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We at Online Village Cafe understand how difficult it can be to find what you are looking for in the ever changing world of shopping. We are here to review popular items on the market today and give our opinions, coupons, advice on products we purchase, try, and then comment on for you. Sometimes reading others opinions before you buy is the best way to test a product without taking on the expense yourself. We also post a great deal of health articles for you to read! So be sure to stop in often and see what we have reviewed lately or what new health article we have posted!

Wednesday, December 30, 2009

House Of Numbers

"The HIV/ AIDS Story is Being Rewritten"

In House of Numbers, an AIDS film like no other, the HIV/AIDS story is being rewritten. This is the first film to present the uncensored POVs of virtually all the major players; in their own settings, in their own words. It rocks the foundation upon which all conventional wisdom regarding HIV/AIDS is based. House of Numbers could well be the opening volley in a battle to bring sanity and clarity to an epidemic gone awry.
Quoted from: Audience Response to the New York Times Critical Review:

I have many friends who gave up checking their numbers and taking cocktails years ago. The drugs did not agree with them, so they figured, "I'll die a natural AIDS death and accept my fate..." and then, they got better...and never looked back. Is this anecdotal? Yes. Does it mean HIV is harmless? No. Does it mean that it doesn't exist? No. But my research has shown that there is much variance surrounding these issues. And given the toxicity of the drugs, the social stigma, and the "death sentence"...and given we were promised a vaccine in the mid 1980s...and given there is no cure...what is wrong with revisiting some issues and facing the fact that AIDS remains a mystery? This film is not dangerous. It is not going to make people run out and have animalistic sex and throw condoms into the ocean. Grow up, people. It's simply a series of interviews based on one man's journey into this complicated world of politics and science surrounding HIV/AIDS. Watch it. Question. Research. And determine your own opinion...– TheatreGuyZ , Portland, OR

Neither an "advocate" nor "denialist". We should never stop asking questions.

Tuesday, December 15, 2009

Food and Depression - Related by XLPharmacy Canada


A new study connects food and mood, finding that a diet high in processed foods makes depression more likely. The study was published in The British Journal of Psychiatry and it makes a strong case that processed junk food can trigger or contribute to depression, while eating whole and healthy food seems protective.

British and French epidemiologists analyzed food and mood data from 3,486 men and women (average age 55) in the Whitehall II study on London-based office staff. Each participant answered a food frequency questionnaire in which they were asked how often they had eaten a designated portion size of a food during the previous year (set responses ranged from "never" to "six or more times per day").

That data was then converted to a daily intake, and two dietary patterns were identified: the "whole food pattern" (defined by a high daily intake of vegetables, fruits, and fish) and the "processed food pattern" (characterized by high consumption of sweetened desserts, chocolates, fried food, processed meat, pies, refined grains, high-fat dairy products, and condiments). Five years later, all the participants answered a short questionnaire designed to measure symptoms of depression in the general population.

After adjusting for variables such as age and sex, the scientists found that high consumption of processed food was associated with increased likelihood of depression, whereas those who had the highest consumption of whole foods were least likely to be depressed, and even less likely than those in the whole food pattern who ate fewer whole foods.

Thursday, November 05, 2009

When to Start HIV Treatment


When should I start treatment?

It remains unclear when the best time to start therapy is. The “best” time for one person may not be the “best” time for another. There’s also much debate about which drugs to start with and in what combinations. Several factors — including HIV levels, CD4+ counts as well as how you feel about therapy — are important to consider when deciding if and when therapy is right for you.

Many questions can also be considered when making these decisions. Should treatment be used immediately when you first learn you have HIV? Should therapy be saved until changes occur in your immune health? Should it be saved until there’s a higher viral load, or until symptoms of HIV develop?

In deciding when to start, switch or change HIV therapy, three medical factors are generally considered:

•What’s happening with measures of your immune health (particularly CD4+ counts)?
•What’s happening with your general health, like symptoms of HIV disease or recurrent conditions despite treatment?
•What’s happening with your HIV levels?

Deciding to begin treatment is not solely a medical matter. Other factors must be considered, including:

•Your feelings about therapy;
•Your readiness and willingness to take therapy, including taking it as prescribed;
•The impact that therapy may have on your quality of life;
•Possible side effects;
•How long therapy can last, and whether or not there will be new and better drugs to replace them if or when they fail; and,
•Your risk of disease progression in the short-, middle-, and long-term.

When is the right time to start?

Some believe there can be no single, right answer to the question of when to start. Some researchers and doctors believe that nearly everyone with HIV — regardless of their CD4+ counts, viral loads or symptoms — should be treated. Some believe people should start therapy only when their CD4+ counts consistently read below 350. Others believe that only people with symptoms of HIV disease should consider therapy.

One note of agreement is that most researchers and doctors believe that the decision to start should be guided by both CD4+ cell counts and overall general health. Increasingly, information suggests that CD4+ counts provide the most accurate tool to monitor the risk of HIV disease progression.

The most commonly used viral load tests are Roche’s RT-PCR (polymerase chain reaction test, called Amplicor HIV Monitor Test), Chiron’s bDNA (branch DNA test, called Quantiplex) and Organon Teknika’s NASBA (nucleic acid sequence based amplification test, called NucliSens). When possible, it’s best to use the same lab and same test every time. For example, RT-PCR results are consistently higher than those obtained with bDNA. Similarly, different labs might get somewhat different results when running a CD4+ count.

The challenges of HIV therapy


The challenges of therapy

Unless HIV replication is controlled, trying to rebuild immune health will ultimately fail — at least most of the time. Although using therapy hinders HIV from replicating, it does not eradicate the virus from your body. Many scientists fear that it’s not possible to fully eliminate it. Others don’t share this pessimism, pointing to newer and better drugs as well as an ever-growing understanding of HIV disease and its effects on the immune system. Over time, HIV can mutate or change enough so that it’s no longer fully blocked by these drugs.

This process is called viral resistance and it can happen to some degree with all HIV drugs. However, keeping HIV under control lengthens a person’s life, and it may be possible — with truly effective therapy — to live out a normal lifespan despite HIV. Abundant evidence shows that using potent HIV therapy has dramatically lowered death rates. It has also increased life and quality of life for people living with HIV.

However, the drugs are not without their risks of side effects. When deciding on therapy, the possible short- and long-term side effects must be weighed against possible short- and long-term benefits, particularly as you consider when to start. There’s little research on using HIV drugs in the earlier stages of HIV disease. Many, if not most, people don’t have to decide this immediately after learning they have HIV.

