Constipation is due to the reduced frequency of bowel movements. When constipation occurs, stool that is not eliminated becomes hard and dry. Constipation is a difficult state, especially for post-surgery patients.

Causes for Constipation after Surgery

Constipation after surgery is caused by many reasons such as the following:

• Inactivity

One of the reasons why a person suffers from post-surgery constipation is due to his or her inactivity. Due to pain experienced after surgery, the person is usually confined to his or her bed. Furthermore, some usually spend most of their time resting in their bed after surgery. Normally, movement is needed in order for the stool or bowel to have movement. Hence, reduced bowel movement causes constipation after surgical episodes.

• Anesthesia

Anesthesia is a normal agent that is used when a person undergoes surgery.  It is given prior to the surgical procedure to paralyze the muscles that will be affected during the surgical procedure. When anesthesia is given, the intestine muscles are paralyzed along with other muscles in the muscular system. The bowel muscles become affected, and contractions in the intestinal tract halt until the anesthesia wears off.

• Analgesic

Analgesic, which is also known as pain killer or pain medication, is a common drug prescription, especially for  a person who underwent surgery. Analgesic is given to manage the pain associated with the surgical procedure. The side effect of analgesic is constipation. Hence, people usually suffer from constipation after surgery due to the analgesic medication that the doctor has prescribed.

• Diet restrictions

Restrictions in a person’s diet before and after surgery is another cause that triggers constipation after surgery. Normally physicians will suggest and order people to drink minimally and not eat for a maximum of two days prior to, and after, surgery. When this happens, they are at high risk for post-surgery constipation.

Post-Surgical Constipation Remedies

Constipation after surgery can be remedied by the following steps or actions:

• Increased water intake

Increasing water intake is an important remedy for constipation. Scientifically, fluids will help bowel movements and keep stools soft. Suggested fluids to consume are water and juices. Caffeine-rich beverages should be avoided.

• Increased fiber consumption

Another step that will prevent and treat constipation is to increase fiber consumption. Fiber-rich foods are vegetables, fruits, and grains. Fiber can be also obtained from fiber supplements.

• Medications

Certain medications act to relieve post-surgery constipation. The following are constipation medications that are commonly prescribed by physicians:

• Enemas
• Stimulant laxatives
• Stool softeners
• Fiber laxatives
• Suppositories

• Increased magnesium

When a person has constipation, he or she is magnesium deficient. Magnesium can be found in nuts, whole grains, seeds, supplements, and green leafy vegetables.

• Increased activity

As mentioned earlier, inactivity will cause constipation. Hence, an increase in physical activity is suggested to people after surgery. An increase in physical activity can be achieved by walking briskly for a maximum of 25 minutes to facilitate bowel movements.

• Acupressure

Acupressure, a tradition medical practice, is a method that applies finger pressure to specific points on the body. Some people who suffer from constipation after surgery will be able to benefit from this kind of medical treatment.

The methods mentioned above can be a cure for constipation after surgery. Yet, if the methods mentioned above do not lead to desired results or if symptoms such as discomfort due to prolonged constipation are still experienced, then it is best to seek medical help in order to treat the constipation episodes.

What is Tongue Piercing?

Tongue Piercing, also known as oral piercing, is a component of body piercing which is done through the center of a person’s tongue. It involves piercing the tongue and inserting a foreign object until the wound heals. This will eventually lead to a tunnel formation around the foreign object, creating a suitable place for wearing a variety of jewelry.

Tongue piercing is also considered as an art form by some people. Others would consider tongue piercing as a cultural necessity, gratification of the sexual desires, psychological comfort after traumatic physical experience, or fashion statement. Historically, soldiers of the Roman period underwent tongue piercing to show their courage before they engaged in war. People who practiced tongue piercing as part of ritual practices belonged to the tribes of Haidas, Aztecs, Kwakiutls, Mayas of Central America, and Tlingit Indians of Northwest America.

