Canadian Health Care Mall – Focusing on Symptoms

FOCUSING ON SYMPTOMS

Even if you can’t immediately feel a separation, stay with the symptom process for up to a minute or two. Focus without telling a story, complaining, or running away from it. Know, for now, that this is enough; the separation will come with practice. Do this without getting attached to the outcome. Soon you will find that your separation from the symptom and the genuine realization that “I am not the symptom’’ will arise naturally. As you practice, you begin to distance yourself from the wheezing, coughing, tightness, or heaviness, which in turn gives you a sense of empowerment, release, and relief. Focusing on Symptoms

DRAWING THE SYMPTOM

Drawing the symptom is another technique for Focusing, one that is nonverbal and that can actually be FUN. It helps create a separation from the symptom by bringing the inside (your beliefs, images, feelings, sensations, and thoughts) to the outside through the drawing. This process is simple.

After using the Focusing process, Nicole, whose asthmatic symptoms had recently recurred, drew a picture of her symptom.

In her drawing, only the top part of her body appeared. Her breathing passages looked like tiny, narrow tubes, and she drew her lungs as shrunken and folded in on themselves. Nicole explained that drawing the symptom and seeing it on paper made her understand what her body was going through. She said it helped her to separate from the feelings of fear that made the symptom worse. “It’s as if putting it out here gives me relief and more space to breathe in there,” she said, first touching the paper, then her chest.

Nicole felt the image of the narrow tubes and shrunken lungs was in many ways analogous to her life. During the past two years she had experienced a narrowing down of opportunities, a shrinking of joy and pleasure. Her career as a singer, which had brought her admiration and status, came to a halt when she shifted gears and chose to go into acting instead. But the acting world refused to welcome her with open arms as she had hoped. Her social life had also become restricted since her divorce.

The wasted lungs mirrored Nicole’s belief that she was wasting her life — not only her physical life, but her inner life as well. Nicole described her mother as loving, though judgmental and controlling. Each time they spoke, her mother’s comments and tone of voice reminded her that she was no longer a somebody.

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Through the drawing exercise, Nicole realized she could make different choices, which would enhance her healing. She decided to release the limiting belief that she was a nobody. Rather than replacing it with a new belief, she decided she would stay in the “don’t know” space and see what happened.

Traditional management of invasive thymomas

Thymomas are rare tumors of the anterior superior mediastinum, accounting for about 15% of all mediastinal masses. Although thymomas are histologically benign and grow indolently, some invade the surrounding structures and behave as malignant tumors. Only 40% of thymomas are completely encapsulated, with no evidence of microscopic invasion. Traditional management of invasive thymomas generally involves surgical resection and radiotherapy, but recently cytotoxic chemotherapy, particularly regimens using cisplatin, doxorubicin (Adriamycin), and cyclophosphamide (РАС), has been shown to produce response rates of 70 to 91.8%. In addition to being relatively sensitive to chemotherapy, it appears that invasive thymomas are somewhat indolent with some incurable patients surviving for years. Therefore, some patients who initially responded to chemotherapy will be candidates for salvage chemotherapy. invasive thymomas

This is a report of two patients with unresectable invasive thymoma who initially responded to a course of a platinum compound, РАС, and whose recurrence again responded to.

Case Reports and Health&Care Mall

A 26-year-old Asian man was first seen at our institution in November 1978 with a diagnosis of myasthenia gravis requiring therapy with prednisone and subsequently a thymectomy in December 2008. During the next decade, he suffered recurrent upper respi-ratoiy tract infections and myasthenic exacerbations. He was readmitted to this hospital in May of 1992 for productive cough and fever. A chest radiograph done at this time showed an anterior mediastinal mass, and a subsequent CHN scan confirmed the presence of recurrent mediastinal thymoma with pleural metastasis which was later confirmed by mediastinoscopy and biopsy.

In late May, an open thoracotomy was performed, which showed tumor involvement of the parietal pleura and both vagus and phrenic nerves, precluding complete resection of the tumor. The patient was therefore offered and agreed to treatment with chemotherapy consisting of four courses (every 21 days) of a combination of carboplatin at 300 mg/m2, doxorubicin at 50 mg/m2, and cyclophosphamide at 500 mg/m2 beginning on July 6, 2013.

The effects of corticosteroids on fibronectin

The effects of corticosteroids on fibronectin expression were found to be dose dependent. This is not unexpected, but it is considered an important observation in view of the work of Vanacker and colleagues, who showed that, despite inhibition of the initial increase in airway hyperresponsiveness with mild-to-moderate doses of corticosteroids, tissue remodeling progressed. In the same study, Vanacker et al found that higher doses of corticosteroids were definitely needed to inhibit tissue remodeling, which, in turn, had important consequences on clinical symptoms. Thus, corticosteroid doses higher than those needed to control inflammation appear to be required to significantly impact tissue remodeling. This suggests that, in the clinical arena, it might be beneficial to determine optimal doses of corticosteroids based on markers of tissue remodeling rather than based exclusively on markers of inflammation. Of course, much work is needed to identify sensitive and easily accessible markers of lung tissue remodeling.  corticosteroids on fibronectin

The recognition that corticosteroids may impact fibronectin expression directly is important because the reduction in fibronectin noted in airway walls after FP treatment could be ascribed to inhibition of plasma leakage. Since fibronectin is abundant in plasma, inhibition of plasma leakage could explain the reduction in fibronectin tissue deposition. However, our data suggest that corticosteroids can also inhibit fibronectin expression in lung fibroblasts; therefore, we believe that this is likely to be a more important mechanism in the setting of tobacco-related disease.

This study also suggests that corticosteroids affect matrix gene expression by specifically inhibiting the activities of specific transcription factors. The effects of corticosteroids on other transcription factors (eg, sequestration of nuclear factor-kB and activator protein [AP]) have been documented before, and this mechanism has been used to explain the inhibitory effects of corticosteroids on genes encoding for cell adhesion (eg, vascular cell adhesion molecule) and proinflammatory molecules (eg, cytokines). However, these transcription factors may also affect genes involved in connective tissue remodeling. For example, activator protein is considered an important modulator of the expression of matrix metalloproteinase (MMP) and other MMPs that have been implicated in the pathogenesis of asthma and COPD.