It's been said that aspirin is so powerful, if were just being introduced today, it might be available only as a prescription drug. But aspirin was introduced to the world in 1897, and the white tablets - touted for their pain-relieving, fever-reducing and anti-inflammatory properties - became readily available over the counter in 1900. A century later, aspirin is still one of the most popular remedies around the world, and nearly every month, it seems, the public reads about the discovery of new benefits for this familiar old drug.
Many physicians now advise their patients to take an aspirin every day - not for relief of pain, fever or inflammation - but to forestall cardiovascular problems. Is aspirin really the right remedy for everyone?
"For patients with known coronary heart disease or for those at risk for cardiovascular problems, I recommend a low-dose (81 mg) aspirin every day. They may not need it every day," he says, "but it's easier to remember if it becomes a daily habit." To prevent gastric upsets, he often suggests they take an enteric, or coated, tablet.
For Adults Only Low-dose aspirin is commonly referred to as children's or baby aspirin, although aspirin generally should not be taken by anyone under 18, Dr. Gutterman says, due to the risk of Reye's syndrome (R. Studies have shown that using aspirin or similar medications to treat viral illnesses like colds and flu increases the risk of developing RS, especially for children. RS affects all organs of the body but is most harmful to the brain and the liver - causing a sudden increase of pressure within the brain and, often, massive accumulations of fat in the liver and other organs.
Cardiovascular disease and the risk for it are especially prevalent among older residents of North America and Europe. To understand why daily aspirin is so widely recommended to prevent cardiovascular problems, consider how the disease develops: When coronary arteries that supply oxygen-rich blood to the heart muscle become narrowed or clogged by cholesterol and fat deposits, the result is coronary heart disease. When the blockage - called atherosclerosis - ruptures or breaks, exposing the underlying blood vessel tissue, the body reacts as if the vessel was cut and begins to generate a clot. This is what causes a heart attack.
Because aspirin slows the blood's clotting ability, regular usage helps to lower the risk of a heart attack. It also helps keep arteries open in people who have had a previous heart bypass or other artery-opening procedure such as coronary angioplasty. For the same reason, aspirin can be helpful in preventing stroke by reducing the risk of ischemia, which occurs when a blood clot decreases the flow of oxygen-rich blood to the brain.
Risks of Aspirin and Other NSAIDs Aspirin is not without risks, Dr. Gutterman says. "Anytime you thin the blood by reducing its ability to clot, you increase the chance of bleeding, particularly in the digestive tract or brain." In part because of that risk, aspirin is currently not approved by the Food and Drug Administration (FDA) for preventing heart attacks in healthy individuals.
The National Heart, Lung and Blood Institute says: "Patients must be assessed carefully to make sure the benefits of taking aspirin outweigh the risks. It may be harmful for some persons, especially those with no risk of heart disease. Talk to your doctor about whether taking aspirin is right for you."
"We recommend very few drugs, if any, to all men and women," Dr. Gutterman says. "It's always a complicated question, and aspirin certainly has side effects. In addition to causing gastric or cerebral bleeding in some people, aspirin can sometimes have adverse effects in people with liver and kidney disease. But, on balance, among well-chosen, at-risk patients, it's a sound choice."
His view is supported by a study involving 55,580 men and women reported in the September 2003 issue of the Archives of Internal Medicine. It found that aspirin use was associated with a 32% reduction in the risk of a first heart attack and a 15% reduction in the risk of all-important vascular events. It concluded that "for apparently healthy individuals whose 10-year risk of a first coronary event is 10% or greater, the benefits of long-term aspirin therapy are likely to outweigh any risks."
Another study, reported in the same publication in January 2004, stated that "more widespread and appropriate combined use of statins and aspirin in secondary prevention of cardiovascular disease will avoid large numbers of premature deaths." Statins are drugs that reduce cholesterol.
In January 2004, the FDA warned consumers against overdosing on over-the-counter pain remedies, especially acetaminophen, including the Tylenol brand as well as generic tablets sometimes labeled "non-aspirin." Patients who take more than the amount of acetaminophen recommended on the label run the risk of liver damage, the FDA said, noting that about 56,000 people are treated in emergency rooms for acetaminophen overdose annually, and approximately 100 die from the effects. Acetaminophen is found in more than 600 products for colds, flu, coughs and pain.
The FDA also warned of overdosing on NSAIDS - non-steroidal anti-inflammatory drugs like aspirin, ibuprofen (such as Motrin), naproxen (such as Aleve) or ketoprofen (brand names include Orudis and Oruvail), citing their risk of such side effects as stomach bleeding and kidney problems.
