**Deepavali… from Darkness to light**

DEEPAVALI, commonly known as DIWALI, is a major Indian festival spread over 5 days that is very significant in Hinduism known as the "Festival of Lights," it symbolizes the VICTORY OF GOOD OVER EVIL and lamps (diyas) are lit as a sign of celebration and hope for humankind.

"Regardless of the explanations one prefers, what the festival of lights really stands for
today is a reaffirmation of hope, a renewed commitment to friendship and goodwill, and a
religiously sanctioned celebration of the simple — and some not so simple — joys of life."
This year (2008) Deepavali is celebrated over a period of 5 days beginning from the 26th October to the 30th October.

Diwali is one of the most popular and eagerly awaited Hindu festivals around the world.
Hindus regard it as a celebration of life and use the occasion to strengthen family and social
relationships. For Hindus it is one of the most important festivals, and it is a New Year
in some Hindu calendars.

The Deepavali lights represent the time when Shree Raam came back from the forest, and
all in Ayodyhya lit lamps to welcome their most beloved Lord back home after fourteen
years of exile in the forest. Many do believe that when the lamps are lit this helps Mother Lakshmi find her way into people's homes. Celebrations focus on lights and lamps, particularly traditional dipa or deeya (earthen lamp).

Diwali is a colloquial name used in North India, while the festival is formally called Deepavali in South India. The Sanskrit word Deepavali means an array of lights that stands for victory of brightness over darkness. As the knowledge of Sanskrit diminished, the name was popularly modified to Diwali, especially in northern India. In South India, Diwali does not coincide with the beginning of a new year as South Indian Hindus follow a different calendar, where it falls on the night of the new moon in the month of Kartik (this year this day falls on the 28th October).

Hindus find cause to celebrate this festival for different reasons:
• It commemorates the killing of Narakasura, an evil demon who created havoc and
was killed by Lord Krishna Himself. Before Narakasura's death, he requested a boon
from his mother (Mother Earth), that everyone should celebrate his death with
colorful light.
• According to the Skanda Purana, Mother Parvati observed 21 days of austerity
starting from ashtami of shukla paksha (eighth day of the waxing period of moon) to
get half of the body of her dear husband Lord Shiva. This vrat (austerity) is known
as Kedhara Vrata. Deepavali is the completion day of this austerity. This is the day
Lord Shiva accepted Mother Parvati into the left half of his form and appeared as
Ardharishvara.
• Diwali also celebrates the return of Shree Ramachandra, King of Ayodhya, with his
wife Sita and brother Shree Lakshmanji to Ayodhya from a war in which He killed
the demon king Ravana. People light oil lamps along the way to light their path in the
darkness.
• In Bhavishyottara and Brahma Vaivarta Purana, Diwali is associated with Bali
Maharaja, who is allowed to return to earth once a year.

The Five days of Diwali:
Diwali is celebrated over five days in most of India. All the days except Diwali are named
using the designation in the Indian calendar. A lunar half-month is 15 days. Diwali as a newmoon
day marks the last day of a 15-day period. Diwali being festival of lights, across India people celebrate it via symbolic diyas or kandils (colorful paper lanterns) as an integral part of Diwali decorations.

1) Dhan-trayodashi or dhan teras (26th October): Dhan means "wealth" and
Trayodashi means "13th day". Thus, as the name implies, this day falls on the 13th day of
the second half of the lunar month. It is an auspicious day for shopping. This day is of
special importance for traders and business people.
2) Naraka Chaturdasi (27th October): Chaturdasi is the fourteenth day on which
demon Narakasura was killed. (The katha is given below). It signifies the victory of good
over evil and light over darkness. In South India, this is the actual day of festivities.
3) Diwali-Amavasya (28th October): The actual day of Diwali, is celebrated on the
third day of the festival, when the moon completely wanes and total darkness sets in the
night sky. Hindus wake up way before dawn as early as 4h00 in the morning, have a fragrant
oil bath and wear new clothes. They light small lamps all around the house and draw
elaborate rangoli (patterns) outside their homes. They perform pujas (prayer) with offerings to
Shree Sita-Raam/Radha-Krishna/Lakshmi-Narayana, as He liberated the world from the
demon Narakasura on this day. Taking a bath before sunrise, when the stars are still visible
in the sky is equivalent to taking a bath in the Ganga River. Hence, when people greet each
other in the morning, they ask "Have you performed your Ganga Snaanam?” (Well most of us
are not in India so what you can do in this case purchase Ganga Water from your nearest
puja shop and in a bucket pour a cap of Ganga water from the bottle and fill the bucket with
normal water and have a bath… it’s the same thing as bathing in Mother Ganga herself). As
this is a day of rejoicement, many will have very elaborate breakfasts and lunches and meet
family and friends. In the evening, lamps are again lit and Mother Lakshmi is worshipped and
offered special dishes. This being a no moon day (New moon/Amavasya), many will offer
tarpana (offerings of water and sesame seeds) to their ancestors. This is from the Garuda
Purana. Like Christmas in the West, Diwali is very much a time for buying and exchanging
gifts.
4) Govardhan Puja or also called Annakut (29th October), is celebrated as the day
Shree Krishna defeated Lord Indradev. For Annakut a mountain of food (normally halva) is
decorated symbolizing Govardhan Mountain lifted by Lord Krishna. On this day men present
gifts to their wives.
5) Bhayiduj (30th October) — on this day, brothers and sisters meet to express their
love and affection for each other. Most Indian festivals bring together families; Bhaiduj
brings together sisters and brothers, and is a significant festive day for them. This festival
is ancient, and pre-dates 'Raksha Bandhan' another brother-sister festival being celebrated
today.

The celebrations vary in different regions:
• In South India, Naraka Chaturdashi is the main day.
• The main festival in North India is on Amavasya evening with Lakshmi Puja which is
followed by lighting of oil lamps around the house.

Three Diwali Kathas…
Three of the Kathas (stories) of Diwali show the triumph of Good over Evil, and tell of the
destruction of two monsters that preyed on humanity.
The killing of Narakasura: - Narakasura was the evil king of Pragjyotishpur, near Nepal. He
ruled with a reign of terror, abducted 16,000 daughters of the deva, and stole the earrings
of Aditi, mother of the devas. The devas asked Lord Krishna for help, and after a mighty
battle He killed the demon, freed the girls, and recovered the earrings. The rescue of the
16,000 girls is the origin of the story that Shree Krishna had 16,000 wives. After His
victory Lord Krishna returned very early in the morning and was bathed and massaged with
scented oils. Taking an early morning bath with oil is still a Diwali tradition. To read the full
katha of the Killing of Narakaasura.

The killing of the demon Ravana: - Ravana, who had ten arms and ten heads, was the wicked king of the island of Shree Lanka, who kidnapped the wife of Shree Raam. Shree Raam had been in exile for 14 years because of a disagreement as to whether He or His brother
should be the next king in Ayodhya. After a great battle Shree Raam killed Ravana demon
and recovered Mother Sita. Shree Raam's return with Mother Sita to Ayodhya and His
subsequent coronation as king is celebrated at Diwali. When Shree Raam and Mother Sita first returned to Ayodhya it was a dark moonless night and they couldn't see where they were going. Their people put little lamps outside their houses so that the new king and queen could find Their way, thus beginning the tradition of the festival of lights.

The Katha of Bali Maharaj: - In the Srimad Bhagavatam 8th canto chapters 15-23 narrates
the katha of Bali Maharaj and Lord Vamanadeva. Bali Maharaj was born in a demon
family and due to his penance he ruled over material creation including Mother Lakshmi. In
the absence of Lakshmi Mata the world was deprived of their basic needs and suffered
immensely. The devas approached Lord Vishnu who didn’t need much coaxing to incarnate to
save the world… the Lord incarnated as the son of Aditi-devi and the great sage Kashyapa
Muni. Then the Lord known as Vamana (dwarf) deva approached Bali maharaja for three
steps of land which Bali Maharaja immediately agreed despite being asked not to do so by
his Guru. The Lord first step covered the entire surface of the world, and by extending His
body He covered the entire sky. With His hands He covered all directions, and with His
second footstep He covered the entire upper planetary system. Therefore there was no
vacant place where He could take His third footstep. The Lord accepted Bali Maharaja’s
defeat because he couldn’t deliver on his promise and was sent to planet Sutala. When this
happened Mother Lakshmi and all the Devi's and Deva's were released and order restored.
This happened on Diwali day.

A bit of controversy to end. ..many will worry that they cannot take 5 days off from work...you can choose any of the 5 days. Many will choose the 28th but we got to look at the bigger
picture and that this is a time for joy and celebrations. We should be proud other religions
have one main day while we have 5 main days to celebrate Diwali. It makes you feel great to
be a Hindu now.

