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Bob M: A little audience reaction to the conference follows:Flyaway: Thank you Bob and Dr cheap aricept 5mg amex. It helped me when I was going to go inpatient to read the stories that you had in there! This conference has given me some things to think about discount aricept 5mg. Bob M: Our topic tonight is Diet Drugs and Weight Control 10mg aricept overnight delivery. We get emails daily about the diet drug controversy and other weight control issues. He is an expert on the issue of weight control, obesity and diet drugs ( eating disorder information ). I believe his entire practice now consists of working with patients concerned about their weight. Can we start off by you telling us a bit about your expertise? Dr Krentzman: Thanks Bob, For the last 23 years I have been interested in obesity. I switched from being a Board Certified Family Physician to only taking care of obesity patients in 1993. For the past 2 1/2 years I have maintained the largest website on obesity and have continued to research this subject. Dr Krentzman: Overweight is defined as being over 20% heavier than the Insurance companies Ideal Body Weight chart for your height and weight. You can be overweight and not obese if you are a weight lifter. The Body Mass Index (BMI) is a single scale used by obesity researchers as a measure of fat. It is a combination of height and weight to give one number. On the BMI scale the government says that 25 or above is overweight and 27+ is obese. Bob M: What is the cause(s) then for being overweight vs. Dr Krentzman: Mostly people are overweight because they were born with the genetics which lead to being overweight. The genes are the program within our bodies that tell our brains how to operate. How we process food seems to be of little importance to obesity. There is an organ in the brain which regulates how much fat our body maintains. That organ is the hypothalamus and through a complex of neurotransmitters in the brain and the sympathetic nervous system, it closely regulates what we want to eat. Dr Krentzman: Since the success rate of long term weight maintenance is 2%, I do not see much point. Now I guess is as good a time as any to bring up the diet drugs. And I want to mention, before we get into it, that everyone here I imagine has heard the FDA warnings about taking fen-Phen and other diet drugs. It is very important that you check with your doctor before taking any weight control drugs. Dr Krentzman: There is a tremendous amount of misunderstanding about the announcements in the press. The Mayo Clinic Press Conference on 7/8/97 was an announcement of a suspected condition (heart valve disease) which MIGHT be connected with obese women. At the press conference, a transcript of which is on my website, the doctor reading the message said that NO patient should stop their medicines without talking to their doctor. There is NO PROOF of any long term problems with the diet drugs as there has been only one article of a study longer than one year. Bob M: Are you saying, contrary to the FDA warning, that taking drugs like Fen-phen and Redux is safe? Dr Krentzman: No, I am saying that the "Warning" is a routine way that the FDA asks all the doctors in the USA to be on the lookout for similar problems and to phone in with case reports when we find one. So far about 70 cases have been found out of the 8,000,000 users of diet drugs. Compare this with the 300,000 people who die each year from obesity related illnesses. Bob M: Everybody has been so patient in the audience. Krentzman is an expert in obesity and weight control. Lady: I have never been to a conference, but I have a question... Why is it soooo much harder if you only have 20 pounds to lose than if you have 100? If you have, for instance, two people who are 5 foot 7 inches tall and one is 150 pounds and the other is 250 pounds then it takes more calories to keep the 250 pound person at that weight. Therefore they can burn more calories in a day than the more slender person can. River: Whether or not there is proof, why would anyone want to create health problems in addition to their weight problem. Dr Krentzman: The FDA asked our help in finding cases so they could get some idea if the diet drugs are somehow involved with heart valve illness. This has not yet been proven, only partly suggested. Should this cause tens of thousands of obese people to die by avoiding the diet drugs WHICH WORK? I guess the choice is the health problem I understand vs. Bob M: Can you please explain when it is appropriate to consider taking diet drugs like Fen-Phen and Redux? Dr Krentzman: Anyone who has a BMI of 30 or more will benefit. Those with less weight (you can see a BMI chart on my website) can benefit if you are a BMI of 27 or more and have heart disease, diabetes or hypertension. Koop, former Surgeon General of the United States believes that Diabetics could benefit down to a BMI of 20 I will not help anyone lose weight below 20 because that is where lifespan begins to shorten. Bob M: What is the difference between Fen Phen and Redux and what is each indicated for? Dr Krentzman: Phen/Fen is made up of two separate drugs, Phentermine and Fenfluramine. Redux is made of one drug which is the active weight controlling half of Fenfluramine (Pondimin). The only side effect I experienced was a horrible headache that lasted 4 days. Lori H: I was on fen - phen for a few months and gained 15 pounds. Dr Krentzman: Phen/Fen is made up of two separate drugs, Phentermine and Fenfluramine. Redux is made of one drug which is the active weight controlling half of Fenfluramine (Pondimin). In other words, fenfluramine and redux are the same. No one has ever given me any proof that my belief, loudly stated on my website, is wrong. Less than 1% have diarrhea or constipation and even less have mental confusion or short term memory problems. All these side effects go away when the level of medicines is reduced or stopped. Dr Krentzman: For the person who wondered why they could gain 15 pounds of Phen-Fen, The medication combination works on 60% of humans, and not on 40%.
