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You should wash your hands after you use the restroom wondersleep 40c on line, after contacting obviously filthy surfaces discount wondersleep 40c free shipping, and before meals. Sometimes public health agencies may issue warnings to wash more frequently or even to wear masks in certain environments. And obviously, if you know someone who has a contagious disease, you’ll probably want to avoid close contact with that person. Chapter 16: Staying Healthy 245 But if you’re struggling to distinguish between what’s reasonable and what’s not, please see a mental-healthcare provider who can provide you with guid- ance. Recalculating the Costs and Benefits of Health Worry Take an honest look at your worry about health. Do you think that you are somehow responsible for keeping others safe and healthy? Is it by frequent trips to the doctor, time spent thinking about your health, or frequently asking others for reassurance? Whatever your personal expression of health anxiety is, the fol- lowing exercise will help. On a piece of paper, in your notebook, or in your computer file, write about your own health anxi- ety. Then, in a column on the left, write out all the benefits you believe that worrying about health gives you. Next, in a column on the right, write out all the possible costs your worry incurs. The following questions may help you discover the possible costs and benefits: ✓ How many times have I actually prevented what I fear the most? The following exam- ple of Arturo, a young man who worries excessively about getting sick from contaminated food, illustrates the cost/benefit analysis. He believes that processing food increases the risk of indus- trial contaminants, rodent droppings, bacteria, or viruses entering into the food supply. His primary-care doctor refers him to a psychologist who helps him develop the cost/benefit analysis shown in Table 16-1 regarding his con- cern about food contamination. Table 16-1 Arturo’s Cost/Benefit Analysis Benefits Costs I don’t eat contaminated food. No one can be safe all the time; I could get hit by lightning or some- thing and die early anyway. Furthermore, he sees that some of his perceived “benefits” for his worry are illusions. Thus, he could eat healthy food, stay slim, and still get sick whether he worries or not. Make lifestyle changes that matter and realize that excessive worries can, by themselves, make you sick. Seek professional help if your health concerns persist in spite of your best efforts. Chapter 16: Staying Healthy 247 Tabulating Risks of the Modern World In the early 1900s, you were lucky to live to age 50. People died of contagious diseases like tuberculosis and influenza or infections caused by simple inju- ries. Heart disease, dementias, and cancers were less likely to be the cause of death only because people succumbed to infections before reaching old age. People over 100 are the fastest-growing sector of the world population, with expectations that this segment will be over 6 million strong by mid-century.

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However buy discount wondersleep 40c line, if you’d like more bang for your buck buy generic wondersleep 40c on-line, take a few extra minutes and write about what you feel grateful for each day. Writing about your boons and blessings improves mood, increases optimism, and may benefit your health. Did your mother ever urge you to clean your plate because of the “starving kids in China? Chapter 4: Clearing the Roadblocks to Change 61 ✓ Nourishment: You probably aren’t starving to death, whereas (as your mother may have noted) millions are. Noticing and actively appreciating what’s right helps counteract that tendency and will make you feel better. Getting Help from Others If your problems with anxiety are significantly interfering with your life, you’re probably going to want to work with a mental-health professional in addition to reading this book. In the following two sections, we tell you what kind of treatment to ask for and give you a set of questions to ask a potential therapist before you begin treatment. Seeking the right therapies Mental-health professionals offer a wide variety of treatments. We’ve thor- oughly studied the research on what works for anxiety disorders so you don’t have to. People with anxiety often have distortions in the way they perceive events, and this approach helps you correct those distortions. For example, an anxious client may be overestimating the risks involved with flying. A cognitive approach would help her discover that the risks are small enough to war- rant tackling her fear. See Chapters 5, 6, and 7 for a thorough discussion about how cognitive therapy can be applied to your problems with anxiety. Using the previous example of the woman with a fear of flying, a behavior therapist would likely help the woman go through a series of steps related to flying such as watching movies of flying, going to the air- port, and eventually booking and taking a flight. Chapter 8 reviews how to bring behavior therapy principles to bear on your anxiety. See Chapter 9 for a discussion of the advantages and disadvantages of medication for anxiety. Seeking the right therapist In addition to knowing the right therapy, you need to know whom to look for. Start by making sure that the therapist you seek is licensed to provide mental-health services, whether as a counselor, psychiatrist, psychiatric nurse, psychologist, or social worker. Sources for finding one of these licensed practitioners include local professional associations (such as state psychology associations, state counselor associations, and so forth), your primary healthcare provider, your insurance company, or trusted friends and family who can recommend someone. After you’ve found someone who seems to fit the bill, be sure to ask the fol- lowing questions: ✓ What are your charges for services, and does my insurance cover them? After a few sessions, you should feel listened to and understood and sense that your therapist has legitimate empathy and concern for your well-being. Don’t hesitate to inquire about the nature of your treatment plan — that plan should make sense to you. Most therapists take a few weeks getting to know you before they formu- late an entire plan. If you’re uncomfortable for any reason, by all means seek a second opinion from another therapist. Research shows that how you feel about the relationship with your therapist makes a big difference in how well the therapy goes. Next you see how the very words you use to think about yourself and the world can intensify anxiety. The good news is that you can replace your worry words with more reasonable language.