How to observe this extremely auspicious day:

After you have taken a bath early in the morning and wearing clean clothes go to your prayer place and offer incense, lamp and flowers (all seven times in a clockwise around the picture of Shree Sita-Raam. After that all the food that has been prepared should be offered first to Shree Sita-Raam. Leave the unoffered food before Their Lordships to bless and after about 10 minutes remove from the prayer place and offer that prashad (blessed food) for all to eat.

Many perform Lakshmi Puja on this day. If one likes to perform this puja visit out website and in the ARTILCES block under Vara Lakshmi Puja we have the full puja method explained. But most importantly enjoy these 5 days. During these five days of Deepavali one should not consume any meat.

Thank you for taking time to read this article. We are trying to reach out not only to Hindus
but to others of other faiths as well. By compiling and publishing these articles we hope
that others will understand what a beautiful and diversified way of life Hinduism (Sanathan
Dharma) really is.

Please do visit our Website to receive more free information about our beautiful culture
www.h4all.org

Compiled (for the upliftment of Sanatan Dharma – the Eternal Religion)
Narottam Das (South Africa)

Phone (+27) 32 9444 108 or (+27) 82 714 1504
E-mail nd@h4all.org

Introducing DUKE - German Shepherd X

On a happier note our family is excited to have our very first pet in New Zealand which we brought home today (Saturday 13 September). Kanthan and I made every excuse in the book in putting this off, e.g. how sad we were when we had to leave our dog Zelda behind with our maid when we immigrated to New Zealand (tears!!). Also, that we are likely to go on overseas holidays now and again, and how sad to leave our doggie behind – excuses, excuses! We have been searching for the perfect pet for some time now and on Monday night Thanusha finally found the one she wanted on Trademe at the Fins and Feathers Petshop. Our pup Duke (named by Kaveshan) is a German Shepherd crossed with either a Siberian Husky or Rottweiler. He is was born on 21/07/08 and is now 7 weeks old, black with light brown legs and is expected to grow between 35kg - 4okg!! Welcome to our family Duke :-)

What is Pneumonia - From the Free Dictionary

Pneumonia
Definition
Pneumonia is an infection of the lung that can be caused by nearly any class of organism known to cause human infections. These include bacteria, amoebae, viruses, fungi, and parasites. In the United States, pneumonia is the sixth most common disease leading to death; 2 million Americans develop pneumonia each year, and 40,000-70,000 die from it. Pneumonia is also the most common fatal infection acquired by already hospitalized patients. In developing countries, pneumonia ties with diarrhea as the most common cause of death. Even in nonfatal cases, pneumonia is a significant economic burden on the health care system. One study estimates that people in the American workforce who develop pneumonia cost employers five times as much in health care as the average worker.
According to the Centers for Disease Control and Prevention (CDC), however, the number of deaths from pneumonia in the United States has declined slightly since 2001.
Description
Anatomy of the lung
To better understand pneumonia, it is important to understand the basic anatomic features of the respiratory system. The human respiratory system begins at the nose and mouth, where air is breathed in (inspired) and out (expired). The air tube extending from the nose is called the nasopharynx. The tube carrying air breathed in through the mouth is called the oropharynx. The nasopharynx and the oropharynx merge into the larynx. The oropharynx also carries swallowed substances, including food, water, and salivary secretion, which must pass into the esophagus and then the stomach. The larynx is protected by a trap door called the epiglottis. The epiglottis prevents substances that have been swallowed, as well as substances that have been regurgitated (thrown up), from heading down into the larynx and toward the lungs.
A useful method of picturing the respiratory system is to imagine an upside-down tree. The larynx flows into the trachea, which is the tree trunk, and thus the broadest part of the respiratory tree. The trachea divides into two tree limbs, the right and left bronchi. Each one of these branches off into multiple smaller bronchi, which course through the tissue of the lung. Each bronchus divides into tubes of smaller and smaller diameter, finally ending in the terminal bronchioles. The air sacs of the lung, in which oxygen-carbon dioxide exchange actually takes place, are clustered at the ends of the bronchioles like the leaves of a tree. They are called alveoli.
The tissue of the lung which serves only a supportive role for the bronchi, bronchioles, and alveoli is called the lung stroma.
Function of the respiratory system
The main function of the respiratory system is to provide oxygen, the most important energy source for the body's cells. Inspired air (the air you breath in) contains the oxygen, and travels down the respiratory tree to the alveoli. The oxygen moves out of the alveoli and is sent into circulation throughout the body as part of the red blood cells. The oxygen in the inspired air is exchanged within the alveoli for the waste product of human metabolism, carbon dioxide. The air you breathe out contains the gas called carbon dioxide. This gas leaves the alveoli during expiration. To restate this exchange of gases simply, you breathe in oxygen, you breathe out carbon dioxide
Respiratory system defenses
The healthy human lung is sterile. There are no normally resident bacteria or viruses (unlike the upper respiratory system and parts of the gastrointestinal system, where bacteria dwell even in a healthy state). There are multiple safeguards along the path of the respiratory system. These are designed to keep invading organisms from leading to infection.
The first line of defense includes the hair in the nostrils, which serves as a filter for large particles. The epiglottis is a trap door of sorts, designed to prevent food and other swallowed substances from entering the larynx and then trachea. Sneezing and coughing, both provoked by the presence of irritants within the respiratory system, help to clear such irritants from the respiratory tract.
Mucus, produced through the respiratory system, also serves to trap dust and infectious organisms. Tiny hair like projections (cilia) from cells lining the respiratory tract beat constantly. They move debris trapped by mucus upwards and out of the respiratory tract. This mechanism of protection is referred to as the mucociliary escalator.
Cells lining the respiratory tract produce several types of immune substances which protect against various organisms. Other cells (called macrophages) along the respiratory tract actually ingest and kill invading organisms.
The organisms that cause pneumonia, then, are usually carefully kept from entering the lungs by virtue of these host defenses. However, when an individual encounters a large number of organisms at once, the usual defenses may be overwhelmed, and infection may occur. This can happen either by inhaling contaminated air droplets, or by aspiration of organisms inhabiting the upper airways.
Conditions predisposing to pneumonia
In addition to exposure to sufficient quantities of causative organisms, certain conditions may make an individual more likely to become ill with pneumonia. Certainly, the lack of normal anatomical structure could result in an increased risk of pneumonia. For example, there are certain inherited defects of cilia which result in less effective protection. Cigarette smoke, inhaled directly by a smoker or second-hand by a innocent bystander, interferes significantly with ciliary function, as well as inhibiting macrophage function.