Assessing your risk of disease progression and making decisions that you feel comfortable with are important parts of building a successful long-term HIV strategy.

Why use anti-HIV therapy

When you’re first infected with HIV, high levels of HIV replication often occur with flu-like symptoms and a decline in the number of CD4+ cells. CD4s are key cells in your immune system that maintain and direct responses against disease. They are also commonly used to measure your immune health.

Without using HIV therapy, your immune system dramatically but incompletely suppresses the virus. In most cases, CD4s return partially toward normal levels and people usually regain good health for many years. Yet, during this time an aggressive battle is waged daily between your immune system and HIV. Over time, the immune system becomes overwhelmed by HIV’s rapid and constant activity.

The relationship between your HIV levels and risk of disease progression is complicated. An influential study by John Mellors found a solid relationship between HIV levels and risk of death over time. Other research suggests that CD4+ counts better predict the risk of disease progression. However, it is well established that reducing HIV levels typically leads to a stronger immune system and better health.

Considering these points, it makes sense to slow down or stop HIV replication as much and for as long as possible. All approved HIV drugs significantly reduce HIV levels, and they almost always cause some rise in CD4+ counts. Lower viral loads and higher CD4+ counts indicate some improvement in your immune system.

Friday, October 16, 2009

XLPharmacy Discusses Erection Problems

What are erection problems?

Erection problems can be a difficult topic to discuss, but if you have problems getting or keeping an erection, you have good reasons to talk with a doctor. Erection problems not only interfere with your sex life, they can be a sign of other health problems.Erection problems can be a sign of blocked blood vessels or nerve damage from diabetes. If you don’t see your doctor, these problems will go untreated and can harm your body.Erection problems used to be called impotence. Now the term erectile dysfunction is more common. Sometimes people just use the initials ED.Your doctor can offer several ED treatments. For many men, the answer is as simple as taking a pill. Other men have to try two or three options before they find a treatment that works for them. Don’t give up if the first treatment doesn’t work. Finding the right treatment can take time.

What causes erectile dysfunction?

Many different conditions can lead to ED. Many of the causes are health problems that affect the heart and blood vessels and need to be treated to help prevent more serious problems. high blood pressure high cholesterol diabetes Unhealthy lifestyle habits can also contribute to ED. Anything that’s bad for your heart is also bad for your sexual health. alcohol and drug abuse smoking overeating lack of exercise Nerve damage from many causes can interfere with the signals that start an erection. spinal cord injury treatments for prostate cancer, including radiation and prostate removal multiple sclerosis and other nerve diseases Some prescription drugs such as some antidepressants or high blood pressure medicines can cause ED. Your doctor may be able to change your drug treatment. Never stop taking a prescribed drug without talking with your doctor.A small number of ED cases result from a reduced level of the male hormone testosterone.Doctors used to believe that most cases of ED resulted from mental or emotional problems. We now know that most ED has a physical cause. But depression and worry or anxiety can still cause ED. And ED from physical causes can lead to depression and worry, making ED worse.A person should not assume ED is part of the normal process of aging. Another cause most likely exists.

Okay...so if I go to the doctor what can I expect?

Talking about ED can be difficult. When you meet with your doctor, you might use a phrase like “I’ve been having problems in the bedroom” or “I’ve been having erection problems.” Remember that a healthy sex life is part of a healthy life. Don’t feel embarrassed about seeking help. ED is a medical problem, and your doctor treats medical problems every day.If talking with your doctor doesn’t put you at ease, ask for a referral to another doctor. Your doctor may send you to a urologist—a doctor who specializes in sexual and urologic problems.Your partner may want to come with you to see the doctor. Many doctors say ED is easier to treat when both partners are involved.To find the cause of your ED, your doctor will take a complete medical history and do a physical exam.

Medical History

Your doctor will ask general questions about your health, as well as specific questions about your erection problems and your relationship with your partner. Bring a list of all the medicines you take, or bring them with you to show to your doctor. Tell your doctor about any surgery you have had.Your doctor will ask about habits like alcohol use, smoking, and exercise.

Your doctor might ask you questions like

How do you rate your confidence that you can get and keep an erection? When you have erections with sexual stimulation, how often are your erections hard enough for penetration? During sexual intercourse, how often are you able to maintain your erection after penetration? When you attempt sexual intercourse, how often is it satisfactory for you? How would you rate your level of sexual desire? How often are you able to reach climax and ejaculate? Do you have an erection when you wake up in the morning? The answers to these questions will help your doctor understand the problem.

Physical Exam

A physical exam can help your doctor find the cause of your ED. As part of the exam, the doctor will examine your testes and penis, take your blood pressure, and check your reflexes. A blood sample will be taken to test for diabetes, cholesterol level, and other conditions that may be associated with ED.

How is erectile dysfunction treated?

Your doctor can offer a number of treatments for ED. You may want to talk with your partner about which treatment fits you best as a couple. Most people want the simplest treatment possible. You may need to try a number of treatments before you find the one that works best for you.

Lifestyle Changes

For some men, getting more exercise, quitting smoking, losing weight, and cutting back on alcohol may solve erection problems.

Counseling

Even though most cases of ED have a physical cause, counseling can help couples deal with the emotional effects. Some couples find that counseling adds to the medical treatment by making their relationship stronger.

Oral Medicines

Since 1998, doctors have been able to prescribe a pill to treat ED. Current brands include Viagra, Levitra, and Cialis. If your health is generally good, your doctor may prescribe one of these drugs. You should not take any of these pills to treat ED if you take any nitrates, a type of heart medicine. All ED pills work by increasing blood flow to the penis. They do not cause automatic erections. Talk with your doctor about when to take the pill. You may need to experiment to find out how soon the pill takes effect.Even if taking a pill solves your erection problem, you should still take care of the other health issues that may have caused your ED.

Injections

Taking a pill doesn’t work for everybody. Many men use medicines that go directly into the penis. Caverject and Edex are injected into the shaft of the penis with a needle. MUSE is a tiny pill inserted into the urethra at the tip of the penis. These medicines usually cause an erection within minutes. These medicines can be very successful, even if other treatments fail.