New Findings Recent news stories have described aspirin's possible role in preventing other health conditions, but results so far have not been compelling.
Prostate Cancer: A study presented in January this year at an American Association for Cancer Research meeting found that aspirin "may modestly reduce the risk that a man will develop prostate cancer."
Hodgkin's Disease: In February, a study from Harvard University said regular aspirin use might lower the risk of Hodgkin's disease, but it added that more research is needed.
Alzheimer's Disease: Evidence is emerging that daily usage of NSAIDS such as aspirin or ibuprofen might help reduce the risk of Alzheimer's disease, based on several theories about the cause of the ailment. Since 1985, scientists at the Medical College of Wisconsin have been studying medications, including aspirin and ibuprofen, for their role in slowing the degeneration of cognitive abilities. "Studies here and at other institutions are continuing," Dr. Gutterman says. "It's still a bit premature for definitive conclusions."
Breast Cancer: The large national study called the Women's Health Initiative reported in 2003 that weekly use of ibuprofen and aspirin seemed to inhibit the formation and growth of breast cancer, according to data published in the Proceedings for the 94th Annual Meeting of the American Association for Cancer Research. One of the scientists involved in the study cautioned that before usage guidelines can be implemented, however, "additional studies are needed." A study reported in the May 26, 2004, Journal of the American Medical Association had similar findings, with the study authors agreeing that further research was needed before doctors recommend that women routinely take aspirin to prevent breast cancer.
"Aspirin can reduce estrogenic effects," Dr. Gutterman says, "similar to drugs like Tamoxifen." The female hormone estrogen influences certain types of breast tumors, and drugs that reduce the hormone's effects may be prescribed to patients who have had breast cancer to prevent a recurrence.
Intestinal polyps: Two studies published in the New England Journal of Medicine in 2003 looked at whether aspirin can prevent colon tumors, but the results were not considered great enough to warrant risking the sometimes deadly side effects of internal bleeding and stroke. "Although aspirin may be of some benefit in preventing colorectal cancer, it cannot yet be recommended for this indication and is not a substitute for screening and surveillance," one of the researchers wrote.
Meantime, the major health risk facing middle-aged and older Americans remains heart disease, and aspirin is known to be effective in helping prevent it, Dr. Gutterman says. "Since more of us will die of heart disease than any other condition, I'd say go where the money is, and reduce your risk with a daily low-dose aspirin. Check with your doctor first though.
"But," he adds, "aspirin's not worth a hill of beans if you take aspirin thinking that alone will protect you. Take the aspirin, and if you smoke, stop, because smoking puts you at the highest risk for heart disease." Other ways to reduce your risk - even if you already have coronary heart disease or have had a previous heart attack - are the old stand-bys: Aim for a healthy weight, be physically active each day, and if you have high blood pressure, high blood cholesterol or diabetes, make sure they're under control.
A vasectomy is considered a permanent method of birth control. A vasectomy prevents the release of sperm when a man ejaculates.
During a vasectomy, the vas deferens from each testicle is clamped, cut, or otherwise sealed. This prevents sperm from mixing with the semen that is ejaculated from the penis. An egg cannot be fertilized when there are no sperm in the semen. The testicles continue to produce sperm, but the sperm are reabsorbed by the body. (This also happens to sperm that are not ejaculated after a while, regardless of whether you have had a vasectomy.) Because the tubes are blocked before the seminal vesicles and prostate, you still ejaculate about the same amount of fluid.
It usually takes several months after a vasectomy for all remaining sperm to be ejaculated or reabsorbed. You must use another method of birth control until you have a semen sample tested and it shows a zero sperm count. Otherwise, you can still get your partner pregnant.
During a vasectomy:
Your testicles and scrotum are cleaned with an antiseptic and possibly shaved.
You may be given an oral or intravenous (IV) medicine to reduce anxiety and make you sleepy. If you do take this medicine, you may not remember much about the procedure.
Your doctor makes one or two small openings in your scrotum. Through an opening, the two vas deferens tubes are cut. The two ends of the vas deferens are tied, stitched, or sealed. Electrocautery may be used to seal the ends with heat. Scar tissue from the surgery helps block the tubes.
The vas deferens is then replaced inside the scrotum and the skin is closed with stitches that dissolve and do not have to be removed.