Stroke, seizures, alcohol, and various drugs interfere with the function of the epiglottis. This leads to a leaky seal on the trap door, with possible contamination by swallowed substances and/or regurgitated stomach contents. Alcohol and drugs also interfere with the normal cough reflex. This further decreases the chance of clearing unwanted debris from the respiratory tract.
Viruses may interfere with ciliary function, allowing themselves or other microorganism invaders (such as bacteria) access to the lower respiratory tract. One of the most important viruses is HIV (Human Immunodeficiency virus), the causative virus in AIDS (acquired immunodeficiency syndrome). In recent years this virus has resulted in a huge increase in the incidence of pneumonia. Because AIDS results in a general decreased effectiveness of many aspects of the host's immune system, a patient with AIDS is susceptible to all kinds of pneumonia. This includes some previously rare parasitic types which would be unable to cause illness in an individual possessing a normal immune system.
The elderly have a less effective mucociliary escalator, as well as changes in their immune system. This causes this age group to be more at risk for the development of pneumonia.
Various chronic conditions predispose a person to infection with pneumonia. These include asthma, cystic fibrosis, and neuromuscular diseases which may interfere with the seal of the epiglottis. Esophageal disorders may result in stomach contents passing upwards into the esophagus. This increases the risk of aspiration into the lungs of those stomach contents with their resident bacteria. Diabetes, sickle cell anemia, lymphoma, leukemia, and emphysema also predispose a person to pneumonia.
Genetic factors also appear to be involved in susceptibility to pneumonia. Certain changes in DNA appear to affect some patients' risk of developing such complications of pneumonia as septic shock.
Pneumonia is also one of the most frequent infectious complications of all types of surgery. Many drugs used during and after surgery may increase the risk of aspiration, impair the cough reflex, and cause a patient to underfill their lungs with air. Pain after surgery also discourages a patient from breathing deeply enough, and from coughing effectively.
Radiation treatment for breast cancer increases the risk of pneumonia in some patients by weakening lung tissue.
Causes and symptoms
The list of organisms which can cause pneumonia is very large, and includes nearly every class of infecting organism: viruses, bacteria, bacteria-like organisms, fungi, and parasites (including certain worms). Different organisms are more frequently encountered by different age groups. Further, other characteristics of an individual may place him or her at greater risk for infection by particular types of organisms:
Pneumonia is suspected in any patient who has fever, cough, chest pain, shortness of breath, and increased respirations (number of breaths per minute). Fever with a shaking chill is even more suspicious. Many patients cough up clumps of sputum, commonly known as spit. These secretions are produced in the alveoli during an infection or other inflammatory condition. They may appear streaked with pus or blood. Severe pneumonia results in the signs of oxygen deprivation. This includes blue appearance of the nail beds or lips (cyanosis).
The invading organism causes symptoms, in part, by provoking an overly-strong immune response in the lungs. In other words, the immune system, which should help fight off infections, kicks into such high gear, that it damages the lung tissue and makes it more susceptible to infection. The small blood vessels in the lungs (capillaries) become leaky, and protein-rich fluid seeps into the alveoli. This results in less functional area for oxygen-carbon dioxide exchange. The patient becomes relatively oxygen deprived, while retaining potentially damaging carbon dioxide. The patient breathes faster and faster, in an effort to bring in more oxygen and blow off more carbon dioxide.
Mucus production is increased, and the leaky capillaries may tinge the mucus with blood. Mucus plugs actually further decrease the efficiency of gas exchange in the lung. The alveoli fill further with fluid and debris from the large number of white blood cells being produced to fight the infection.
Consolidation, a feature of bacterial pneumonias, occurrs when the alveoli, which are normally hollow air spaces within the lung, instead become solid, due to quantities of fluid and debris.
Viral pneumonias and mycoplasma pneumonias do not result in consolidation. These types of pneumonia primarily infect the walls of the alveoli and the stroma of the lung.
Severe acute respiratory syndrome (sars)
Severe acute respiratory syndrome, or SARS, is a contagious and potentially fatal disease that first appeared in the form of a multi-country outbreak in early February 2003. Later that month, the CDC began to work with the World Health Organization (WHO) to investigate the cause(s) of SARS and to develop guidelines for infection control. SARS has been described as an "atypical pneumonia of unknown etiology;" by the end of March 2003, the disease agent was identified as a previously unknown coronavirus.
The early symptoms of SARS include a high fever with chills, headache, muscle cramps, and weakness. This early phase is followed by respiratory symptoms, usually a dry cough and painful or difficult breathing. Some patients require mechanical ventilation. The mortality rate of SARS is thought to be about 3%.
As of the end of March 2003, the CDC did not have clearly defined recommendations for treating SARS. Treatments that have been used include antibiotics known to be effective against bacterial pneumonia; ribavirin and other antiviral drugs; and steroids.
Diagnosis
For the most part, diagnosis is based on the patient's report of symptoms, combined with examination of the chest. Listening with a stethoscope will reveal abnormal sounds, and tapping on the patient's back (which should yield a resonant sound due to air filling the alveoli) may instead yield a dull thump if the alveoli are filled with fluid and debris.
Laboratory diagnosis can be made of some bacterial pneumonias by staining sputum with special chemicals and looking at it under a microscope. Identification of the specific type of bacteria may require culturing the sputum (using the sputum sample to grow greater numbers of the bacteria in a lab dish.).
X-ray examination of the chest may reveal certain abnormal changes associated with pneumonia. Localized shadows obscuring areas of the lung may indicate a bacterial pneumonia, while streaky or patchy appearing changes in the x-ray picture may indicate viral or mycoplasma pneumonia. These changes on x ray, however, are known to lag in time behind the patient's actual symptoms.
Treatment
Prior to the discovery of penicillin antibiotics, bacterial pneumonia was almost always fatal. Today, antibiotics, especially given early in the course of the disease, are very effective against bacterial causes of pneumonia. Erythromycin and tetracycline improve recovery time for symptoms of mycoplasma pneumonia. They, do not, however, eradicate the organisms. Amantadine and acyclovir may be helpful against certain viral pneumonias.
A newer antibiotic named linezolid (Zyvox) is being used to treat penicillin-resistant organisms that cause pneumonia. Linezolid is the first of a new line of antibiotics known as oxazolidinones. Another new drug known as ertapenem (Invanz) is reported to be effective in treating bacterial pneumonia.