Vacuum Device

Another way to create an erection is to use a specially designed vacuum tube. The penis is inserted into the tube, which is connected to a pump. As air is pumped out of the tube, blood flows into the penis and makes it larger. A specially designed elastic ring is moved from the end of the tube to the base of the penis to keep the blood from flowing out.When air is pumped out of the tube, blood flows into the penis and causes an erection.

Penile Implant

If the other options fail, some men need surgery to treat ED. A surgeon can implant a device that inflates or unbends to create an erection. Implanted devices do not interfere with the way sex feels.Penile implant operations cannot be reversed. Once a man has a penile implant, he must use the device to have an erection. Talk with your doctor about the pros and cons of having a penile implant.A pump implanted under the skin fills two rods with fluid to cause an erection.

Points to Remember

Erection problems may be a sign of health problems. A doctor can help you overcome erection problems. Smoking, being overweight, drinking too much alcohol, and avoiding exercise can contribute to erection problems. Most cases of erectile dysfunction (ED) have a physical cause, but counseling can help couples build a stronger relationship. Many men can take a pill to treat ED. These men should still treat the health conditions that caused ED. Taking a pill doesn’t work for all men. Men who take medicines called nitrates should not take a pill to treat ED. Additional treatment options for ED include injections, urethral inserts, a vacuum device, and a surgical implant.

Saturday, September 19, 2009

Hair loss by XLPharmacy Online


Every hair on your head grows for anywhere from two to six years. After it stops growing the hair will fall out and new hair will grow in its place. For different reasons, in some people this process of renewal begins to slow down. This eventually leads to alopecia, or baldness. Throw out your preconceived notions – just because your mom’s dad lost his hair doesn’t mean you’ll lose yours.1 Baldness can be the result of a variety of factors, including, yes, heredity, but also certain medications or underlying medical conditions. And let’s say it again – anyone, men, women or children, can experience hair loss.

There are different types of treatment available depending on the extent of your baldness and the reasons behind it. Treatment isn’t necessary for hair loss, if you’re willing to accept the hand that nature has dealt you. But hey, that’s not for everyone, and that’s why there are options ranging from makeup and hairpieces to medications and even surgical procedures to treat baldness.

Losing your hair can be hard to accept, especially for those who have been maintaining a flowing head of hair for years. There are coping methods available that can help to soothe what’s below your scalp as well as what’s on top.

You’re noticing hair loss and you want to do something about it. The first step should be a visit to your doctor. They will be able to correctly identify the type of baldness you may be experiencing and suggest possible treatment options.

Everyone’s heard of "male pattern baldness", or androgenetic alopecia, as it’s known in scientific circles. Men with this condition can experience hair loss as early as their teen years. Male pattern baldness can be identified by a receding hairline and hair thinning on the crown. It’s usually a hereditary condition and can lead to a bald spot or complete loss of hair. Women can also experience androgenetic alopecia, though female pattern baldness rarely results in total baldness. Unlike male pattern baldness, the condition generally results in thinner hair all over the head, but a normal hairline.

Another type of baldness, alopecia areata, usually results in the sudden loss of hair in one particular area. The hair usually grows back after several months, but re-growth does not always happen.1 Alopecia areata can also lead to body hair loss.

There are other less common types of baldness, including hair loss resulting from scars, illness, certain medications and trichotillomania, or hair pulling.

Simply put, baldness occurs when hair loss exceeds the rate of hair re-growth, when new hair is thinner than the old hair it has replaced or when hair comes out in patches.
Every hair on your body sits in a hole in your skin called a follicle. In people who experience baldness, the follicle has shrunken over time, resulting in shorter, finer hair. Sometimes, these follicles are unable to produce any new hair at all. But the follicles remain alive – and have the potential to grow new hair.6

It’s believed hair loss is mostly caused by a combination of factors like aging, hormone changes, illness, a family history of baldness, burns and trauma. In the myth-shattering department, note that poor circulation of the scalp, dandruff, excessive hat wearing and a gene passed on from your mom’s dad are not responsible for baldness.

Heredity is responsible for androgenetic alopecia, or pattern baldness. A history of pattern baldness on both sides of your family increases your risk of balding. Alopecia areata is actually seen as an autoimmune disease, though its cause is unknown. People in good health can develop this type of baldness and a family history of the condition makes its onset more likely.
There are a number of causes of temporary hair loss. Medications, like certain drugs used to treat gout, arthritis, depression, heart problems and high blood pressure, can cause hair loss in some people. Birth control pills can also result in hair loss for some women.

Disease, poor nutrition, trauma caused by surgery, high fever and severe flu can also cause temporary hair loss. Medical treatments like chemotherapy can cause your to fall out, though it usually re-grows after the treatment ends. Newborns often lose their hair during the first several months of their lives, while women can also experience hair loss after delivering a baby.

It’s a good news/bad news story. First, the bad news – most forms of baldness have no cure. The good news, though, is that these conditions can still be treated, and some types of baldness will disappear without any treatment. Your doctor will suggest treatments for baldness depending on a number of factors, include your age, health, the extent of your condition and your own preference. Different forms of treatment can be found at XLPharmacy-Online.

Sunday, August 23, 2009

Caffeine and Vitamin Absorbtion


We've been asked this question many times. We did some research and found a wonderful article on this. The articles follow, and so does the link to the articles. We hope that it helps alleveiate anyones misconceptions about their morning cup of coffee and their calcium and vitamin D intake.
Original article can be found here: Askville at Amazon

Question on Askville:

I've been told caffeine affects Calicum/Vitamin D absorption. I like coffee in the morning, so should I take my vitamins at night?

Answer from Askville:

It shouldn't be necessary. I did some checking, and it appears that the amount of extra calcium that's excreted via the urinary tract when you have a cup of coffee is minimal - around 5 mg per cup.When you consider that most calcium supplements are between 600 mg. and 1.2 g., you'd have to drink a LOT of coffee to see an adverse effect.

I offer up these two websites for you to take a look at. This one does recommend separating your calcium supplement from your coffee, but only by half an hour, and confirms that the calcium loss is minuscule. This one says there's no problem at all with taking them together.

The National Dairy Council tells you not to worry about it.Vitamin D is a little different. It appears that caffeine consumption in excess of 300 mg. a day (not hard to do) can impair your body's ability to use vitamin D. I promise I looked, but I couldn't find a single thing that confirmed this (I found secondary references, and I found a lab rat study, but nothing that convinces me). I did find some mention about it on a website that deals with osteopenia; essentially, they imply that while cutting back on caffeine consumption is never a bad thing, there really isn't cause for alarm unless you've actually got osteoporosis or osteopenia.

