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Symptoms.indd

MS-UK believes that based on experience, people cope best when they look
at what is happening, rather than what might be. MS can cause a long list of
symptoms. This list is not exhaustive and it is extremely unlikely that any one
person would experience all or even most of these symptoms. Most will only
experience a small number of these. The combination, severity and frequency
will be different for everyone.

Symptoms can come and go; some are much more responsive to treatment whereas others are more difficult to manage.
Outside influences can exacerbate symptoms. For example, hot weathercan make fatigue worse. Infections can cause all sorts of othercomplications, although once the infection is treated, the symptoms shouldsubside.
New symptoms may not always be down to your MS. It is important toremember that not every ache and pain is connected and if a newsymptom persists and becomes an on-going problem, you should seekmedical advice.
Below are some of the more common symptoms experienced, with a briefexplanation. If you are experiencing any of these symptoms and they arecausing you problems, it is advisable to contact your GP or MS Nurse orask to be referred to the appropriate specialist. Most symptoms can betreated; you do not have to just ‘put up’ with them! Please note that whilst some are common to most people, some are relatively rare.
Visual disturbances
There are several problems that can affect the vision of people with MS. The most common symptom is optic neuritis – inflammation of the optic nerve, which is also one of the more common first symptoms that can lead to a diagnosis of MS. Other problems can include; double vision (diplopia) a symptom which can occur as part of a relapse of MS, but will often recover partially or fully with the use of steroids and nystagmus (rhythmical oscillations of the eye ball) which sometimes goes unnoticed by the person, but is obvious to others. NICE Guidelines for management of MS states that be treated accordingly with either drugs or by seeing “any person who has nystagmus that causes reduced someone like a Physiotherapist or a Pain Clinic. Pain visual acuity or other visual symptoms should be can be described in various ways such as stabbing, offered a time-limited trial of treatment with oral burning, tingling or pins and needles. But all pain is gabapentin. This should be initiated and monitored by subjective and no two people will experience pain in the same way and can only be described best by the person experiencing it.
For more detailed information, please see our choices leaflet ‘Visual Disturbances’.
For more detailed information, please see our choices Bladder and Bowel problems
Cognition
Bladder problems are one of the most common symptoms in MS. Bladder problems tend to fall into Approximately half of people diagnosed with MS will four areas; urgency – the need to ‘go’ with little or no
have cognitive problems. These will range from fairly warning; frequency – having to ‘go’ more than 8 times
mild on a day to day basis to an increased worsening per day; hesitancy – finding emptying the bladder
during a relapse. Initially, people may not realise that difficult; retention – you can empty the bladder, but
cognitive problems are associated with their MS. The have a feeling of incompletion. Many people have a most common problems are memory, information processing, problem solving, word finding and concentration. To manage these problems, people may Approximately half of people with MS will have bowel have to look at different ways to help themselves such problems and constipation and emptying are the most as creating aide memoirs or using technology and common. The other problem area is incontinence and avoiding jobs which need concentration when fatigued lack of control over the bowel opening. It is possible to Symptoms can become more pronounced when MS A referral to a Continence Advisor will help to find is active and may lessen or disappear again when the ways in which to deal with problems in all these areas.
MS is quiet. In some people, symptoms fluctuate when the person is tired, upset or anxious. For more detailed information, please see our choices If you are experiencing some of these symptoms, or others that may not be mentioned, you can contact MS-UK for more information, advice and support.
For more detailed information, please see our choices The impairment of sensory perception includes the loss of feeling in limbs and other areas; tingling, crawling sensation, numbness or tightness and varying degrees of pain. The medical term for Muscle and Motor Disturbances
uncomfortable, abnormal sensations, such as these is dysaesthesia or paraesthesia. These feelings are This can be the loss of control of one or more limbs. classed as neuropathic pain symptoms.
For example: Myoclonus (sudden and uncontrollable shock-like movements or “jerks” of a muscle or a group of muscles), swallowing difficulties, tremor and the inability to perform fine movements – e.g. doing up buttons, tying shoe laces etc. Legs or arms There are two main types of pain that can occur – may suddenly go into spasm which is often painful. neuropathic and musculoskeletal and about half of people diagnosed with MS will experience pain at some time. Once the cause is identified the pain can MS-UK Unsworth House, Hythe Quay, Colchester, Essex, CO2 8JF
Tel: 01206 226500 Email: info@ms-uk.org www.ms-uk.org
Loss of Co-ordination
degree. This can be caused by damage affecting the coordination of the various muscles involved. This can include dizziness and vertigo, ataxia, The result can be difficulty chewing or episodes of staggering, clumsiness (spilling and dropping things).
coughing or choking when eating and drinking.
If the swallowing problems are more advanced and eating is putting the individual at risk, nutrition can be provided through a procedure called percutaneous endoscopic gastrostomy (PEG).
Extreme tiredness, otherwise known as fatigue, is a common symptom of MS. This is an invisible symptom For more detailed information, please see our choices that is not obvious to other people and can be quite leaflet ‘Speech & Swallowing’.
difficult to cope with and manage. There are a number of ways in which people learn to live with their fatigue and drug treatments are also available. Spasticity
For more detailed information, please see our choices Spasticity is where the signals from the brain are interrupted and the muscle remains in its shortened, contracted state. This causes the affected muscle to feel stiff or tight and to be resistant to movement. Foot Drop
The degree of spasticity will vary from person to person and can greatly impact on many activities. Foot drop is a symptom experienced by some people Nevertheless, spasticity can be successfully managed.
with MS and it is caused by a weakness in the ankle that causes the foot to drag along the ground or hang Left untreated, spasticity can lead to complications down when walking. People who experience foot drop such as frozen or immobilised joints and pressure are more vulnerable to tripping and falling. When sores. However, treatment can be very effective and walking, they use more energy and people may alter includes physiotherapy and drugs such as Baclofen their gait to compensate, by lifting their leg higher. (Lioresal) and Tizanidine (Zanaflex).
Foot drop can be treated using functional electrical stimulation. FES uses small electrical charges to force the foot into a more natural position for walking and an ankle splint (orthosis) can also be used to hold the foot in a rigid position.
Tremor is involuntary, uncontrolled movements. The type of tremor that is most frequently experienced in MS is intention tremor - a tremor that worsens as Speech & Swallowing
the individual reaches for an object. It is thought that tremor is due to lesions in the cerebellum, the area of Speech and swallowing disorders can arise as a the brain responsible for balance, co-ordination and symptom of MS for some people. Speech disorders ‘fluidity’ of movement. Tremor can also result from include dysarthria (a slurring of speech due to demyelination of the thalamus and the basal ganglia weakness or lack of coordination in the muscles used in the brain. Stress and fatigue are known to worsen in speech) and dysphagia (swallowing difficulties). Although they may develop at any stage, for most About one third of people with multiple sclerosis people, speech disorders only become apparent in may have tremor to some degree. For some people the later stages of the condition and this may mean it can be a relatively mild problem with coordination the help of a speech and language therapist. More called ataxia, but for others it can be one of the most complex problems may also benefit from the use of Studies have found that around a third of people with MS experience swallowing difficulties to some MS-UK Unsworth House, Hythe Quay, Colchester, Essex, CO2 8JF
Tel: 01206 226500 Email: info@ms-uk.org www.ms-uk.org

Source: http://www.ms-uk.org/files/choices_symptoms.pdf

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