If you need to seek medical attention for abdominal pain the encounter should follow this line of questioning. If it does not follow this line of questioning make sure you answer these questions out loud to the health care provider anyway weather they ask them or not. Try to answer as many of these questions as you can.

If your having acute (new or sudden onset) abdominal pain it could be very serious or something as simple as gas that will pass.

* indigestion/gas pain

* constipation

* menstrual or cramps

* gallbladder pain

* bladder or kidney infection

* pelvic inflammatory disease

* endometriosis

* ectopic (tubal) pregnancy

* appendicitis

* ovarian cysts

* ulcers

* prostatitis

* other rare conditions presenting with abdominal pain: angina, heart attack, abdominal aneurysm, pericarditis, pancreatitis, hepatitis, certain tumors.

How you answer the questions that follow will help determine what the underlying cause might be. It may help to print this page and write down the answers to take with you when you see a health care provider. Some questions are specific to women.

___ When was the first day of your last period This is usually the first question asked. You will also be asked if this was a “normal” period: Was the flow heavy or light Was it on time, early or late If you might be pregnant or are trying to get pregnant, say so right away.

___ What are you using for contraception Be honest if you are not using regular contraception. Your Nurse Practitioner may also ask frank questions about your partner(s) and other high risk behaviors. These questions are not meant to embarrass or offend you, but they are intended to help make a proper diagnosis and select the appropriate medical tests.

___ Severity: On a scale of 1 to 10, how bad is the pain If you’ve given birth, how does it compare to labor pain How does it compare to menstrual cramps Or is it similar to anything you’ve ever felt before, or if you’ve had this pain before

___ Location: Where is the pain now Where was it when it began Think of dividing your belly into 9 sections (like a tic-tac-toe board), or “regions”. Different conditions are usually characterized by the location of their pain. Some pain is “diffuse”, meaning it’s all over your belly, whereas other pains localize in the upper half of the abdomen or the lower half.

___ Referral: Does the pain go to another location For example, does it start somewhere specific and then radiate elsewhere

___ Quality: Is the pain sharp, dull (like a toothache), “boring” (e.g. like a bull’s horn going through you), burning, crampy, or just overwhelming If you’ve had this type of pain before, how is it different this time What did you do about it then Have you tried that already

___ Timing/Duration: How long have you had the pain Is this the first time you’ve had this particular type of pain or have you had it before When What were you doing when the pain started this time Does it wake you from sleep Does it seem to occur around the same set of circumstances (particular foods, time of the month, after certain activity etc.) Does it come/go or is it constant in nature If so, how much alcohol do you drink (regularly or sporadically) Describe your diet, especially spicy or fatty foods. Do you binge eat or make yourself vomit

___ What makes it better/what makes it worse This includes movement, positions, exercise, sex, foods, medicines (prescription, over the counter, and illicit), bowel movements or passing gas, vomiting, etc.

___ What other symptoms do you have in addition to the pain This includes everything that’s just not normal for you: Increased or decreased appetite, fever, chills, changes in your bowel or bladder habits (constipation, diarrhea, increased or decreased urination, burning with urination), blood coming from anywhere (stool, urine, vagina, nose), pain elsewhere in your body, dizziness, or fainting.

Give these questions some thought because the answers to these simple questions can actually lead you to or away from various tests (both invasive and non-invasive) and in the most serious cases surgery.

Strattera or atomoxetine is used for ADHD therapy and also for enhancing the usefulness of antidepressants. Strattera is from the class of drugs called selective norepinephrine reuptake inhibitors and even though doctors are not quite sure how it works, what they do know is that Strattera increases levels of norepinephrine in the brain, somewhat like adrenaline and it elevates the levels of dopamine in the brain. When levels of norepinephrine and dopamine are increased in the brain, mood and behavior improves with ADHD symptoms.

Strattera seems to be safer than Ritalin and not as addictive as Adderall or Vyvanse. So, because of this doctors will usually try Strattera before the others. This does not mean that the side effects from Strattera don’t exist. Strattera is classified as a non-stimulant and prescribed if other stimulants aren’t effective for some children or the person has had reactions to the other ADHD drugs that are available.

Minor problems from Strattera in children include mood swings, dizziness, decreased appetite and nausea and vomiting. In adults Strattera side effects can include sexual dysfunction, constipation, nausea, insomnia, menstrual cramps and upset stomach among others.