Remember that the person involved in emotional crisis is not thinking clearly order aricept 5mg line; encourage him or her to refrain from making any serious buy aricept 5mg fast delivery, irreversible decisions while in a crisis aricept 10mg mastercard. Talk about the positive alternatives which may establish hope for the future. Although you want to help, do not take full responsibility by trying to be the sole counsel. Seek out resources which can lend qualified help, even if it means breaking a confidence. Let the troubled person know you are concerned - so concerned that you are willing to arrange help beyond that which you can offer. UCLA suicide prevention experts have summarized the information to be conveyed to a person in crisis as follows:The suicidal crisis is temporary. Divorce, separation, broken relationship, stress on family. Loss of job, home, money, status, self-esteem, personal security. In younger individuals, depression may be masked by hyperactivity or acting out behavior. In the elderly, it may be incorrectly attributed to the natural effects of aging. Depression that seems to quickly disappear for no apparent reason is cause for concern. The early stages of recovery from depression can be a high-risk period. Suicidal feelings are often the result of longstanding problems that have been exacerbated by recent precipitating events. The precipitating factors may be new pain or the loss of pain coping resources. Hopelessness: the feeling that the pain will continue or get worse; things will never get better. Feelings of worthlessness, shame, guilt, self-hatred, "no one cares". Personality changes: becomes sad, withdrawn, tired, apathetic, anxious, irritable, or prone to angry outbursts. Declining performance in school, work, or other activities. Declining interest in sex, friends, or activities previously enjoyed. Neglect of personal welfare, deteriorating physical appearance. Alterations in either direction in sleeping or eating habits. Difficult times: holidays, anniversaries, and the first week after discharge from a hospital; just before and after diagnosis of a major illness; just before and during disciplinary proceedings. Explicit statements of suicidal ideation or feelings. Development of suicidal plan, acquiring the means, "rehearsal" behavior, setting a time for the attempt. Self-inflicted injuries, such as cuts, burns, or head banging. Making out a will or giving away favorite possessions. The majority of the population, at any one time, does not have many of the warning signs and has a lower suicide risk rate. But a lower rate, in a larger population, is still a lot of people - and many completed suicides had only a few of the conditions listed above. In a one person to another person situation, all indications of suicidality need to be taken seriously. Crisis Intervention Hotlines that accept calls from the suicidal, or anyone who wishes to discuss a problem, are (in New York City): The Samaritans at 212-673-3000 and Helpline at 212-532-2400. The common link among people who kill themselves is the belief that suicide is the only solution to a set of overwhelming feelings. The attraction of suicide is that it will finally end these unbearable feelings. The tragedy of suicide is that intense emotional distress often blinds people to alternative solutions... We all experience feelings of loneliness, depression, helplessness, and hopelessness, from time to time. The death of a family member, the breakup of a relationship, blows to our self-esteem, feelings of worthlessness, and/or major financial setbacks are serious which all of us may have to face at some point in our lives. What may seem of minor importance to someone else - and an event that may be in-significant to you can be extremely distressful to another. Regardless of the nature of the crisis, if a person feels overwhelmed, there is danger that suicide may seem an attractive solution. At least 70 percent of all people committing suicide give some clue as to their intentions before they make an attempt. If a person you know is going through a particularly stressful situation - perhaps having difficulty maintaining a meaningful relationship, having consistent failure in meeting preset goals, or even experiencing stress at having failed an important test- watch for other signs of crisis. It is important to listen to these "cries for help" because they are usually desperate attempts to communicate to others the need to be understood and helped. Often persons thinking about suicide show outward changes in their behavior. They may prepare for death by giving away prized possessions, making a will, or putting other affairs in order. They may withdraw from those around them, change eating or sleeping patterns, or lose interest in prior activities or relationships. A sudden, intense lift in spirits may also be a danger signal, as it may indicate the person already feels a sense of relief knowing the problems will "soon be ended. Most suicides and suicide attempts are made by intelligent, temporarily confused individuals who are expecting too much of themselves, especially in the midst of a crisis. MYTH: "Once a person has made a serious suicide attempt, that person is unlikely to make another. Persons who have made prior suicide attempts may be at greater risk of actually committing suicide; for some, suicide attempts may seem easier a second or third time. MYTH: "If a person is seriously considering suicide, there is nothing you can do. Persons attempting suicide want to escape from their problems. Instead, they need to confront their problems directly in order to find other solutions - solutions which can be found with the help of concerned individuals who support them through the crisis period, until they are able to think more clearly. MYTH: "Talking about suicide may give a person the idea. Your openness and concern in asking about suicide will allow the person experiencing pain to talk about the problem which may help reduce his or her anxiety. This may also allow the person with suicidal thoughts to feel less lonely or isolated, and perhaps a bit relieved. Comprehensive Information on Suicide After the suicide of a loved one or friend, you may feel shock, disbelief and, yes, anger. They made a devastating choice that will impact the rest of your life, leaving you to pick up the pieces and deal with the aftermath. As yourself whether you love or hate the person you lost. Do you feel guilty about loving and missing your loved one? The question is, are you angry at the person who committed suicide or are you angry about the choice he/she made to end his/her life, leaving you behind with the legacy of pain and hurt? Chances are, you are angry at the choice, not the person - and it was your loved one who made that choice, not you.
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