I want to point out that nothing I found indicates that this vitamin D issue is a problem with taking in vitamin D and caffeine at the same time (like you're wondering about) - it seems to be a more overall problem, which tells me that drinking coffee at any point during the day will limit your vitamin D metabolism.

Taking the two separately isn't going to change that if my hunch is correct.So if you really want to get the most out of your supplements, separate them from your coffee consumption by half an hour (or an hour, to be safe). It might improve your calcium absorption by a tiny bit, and probably isn't going to affect your vitamin D absorption at all - cutting back on coffee is the only thing that might help with that. (And let's get real, here! I wouldn't cut back on coffee until I've got a broken hip!) The only other thing I can recommend is that you take your supplement with a meal (any meal).
All information in this post is from Askville at Amazon and XLPharmacy is only relating that article here, we take zero kudus. Full article can be found at the link above this story.

Saturday, August 22, 2009

Alternative therapy for AIDS by XLPharmacy

The Key

The key to effective treatment is early detection and intervention. Some early treatments aim to strengthen the immune system, help patients reduce stress, and maintain good nutritional practices and appropriate exercise regimens. Many of the alternative therapies described below place significant emphasis on these lifestyle issues. Taking an active role in any disease is an important adjunct to treatment. Consideration of alternative therapies in conjunction with conventional medicine may offer additional opportunities for persons living with HIV/AIDS to be proactively involved in their treatment.

How to Approach Alternative Therapies

Here are a few suggestions to follow before involved in any alternative therapy:

Obtain objective information about the therapy. Besides talking with the person promoting the approach, speak with people who have gone through the treatment—preferably those who were treated recently and those treated in the past. Ask about the advantages and disadvantages, risks, side effects, costs, results they experienced, and over what time span results can be expected.
Inquire about the training and expertise of the person administering the treatment (i.e., certification). If any uncertainty remains, verify the information.
Consider the costs. Alternative treatments may not currently be reimbursable by health insurance.
Discuss all treatments with your primary care provider, who needs this information in order to have a complete picture of your treatment plan. People with HIV/AIDS in the United States use many kinds of alternative approaches to treatment. Some of the most common are briefly described below and continue on the Life Positive link shown.

The use of acupuncture and Chinese herbal medications has become one of the most commonly used alternative therapies for AIDS. Its use has become so widely accepted that two Chinese Medicine Clinics in San Francisco have been awarded contracts through the SF Health Department`s AIDS Office to provide Chinese Medical treatment to people with HIV.

The contracts are funded by Ryan White CARE Act allocations. Most people with HIV who use acupuncture and Chinese herbs do so in conjunction with western medicine. There are, however, some who use it as their principal form of medical treatment. It is strongly suggested that it be used under the supervision of a licensed practitioner.
...read more at Life Positive

story related by XLPharmacy Blog

Thursday, August 06, 2009

Breakthrough Drug 'Melts Away' Lung Cancer

Breakthrough Drug 'Melts Away' Lung Cancer

A breakthrough drug treatment may stop a form of non-small cell lung cancer in its tracks, according to the University of Colorado Cancer Center.

Although the drug doesn’t actually cure the disease, it turns a certain death sentence into a chronic but manageable condition.

This type of lung cancer is characterized by molecular changes in the tumor that drives its growth. It kills 20,000 Americans every year, but a new oral drug called an “ALK inhibitor” brings it to a standstill.

In effect, the revolutionary drug “melts away” this subtype of lung cancer, raising the prospect that similar drugs for other forms of lung cancer also may be found.

This is the latest from NewsMax.

Wednesday, August 05, 2009

Treatment for genital herpes


There are three antiviral medications that are FDA-approved for the treatment of genital herpes and all are available at XLPharmacy under our medications drop down list at the link given here. We encourage you to discuss with your doctor your options and course of treatment, but hope you can find some information here that may help you and your doctor decide the right course for you.


Acyclovir


The oldest antiviral medication for herpes is acyclovir. Acyclovir is available as a generic drug and is also sold under the brand name Zovirax®. It has been available since 1982 in a topical form (as an ointment) and sold since 1985 in pill form. Acyclovir has been shown to be safe in persons who have used it continuously (every day) for as long as 10 years.


Valacyclovir


A newer drug, valacyclovir (brand name Valtrex®), actually uses acyclovir as its active ingredient. This medication delivers acyclovir more efficiently so that the body absorbs much of the drug, which has the advantage of taking the medication fewer times during the day.


Famciclovir


Famciclovir (brand name Famvir®) utilizes penciclovir as its active ingredient to stop HSV from replicating. Like valacyclovir, it is well absorbed, persists for a longer time in the body, and can be taken less frequently than acyclovir.


Antiviral medication is commonly prescribed for patients having a first episode of genital herpes, but they can be used for recurrent episodes as well. There are two kinds of treatment regimens: (1) episodic therapy and

(2) suppressive therapy.


Episodic TherapyIn this approach, a person begins taking medication at the first sign of recurrence (or ideally at first signs of prodrome) and would continue for several days, in order to hasten the healing, or even prevent an outbreak from fully occurring.


All three of the antiviral treatments mentioned above have been proven to help shorten the amount of time that a person may experience symptoms of herpes. However, keep in mind that results may vary from person to person.


Many people feel the advantages of using medication for recurrent episodes are marginal compared with use in a primary episode. But for others, episodic therapy offers a useful way to manage outbreaks by cutting the length of an outbreak by a day or two, on average.


The benefits may be greater for those whose outbreaks tend to last longer. Also, episodic therapy has its best results when treatment begins at the very first sign of prodrome. If lesions are already present, therapy may offer little benefit.


Because the medications differ in their absorption rate and duration of effectiveness, dosages vary with episodic therapy treatment ranging from one to five pills every day for three to five days during an outbreak.


Suppressive Therapy


People with genital herpes who want to eliminate (suppress) outbreaks altogether can take antiviral medication daily to hold HSV in check so that it's less likely to flare up and cause symptoms. For individuals who have frequent recurrences (six or more per year), studies have shown that suppressive therapy can reduce the number of outbreaks by at least 75% while the medication is being taken.


Also, for some, taking an antiviral on a daily basis can prevent outbreaks altogether.While antivirals can be successful in controlling herpes symptoms, researchers also have turned their attention to the important issue of antiviral therapy and asymptomatic shedding. Does suppressive therapy lower the risk of unrecognized herpes reactivation as well as curb recognized outbreaks?


