By H. Fasim. A. T. Still University. 2018.
When we have thus given the Materia Medica a review 50 mg elavil with mastercard, we will be better able to make a classification elavil 10mg fast delivery. In all acute, and most chronic diseases, our examination of the patient and our therapeutics will take this order: 1. With reference to the condition of the stomach and intestinal canal - bringing them to as nearly a normal condition as possible, that remedies may be kindly received and appropriated, and that sufficient food may be taken and digested. With reference to the circulation of the blood, and the temperature - obtaining a normal circulation as regards frequency and freedom, and a temperature as near 98° as possible. With reference to the presence of a zymotic poison, or other cause of disease - which may be neutralized, antagonized or removed. With reference to the processes of waste and excretion - that the worn-out or enfeebled material may be broken down and speedily removed from the body. With reference to blood- making and repair - that proper material be furnished for the building of tissue, and that the processes of nutrition are normally conducted. These are general outlines for the study of disease, and the action of remedies in antagonizing it, and may aid in giving direction to our study, and enable each one to make a classification of remedies for himself. It must be in such condition that it will receive remedies kindly, and permit their speedy absorption, in order that they give us the desired results. Surely, it is not difficult to see the necessity of this, if we take no further view than to obtain the curative action of remedies. If the stomach does not receive a remedy kindly, is irritated by it, we can not expect ready absorption, or the complete curative action. If the stomach throws out its juices, which digest or decompose a remedy, we can not expect its curative action. If the stomach is secreting mucus in large quantity, if it is in that condition in which it is but a receptacle or retainer, then we can not expect the ready absorption of remedies, and will not get their curative action. We are accustomed to specify two conditions of the stomach, which may be tolerably easily determined by constant symptoms, and which should always be corrected. These are: - Irritation of the stomach, marked by a reddened (bright) tongue, elongated and pointed, with sometimes reddened and erect papillæ. It is accompanied with unpleasant sensations of constriction, and tenderness on pressure over the epigastrium. Its treatment takes precedence of everything else, for until removed we can not expect the kindly or definite action of remedies. The remedies employed for its removal are: minute doses of Aconite; small doses of Ipecac or Lobelia; Hydrocyanic Acid, or better, a preparation of the bark of the Peach tree; Rhubarb; Bismuth. These may be aided by the external use of the cold pack, hot fomentations, or rubefacient application, and sometimes an enema to remove the torpor of the lower bowel. But, the reader may ask, why if remedies are specific, name so many for the relief of so simple a pathological condition as gastric irritation? Each of these remedies has a direct action in this condition, and each may be relied upon as a remedy. We choose the remedy, however, with reference to the association of diseased action, and in some cases one will be found best, in others another. The atonic stomach, with increased secretion of mucus, and sometimes with considerable accumulations. It is marked by the broad tongue, heavily coated at its base, bad taste in the mouth, and feeling of weight and heaviness in the epigastrium. It needs to be prompt and thorough in action, not producing debility or leaving the organ irritable. If not requiring this, we may accomplish the same object by the use of the Alkaline Sulphites, followed by Nux Vomica. We have many minor lesions that can not be classified under these, to which we will find single remedies specific. Increased mucous secretion with impaired functional activity, minute doses of Podophyllin, etc. We recognize the fact, that just in proportion to the variation of the circulation and temperature from the normal standard is the severity and activity of disease. The more frequent the pulse, and the higher the temperature, the more active a zymotic poison, the more rapid the progress of local or general disease, and the less able the body to protect itself, or expel the cause of disease. In therapeutics we find - that just in proportion as the circulation and temperature can be, brought to, and ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ * See Practice of Medicine, page 27. These facts must surely have been noticed by observers, and we can only wonder that they have never been clearly stated, and practiced upon. If we take as an example a case of fever, we will find that remedies that will reduce the pulse to a normal frequency, giving freedom to the circulation, will reduce the temperature, and that just in proportion as this is accomplished, the febrile symptoms disappear, and the various vital functions are re-established. If we maintain the circulation and temperature at this point, the fever must certainly cease. In acute inflammation, the rapidity of the local disease and destruction of tissue, is in the ratio of frequency of pulse and increase of temperature. Just in proportion as we get a normal circulation with reference to frequency and freedom, and diminished temperature, just in that proportion the inflammatory process is arrested. In asthenic inflammation we find another element in the pathology of the disease - a want of vital power, either in the whole or in the part.