Shortness of Breath - From the Free Dictionary

Shortness of Breath
Definition
Shortness of breath, or dyspnea, is a feeling of difficult or labored breathing that is out of proportion to the patient's level of physical activity. It is a symptom of a variety of different diseases or disorders and may be either acute or chronic.
Description
The experience of dyspnea depends on its severity and underlying causes. The feeling itself results from a combination of impulses relayed to the brain from nerve endings in the lungs, rib cage, chest muscles, or diaphragm, combined with the patient's perception and interpretation of the sensation. In some cases, the patient's sensation of breathlessness is intensified by anxiety about its cause. Patients describe dyspnea variously as unpleasant shortness of breath, a feeling of increased effort or tiredness in moving the chest muscles, a panicky feeling of being smothered, or a sense of tightness or cramping in the chest wall.
Causes and symptoms
ACUTE DYSPNEA. Acute dyspnea with sudden onset is a frequent cause of emergency room visits. Most cases of acute dyspnea involve pulmonary (lung and breathing) disorders, cardiovascular disease, or chest trauma.
PULMONARY DISORDERS. Pulmonary disorders that can cause dyspnea include airway obstruction by a foreign object, swelling due to infection, or anaphylactic shock; acute pneumonia; hemorrhage from the lungs; or severe bronchospasms associated with asthma.
CARDIOVASCULAR DISEASE. Acute dyspnea can be caused by disturbances of the heart rhythm, failure of the left ventricle, mitral valve (a heart valve) dysfunction, or an embolus (a clump of tissue, fat, or gas) that is blocking the pulmonary circulation. Most pulmonary emboli (blood clots) originate in the deep veins of the lower legs and eventually migrate to the pulmonary artery.
TRAUMA. Chest injuries, both closed injuries and penetrating wounds, can cause pneumothorax (the presence of air inside the chest cavity), bruises, or fractured ribs. Pain from these injuries results in dyspnea. The impact of the driver's chest against the steering wheel in auto accidents is a frequent cause of closed chest injuries.
OTHER CAUSES. Anxiety attacks sometimes cause acute dyspnea; they may or may not be associated with chest pain. Anxiety attacks are often accompanied by hyperventilation, which is a breathing pattern characterized by abnormally rapid and deep breaths. Hyperventilation raises the oxygen level in the blood, causing chest pain and dizziness.
Chronic dyspnea
PULMONARY DISORDERS. Chronic dyspnea can be caused by asthma, chronic obstructive pulmonary disease (COPD), bronchitis, emphysema, inflammation of the lungs, pulmonary hypertension, tumors, or disorders of the vocal cords.
HEART DISEASE. Disorders of the left side of the heart or inadequate supply of blood to the heart muscle can cause dyspnea. In some cases a tumor in the heart or inflammation of the membrane surrounding the heart may cause dyspnea.
NEUROMUSCULAR DISORDERS. Neuromuscular disorders cause dyspnea from progressive deterioration of the patient's chest muscles. They include muscular dystrophy, myasthenia gravis, and amyotrophic lateral sclerosis.
OTHER CAUSES. Patients who are severely anemic may develop dyspnea if they exercise vigorously. Hyperthyroidism or hypothyroidism may cause shortness of breath, and so may gastroesophageal reflux disease (GERD). Both chronic anxiety disorders z of physical fitness can also cause episodes of dyspnea. Deformities of the chest or obesity can cause dyspnea by limiting the movement of the chest wall and the ability of the lungs to fill completely.
Diagnosis
Patient history
The patient's history provides the doctor with such necessary information as a history of gastroesophageal reflux disease (GERD), asthma, or other allergic conditions; the presence of chest pain as well as difficulty breathing; recent accidents or recent surgery; information about smoking habits; the patient's baseline level of physical activity and exercise habits; and a psychiatric history of panic attacks or anxiety disorders.
ASSESSMENT OF BODY POSITION. How a person's body position affects his/her dyspnea symptoms sometimes gives hints as to the underlying cause of the disorder. Dyspnea that is worse when the patient is sitting up is called platypnea and indicates the possibility of liver disease. Dyspnea that is worse when the patient is lying down is called orthopnea, and is associated with heart disease or paralysis of the diaphragm. Paroxysmal nocturnal dyspnea (PND) refers to dyspnea that occurs during sleep and forces the patient to awake gasping for breath. It is usually relieved if the patient sits up or stands. PND may point to dysfunction of the left ventricle of the heart, hypertension, or narrowing of the mitral valve.
Physical examination
The doctor will examine the patient's chest in order to determine the rate and depth of breathing, the effort required, the condition of the patient's breathing muscles, and any evidence of chest deformities or trauma. He or she will listen for wheezing, stridor, or signs of fluid in the lungs. If the patient has a fever, the doctor will look for other signs of pneumonia. The doctor will check the patient's heart functions, including blood pressure, pulse rate, and the presence of heart murmurs or other abnormal heart sounds. If the doctor suspects a blood clot in one of the large veins leading to the heart, he or she will examine the patient's legs for signs of swelling.
Diagnostic tests
BASIC DIAGNOSTIC TESTS. Patients who are seen in emergency rooms are given a chest x ray and electrocardiogram (ECG) to assist the doctor in evaluating abnormalities of the chest wall, also to determine the position of the diaphragm, possible rib fractures or pneumothorax, irregular heartbeat, or the adequacy of the supply of blood to the heart muscle. Also, the patient may be given a breathing test on an instrument called a spirometer to screen for airway disorders.
The doctor may order blood tests and arterial blood gas tests to rule out anemia, hyperventilation—from an anxiety attack—, or thyroid dysfunction. A sputum culture can be used to test for pneumonia.
SPECIALIZED TESTS. Specialized tests may be ordered for patients with normal results from basic diagnostic tests for dyspnea. High-resolution CT scans can be used for suspected airway obstruction or mild emphysema. Tissue biopsy performed with a bronchoscope can be used for patients with suspected lung disease.
If the doctor suspects a pulmonary embolism, heor she may order ventilation-perfusion scanning to inspect lung function, an angiogram of blood vessels, or ultrasound studies of the leg veins. Echocardiography can be used to test for pulmonary hypertension and heart disease.
Pulmonary function studies or electromyography (EMG) are used to assess neuromuscular diseases. Exercise testing is used to assess dyspnea related to COPD, anxiety attacks, poor physical fitness, and the severity of lung or heart disease. The level of acidity in the patient's esophagus may be monitored to rule out GERD.
Treatment
Treatment of dyspnea depends on its underlying cause.
Acute dyspnea
Patients with acute dyspnea are given oxygen in the emergency room, with the following treatments for specific conditions:
Chronic dyspnea
The treatment of chronic dyspnea depends on the underlying disorder. Asthma can often be managed with a combination of medications to reduce airway spasms and removal of allergens from the patient's environment. COPD requires both medication, lifestyle changes, and long-term physical rehabilitation. Anxiety disorders are usually treated with a combination of medication and psychotherapy. GERD can usually be managed with antacids, other medications, and dietary changes. There are no permanent cures for myasthenia gravis or muscular dystrophy.
Tumors and certain types of chest deformities can be treated surgically.
Alternative treatment
The appropriate alternative therapy for shortness of breath depends on the underlying cause of the condition. When dyspnea is acute and severe, oxygen therapy is used either in the doctor's office or in the emergency room. For shortness of breath with an underlying physical cause like asthma, anaphylactic shock, or pneumonia, the physical condition should be treated. Botanical and homeopathic remedies can be used for acute dyspnea, if the proper remedies and formulas are prescribed. If the dyspnea has a psychological basis (especially if it is caused by anxiety), acupuncture, botanical medicine, and homeopathy can help the patient heal at a deep level.

