year, from 6.5% to 9.2% according to the National Household Survey on Drug Abuse. It's still continuing to rise: 1997-6.8%, 1998-7.4, and 1999-8.4%. Even if the use of marijuana continues to rise and it is legalized, how will the poor households obtain it if they can not afford it?

The City of Berkeley, Calif. recently announced a new law in which marijuana dispensaries will have to donate 2% of their cannabis to low-income people starting in August of next year (OpposingViews). This could be a good law that other states like Florida can use to regulate to use of marijuana if they do decide to make it legal. With the donation law, poor individuals can get access to the marijuana they need which is known to sell for at least $ 400 an ounce in California. This price is only the street value of the plant-form (what you smoke) of medical marijuana, so other forms such as liquid or extracted may cost more. The most important part about state regulation is that poor families with “debilitating medical conditions” will have a way to obtain the medical marijuana they need to alleviate their symptoms.

With all the factual evidence pointing to the amazing benefits of medical marijuana, I agree and vote yes on amendment 2 which will legalize medical marijuana. I have a grandmother who has epilepsy seizures and if a dose of prescribed marijuana will help alleviate her or any other patient's symptoms, why not give her or other patients dosages by pill? The Epilepsy Foundation released a statement earlier this year that supported the rights of patients and families living with seizures and epilepsy to access physician-directed care, including marijuana (OpposingViews). There is no factual evidence of anyone dying from marijuana and my research mostly mostly positive benefits. Weighing out the benefits of medical marijuana and the fact that poor households may have a way to obtain it, gives the state of Florida all the reasons and factual evidence it needs to legalize marijuana.

Sources:

1. Ballotpedia “Florida Right to Medical Marijuana Initiative, Amendment 2 (2014)

2. Procon.org October 2014

3. Opposing Views “Bishop Ron Allen Claims Medical Marijuana Will Increase Crime Poverty” 4 Sept. 2014

4. Ferner, M. “Legalizing Medical Marijuana May Actually Reduce Crime, Study Says” Huffington Post 27 March 2014

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Things to Consider When Choosing a Primary Care Physician

Taking charge of your healthcare is imperative no matter how old you are. One of the most important decisions you can make is choosing a great Primary care physician. The primary care physician is on the front lines of your healthcare and can be the difference between receiving early intervention, delayed diagnosis or misdiagnosis. Therefore, there are several questions you should consider before choosing your doctor.

What insurances is your doctor in network with?

• In today's world, insurance is the driving force for healthcare. Physicians complain that they do not receive enough reimbursements for their services and patients complain that nothing is covered.

Choosing the physician that accepts your insurance can be the difference in a $ 50 copay or $ 10 copay.

What is your doctor's availability during an emergency? If he can not attend to you immediately, who will cover for him?

• It is important to consider the physician's office hours as well as how well he handles situations after hours. Many doctors use an answering service after hours but, you should ask what his average response time is if you have an emergency. You should also be able to meet the physician who covers for your doctor during emergencies, vacations and afterhours.

What is your doctor's education? Is he board certified? How long has he practicing primary care?

• When it comes to doctors, nothing is more important than experience. You want a doctor that has seen it all and has deal with problems effectively. His education is certainly a close second as is demonstrating that he has been certified by the state to practice family or primary care medicine.

Does your doctor have any sub specialties?

• You would be surprised as to how many primary care physicians have subspecialties in many different areas like: HIV, Dermatology and gynecology. This information is important because you should know the amount of you physician's experience.

What languages ​​does your doctor speak?

• All doctors practicing medicine in the United States should be able to communicate effectively in English. Moreover, patients should be able to clearly understand what his physician is saying so that there is no miscommunication on important issues with your health. Some patients feel more comfortable in communicating in their native language therefore they should find a doctor that can speak their native tongue.

What is the average time spent waiting during appointments? What is the average time spent with his patients?

• In my many years in the pharmaceutical industry, I have witnessed primary care physicians seeing 45 to 50 patients per day. Some doctors are simply concerned with seeing as many patients as possible in order to bill for as many services they can. The average time spent with their patients did not exceed 10 minutes. Make sure your doctor can spend time with you discussing your health (physical and mental) and medicines.

What hospital is your doctor associated with?

• Knowing the hospital your doctor is associated with is very important because hospital is where you will most likely end up if you have an emergency. Investigate if that hospital has sufficient resources to deal with any future health issues that may arise.

Does your doctor communicate effectively with you?

• When it comes to communication with your doctor, being able to express your thoughts freely is important. You must be able to discuss, openly, what you are feeling, physically and mentally, so that he can correctly diagnose your problem.

Do you feel your doctor has a philosophy of treatment that is in-line with yours?

• Make sure you research how your doctor approaches medicine. There are doctors that prefer to treat preventatively; others may choose a more holistic approach while others have a more wait and see approach to medicine. It is important that you know this because it will save you from major heads down the road when you need second opinions.

In conclusion, choosing a primary care physician is an important undertaking that should not be taken lightly. Communication is a two way street that you must feel comfortable traveling down with your physician. Your Primary care physician is the center of your healthcare network and will refer you to specialists should you have the need.

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