Think of the kidneys as a colander full of tiny holes of various sizes that let certain things through them but not bigger things buy generic elavil 25 mg. These holes are constantly being adjusted by the adrenals which sit right on top of the kidneys and “supervise” generic 50mg elavil free shipping. If the elderly person is not producing four cups of urine in a day (24 hours), it is not enough. Use the kidney herb recipe—but only half a dose (so it will take six weeks instead of three to see good effects). As the tiny “colander” holes open up there is freer flow and many more trips to the bathroom result. Now that water and wastes (urea and uric acid and other acids) can leave the body quickly through more holes, it takes less pressure from the heart to get blood pushed through the kidneys. If too much is drunk at once, especially on the first day, a stomach ache can develop and a pressure felt in the bladder that is most uncomfortable. Go extra slow on the first few days, even though you find it quite tasty, so there is no discomfort (only lots of bathroom visits). Keep track of this twice a day with a modern electronic finger device (not an arm cuff that itself can break blood vessels). Cut down on drug diuretics gradually, using only ¾ dose the first day, then ½ dose, then ¼ dose. The amount of urine produced or the weight of the person can be used to assess how effective your method is. Again, mood will improve dramatically when diuretic drugs are removed for your loved one. With a parasite and pollution-free heart and a low-resistance, freely flowing kidney, some reserve strength will soon be built up. Your loved one is walking better, needing less sleep, and a “golden age” finally arrives. It is free of pain, free of medicine, free of shots and doctor visits, free of dementia, free of the dreadful weakness that demands so much help. Seeing themselves gain strength and be able to do more for themselves gives the elderly a sense of pride. When they balk at having to take herbs or vegetable juice, remind them of the days they were on a handful of pills and still had heart fail- ure, pain and kidney disease. A shawl, a lap-blanket, woolen sweater, long underwear and fleecy thermal outerwear help a lot. It is much healthier to be warmly dressed and breathe cool air than to be lightly dressed in an 80°F room. Keep your elderly person warmly dressed, away from air conditioner or fan drafts, but keep it cool. Being comfortable, knowing you are there to care for them, brings out the best in your elderly person. This can be very rewarding if they are still able to communicate and distill their life experience into wisdom for you. If you can listen and be interested in their dis- tillations or their ramblings their longing for relationship will be fulfilled. Hearing Loss The hearing deficit in an elderly person is always much greater than they or you realize. The results of a hearing test, as it is told by a salesperson, is much more persuasive than you can be. Let the salesperson use his or her special talents to sell your loved one on hearing aids. Clogged hearing aids are the most troublesome feature of any of them—and never mentioned! Make it a rule to buy your batteries at the same hearing aid office where they are cleaned free of charge. Hearing loss is too subtle to leave to chance; have the hearing aids cleaned each time you buy fresh batteries (about three months). Take your loved one to a nurse for ear cleaning every six months after hearing aids are begun. With hearing aids that hear, and kidneys that flush and a heart that beats strongly, your elderly person may choose to attend concerts again, go to church or gatherings—and leave you out of the picture. If the excitement of a night out keeps him or her from sleeping use ornithine and valerian capsules. But if insomnia is the rule, not the exception, you need to go after it as a special problem. This leads me to believe it is their waste products, namely ammonia, that really causes insomnia. Your elderly person will have more energy throughout the day and a better mood if sleep was good.