One study addressing this question found that women on suppressive acyclovir (400 mg, twice daily) had a 94% reduction in subclinical shedding while taking daily therapy. This type of study has also been done with famciclovir and valacyclovir, yielding similar reductions in both men and women.


Suppressive therapy has been studied in thousands of patients and it appears to be both safe and effective. Because the medications differ in their absorption rate and duration of effectiveness, dosages vary with suppressive therapy treatment ranging from one to two pills every day.


Treatment for oral herpes


The antiviral medications available in pill form (acyclovir, valacyclovir, famciclovir) have been specifically developed for the treatment of genital herpes. However, it is not uncommon for health care providers to prescribe the antiviral drugs to those who have frequent or severe outbreaks of oral herpes.


A recent study found valacyclovir (Valtrex®) to be effective for treating oral herpes in a one-day treatment of 2 grams taken at the first sign of a cold sore, and then again about 12 hours later.


There are two topical antiviral medications prescribed for the treatment of oral HSV symptoms:


acyclovir ointment (brand name Zovirax®) and

penciclovir cream (brand name Denavir®).


Both work to speed up the healing process and reduce the viral activity. These topical drugs are put directly on the lesions themselves, but can also be used at the onset of prodrome.


Other topical treatments for oral herpes are available over-the-counter (OTC), but are not antiviral compounds like acyclovir and penciclovir. Some also contain ingredients that numb the area and induce temporary relief from the discomfort of an outbreak.


Unfortunately, some OTC treatments may actually delay the healing time of symptoms because they can further irritate the area with repeated applications. There is only one OTC FDA-approved cream, called Abreva®, which has been clinically proven to help speed the healing process.

Monday, August 03, 2009

XLPharmacy talks Licorice Herb and HIV


Licorice is a powerful herbal remedy in treating peptic ulcers and shows much promise in the treatment of HIV and AIDS.Preparations of licorice containing glycyrrhizin are showing promise in the treatment of HIV and AIDS, as well as hepatitis. One long-term study was performed on 16 HIV+ patients. None of the people who received glycyrrhizin progressed to AIDS or did their immune function deteriorate. Individuals who did not take glycyrrhizin, had a decrease in helper and total T-cell counts and antibody levels. Two developed AIDS.[2]

Taking Licorice Has been ResearchedThere has been a great deal of research on Licorice and HIV, all one has to do is GOOGLE "Licorice and HIV" to see the many studies. One should consult with their doctor on the proper amount of licorice as it has been know to raise blood pressure if taken in large amounts.

The information in the article this disclaimer is linked from should not be considered medical advice. The information in the article this disclaimer is linked from is not meant to treat, diagnose, prescribe or cure any ailment. Always check with your physician before taking any products or following any advice you have read on this or any other article on this research.

Always consult your doctor before you start, stop or change anything that has been previously prescribed. Certain herbs and holistic remedies are unsuitable to take if you are pregnant or nursing and must always be cleared by your doctor before use.

read more...here page 91 and 92 (Understanding Herbal Healing)

Note: Licorice candy has no real licorice in it, just artificial flavor.

HOW TO TAKE THIS HERB: as a decoction: 1 teaspoon or cut root per cup of water, cover and simmer for 15 to 20 minutes. Strain and drink. It may be combined with other herbs like astragalus, burdock, dandelion, slippery elm, etc.; it enhances the properties of other herbs. Licorice is also available as a tincture and in capsules (follow manufacturer's instructions).
• To make licorice tea, add 1 teaspoon of licorice root powder to 1 cup of hot water and steep for 5 minutes.• You can also chew on whole sticks to extract the juice.• If you take DGL capsules, you must chew on them to get the health benefits of licorice (saliva activates DGL).

Please note...No known herbal remedy has been shown to cure AIDS or even reduce chances of AIDS-related infections. Still, some herbs can be worth trying if you use them safely and in consultation with a qualified practitioner who not only understands herbs but also has experience treating AIDS and HIV infection.Aloe vera, St. Johnswort, echinacea, licorice, and ginseng are just a few of the herbs used to treat HIV/AIDS.

Taking immunity-boosting herbs (such as astragalus, echinacea, and ginkgo) may help revive an ailing immune system, and certain herbs (such as garlic) may help battle bacteria and viruses. Deglycyrrhizinated licorice can soothe the mouth and throat ulcers that often accompany full-blown AIDS. Just remember that even if these herbs have these powers, no one yet understands just how they work in helping AIDS or whether using them really makes a difference in the course of the disease.

Tuesday, July 14, 2009

Watermelon May Have Effects Similar to Viagra - XLPharmacy


Watermelon May Have Effects Similar to Viagra


One of watermelon's ingredients triggers production of a chemical that works similar to Viagra. And the millions of watermelons being enjoyed across the nation this summer just might help men get their groove back. In fact, the ingredient, citrulline, might not only treat erectile dysfunction but also help prevent it.

In the body, citrulline is converted to arginine, an amino acid known to improve the heart and circulatory system and to boost the immune system. It helps erectile dysfunction by relaxing blood vessels, similar to Viagra's effect. Arginine boosts nitric oxide, which relaxes blood vessels, the same basic effect that Viagra has, to treat erectile dysfunction and maybe even prevent it.The more research done on watermelons, the more we learn just how amazing a fruit it is in providing natural enhancers to the human body.

Watermelon may not be as organ-specific as Viagra, but it’s a great way to relax blood vessels without any drug side effects. We’ve always known that watermelon is good for you, but the list of its very important healthful benefits grows longer with each study.

Saturday, May 30, 2009

New Angle on HIV / AIDS



New Angle on HIV / AIDS

Scientists are now trying to work around direct attacks on AIDS that don't seem to be working and focusing on a new method of inserting a gene into the muscle that can cause it to produce protective antibodies against HIV / AIDS. The new method has worked in ice and now has also proven successful in monkeys. The Nature Medicine Journals online edition has a story on this same possible breakthrough. There is a team of researchers at a Children's Hospital in Philadelphia that consider this a real possibility, although they agree that much testing is still applicable before a product is ready for human use.

Every angle possible should be utilized for eradicating this disease and this new research may well be the light at the end of the tunnel for millions waiting for and hoping for help. There are over 33 million people living with HIV today, with 56,000 new cases reported annually just in the United States.

