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Andrew John Rynne, MD  
Male, 72
Dublin, Ireland

Specialties: sexual dysfunctions, reverse vasectomy

Interests: sexual medicine, Testosterone Therapy
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Sleep Apnoea

Jun 28, 2014 - 1 comments
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Sleep apnoea

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snoring

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cure sleep apnoea




What is Sleep Apnoea?

Sleep apnoea is where a sleeper stops breathing altogether for periods of up to 10 to 20 seconds only to resume breathing again spontaneously and usually with a gasp or choking sound. This may occur several times during the night while the sleeper is unaware of what’s happening.

Sleep apnoea is usually diagnosed by the sleeper’s room partner who has to wonder if the person will ever start breathing again. Sleep apnoea does carry a mortality rate and therefore must always be taken seriously. That aside, it causes chronic sleep deprivation and all the negative consequences of that.

Types of Sleep Apnoea:

There are three types of sleep apnoea.

• Obstructive. This is by far the commonest type of sleep apnoea. There is always a history of snoring. It is if you like a progression of snoring and is caused by many factors including obesity, deviated nasal septum, chronic rhinitis, nasal polyps, smoking and alcohol excess.
• Central. This is a lees common form of sleep apnoea and occurs in someone with no history of snoring or airways obstruction. It has to do with signals not getting through to the breathing centres in the brain.
• Complex. This is a combination of both of the above and again is rare.

Risk Factors Associated with Sleep Apnoea:

• Obesity or pot belly. Thick neck.
• Male over the age of 65.
• Family history and personal history of loud snoring.
• Smoking and excess alcohol.
• Nasal obstruction -- nasal polyps, chronic rhinitis, deviated nasal septum.

Diagnosis of Sleep Apnoea.

Sleep apnoea is usually diagnosed by the room partner of the person suffering from the condition. This unfortunate person may have their own sleep very disturbed as they lie there wondering if their partner will breathe again.

If you live alone, have some of the risk factors for sleep apnoea and suspect that you may have the condition then consider recording yourself while you sleep.

That aside, all sufferers of this condition will experience the negative effects of chronic sleep deprivation. These will include:

• Poor concentration and work performance.
• Tendency to fall asleep inappropriately during the day.
• Depression and irritability.

How to Cure or Manage Sleep Apnoea:

Self help. There are a number of things that you can do for yourself to ease or even cure your sleep apnoea. These include:

• Reduce your weight by even as little as 10% and get fit.
• Quit smoking and reduce your alcohol intake.
• If you take sedatives or sleeping pills try to wean yourself off of these.

Medical and surgical management.

• Clear your nasal airways with nasal sprays.
• Have surgery to straighten nasal septum, tighten soft pallet and remove nasal polyps.
• Be fitted with a Continuous Positive Airflow Pressure (CPAP) apparatus. These have improved enormously over the last few years. They are now light, comfortable and quiet and solve sleep apnoea allowing you to have a full night of quality sleep and be well and alert the next day.


Colds Flu Cough

Jun 28, 2014 - 0 comments
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head cold

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Influenza

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cough



Colds Flu and Coughs.

Colds, flu and coughs are the commonest ailments to afflict all of us, men women and children but particularly children whose immune system is not yet fully developed. They are the commonest reason for doctor visits and the commonest excuse given for absenteeism from work or school.

Causes of colds, flu and coughs.

The preponderance of these ailments is caused by viruses and therefore in the vast majority of cases antibiotics are inappropriate and too often prescribed. This is an abuse of antibiotic and is not only a waste of money but also encourages the emergence of antibiotic resistance strains of bacteria (mutation). It is bad medicine with many potential side effects including the development of Irritable Bowel Syndrome and chronic vaginitis.

Why antibiotics are prescribed when they are not needed?

• Patients expect and demand antibiotics for viral illness even though they know they will not work.
• Doctors prescribe them in order to satisfy patient expectation. Doctors justify this poor practise on the bases that if they don’t prescribe antibiotics the patient may go elsewhere and they loose that patient.


The difference between colds and flu:

The two terms are all too often used synonymously and yet there is a vast difference between a head cold and influenza. A head cold is uncomfortable, debilitating to some degree and very inconvenient. However you can usually get over it on your feet or at most take a few early nights.

Influenza on the other hand is something else altogether. It sticks suddenly and is extremely debilitating such that you are bed bound, not because you want to be but rather because you have no choice. Influenza gives rise to very high temperatures and periods of low temperatures where the patient shivers. This is called rigors and it is your body’s attempt to generate some heat.    Influenza lasts four to five days during which time the sufferer is totally bedbound, off all food, perspiring copiously feeling extremely weak and only managing to crawl to the bathroom when necessary.





Coughs.

It is not unusual for a non-productive cough to accompany or follow a head cold. These kind of coughs usually are self-limiting and do not warrant a doctor visit. They usually go away spontaneously in a matter of a week or so.

When a cough is a recurring and debilitating problem it may represent chronic bronchitis or asthma or both. Such coughs do require medical attention and probably antibiotics. Chest x-rays may also be warranted to establish diagnosis and rule out lung cancer.