You now have the ability to move past what has gone on previously and make the best decisions going forward buy discount elavil 75 mg online. This will allow you to deal with your stress in the best state of mind possible under the circumstances elavil 75mg for sale. The characteristic of equanimity is cultivated by two more questions that you should ask yourself in times of stress: • “What can I do, at this point in time, to best deal with the situation? You’re then able to access the greater wealth of intuitive wisdom that you have, that goes beyond the self-centered needs of your own inner child. Doing so will actually allow you to truly act in your own best interest during times of extreme stress. It’s Just Your Nature You are no different than an animal in the sense that you have a primal urge to be safe. You are programmed from the beginning of time to be aware of the dangers in the world, real or perceived and to act accordingly. When your mind starts to talk, criticize and judge, remember that this reflects a basic urge to protect yourself. Other Techniques for Stress Management • 147 Practice Like mindfulness, the techniques listed here take practice and development. When you become aware of your inner voice, write down what it’s saying on the left side of a sheet of paper, which you’ve divided vertically into three columns. When you see what your inner voice is saying in writing, you can often see that it’s being extreme, reactionary and is trying to scare you with the worst possible outcome. Practice equanimity today with a stressful situation you may have recently encountered, even if it was a minor one. Ask yourself these questions: “Can I change what has already happened in the past? Recognize that you have made the best decision that you could have made for who you were at that point in time. In fact, the sense of you as being an I“I”, a discrete entity or an individual, is constantly going through a process of creation and extinction. The “I” is not a solid permanent identity, but a fabricated, temporary, mental creation. Most of the time, your sense of your own identity as a unique, persisting, and separate being, is just not foremost in your mind or even required for that matter. You’re likely often present to what you experience without a sense of yourself as the inner “I” behind it. You hear the sounds of birds or cars, eat food, smell flowers, see the sun, go to the bathroom, walk, run, or drive with no conscious sense of an “I” who is doing these activities. At those times you’re just the process of doing something without a sense of an “I” who is doing the act. You don’t need to be self-aware or engage in a self-assessment during these activities commonly, so you don’t have a tendency to think, “I am driving” or “I am walking,” as you privately go about routine tasks. If you mindfully bring your awareness to the times when there is no “I” concept foremost in your mind, but rather just the process of doing something, you’ll see that the essential “you” naturally operates from a place of peace and equanimity. By continuing to bring your attention to this place, you’ll start to become familiar with this feeling. You’ll quickly come to recognize that, for much of the day, your sense of self, or 149 150 • Mindfulness Medication separate identity is just not needed. It’s interesting to see how the “I” is created in response to certain circumstances coming together. For example, if you forget to pay a bill, your mind starts to criticize you for your thoughtless action: The bill wasn’t paid. If you break this criticism down, it’s interesting to view the chain of events that occurs. A value judgment is placed on whatever you do by measuring it against your inner belief system, which in this circumstance states that it’s important to always pay bills on time. You adopted these values as a child to help guide your behaviour so that you would continue to be cared for and would not get into trouble. As a child you were very vulnerable and fundamentally feared abandonment or being overwhelmed. The inner critic, triggered by a violation of your belief system, quickly takes control to go from “this is bad” to “I am bad. It determines that the action was bad and generalizes, with the creation of the identity “I” that “I am bad. The “I” is created when there is a perceived threat to the integrity of your internalized belief system. It reflects how you think you should behave in the world to maintain a feeling of being loved and accepted.
