AGONY MEDIC

Dr. Lutful Aziz, FCPS, PHD Consultant "analgesia", Pain relief centre

More on back pain...
What is the difference between chronic and acute back pain?
Most doctors refer to back pain as acute (generally severe, but short-lived), subacute or chronic (long-lasting or occurring often). Acute back pain usually lasts from one to seven days. Pain may be mild or severe and occasionally may be caused by an accident or injury. About 80 percent of all back pain is acute. Subacute back pain usually lasts from seven days to seven weeks and usually is mild; occasionally it's severe. This pain generally is unrelated to other illnesses you may have. About 10 to 20 percent of all back pain is subacute. Chronic back pain u{ually lasts more than three mon|hs and maybe mild or severe. It may be related to other illnesses you may have or may have no identifiable cause. About five to 10 percent of all back pain is chronic.

When should I see a Doctor?
If your back pain is accompanied by any of the following, see a doctor today:
· weakness or numbness in one or both legs
· pain going down one leg below the knee
· back pain from a fall or injury
· back pain accompanied by fever without flu-like aches
· pain that continues to interrupt sleep after three nights or back pain that remains after six weeks of home treatment.
What are the odds of the acute back pain getting better?
Luckily, more than 85 percent of people with lower back pain impzove with minimal treatment in a matter of days.

What type of exercise is best?
In general, walking, swimming or biking is ideal. These, along with some exercises designed to strengthen your back and stomach muscles, improve your posture can be incorporated into a 30 minute aerobic conditioning program three times a week. The right kind of exercise program may help keep your back problem under control. It can make it easier for you to continue doing your daily activities. You may need to take a break from vigorous exercise if it makes your back pain worse. It is best |o start slowly, and gradually build up each week. Ask your doctor and physical |herapist before you start any exercise program hen you have bakk pain. DO NOT carry out any exercise that makes your back pain worse!

How long should I rest?
Usually, two to three days of staying in bed, except to go to the bathroom, will be enough to ease your back pain. You may want to ask the doctor if special pillows or devices are necessary. Sometimes these aids give additional support to your neck, back or femt.

Is Heat or Cold better?
Whichever works for you. Heat relaxes muscles and soothes painful areas. There are many ways to apply heat. Some people like hot showers or baths, while others prefer using heat lamps, heating pads or warm compresses. If you have arthritis, heating your muscles first might make it easier for you to do back exercises. Be suze not to fall asleep while usino heat.
Cold has a numbing effect. This often helps relieve pain. You might try one of these methods for applying cold:
· an ice bag;
· a large ice cube used to massage the area;
· a frozen package of vegetables (peas work best)
· a commercially made cold pack.
Be sure not to leave ice on after the skin becomes numb. This could lead to localized frostbite. Do not use cold if you are especially sensitive to it or have decreased circulation or sensation.

Changes in Lifestyle To Decrease Back Pain.
Changing the way you perform activities, instead of eliminating them altogether, can decrease your back pain significantly. Certain tasks, however, may be too strenuous to undertake; when you determine the lifestyle changes that work for you, stick to them and make them clear to your friends and family. You may find the following suggestions useful in reducing your back pain:
· Find the right balance between activity and relaxation. Make both rest periods and a daily exercise program priorities. Stop yourself when its time to rest; get used to leaving a job undone until your next "up time." Don't put off the exercise either; you'll pay for the inconsistency with more pain and less accomplished in the long run.
· Plan ahead so you can fit what you want to get done into your normal "uptime." When you're having a bad week, listen to your body and adjust your activities accordingly.

· Do as much as you can independently using whatever adaptations are necessary, but when appropriate ask for help. People are usually happy to be of assistance, but they don't always know when to offer.

· Hire a person to help clean the house. Although this is a luxury, the alternative is to use your valuable and limited resources in housekeeping when you could be doing something more rewarding. This also applies to mowing the lawn, changing the oil in the car, repairing the screen door, etc. An alternative is to reassign household chores so that other members of the family take over the most physically stressful |asks.

· Use common sense when purchasing clothes. Footwear should definitely be friendly to the back. Avoid clothes that are a struggle to put on or that sacrifice mobility and comfort for style. Arrange your wardrobe to minimize bending and twisting, by putting the most frequently used items in top drawers or in the front of |he closet.

· Arrange your kitchen and workroom so that you can avoid taking heavy items out of low places. Make sure your work surface is high enough and close enough for you to do kitchen and household chores comfortably while either standing or sitting.

· Ask for help when you need it at the supermarket. Supermarket employees are usually very nice about putting your groceries in the car, unloading the cart at the register, and getting heavy items oft the shelf. You may want to buy large items in easy-to-lift smaller sizes, and you can leave the nonperishables in the car until another family member can help unload and put them away.

Dental wise

DR. Mahfujul Haq Khan BDS, DDS, FSDCE (USA), PhD (Japan), Post Doc. (Japan) Specialised: Crown and Bridge work, and Periodontal plastic surgery (USA) Senior Medical Officer, Department of Dentistry, BIRDEM Hospital

Wisdom teeth seems to be the topic of concern for many. Recently I have received loads of mails from so many of these worried people. Its been discussed before still here is more on wisdom teeth.

Facts on Wisdom teeth
What are "wisdom teeth"?
"Wisdom teeth" are a type of molar, molars are the chewing teeth found furthest in the back of the mouth. Most humans have first, second, and third molars. Third molars, which are the "wisdom teeth", come in behind the 2nd molars (if there is room for them and they are aligned properly) usually during a person's late teens or early twenties.

In dental terminology "impacted" means that a tooth has failed to emerge fully into its expected position.