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Special attention should be given to pressure areas in contact with the transfer board generic wondersleep 40c on line. Pressure-sensitive areas should be kept well lubricated and soft with hand cream or lotion 40c wondersleep otc. To increase understanding of the reasons for preventive measures, the patient is educated about the danger of pressure ulcers and is encouraged to take control and make decisions about appropriate skin care (Kinder, 2005). Because the patient has no sensation of bladder distention, overstretching of the bladder and detrusor muscle may occur, delaying the return of bladder function. At an early stage, family members are shown how to carry out intermittent catheterization and are encouraged to participate in this facet of care, because they will be involved in long- term follow-up and must be able to recognize complications so that treatment can be instituted. The patient is taught to record fluid intake, voiding pattern, amounts of residual urine after catheterization, characteristics of urine, and any unusual sensations that may occur. The management of a neurogenic bladder (bladder dysfunction that results from a disorder or dysfunction of the nervous system) is discussed in detail in Chapter 11. As soon as bowel sounds are heard on auscultation, the patient is given a high-calorie, high-protein, high-fiber diet, with the amount of food gradually increased. The nurse administers prescribed stool softeners to counteract the effects of immobility and analgesic agents. Providing Comfort Measures A patient who has had pins, tongs, or calipers placed for cervical stabilization may have a slight headache or discomfort for several days after the pins are inserted. Patients initially may be bothered by the rather startling appearance of these devices, but usually they readily adapt to it because the device provides comfort for the unstable neck. The patient may complain of being caged in and of noise created by any object coming in contact with the steel frame of a halo device, but he or she can be reassured that adaptation to such annoyances will occur. The Patient in Halo Traction The areas around the four pin sites of a halo device are cleaned daily and observed for redness, drainage, and pain. If one of the pins becomes detached, the head is stabilized in a neutral position by one person while another notifies the neurosurgeon. A torque screwdriver should be readily available in case the screws on the frame need tightening. The skin under the halo vest is inspected for excessive perspiration, redness, and skin blistering, especially on the bony prominences. The liner of the vest should not become wet, because dampness causes skin excoriation. Powder is not used inside the vest, because it may contribute to the development of pressure ulcers. If the patient is to be discharged with the vest, detailed instructions must be given to the family, with time allowed for them to return demonstrate the necessary skills of halo vest care (Chart 63-9). The circumferences of the thighs and calves are measured and recorded daily; further diagnostic studies are performed if a significant increase is noted. Patients remain at high risk for thrombophlebitis for several months after the initial injury. Patients with paraplegia or tetraplegia are at increased risk for the rest of their lives. Anticoagulation is initiated once head injury and other systemic injuries have been ruled out. Low-dose fractionated or unfractionated heparin may be followed by long- term oral anticoagulation (ie, warfarin) or subcutaneous fractionated heparin injections. Additional measures such as range-of-motion exercises, thigh-high elastic compression stockings, and adequate hydration are important preventive measures.

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