What is Asthma - From the Free Dictionary

Asthma
Definition
Asthma is a chronic (long-lasting) inflammatory disease of the airways. In those susceptible to asthma, this inflammation causes the airways to narrow periodically. This, in turn, produces wheezing and breathlessness, sometimes to the point where the patient gasps for air. Obstruction to air flow either stops spontaneously or responds to a wide range of treatments, but continuing inflammation makes the

A comparison of normal bronchioles and those of an asthma sufferer.
(Illustration by Hans & Cassady.)airways hyper-responsive to stimuli such as cold air, exercise, dust mites, pollutants in the air, and even stress and anxiety.
Description
Between 17 million and 26 million Americans have asthma, and the number seems to be increasing. In about 1992, the number with asthma was about 10 million, and had risen 42% from 1982, just 10 years prior. Not only is asthma becoming more frequent, but it also is a more severe disease than before, despite modern drug treatments. Asthma accounts for almost 500,000 hospitalizations, two million emergency department visits, and 5,000 deaths in the United States each year.
The changes that take place in the lungs of asthmatic persons makes the airways (the "breathing tubes," or bronchi and the smaller bronchioles) hyperreactive to many different types of stimuli that don't affect healthy lungs. In an asthma attack, the muscle tissue in the walls of bronchi go into spasm, and the cells lining the airways swell and secrete mucus into the air spaces. Both these actions cause the bronchi to become narrowed (bronchoconstriction). As a result, an asthmatic person has to make a much greater effort to breathe in air and to expel it.
Cells in the bronchial walls, called mast cells, release certain substances that cause the bronchial muscle to contract and stimulate mucus formation. These substances, which include histamine and a group of chemicals called leukotrienes, also bring white blood cells into the area, which is a key part of the inflammatory response. Many patients with asthma are prone to react to such "foreign" substances as pollen, house dust mites, or animal dander; these are called allergens. On the other hand, asthma affects many patients who are not allergic in this way.
Asthma usually begins in childhood or adolescence, but it also may first appear during adult years. While the symptoms may be similar, certain important aspects of asthma are different in children and adults.
Child-onset asthma
Nearly one-third on the 17 to 26 million Americans with asthma are children. When asthma begins in childhood, it often does so in a child who is likely, for genetic reasons, to become sensitized to common allergens in the environment (atopic person). When these children are exposed to house-dust mites, animal proteins, fungi, or other potential allergens, they produce a type of antibody that is intended to engulf and destroy the foreign materials. This has the effect of making the airway cells sensitive to particular materials. Further exposure can lead rapidly to an asthmatic response. This condition of atopy is present in at least one-third and as many as one-half of the general population. When an infant or young child wheezes during viral infections, the presence of allergy (in the child or a close relative) is a clue that asthma may well continue throughout childhood.
Adult-onset asthma
Allergenic materials may also play a role when adults become asthmatic. Asthma can actually start at any age and in a wide variety of situations. Many adults who are not allergic have conditions such as sinusitis or nasal polyps, or they may be sensitive to aspirin and related drugs. Another major source of adult asthma is exposure at work to animal products, certain forms of plastic, wood dust, or metals.
Causes and symptoms
In most cases, asthma is caused by inhaling an allergen that sets off the chain of biochemical and tissue changes leading to airway inflammation, bronchoconstriction, and wheezing. Because avoiding (or at least minimizing) exposure is the most effective way of treating asthma, it is vital to identify which allergen or irritant is causing symptoms in a particular patient. Once asthma is present, symptoms can be set off or made worse if the patient also has rhinitis (inflammation of the lining of the nose) or sinusitis. When, for some reason, stomach acid passes back up the esophagus (acid reflux), this can also make asthma worse. A viral infection of the respiratory tract can also inflame an asthmatic reaction. Aspirin and a type of drug called beta-blockers, often used to treat high blood pressure, can also worsen the symptoms of asthma.
The most important inhaled allergens giving rise to attacks of asthma are:
Key terms
Allergen — A foreign substance, such as mites in house dust or animal dander which, when inhaled, causes the airways to narrow and produces symptoms of asthma.
Atopy — A state that makes persons more likely to develop allergic reactions of any type, including the inflammation and airway narrowing typical of asthma.
Hypersensitivity — The state where even a tiny amount of allergen can cause the airways to constrict and bring on an asthmatic attack.
Spirometry — A test using an instrument called a spirometer that shows how difficult it is for an asthmatic patient to breathe. Used to determine the severity of asthma and to see how well it is responding to treatment.
Inhaling tobacco smoke, either by smoking or being near people who are smoking, can irritate the airways and trigger an asthmatic attack. Air pollutants can have a similar effect. In addition, there are three important factors that regularly produce attacks in certain asthmatic patients, and they may sometimes be the sole cause of symptoms. They are:
Wheezing is often obvious, but mild asthmatic attacks may be confirmed when the physician listens to the patient's chest with a stethoscope. Besides wheezing and being short of breath, the patient may cough and may report a feeling of "tightness" in the chest. Children may have itching on their back or neck at the start of an attack. Wheezing is often loudest when the patient breathes out, in an attempt to expel used air through the narrowed airways. Some asthmatics are free of symptoms most of the time but may occasionally be short of breath for a brief time. Others spend much of their days (and nights) coughing and wheezing, until properly treated. Crying or even laughing may bring on an attack. Severe episodes are often seen when the patient gets a viral respiratory tract infection or is exposed to a heavy load of an allergen or irritant. Asthmatic attacks may last only a few minutes or can go on for hours or even days (a condition called status asthmaticus).
Being short of breath may cause a patient to become very anxious, sit upright, lean forward, and use the muscles of the neck and chest wall to help breathe. The patient may be able to say only a few words at a time before stopping to take a breath. Confusion and a bluish tint to the skin are clues that the oxygen supply is much too low, and that emergency treatment is needed. In a severe attack that lasts for some time, some of the air sacs in the lung may rupture so that air collects within the chest. This makes it even harder to breathe in enough air.
Diagnosis
Apart from listening to the patient's chest, the examiner should look for maximum chest expansion while taking in air. Hunched shoulders and contracting neck muscles are other signs of narrowed airways. Nasal polyps or increased amounts of nasal secretions are often noted in asthmatic patients. Skin changes, like atopic dermatitis or eczema, are a tipoff that the patient has allergic problems.
Inquiring about a family history of asthma or allergies can be a valuable indicator of asthma. The diagnosis may be strongly suggested when typical symptoms and signs are present. A test called spirometry measures how rapidly air is exhaled and how much is retained in the lungs. Repeating the test after the patient inhales a drug that widens the air passages (a bronchodilator) will show whether the airway narrowing is reversible, which is a very typical finding in asthma. Often patients use a related instrument, called a peak flow meter, to keep track of asthma severity when at home.
Often, it is difficult to determine what is triggering asthma attacks. Allergy skin testing may be used, although an allergic skin response does not always mean that the allergen being tested is causing the asthma. Also, the body's immune system produces antibody to fight off the allergen, and the amount of antibody can be measured by a blood test. This will show how sensitive the patient is to a particular allergen. If the diagnosis is still in doubt, the patient can inhale a suspect allergen while using a spirometer to detect airway narrowing. Spirometry can also be repeated after a bout of exercise if exercise-induced asthma is a possibility. A chest x ray will help rule out other disorders.
Treatment
Patients should be periodically examined and have their lung function measured by spirometry to make sure that treatment goals are being met. These goals are to prevent troublesome symptoms, to maintain lung function as close to normal as possible, and to allow patients to pursue their normal activities including those requiring exertion. The best drug therapy is that which controls asthmatic symptoms while causing few or no side-effects.
Drugs
METHYLXANTHINES. The chief methylxanthine drug is theophylline. It may exert some anti-inflammatory effect, and is especially helpful in controlling nighttime symptoms of asthma. When, for some reason, a patient cannot use an inhaler to maintain long-term control, sustained-release theophylline is a good alternative. The blood levels of the drug must be measured periodically, as too high a dose can cause an abnormal heart rhythm or convulsions.
BETA-RECEPTOR AGONISTS. These drugs, which are bronchodilators, are the best choice for relieving sudden attacks of asthma and for preventing attacks from being triggered by exercise. Some agonists, such as albuterol, act mainly in lung cells and have little effect on other organs, such as the heart. These drugs generally start acting within minutes, but their effects last only four to six hours. Longer-acting brochodilators have been developed. They may last up to 12 hours. Bronchodilators may be taken in pill or liquid form, but normally are used as inhalers, which go directly to the lungs and result in fewer side effects.
STEROIDS. These drugs, which resemble natural body hormones, block inflammation and are extremely effective in relieving symptoms of asthma. When steroids are taken by inhalation for a long period, asthma attacks become less frequent as the airways become less sensitive to allergens. This is the strongest medicine for asthma, and can control even severe cases over the long term and maintain good lung function. Steroids can cause numerous side-effects, however, including bleeding from the stomach, loss of calcium from bones, cataracts in the eye, and a diabetes-like state. Patients using steroids for lengthy periods may also have problems with wound healing, may gain weight, and may suffer mental problems. In children, growth may be slowed. Besides being inhaled, steroids may be taken by mouth or injected, to rapidly control severe asthma.
LEUKOTRIENE MODIFIERS. Leukotriene modifiers (montelukast and zafirlukast) are a new type of drug that can be used in place of steroids, for older children or adults who have a mild degree of asthma that persists. They work by counteracting leukotrienes, which are substances released by white blood cells in the lung that cause the air passages to constrict and promote mucus secretion. Leukotriene modifiers also fight off some forms of rhinitis, an added bonus for people with asthma. However, they are not proven effective in fighting seasonal allergies.
OTHER DRUGS. Cromolyn and nedocromil are anti-inflammatory drugs that are often used as initial treatment to prevent asthmatic attacks over the long term in children. They can also prevent attacks when given before exercise or when exposure to an allergen cannot be avoided. These are safe drugs but are expensive, and must be taken regularly even if there are no symptoms. Anti-cholinergic drugs, such as atropine, are useful in controlling severe attacks when added to an inhaled beta-receptor agonist. They help widen the airways and suppress mucus production.
If a patient's asthma is caused by an allergen that cannot be avoided and it has been difficult to control symptoms by drugs, immunotherapy may be worth trying. Typically, increasing amounts of the allergen are injected over a period of three to five years, so that the body can build up an effective immune response. There is a risk that this treatment may itself cause the airways to become narrowed and bring on an asthmatic attack. Not all experts are enthusiastic about immunotherapy, although some studies have shown that it reduces asthmatic symptoms caused by exposure to house-dust mites, ragweed pollen, and cat dander.
Managing asthmatic attacks
A severe asthma attack should be treated as quickly as possible. It is most important for a patient suffering an acute attack to be given extra oxygen. Rarely, it may be necessary to use a mechanical ventilator to help the patient breathe. A beta-receptor agonist is inhaled repeatedly or continuously. If the patient does not respond promptly and completely, a steroid is given. A course of steroid therapy, given after the attack is over, will make a recurrence less likely.
Maintaining control
Long-term asthma treatment is based on inhaling a beta-receptor agonist using a special inhaler that meters the dose. Patients must be instructed in proper use of an inhaler to be sure that it will deliver the right amount of drug. Once asthma has been controlled for several weeks or months, it is worth trying to cut down on drug treatment, but this must be done gradually. The last drug added should be the first to be reduced. Patients should be seen every one to six months, depending on the frequency of attacks.
Starting treatment at home, rather than in a hospital, makes for minimal delay and helps the patient to gain a sense of control over the disease. All patients should be taught how to monitor their symptoms so that they will know when an attack is starting, and those with moderate or severe asthma should know how to use a flow meter. They should also have a written "action plan" to follow if symptoms suddenly become worse, including how to adjust their medication and when to seek medical help. A 2004 report said that a review of medical studies revealed that patients with self-management written action plans had fewer hospitalizations, fewer emergency department visits, and improved lung function. They also had a 70% lower mortality rate. If more intense treatment is necessary, it should be continued for several days. Over-the-counter "remedies" should be avoided. When deciding whether a patient should be hospitalized, the past history of acute attacks, severity of symptoms, current medication, and whether good support is available at home all must be taken into account.