If a cough develops for no obvious reason and is productive of rust coloured sputum then pneumonia or tuberculosis should be suspected and medical attention sought.

Cough Bottles. There is no good clinical evidence that any cough bottle, cough suppressant or expectorant do any good, relieve symptoms or shorten the duration of the cough. They are in the main a waste of money and time.

If you are worried about a cough that has been bothering you for some time then please get in touch with us and we will see how we can best help you.






Osteoparosis

Jun 28, 2014 - 0 comments
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Osteoporos

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brittle bone disease

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prevent osteoparosis



Osteoporosis or Brittle Bone Disease.

Translating Osteoporosis from its Greek origins it simply means “porous bones”. The spaces within the bone matrix that should be filled with calcium are now empty or nearly so. Bones stripped of calcium loose their strength and become fragile and easily broken.

Incidence of Osteoporosis:

Osteoporosis is an extremely common bone disease. As many as one in two women and one in five men, over the age of 50 will have a fractured bone due to Osteoporosis. Here are two common myths that need to be dispelled immediately:

• That Osteoporosis only affects older people. This is NOT true. It manifests itself in older people but its onset is much much earlier often in your twenties or thirties.
• That Osteoporosis only affects women. This is not so. It affects men as well only not to the same extent.

What are the causes of Osteoporosis?:

In order for your bones to be properly calcified you need three things:

1. Adequate calcium in your diet.
2. Adequate intake of vitamin D
3. Normal hormonal levels.
No matter how good your calcium intake is, it can not get into your bones without adequate oestrogen and progesterone in women or testosterone in men. In addition to that you need vitamin D. These are what I call the “wheelbarrows” for getting calcium into your bones.

On top of that there are other factors that lead to Osteoporosis. In the main these are:

• A family history of Osteoporosis -- genetic factor.
• An overactive parathyroid gland.
• Diabetes.
• Lack of exercise.
• Too much mental stress.
• Inadequate hormone levels. Post menopausal women and testosterone deficient men.
• Certain medications particularly the long-term use of steroids.

If any of these factors apply to you then you should consider having a DEXA scan to determine your level of bone mineralisation. Once the presence of Osteoporosis is determined then the exact cause needs to be identified and dealt with.

How is osteoporosis treated?

You can not adequately treat osteoporosis without knowing the cause. Find the cause first and then correct that cause. This may involve hormone replacement therapy or surgery if the problem is coming for your parathyroid. However, increased exercise will always be part of the treatment of osteoporosis.

What are the symptoms of Osteoporosis?

Osteoporosis is a silent disease. Awareness and a high level of suspicion should prompt you to have a DEXA scan and then to address the problem should it exist.. Otherwise sadly a fractured hip, wrist or vertebrae are all too often the first symptom of this insidious disease.

If you are worried that you might have Osteoporosis and would like some help or support in dealing with it, then we are here to help you.



ADHD

Jun 28, 2014 - 0 comments
Tags:

ADHD

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Attention Deficit Hyperactivity Disorder



Attention Deficit Hyperactive Disorder. ADHD.

Prevalence.

Attention Deficit Hyperactive Disorder or ADHD is today largely accepted as a bona fide psychiatric or neurobehavioral disorder affecting some 5-7% of children and adolescents. The prevalence will depend on the diagnostic criteria used. It was once thought to be three times commoner in boys than in girls though not all studies support that figure. About 50% of ADHD children will carry the condition into adulthood. For the rest their behaviour will modify as they grow into adulthood.

Controversy:

In the recent past and even today ADHA struggles to be accepted as a “disorder” as distinct form behaviour or “boldness”. For example, older teachers and grandparents who grew up to believe that the behaviour of ADHD children was simply wilful naughtiness that should be disciplined  are now being asked to believe that it is a “disorder” that should be treatment.

Symptoms and Diagnosis:

ADHD is diagnosed on the bases of the child’s behaviour alone. This may be done using the International Classification of Diseases or ICD-10. There are no other tests to confirm the diagnosis and this again may cause difficulty in accepting ADHD as a disorder.
Features of ADHD behaviour will include:
• Inattention to instructions.
• Inability to learn or retain.
• Inability to stay with a specific task or to complete it.
• Inability to hold attention to what is being said to them.
• Hyperactivity. Constantly fidgeting and moving around the place.
• Impulsivity like suddenly standing up and leaving their seat in class or throwing things at teacher or other children.
• Reckless and ill-considered behaviour.
Any or all of the above to a level that is inconsistent with the behaviour of other children of the same age.

Management of ADHT.

There are basically two approaches to the management of ADHD – behavioural modification and medication. Of the two the former is preferable of course although it does require many hours and great patients. Medication on the other hand might be seen as a quick fix. The medication most often used today is a drug called Ritalin. This is not without potential side-effects some of them life long and serious.. However, it does not need to be one or the other. Often a combination of medications and behavioural therapy work best.

If you have a child recently diagnosed with ADHD or are wondering if that may be a problem with your child then we are here to help and support you.