Information on popular complementary and alternative medical topics

The mental status examination is one of the techniques used by psychiatrists and other mental health workers. The purpose is to guide observation and assist the interviewer in gathering essential data about mental functioning. It consists of standard items, which are routinely covered, insuring nothing important is overlooked. The format also helps mental health workers record their findings in a fashion that is easily understood by their colleagues.
Three aspects of mental functioning are always included: mood and affect, thought processes, and cognitive functioning. Mood and affect refer to the dominant feeling state. They are deduced from general appearance, what the client reports, posture, body movement, and attitude toward the interviewer. Thought processes zero in on how the client presents his ideas. Are his thoughts ordered and organized, or does he jump all over the place? Are his sentences logical? Is the content (what he talks about) sensible, or does it include delusions and bizarre ideas? Finally, cognitive functioning refers to intellectual functioning, memory, ability to concentrate, comprehensions, and ability to abstract. This latter portion of the mental status examination involves asking specific questions, for example, about current events, definitions of words, or meanings of proverbs. The interviewer considers the individual’s education, life-style, and occupation in making a judgment about the responses.
If the alcohol counselor can get some training in how to do a simple mental status examination, it can be helpful in spotting clients with particular problems. It can also greatly facilitate your communication with mental health workers. Just telling a psychiatrist the fellow you are referring to him is “crazier than a bedbug” isn’t very useful.
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If you or your children have a chronically stuffy nose, you may have one of the five disorders listed below. All are correctable using modern surgical procedures.

Deviated Nasal Septum
The wall that divides the inside of our nose into right and left sides is called the nasal septum (septum means a partition). If this wall is crooked, i.e., if it encroaches on one side of the nose or the other, it is called a deviated (off course) septum. If the septum deviates too much, it can actually block the flow of air through one side of the nose. On rare occasions, it can deviate in both directions, causing symptoms of stuffiness on both sides of the nose.

Cleft Palate
The palate is the roof of your mouth. When it does not develop properly, it leaves a large opening in the roof of the mouth. This causes the nose and the mouth to connect abnormally, and results in many different problems for someone so affected.

Choanal Atresia (Bilateral)
The term choanal (funnel) refers to the shape of each side of the nose from the outside toward the throat. The term atresia (no hole) refers to the lack of an opening at the end of this funnel. Someone with bilateral choanal atresia has no opening into the throat for either of the nasal passageways, and no air can pass through the nose to the lungs. Choanal Atresia is a life-threatening situation for an infant.

Pharyngeal Stenosis
This is a very uncommon disorder in which the pharynx, located at the back of the nose and the top of the throat, is abnormally narrowed. Just as in a pinched pipe, such narrowing does not permit normal flow of air or fluid through the nose.

Benign Tumors
There are a variety of abnormal but not cancerous (benign) growths that can occur in the nasal passageways. These may block the flow of air through the nose on the side in which they occur. Nasal Polyps, balloon like swellings of the lining of the nose, are the most common of these.
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As attention shifts to pain, alertness appears. There is something wrong. Alarm bells ring. Action stations! Muscles tense and the body stiffens to a ramrod. Unknown to the victim, these overt changes are part of a massive reorganisation of many parts of the body. The heart and vascular system get ready for action, the hormone system mobilizes sugar and alerts the immune system, the gut becomes stationary and sleep as an option is cancelled.
The eyes, head and neck turn to inspect where the pain seems to be located. The hands explore the area. Muscles are contracted to learn what makes the pain worse and what eases it, and to seek a comfortable position and then hold it. The end result is a body fixed in an overall pain posture. Muscles are in steady contraction and, as time goes by, some muscles grow while joints and tendons deteriorate because this frozen posture itself sets off local changes. The vascular and endocrine systems hold their emergency state if pain is prolonged, but these systems are not evolved to cope with this prolonged stress state. The quiet gut demonstrates its inactivity as constipation. Perhaps worst of all, sleep is impossible and chronic pain patients become completely exhausted. Even intermittent sleep deprivation drives the strongest of us into pretty peculiar ways of thinking, as any doctor on night duty and any parent with a new-born baby know. Patients with chronic pain reach their wits’ end as their grim experience is prolonged.
Clearly, this state of affairs needs therapeutic attack. The key word is relaxation and much ingenuity has been used. The problem is to override a natural defence mechanism that has a protective role in brief emergencies but becomes maladaptive when prolonged. Drugs that inhibit the overactive muscle are commonly prescribed but they are sedative and intellectually flattening. After a while, patients refuse them or become zombies. Physiotherapists have many ways of relaxing muscles and of re-establishing movement in frozen zones. First, they have to overcome the patients’ natural fear that movement which produces pain does not necessarily increase the injury, and that lack of movement which seems at first to prevent pain eventually acts to prolong pain. Yoga and the Alexander technique are examples of posture training. Relaxation is not easy and training methods are needed. One successful version, ‘bio-feedback’ training, provides the patient with an electronic indicator of the amount of contraction in a muscle and allows the patient to judge, second by second, their success in relaxation. The patient has to learn how to relax and how to prolong the effect into real life outside the training sessions. Sleep follows relaxation hut it may need help of its own, so no-one should resist tablets until they can sleep on their own.
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