What is Bronchitus - From the Free Dictionary

Bronchitis
Definition
Bronchitis is an inflammation of the air passages between the nose and the lungs, including the windpipe or trachea and the larger air tubes of the lung that bring air in from the trachea (bronchi). Bronchitis can either be of brief duration (acute) or have a long course (chronic). Acute bronchitis is usually caused by a viral infection, but can also be caused by a bacterial infection and can heal without complications. Chronic bronchitis is a sign of serious lung disease that may be slowed but cannot be cured.
Description
Although acute and chronic bronchitis are both inflammations of the air passages, their causes and treatments are different. Acute bronchitis is most prevalent in winter. It usually follows a viral infection, such as a cold or the flu, and can be accompanied by a secondary bacterial infection. Acute bronchitis resolves within two weeks, although the cough may persist longer. Acute bronchitis, like any upper airway inflammatory process, can increase a person's likelihood of developing pneumonia.
Anyone can get acute bronchitis, but infants, young children, and the elderly are more likely to get the disease because people in these age groups generally have weaker immune systems. Smokers and people with heart or other lung diseases are also at higher risk of developing acute bronchitis. Individuals exposed to chemical fumes or high levels of air pollution also have a greater chance of developing acute bronchitis.
Chronic bronchitis is a major cause of disability and death in the United States. The American Lung Association estimates that about 14 million Americans suffer from the disease. Like acute bronchitis, chronic bronchitis is an inflammation of airways accompanied by coughing and spitting up of phlegm. In chronic bronchitis, these symptoms are present for at least three months in each of two consecutive years.
Chronic bronchitis is caused by inhaling bronchial irritants, especially cigarette smoke. Until recently, more men than women developed chronic bronchitis, but as the number of women who smoke has increased, so has their rate of chronic bronchitis. Because this disease progresses slowly, middle-aged and older people are more likely to be diagnosed with chronic bronchitis.
Key terms
Acute — Disease or condition characterized by the rapid onset of severe symptoms.
Bronchi — The larger air tubes of the lung that bring air in from the trachea.
Chronic — Disease or condition characterized by slow onset over a long period of time.
Chronic obstructive pulmonary disease (COPD) — A term used to describe chronic lung diseases, like chronic bronchitis, emphysema, and asthma.
Emphysema — One of the several diseases called chronic obstructive pulmonary diseases, emphysema involves the destruction of air sac walls to form abnormally large air sacs that have reduced gas exchange ability and that tend to retain air within the lungs. Symptoms include labored breathing, the inability to forcefully blow air out of the lungs, and an increased susceptibility to respiratory tract infections.
Chronic bronchitis is one of a group of diseases that fall under the name chronic obstructive pulmonary disease (COPD). Other diseases in this category include emphysema and chronic asthmatic bronchitis. Chronic bronchitis may progress to emphysema, or both diseases may be present together.
Causes and symptoms
Acute bronchitis
Acute bronchitis usually begins with the symptoms of a cold, such as a runny nose, sneezing, and dry cough. However, the cough soon becomes deep and painful. Coughing brings up a greenish yellow phlegm or sputum. These symptoms may be accompanied by a fever of up to 102°F (38.8°C). Wheezing after coughing is common.
In uncomplicated acute bronchitis, the fever and most other symptoms, except the cough, disappear after three to five days. Coughing may continue for several weeks. Acute bronchitis is often complicated by a bacterial infection, in which case the fever and a general feeling of illness persist. To be cured, the bacterial infection should be treated with antibiotics.
Chronic bronchitis
Chronic bronchitis is caused by inhaling respiratory tract irritants. The most common irritant is cigarette smoke. The American Lung Association estimates that 80-90% of COPD cases are caused by smoking. Other irritants include chemical fumes, air pollution, and environmental irritants, such as mold or dust.
Chronic bronchitis develops slowly over time. The cells that line the respiratory system contain fine, hair-like outgrowths from the cell called cilia. Normally, the cilia of many cells beat rhythmically to move mucus along the airways. When smoke or other irritants are inhaled, the cilia become paralyzed or snap off. When this occurs, the cilia are no longer able to move mucus, and the airways become inflamed, narrowed, and clogged. This leads to difficulty breathing and can progress to the life-threatening disease emphysema.
A mild cough, sometimes called smokers' cough, is usually the first visible sign of chronic bronchitis. Coughing brings up phlegm, although the amount varies considerably from person to person. Wheezing and shortness of breath may accompany the cough. Diagnostic tests show a decrease in lung function. As the disease advances, breathing becomes difficult and activity decreases. The body does not get enough oxygen, leading to changes in the composition of the blood.
Diagnosis
Initial diagnosis of bronchitis is based on observing the patient's symptoms and health history. The physician will listen to the patient's chest with a stethoscope for specific sounds that indicate lung inflammation, such as moist rales and crackling, and wheezing, that indicates airway narrowing. Moist rales is a bubbling sound heard with a stethoscope that is caused by fluid secretion in the bronchial tubes.
A sputum culture may be performed, particularly if the sputum is green or has blood in it, to determine whether a bacterial infection is present and to identify the disease-causing organism so that an appropriate antibiotic can be selected. Normally, the patient will be asked to cough deeply, then spit the material that comes up from the lungs (sputum) into a cup. This sample is then grown in the laboratory to determine which organisms are present. The results are available in two to three days, except for tests for tuberculosis, which can take as long as two months.
Occasionally, in diagnosing a chronic lung disorder, the sample of sputum is collected using a procedure called a bronchoscopy. In this procedure, the patient is given a local anesthetic, and a tube is passed into the airways to collect a sputum sample.
A pulmonary function test is important in diagnosing chronic bronchitis and other variations of COPD. This test uses an instrument called a spirometer to measure the volume of air entering and leaving the lungs. The test is done in the doctor's office and is painless. It involves breathing into the spirometer mouthpiece either normally or forcefully. Volumes less than 80% of the normal values indicate an obstructive lung disease.
To better determine what type of obstructive lung disease a patient has, the doctor may do a chest x ray, electrocardiogram (ECG), and blood tests. An electrocardiogram is an instrument that is used to measure the electrical activity of the heart and is useful in the diagnosis of heart conditions. Other tests may be used to measure how effectively oxygen and carbon dioxide are exchanged in the lungs.
Treatment
Acute bronchitis
When no secondary infection is present, acute bronchitis is treated in the same way as the common cold. Home care includes drinking plenty of fluids, resting, not smoking, increasing moisture in the air with a cool mist humidifier, and taking acetaminophen (Datril, Tylenol, Panadol) for fever and pain. Aspirin should not be given to children because of its association with the serious illness, Reye's syndrome.
Expectorant cough medicines, unlike cough suppressants, do not stop the cough. Instead they are used to thin the mucus in the lungs, making it easier to cough up. This type of cough medicine may be helpful to individuals suffering from bronchitis. People who are unsure about what type of medications are in over-the-counter cough syrups should ask their pharmacist for an explanation.
If a secondary bacterial infection is present, the infection is treated with an antibiotic. Patients need to take the entire amount of antibiotic prescribed. Stopping the antibiotic early can lead to a return of the infection. Tetracycline or ampicillin are often used to treat adults. Other possibilities include trimethoprim/sulfamethoxazole (Bactrim or Septra) and the newer erythromycin-like drugs, such as azithromycin (Zithromax) and clarithromycin (Biaxin). Children under age eight are usually given amoxicillin (Amoxil, Pentamox, Sumox, Trimox), because tetracycline discolors permanent teeth that have not yet come in.
Chronic bronchitis
The treatment of chronic bronchitis is complex and depends on the stage of chronic bronchitis and whether other health problems are present. Lifestyle changes, such as quitting smoking and avoiding secondhand smoke or polluted air, are an important first step. Controlled exercise performed on a regular basis is also important.
Drug therapy begins with bronchodilators. These drugs relax the muscles of the bronchial tubes and allow increased air flow. They can be taken by mouth or inhaled using a nebulizer. A nebulizer is a device that delivers a regulated flow of medication into the airways. Common bronchodilators include albuterol (Ventolin, Proventil, Apo-Salvent) and metaproterenol (Alupent, Orciprenaline, Metaprel, Dey-Dose).
Anti-inflammatory medications are added to reduce swelling of the airway tissue. Corticosteroids, such as prednisone, can be taken orally or intravenously. Other steroids are inhaled. Long-term steroid use can have serious side effects. Other drugs, such as ipratropium (Atrovent), are given to reduce the quantity of mucus produced.
As the disease progresses, the patient may need supplemental oxygen. Complications of COPD are many and often require hospitalization in the latter stages of the disease.
Alternative treatment
Alternative practitioners focus on prevention by eating a healthy diet that strengthens the immune system and practicing stress management. Bronchitis can become serious if it progresses to pneumonia, therefore, antibiotics may be required. In addition, however, there are a multitude of botanical and herbal medicines that can be formulated to treat bronchitis. Some examples include inhaling eucalyptus or other essential oils in warm steam. Herbalists recommend a tea made of mullein (Verbascum thapsus), coltsfoot (Tussilago farfara), and anise seed (Pimpinella anisum). Homeopathic medicine and traditional Chinese medicine may also be very useful for bronchitis, and hydrotherapy can contribute to cleaning the chest and stimulating immune response.