More serious Strattera side effects can be life threatening such as suicidal thoughts, paranoia, heart problems and severe liver damage, especially in teenagers. Particularly in the first part of treatment warning signs should be carefully observed. If you suspect that your teen is having suicidal thoughts, or any other side effects, call your doctor immediately. Strattera side effects that have been reported are sudden death in patients with heart problems/heart defects, and stroke. Children can have slowing and loss of growth. Qualified and thorough testing must be done before Strattera is given and should be monitored by a physician throughout treatment.

If you would rather not use Strattera because of the risk for yourself or your child alternative remedies do not have any side effects and hundreds of people have used them with great success. Formulated products for ADHD are natural safe alternatives to prescription drugs prescribed for ADHD. They contain herbal compounds that have been found to aid improvement of ADHD behaviors.

Latest Developments:

• On September 18th, 2009 McNeil Consumer Healthcare, the makers of Children’s & Infant’s Tylenol announced that it is voluntarily recalling certain lots of it’s Children’s & Infant’s Tylenol… NOT all of them
• Why were they recalled? A certain type of bacteria was found in one of the inactive ingredients used to make these products. NOTE that the recall is a purely precautionary move and NO bacteria has been detected in any of the finished products
• The recalled lots are those that were manufactured between April and June of 2008
• Be sure to check your stash of kids’ medications to see if you have any of these and if you have any concerns please contact your healthcare provider
• You can find a complete list of the recalled batch lot numbers for each of these Tylenol preparations on our site, just follow the link below and look in the “Drug Blog” section
• To locate the lot number look either at the bottom of the outer packaging box OR on the sticker on the actual bottle itself
• If you find that you have a product from one of the recalled lots, contact McNeil Consumer Healthcare’s customer care center @ 1-800-962-5357 and they will send you a coupon for a new bottle

Guide To Using Pain Medicines Safely

Pain medications are available both over-the-counter and by prescription.

OTC pain medications are primarily used to treat minor aches and pains caused by headaches, cold, flu, fever, arthritis, toothaches, and menstrual cramps and they fall into two (2) main groups:

• Acetaminophen - which is the active ingredient in over 600 OTC products including cough and cold medications as well as pain relievers
• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) - include medications with the active ingredients aspirin, ibuprofen, and naproxen; popular brand names include Bayer, Advil, Motrin and Aleve.

Prescription pain medications include:

• Opioids, which are derived from opium and they work by changing the way one experiences/feels pain. They include medications like morphine, codeine, oxycodone and hydrocodone (which is usually combined with acetaminophen or some other non-opioid pain reliever).

When used as directed, pain medications are safe and effective but if they are misused they not only have the potential to be extremely harmful, they can also be deadly.

Potential Problems With Pain Relievers, Who’s @ Risk & What To Do

Acetaminophen:

Taking too much can result in liver damage

• At Risk: those who drink 3 or more alcoholic beverages a day while taking medications that contain acetaminophen
• Be very careful with dosing in children and infants because the concentration of medication in the two formulas is quite different - the infant formula is 3 times stronger than the children’s strength formula
• Signs of liver damage to watch out for include abnormally yellow skin and eyes, light-colored stools, dark urine, nausea and vomiting, loss of appetite, and in more serious cases, mental confusion, coma and even death.

NSAIDs:

Taking too much can cause bleeding in the stomach

• At Risk: people over 60 years old; people who take blood thinners; people who have a history of stomach bleeding or ulcers; people who have a history of bleeding problems

Taking too much can also cause kidney damage (but this is usually reversible)

• At Risk: people over 60 years old; people who take water pills (a.k.a. diuretics); people with high blood pressure, heart failure or pre-existing kidney disease

Safety Precautions You Can Take In Order To Avoid Problems

• Always follow the directions given for taking the medication(s); for children and infants, do NOT interchange formulas if you can help it and be sure to use the measuring device provided so that they get the correct dose
• Keep your healthcare providers in the loop - let them know what other medications and supplements you are taking so as to avoid drug interactions … some of which can be life-threatening; also let them know if you have a history of substance abuse so that you get the appropriate care and monitoring needed
• Always double-check the active ingredients, especially with over-the-counter pain medications and cough and cold medications; some may be duplicated and this can cause some potentially serious and even fatal incidents.