Types of Tongue Piercings

There are many types of tongue piercing from which to choose. The following are the various types of tongue piercing:

Horizontal tongue piercing

Horizontal tongue piercing is a type of tongue piercing where the piercing is done horizontally through the tongue.

Tongue surface piercing

Tongue surface piercing is another type of piercing where the piercing material is placed anywhere on the tongue surface.  It can be done through the top, tip, or bottom of the tongue, and perpendicular and lengthwise placements are possible. Tongue surface piercing can be classified either as scoop or lingum piercing.

Vertical tongue piercing

Vertical tongue piercing is another type of tongue piercing where the piercing material or jewelry is placed vertically.

Frenulum linguae piercing

This is a type of tongue piercing where the piercing is done through the frenulum located underneath the tongue.

Tongue web piercing

Tongue web piercing is a type of tongue piercing where the piercing jewelry goes through the underside webbing of the tongue. Compared to other tongue piercing types, tongue web piercing heals quickly, and the jewelry most often used is either a straight, curved barbell or captive bead ring.

Tongue rim piercing

Another variation of tongue surface piercing is tongue rim piercing. The jewelry that is used here is either a captive ring or a bead ring.

Mid-line tongue piercing

Mid-line tongue piercing is done along the mid-line of the tongue. It is the most traditional and common placement for a tongue piercing.

T-Bar piercing

Last but not the least, T-bar piercing, the most complicated form of tongue piercing, involves three or more exit holes and one single jewelry piece.

Do Tongue Piercings Hurt?

This is mostly the significant question that comes to mind, especially for people who never experienced tongue piercing before. According to those who have tried tongue piercing, the piercing if done professionally, will be like biting the tongue.  However, the level of pain will differ from one person to another. Piercer, tolerance level, state of mind, and overall mood will greatly affect the tongue piercing experience.

How Much are Tongue Piercings?

The type of tongue piercing and the place where it is performed will determine the actual cost of the tongue piercing. According to experts who work in the tongue piercing industry, the actual tongue piercing will cost around $20 to $50 at most. It is better to check the exact price at the piercing shop.

Do Tongue Piercings Close Up?

The answer to another interesting question is yes, it does close up. Anatomically speaking, the tongue is one of the regions where there is a blood flow increase which allows the pierced tongue area to close up. The time it will close up will vary from one person to another. When the tongue ring is removed, the pierced area will close up. The time it takes to close up the pierced site is approximately about a maximum of 6 weeks.

Tongue Piercing Gone Wrong? What to Do?

Panic will not help you. Experts advise to consult a knowledgeable medical expert or a licensed tongue piercer when tongue piercing goes wrong. Most importantly, the licensed tongue piercer should have all the necessary equipment to perform the piercing, especially when  it does go wrong.

Tongue Piercing Aftercare

The following are precautionary steps for tongue piercing aftercare:

• It is normal that a person experiences swelling episodes after tongue piercing. As a result, this symptom may lead to difficulty in eating or speaking. Experts would recommend that the person consumes a lot of cold beverages or suck on ice cubes to reduce the swelling.
• When breathing is considered a problem, it is advised to seek medical help.
• Avoiding hot and spicy foods is a must to prevent swelling episodes and further tongue piercing problems
• Consuming juices, ice cream, and milkshake not only solves the swelling, but it is also a good source of  energy food.
• Rinsing the mouth with saline water is also advised to prevent bad breath.
• Washing hands before touching the tongue jewelry is advised to prevent infection.
• Taking zinc and vitamin c will aid in the healing process.
• In the first few weeks, people who have undergone tongue piercing are advised to eat an easy diet that does not involve a lot of chewing.

