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One of the most important discussions between a midwife and a woman planning for the birth of her baby has to do with the pain of labor. A woman wants to be prepared for birth and confident that it will be a safe experience. She also wants to be reassured that she will be able to cope with labor.

This leads us to talk about the different options we have as midwives to help a woman give birth to her baby in a safe and satisfying way. anxiety attack treatment nhs Midwives are trained to address all of the choices for pain management during labor. During prenatal visits with the midwife, these options can be discussed in detail, including the risks, benefits and any side effects of each. How to look at pain

There are two ways to look at pain: Pain can be viewed as, “Something is wrong,” or as our body’s way of saying, “This needs attention.” Pain can be seen as a normal process – especially when it comes to labor.

Uterine contractions need to be strong, regular and frequent, and the experience can be intense. This intensity is completely normal, and the pain does not indicate anything is wrong. Midwives approach the discussion of pain management during labor first by asking how a woman intends to cope with the intensity. This is how we begin planning for pain management during labor and birth. Pain management

Some of the methods we recommend for pain management don’t have an effect on the process of labor or on the baby. These methods include frequent position changes, freedom of movement, massage or distraction. In fact, these actions can actually promote or enhance the process of labor.

We often recommend sitting on a ”birth ball,” which is just like an exercise ball, during labor to open the pelvis as a comfortable alternative to being in bed. Other more technical actions may include hypnosis, which requires training and practice, or acupuncture, which requires a trained professional to administer.

Another effective method of non-medical pain relief during labor is the use of hydrotherapy, which involves standing in the shower or being immersed into a pool or tub of water. Hydrotherapy can be very soothing and relaxing. anoxic tank design This not only helps a mother manage the discomfort but also reduces her stress and anxiety. We use the tub frequently for mothers who are at low risk for complications and do not require constant fetal monitoring. Medications

We also have more medical methods of pain management for labor and birth. Each of the medical forms of addressing pain during labor require more attention to how the baby is tolerating the medicine as well as side effects that can affect the progress of labor and/or the baby.

With the assistance of the anesthesiologist, spinal or epidural anesthesia can be used to provide effective pain relief. anxiety attack meaning in tagalog Medications are injected into the lower back outside of the spinal canal to cause some loss of feeling and numbness in the lower part of the body while allowing the laboring mother to be awake and alert. Epidural anesthesia is common, and more than 60 percent of women use this form of pain management during labor.

As a family medicine physician for the past eight years, I know that having a primary care doctor is very important. From performing wellness checkups to managing chronic diseases, primary care providers offer patients a holistic view of their health and can recognize and manage serious conditions that require more care.

Although I had never heard of family medicine before I entered medical school, I knew pretty quickly that this was the field of medicine for me. Here was a specialty that focused on everything. I trained with family medicine doctors who cared for babies, children, adults and geriatric patients. They knew how to diagnose sports injuries and do joint injections. They counseled patients in times of depression and anxiety. They delivered babies during busy nights covering the hospital. anxiety attack vs panic attack reddit Most importantly, they formed lasting relationships with patients they saw in their offices. Primary care doctors are essential

Primary care is so important for the health of individuals and communities. We know that access to more primary care doctors means better health outcomes for communities. Although specialists are necessary in certain situations, everyone still needs a dedicated primary care provider who can provide patient-centered and continuous care.

Primary care providers can also detect and screen for the initial symptoms of mental health issues or early signs of cancer or chronic illness. Patients who see a primary care provider can start to manage these health problems before they become more severe. Within primary care, family medicine physicians can care for patients throughout their lives and in different situations, including in the clinic and at the hospital. What does a family medicine doctor do?

Every family doctor is different, but a typical day for me involves seeing patients in the clinic. I do well checkups for babies, annual physicals for adults, check-ins with pregnant patients as well as manage chronic diseases and advise on acute complaints. Additionally, I work at the hospital and make home visits to newborns and older patients.

His local pulmonologist referred him to UK HealthCare, where surgeons decided a resection of the tumors might be too dangerous. He then met with UK Markey Cancer Center medical oncologist Dr. Lowell Anthony, who specializes in these neuroendocrine tumors.

Roark received a combined oral chemotherapy of capecitabine and temozolomide (known as CAPTEM) to shrink his tumors. anxiety attack treatment in er However, Roark – who has a history of heart problems – had a heart attack shortly after, which led to a transient ischemic attack (TIA), also known as a mini-stroke. He was taken off CAPTEM and given temozolomide alone, followed by everolimus, which was safer for his heart.

For roughly a year, his cancer remained stable. But in 2016, his tumors began growing again, mostly proliferating in the liver. Despite a hepatic artery embolization to kill the blood supply to the tumors, the cancer continued to grow, and a gallium (Netspot) scan in 2017 showed that his liver was close to rupturing.

Roark was out of options – until earlier this year, when the Food and Drug Administration approved a new peptide receptor radionuclide therapy (PRRT) called Lutathera specifically for neuroendocrine tumors occurring in the pancreas or gastrointestinal tract. Patients who receive this therapy have failed standard of care and/or have cancer that continues to progress.

Anthony, who was among the first oncologists to run clinical trials with the therapy dating back to 1995, was eager to bring the newly FDA-approved therapy to Markey. In June 2018, Roark became the first Markey patient to receive a dose of the therapy.

Lutathera is a radioactive drug that works by binding to a part of a cell called a somatostatin receptor, which might be present on certain tumors. After binding to the receptor, the drug enters the cell allowing radiation to cause damage to the tumor cells. In other words, the “hot” radioactive drug is encased in a “cold” drug, which allows it to move throughout the bloodstream safely. Once it reaches the tumors, the cold drug wears off and allows the radiation to kill the cancer.

Potential patients are first screened using the Netspot scan to determine whether the therapy will be effective for their type of tumor. Then, therapy is administered in up to four total doses, given once every two months. Prior to receiving the drug, patients receive a four-hour amino acid infusion to protect the kidneys, followed by the 30-minute Lutathera infusion. anoxic brain damage prognosis Because of the active radiation, special precautions are taken while administering the therapy, and patients are given specific instructions around limiting close contact with others for several days after.

“Studies show that Lutathera is an extremely effective treatment against these types of pancreatic or GI tumors,” said Anthony. “When it comes to aggressive neuroendocrine tumors, the realistic goal is generally not cure but rather control of the disease and a good quality of life for the patient. As someone who’s been involved in research on this therapy for more than two decades, I’m thrilled that it’s now FDA-approved and that we are able to offer it here at Markey for our patients.”