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| Sunday, 18 July 2004 |
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Features |  |
| News Business Features Editorial
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Dealing with stress Stress is a normal human emotion experienced, when a person faces a difficult or threatening situation, says Dr. Hans Vischjager a psychotherapist fromthe Netherlands now residing in Sri Lanka. In an interview with Indira Dahanayake of Sunday Observer he explains the symptoms of day-to-day problems caused mainly by stress.
For example; he points out, if you have to sit for an examination, it is natural to feel some stress. This stress may be useful, as it will make you more alert and inspires you to study harder. However, if the stress is so intense that you are unable to recall what you have studied, then it becomes a problem. Types of stress disorder General anxiety: This is experienced in the absence of an immediately obvious cause and is sustained. Panic attack: Unexpected sudden surges of stress. The fear that is experienced is so intense that it makes the person feel that he is dying or losing consciousness. PhobiA: A person who has a phobia feels symptoms of intense stress when faced with particular situations and they make an effort to avoid these situations, e.g. a person who has a social phobia will avoid people, while those who fear heights will avoid heights. Phobias become a problem if the person has to face it daily and as a result he or she is unable to carry out day-to-day activities. Obsessive Compulsive Disorders (OCD) A person may be plagued by repetitive disturbing thoughts which they are unable to resist eg. thoughts that their loved ones may die, or they may feel compelled to do an action over and over again e.g. washing hands or cheeking repeatedly if the door is closed. These thoughts and actions intrude and disrupt day to day activities. Symptoms of anxiety Palpitations; chest pains; difficulty in breathing; heavyness and pain in the limbs; sweating; abdominal pain; indigestion; nausea; headaches; dizziness; tingling of the hands or feet; sleep disturbances. ###### Harnessing nuclear energy for healing Nuclear medicine is a comparatively new discipline in the medical field. Dr. ANSHU RAJNISH SHARMA, of the Department of Nuclear Medicine, Apollo Hospitals Colombo, explains to CAROL ALOYSIUS the significance of nuclear medicine in detecting, diagnosing and treating several serious illnesses.
Q: What is nuclear medicine ? A: Nuclear Medicine is a medical specialty that uses very small amounts of radioactive materials (or tracers) to diagnose and treat a variety of diseases. Nuclear Medicine is an ideal example of peaceful and constructive use of nuclear energy. In this medical discipline, energy (gamma rays) emitted from decay of radioisotopes are used for imaging various organs of the body. Q: Is Nuclear Medicine an imaging modality alone ?
A: Majority of our clinical work involves diagnostic imaging nowadays. But radioisotopes like radioiodine have been used for the last 50 years throughout the world for treatment of thyroid diseases like hyperthyroidism, toxic adenoma and thyroid cancer. Breast cancer in women and prostate cancer in men have a tendency to spread to bones and cause severe bone pains. Usually analgesics and narcotic drugs give symptomatic relief in such patients. If this treatment fails, use of radioisotopes like Strontium 89, Phosphorus 32, Samarium 153 and Rhenium 186 is the only option left for palliation of bone pain and improving quality of life of such patients with extensive secondaries. Q:How does it differ from diagnostic radiology ? A: In Nuclear Imaging, source of radiation i.e. isotope is introduced within the organ and the body and a special camera (Gamma camera) receives gamma rays emitting from he patient to make an image (Emission Scan). In diagnostic radiology, source of radiation (X-rays tube) is placed outside body and X-rays are beamed and made to pass through the organ of interest so as to make an image on film (Transmission Scan). Nuclear Medicine is unique in that it diagnoses disease based on organ function (Functional Imaging), in contrast to diagnostic radiology, which determines presence of disease based on structural appearance (Anatomical Imaging). Q: How significant is information about organ function ? A: Each organ in our body performs a particular function like kidneys eliminate toxic substances from the body. With the onset of disease process, derangement in organ function starts well before any structural changes take place within the organ. Because of this inherent reason, Nuclear Scans (Functional Imaging) have the advantage of picking up or diagnosing disease well in advance before it becomes clinically apparent or demonstrable by other diagnostic tests. Therefore nuclear scans are highly sensitive and help in early detection of disease. This early detection allows the disease to be treated early in its course when there are better chances