No-scalpel vasectomy is a technique that uses a small clamp with pointed ends. Instead of using a scalpel to cut the skin, the clamp is poked through the skin of the scrotum and then opened. The benefits of this procedure include less bleeding, a smaller hole in the skin, and fewer complications. No-scalpel vasectomy is as effective as traditional vasectomy.1
In the Vasclip implant procedure, the vas deferens is locked closed with a device called a Vasclip. The vas deferens is not cut, sutured, or cauterized (sealed by burning), which possibly reduces the potential for pain and complications. Some studies show that clipping is not as effective as other methods of sealing off the vas deferens.2
What To Expect After Surgery
Your scrotum will be numb for 1 to 2 hours after a vasectomy. Apply cold packs to the area and lie on your back as much as possible for the rest of the day. Wearing snug underwear or a jockstrap will help ease discomfort and protect the area.
You may have some swelling and minor pain in your scrotum for several days after the surgery. Unless your work is strenuous, you will be able to return to work in 1 or 2 days. Avoid heavy lifting for a week.
You can resume sexual intercourse as soon as you are comfortable, usually in about a week. However, you can still get your partner pregnant until your sperm count is zero. You must use another method of birth control until you have a follow-up sperm count test 2 months after the vasectomy (or after 10 to 20 ejaculations over a shorter period of time). Once your sperm count is zero, no other birth control method is necessary.
A vasectomy will not interfere with your sex drive, ability to have erections, sensation of orgasm, or ability to ejaculate. You may have occasional mild aching in your testicles during sexual arousal for a few months after the surgery.
Why It Is Done
A vasectomy is a permanent method of birth control. Only consider this method when you are sure that you do not want to have a child in the future.
How Well It Works
Vasectomy is a very effective (99.85%) birth control method. Only 1 to 2 women out of 1,000 will have an unplanned pregnancy in the first year after their partners have had a vasectomy.3
Risk of failure
Pregnancy may occur after vasectomy because of:
Failure to use another birth control method until the sperm count is confirmed to be zero. It usually takes 10 to 20 ejaculations to completely clear sperm from the semen.
Spontaneous reconnection of a vas deferens or an opening in one end that allows sperm to mix with the semen again. This is very rare.
The risk of complications after a vasectomy is very low. Complications may include:
Bleeding under the skin, which may cause swelling or bruising.
Infection at the site of the incision. In rare instances, an infection develops inside the scrotum.
Sperm leaking from a vas deferens into the tissue around it and forming a small lump (sperm granuloma). This condition is usually not painful, and it can be treated with rest and pain medication. Occasionally, surgery may be needed to remove the granuloma.
Inflammation of the tubes that move sperm from the testicles (congestive epididymitis).
In rare cases, the vas deferens grows back together (recanalization), and the man becomes fertile again.
What To Think About Advantages
Vasectomy is a permanent method of birth control. Once your semen does not contain sperm, you do not need to worry about using other birth control methods.
Vasectomy is a safer, cheaper procedure that causes fewer complications than tubal ligation in women.1
Although vasectomy is expensive, it is a one-time cost and is often covered by medical insurance. The cost of other methods, such as birth control pills or condoms and spermicide, is likely to be greater over time.
If you are considering a vasectomy, be absolutely certain that you will never want to father a child. Think through whether this might change after any of the following life events:
One of your living children dies (if you are a father).
You divorce and lose custody of your children.
You have a new partner who wants children.
Your financial situation improves and you can afford another child.
Your children grow up and leave home.
A vasectomy is not usually recommended for men who are considering banking sperm in case they decide later to have children. Discuss other options with your partner and your health professional.
Surgery to reconnect the vas deferens (vasectomy reversal) is available. However, the reversal procedure is difficult. Sometimes a doctor can remove sperm from the testicle in men who have had a vasectomy or a reversal that didn't work. The sperm can then be used for in vitro fertilization. Both vasectomy reversal and sperm retrieval can be expensive, may not be covered by insurance, and may not always work.
Some older studies showed a risk of prostate cancer in men who have had vasectomies. However, many years of research have found no clear evidence that vasectomy is linked to prostate cancer.1
Some doctors or health insurance plans may require a waiting period from the time you request a vasectomy and the time the procedure is done. This time allows you to be certain about your decision.
Researchers are studying other male birth control methods, such as reversible vasectomy or hormonal methods. Reversible vasectomy involves plugging the vas deferens and then removing the plug when birth control is no longer wanted. Hormonal methods include pills or injections that the man would use to prevent sperm production. So far, no new method has been shown to be effective enough, with low side effects, to be marketed for men.
Your hair loss may have started with a few extra hairs in the sink or in your comb. But now you can't look in the mirror without seeing more of your scalp.
Baldness typically refers to excessive hair loss from your scalp and can be the result of heredity, certain medications or an underlying medical condition. Anyone — men, women and children — can experience hair loss.