Most efforts at blocking AIDS have sought to stimulate the body's immune system to produce antibodies that fight the disease. This approach has worked for diseases like measles and smallpox, however it hasn't done well with HIV / AIDS.

This team however took a different approach. They used what they cal a leapfrog strategy, bypassing the natural immune system response that was the target of all previous HIV and SIV vaccine candidates. The closely related Simian virus, or SIV, affects monkeys. The researchers knew there wer proteins that could neutralize the HIV virus, so they began thinking about whether they could use them to fight the disease.

In a ten year long effort the team developed immunoadhesins, antibody like proteins designed to attach to SIV and block it from infecting cells.

Read more at Johnson Research Laboratory...

Wednesday, May 20, 2009

Wheat Extract May Fight Alzheimer’s


Wheat Extract May Fight Alzheimer’s

Wheat, the staff of life, also may be used to fight Alzheimer’s disease.
Korean scientists believe that an extract of wheat could be used to develop treatments to treat and prevent Alzheimer’s.

Water extract of wheat suppresses beta amyloid in the brain, said researcher Lee Jong-Wong of Daegu Catholic University. Beta amyloid is the main component of the amyloid plaques in the brains of victims of Alzheimer’s.

In addition to treating and preventing Alzheimer’s, Lee believes the wheat extract could be pivotal in developing treatments to improve dementia and common forgetfulness.
“Aricept and a number of other drugs produce short-time improvements in memory loss and cognition in Alzheimer’s patients, but side effects were an obvious problem,” Lee told Korea Times.

“Drugs like Aricept focus on improving memory assessment through brain cells that are alive, while wheat extract works by preventing brain cells from dying, which would make them complementary to existing treatments and drugs and provide a synergy effect.”

Animal tests showed that the wheat extract can treat damaged cells as well as prevent Alzheimer’s and speculates that as little as five grams daily could prevent the disease, Lee said.

Wednesday, May 06, 2009

Colon Cancer Connected to Gut Reaction

A medical doctor at the University of Pittsburgh has compiled evidence confirming that what people eat provides the link between diet and colon cancer.

The research learned it's because diet has a direct effect on the diversity of microbes in the gut.That may not be surprising to most people. After all, the typical Western diet, rich in meats and fats and low in fruits, vegetables and complex carbohydrates, has been recognized for years as a risk factor for colon cancer.

Healthy diets with lots of complex carbohydrates provide the gut with significant numbers of micro-organisms called firmicutes. Those organisms use starches and proteins to manufacture short-chain fatty acids and vitamins such as folate and biotin to maintain a healthy colon. But the microbes in the gut also produce toxic products from food residues.

Diets heavy in meats produce sulfur, which decreases the actions of “good” bacteria and increases the production of other possible carcinogens. Colon cancer is the second-leading cause of cancer-related deaths in adults in Westernized communities. The research results suggest that a diet that maintains the health of the colon wall is also one that maintains general body health and reduces heart disease.

A diet rich in fiber and resistant starch encourages the growth of good bacteria and increases production of short-chain fatty acids, which lessen the risk of cancer, while a high meat and fat diet reduces the numbers of these good bacteria. Colons host more than 800 bacterial species and 7,000 different strains that could be key to treating diseases.

Monday, April 27, 2009

Walnuts May Prevent Breast Cancer

Walnuts May Prevent Breast Cancer

Walnut consumption may provide the body with essential omega-3 fatty acids, antioxidants and phytosterols that reduce the risk of breast cancer, according to a study presented at the American Association for Cancer Research 100th Annual Meeting 2009.

While the study was done with laboratory animals rather than humans, people should heed the recommendation to eat more walnuts.

Walnuts are better than cookies, french fries or potato chips when you need a snack,” researchers say. We all know a healthy diet overall prevents all manner of chronic diseases.
The researchers studied mice that were fed a diet that they estimated was the human equivalent of two ounces of walnuts per day. A separate group of mice were fed a control diet.

Standard testing showed that walnut consumption significantly decreased breast tumor incidence, the number of glands with a tumor and tumor size.

The researchers found that laboratory mice typically have 100 percent tumor incidence at five months; walnut consumption delayed those tumors by at least three weeks.

Molecular analysis showed that increased consumption of omega-3 fatty acids contributed to the decline in tumor incidence, but other parts of the walnut contributed as well.

Researchers stated that with dietary interventions one can see multiple mechanisms when working with the whole food and that it is clear walnuts contribute to a healthy diet that can reduce breast cancer.

XLPharmacy

Friday, April 03, 2009

Avoid Pistachios

FDA Warns: Avoid Pistachios

In another food scare sure to rattle consumers still reeling from the national salmonella outbreak in peanuts, federal food officials now are warning people not to eat any food containing pistachios, which could carry contamination from the same bacteria. Central California-based Setton Pistachio of Terra Bella Inc., the nation's second-largest pistachio processor, is voluntarily recalling more than 2 million pounds of its roasted nuts shipped since last fall, the Food and Drug Administration said. The advice to consumers is that we avoid eating pistachio products, and that we hold on to those products.

The number of products that are going to be recalled over the coming days will grow, simply because these pistachio nuts have then been repackaged into consumer-level containers. Two people called the FDA complaining of gastrointestinal illness that could be associated with the nuts, but the link hasn't been confirmed. Still, the plant decided to shut down late last week, officials said.

We have a staffer who spent 3 weeks in gastro pain after eating a bulk bag of pistachios over the course of 3-4 days from a California plant. Two trips to the doctor, one to the ER, and blood tests and ultrasounds, yet still no one could say "why". Does it always seem these news stories hit the shelf weeks after the incidence of eating these tainted products? Are we all going to have to give up eating anything off the shelves...existing on what we can grow ourselves?

The recalled nuts represent a small fraction of the 55 million pounds of pistachios that the company's plant processed last year and an even smaller portion of the 278 million pounds produced in the state in the 2008 season, according to the Fresno-based Administrative Committee for Pistachios. The FDA learned about the problem March 24, when Kraft Foods Inc. notified the agency that it had detected salmonella in roasted pistachios through routine product testing. Kraft and the Georgia Nut Co. recalled their Back to Nature Nantucket Blend trail mix the next day. The FDA contacted Setton Pistachio and California health officials shortly afterward.