Pros and Cons of Tongue Piercing

People who consider undergoing tongue piercings will have to know the pros and cons before they choose to do so. The following are the pros of tongue piercing:

• Fad or fashion statement
• Cultural rite of passage

The following are the cons of tongue piercing:

• It can cause inflammation.
• It can cause injury.
• Bleeding can happen.
• It can alter the tongue anatomy.
• It can pose a  risk of infection and other diseases
• It can make speaking, swallowing, and eating difficult
• It can lead to tooth, gum, and other oral damages

A forked tongue after post-tongue-piercing inflammation and infection

Tongue Piercing Side Effects and Risks

There are risks associated with tongue piercing. The following are risks that is associated with tongue piercing:

• HIV or hepatitis
• Tongue infection
• Blood loss
• Pain
• Increased saliva production
• Gum shrinkage
• Inflammation
• Nerve damage
• Tooth damage
• Difficulty in speech and taste

It is advised to first weigh the side effects as well as the advantages of tongue piercing before undergoing the procedure.

What is a swollen thyroid?

Anatomically speaking, the thyroid gland, located at the front portion of the neck, is part of the endocrine body system. A swollen thyroid or medically termed as goiter is an enlargement of the thyroid gland. Furthermore,  people who suffer from a swollen thyroid are occasionally battling against hypothyroidism. However, there are actually a lot of reasons which cause the thyroid gland to swell. These reasons will be explained later in the discussion on the causes for a swollen thyroid.

What does a swollen thyroid mean?

When a person has a swollen thyroid, it can bring about many problems. Often termed as a disorder in the thyroid gland, a swollen thyroid does not mean that the thyroid gland is malfunctioning, but rather it describes the gland’s size.

What causes a swollen thyroid?

As mentioned earlier, there are a lot of triggering factors which lead to a swollen thyroid gland. The following are common causes of a swollen thyroid:

1. Pregnancy

When a woman is pregnant, it is a normal that there will be a massive hormone production in the thyroid gland, causing it to swell. During pregnancy, the body produces a hormone called human chorionic gonadotropin  (HCG), which causes the thyroid gland to swell.

2. Graves’ disease

Another condition which causes the swelling of the thyroid gland is Graves’ disease, which is an autoimmune disease. Here, the antibodies in the immune system would stimulate the thyroid gland to overproduce hormones in the thyroid gland.

3. Iodine insufficiency

In the past, iodine insufficiency was considered to be the major cause of a swollen thyroid. When a person has insufficient iodine in his or her body, the pituitary gland will then send a message to the thyroid gland for the latter to produce iodine, which will then, in turn, cause a swollen thyroid gland or thyroid goiter.

4. Inflammation of the thyroid gland

The inflammation of the thyroid gland is often called thyroiditis. The inflammation will lead to a swollen thyroid gland as well as pain and difficulty in swallowing. This medical condition may cause hyperthyroidism or hypothyroidism.

5. Hashimoto disease

This is an immune disorder wherein the immune system destroys the thyroid gland, leading to its damage and eventually its swelling.

6. Thyroid cancer

In the case of thyroid cancer, which is a rare condition, the person will manifest a swollen nodule or a cancerous growth on one side of the neck.

7. Nodules

Nodules is a medical term which means bumps or lumps that can be found in the thyroid gland. When there is a benign nodule, it is mostly singular in number. However, when there are multiple nodules (more than one), the thyroid gland becomes swollen.

Swollen Thyroid Symptoms

A bump on the neck as a common sign of goiter

People who have a swollen thyroid will manifest one or some of the following symptoms:

• Migraine
• Excessive fatigue
• Abnormally heavy menstrual bleeding
• Swollen and stiff joints
• high cholesterol level
• Increased weight
• Cramps and weakness in the muscular region
• Constipation
• Dizziness
• Stridor
• Sensitive to cold weather
• Hypersomnia
• Diarrhea
• Sleeping problems
• Reddened skin
• Abnormal pulse rate
• Brittle hair
• Weight loss
• Heat intolerance
• Swallowing difficulties
• Hoarse voice
• Forgetfulness
• Mood swings
• Nervousness
• Faster-or slower- than-average metabolism
• Enlargement of the front portion of the neck
• Pain in the throat
• Swollen lymph node in the neck

If one or some of the above symptoms occurs, it is advised to seek medical help to prevent further aggravation of the symptoms.