Some people prefer to let their baldness run its course untreated and unhidden. Others may cover it up with hairstyles, makeup, hats or scarves. And still others choose one of the medications and surgical procedures that are available to treat hair loss. Before pursuing any of these treatment options, talk with your doctor about the cause of and best possible treatments for your hair loss.
Nearly everyone has occasional sleepless nights, perhaps due to stress, heartburn, or drinking too much caffeine or alcohol. Chronic insomnia is defined when you have problems falling asleep, maintaining sleep, or experience nonrestorative sleep that occurs on a regular or frequent basis, often for no apparent reason.
How much sleep is enough varies from person to person. Although 7 1/2 hours of sleep is about average, some people do well on four to five hours of sleep. Other people need nine to 10 hours of sleep each night.
Insomnia can affect not only your energy level and mood, but also your health as well because sleep helps bolster your immune system. Fatigue, at any age, leads to diminished mental alertness and concentration. Lack of sleep caused by insomnia is linked to accidents both on the road and on the job.
Insomnia is a common problem that may be temporary or chronic. As many as one in 10 Americans have chronic insomnia, and at least one in four has difficulty sleeping sometimes. But that doesn't mean you have to just put up with sleepless nights. Some simple changes in your daily routine and habits may result in better sleep.
A urinary tract infection is an infection that begins in your urinary system. Your urinary system is composed of the kidneys, ureters, bladder and urethra. Any part of your urinary system can become infected, but most infections involve the lower urinary tract — the urethra and the bladder.
Women are at greater risk of developing a urinary tract infection than are men. A urinary tract infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a urinary tract infection spreads to your kidneys.
Antibiotics are the typical treatment for a urinary tract infection. But you can take steps to reduce your chance of getting a urinary tract infection in the first place.
Prostate cancer is cancer of the small walnut-shaped gland in males that produces seminal fluid, the fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer in men, affecting about one in six men in the United States. A diagnosis of prostate cancer can be scary not only because it can be life-threatening, but also because treatments can cause side effects such as bladder control problems and erectile dysfunction (impotence). But diagnosis and treatment of prostate cancer have gotten much better in recent years.
Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly. If prostate cancer is detected early — when it's still confined to the prostate gland — you have a better chance of successful treatment.
There is really only one certainty in life. Life is uncertain. We often live as though nothing will change, but it does. This continuous battle between wanting things to stay the same and finding that nothing does stay the same creates something inside us. This creation of constant change is a movement, a force of nature, and a guiding path.
This movement within us and outside us is the spirit of living, of which, we all take part in. None of us can predict the future. This creates uncertainty on the human level, yet we all learn to trust and even welcome change in the deepest part of who we are. No one is perfect, we wake up each day with the opportunity to create something different in every moment.
When we come to expect the unexpected, we are beginning to trust in a wisdom greater than knowledge to lead us through each day. Religious communities call this the path of God, science calls this higher consciousness, but for our purposes - let's call this the path we were meant to follow with certainty in uncertainty.
To move toward something we cannot see creates uneasiness. This part of us is our human nature. Our human nature wants things in life to be predictable. At the same time, there are things in human existence that we are also glad to leave behind and in the past.
Have you ever noticed how the heart and the mind feel like they are being pulled forward by a magnetic force when we follow what we cannot see or feel? It is as though our whole body/self is being drawn into an experience. This pathless path is one we all take each day and each moment.
Wonder what would happen if you were to live for these moments and find joy in them? I suspect you would find yourself becoming more and more living in the state of anticipated joy. This does not mean that nothing in the future will be sad, but you can begin to accept each moment with anticipated joy in knowing that the awareness of this anticipated joy will fill you. It will be the filling of your body with the joy of living. The joy of living fully in soul. And, the uncertainty of the future will be met with joyful trust that all will be known when the time is right for us to know.
Such a journey was known to us as a child. Do you remember laying on the ground and finding yourself breathing in the aroma of the ground and grass? As an adult, I suspect you don't have such clarity with your senses. Let us never forget that child inside us that knew how to play all day and never tire. Our creativity was endless and filled with anticipated joy in knowing that what was about to be created next would be fun.
Samuel Oliver, author of, "What the Dying Teach Us: Lessons on Living"
I think of the word,
"Mother," many things
come into my mind.
sweet mother, of course,
who to me, will always be
think, too, of myself,
for I am the mother
of three, the step-mother
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A man who owned a horse
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Where's the justice?
By Andrew Helton
Target: Sonoma County
Judge Robert LaForge
Goal: Give man who
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The unhealthy affects of
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