By Friday, grocery operator Kroger Co. recalled one of its lines of bagged pistachios because of possible salmonella contamination, saying the California plant also supplied its nuts. Those nuts were sold in 31 states. Fabia D'Arienzo, a spokeswoman for Tulare County-based Setton Pistachio, said the company was recalling only certain bulk roasted in-shell and roasted shelled pistachios that were shipped on or after Sept. 1. Because Setton Pistachio shipped tote bags of nuts weighing up to 2,000 pounds to 36 wholesalers across the country, it will take weeks to figure out how many products could be affected, the Food and Drug Branch of the California Department of Public Health states.

It will be safe to assume based on the volume that this will be an ingredient in a lot of different products, and that may possibly include things like ice cream and cake mixes. Nothing seems to be safe for us to consume now days.

Monday, March 23, 2009

Alarm Warns of Heart Attack

Modern medicine finally has developed a gadget the late comic George Carlin would have loved: a real version of his “2-minute warning.” The AngelMed Guardian lets you know you’re about to have a type of heart attack that often kills its victims before they can reach the hospital.
The device, which is about the size of a matchbox, vibrates when changes in the heart’s electrical pattern signal an imminent heart attack and also sends a message to a pager which sounds a warning. It could warn patients hours, or even days, ahead of a heart attack, allowing them time to get emergency help.
The majority of heart attacks occur when a clot cuts blood supply to the heart and disrupts normal electrical signals. About a third of those who have heart attacks due to clots die before they get to the hospital. Often the delay is because the patient delayed getting help, ignoring warning signs such as pain in the chest, shoulder, back or jaw. A British study found that 42 percent of people with pains indicating a possible heart attack took a “wait and see” attitude. Other patients delayed getting help because they weren’t able to interpret the warnings correctly.
One million heart attacks occur in the United States each year, and approximately 460,000 are fatal. The AngelMed Guardian will allow patients to get to the hospital in time for clot-busting drugs to be administered, cutting death rates as well as reducing heart damage in those who survive.
The AngelMed Guardian, like current pacemakers, is implanted in the chest underneath the left collarbone. A wire with an electrode connects to the heart’s right ventricle, and constantly checks rhythm patterns in the heart. In addition to signaling an imminent heart attack, the data collected by the device can be examined by the doctor at any time via a wireless computer program.
Although not yet approved by the FDA, the AngelMed Guardian has successfully completed a phase one clinical trial and additional trials are beginning. The device is already approved for use in some countries, including Brazil.
XLPharmacy

Friday, March 13, 2009

Type of Exercise Affects the Food You Crave


We have learned that the type of exercise you engage in affects how hungry you are afterwards as well as the types of foods you crave. Instead of helping you fight the battle of the bulge, some workouts can actually leave you ravenous and craving high-fat, high calorie, and sweet foods.
Those who want to lose weight should stick to running. Some runners don’t feel hungry after exercising because their activity suppresses the ghrelin hormone that stimulates appetite. Swimming creates a craving for fatty foods, such as cookies and chocolate while weight-lifters crave potatoes and pasta.
While some high-intensity exercise, such as running in hot conditions, suppresses the ghrelin hormone, which stimulate appetite, other high-intensity exercise, such as swimming in cold water, actually increases the hormone which, in turn, increases hunger.
The body tends to respond to exercise so it can do it more efficiently in future. The lighter you are, the better for long-distance running, so your body will crave watery foods that lower your body temperature by rehydration while not piling on the pounds. But if you are lifting weights, then you will crave carb- and protein-rich foods that will bulk up your muscles. Also, if you are regularly swimming in cold water, your body benefits if your brain guides you towards foods that will give you a layer of protective fat. Runners appetites continued even after they had recovered from their exercise.
People don’t seem to overcompensate for missed meals when their body returns to its rest state. So if you run for 90 minutes, you will burn around 1,300 calories but will not increase your food intake in the 24 hours after that exercise. In short, you burn all those calories but you don’t get hungrier than you would have had you not exercised at all. Interesting!

Sunday, February 15, 2009

No Backyard? Making Room for a Vegetable Garden


No Backyard? No Problem. Reap the Rewards of a Vegetable Garden

(ARA)

During World War II, Americans were encouraged to convert their backyards into Victory Gardens to contribute to the war effort. The gardens also saved families money, something that was not abundant to most at the time. With the current economic downturn affecting many families’ budgets and in light of produce scares in 2008, starting a backyard vegetable garden is a great way to help reduce grocery bills during the summer months while keeping your family supplied with healthy foods. Even if you don't have a lot of space -- maybe only a balcony -- you can still produce plump red tomatoes, fresh lettuce, spicy peppers and more before the end of summer.

Here are some simple tips for gardening in small spaces for big results:

Mix Vegetables with Your Flowers

If you already have an established flower bed, but no more land available for a vegetable patch, work some of your vegetables in between perennials. Carrots and onions don't need a lot of root space, and their foliage above ground can bring variety to the overall look of your landscape. Just make sure your vegetables will have plenty of sunshine and are protected from hungry wildlife.

Start a Container Garden

Balconies and porches are perfect locations for container gardens. Start easy with lettuce seeds or onions set in a deep window box. Or use a larger pot for peppers or tomatoes. To kick off the growing season for your tomatoes and peppers, use a Season Starter like the one from Dalen Products, Inc. in your container. This innovative insulating system helps protect seedlings from frost conditions and extends the growing season. Once established, growing plants can benefit from many products that help contribute to larger yields and vegetation protection. Buying a Tomato Tray that is designed to channel water directly to a vining plant’s root system – critical for establishing healthy tomato plants in the early season. Also, items like Better Reds Mulch Film and Harvest Guard work to ensure that throughout the growing and harvesting season your plants are protected from weeds, drought conditions and early frosts.

Some helpful tips for container gardening are:

* Find containers that are large enough for the fully-grown plant to prevent root binding.
* Make sure containers have adequate drainage holes and are not plugged with soil or rocks.
* Avoid container materials that contain products toxic or harmful to plants.
* Don't use regular garden soil. Instead, use potting soil or a mix of garden soil with compost or perlite for enhanced drainage.
* Water plants frequently as plants in containers are more likely to dry out due to sun and wind exposure.

Grow Tall Gardens

Cucumbers, squash and melon plants take up plenty of space when they're sprawling across your ground. But getting them off the ground is an ideal solution for maximizing your harvest in a minimum amount of area. Installing a trellis next to plants allows you to direct vine plants' growth upward, while protecting fruit and vegetables from ground rot and pests. Using nylon netting, like Trellis Netting, around your container pots, a porch railing or your garden beds is a great and durable way to encourage climbing vines. With good management, you will have beautiful fruits and vegetables available this summer for cooking, canning and snacking - saving you money at the grocery store and giving your family safe and healthy food options.