of successful treatment and cure. Q: Will Nuclear Medicine scans make the patient radioactive ? A: In Nuclear Medicine, short-lived radioisotope are injected in tiny amounts for scanning purpose, which lose their energy or radioactivity very quickly (usually within hours) and pass out of the body quickly in urine. Q: Do Nuclear Scans hurt? A: Other than the minor needle prick, Nuclear Scan are painless and safe. They are remarkably free of any allergy, inconvenience, or after effects ! Q: Is Nuclear Scan Safe ? A: Nuclear Scans are among safest diagnostic imaging exams available. Millions of Nuclear Scans are performed worldwide each year. The amount of radiation from Nuclear Scan is comparable to that received during a diagnostic X-ray. During our day-to-day life, we are continuously exposed to radiation from natural sources like rocks, soil, space and constituents of our body itself. This accounts for 85 per cent of total radiation exposure. Additional exposure is through manmade household consumer products like watch dials, television sets, smoke detectors etc. The remainder exposure is from X-ray and Nuclear Medicine Scans. This exposure from medical imaging is equivalent to radiation exposure acquired in a few days to months of normal living. Q: What types of scans are performed with this techniques ? A: A Nuclear Medicine facility offers a wide range of scans like Whole Body Bone Scan to detect cancer spread, Heart Scan (Myocardial Perfusion SPECT) for Coronary Artery Disease, Dynamic Renal Scans for studying function and drainage pattern of kidneys, DMSA Renal scans in urinary tract infection and congenital anomalies, Hepatobiliary Scans for Gall Bladder Diseases, Liver-Spleen Scans for Alcoholic Liver Disease and Cirrhosis (liver failure), Lung Perfusion Scans for diagnosing blood clots in the lungs (Pulmonary Embolism), Thyroid Scans for various thyroid disorders, Radioiodine (1-131) Whole Body Scans for detection of metastasis from Thyroid Cancer, Parathyroid Scans for Parathyroid Tumor, Brain SPECT Scan for various spectrum of dementias, epilepsy and stroke. Q: Do patients require any special preparations before a scan ? A: There is no special preparation like overnight fasting or full bladder for majority of scans except for Myocardial Perfusion scan and Hepatobiliary Scan. However, prior appointment with the concerned department is appreciated. Q: How much does this procedure cost ? It is more expensive than other procedures ? A: It is less expensive than or equivalent to a CT Scan and less costly than an MRI. (Magnetic Resonance Imaging) Q: What is a SPECT Scan? SPECT stands for (Single Photo Emission Computerised Technology) A: The Gamma Camera revolves around the patient gathering information from all angles and creates cross sectional images of the organ, so that deep seated lesions are better detected. Certain diseases which are located deep in the organ can be diagnosed by SPECT. What we do is to, create 'slices' of the organs and these 'slices' are displayed in certain orientations e.g. transaxiel, long axiel, or oblique views to give better delineation of a local disease process deeply located within the organ. Q: What about heart diseases ? Can in this procedure help detect heart disease early? A: With the help of Myocardial Perfusion SPECT and Gaited SPECT Scan, we can diagnose coronary heart disease and its extent non invasively. Q: What does this procedure involve ? A: In this procedure, we make patients walk on a treadmill machine and we give them an injection of radio-tracer (myoview) intravenously, after which we take a run of their heart. Similarly a second injection is given at rest after two hours. These 'stress scans and 'rest' scans are then compared to find out whether the patient has shown a reduction in blood supply to the muscle of the heart during stress due to significant blocking of the coronary arteries. By this test the function of the pumping capacity of the heart is also known. Q: What is the normal heart pumping capacity ? A: Normally heart pumping capacity (ejection flexion) should be more than 55 per cent, If it is less we can quantify the functional status of the heart. Q: Is this procedure expensive ? A: It is cheaper than an Angiogram. Furthermore it eliminates that need for hospitalisation as it is done in the OPD. Q: How long does the whole procedure take ? A: It takes about 4-5 hours after which the patient can go back home. Q: What is the greatest advantage of using this technique ? A: These Nuclear Scans (Functional Imaging) can help in early detection of disease in organ functioning thereby allowing for early treatment and better chance of recovery and survival. |
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| Editorial | Security Produced by Lake House |
All of us experience stress for short periods from time to time.
However, when the feeling of stress is so intense a person is unable to
carry out day-to-day activities. Stress to this degree can be considered
an illness," says Dr. Hans Vischjager.