This reflected an attempt to create a more equal and collaborative dynamic buy discount elavil 75mg online, in which interviewees were able to bring their own knowledge to bear on the questions in ways that I had not necessarily anticipated (Maxwell purchase 50 mg elavil free shipping, 2005). Some examples of questions that were included in the schedule are: What influences you to take/not take your antipsychotic medication? Following the collection of demographic information, an opening question that overviewed the topic and set the stage for the interview, was typically posed (although worded differently each time, the question was usually something along the lines of: Can you please tell me about your experiences with taking antipsychotic medication? Sometimes referred to as the “grand tour” question, this question was designed to elicit narratives detailing interviewees’ conceptions of the identified domain (Hesse-Biber & Leavy, 2004). There was no fixed ordering or wording of questions (except in the demographic information section). Questions tended to graduate from general to more particular in focus, largely dependent on interviewees’ responses. Due to the semi- structured nature of interviews, I, the interviewer, had the freedom to probe or prompt discussion of interesting issues that arose in vivo. Questions aimed to be open-ended and not leading in nature, however inevitably this was not always accomplished and my influence on the interview itself and potentially on the responses attained is undeniable. My training in Clinical Psychology equipped me with counselling skills which proved useful such as reflection or paraphrasing interviewees’ responses to ensure that my interpretation matched what the interviewee was intending to communicate (enhancing respondent validation), as well as rapport-building skills such as advanced empathy and unconditional positive regard. I collected field notes during and following interviews regarding my observations and impressions of participants and their responses. Interesting findings were noted, including tangential topics raised by 80 interviewees. These field notes influenced topics followed up on in subsequent interviews and helped to inform the analysis. As a quality check, after the pilot interview, I transcribed the recording immediately and distributed the transcription to my supervisory panel. I also listened to the interview several times to review my interview technique and the interview schedule. Whilst the interview was deemed satisfactory overall and data from it has been included in that anaylsis, several changes were subsequently made in my approach to interviews. As previously mentioned, interviews from thereon were one-to-one as opposed to involving two consumers at once. Moreover, the demographic information section of the interview was also recorded, as field notes indicated that crucial information was gathered at this stage but had not been recorded. I noticed that during the pilot interview I remained very close to my interview schedule and, thus, did not follow up on interesting information raised by interviewees, potentially limiting my findings. I also noticed that I did not probe interviewees enough and was quick to respond to interviewees perhaps as a result of feeling uncomfortable with silences. Although these flaws in my technique were inevitably not entirely resolved following the pilot interview, my awareness of them undoubtedly lead to an improvement in my technique, which actually continued to improve with experience and as I gained knowledge from interviewees. Interviews were then saved onto a computer and transcribed verbatim into a word processing document. More detailed transcriptions 81 were not required given research questions and the analytic approach. Albeit time- consuming, transcribing the interviews immersed me in the data and provided me with the opportunity to review and reflect on my interview technique. Transcribing was also a way for me to commence analysis, as I became aware of codes and categories within and across interviews and was, thus, able to follow up on these in subsequent interviews. I aimed to transcribe interviews as soon as possible following their occurrence and before further interviews were conducted. Whilst I still took notes during and post interviews and reflected on interviews after their completion, listening to them again when possible, I was aware that not having tangible transcripts of interviews meant that I could not begin formal coding, which requires line-by-line analysis. I, thus, decided to stop data collection after the completion of seven interviews in order to become up-to-date with transcribing, to review my technique and to begin formal coding. This process was in line with one of the core principles of grounded theory, which recommends that the researcher constantly shift between data collection and data analysis in order to strengthen theory generation (Glaser & Strauss, 1967). Yet to reach theoretical saturation, I then continued interviewing, equipped with a greater understanding of the consumer perspective and more areas identified in which to follow up. Having some coding categories in mind after analyzing early interviews, when I began interviewing again I was able to follow up on these and expand on them. I conducted the following interviews in a relatively short period of time, remaining as up-to-date with transcribing as possible, re-listening to 82 interviews when I was unable to transcribe them prior to the conduct of more interviews and continuing to write field notes and memos. Field notes and memos were written at various stages also to capture observations. Constant comparison took place throughout the coding process and is described below. Open coding involves identifying, naming, categorizing and describing phenomena found in text (Glaser & Strauss, 1967). Codes developed initially were concrete; that is, they were closely linked to the data and descriptive in nature. The properties of each code were elaborated in an attempt to describe and account for all incidences of the code in the data, while continually searching for new codes. Upon application of the same code, data were checked for consistency and that which did not fit pre-established codes were labelled as new codes.
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