Courtesy of ARAcontent

Saturday, February 07, 2009

Stroke: Recognizing the five signs


(ARA) - When a stroke strikes, every minute counts in saving the person's life and ensuring they will regain their health. Speedy treatment depends on the person afflicted or someone near them recognizing the five signs that a stroke is occurring and getting emergency help fast. You can remember the five signs of stroke with these five words: walk, talk, reach, see, and feel.
Stroke is the third-leading cause of death in the United States and a leading cause of disability. About 5.3 million Americans suffer from strokes annually, which means you or someone you care about could be affected.
Dr. Diana Fite, an emergency physician from Houston, experienced a stroke in 2006 while driving her car. She was 53 at the time. Thanks to her quick reaction and prompt medical attention, she made a full recovery.
"Because I am an emergency physician, I knew to call 9-1-1 to get help immediately, which is why I recovered quickly," Fite says. "But I know from my experience as a doctor that too many people ignore stroke symptoms or wait for them to go away, with tragic results."
Fite is the spokesperson for "Give Me 5 for Stroke: Walk, Talk, Reach, See, Feel," a campaign aimed at educating Americans about the five warning signs of a stroke. The campaign is made up of three organizations: the American Academy of Neurology, the American College of Emergency Physicians and the American Stroke Association. The group came up with five words to help people remember the warning symptoms of stroke more easily: walk, talk, reach, see and feel. By paying attention to how a person walks, talks, reaches, sees and feels, individuals and family members can recognize when a stroke is happening and react immediately.
"Walk" is to recognize if a person's balance is off-kilter, "talk" identifies if a person's speech is slurred or their face is droopy, "reach" points out if the person feels numb on one side, "see" pin points if the person has partially or completely lost their vision and "feel" discovers if the person has a severe headache. If any of these stroke symptoms occur suddenly, call 9-1-1 immediately.
Actress Morgan Fairchild, who recently played Sophia Blakely in “Fashion House” and is remembered as Jordan Roberts in the ‘80s TV drama “Falcon Crest,” has teamed up with the organizations in promoting "Give Me 5 for Stroke."
"I witnessed first-hand the devastating effects of stroke on my mother," says Fairchild, the primary caregiver for her mother, who suffered a series of debilitating strokes until her death in 1999. "Stroke is a killer, but for too many people, it doesn't need to be. If you know the warning signs and get medical help right away, you have an excellent chance of making a good recovery.
“Women especially need to know the warning signs, because they account for over 60 percent of the deaths from stroke,” Fairchild adds. “We are also the health information keepers for our families and must spread the word to our siblings, spouses, parents and friends about how to recognize a stroke."
For additional information about "Give Me 5 for Stroke: Walk, Talk, Reach, See, Feel" and resources about strokes, visit
http://www.giveme5forstroke.org/
- or call the toll free number (888) 4STROKE.
Courtesy of ARAcontent

Sunday, January 18, 2009

Coffee Cuts Risk of Alzheimer’s and Dementia by 65%


A Finnish study found that drinking coffee during midlife can slash your risk of developing dementia and Alzheimer’s disease. The study found that those who drank coffee during midlife had a lower risk of developing dementia or Alzheimer’s disease later in life than those who drank no coffee at all. Those who drank three to five cups of coffee a day lowered their risk by a whopping 65 percent.

The lead researcher Miia Kivipelto stated, “We aimed to study the association between coffee and tea consumption at midlife and dementia/AD risk in late-life, because the long-term impact of caffeine on the central nervous system was still unknown, and as the pathologic processes leading to Alzheimer’s disease may start decades before the clinical manifestation of the disease."

Coffee drinking was categorized into three groups: low (0 to 2 cups daily), moderate (3 to 5 cups) and high (more than 5 cups). Tea-drinking was categorized into two groups: those not drinking tea and those who drank at least one cup daily. While all coffee drinkers had a lower risk of dementia and Alzheimer’s disease than non-drinkers, those who drank moderate amounts of coffee lowered their risk by a surprising 65 percent. Drinking tea had no impact on the risk of developing dementia.

The study results have important implications in the delay or prevention of demenita/AD as there is a large amount of coffee consumption globally. The Finnish study still needs to be confirmed by other studies, but it opens the possibility that dietary interventions could modify the risk of dementia/AD. The Finnish researcher also stated,“the identification of mechanisms of how coffee exerts its protection against dementia/AD might help in the development of new therapies for these diseases.”

Friday, January 02, 2009

XLPharmacy discusses Endometriosis


What is it?


Endometriosis is a condition where tissue similar to the lining of the uterus (the endometrial stroma and glands, which should only be located inside the uterus) is found elsewhere in the body. Endometriosis lesions can be found anywhere in the pelvic cavity: on the ovaries, the fallopian tubes, and on the pelvic sidewall. Other common sites include the uterosacral ligaments, the cul-de-sac, the Pouch of Douglas, and in the rectal-vaginal septum. In addition, it can be found in caecarian-section scars, laparoscopy or laparotomy scars, and on the bladder, bowel, intestines, colon, appendix, and rectum. But these locations are not so common. In even more rare cases, endometriosis has been found inside the vagina, inside the bladder, on the skin, even in the lung, spine, and brain.

What are the Symptoms?

The most common symptom of endometriosis is pelvic pain. The pain often correlates to the menstrual cycle, but a woman with endometriosis may also experience pain that doesn’t correlate to her cycle. For many women, the pain of endometriosis is so severe and debilitating that it impacts their lives in significant ways.

What does it do?

Endometriosis can also cause scar tissue and adhesions to develop that can distort a woman’s internal anatomy. In advanced stages, internal organs may fuse together, causing a condition known as a "frozen pelvis." It is estimated that 30-40% of women with endometriosis may not be able to have children (if you suspect you suffer from infertility, please see our section on endometriosis and infertility)

What can I do about it?

If you or someone you care about has endometriosis, it is important to research the disease as much as possible. Many myths and misconceptions about endometriosis still persist, even in medical literature. For many women, management of this disease may be a long-term process. Therefore, it is important to educate yourself, take the time to find a good doctor, and consider joining a local support group.