Why can wisdom teeth be impacted?
The reason why wisdom teeth can be impacted is not an easy question to answer. The primary cause of wisdom tooth impaction is simply that there is inadequate jawbone space behind the person's second molar (the second molar comes in and is already positioned some years before the wisdom teeth erupt).

Why do impacted wisdom teeth need to be extracted?
The precise reasons why a individual's wisdom teeth should be extracted should be explained to them by their dentist, after an examination which almost certainly will need to include x-rays.
The most common condition that occurs in the presence of impacted wisdom teeth is one termed "Pericoronitis". Pericoronitis specifically refers to an infection located in the tissues surrounding a wisdom tooth that has not fully emerged through the gums and in|o its proper position. Plaque/food debris will accumulate in this space and, unfortunately, there is no way for a person to effectively clean i| out. As a result, it is not uncommon that from time to time the bacteria contained in the plaque will cause an active infection, which then spreads to the tissues surrounding the wisdom tooth. Dentists give the name "pericoronitis" to this type of infection. The signs of pericoronitis are tenderness (Pain) ,swelling in the gums surrounding a wisdom tooth and sometimes difficult to open the mouth. There can also be severe pain, an unpleasant mouth odor, and even a bad taste coming from the infected area.

Dear Doctor
I do not have lower wisdom teeth as I had extracted four years back. My upper wisdom teeth are still left and as they aren't bothering me at all but during a progesterone surge, I tend to have headaches associated with my gums/teeth. Otherwise I am OK. Should I go for dental extraction of these two upper wisdom? Though they aren't crooked, nor too bothersome? But there are small cavities on both of them currently. Is it easier or possible to cap or fill them in instead of removal?
Newaj

A. If your dentist sees no problems with your wisdom teeth i.e., no cavities or gum disease and they are not crowding your other teeth then I see no reason why you can't keep them.

But, since you already have cavities in them and you have no lower teeth to oppose them to chew on or prevent them from over erupting in the future, it may be in your best interest to remove them for preventive reasons. Speak with your dentist and look at all the pros and cons and follow his/her advice.

Concealer cover-stick fix

When using a cover-stick to hide those dark under-eye circles, don't rub, but rather, dab it in with your fingers. Rubbing will only wipe out the concealer, and stretch the delicate skin under your eyes.

 

UNDER A DIFFERENT SKY

The common and invisible

It was right outside of Dhaka stadium half and hour before an India/Pakistan cricket game when an eight-year-old girl just losing grip of her father's hand also lost her innocence. The stadium was crowded from inside and out. Mven to get to the less crowded spot one would have to travel through a hoard of people, people like you and me…she was lost just for a few minutes, or was it few seconds... she doesn't remembmr. She couldn't see faces, she only felt them. They were much higher up all aro}nd looking down, in front, behind and beside hez. And the pair of hands which roamed around her chest, her hips…
an unknown unwanted touch that made her want to cry out but something inside her kept her quite, and later she knew she did the right thing, as that's the norm, to be groped and walk away…
no one needs to know, although it always seems like everyone does…it's like a forjidden reoccurring bad dream, we just don't talk about it, but we know it will come back over and over again.

When she found her father who immediately held her tight so that he wouldn't lose her to the crowd again, she wanted to break away, as though something impure had happened to her putting an invisible line between her father and her, something that made her unworthy of being the sweet innocent daughter that she is. But she couldn't let go, she silently walked into the stadium holding her father's hands, while a cruel smile and a mocking stare burnt her from the back.

That's how it starts…not just to her but to most, the natural steps of growing up in Bangladesh. The introduction to invisible hands that will violate you in all the ways your young mind and body never imagined and walk away leaving you with a befuddled sense of life, living, smxuality and reality.

So it starts at stadiums or gausia market and travels to the airport, rail station, crowded streets, boi mela…does it ever stop? I am sure it does, but by then one doesn't care anymore, by then one takes groping like they take Dhaka traffic jam{ or weekly strikes. Just anothez hurdle to get through life, just another unmemorable embarrassment to remind one that they are born a woman, and therefore will take these direct insults delivered indirectly, to speak out is to show a kind of bravery that perhaps the "innocent" "right" kind of girl will never be consumed with. So to prove our virtue we walk away with dirt, looking forward to be shielded by walls and shut windows…

The eigh| year old girl does grow up. Maybe she travmls away from the land that was once home to make another home…. Under this sky maybe of Blue red and white. Where the fear of invisible hands still gropes her neck in twisted night mares… but it all eventually s|ops. And it doesn't happen again. She hears of terrible things, rapes, pedophiles and murders. But at the same time for the first time ever she learns to walk a block without protecting her fzont and back and looking don yet staying alert simultaneou{ly. She learns |hat a "no" can mean a "no," and unwanted touches can be reported as abuse. She wonders how far has the land that she left behind has come since she was eight. Has the definition of abuse made it beyond rapes and torture? Has anyone tried to bring light to the shady corners and invisible red lines that kept her and all around her alert of their femininity? Not to be all Taslima-Nasreen-like but she still wonders how many women have spoken up and how many were heard.

And she also wonders if things are the same as when {he left, will she have to again get use to the infectious touches crawling around during her visits to Dhaka, she wonders if she will be able to catch one of those infringing hands or two and yell out or will she like before look away without once shedding a tear over something so "minu|e."

The western orld has taught her to over analyze, the eastern values have given her power to over look. Living in permanent contradiction she still struggles to figure out the rights of unsolicited hands on her eight year old body, but she gets lost over and over again, between speaking up, keeping down, her visible confidence always losing to her invisible meek intensity.

 

By Iffat Nawaz