What is Cough? - From the Free Dictionary

Cough
Definition
A cough is a forceful release of air from the lungs that can be heard. Coughing protects the respiratory system by clearing it of irritants and secretions.
Description
While people can generally cough voluntarily, a cough is usually a reflex triggered when an irritant stimulates one or more of the cough receptors found at different points in the respiratory system. These receptors then send a message to the cough center in the brain, which in turn tells the body to cough. A cough begins with a deep breath in, at which point the opening between the vocal cords at the upper part of the larynx (glottis) shuts, trapping the air in the lungs. As the diaphragm and other muscles involved in breathing press against the lungs, the glottis suddenly opens, producing an explosive outflow of air at speeds greater than 100 mi (160 km) per hour.
In normal situations, most people cough once or twice an hour during the day to clear the airway of irritants. However, when the level of irritants in the air is high or when the respiratory system becomes infected, coughing may become frequent and prolonged. It may interfere with exercise or sleep, and it may also cause distress if accompanied by dizziness, chest pain, or breathlessness. In the majority cases, frequent coughing lasts one to two weeks and tapers off as the irritant or infection subsides. If a cough lasts more than three weeks it is considered a chronic cough, and physicians will try to determine a cause beyond an acute infection or irritant.
Coughs are generally described as either dry or productive. A dry cough does not bring up a mixture of mucus, irritants, and other substances from the lungs (sputum), while a productive cough does. In the case of a bacterial infection, the sputum brought up in a productive cough may be greenish, gray, or brown. In the case of an allergy or viral infection it may be clear or white. In the most serious conditions, the sputum may contain blood.
Causes and symptoms
In the majority of cases, coughs are caused by respiratory infections, including:
Environmental pollutants, such as cigarette smoke, dust, or smog, can also cause a cough. In the case of cigarette smokers, the nicotine present in the smoke paralyzes the hairs (cilia) that regularly flush mucus from the respiratory system. The mucus then builds up, forcing the body to remove it by coughing. Post-nasal drip, the irritating trickle of mucus from the nasal passages into the throat caused by allergies or sinusitis, can also result in a cough. Some chronic conditions, such as asthma, chronic bronchitis, emphysema, and cystic fibrosis, are characterized in part by a cough. A condition in which stomach acid backs up into the esophagus (gastroesophageal reflux) can cause coughing, especially when a person is lying down. A cough can also be a side-effect of medications that are administered via an inhaler. It can also be a side-effect of beta-blockers and ACE inhibitors, which are drugs used for treating high blood pressure.
Diagnosis
To determine the cause of a cough, a physician should take an exact medical history and perform an exam. Information regarding the duration of the cough, other symptoms may accompanying it, and environmental factors that may influence it aid the doctor in his or her diagnosis. The appearance of the sputum will also help determine what type of infection, if any, may be involved. The doctor may even observe the sputum microscopically for the presence of bacteria and white blood cells. Chest x rays may help indicate the presence and extent of such infections as pneumonia or tuberculosis. If these actions are not enough to determine the cause of the cough, a bronchoscopy or laryngoscopy may be ordered. These tests use slender tubular instruments to inspect the interior of the bronchi and larynx.
Treatment
Treatment of a cough generally involves addressing the condition causing it. An acute infection such as pneumonia may require antibiotics, an asthma-induced cough may be treated with the use of bronchodialators, or an antihistamine may be administered in the case of an allergy. Physicians prefer not to suppress a productive cough, since it aids the body in clearing the respiratory system of infective agents and irritants. However, cough medicines may be given if the patient cannot rest because of the cough or if the cough is not productive, as is the case with most coughs associated with colds or flu. The two types of drugs used to treat coughs are antitussives and expectorants.

The BEST PRAYER to start your DAY

Now here is a wonderful prayer, my sister Cindy emailed to me, to start your day the right way.
I like it sooo much that I have printed it for my daily morning prayer. Hope it touches you in the same way that it touched me. Thanks Cindy – I really needed this today!!


" Dear Lord, I thank You for this day,
I thank You for my being able to see
and to hear this morning.
I'm blessed because You are
a forgiving God and
an understanding God.
You have done so much for me
and You keep on blessing me.
Forgive me this day for everything
I have done, said or thought
that was not pleasing to you.I ask now for Your forgiveness.
Please keep me safe
from all danger and harm.
Help me to start this day
with a new attitude and plenty of gratitude.
Let me make the best of each and every day
to clear my mind so that I can hear from You.
Please broaden my mind
that I can accept all things.
Let me not whine and whimper
over things I have no control over.And give me the best response
when I'm pushed beyond my limits.I know that when I can't pray,
You listen to my heart.
Continue to use me to do Your will.
Continue to bless me that I may be
a blessing to others.
Keep me strong that I may help the weak...
Keep me uplifted that I may have
words of encouragement for others.
I pray for those that are lost
and can't find their way.

I pray for those that are misjudged
and misunderstood.
I pray for those who
don't know You intimately.
I pray for those that don't believe.But I thank You that I believe
that God changes people and
God changes things.
I pray for all my sisters and brothers.
For each and every family member
in their households.
I pray for peace, love and joy
in their homes; that they are out of debt
and all their needs are met.
I pray that every eye that reads this
knows there is no problem, circumstance,
or situation greater than God.
Every battle is in Your hands for You to fight.

I pray that these words be received into the hearts of every eye that sees or everyone who hears it.
Now repeat this phrase and see how God will touch you.
“God I love you and I need you, please come into my heart.”

Kree - Asthma + Bronchitus - what next??

My cough started acting up on Sunday morning 7 September (Father’s Day in NZ as well as Kanthan’s 9th year of sobriety). Later that day I had a sore throat and on Monday my neck was stiff and sore. By Tuesday, I was losing was voice, had a blocked nose, sneezing, nausea, no taste and smell – the works! On Wednesday my voice was really bad and every sentence I spoke required great effort. Yes, I was at school all three days – meetings, as usual, only left school 5pm Monday and Tuesday. On Wednesday I made a doctor’s appointment (Kaveshan’s advice) for that afternoon – the earliest appointment was 3:45pm. By lunch break I knew I was too sick to come to school Thursday and Friday and emailed the DP. I pushed myself to cope until 2:30pm when school ends, hardly taking a break from teaching/talking all day. By that time my voice was just a squeak and my chest was tight, burning and sore, all the way up to my throat and neck. When I arrived at the surgery, my heart was racing and I was so out of breath that I couldn’t say my name out clearly. Luckily the nurse immediately picked up on the signs and quickly put me on a Ventolin nebulizer. It relieved me quite a bit but by now I was rather anxious – imagine battling to breathe – it feels like you’re dying!! I never realised what Asthmatic sufferers have to deal with, like my sister Julie. I myself have not been asthmatic – however this is the third time in three months that I have experienced severe coughing and wheezing. At my last consultation a month ago, the doctor gave me two inhalers to be used during the wintertime. I wasn’t aware that I was mildly asthmatic. The medication I was given from yesterdays consultation are: Bricanyl Turbuhaler; Pulmicort Turbuhaler; Prednisone; Co-trimoxazole (antibiotic). I really pray that these meds will work soon because my voice has not yet improved, and without a voice I cannot teach. If any of you are asthmatic or can offer advice, it would be a great help.

After 3 days of medication, there was little improvement and on Friday the nausea was worsening, aggravated by the cough, little improvement in my voice and my nose still blocked. Today, Saturday 13th September, I went to another doctor for fear that it could be my thyroid playing up or even pheumonia!! The doctor's diagnosis was Bronchitus as well as Asthma and he changed my antibiotic to Augmentin (which has worked well for me in the past). He also prescribed Otrivin nasal spray which cleared my nose with just one swirt and has so far released loads of phlegm. I have been put off work until Wednesday and need lots of rest. Thanks to all who have emailed and posted Facebook messages on my wall.

. . . REMEMBER ME . . .

A Poem from our dearly departed:

. . . REMEMBER ME . . .

I never meant to leave you,

Could I have only stayed;

We would be going on in life,

With all the plans we made.

Now all the hopes and dreams we shared,

Are but sweet memories;

For you to tuck inside your heart,

Now when you remember me.

Remember all the good times,

And all the joy we shared;

Remember how you touched my life,

And how I really cared.

Think back on all the laughter,

And wipe away your tears;

You still have many miles to go,

And still have many years.

Don't look back....look forward,

This day is a brand new start;

And as you travel on in life,

You'll take a bit of my heart.

I never meant to leave you,

But still you'll not be alone;

For as long as my love lives in you,

I'll never really be gone.

Allison Chambers Coxsey©1995 ~ All Rights Reserved

Sad News - Uncle Frank

It is with great sadness that we learned about the passing away of our beloved Uncle Frank Thaver on Sunday 22 June 2008. After a month of hospitalisation and about two weeks on the ventilator, his heart stopped shortly after sunrise. The funeral was held in Durban on the same day. Wish I could have been there, it is the hardest thing to be miles away when a loved one moves on. Just a year ago last year, his brother George passed away on 18 May, so we are all deeply saddened to be losing such important people in our family. Uncle Frank will always be remembered for his cheerful and jovial personality. He loved to laugh and make people laugh. He enjoyed life to the fullest and was fortunate to have become a millionaire in his lifetime. He leaves behind his wife Thunga (teenage sweetheart), daughter Desiree and son Wesley, grand-daughter Tia, son-in-law Clive, three brothers, two sisters and all of the Thaver family.

You are in a better place now. We know that God chooses the best first and that you are smiling down on us from heaven. May your soul rest in Heaven's Peace.

A poem that comforts me during this hard time:
Do not stand at my grave and weep,
I am not there, I do not sleep.
I am a thousand winds that blow.
I am the diamond glint on snow.
I am the sunlight on ripened grain.
I am the gentle autumn rain.
When you wake in the morning hush,
I am the swift, uplifting rush Of quiet birds in circling flight.
I am the soft starlight at night.
Do not stand at my grave and weep.
I am not there, I do not sleep.
Do not stand at my grave and cry.
I am not there, I did not die!
Do not stand at my grave and weep.
I am not there, I do not sleep.
I am the song that will never end.
I am the love of family and friend.
I am the child who has come to rest
In the arms of the Father who knows him best.
When you see the sunset fair,
I am the scented evening air.
I am the joy of a task well done.
I am the glow of the setting sun.
Do not stand at my grave and weep.
I am not there, I do not sleep.
Do not stand at my grave and cry.
I am not there, I did not die!
~ Mary E. Frye ~

Food for the Soul

Those who revolve in the consciousness of the Divine are safe-guarded.