Swollen Thyroid Treatments

Before discussing treatments for a swollen thyroid, a physician should first inspect the degree of enlargement of the thyroid gland. When the production of thyroid hormones minimally deviates from the normal acceptable level, there is no need to worry for it does not warrant treatment. However, when the production of thyroid hormones significantly deviates from the normal acceptable level, treatment is warranted. The following are treatments that are used to treat a swollen thyroid:

Pharmacological treatment

The medical state of the thyroid gland, be it underactive or overactive, will be the basis of the treatment management. If, for instance, a person has an underactive thyroid gland, then the following treatments are prescribed:

1. Synthetically prepared thyroid hormones
2. Synthroid
3. Levothyroid

If there is an overactive thyroid gland, then the  following anti thyroid medications are prescribed:

1. Methimazole
2. Propylthiouracil
3. Radioactive iodine

Other prescribed medications that manage symptoms of a swollen thyroid gland include anti-inflammatory drugs such as:

1. Prednisone
2. Cortisone
3. Aspirin

Surgical treatment

This treatment procedure is done only when the swollen thyroid gland interferes with a person’s breathing. The usual surgical treatment procedure is called thyroidectomy, which involves the removal of the thyroid gland. This will warrant a lifetime medication to maintain the normal thyroid hormone level.

What is Low Platelet Count?

Low Platelet Count is medically termed as thrombocytopenia. Platelets, which are colorless blood cells, actually play a vital role in the circulatory system, and they are associated with abnormal bleeding and clotting. Platelets, which are produced in the bone marrow, halt blood loss by clumping together and forming plugs in blood vessel holes. Low platelet count is considered to be an abnormal medical condition which can happen to anybody, and it is brought about by many reasons.  When treated properly, the condition of the person improves.

What does low platelet count mean?

Normally, the platelet count is around 150,000 to 450.000 per microliter. Thrombocytopenia occurs when the platelet count is less than 50,000 per microliter.  When a person has a low platelet count, he or she is prone to bleeding episodes which do not stop due to insufficient platelets.

Low Platelet Count Symptoms and Signs

People who have a low platelet count will experience the following symptoms and signs:

• Easy bruising
• Prolonged bleeding
• Spontaneous bleeding either from nose or gums
• Unusual heavy menstrual flow
• Profuse bleeding
• Petechiae or pinpoint-sized reddish or purplish spot
• Purpura
• Ecchymoses

Low Platelet Count Causes and Risk Factors

There are a lot of causes of a low platelet count. The following are the common reasons behind a low platelet count:

• Fancoi anemia
• Sepsis
• Bacterial infection
• Viral infection
• Folic acid deficiency
• Leukemia
• Bernard Soulier syndrome
• Aplastic anemia
• May Hegglin anomaly
• Vitamin B12 deficiency
• Grey platelet syndrome
• Myelodysplasia
• Bone marrow infection
• Paroxysmal nocturnal hemoglobinuria
• Post-transfusion purpura
• Systemic lupus erythematosus
• Pseudothrombocytopenia
• Dilutional thrombocytopenia
• Neonatal alloimmune thrombocytopenia
• Hemolytic uremic syndrome
• Pregnancy
• HIV-associated thrombocytopenia
• Dengue fever
• Hypersplenism
• Idiopathic thrombocytopenic purpura
• Antiphospholipid syndrome
• Hemolysis, elevated liver enzymes, and low platelets  syndrome
• Vasculitis
• Disseminated intravascular coagulation
• Wiskott-Aldrich syndrome
• Alport syndrome
• Thrombocytopenia-inducing drugs such as:

• Panobinostat
• Isotretinoin
• Carboplatin
• Methotrexate
• Valproic acid
• H2 blockers
• Proton pump inhibitors
• Chemotherapy medications
• Quinidine drugs
• Digoxin
• Rifampin

Low Platelet Count Diagnosis

There are two important tests used to diagnose low platelet count:

Physical examination

A physical examination is the primary exam that a person who is suspected of having a low platelet count should undergo. It is actually protocol that a physical examination is part of every diagnostic test in every suspected case. When a person with a low platelet count undergoes a physical examination, he or she will manifest petechiae (bruising) and spleen enlargement.

Blood examination

A low platelet count is normally detected in a blood examination. Usually a complete blood count (CBC) is performed to determine the actually number of blood cells (which include platelets) in the blood sample that the phlebotomist has taken from the person. If, for instance, a person has less than 150 platelets per microliter, then he or she has a low platelet count.

Other tests include the following:

• Aspiration of the bone marrow
• Biopsy
• Platelet-associated antibodies

Low Platelet Count Treatments

The type of treatment will depend on the cause and the severity of thrombocytopenia. For those who are suffering a milder form of low platelet count, treatment is usually unnecessary for it will resolve on its own. The following are suggested treatments for people who suffer from low platelet count:

1. Blood transfusions

This is necessary if the blood count is lower than normal. The physician can order platelets or packed red blood cells for transfusions sessions.

2. Pharmacological treatment

Medications like corticosteroids which block antibodies that are known to attack platelets may be a good treatment for people with idiopathic thrombocytopenic purpura. Those who suffer from autoimmune thrombocytopenia may respond well to intravenous immunoglobulin. However, there are cases when  pharmacological drugs causes a low platelet count. Hence, such medications like heparin products, for example, should be removed or avoided.

3. Surgical removal of the spleen

Splenectomy, a surgical removal of the spleen, is performed on people who suffer from idiopathic thrombocytopenic purpura and who do not get relief from corticosteroids.

4. Treatment of the primary underlying cause of a low platelet count

Physicians identify and treat  the underlying cause of thrombocytopenia.

Pseudoephedrine or PSE is a sympathomimetic drug belonging to the class of amphetamine and phenethylamine chemicals. Pseudoephedrine is found in several over the counter medications in combination with other drugs or as single ingredient. It is often combined with antihistamines, dextromethorphan, paracetamol (acetaminophen), guaifenesin or an NSAID.  Pseudoephedrine is readily reduced to methamphetamine. Pseudoephedrine is present as a plant alkaloid in Ephedra species (ma huang). However, PSE for commercial use is usually produced from the fermentation of dextrose with benzaldehyde. Its use is monitored because of its side effects and because of the potential in using it in the making of illegal drugs such as methamphetamine.

Uses

1. PSE is a stimulant and is most commonly used as a nasal or sinus decongestant. It reduces nasal congestion by constricting the blood vessels and reducing swelling in the nasal mucosa. It is often indicated for allergies and common colds associated with nasal congestion.
2. Additional effects include decongestion of the Eustachian tubes and drainage of secretions in the sinus because of its vasoconstriction action.
3. Pseudoephedrine can be used as a topical decongestant or can be orally taken. The benefit of taking the oral form is that it does not cause rebound congestion.
4. Pseudoephedrine may also be used as an antitussive (cough suppression).
5. Because of its sympathomimetic effect, it is also used in priapism (painful and prolonged erection).

Pseudoephedrine Side effects

Pseudoephedrine side effects are sympathomimetic. These include CNS stimulation, excitability, restlessness, insomnia and nervousness, tachycardia or palpitations, tremors and irritability, mania, hypertension, impotence, anginal pain, and rebound congestion.

1. CNS stimulation, excitability, restlessness

Pseudoephedrine releases endogenous norepinephrine which stimulates the sympathetic nervous system to a fight or flight response. This leads to stimulation and excitability. Pseudoephedrine should not be used by a person with an anxiety disorder because it may cause heightened anxiety levels. Other stimulants such as caffeine should be avoided to prevent further pseudoephedrine CNS side-effects.