Didst thou not come naked from thy mother's womb? Didst thou not have thy soul in safety even before thy body's birth? Why art thou then fretful and anxious? One who watched over thee then, watches over thee now; one who loved thee then, loves thee now.
My mind remember this and be still.

[Swami Paramananda, Book of Daily Thoughts and Prayers, p. 186]

Prayer for the Sick

My Uncle Frankie is in hospital for three weeks now. He has undergone surgery but is not making much progress. Our thoughts and prayers are with him and our families as we hope that he will be restored to good health.

Also my niece (my Godchild) Barshni has not been well for the past two weeks, having a high temperature and headaches that doctors could not find the cause of. We are praying for your speedy recovery.

PRAYER FOR THE SICK
Father of goodness and love, hear our prayers for the sick members of our community and for all who are in need. Amid mental and physical suffering may they find consolation in your healing presence. Show your mercy as you close wounds, cure illness, make broken bodies whole and free downcast spirits. May these special people find lasting health and deliverance, and so join us in thanking you for all your gifts. We ask this through the Lord Jesus who healed those who believed. Amen.

Food for the Soul

O Lord, through Thy Grace may I overcome all egotism, pride and self-willAnd realize that Thou art all in all. I am only an instrument in Thy almighty Hand. Do Thou use my hands and feet, my heart and mind to carry out Thy great plan; And may I never forget Thy vastness and Thy glory.[Swami Paramananda, Book of Daily Thought & Prayers, p185]

Room 8 Soccer Stars

Soccer World Cup Update:
In term 2 and term 3 Kelvin Road School children are participating in its own Soccer World Cup.
More to follow...

Graduation - Victoria University of Wellington

Kanthan and I took a one hour flight to Wellington on Tuesday 13th May and spent two nights in the wonderful windy city. To my surprise, I didn't feel it as cold there as it was in Auckland this past week. On Wednesday morning we had a scrumptious hotel breakfast and then set off on foot to collect my graduation gown. We started off walking in the opposite direction to where we were going and fortunately a courier guy pointed us on the right path. We made our way up a steep hill with over one hundred steps to climb into the street above leading to Kelburn Parade. It was an arduous climb which must have taken about fifteen minutes what with all the stops I made after climbing each flight of steps. We then staggered another twenty minutes until we reached Murphy Building and collected my graduation gown, hood and trencher. I refused to walk back so we grabbed a taxi to the Law School at Lambton Quay for the graduates street parade. It was a new and exciting experience for me but I only wish I could have had more family and friends there to share in my joy like the rest of the graduates. The parade started at 12 noon and finished around 12:45 in time for ceremony 1 starting at 1pm. Luckily my ceremony was at 6pm that evening which gave us time to enjoy a delicious lunch at an Irish restaurant before heading back to the hotel for a two hour nap. With all that walking, it was a well deserved and refreshing sleep before getting dressed for the ceremony. We took the taxi to the Michael Fowler Centre at 5:25 pm and arrived there on time at 5:30pm. All the graduands looked wonderful, wearing hoods and gowns appropriate to their degree, and carrying their trenchers. We lined up according to our marshalling numbers for an unrehearsed ceremony. When we walked into the dark hall, a Maori Kapa Haka group was rendering some beautiful waita ringa. After singing the national anthem and some speeches we were capped. It was a fantastic ceremony and I couldn't help but feel so proud of my achievement. I remembered my late Dad and my mum who were at my first graduation at Springfield College twenty years ago in 1988 and gave thanks to them for my journey - not forgetting the Grace of God.

After the graduation there was a reception for everybody. Kanthan and I walked back to the hotel so I could change out of my sari and we set off for dinner.

We slept in on Thursday morning until 9am and after breakfast we spent the rest of the day at Te Papa Museum, then had a light lunch before flying back to Auckland at 4:30pm.

All in all, a fantastic and memorable graduation experience.

Elim School River Tragedy

New Zealand weeps over the tragic drowning of students and a teacher in the Mangatepopo River on 15 April. Six students and one teacher have died after being swept away on the Mangatepopo River near Turangi. It is reported that a flash flood swept down the river.
The students were from Elim Christian College in Howick, Auckland.

Our thoughts and prayers are with the family & friends of these seven courageous people. May their souls rest in Heaven's Peace.

Read more

Our Celebrations

On 18 March Kanthan celebrated his 7th year of being a non-smoker - what a difference this has made to our lives. I wish every smoker reading this 'Good Luck' in kicking this stinking habit - do it for the people you love, if not for yourself.
On 31st March Kanthan & I celebrated our 17th wedding anniversary, we thank God for every new year He gives us together.
Two days after our anniversary was Thanusha's sweet 16th birthday - can't believe that our baby girl is growing up so fast! Four days after Thanusha's birthday was Kaveshan's 13th birthday - at last he is a teenager although he has been acting like one for the past three years!
And all these celebrations are only through the Grace of God, to Whom we give our humble gratitude every day. Thank you GOD.
Birthday Pics

Kree's health

If you were wondering why I have not been in touch for most of this year, it was because of my terrible health. In February, I was surprised when the doctor told me that my blood pressure was 200/90 and I was put on pressure tablets again after 8 years. The Inhibace tablets prescribed caused a terrible cough and after one month my pressure was still high. My tablets were changed and the new pressure pills Felo 5er caused severe headaches. After 10 days I couldn't stand it and returned to the doctor for the third time. My pressure was 180/100 and I was worrying about my continuous periods. The doc prescribed Ferrograd for the anaemia, Provera to stop the periods and doubled the Thyroxin for my underactive thyroid. He didn't think there was any serious concern saying that I was just overly anxious and even suggested me getting a second opinion when he noticed that I was not too happy with his diagnosis.
I decided to change to a female doctor and on my first visit to her, she changed my pressure tablet to Cozaar (which is the one I had been taking in SA about 8 years ago). The tablet was miraculous and it decreased my pressure and I have not had a headache for the past two weeks. Since February I have undergone bloodtests four times, fortunately, we do not pay for diagnostic tests in NZ. On my second visit to my new GP on Monday (which makes that the 5th doctors visit in two months) I was told that I have Helicobacter Pylori infection of my stomach lining! It appears that around 75% of the world's population have this infection and 50% of patients diagnosed with stomach cancer have it! Well that means more medication for me so today I started on a triple pack 14 day treatment including Losec and antibiotics - hope it works. The doc has also booked me down for an ultrasound as my periods have not stopped in 34 days! I will be on the waiting list for 6 - 8 weeks before I am given a date for the ultrasound - the price to pay for using public health. If the ultrasound confirms a recurrence of Fibroids which I've had 10 years ago, then the doc suggests undergoing a hysterectomy. So there - now you know what I've been up to since I returned from my holiday overseas. So what's your excuse for not keeping in touch?

Food for the Soul

When we are impatient we throw away our opportunities.

Far have I travelled, Long have I struggled, Following the impulses of my restless will. Seeking! Seeking! Seeking! In quest of happiness I sought through life's mansion, But happiness I found not there. I found happiness nowhere till my self will was lost in His Will.

The real sign of a spiritually minded person is his silent, tolerant, patient attitude. He attains his end because he does not interfere with the higher plan. He moves with the higher forces. He is always in harmony with the Divine Will. Anger, impatience, calculation, quarelling and disputes; this is what we find in the world. Those who have taken up the spiritual life cannot afford to indulge in such things.

O Lord, grant unto me calmness of spirit and serenity of heart,Shield me from the entanglements of my lower nature.Help me to seek Thee with perseverence and unswerving consecration.May I never tire in my search after TheeOr turn aside and forget Thee.[Swami Paramananda, Book of Daily Thoughts & Prayers, p. 102]

Back from my holiday to South Africa & Thailand

Hi, how are you? I am sooo happy to be back in my home sweeeeet home in Papakura, Auckland. There is no place like New Zealand! We had a fantastic time in South Africa, visiting family & friends in Middelburg & Durban...it was an emotional rollercoaster ride, one minute we were so happy to be reunited with people, the next minute sad to say farewell, wondering when our paths will cross again! The weather was unbearably hot and humid, often a sticky 35 degrees! After two weeks we got really exhausted from the heat and all the driving and visiting. The last four days was spent in Thailand - we loved the beautiful temples in Bangkok and the shopping was great...so great that we had to buy two extra hand luggage bags and paid an extra $500 for overweight luggage - bugger! Will upload some of the 2000 digital photos I have so check my album for these.The weather in Auckland is to die for - such magnificent perfect summer days :-)Have a safe and happy 2008 - love & laughter always.
**Kree**