2. Insomnia and nervousness

Because of heightened stimulation, people taking PSE may experience insomnia and nervousness. These side-effects may be relieved through ingestion of warm milk at bedtime to induce sleeping. Pseudoephedrine should only be taken during the day to prevent difficulty falling asleep at night.

3. Tachycardia or palpitations

Pseudoephedrine causes an adrenergic response.  This means it can increase the stimulation of the heart muscle leading to fast heart rate and/or palpitations. To prevent this, inform your physician if you have a heart condition or wear a pacemaker.

4. Tremors and irritability

Norepinephrine is released in the neuronal synapse which increases nerve impulse transmission in the brain causing elevated motor activities but can be relieved through engaging in activities involving the hand such as using stress balls and range of motion exercises.

5. Mania

People with bipolar disorder may experience mania and restlessness as pseudoephedrine side-effects through over stimulation of the CNS. An anti-manic drug such as valproic acid is often prescribed for manic patients who are advised to avoid further stimulation by remaining in calm and neutral surroundings.

6. Hypertension (high blood pressure)

PSE exerts a vasoconstriction effect. When the arteries are constricted, there is an increase in pressure and peripheral resistance, causing hypertension.  Though this may be treated with antihypertensive medications their effects may be lessened by PSE. Home remedies may include avoidance of high fat and high salt foods. Patients receiving PSE should discuss the presence of hypertension thus allowing their physician to choose an alternative nasal decongestant.

7. Impotence

Penile erection is a major function of the parasympathetic nervous system. In the administration of pseudoephedrine, the sympathetic nervous system is stimulated, thereby relaxing the parasympathetic nervous system, which may eventually lead to impotence. Short-term use of the drug may not cause significant effect on erection, but long-term use may eventually lead to impairment of sexual function.

8. Anginal Pain

Vasoconstriction of the coronary arteries leads to reduced blood flow to the myocardium (heart muscle), increasing its workload. There is a decrease in the oxygen supply to the myocardium which cannot cope with the increase in demand, leading to angina pain or chest pains.

9. Rebound Congestion

As previously stated, pseudoephedrine can be used as a topical decongestant or can be orally taken. The benefit of taking the oral form is that it does not cause rebound congestion.  In other forms, however, rebound congestion may result.
When blood vessels constrict, there is reduction in capillary permeability, which reduces swelling in the nasal passages. This relieves nasal congestion and improves drainage. However, body has a balancing effect to maintain equilibrium, and these blood vessels dilate after constriction to regulate blood pressure and blood circulation. Once the blood vessels dilate, it causes congestion again. The more a person takes a non-oral form of pseudoephedrine, the more the rebound effect will occur. To prevent this, patients should not use PSE for prolonged periods.

Advantages of Pseudoephedrine

Despite the side-effects, it is often prescribed because of its advantages in reducing nasal congestion and as a stimulant. The use of pseudoephedrine is beneficial when proper administration is carried out. The advantage of pseudoephedrine as a nasal decongestant or stimulant is that it has a faster effect than other sympathomimetics. Pseudoephedrine is a powerful medication and is centrally acting, thereby enhancing its effects.
Interactions

1. Pseudoephedrine should not be used concomitantly with MAOI’s (monoamine oxidase inhibitors) because of hypertension.
2. The use of pseudoephedrine with antihypertensive medications reduces their effects on lowering blood pressure.
3. Increase in pacemaker activity may be noted when used concomitantly with digitalis.
4. Kaolin inhibits absorption of pseudoephedrine, while antacids increase the rate of absorption.

Contraindications

Pseudoephedrine is contraindicated in patients with cardiovascular disease, diabetes mellitus, uncontrolled hypertension, prostatic hypertrophy, closed angle glaucoma, coronary artery disease and hyperthyroidism. It is also contraindicated during pregnancy because it causes poor placental perfusion.

News

Pseudoephedrine has been a regulated drug because of its use in the production of methamphetamine by illegal drug makers. It is banned for use by athletes because of its stimulating effect and because it may cause them to test positively for amphetamine use. This has caused its withdrawal from the market.